ORCID Profile
0000-0001-9497-601X
Current Organisation
Garvan Institute of Medical Research
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Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.HLC.2017.12.012
Abstract: In iduals with hypertrophic cardiomyopathy (HCM) may be asymptomatic or display activity-limiting symptoms. A common cause of symptoms is left ventricular outflow tract obstruction (LVOTO), which may impact the in iduals' ability to undertake physical activity. This study sought to examine daily step count as a potential marker of exercise capacity, which may represent a proxy marker of disease severity in HCM. A cross-sectional study of 63 HCM patients was conducted from March to November 2015. Participants wore an ActiGraph GT3X+ (Pensacola, Florida, USA) accelerometer for 7 days. Minutes per day of light, moderate and vigorous physical activity and step count were calculated, and those with LVOTO were compared to those without. Similarly, those with good functional capacity (New York Heart Association NYHA class I) were compared to those with NYHA class II-IV. The majority of HCM patients were male (n=45, 71%) with mean age of 48.8±14.9years. Hypertrophic cardiomyopathy patients with history of LVOTO and those NYHA class II-IV took significantly fewer steps per day (LV obstruction: 5527±2370 versus 7027±2095, p=0.01 and NYHA: 5346±1898 versus 6801±2339, p=0.03). No differences were observed across the different intensities of physical activity. Measurement of daily step count may be a useful and simple tool to determine exercise capacity and provide an indicator of disease severity in in iduals with HCM.
Publisher: Oxford University Press (OUP)
Date: 14-06-2017
Abstract: Physical activity is associated with improved quality of life. Patients with an implantable cardioverter defibrillator (ICD) face unique clinical and psychological challenges. Factors such as fear of ICD shock may negatively impact on physical activity, while a sense of protection gained from the ICD may instil confidence to be active. We aimed to examine the impact of an ICD on physical activity levels and factors associated with amount of activity. Two cross-sectional studies were conducted. Accelerometer data (seven-day) was collected in March–November 2015 for 63 consecutively recruited hypertrophic cardiomyopathy patients, with or without an ICD, aged ⩾18 years. A survey study was conducted in July–August 2016 of 155 in iduals aged ⩾18 years with an inherited heart disease and an ICD in situ. Based on the International Physical Activity Questionnaire, mean leisure time physical activity was 239 ± 300 min/week with 51% meeting physical activity guidelines. Accelerometry showed that mean moderate–vigorous physical activity was the same for patients with and without an ICD (254 ± 139 min/week versus 300 ± 150 min/week, p=0.23). Nearly half of survey participants ( n=73) said their device made them more confident to exercise. Being anxious about ICD shocks was the only factor associated with not meeting physical activity guidelines. Patients with inherited heart disease adjust differently to their ICD device, and for many it has no impact on physical activity. Discussion regarding the appropriate level of physical activity and potential barriers will ensure best possible outcomes in this unique patient group.
Publisher: Elsevier BV
Date: 09-2023
Publisher: BMJ
Date: 16-07-2015
Publisher: Elsevier BV
Date: 10-2014
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2021
DOI: 10.1161/CIRCEP.121.009834
Abstract: The overall incidence of sudden cardiac death is considerably lower among women than men, reflecting significant and often under-recognized sex differences. Women are older at time of sudden cardiac death, less likely to have a prior cardiac diagnosis, and less likely to have coronary artery disease identified on postmortem examination. They are more likely to experience their death at home, during sleep, and less likely witnessed. Women are also more likely to present in pulseless electrical activity or systole rather than ventricular fibrillation or ventricular tachycardia. Conversely, women are less likely to receive bystander cardiopulmonary resuscitation or receive cardiac intervention post-arrest. Underpinning sex disparities in sudden cardiac death is a paucity of women recruited to clinical trials, coupled with an overall lack of prespecified sex-disaggregated evidence. Thus, predominantly male-derived data form the basis of clinical guidelines. This review outlines the critical sex differences concerning epidemiology, cause, risk factors, prevention, and outcomes. We propose 4 broad areas of importance to consider: physiological, personal, community, and professional factors.
