ORCID Profile
0000-0001-9112-134X
Current Organisation
Dasman Diabetes Institute
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Public Health and Health Services | Health Promotion | Family and Household Studies | Social and Cultural Geography | Public Health And Health Services Not Elsewhere Classified | Health and Community Services | Epidemiology | Primary Health Care | Aboriginal and Torres Strait Islander Health | Public Health and Health Services not elsewhere classified | Health Information Systems (incl. Surveillance) | Urban Design | Demography Not Elsewhere Classified
ANZSRC Socio-Economic Objective (SEO)
Social Structure and Health | Demography | Public Health (excl. Specific Population Health) not elsewhere classified | Cardiovascular System and Diseases | Aboriginal and Torres Strait Islander Health - Determinants of Health | Behaviour and Health | Clinical health not specific to particular organs, diseases and conditions | Health and support services not elsewhere classified | Public Services Policy Advice and Analysis | Expanding Knowledge in Built Environment and Design | Health Policy Economic Outcomes |
Related Links
Publications
Relative residential property value as a socio-economic status indicator for health research
Publisher: Springer Science and Business Media LLC
Date: 2013
Evolution and Implications of P.A.R. for Public Health
Publisher: SAGE Publications
Date: 12-1996
DOI: 10.1177/102538239600300403
Abstract: Participatory Action Research (PAR) has attracted the interest of public health practitioners and researchers who seek to combine research with education and action, and those who want to go beyond knowledge development to the diffusion of research findings and to the implementation of change processes in light of their findings.
Association of fast-food restaurant and fruit and vegetable store densities with cardiovascular mortality in a metropolitan population
Publisher: Springer Science and Business Media LLC
Date: 07-09-2010
DOI: 10.1007/S10654-010-9499-4
Abstract: Most studies that link neighbourhoods to disease outcomes have represented neighbourhoods as area-level socioeconomic status. Where objective contextual attributes of urban environments have been measured, few studies of food availability have evaluated mortality as an outcome. We sought to estimate associations between the availability of fast-food restaurants (FFR), fruit and vegetable stores (FVS), and cardiovascular mortality in an urban area. Food business data were extracted from a validated commercial database containing all businesses and services in the Montréal Census Metropolitan Area (MCMA). Mortality data (1999-2003) were obtained for the MCMA (3.4 million residents). Directly standardised mortality rates for cardiovascular deaths (n = 30,388) and non-cardiovascular deaths (all causes - cardiovascular deaths) (n = 91,132) and FFR and FVS densities (n/km²) were analysed for 845 census tracts. Generalised additive models and generalised linear models were used to analyse food source-mortality relationships. FVS density was not associated with cardiovascular or non-cardiovascular mortality (relative risk (RR) = 1.02, 95% confidence interval (CI): 0.76, 1.36, and RR = 1.14, 95% CI: 0.87, 1.50, respectively). Higher FFR density was associated with mortality in bivariate and multivariable analyses. Relative risks of death (95% CI) per 10% increase in FFR density were similar for both cardiovascular and non-cardiovascular mortality: 1.39 (1.19, 1.63) and 1.36 (1.18, 1.57), respectively, accounting for socio-demographic covariates. FFR density is associated with cardiovascular mortality but this relationship is no different in magnitude than that for non-cardiovascular mortality. These results together with null associations between FVS density and mortality do not support a major role for food source availability in cardiovascular outcomes.
Predictors of Quality of Life in Montreal, Canada: A Longitudinal Study
Publisher: Springer Science and Business Media LLC
Date: 03-10-2019
DOI: 10.1007/S10597-018-0340-Y
Abstract: This study sought to assess factors associated with quality of life (QoL), and predictive of improvements in QoL over time, in a population-based cohort study. A 4-year longitudinal survey was administered to 2433 in iduals at the study baseline of these, 1828 in iduals participated in Wave 2, and 1303 participated in Wave 3. QoL was measured by the Satisfaction with Life Domains Scale. Thirty-two variables were correlated with baseline QoL and together explained 58.2% of the variance. Eleven variables were independent predictors of improvement in QoL over time. Among these variables, social support and stress/coping showed the strongest association with QoL, and neighbourhood characteristics had an additional influence. Multidimensional modelling of a broad spectrum of the factors related to QoL enabled situating mental health and well-being in an ecological system with attendant implications for public health and social policy intervention to facilitate improvement of QoL in the population.
Social Inequalities in Food Exposure Around Schools in an Urban Area
Publisher: Elsevier BV
Date: 07-2010
DOI: 10.1016/J.AMEPRE.2010.03.014
Abstract: The obesity epidemic among children and youth, and the social gradient in this relationship, could be related to differential exposure to food sources in primary environments. Although the positive association between area-level deprivation and fast-food outlets offering high-calorie foods has been well documented, few studies have evaluated food sources around school settings. This study evaluated the relationships among food sources around schools, neighborhood income, and commercial density. A GIS was used to derive measures of exposure to fast-food outlets, fruit and vegetable stores, and full-service restaurants near primary and secondary schools in Montreal, Canada, in 2005. Food source availability was analyzed in 2009 in relation to neighborhood income for the area around schools, accounting for commercial density. For the 1168 schools identified, strong neighborhood income gradients were observed in relation to food sources. Relative to the highest income-quartile schools, the odds of a fast-food outlet being located within 750 m of a low income-quartile school was 30.9 (95% CI=19.6, 48.9). Similar relationships were observed for full-service restaurants (OR=77, 95% CI=35, 169.3) and fruit and vegetable stores (OR=29.6, 95% CI=18.8, 46.7). These associations were reduced, but remained significant in models accounting for commercial density. Food source exposure around schools is inversely associated with neighborhood income, but commercial density partly accounts for this association. Further research is necessary to document food consumption among youth attending schools in relation to nearby food source opportunities.
Fasting criteria for screening: Test properties and agreement with glucose tolerance
Publisher: Elsevier BV
Date: 11-2002
DOI: 10.1016/S0168-8227(02)00133-X
Abstract: The objective of this study was to characterise test properties and agreement for fasting glucose cut-offs used for screening diabetes in Indigenous Australian communities, across a range of diabetes prevalence. The oral glucose tolerance test (OGTT) was administered to adult volunteers (n=3249) for community-based diabetes screening in isolated settlements (n=25). Two-hour post-load glucose concentration was the 'gold standard' against which test properties were characterised for fasting plasma glucose cut-offs at concentrations of > or = 7.0 mmol/l (ADA criterion) and > or = 7.8 mmol/l (WHO criterion). Test sensitivity (95% CI) was greater for the ADA (72.5%, 67.4-77.1%) versus the WHO criterion (61.5%, 56.1-66.6%). Specificity was high (>98%) using either criterion. The post-test likelihood of diabetes, given a population prevalence of 14.8%, was 89.1% using the ADA criterion, and 94.9% using the WHO criterion. The ADA criterion gave better agreement than did the WHO criterion for diabetes prevalence > or = 8.6%, and the probability of false results was lower using the ADA criterion, when diabetes prevalence was > or = 12.8%. According to the ADA criterion most in iduals ascribed false negative results were aged > or = 35 years, overweight/obese, or had impaired fasting glucose. The fasting glucose criterion of 7.0 mmol/l was superior to 7.8 mmol/l in screening for diabetes.
Thinking in time within urban health
Publisher: Center for Open Science
Date: 28-01-2019
Abstract: Time as a dimension is beguiling. Philosophy has puzzled over it, physics queried its nature, and popular culture entertained us with its peculiarities. As a construct, time is multifaceted. While we experience time, we are subject to it. We also harness time, and apply it as an instrument and a lens. However, time also represents a means to enrich knowledge of urban health. To achieve this aim will involve accounting for time as well as thinking in time.Thinking in time within urban health draws attention to the evolution of urban contexts, such as neighbourhoods, the life-courses of these settings and, the dynamics between the life-course of people and their health in place, with the life-course of place. Thinking in time also entails attending to the nature of time itself, and the manner by which re-imagining time may transform how urban health is queried.Cross-disciplinary in nature, and trans-disciplinary in its intent, this conceptual review reflects on observational research to consider what has been discovered about neighbourhood effects, and how time features in this information. Furthermore, this review outlines theories and methods for thinking in time to advance understandings of how, why and for whom neighbourhoods matter to health.
Residential area sociodemographic and breast cancer screening venue location built environmental features associated with women's use of closest venue in greater Sydney, Australia
Publisher: MDPI AG
Date: 27-10-2021
Abstract: Understanding environmental predictors of women’s use of closest breast screening venue versus other site(s) may assist optimal venue placement. This study assessed relationships between residential-area sociodemographic measures, venue location features, and women’s use of closest versus other venues. Data of 320,672 Greater Sydney screening attendees were spatially joined to residential state suburbs (SSCs) (n = 799). SSC-level sociodemographic measures included proportions of: women speaking English at home university-educated full-time employed and dwellings with motor-vehicles. A geographic information system identified each woman’s closest venue to home, and venue co-location with bus-stop, train-station, hospital, general practitioner, and shop(s). Multilevel logistic models estimated associations between environmental measures and closest venue attendance. Attendance at closest venue was 59.4%. Closest venue attendance was positively associated with SSC-level women speaking English but inversely associated with SSC-level women university-educated, full-time employed, and dwellings with motor-vehicles. Mobile venue co-location with general practitioner and shop was positively, but co-location with bus-stop and hospital was inversely associated with attendance. Attendance was positively associated with fixed venue co-location with train-station and hospital but inversely associated with venue co-location with bus-stop, general practitioner, and shop. Program planners should consider these features when optimising service locations to enhance utilisation. Some counterintuitive results necessitate additional investigation.
