ORCID Profile
0000-0002-0325-6015
Current Organisation
University of Southampton
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Springer Science and Business Media LLC
Date: 07-09-2020
DOI: 10.1186/S12889-020-09446-2
Abstract: Tobacco and alcohol use are major behavioural risks in developing countries like Nepal, which are contributing to a rapid increase in non-communicable diseases (NCDs). This causal relationship is further complicated by the multi-level social determinants such as socio-political context, socio-economic factors and health systems. The systems approach has potential to facilitate understanding of such complex causal mechanisms. The objective of this paper is to describe the role of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. The study adopted a qualitative study design guided by the Systemic Intervention methodology. The study involved key informant interviews ( n = 63) and focus group discussions ( n = 12) at different levels (national, district and/or community) and was informed by the adapted Social Determinants of Health Framework . The data analysis involved case study-based thematic analysis using framework approach and development of causal loop diagrams. The study also involved three sense-making sessions with key stakeholders. Three key themes and causal loop diagrams emerged from the data analysis. Widespread availability of tobacco and alcohol products contributed to the use and addiction of tobacco and alcohol. Low focus on primary prevention by health systems and political influence of tobacco and alcohol industries were the major contributors to the problem. Gender and socio-economic status of families/communities were identified as key social determinants of tobacco and alcohol use. Tobacco and alcohol use facilitated interaction of the social determinants of NCDs in the context of Nepal. Socio-economic status of families was both driver and outcome of tobacco and alcohol use. Health system actions to prevent NCDs were delayed mainly due to lack of system insights and commercial influence. A multi-sectoral response led by the health system is urgently needed.
Publisher: MDPI AG
Date: 04-02-2022
Abstract: Physical activity (PA) participation was substantially reduced at the start of the COVID-19 pandemic. The purpose of this study was to assess the association between PA, mental health, and wellbeing during and following the easing of COVID-19 restrictions in the United Kingdom (UK) and New Zealand (NZ). In this study, 3363 adults completed online surveys within 2–6 weeks of initial COVID-19 restrictions (April/May 2020) and once restrictions to human movement had been eased. Outcome measures included the International Physical Activity Questionnaire Short-Form, Depression Anxiety and Stress Scale-9 (mental health) and World Health Organisation-5 Wellbeing Index. There were no differences in PA, mental health or wellbeing between timepoints (p 0.05). In iduals engaging in moderate or high volume of PA had significantly better mental health (−1.1 and −1.7 units, respectively) and wellbeing (11.4 and 18.6 units, respectively) than in iduals who engaged in low PA (p 0.001). Mental health was better once COVID-19 restrictions were eased (p 0.001). NZ had better mental health and wellbeing than the UK (p 0.001). Participation in moderate-to-high volumes of PA was associated with better mental health and wellbeing, both during and following periods of COVID-19 containment, compared to participation in low volumes of PA. Where applicable, during the current or future pandemic(s), moderate-to-high volumes of PA should be encouraged.
Publisher: SAGE Publications
Date: 12-04-2021
DOI: 10.1177/17579759211001718
Abstract: Non-communicable diseases (NCDs) are a rapidly emerging global health challenge with multi-level determinants popularly known as social determinants. The objective of this paper is to describe the in idual and community experiences of NCDs in the two case districts of Nepal from a social determinants of health perspective. This study adopted qualitative study design to identify the experiences of NCDs. Sixty-three interviews were conducted with key informants from different sectors pertinent to NCD prevention at two case districts and at the policy level in Nepal. Twelve focus group discussions were conducted in the selected communities within those case districts. Data collection and analysis were informed by the adapted Social Determinants of Health Framework. The research team utilised the framework approach to carry out the thematic analysis. The study also involved three sense-making workshops with policy level and local stakeholders. Three key themes emerged during the analysis. The first theme highlighted that in iduals and communities were experiencing the rising burden of NCDs and metabolic risks in both urban and rural areas. The other two themes elaborated on the participant’s experiences based on their socio-economic background and gender. Disadvantaged populations were more vulnerable to the risk of NCDs. Further, being female put one into an even more disadvantaged position in experiencing NCD risks and accessing health services. The findings indicated that key social determinants such as age, geographical location, socio-economic status and gender were driving the NCD epidemic. There is an urgent need to take action on social determinants of health through multi-sectoral action, thus also translating the spirit of the recommendations made a decade ago by the Commission on Social Determinants of Health in addressing a complex challenge like NCDs in Nepal.