Publisher: BMJ
Date: 02-2020
DOI: 10.1136/BMJOPEN-2019-034036
Abstract: Compared with sighted in iduals, people with visual impairment have a higher prevalence of chronic conditions and lower levels of physical activity. This review aims to systematically review physical activity interventions for those with a visual impairment and to assess their effectiveness. A systematic review of articles reporting physical activity interventions in visually impaired in iduals was conducted. Medline, EMBASE, The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Physiotherapy Evidence Database were searched in August 2018. Meta-analyses were conducted on randomised controlled trials with the same outcome measure. Most interventions were conducted in a group setting, with some including an at-home, self-directed component. Following identification of a recent systematic review of physical activity interventions in children, our review focused on adults aged 18 years and older with a visual impairment. Outcomes included measures of balance, mobility, mental well-being (eg, quality of life), number of falls, muscle strength, flexibility and gait. Eighteen papers from 17 studies met inclusion criteria. Physical activity components include falls prevention and/or balance-based activities, walking, tai chi, Alexander Technique, Yoga, dance, aerobics and core stability training. Significant results in favour of the intervention were reported most commonly in measures of functional capacity (9/17 studies) and in falls/balance-related outcomes (7/13 studies). The studies identified were generally small and erse in study design, and risk of bias was high across several categories for most studies. Meta-analyses indicated non-significant effects of the included interventions on the Timed Up and Go, Chair Sit Test and Berg Balance Scale. Physical activity interventions in in iduals with visual impairment incorporating activities such as tai chi, Yoga and dance can have positive results, particularly in physical measures such as mobility and balance. However, when performing a meta-analysis of randomised controlled trials, the evidence for effectiveness is less clear. More studies with larger s le sizes, stronger designs and longer follow-up periods are needed. CRD42018103638.
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.CCL.2016.06.003
Abstract: Athletes are often regarded as in iduals at the pinnacle of health and fitness, nearly to the point of invincibility. The sudden cardiac death (SCD) of an athlete is therefore generally unexpected and extremely traumatic. Some of the most commonly identified causes of SCD in athletes include the genetic heart diseases. Despite thorough clinical and genetic investigation, in some cases a cause of death cannot be elucidated. Further research in these areas, spanning clinical, genetic, and public health perspectives, is required to help guide clinicians and those encountering the tragedy of SCD in an athlete.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.HLC.2018.03.026
Abstract: Sudden cardiac death (SCD) in athletes is a rare but tragic complication of a number of cardiovascular diseases. Inherited causes such as the structural and arrhythmogenic genetic heart conditions are often found or suspected to be the underlying cause of death at post mortem examination. Physical activity and intense exercise may trigger cardiac arrhythmias in in iduals with these conditions leading to SCD. Prevention and treatment strategies include in idual athlete management strategies, coupled with public health measures such as universal cardiopulmonary resuscitation (CPR) training and availability of automatic external defibrillators (AEDs) in public places, thereby preventing SCD in both athletes and the general population. Where an athlete is known to have a cardiac condition, some restrictions from participation may be prudent, however, new evidence is emerging that perhaps current restrictions are too strict and could be relaxed in some cases. An athlete-centred model of care is essential to ensure the clinical implications and athlete preferences are balanced providing the best outcome for all concerned.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.PRRV.2014.09.006
Abstract: Many factors have been implicated in SIDS cases including environmental influences such as sleeping arrangements and smoking. Most recently, cardiac abnormalities have been hypothesised to play a role in some cases, particularly the primary genetic arrhythmogenic disorders such as familial long QT syndrome (LQTS). Both post-mortem and clinical studies of SIDS cases have provided supporting evidence for the involvement of cardiac genetic disorders in SIDS. This review provides a summary of this evidence focussing particularly on the primary hypothesis related to underlying familial LQTS. In addition, the current literature relating to other cardiac genetic conditions such as Brugada syndrome (BrS) and structural heart diseases such as hypertrophic cardiomyopathy (HCM) is briefly presented. Finally, the implications of a possible cardiac genetic cause of SIDS is discussed with reference to the need for genetic testing in SIDS cases and subsequent clinical and genetic testing in family members.
Publisher: JMIR Publications Inc.