Association of Built Environmental Features with Rates of Infectious Diseases in Remote Indigenous Communities in the Northern Territory, Australia
Publisher: MDPI AG
Date: 17-01-2022
DOI: 10.3390/HEALTHCARE10010173
Abstract: The health of Indigenous Australians is far poorer than non-Indigenous Australians, including an excess burden of infectious diseases. The health effect of built environmental (BE) features on Indigenous communities receives little attention. This study’s objective was to determine associations between BE features and infectious disease incidence rates in remote Indigenous communities in the Northern Territory (NT), Australia. Remote Indigenous communities (n = 110) were spatially joined to 93 Indigenous Locations (ILOC). Outcomes data were extracted (NT Notifiable Diseases System) and expressed as ILOC-specific incidence rates. Counts of buildings were extracted from community asset maps and grouped by function. Age-adjusted infectious disease rates were dichotomised, and bivariate binomial regression used to determine the relationships between BE variables and infectious disease. Infrastructure Shelter BE features were universally associated with significantly elevated disease outcomes (relative risk 1.67 to 2.03). Significant associations were observed for Services, Arena, Community, Childcare, Oval, and Sports and recreation BE features. BE groupings associated with disease outcomes were those with communal and/or social design intent or use. Comparable BE groupings without this intent or use did not associate with disease outcomes. While discouraging use of communal BE features during infectious disease outbreaks is a conceptually valid countermeasure, communal activities have additional health benefits themselves, and infectious disease transmission could instead be reduced through repairs to infrastructure, and more infrastructure. This is the first study to examine these associations simultaneously in more than a handful of remote Indigenous communities to illustrate community-level rather than aggregated population-level associations.
Effects of skin thickness and skinfold compressibility on skinfold thickness measurement
Publisher: Wiley
Date: 1992
Abstract: Variability in both skin thickness and skinfold compressibility affects the relationship between the skinfold caliper reading at a particular site on the body and the actual adipose thickness at that site, thus inducing error in the estimation of body fatness. To investigate this variability, skinfold thickness by caliper and incised depth of subcutaneous adipose tissue were measured at 13 skinfold sites in 6 male and 7 female unembalmed cadavers aged 55 to 94 years. All skin was then removed and its thickness measured at the exact sites of skinfold measurement. The regional patterns for skin thickness were similar in men and women, though women had significantly (P < .05) thinner skin than men at the biceps, chest, supraspinale, and abdominal sites. Mean (SD) skin thickness for each cadaver over all sites ranged from 0.76 mm (0.28 mm) to 1.47 mm (0.43 mm), with an overall mean for men of 1.22 mm (0.36 mm) and for women of 0.98 mm (0.36 mm). The thickness of a double layer of skin expressed as a percentage of skinfold thickness for all cadavers over all 13 sites ranged from 7.1% to 33.4%. Because of their leanness and thicker skin, the mean for men, 22.7% (10.1%), was significantly greater than that for women, 10.8% (6.2%) (P < .0001). Mean skinfold compressibility over all sites was 53.5% (16.4%) in men adn 51.9% (16.5%) in women (not significant). Such marked variability in skinfold compressibility and in the relative contribution of skin thickness to skinfold thickness suggests the need for caution in comparing estimates of fatness by skinfold caliper between different subjects. © 1992 Wiley-Liss, Inc.
Perceived everyday racism, residential segregation, and HIV testing among patients at a sexually transmitted disease clinic
Publisher: American Public Health Association
Date: 04-2009
Abstract: Objectives. More than one quarter of HIV-infected people are undiagnosed and therefore unaware of their HIV-positive status. Blacks are disproportionately infected. Although perceived racism influences their attitudes toward HIV prevention, how racism influences their behaviors is unknown. We sought to determine whether perceiving everyday racism and racial segregation influence Black HIV testing behavior. Methods. This was a clinic-based, multilevel study in a North Carolina city. Eligibility was limited to Blacks (N = 373) seeking sexually transmitted disease diagnosis or screening. We collected survey data, block group characteristics, and lab-confirmed HIV testing behavior. We estimated associations using logistic regression with generalized estimating equations. Results. More than 90% of the s le perceived racism, which was associated with higher odds of HIV testing (odds ratio = 1.64 95% confidence interval = 1.07, 2.52), after control for residential segregation, and other covariates. Neither patient satisfaction nor mechanisms for coping with stress explained the association. Conclusions. Perceiving everyday racism is not inherently detrimental. Perceived racism may improve odds of early detection of HIV infection in this high-risk population. How segregation influences HIV testing behavior warrants further research.
Aboriginal status is a prognostic factor for mortality among antiretroviral naïve HIV-positive individuals first initiating HAART
Publisher: Springer Science and Business Media LLC
Date: 24-05-2006
Abstract: Although the impact of Aboriginal status on HIV incidence, HIV disease progression, and access to treatment has been investigated previously, little is known about the relationship between Aboriginal ethnicity and outcomes associated with highly active antiretroviral therapy (HAART). We undertook the present analysis to determine if Aboriginal and non-Aboriginal persons respond differently to HAART by measuring HIV plasma viral load response, CD4 cell response and time to all-cause mortality. A population-based analysis of a cohort of antiretroviral therapy naïve HIV-positive Aboriginal men and women 18 years or older in British Columbia, Canada. Participants were antiretroviral therapy naïve, initiated triple combination therapy between August 1, 1996 and September 30, 1999. Participants had to complete a baseline questionnaire as well as have at least two follow-up CD4 and HIV plasma viral load measures. The primary endpoints were CD4 and HIV plasma viral load response and all cause mortality. Cox proportional hazards models were used to determine the association between Aboriginal status and CD4 cell response, HIV plasma viral load response and all-cause mortality while controlling for several confounder variables. A total of 622 participants met the study criteria. Aboriginal status was significantly associated with no AIDS diagnosis at baseline (p = 0.0296), having protease inhibitor in the first therapy (p = 0.0209), lower baseline HIV plasma viral load (p 0.001), less experienced HIV physicians (P = 0.0133), history of IDU (p 0.001), not completing high school (p = 0.0046), and an income of less than $10,000 per year (p = 0.0115). Cox proportional hazards models controlling for clinical characteristics found that Aboriginal status had an increased hazard of mortality (HR = 3.12, 95% CI: 1.77–5.48) but did not with HIV plasma viral load response (HR = 1.15, 95% CI: 0.89–1.48) or CD4 cell response (HR = 0.95, 95% CI: 0.73–1.23). Our study demonstrates that HIV-infected Aboriginal persons accessing HAART had similar HIV treatment response as non-Aboriginal persons but have a shorter survival. This study highlights the need for continued research on medical interventions and behavioural changes among HIV-infected Aboriginal and other marginalized populations.
Sense of mastery and metabolic risk: Moderating role of the local fast-food environment
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2010
A workplace health promotion application of the Precede-Proceed model in a regional and remote mining company in Whyalla, South Australia
Publisher: Emerald
Date: 14-09-2015
DOI: 10.1108/IJWHM-08-2014-0028
Abstract: – Workplace health promotion enables the dissemination of health-related information to a large portion of society and provides a vehicle for translating results of efficacy studies to effective lifestyle interventions under less controlled real-world conditions. To achieve effectiveness there needs to be a systematic approach to the design, implementation, and evaluation of workplace health promotion interventions. The purpose of this paper is to describe the development of a workplace programme in a mining and steel making town in regional South Australia. – The Precede-Proceed model (PPM) was used as a framework to design the development, implementation, and evaluation of the programme. – Quality of life issues and antecedents of modifiable behavioural and environmental factors to be targeted by interventions were identified. Relevant socio-behavioural theories were used to guide intervention development and evaluation. An intervention programme was planned to enable the delivery of educational and skills-development strategies by peers within structured organisational work units. – This research utilises the PPM to develop, implement, and evaluate intervention strategies targeting the development of diabetes and cardiometabolic risk in a remotely located workplace population. Novel to this approach is the utilisation of the entire PPM in the research the multiple baseline, interrupted time series design of the study and its application in a workplace environment noted for increased health risk factors, within a community at high risk of development of type 2 diabetes.
Examining adherence to activity monitoring devices to improve physical activity in adults with cardiovascular disease: A systematic review
Publisher: Oxford University Press (OUP)
Date: 15-10-2018
Abstract: Activity monitoring devices are currently being used to facilitate and monitor physical activity. No prior review has examined adherence to the use of activity monitoring devices amongst adults with cardiovascular disease. Literature from June 2012 to October 2017 was evaluated to examine the extent of adherence to any activity monitoring device used to collect objective physical activity data. Randomized control trials comparing usual care against the use of an activity monitoring device, in a community intervention for adults from any cardiovascular diagnostic group, were included. A systematic search of databases and clinical trials registers was conducted using Joanna Briggs Institute methodology. Of 10 eligible studies, two studies reported pedometer use and eight accelerometer use. Six studies addressed the primary outcome. Mean adherence was 59.1% (range 39.6% to 85.7%) at last follow-up. Studies lacked equal representation by gender (28.6% female) and age (range 42 to 82 years). This review indicates that current research on activity monitoring devices may be overstated due to the variability in adherence. Results showed that physical activity tracking in women and in young adults have been understudied.
Rating health and social indicators for use with indigenous communities: A tool for balancing cultural and scientific utility
Publisher: Springer Science and Business Media LLC
Date: 25-11-2009
Mastery, perceived stress and health-related behaviour in northeast Arnhem Land: A cross-sectional study
Publisher: Springer Science and Business Media LLC
Date: 27-09-2006
Built Environment Features and Cardiometabolic Mortality and Morbidity in Remote Indigenous Communities in the Northern Territory, Australia
Publisher: MDPI AG
Date: 08-2022
Abstract: Indigenous Australians experience poorer health than non-Indigenous Australians, with cardiometabolic diseases (CMD) being the leading causes of morbidity and mortality. Built environmental (BE) features are known to shape cardiometabolic health in urban contexts, yet little research has assessed such relationships for remote-dwelling Indigenous Australians. This study assessed associations between BE features and CMD-related morbidity and mortality in a large s le of remote Indigenous Australian communities in the Northern Territory (NT). CMD-related morbidity and mortality data were extracted from NT government health databases for 120 remote Indigenous Australian communities for the period 1 January 2010 to 31 December 2015. BE features were extracted from Serviced Land Availability Programme (SLAP) maps. Associations were estimated using negative binomial regression analysis. Univariable analysis revealed protective effects on all-cause mortality for the BE features of Education, Health, Disused Buildings, and Oval, and on CMD-related emergency department admissions for the BE feature Accommodation. Incidence rate ratios (IRR’s) were greater, however, for the BE features Infrastructure Transport and Infrastructure Shelter. Geographic Isolation was associated with elevated mortality-related IRR’s. Multivariable regression did not yield consistent associations between BE features and CMD outcomes, other than negative relationships for Indigenous Location-level median age and Geographic Isolation. This study indicates that relationships between BE features and health outcomes in urban populations do not extend to remote Indigenous Australian communities. This may reflect an overwhelming impact of broader social inequity, limited correspondence of BE measures with remote-dwelling Indigenous contexts, or a ‘tipping point’ of collective BE influences affecting health more than singular BE features.