Publisher: Springer Science and Business Media LLC
Date: 02-05-2016
DOI: 10.1007/S40279-016-0537-6
Abstract: The global rise in obesity prevalence among children and adolescents has been linked to modifiable lifestyle factors, including lack of physical activity. However, no known meta-analysis has been conducted on the effects of exercise intervention on body composition and cardiometabolic risk factors in overweight and obese adolescents. The aim of this study was to (1) estimate whether exercise intervention meaningfully improves body composition and cardiometabolic risk factors in overweight and obese adolescents and (2) discuss the implications of the findings in terms of primary healthcare provision and public health policy, using New Zealand as an exemplar context. Electronic databases (PubMed, Web of Science, SPORTDiscus, Google Scholar) from inception to May 2015. The reference lists of eligible articles and relevant reviews were also checked. Inclusion criteria were (1) randomized controlled trial (2) structured exercise intervention, alone or combined with any other kind of intervention (3) control group received no structured exercise or behavioural modification designed to increase physical activity (4) participants overweight or obese (body mass index [BMI] ≥85th percentile) and (5) participants aged between 10 and 19 years. Initially, 1667 articles were identified. After evaluation of study characteristics, quality and validity, data from 13 articles (15 trials) involving 556 participants (176 male, 193 female, 187 unknown) were extracted for meta-analysis. Meta-analyses were completed on five body composition parameters and ten cardiometabolic parameters. Effect sizes (ESs) were calculated as mean differences, as well as standardized mean differences in order to determine effect magnitude. Exercise intervention reduced BMI (mean 2.0 kg/m Most of the included trials were short term (6-36 weeks) and 13 had methodological limitations. Additionally, the meta-analyses for some of the secondary outcomes had a small number of participants or substantial statistical heterogeneity. The current evidence suggests that exercise intervention in overweight and obese adolescents improves body composition, particularly by lowering body fat. The limited available evidence further indicates that exercise intervention may improve some cardiometabolic risk factors.
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.ATHEROSCLEROSIS.2015.06.041
Abstract: Monitoring central hemodynamic responses to an orthostatic challenge may provide important insight into autonomic nervous system function. Oscillometric pulse wave analysis devices have recently emerged, presenting clinically viable options for investigating central hemodynamic properties. The purpose of the current study was to determine whether oscillometric pulse wave analysis can be used to reliably (between-day) assess central blood pressure and central pressure augmentation (augmentation index) responses to a 5 min orthostatic challenge (modified tilt-table). Twenty healthy adults (26.4 y (SD 5.2), 55% F, 24.7 kg/m(2) (SD 3.8)) were tested on 3 different mornings in the fasted state, separated by a maximum of 7 days. Central hemodynamic variables were assessed on the left arm using an oscillometric device. Repeated measures analysis of variance indicated a significant main effect of the modified tilt-table for all central hemodynamic variables (P < 0.001). In response to the tilt, central diastolic pressure increased by 4.5 mmHg (CI: 2.6, 6.4), central systolic blood pressure increased by 2.3 (CI: 4.4, 0.16) mmHg, and augmentation index decreased by an absolute - 5.3%, (CI: -2.7, -7.9%). The intra-class correlation coefficient values for central diastolic pressure (0.83-0.86), central systolic blood pressure (0.80-0.87) and AIx (0.79-0.82) were above the 0.75 criterion in both the supine and tilted positions, indicating excellent between-day reliability. Central hemodynamic responses to an orthostatic challenge can be assessed with acceptable between-day reliability using oscillometric pulse wave analysis.
Publisher: Public Library of Science (PLoS)
Date: 06-02-2023
DOI: 10.1371/JOURNAL.PONE.0281355
Abstract: Unhealthy dietary habits and physical inactivity are major risk factors of non-communicable diseases (NCDs) globally. The objective of this paper was to describe the role of dietary practices and physical activity in the interaction of the social determinants of NCDs in Nepal, a developing economy. The study was a qualitative study design involving two districts in Nepal, whereby data was collected via key informant interviews (n = 63) and focus group discussions (n = 12). Thematic analysis of the qualitative data was performed, and a causal loop diagram was built to illustrate the dynamic interactions of the social determinants of NCDs based on the themes. The study also involved sense-making sessions with policy level and local stakeholders. Four key interacting themes emerged from the study describing current dietary and physical activity practices, influence of junk food, role of health system and socio-economic factors as root causes. While the current dietary and physical activity-related practices within communities were unhealthy, the broader determinants such as socio-economic circumstances and gender further fuelled such practices. The health system has potential to play a more effective role in the prevention of the behavioural and social determinants of NCDs.
Publisher: SAGE Publications
Date: 09-2017
Abstract: Developing countries such as Nepal are experiencing a double burden of communicable and non-communicable diseases (NCDs) resulting in social and economic losses. In Nepal, more than half of the disease burden is due to NCDs. The major NCDs in Nepal are cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. Behavioural factors such as tobacco use, alcohol consumption, physical inactivity and unhealthy diet are driving the epidemic of NCDs, which are further influenced by social, economic and environmental determinants. The health system of Nepal has not been able to address the ever-increasing burden of NCDs. With the formulation of the Multisectoral Action Plan for Prevention and Control of NCDs 2014–2020, there has been some hope for tackling the NCDs and their social determinants in Nepal through a primary prevention approach. This paper discusses the systemic challenges and recommends two key actions for the prevention and control of NCDs in Nepal.