Date: 05-2023
Abstract: enetic heart diseases such as hypertrophic cardiomyopathy can cause significant morbidity and mortality, ranging from syncope, chest pain and palpitations to heart failure and sudden cardiac death. These diseases are inherited in an autosomal dominant fashion, meaning family members of affected in iduals have a one in two chance of also inheriting the disease (‘at-risk relatives’). The healthcare utilisation patterns of in iduals with a genetic heart disease including emergency department presentations and hospital admissions, are poorly understood. By linking genetic heart disease registry data to routinely collected health data we aim to provide a more comprehensive clinical dataset to examine the burden of disease on in iduals, families and healthcare systems. he objective of this study is to link the Australian Genetic Heart Disease (AGHD) Registry with routinely collected whole-population health datasets to investigate the healthcare utilisation of in iduals with a genetic heart disease and their at-risk relatives. This linked dataset will allow for investigation of differences in outcomes and healthcare utilisation due to disease, sex, socioeconomic status and other factors. he AGHD Registry is a nationwide dataset which began in 2007 and aims to recruit in iduals with a genetic heart disease and their family members. In this study, demographic, clinical, and genetic data (available 2007-2019) for AGHD Registry participants and at-risk relatives residing in New South Wales (NSW) Australia, were linked to routinely collected health data. These data included NSW based datasets covering hospitalisations (2001-2019) and emergency department presentations (2005-2019), and both state-wide and national mortality registries (2007-2019). The linkage was performed by the Centre for Health Record Linkage (CHeReL). Investigations stratifying by diagnosis, age, sex, socioeconomic status and gene status will be undertaken and reported using descriptive statistics. SW AGHD Registry participants were linked to routinely collected health datasets using probabilistic matching (November 2019). Of 1720 AGHD Registry participants, 1384 had linkages with 11,610 hospital records, 7032 emergency department records and 60 death records. Data assessment and harmonisation were performed, and descriptive data analysis is underway. e intend to provide insights into the healthcare utilisation patterns of in iduals with a genetic heart disease and their at-risk relatives, including frequency of hospital admissions and differences due to factors such as disease, sex and socioeconomic status. Identifying disparities and potential barriers to care may highlight specific healthcare needs (e.g. between sexes) and factors impacting healthcare access and utilisation. > ERR1-10.2196/48636
Publisher: Elsevier BV
Date: 2016
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.AMJCARD.2018.05.023
Abstract: Hypertrophic cardiomyopathy (HC) is the most common genetic heart disease. Consensus guidelines recommend restriction from competitive and/or high-intensity physical activities however, sufficient light-moderate intensity physical activity remains important for health and wellbeing. This study aimed to evaluate the effectiveness and appeal of a control theory-based intervention to increase physical activity levels in in iduals with HC. A pre to post trial of HC participants (n = 25) recruited from May 2016 to April 2017 from a specialized, multidisciplinary clinic was conducted. A 12-week intervention based on principles of control theory was developed. The primary outcome measures were self-reported leisure and transport-related physical activity. The mean age of participants was 42 ± 13years and the majority were men (n = 15, 60%). Although both the primary (self-report) and secondary (objective) outcome measures of physical activity increased, such as leisure-time physical activity: 98 ± 132 minutes per week to 151 ± 218 minutes per week, these were not statistically significant. Secondary outcome measures improved, including physical health-related quality of life (HR-QoL 43 ± 6 to 50 ± 8, p = 0.004), self-efficacy (14 ± 3 to 16 ± 4, p <0.001), and the number of barriers identified (4 ± 3 to 3 ± 2 barriers, p = 0.02). This simple, easy-to-administer intervention to promote physical activity in HC improved willingness to undertake physical activity, increased self-efficacy, and improved physical quality of life. This may help patients overcome perceived barriers and a lack of confidence regarding physical activity, with the ultimate goal to improve overall health outcomes in HC patients.
Publisher: Elsevier BV
Date: 11-2013
DOI: 10.1016/J.SCHRES.2013.08.029
Abstract: Schizophrenia is a devastating mental disorder, associated with mortality rates up to three times higher than those in the general population. This post-mortem study sought to investigate the causes of death in a consecutive series of schizophrenia cases, with a specific focus on cardiovascular disease and sudden death. A 10-year review of autopsies in schizophrenia related-cases performed at the Department of Forensic Medicine in Sydney, Australia was undertaken. Premorbid clinical and demographic information was recorded, as well as the key pathological findings and final cause of death. From 2003 to 2012, there were 19,478 postmortem examinations performed of which 683 (3.5%) were deaths in people with a history of schizophrenia. In these cases, the mean age at death was 51years (range 18-93years), with 43% in the 41-60year age group. Males comprised 67% of cases. Overall, 62% of cases had a BMI≥25kg/m(2), indicating overweight or obese in iduals. The three primary causes of death were "cardiovascular" (23%), "suicide" (20%), and "drug toxicity" (17%). In 11% of cases (n=72), no definitive cause of death was found, the so-called "unexplained" cases. In conclusion, patients with schizophrenia have premature mortality. The major contributing factors include cardiovascular diseases, suicide and drug toxicity. The "unexplained" and frequently sudden deaths may suggest underlying cardiac arrhythmias as a cause of death in a subgroup of schizophrenia patients.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2015
Publisher: JMIR Publications Inc.
Date: 20-09-2023
DOI: 10.2196/48636
Publisher: Elsevier BV
Date: 06-2019
Publisher: Public Library of Science (PLoS)
Date: 16-10-2017
Publisher: BMJ
Date: 07-2016
No related grants have been discovered for Joanna Sweeting.