Built Environments and Cardiometabolic Morbidity and Mortality in Remote Indigenous Communities in the Northern Territory, Australia
Publisher: MDPI AG
Date: 25-01-2020
Abstract: The health of Indigenous Australians is dramatically poorer than that of the non-Indigenous population. Amelioration of these differences has proven difficult. In part, this is attributable to a conceptualisation which approaches health disparities from the perspective of in idual-level health behaviours, less so the environmental conditions that shape collective health behaviours. This ecological study investigated associations between the built environment and cardiometabolic mortality and morbidity in 123 remote Indigenous communities representing 104 Indigenous locations (ILOC) as defined by the Australian Bureau of Statistics. The presence of infrastructure and/or community buildings was used to create a cumulative exposure score (CES). Records of cardiometabolic-related deaths and health service interactions for the period 2010–2015 were sourced from government department records. A quasi-Poisson regression model was used to assess the associations between built environment “healthfulness” (CES, dichotomised) and cardiometabolic-related outcomes. Low relative to high CES was associated with greater rates of cardiometabolic-related morbidity for two of three morbidity measures (relative risk (RR) 2.41–2.54). Cardiometabolic-related mortality was markedly greater (RR 4.56, 95% confidence interval (CI), 1.74–11.93) for low-CES ILOCs. A lesser extent of “healthful” building types and infrastructure is associated with greater cardiometabolic-related morbidity and mortality in remote Indigenous locations. Attention to environments stands to improve remote Indigenous health.
Does IQ Vary Systematically with All Measures of Socioeconomic Status in a Cohort of Middle-Aged, and Older, Men?
Publisher: Scientific Research Publishing, Inc.
Date: 2012
La création d’une nouvelle génération d’études épidémiologiques en santé mentale
Publisher: Consortium Erudit
Date: 25-03-2008
DOI: 10.7202/017808AR
Abstract: Grâce à une subvention des Instituts de recherche en santé du Canada (IRSC), il se développe actuellement une nouvelle génération d’études en épidémiologie sociale et psychiatrique dans une zone circonscrite se situant dans le sud-ouest de Montréal où vivent 258 000 personnes. Ce programme de recherche repose sur une étude prospective longitudinale visant à identifier les déterminants de la santé mentale de la population, et sur quatre études spécifiques qui abordent des paramètres importants pour la santé mentale : l’écologie sociale et physique des quartiers, le soutien social, le stigma social et les services en santé mentale. Ce programme est complété par l’utilisation de la dernière génération des outils technologiques et informatiques soit un système d’information géographique (SIG) qui permet d’apprécier les effets du contexte sur la santé mentale. Les bases théoriques sur lesquels repose ce modèle sont présentées de même qu’une description sommaire des méthodes utilisées.
Association between smoking, insulin resistance and β-cell function in a North-western First Nation
Publisher: Wiley
Date: 30-01-2004
DOI: 10.1046/J.1464-5491.2003.01064.X
Abstract: Aboriginal peoples have a high prevalence of smoking and are at major risk for diabetes. The role of insulin resistance vs. compromised beta-cell function in the link between smoking and glycaemic disease is not clear. This study tested whether relations between insulin resistance and beta-cell function differ between current smokers, former smokers and non-smokers, and if having diabetes modifies smoking-related effects. A community-based diabetes screening initiative was mounted for a North-western First Nation (Interior Salishan) in rural British Columbia, Canada. Respondents were on-reserve Aboriginal people (n=156), all adults 18+ years. Glycaemic status was determined by oral glucose tolerance test. Fasting values for glucose and insulin were used to estimate beta-cell function and insulin resistance by homeostasis model assessment (HOMA). Analyses adjusted for age, sex, alcohol intake, education, body mass index and physical activity. For normoglycaemic persons (n=119) current smokers relative to non-smokers had high beta-cell values [difference (95% confidence interval) 19.5 (17.1, 21.9)], while former smokers had low beta-cell values [difference -22.8 (-20.3, -25.3)] (P<0.0001). For diabetic persons (n=37) differences were of equivalent direction but greater magnitude (P<0.0001). Insulin resistance was for normoglycaemic persons highest for current smokers, and for diabetic persons lowest for current smokers (P=0.021). Former smoking is associated with low beta-cell function, and current smoking with high beta-cell function, independent of diabetes in the North-western First Nation surveyed. Associations between smoking and insulin resistance vary according to glycaemic status. Smoking may have diametric acute and post-cessation effects on beta-cell function and insulin resistance.
Non-linear Modelling of Fasting Plasma Glucose Concentration and Peak 2-hour Insulin Response to Glucose Challenge in Australian Aboriginal People
Publisher: Herbert Publications PVT LTD
Date: 2012
The Keeping on Track Study: Exploring the Activity Levels and Utilization of Healthcare Services of Acute Coronary Syndrome (ACS) Patients in the First 30-Days after Discharge from Hospital
Publisher: MDPI AG
Date: 19-04-2019
Abstract: The aim of this study was to investigate the impact of bedside discharge education on activity levels and healthcare utilization for patients with acute coronary syndrome (ACS) in the first 30 days post-discharge. Knowledge recall and objective activity and location data were collected by global positioning systems (GPS). Participants were asked to carry the tracking applications (apps) for 30–90 days. Eighteen participants were recruited (6 metropolitan 12 rural) 61% ST elevation myocardial infarction (STEMI), mean age 55 years, 83% male. Recall of discharge education included knowledge of diagnosis (recall = 100%), procedures (e.g., angiogram = 40%), and comorbidities (e.g., hypertension = 60%, diabetes = 100%). In the first 30 days post-discharge, median steps per day was 2506 (standard deviation (SD) ± 369) steps (one participant completed 10,000 steps), 62% visited a general practitioner (GP) 16% attended cardiac rehabilitation, 16% visited a cardiologist, 72% a pharmacist, 27% visited the emergency department for cardiac event, and 61% a pathology service (blood tests). Adherence to using the activity tracking apps was 87%. Managing Big Data from the GPS and physical activity tracking apps was a challenge with over 300,000 lines of raw data cleaned to 90,000 data points for analysis. This study was an ex le of the application of objective data from the real world to help understand post-ACS discharge patient activity. Rates of access to services in the first 30 days continue to be of concern.
Associations between Area-Level Unemployment, Body Mass Index, and Risk Factors for Cardiovascular Disease in an Urban Area
Publisher: MDPI AG
Date: 04-12-2009
Reliability of an instrument for direct observation of urban neighbourhoods
Publisher: Elsevier BV
Date: 09-2010
Trends in human immunodeficiency virus incidence and risk behavior among injection drug users in Montreal, Canada: A 16-year longitudinal study
Publisher: Oxford University Press (OUP)
Date: 03-2011
DOI: 10.1093/AJE/KWQ479
Social capital and core network ties: A validation study of individual-level social capital measures and their association with extra- and intra-neighborhood ties, and self-rated health
Publisher: Elsevier BV
Date: 03-2011
DOI: 10.1016/J.HEALTHPLACE.2010.12.010
Abstract: Research on social capital and health has assumed that measures of trust, participation, and perceived cohesion capture aspects of people's neighborhood social connections. This study uses data on the personal networks of 2707 Montreal adults in 300 different neighborhoods to examine the association of socio-demographic and social capital variables with the likelihood of having core ties, core neighborhood ties, and high self-rated health (SRH). Persons with higher household income were more likely to have core ties, but less likely to have core neighborhood ties. Persons with greater ersity in extra-neighborhood network capital were more likely to have core ties, and persons with greater ersity in intra-neighborhood network capital were more likely to have core neighborhood ties. Generalized trust, perceived neighborhood cohesion, and extra-neighborhood network ersity were shown associated with high SRH. Conventional measures of social capital may not capture network mechanisms. Findings suggest a critical appraisal of the mechanisms linking social capital and health, and the further delineation of network and psychosocial mechanisms in understanding these links.
Short-term injection drug use changes following hepatitis C virus (HCV) assessment and treatment among persons who inject drugs with acute HCV infection
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.DRUGPO.2017.05.033
Abstract: It is unclear whether treatment and care for hepatitis C virus (HCV) infection can help people who inject drugs (PWID) modify their injection drug use behaviours. This study examined changes in injection drug use among PWID with acute HCV systematically referred for HCV clinical assessment and treatment and offered targeted health care services, over the course of one year. The study s le included PWID with documented acute HCV infection recruited and followed-up semi-annually at least twice in IMPACT (2007-2015), a longitudinal community-based prospective study in Montréal, Canada. Following enrolment, participants with contra-indications to treatment due to severe co-morbidity were offered targeted health care services. Pegylated interferon-alpha (12-24 weeks) was offered to all other participants who did not spontaneously resolve their infection. At each study visit, data were collected on socio-demographic factors and drug use patterns. Logistic regression was used to assess changes in injection drug use at one-year follow-up. Of the 87 eligible participants (mean age: 35.6 78.2% male), 21.8% received treatment [(RT), Sustained virological response: 84.2%], 25.3% spontaneously resolved their infection (SR), 14.9% had contra-indication(s) (CI) and 37.9% chose not to engage in HCV care post-diagnosis (NE). In multivariate analyses adjusting for age, gender and injection drug use at baseline, the RT [Adjusted odds ratio (AOR): 0.18 95% Confidence interval (CI): 0.04-0.76], SR (AOR: 0.34 95% CI: 0.08-1.40), and CI (AOR: 0.24 95% CI: 0.05-1.22) groups were less likely to report injection drug use at follow-up relative to the NE group. PWID who received treatment, spontaneously resolved their infection or presented with treatment contra-indication(s) reported reduced injection drug use at one-year follow-up relative to those who did not engage in therapy. Findings suggest that the benefits of HCV assessment and treatment may extent to helping PWID modify their injection drug use patterns.