Publisher: Springer Science and Business Media LLC
Date: 26-01-2012
DOI: 10.1007/S00421-012-2326-8
Abstract: The validity of predicting peak oxygen uptake ([Formula: see text]) in sedentary participants from a perceptually regulated exercise test (PRET) is limited to two cycle ergometry studies. We assessed the validity of a treadmill-based PRET. Active (n = 49 40.7 ± 13.8 years) and sedentary (n = 26 33.4 ± 13.2 y) participants completed two PRETS (PRET 1 and PRET2), requiring a change in speed or incline corresponding to ratings of perceived exertion (RPE) 9, 11, 13 and 15. Extrapolation of RPE: [Formula: see text] data to RPE 19 and 20 from the RPE 9-13 and 9-15 ranges were used to estimate [Formula: see text], and compared to [Formula: see text] from a graded exercise test (GXT). The [Formula: see text] :heart rate (HR) data (≥RPE 15) from the GXT were also extrapolated to age-predicted maximal HR (HRmax(pred)) to provide further estimation of [Formula: see text]. ANOVA revealed no significant differences between [Formula: see text] predictions from the RPE 9-15 range for PRET 1 and PRET 2 when extrapolated to RPE 19 in both active (54.3 ± 7.4 52.9 ± 8.1 ml kg(-1) min(-1)) and sedentary participants (34.1 ± 10.2 34.2 ± 9.6 ml kg(-1) min(-1)) and no difference between the HRmax(pred) method and measured [Formula: see text] from the GXT for active (53.3 ± 10.0 53.9 ± 7.5 ml kg(-1) min(-1), respectively) and sedentary participants (33.6 ± 8.4, 34.4 ± 7.0 ml kg(-1) min(-1), respectively). A single treadmill-based PRET using RPE 9-15 range extrapolated to RPE 19 is a valid means of predicting [Formula: see text] in young and middle to older-aged in iduals of varying activity and fitness levels.
Publisher: Wiley
Date: 09-06-2009
DOI: 10.1111/J.1469-8986.2009.00826.X
Abstract: This study assessed the validity of the Eston-Parfitt (E-P) curvilinear Ratings of Perceived Exertion (RPE) Scale and a novel marble quantity task to provide estimates of perceived exertion during cycle ergometry. Fifteen children aged 7-8 years performed a discontinuous incremental graded-exercise test, and reported exertional ratings at the end of each minute. Significant increases in physiological and perceptual data were observed with increasing work rate. The relationship between work rate and marbles was curvilinear (mean R(2)=.94), supporting the theoretical justification for the E-P Scale. Strong linear (R(2)=.93) and curvilinear (R(2)=.94) relationships between RPE from the E-P Scale and work rate confirmed the robustness of the E-P Scale. Valid exertional ratings may be obtained using the E-P Scale with young children. The novel marble quantity task offers an alternative method of deriving perceived exertion responses in children.
Publisher: Springer Science and Business Media LLC
Date: 02-06-2009
DOI: 10.1007/S00421-009-1093-7
Abstract: This study assessed the utility of a single, continuous exercise protocol in facilitating accurate estimates of maximal oxygen uptake V(O)(2max) from submaximal heart rate (HR) and the ratings of perceived exertion (RPE) in healthy, low-fit women, during cycle ergometry. Eleven women estimated their RPE during a continuous test (1 W 4 s(-1)) to volitional exhaustion (measured V(O)(2max)). In idual gaseous exchange thresholds (GETs) were determined retrospectively. The RPE and HR values prior to and including an RPE 13 and GET were extrapolated against corresponding oxygen uptake to a theoretical maximal RPE (20) and peak RPE (19), and age-predicted HRmax, respectively, to predict V(O)(2max)). There were no significant differences (P > 0.05) between measured (30.9 +/- 6.5 ml kg(-1) min(-1)) and predicted V(O)(2max) from all six methods. Limits of agreement were narrowest and intraclass correlations were highest for predictions of V(O)(2max) from an RPE 13 to peak RPE (19). Prediction of V(O)(2max) from a regression equation using submaximal HR and work rate at an RPE 13 was also not significantly different to actual V(O)(2max) (R( 2 ) = 0.78, SEE = 3.42 ml kg(-1) min(-1), P > 0.05). Accurate predictions of V(O)(2max) may be obtained from a single, continuous, estimation exercise test to a moderate intensity (RPE 13) in low-fit women, particularly when extrapolated to peak terminal RPE (RPE(19)). The RPE is a valuable tool that can be easily employed as an adjunct to HR, and provides supplementary clinical information that is superior to using HR alone.
Publisher: BMJ
Date: 18-09-2014
Publisher: Springer Science and Business Media LLC
Date: 22-04-0012
Publisher: Elsevier BV
Date: 04-2021
Publisher: Wiley
Date: 25-03-2019
DOI: 10.1113/EP087444
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Danielle Lambrick.