Exploring the Intervention— Context Interface
Publisher: SAGE Publications
Date: 10-11-2009
Abstract: It has been acknowledged for several decades that programs interact with context. The nature of this interactivity, and how it defines a program, has not been adequately addressed. We view this lacuna as a function of the dominant theoretical perspectives guiding knowledge of program operations. We propose the actor-network theory (ANT) and its conceptual apparatus, the sociotechnical network, as suitable for guiding the acquisition of general knowledge on program operations. We tested this proposition with an instrumental case study of health professional practices during the implementation of a nutrition program into an elementary school setting. Data collection and analysis were guided by the ANT. Data were derived from semistructured interviews completed with six health professionals (nutritionists). Analysis procedures focused on the nutritionists’ collective representation of the microprocesses by which they aimed to build a sociotechnical network of alliances with educational stakeholders. Findings identified nutritionists as preoccupied with three overarching goals during the implementation of the nutrition program, whereby goals were found to take form interactively with the interests of the program participants (primarily students) and stakeholders (primarily teachers). Nutritionists strategically translated program components as a means of negotiating with participants and stakeholders. The findings of this study support the theoretical proposition that program implementation is a process of expanding a sociotechnical network. Beyond simply reaffirming that programs do indeed adapt to context, we interpret this adaptation through the lens of a social theory that suggests why and how adaptation is an inevitable component of program implementation.
Association between perceived security of the neighbourhood and small-for-gestational-age birth
Publisher: Wiley
Date: 04-08-2008
DOI: 10.1111/J.1365-3016.2008.00959.X
Abstract: Evidence points to an association between a mother's place of residence and her newborn's health, independent of in idual characteristics. Neighbourhood constructs such as immigrant density, deprivation and crime have all been separately associated with birth outcomes. Little research has considered the joint influence of variables representing a spectrum of neighbourhood constructs. Subjective vs. objective measures of neighbourhood constructs (e.g. reported vs. perceived crime) are often not considered. We sought to evaluate the relationship between neighbourhood measures of reported crime, neighbourhood perceived security, immigrant density, material/social deprivation, residential stability and the odds of small-for-gestational-age (SGA) birth in an urban setting in Canada. Neighbourhood was defined as police districts (n = 49). We linked Montreal livebirths 1997-2001 (n = 98 330) to police district crime measures, survey data on perceived security, and 2001 census data. We used multi-level analysis to calculate odds ratios (OR) for neighbourhood effects on SGA birth accounting for in idual characteristics. Mothers residing in neighbourhoods with the most favourable perception had a lower odds of SGA birth than neighbourhoods with the least favourable perception [OR 0.87, 95% CI 0.77, 0.97]. Mothers in neighbourhoods with lower proportions of immigrants had lower odds of SGA birth relative to neighbourhoods with the highest proportion of immigrants. Reported crime, residential stability and material/social deprivation (accounting for neighbourhood perception) were not associated with SGA birth. Immigrant density and subjective perceptions of neighbourhood security are associated with SGA birth. Public health strategies to improve fetal growth should target neighbourhoods with low perceived security and high immigrant density.
The role of living context in prescription opioid injection and the associated risk of hepatitis C infection
Publisher: Wiley
Date: 21-07-2016
DOI: 10.1111/ADD.13470
Abstract: Prescription opioid injection (POI) is a leading risk factor for hepatitis C virus (HCV). Residential context relates to high‐risk injection behaviour. This study assessed whether residence in the inner city (versus surrounding areas in Montréal Island) modified the effects of correlates of POI or the relationship between POI and HCV incidence. Prospective cohort study. Montréal, Canada. A total of 854 people who inject drugs (18% female, 25% age < 30 years), living on Montréal Island, were interviewed every 3–6 months from 2004 to 2012. Study visits included HCV antibody testing and an interviewer‐administered questionnaire. Generalized estimating equations were used to test whether place of residence modified the effects of correlates of POI. Cox regression was used to test whether place of residence modified the relationship between POI and HCV incidence. At baseline, inner‐city participants were more likely to report POI in the past month (40 versus 25%, P < 0.001). The association between POI and heroin injection, syringe sharing and sharing of injecting equipment varied according to place of residence and was greater in the inner city. The hazard of HCV infection associated with POI was greater among inner‐city participants compared to those in the surrounding areas [adjusted hazard ratio (HR) = 3.38, 95% confidence interval (CI) = 1.88–6.07 versus HR = 1.26, 95% CI = 0.65–2.42, P = 0.025]. Among people who inject prescription opioids in Montréal, Canada, those who live in inner‐city areas are more likely to engage in injecting‐related risk behaviours and have a higher risk of hepatitis C virus infection than those who live in the suburbs.
Policy, research and residents’ perspectives on built environments implicated in heart disease: A concept mapping approach
Publisher: MDPI AG
Date: 09-02-2017
Neighborhood resources and social participation among older adults: Results from the VoisiNuage study
Publisher: SAGE Publications
Date: 21-12-2013
Abstract: Objective: This article examined the associations between proximity to selected locations considered to be conducive to social participation, and social participation itself, in urban-dwelling seniors. Methods: A s le of 520 older adults residing in the Montreal area provided reports of social participation and information about health, sociodemographic characteristics, social networks, and perceptions about features of their residential environment. Information about the distance between their home and five locations deemed to be conducive to social participation were obtained from a geographic information system. Results: Analyses showed a significant association between proximity to selected locations and social participation while accounting for in idual characteristics and perceptions of neighborhood features (β = 0.37 SE = 0.17 p 0.05). Discussion: Findings were consistent with contributions highlighting the impact of the built environment on seniors’ health-related behavior. Future work would benefit from the use of longitudinal designs and examinations of social participation through alternate channels.
Associations between Community Environmental-Level Factors and Diet Quality in Geographically Isolated Australian Communities
Publisher: MDPI AG
Date: 31-05-2019
Abstract: Remote Indigenous Australians experience disproportionately poor cardio-metabolic health, which is largely underpinned by adverse dietary intake related to social determinants. Little evidence exists about the community environmental-level factors that shape diet quality in this geographically isolated population group. This study aimed to explore the modifiable environmental-level factors associated with the features of dietary intake that underpin cardio-metabolic disease risk in this population group. Community-level dietary intake data were estimated from weekly store sales data collected throughout 2012 and linked with concurrent social, built, and physical environmental dimension data for 13 remote Indigenous Australian communities in the Northern Territory. Statistical analyses were performed to investigate associations. At the community level, store sales of discretionary foods were lower in communities with greater distance to a neighbouring store (r = −0.45 (p 0.05)). Sales of sugar-sweetened beverages were lower in communities with higher levels of household crowding (r = −0.55 (p 0.05)), higher levels of Indigenous unemployment (r = −0.62 (p = 0.02)), and greater distance to neighbouring stores (r = −0.61 (p = 0.004)). Modifiable environmental-level factors may be associated with adverse diet quality in remote Indigenous Australian communities and further investigations of these factors should be considered when developing policies to improve dietary intake quality in geographically isolated populations.
Describing the Situational Contexts of Sweetened Product Consumption in a Middle Eastern Canadian Community: Application of a Mixed Method Design
Publisher: Public Library of Science (PLoS)
Date: 21-09-2012
Association between neighbourhood socioeconomic characteristics and high-risk injection behaviour amongst injection drug users living in inner and other city areas in Montréal, Canada
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.DRUGPO.2009.01.004
Abstract: Area-level socioeconomic conditions are associated with epidemic rates of viral hepatitis and HIV amongst urban injection drug users (IDUs), but whether specific socioeconomic markers are uniformly related to IDU outcomes across different urban environments is unclear. We evaluated whether injection behaviour is differentially related to neighbourhood socioeconomic characteristics for IDUs in inner city vs. surrounding urban areas. The study population was 468 active IDUs on the Island of Montréal. Neighbourhoods were represented as 500m radius buffers around in idual IDU dwelling places. High-risk injection behaviour (HRIB) was defined dichotomously. Relations between neighbourhood socioeconomic disadvantage (percentage households below low-income cutoff), neighbourhood educational attainment (percentage adults with university degree), and HRIB were assessed using multivariate logistic regression. Stratified analyses were conducted for inner city IDUs (n=219), and those in surrounding areas (n=249). Similar proportions of IDUs in inner city and surrounding areas reported HRIB. Neighbourhood socioeconomic characteristics were not associated with HRIB for IDUs in surrounding areas. For inner city IDUs, those in socioeconomically disadvantaged neighbourhoods were more likely to practice HRIB (OR 4.34 95% CI 1.15-16.35). Conversely, inner city IDUs residing in lower educational attainment neighbourhoods had a lower odds of HRIB (OR 0.41 95% CI 0.21-0.80). HRIB did not vary according to urban environment but for inner-city IDUs was differentially related to socioeconomic markers. Associations between HRIB and neighbourhood socioeconomic disadvantage and lower educational attainment, positive and negative, respectively, indicate that adverse socioeconomic circumstances are not related to a uniformly greater likelihood of HRIB.
Waist-to-hip ratio and adipose tissue distribution: Contribution of subcutaneous adiposity
Publisher: Wiley
Date: 14-04-2003
DOI: 10.1002/AJHB.10165
Abstract: The waist-to-hip ratio (WHR) reflects the relative distribution of adipose tissue in the human body. However, whether this is due to the musculoskeletal structures of the waist and hip or the overlying subcutaneous adipose tissue has been disputed. We measured waist and hip girths in 11 male and 11 female cadavers, aged 55-94 years, before and after complete removal of skin and subcutaneous adipose tissue. Girths measured following removal of subcutaneous adipose tissue were termed "waist gx" and "hip gx", and their ratio "WHRx". Masses of regional adipose tissue segments were obtained by complete dissection, and the adipose mass ratios "trunk/arm-plus-leg", "trunk/leg", "internal/arm-plus-leg", and "internal/leg" were derived. As assessed by analysis of variance, WHR accounted for significant (P < 0.05) portions of the variance in all adipose mass ratios adjustment for internal adipose mass increased the significance of all these relationships (P < 0.005). The ratio WHRx was not related to any ratio of regional adipose masses. Waist girth was related to trunk (P < 0.001) and internal (P < 0.05) adipose masses, and hip girth was related to arm-plus-leg adipose mass (P < 0.0001) and leg adipose mass (P < 0.0001), but waist gx and hip gx were not related to dependent variables. The results indicate that the ability of WHR and waist and hip girths to reflect the regional distribution of adipose tissue in the body is dependent upon the subcutaneous adipose tissue mass of the waist hip area, not its musculoskeletal constituency.
Towards a brain-to-society systems model of individual choice
Publisher: Springer Science and Business Media LLC
Date: 30-09-2008
The impacts of withdrawal and replacement of general practitioner services on aeromedical service trends: A 13-year interrupted time-series study in Tennant Creek, Northern Territory
Publisher: Springer Science and Business Media LLC
Date: 06-2015
Screening for diabetes in indigenous populations using glycated haemoglobin: Sensitivity, specificity, post-test likelihood and risk of disease
Publisher: Wiley
Date: 23-06-2005
DOI: 10.1111/J.1464-5491.2005.01447.X
Abstract: Screening for diabetes using glycated haemoglobin (HbA1c) offers potential advantages over fasting glucose or oral glucose tolerance testing. Current recommendations advise against the use of HbA1c for screening but test properties may vary systematically across populations, according to the diabetes prevalence and risk. We aimed to: (i) characterize the properties of test cut-offs of HbA1c for diagnosis of diabetes relative to a diagnosis based on a fasting plasma glucose concentration of 7.0 mmol/l for high-risk Indigenous populations and (ii) examine test properties across a range of diabetes prevalence from 5 to 30%. Data were collected from Aboriginal and Torres Strait Islander communities in Australia and a Canadian First Nations community (diabetes prevalence 12-22%) in the course of diabetes diagnostic and risk factor screening programmes (n = 431). Screening test properties were analyzed for the range of HbA1c observed (3-12.9%). In separate and pooled analyses, a HbA1c cut point of 7.0% proved the optimal limit for classifying diabetes, with summary analysis results of sensitivity = 73 (56-86)%, specificity = 98 (96-99)%, overall agreement (Youden's index) = 0.71, and positive predictive value (for an overall prevalence of 18%) = 88%. For diabetes prevalence from 5 to 30% the post-test likelihood of having diabetes given HbA1c = 7.0% (positive predictive value) ranged from 62.7 to 93.2% for HbA1c < 7.0%, the post-test likelihood of having diabetes ranged from 4.5 to 27.7%. The results converge with research on the likelihood of diabetes complications in supporting a HbA1c cut-off of 7.0% in screening for diabetes in epidemiological research. Glycated haemoglobin has potential utility in screening for diabetes in high-risk populations.
Place and Posttraumatic Stress Disorder
Publisher: Wiley
Date: 21-07-2016
DOI: 10.1002/JTS.22108
Abstract: Research on traumatic stress has focused largely on in idual risk factors. A more thorough understanding of risk factors may require investigation of the contribution of neighborhood context, such as the associations between perceived neighbourhood disorder and social cohesion with reported trauma exposure (yes/no) and posttraumatic stress disorder (PTSD) diagnostic status (past-year PTSD, remitted). To examine these associations, we used a cross-sectional analysis of an epidemiological catchment area survey (N = 2,433). Visible cues, indicating a lack of order and social control in the community (neighbourhood disorder), were associated with increased trauma exposure (adjusted odds ratio [AOR] = 1.21, 95% confidence interval [CI] [1.12, 1.31]). For trauma-exposed in iduals, neighbourhood disorder was associated with greater odds of lifetime PTSD (AOR = 1.38, 95% CI [1.10, 1.75]), and the willingness of residents who realize common values to intervene for the common good (social cohesion), was associated with lower likelihood of past-year PTSD (AOR = 0.64, 95% CI [0.42, 0.97]). For participants with a lifetime diagnosis of PTSD (including past-year), increased social cohesion was associated with higher odds of remission (AOR = 2.59, 95% CI [1.55, 4.30]). Environmental contexts play a role in the development and progression of PTSD. As such, traumatic stress outcomes may be better understood through a perspective that integrates in idual and contextual risk factors.
Educational Inequalities in Preterm and Term Small-for-Gestational-Age Birth Over Time
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.ANNEPIDEM.2012.01.004
Abstract: Time trends in educational inequalities in small-for-gestational-age (SGA) birth are important to evaluate for policy, especially at preterm gestational ages when morbidity and mortality are typically greater. We evaluated educational inequalities in preterm and term SGA birth over time, accounting for potential bias at preterm gestational ages. Data included 2,204,056 singleton live births from 25 to 43 gestational weeks, 1981 to 2007. We estimated prevalence ratios (PR) and percent prevalence differences (PPD) of preterm and term SGA birth for a continuous education score, accounting for maternal characteristics. Sensitivity analyses included correction for misclassification of preterm SGA status, and use of fetuses-at-risk denominators in regression models. Although prevalence of SGA birth decreased over time, relative educational inequalities (PRs) persisted for preterm and term cases. PPDs decreased slightly, but more for term than preterm SGA birth. Sensitivity analyses indicated that PRs for education were stronger for preterm than term SGA birth. PPDs were larger for term SGA birth in the first period, but greater for preterm SGA birth in the last period. Relative educational inequalities in SGA birth persisted over time. The difference in prevalence between the least and most educated mothers is currently greater for preterm than for term SGA birth.
Stillbirth in an Anglophone minority of Canada
Publisher: Springer Science and Business Media LLC
Date: 15-01-2015
DOI: 10.1007/S00038-015-0650-6
Abstract: We assessed trends in stillbirth over time for Francophones and Anglophones of Quebec, a large Canadian province with publically funded health care and an English-speaking minority. We calculated stillbirth rates for Francophones and Anglophones, and estimated hazard ratios (HR) by decade from 1981 to 2010, adjusting for maternal characteristics. We analyzed temporal trends by gestational interval and cause of fetal death. Stillbirth rates decreased in Quebec during the three decades, due to improved rates in Francophones. Rates decreased for Anglophones in 1991-2000, but increased in 2001-2010 at term, during the second trimester, and for most causes of fetal death. In the 2000s, the hazard of stillbirth for Anglophones was nearly the same as the hazard for Francophones in the 1980s (HR 0.93, 95 % confidence interval 0.82, 1.05). Stillbirth rates declined in both Francophones and Anglophones before the turn of the century, but increased thereafter for Anglophones, suggesting that linguistic inequalities in stillbirth may be emerging in Quebec. Linguistic status may be a useful marker for surveillance of inequalities in stillbirth.
Characterising the smoking status and quit smoking behaviour of aboriginal health workers in South Australia
Publisher: MDPI AG
Date: 13-12-2013
Cadaver-assessed validity of anthropometric indicators of adipose tissue distribution
Publisher: Springer Science and Business Media LLC
Date: 14-08-2003
Assessing community readiness online: A concurrent validation study
Publisher: Springer Science and Business Media LLC
Date: 02-07-2015
Prioritizing Built Environmental Factors to Tackle Chronic and Infectious Diseases in Remote Northern Territory (NT) Communities of Australia: A Concept Mapping Study
Publisher: MDPI AG
Date: 13-05-2021
Abstract: High prevalence of chronic and infectious diseases in Indigenous populations is a major public health concern both in global and Australian contexts. Limited research has examined the role of built environments in relation to Indigenous health in remote Australia. This study engaged stakeholders to understand their perceptions of the influence of built environmental factors on chronic and infectious diseases in remote Northern Territory (NT) communities. A preliminary set of 1120 built environmental indicators were systematically identified and classified using an Indigenous Indicator Classification System. The public and environmental health workforce was engaged to consolidate the classified indicators (n = 84), and then sort and rate the consolidated indicators based on their experience with living and working in remote NT communities. Sorting of the indicators resulted in a concept map with nine built environmental domains. Essential services and Facilities for health/safety were the highest ranked domains for both chronic and infectious diseases. Within these domains, adequate housing infrastructure, water supply, drainage system, reliable sewerage and power infrastructure, and access to health services were identified as the most important contributors to the development of these diseases. The findings highlight the features of community environments amenable to public health and social policy actions that could be targeted to help reduce prevalence of chronic and infectious diseases.
Geographic Clustering of Cardiometabolic Risk Factors in Metropolitan Centres in France and Australia
Publisher: MDPI AG
Date: 21-05-2016
Finite Element Failure Analysis of GFRP Laminates in Plate-Cone Reticulated Shell
Publisher: Hindawi Limited
Date: 19-06-2020
DOI: 10.1155/2020/2809302
Abstract: Plate-cone reticulated shell is a new type of spatial structures with good mechanical behavior, technical economy, and architectural appearance. In this paper, using ANSYS software, the strength failure analysis model of composite laminates is established in cooperation with the Strength Criterion of Hoffman. The effects of layer number, laying direction, and thickness of laminates on the ultimate strength of laminates are studied by detailed parametric analysis, which provides a theoretical basis for the design of composite plate-cone reticulated shell and GFRP laminated plates. Some important conclusions are obtained and can be applied to engineering practice.
Contribution of local area deprivation to cultural-linguistic inequalities in foetal growth restriction: Trends over time in a canadian metropolitan centre
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.HEALTHPLACE.2013.03.003
Abstract: This study investigated temporal trends in heterogeneity of foetal growth restriction across neighbourhood deprivation levels for two culturally distinct communities (Anglophones and Francophones) in a North American metropolitan centre. Inequalities in foetal growth restriction related to deprivation fell from 1989 to 2008 for Francophones, but initial improvements for Anglophones later reversed with a rise in poor foetal growth in the most materially disadvantaged and, unexpectedly, advantaged areas as well. Inequalities in foetal growth restriction related to neighbourhood material deprivation may be emerging in this minority Anglophone population. Potential mechanisms underlying these trends are discussed, as well as implications for perinatal health policy.
The joint influence of marital status, interpregnancy interval, and neighborhood on small for gestational age birth: A retrospective cohort study
Publisher: Springer Science and Business Media LLC
Date: 28-02-2008
Factors influencing health care utilisation among Aboriginal cardiac patients in central Australia: A qualitative study
Publisher: Springer Science and Business Media LLC
Date: 06-03-2013
Abstract: Aboriginal Australians suffer from poorer overall health compared to the general Australian population, particularly in terms of cardiovascular disease and prognosis following a cardiac event. Despite such disparities, Aboriginal Australians utilise health care services at much lower rates than the general population. Improving health care utilisation (HCU) among Aboriginal cardiac patients requires a better understanding of the factors that constrain or facilitate use. The study aimed to identify ecological factors influencing health care utilisation (HCU) for Aboriginal cardiac patients, from the time of their cardiac event to 6–12 months post-event, in central Australia. This qualitative descriptive study was guided by an ecological framework . A culturally-sensitive illness narrative focusing on Aboriginal cardiac patients’ “typical” journey guided focus groups and semi-structured interviews with Aboriginal cardiac patients, non-cardiac community members, health care providers and community researchers. Analysis utilised a thematic conceptual matrix and mixed coding method. Themes were categorised into Predisposing, Enabling, Need and Reinforcing factors and identified at In idual, Interpersonal, Primary Care and Hospital System levels. Compelling barriers to HCU identified at the Primary Care and Hospital System levels included communication, organisation and racism. In idual level factors related to HCU included language, knowledge of illness, perceived need and past experiences. Given these in idual and health system barriers patients were reliant on utilising alternate family-level supports at the Interpersonal level to enable their journey. Aboriginal cardiac patients face significant barriers to HCU, resulting in sub-optimal quality of care, placing them at risk for subsequent cardiovascular events and negative health outcomes. To facilitate HCU amongst Aboriginal people, strategies must be implemented to improve communication on all levels and reduce systemic barriers operating within the health system.
Changing Primary School Children’s Engagement in Active School Travel Using Safe Routes to School Interventions: A Rapid Realist Review
Publisher: MDPI AG
Date: 12-08-2022
Abstract: Safe Routes to School (SR2S) interventions have been implemented in many economically developed countries to improve children’s engagement in Active School Travel (AST). Evaluations have highlighted inconsistencies in SR2S intervention outcomes, raising questions as to how, why, and under what contextual conditions these interventions work. This review used a Rapid Realist Review (RRR) methodology to build, test, and refine an overarching program theory that unpicks the contextual factors and underlying mechanisms influencing children’s engagement in AST. From the 45 included documents, 16 refined Context–Mechanism–Outcome Configurations (CMOCs) were developed and clustered into three partial program theories (i.e., implementor/implementation, child, and parent), with the associated mechanisms of: (1) School Reliance (2) School Priority (3) Fun (4) Pride (5) Perceived Safety (6) Distrust (7) Convenience (8) Perceived Capabilities and (9) Reassurance. The overarching program theory delineates the pathways between intervention implementation, children’s motivation, parental decision-making, and children’s engagement in AST. The findings suggest SR2S interventions can motivate children to engage in AST, but whether this motivation is translated into engagement is determined by parental decision-making. This review is novel for highlighting that many of the factors influencing parental decision-making are contextually driven and appear to be unaddressed by the current suite of SR2S intervention strategies. The review additionally highlights the complexity of parental perceptions of safety, with the traffic and the road environment shaping only part of this multidimensional mechanism. Practitioners and policymakers need to tailor SR2S interventions to local contexts to better influence parental decision-making for children’s engagement in AST.
Methodology for establishing demographic, development and environmental geospatial data surveillance platform in the context of a resource constrained environment: lessons from SOMAARTH DDESS, Palwal
Publisher: JMIR Publications Inc.
Date: 05-01-2018
Abstract: nadequate administrative health data, sub-optimal public health infrastructure, rapid and unplanned urbanization,environmental degradation and poor penetration of information technology make the tracking of health and well being of the populations within developing countries more challenging. This necessitates setting-up comprehensive surveillance platforms integrated with the information technologies that can cater to the full spectrum of the public health problems. his manuscript aims to provide methodological insights on establishing GIS integrated comprehensive surveillance platform in resource constrained rural settings. he INCLEN (International Clinical Epidemiology Network) Trust International established a comprehensive SOMAARTH Demographic, Development and Environmental Surveillance Site (DDESS) in a northern Indian rural setting. The surveillance platform evolved through adopting four major steps: 1) site preparation 2) data construction 3) data quality assurance 4) data update and maintenance system. Arc GIS 10.3 and QGIS 2.14 software were employed for geo-spatial data construction. Surveillance data architecture was built upon the geo-referenced land parcel data sets. The composition data pertaining to the land use (residential, non-residential, and vacant), water bodies, roads, railways, community trails, landmarks, water, sanitation and food environment, weather and air quality, demographic characteristics were constructed in relational manner within the surveillance platform. comprehensive surveillance platform encompassing 0.2 million population residing in 51 villages over a land mass of 251.7 sq. Km having 32,662 households and 19,260 nonresidential features (cattle shed, shops, health, education, banking, religious institutions etc.) is established. The processes adopted for sub ision of villages into sectors helped in developing geo-referenced location identification system in a setting where no postal addresses or postal codes system were in place. Also the socially and economically homogeneous community clusters (78% of 676 sectors) which usually hide within the village aggregates were disclosed. Characterization and storage of variety of data sets critical for health and epidemiology and generation of new information e.g. water, sanitation and hygiene through geo-analytics were demonstrated. Settlement pattern was compact to the extent that 80% of habitation was concentrated in 9% of the total village area. Community involvement proved helpful in the ground-truthing of the data sets for ascertaining the level of positional, temporal and attribute accuracies and identification of small habitations, missing in the official records. OMAARTH experience allowed characterization and monitoring of wide range of attributes from demography, development, and environmental domains and developed geospatial inter-phase to explore and explain their dynamic relationships, associations and pathways across multiple levels i.e. in idual, household, neighborhood, and village. The methodology takes care of the common challenges faced while building information system in the developing countries. However generalizability and scalability needs to be tested in other resource constrained settings as well.
Finite mixture models in neighbourhoods-to-health research: A systematic review
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.HEALTHPLACE.2019.05.018
Abstract: A systematic review was conducted, following PRISMA guidelines, to examine the application of finite mixture models (FMMs) in the study of neighbourhoods and health. Two reviewers screened 814-studies identified through database searches and citation tracking. Data were extracted from 19-studies that met the inclusion criteria, and a risk of bias analysis undertaken. Data were synthesised narratively, with a focus on methodological issues idiosyncratic to FMMs. Motivated by a desire to account for neighbourhood heterogeneity, studies sought to identify meaningful neighbourhood-level typologies that explained the distributional nature of health outcomes. Neighbourhood-centred applications of FMMs were promising but there remains scope for advancement. Research-based recommendations are outlined to strengthen prospective neighbourhood-centred studies applying FMMs.
Conceptual and Operational Considerations in Identifying Socioenvironmental Factors Associated with Disability among Community-Dwelling Adults
Publisher: MDPI AG
Date: 03-04-2015
Telephone call reminders did not increase screening uptake more than SMS reminders: a recruitment study within a trial.
Publisher: Elsevier BV
Date: 08-2001
DOI: 10.1016/J.JCLINEPI.2019.04.009
Abstract: The aim of the study was to compare the response rates and costs of phone call vs. short message service (SMS) screening reminders to prospective randomized controlled trial (RCT) participants. This study was a randomized evaluation within a large Australian diabetes prevention RCT. Participants were men aged 50-74 years, overweight or obese, without a previous type 2 diabetes diagnosis. Those eligible on a prescreening questionnaire who did not attend a further screening assessment within 4 weeks were randomized to receive an SMS or phone call reminder (N = 709). The primary outcome was attendance for further screening assessment within 8 weeks of prescreening. Attendance was 18% (62/354) in the SMS reminder group, and 23% (80/355) in the phone reminder group, with no statistically significant difference in response according to reminder type (relative risk = 1.29, 95% confidence interval [CI]: 0.96-1.73, P = 0.09). The lower confidence limits for response to SMS (95% CI: 14-22%) and phone reminders (95% CI: 18-27%) did not include the 8-week attendance rate before this evaluation, 12%. Phone reminders cost substantially more than SMS reminders (AU$6.21 vs. AU$0.53 per reminder). SMS reminders were as adequate a method as phone reminders to boost RCT screening uptake and were considerably more affordable.
The food environment and diet quality of urban-dwelling older women and men: Assessing the moderating role of diet knowledge
Publisher: Springer Science and Business Media LLC
Date: 2016
Life expectancy gap between the Francophone majority and Anglophone minority of a Canadian population
Publisher: Springer Science and Business Media LLC
Date: 28-12-2012
DOI: 10.1007/S10654-011-9644-8
Abstract: Language is an important determinant of health, but analyses of linguistic inequalities in mortality are scant, especially for Canadian linguistic groups with European roots. We evaluated the life expectancy gap between the Francophone majority and Anglophone minority of Québec, Canada, both over time and across major provincial areas. Arriaga's method was used to estimate the age and cause of death groups contributing to changes in the life expectancy gap at birth between 1989-1993 and 2002-2006, and to evaluate patterns across major provincial areas (metropolitan Montréal, other metropolitan centres, and small cities/rural areas). Life expectancy at birth was greater for Anglophones, but the gap decreased over time by 1.3 years (52% decline) in men and 0.9 years (47% decline) in women, due to relatively sharper reductions in Francophone mortality from several causes, except lung cancer which countered reductions in women. The life expectancy gap in 2002-2006 was widest in other metropolitan centres (men 5.1 years, women 3.2 years), narrowest in small cities/rural areas (men 0.8 years, women 0.7 years), and tobacco-related causes were the main contributors. Only young Anglophones <40 years in small cities/rural areas had mortality higher than Francophones, resulting in a narrower gap in these areas. Differentials in life expectancy favouring Anglophones decreased over time, but varied across areas of Québec. Tobacco-related causes accounted for the majority of the current life expectancy gap.
Associations of Supermarket Characteristics with Weight Status and Body Fat: A Multilevel Analysis of Individuals within Supermarkets (RECORD Study)
Publisher: Public Library of Science (PLoS)
Date: 04-04-2012
Practical utility of general practice data capture and spatial analysis for understanding COPD and asthma
Publisher: Springer Science and Business Media LLC
Date: 26-11-2018
Framing the biosocial pathways underlying associations between place and cardiometabolic disease
Publisher: Elsevier BV
Date: 06-2008
DOI: 10.1016/J.HEALTHPLACE.2007.05.003
Abstract: Causal inference regarding the impact of place on health is constrained by limited attention to the biological plausibility of associations. The utility of such evidence also requires demonstrating that place-based exposures precede effects on health. We propose a conceptual framework that integrates time and two plausible biosocial pathways by which the geospatial clustering of social disadvantage might be viewed as causally related to the development of cardiovascular and glycemic disease. The framework distinguishes environmental risk conditions that condition the expression of in idual behavioural and psychosocial characteristics, and socioeconomic and material conditions that influence regulatory systems through conscious and non-conscious mechanisms.
Effectiveness of discharge education on outcomes in acute coronary syndrome patients: a systematic review protocol
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2018
DOI: 10.11124/JBISRIR-2017-003543
Abstract: The question of this review is what is the effectiveness of discharge education on outcomes in acute coronary syndrome patients?
Testosterone therapy to prevent type 2 diabetes mellitus in at-risk men (T4DM): Design and implementation of a double-blind randomized controlled trial.
Publisher: Wiley
Date: 04-01-2019
DOI: 10.1111/DOM.13601
Abstract: Low circulating testosterone is associated with an increased risk of developing type 2 diabetes (T2DM) in overweight men with impaired glucose tolerance (IGT). To determine in a multi-centre, double-blinded placebo-controlled randomized trial whether testosterone treatment combined with lifestyle intervention (Weight Watchers) relative to lifestyle intervention alone reduces T2DM incidence and improves glucose tolerance at 2 years. Overweight or obese men aged 50-74 years with a serum testosterone of ≤14 nmol/L and IGT or newly diagnosed T2DM established by an oral glucose tolerance test (OGTT). Six Australian capital city-based tertiary care centres. Participants were randomized 1:1 and injected with testosterone undecanoate (1000 mg/4 mL) or vehicle (4 mL castor oil), at baseline, 6 weeks and 3-monthly thereafter. PRIMARY ENDPOINTS: (a) Proportion of participants with 2-hour OGTT ≥11.1 mmol/L at 2 years, and (b) a difference at 2 years ≥0.6 mmol/L in the mean 2-hour OGTT glucose between treatments. Fasting insulin, HbA1c, body composition, maximal handgrip strength sexual function and lower urinary tract symptoms serum sex steroids and sex hormone binding globulin mood and psychosocial function adherence to lifestyle intervention and healthcare utilization and costs. Overseen by an Independent Data Safety Monitoring Committee. Haematocrit, lipids and prostate-specific antigen (PSA) are assessed 6-monthly and information relating to haematological, urological and cardiovascular adverse events from each clinic visit. SUB-STUDIES: (a) Changes in bone density and micro-architecture, (b) motivation and behaviour, (c) telomere length, (d) extended treatment up to 4 years, and (e) hypothalamo-pituitary testicular axis recovery at treatment end.
Children and youth perceive smoking messages in an unbranded advertisement from a NIKE marketing campaign: A cluster randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 08-04-2011
Interactions between neighborhood characteristics and individual functional status in relation to disability among Québec urbanites
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.DHJO.2013.02.004
Abstract: Disability is conceived as a person-context interaction. Neighborhoods are among the contexts potentially influencing disability. It is thus expected that neighborhood characteristics will be associated with disability prevalence and that such associations will be moderated by in idual-level functional status. Empirical research targeting the influences of features of urban environments is relatively rare. To evaluate the presence of contextual differences in disability prevalence and to assess the moderating role of in idual functional status on the association between neighborhood characteristics and disability prevalence. Multi-level analyses of in idual-level data obtained from the Canadian Community Health Survey and neighborhood-level data derived from the Canada census. A contextual component was observed in the variability of disability prevalence. Significant neighborhood-level differences in disability were found across levels of social deprivation. Evidence of person-place interaction was equivocal. The contextual component of the variability in disability prevalence offers potential for targeting interventions to neighborhoods. The pathway by which social structure is associated with disability prevalence requires further research. Analyses of particular functional limitations may enhance our understanding of the mechanisms by which socioenvironmental factors affect disability. Publicly available survey data on disability in the general Canadian population, while useful, has limitations with respect to estimating socioenvironmental correlates of disability and potential person-place interactions.
Community-based prevention and chronic disease self-management programmes: Problems, praises and pitfalls
Publisher: Springer Science and Business Media LLC
Date: 1999
Prevalence of psychological distress and mental disorders, and use of mental health services in the epidemiological catchment area of Montreal South-West
Publisher: Springer Science and Business Media LLC
Date: 30-10-2012
Paradigm change and uncertainty about funding of public health research: Social and scientific implications
Publisher: Informa UK Limited
Date: 05-06-1998
Sustained drug use changes after hepatitis c screening and counseling among recently infected persons who inject drugs: A longitudinal study
Publisher: Oxford University Press (OUP)
Date: 20-12-2014
DOI: 10.1093/CID/CIT938
Abstract: Notification of hepatitis C virus (HCV) positive status is known to have short-term impacts on subsequent alcohol, drug use and injection behaviors among persons who inject drugs (PWID). It remains to be established whether postscreening behavioral changes extend over time for PWID and whether screening test notification has behavioral impacts among HCV-negative PWID. This study sought to longitudinally assess substance use and injection behaviors after HCV status notification among HCV seroconverters and HCV-negative PWID. Initially HCV-seronegative PWID (n = 208) were followed prospectively between 2004 and 2011 in Montreal, Canada. Semiannual screening visits included blood s ling and an interview-administered questionnaire assessing substance use and injection behaviors. Multivariable generalized estimating equation analyses were conducted to assess substance use and behavior changes over time and compare changes between HCV seroconverters and HCV-seronegative participants while adjusting for baseline characteristics. Of the 208 participants (83% male mean age, 34.7 years, mean follow-up time, 39 months), 69 (33.2%) seroconverted to HCV. A linear decrease in syringe sharing behavior was observed over time after HCV and status notification, whereas a 10% decrease for each additional 3 months of follow-up was observed for injection cocaine and heroin use among HCV seroconverters but not among HCV-seronegative PWID (P < .05). No significant changes were observed in alcohol use. Our results indicate that notification of HCV-positive status is associated with reduced injection drug use among seroconverters. Among PWID deemed seronegative after screening, there is no sustained trend for change in risk behavior.
Associations among education, cortisol rhythm, and BMI in blue-collar women
Publisher: Wiley
Date: 02-2006
DOI: 10.1038/OBY.2006.42
Abstract: This study sought to test whether a biological measure of chronic stress, Delta cortisol, was related to BMI and whether the relationship between Delta cortisol and BMI varied according to education and positive affect. One hundred fifty-four women from a blue-collar women's health project in 11 industrial sites in rural North Carolina provided saliva for cortisol assays for a substudy on "stress." Delta Cortisol, the difference between awakening and midday cortisol measures representing diurnal decline, was calculated (lower values = greater stress). BMI was regressed on Delta cortisol, education, and positive affect. Analyses were controlled for age, race, and worksite. Standardized beta-coefficients were calculated. For participants with complete data (n = 129), BMI was greater (beta 95% confidence interval) for women with less than high school education (0.56 0.18, 0.94) and those who completed high school (0.26 -0.05, 0.57) relative to women with greater than a high school education (p = 0.009). Delta Cortisol was inversely related to BMI (-0.32 -0.59, -0.05 p = 0.022). Education positively modified the inverse relationship between Delta cortisol and BMI (p = 0.047). Positive affect was negatively associated with BMI (-0.44 -0.82, -0.06 p = 0.026) and positively modified the inverse association between Delta cortisol and BMI (0.33 -0.03, 0.69 p = 0.074). Education and Delta cortisol were inversely related to BMI, and the magnitude of the association between Delta cortisol and BMI was buffered by higher education. Positive affect was inversely related to BMI. Chronic stress is associated with higher BMI, with this relation attenuated by higher education and, possibly, a positive affect.
Sex ratio patterns according to Asian ethnicity in Québec, 1981-2004
Publisher: Springer Science and Business Media LLC
Date: 25-12-2009
DOI: 10.1007/S10654-008-9307-6
Abstract: Elevated ratios of male to female births are emerging in Asian countries due to selective abortion of female foetuses. Little research has evaluated the possibility of sex selection among Asians in the West. We evaluated patterns in the secondary sex ratio (SSR, number of male per 100 female births) according to ethnicity in Québec, Canada. We performed a population-based retrospective analysis of live and still births in urban Québec, 1981-2004 (N = 1,612,614 live births). Outcomes included: (1) first and second order SSR over four consecutive 6-year intervals analysed according to parental mother tongue, parental birth region, and mothers still speaking her mother tongue at home, (2) adjusted relative risk (RR) of female birth by parental ethnicity, and (3) estimated number of unborn females. For the period 1987-1992, first order SSRs were elevated (range 118-121) for Indo-Pakistani parental mother tongue and mothers currently speaking Indo-Pakistani at home. Second order SSRs were not elevated. For Indo-Pakistani mother tongues, the RR of female birth was lower than French/English in the same period (adjusted RR 0.96, 95% CI 0.92-0.99). SSRs were not imbalanced in the late 1990s among Indo-Pakistani parents, or among Chinese ethnicity in any study period. The SSR in Québec was elevated in the 1980s and early 1990s among firstborn relative to subsequent born infants of Indo-Pakistani descent. The reason for this imbalance is unclear. Further research in other Western settings is necessary to evaluate the possibility of sex selection.
Hypertriglyceridemic waist and newly-diagnosed diabetes among remote-dwelling indigenous Australians
Publisher: Informa UK Limited
Date: 19-07-2013
DOI: 10.3109/03014460.2013.806588
Abstract: Hypertriglyceridemic waist (HTgW) is predictive of cardiovascular disease. The HTgW relationship with diabetes is little studied. This study analysed data from diabetes and cardiovascular risk factor screening programmes in remote Indigenous Australian settlements. Elevated waist girth (EW) was defined as ≥90 cm for men (n = 1134) or ≥80 cm for women (n = 1313). Hypertriglyceridemia (ETg) was defined as ≥1.7 mmol/L. Diabetes was defined as fasting plasma glucose ≥7.0 mmol/L. Body mass index (BMI) was categorised as 25.0 kg/m(2). Logistic regression was used to analyse the odds of newly-diagnosed diabetes for in iduals with either HTgW, ETg or EW, relative to in iduals with values below cut-offs. The prevalence of HTgW was 33.2% for men and 34.8% for women. Accounting for age-group and gender, newly-diagnosed diabetes was associated (odds ratio (OR) (95% confidence interval)) with HTgW: 9.6 (6.6, 13.8). The relationship remained strong after accounting for the covariates BMI and smoking (OR = 4.9 (2.7, 8.8)). In BMI-stratified analyses the strongest odds were observed for the lowest category (<22 kg/m(2): OR = 12.9 (4.0, 41.7)). HTgW has a high prevalence and is associated with newly-diagnosed diabetes in Indigenous people, particularly those with BMI <22 kg/m(2), whom clinicians might not normally consider for screening.
Rising disparities in severe adverse birth outcomes among Haitians in Québec, Canada, 1981-2006
Publisher: Springer Science and Business Media LLC
Date: 20-03-2012
DOI: 10.1007/S10903-011-9460-Y
Abstract: Perinatal health data for Haitians are scant. We evaluated adverse birth outcomes for Haitians in Québec, Canada. We analyzed 2,124,909 live births from 1981 to 2006. Haitian ethnicity was assessed using maternal birth country (Haiti, other Caribbean country, other foreign country, Canada) and home language (Creole, French/English but Creole mother tongue, French/English, other). Associations between ethnicity and preterm birth (PTB), low birth weight (LBW), and small-for-gestational-age (SGA) birth were calculated. Adverse birth outcomes were more common among mothers with Haitian ethnicity. Relative to Canadian-born mothers, odds for Haitian-born mothers were 4 times greater for extreme PTB (≤27 weeks), twice greater for very PTB (28-31 weeks), and 25% higher for moderate PTB (32-36 weeks). Patterns were similar for SGA birth and severe cases of LBW. Despite overall decreases LBW and SGA birth, relative and absolute inequalities increased over time. Perinatal health inequalities are increasing for Haitian-born mothers.
Internal consistency, concurrent validity, and discriminant validity of a measure of public support for Policies for Active Living in Transportation (PAL-T) in a population-based sample of adults
Publisher: Springer Science and Business Media LLC
Date: 10-01-2012
Evaluation of data accuracies within a comprehensive geospatial-health data surveillance platform: SOMAARTH Demographic Development and Environmental Surveillance Site, Palwal, Haryana, India
Publisher: Hindawi Limited
Date: 2018
DOI: 10.1017/GHEG.2018.17
Abstract: Evidence exists of an increasing prevalence of chronic conditions within developed and developing nations, notably for priority population groups. The need for the collection of geospatial data to monitor the health impact of rapid social-environmental and economic changes occurring in these countries is being increasingly recognized. Rigorous accuracy assessment of such geospatial data is required to enable error estimation, and ultimately, data utility for exploring population health. This research outlines findings from a field-based evaluation exercise of the SOMAARTH DDESS geospatial-health platform. Participatory-based mixed methods have been employed within Palwal-India to capture villager perspectives on built infrastructure across 51 villages. This study, conducted in 2013, included an assessment of data element position and attribute accuracy undertaken in six villages, documenting mapping errors and land parcel changes. Descriptive analyses of 5.1% ( n = 455) of land parcels highlighted some discrepancies in position (6.4%) and attribute (4.2%) accuracy, and land parcel changes (17.4%). Furthermore, the evaluation led to a refinement of the existing geospatial health platform incorporating ground-truthed reflections from the participatory field exercise. The evaluation of geospatial data accuracies contributes to understandings on global public health surveillance systems, outlining the need to systematically consider assessment of environmental features in relation to lifestyle-related diseases.
Residential proximity to gasoline service stations and preterm birth
Publisher: Springer Science and Business Media LLC
Date: 28-04-2013
DOI: 10.1007/S11356-013-1677-Y
Abstract: Preterm birth (PTB) is a growing public health problem potentially associated with ambient air pollution. Gasoline service stations can emit atmospheric pollutants, including volatile organic compounds potentially implicated in PTB. The objective of this study was to evaluate the relationship between residential proximity to gasoline service stations and PTB. Singleton live births on the Island of Montreal from 1994 to 2006 were obtained (n=267,478). Gasoline service station locations, presence of heavy-traffic roads, and neighborhood socioeconomic status (SES) were determined using a geographic information system. Multivariable logistic regression was used to analyze the association between PTB and residential proximity to gasoline service stations (50, 100, 150, 200, 250, and 500 m), accounting for maternal covariates, neighborhood SES, and heavy-traffic roads. For all distance categories beyond 50 m, presence of service stations was associated with a greater odds of PTB. Associations were robust to adjustment for maternal covariates for distance categories of 150 and 200 m but were nullified when adjusting for neighborhood SES. In analyses accounting for the number of service stations, the likelihood of PTB within 250 m was statistically significant in unadjusted models. Associations were, however, nullified in models accounting for maternal covariates or neighborhood SES. Our results suggest that there is no clear association between residential proximity to gasoline service stations in Montreal and PTB. Given the correlation between proximity of gasoline service stations and SES, it is difficult to delineate the role of these factors in PTB.
Shell fluctuating asymmetry in the sea-dwelling benthic bivalve Mytilus galloprovincialis (Lamarck, 1819) as morphological markers to detect environmental chemical contamination
Publisher: Springer Science and Business Media LLC
Date: 10-02-2017
DOI: 10.1007/S10646-017-1772-9
Abstract: Investigations on asymmetries showed that deviations from perfect bilateral symmetry are interpreted as environmental changes inducing developmental instability. Since morphological abnormalities increase with pollution, deformations may be considered indicators of the organism exposition to pollution. Therefore, the onset of asymmetry in otherwise normally symmetrical traits has been used as a measure of some stresses as well. In this context, we studied how marine pollution affects the valve morphological alterations in the mussel Mytilus galloprovincialis. We used 180 specimens (30 per site) from the aquaculture area of Goro (River Po delta, northern Adriatic Sea), translocated, and released within 50 × 50 × 50 cm cages in five sites: two disturbed and one undisturbed near Naples (eastern Tyrrhenian Sea), and one disturbed and one undisturbed near Siracusa (western Ionian Sea). Disturbed sites were stressed by heavy industrialization and heavy tankers traffic of crude and refined oil, and were defined basing on sediment contamination. In particular, by the cone-beam computed tomography we obtained 3D virtual valve surfaces to be analyzed by the geometric morphometric techniques. Specifically, we focused the levels of the shell shape fluctuating asymmetry in relation to the degrees of marine pollution in different sites of the Tyrrhenian Sea. The Mahalanobis distances (interpreted as proxy of the in idual shape asymmetry deviation from the mean asymmetry) significantly regressed with the sediment contamination gradient. Indeed, although the left-right differences were normally distributed in each studied site, the in idual asymmetry scores (IAS) significantly varied amongst the investigated sites. IAS showed higher values in disturbed areas than those of undisturbed ones in both Tyrrhenian and Ionian Sea. Our results are consistent with past studies on molluscans and other taxa, demonstrating some detrimental effects of chemicals on organisms, although the investigated morphological marker did not discriminate the real disturbance source. Our findings indicate that the mussels act as a prognostic tool for sea pollution levels driving detrimental effects on benthic community.
A high-volume, low-cost approach to participant screening and enrolment: Experiences from the T4DM diabetes prevention trial.
Publisher: SAGE Publications
Date: 03-10-2019
Abstract: Participant recruitment to diabetes prevention randomised controlled trials is challenging and expensive. The T4DM study, a multicentre, Australia-based, Phase IIIb randomised controlled trial of testosterone to prevent Type 2 diabetes in men aged 50–74 years, faced the challenge of screening a large number of prospective participants at a small number of sites, with few staff, and a limited budget for screening activities. This article evaluates a high-volume, low-cost, semi-automated approach to screen and enrol T4DM study participants. We developed a sequential multi-step screening process: (1) web-based pre-screening, (2) laboratory screening through a network of third-party pathology centres, and (3) final on-site screening, using online data collection, computer-driven eligibility checking, and automated, email-based communication with prospective participants. Phone- and mail-based data collection and communication options were available to participants at their request. The screening process was administered by the central coordinating centre through a central data management system. Screening activities required staffing of approximately 1.6 full-time equivalents over 4 years. Of 19,022 participants pre-screened, 13,108 attended a third-party pathology collection centre for laboratory screening, 1217 received final, on-site screening, and 1007 were randomised. In total, 95% of the participants opted for online pre-screening over phone-based pre-screening. Screening costs, including both direct and staffing costs, totalled AUD1,420,909 (AUD75 per subject screened and AUD1411 per randomised participant). A multi-step, semi-automated screening process with web-based pre-screening facilitated low-cost, high-volume participant enrolment to this large, multicentre randomised controlled trial. Centralisation and automation of screening activities resulted in substantial savings compared to previous, similar studies. Our screening approach could be adapted to other randomised controlled trial settings to minimise the cost of screening large numbers of participants.
Concurrent assessment of urban environment and cardiometabolic risk over 10 years in a middle‐aged population‐based cohort
Publisher: Wiley
Date: 08-11-2018
Is walkability associated with a lower cardiometabolic risk?
Publisher: Elsevier BV
Date: 05-2013
DOI: 10.1016/J.HEALTHPLACE.2013.01.009
Abstract: Walkability of residential environments has been associated with more walking. Given the health benefits of walking, it is expected that people living in locations with higher measured walkability should have a lower risk of cardiometabolic diseases. This study tested the hypothesis that higher walkability was associated with a lower cardiometabolic risk (CMR) for two administrative spatial units and three road buffers. Data were from the North West Adelaide Health Study first wave of data collected between 2000 and 2003. CMR was expressed as a cumulative sum of six clinical risk markers, selected to reflect components of the metabolic syndrome. Walkability was based on an established methodology and operationalised as dwelling density, intersection density, land-use mix and retail footprint. Walkability was associated with lower CMR for the three road buffer representations of the built environment but not for the two administrative spatial units. This may indicate a limitation in the use of administrative spatial units for analyses of walkability and health outcomes.
Neighborhood poverty and self-reported health among low-income, rural women, 50 years and older
Publisher: Elsevier BV
Date: 09-2003
DOI: 10.1016/S1353-8292(02)00058-8
Abstract: We examined the relationship between neighborhood socioeconomic context and self-reported health among low-income, rural women aged 50+ years, without a history of breast cancer. Tract-level census data were linked to in idual level data from the baseline survey of a community trial to increase breast cancer screening rates. Generalized estimating equations were used to analyze data for 1988 women and 56 census tracts. Neighborhood poverty was associated with a greater likelihood of poor self-reported health, adjusted for age, race and socioeconomic status (OR=1.35, 95% CI=1.08-1.68). This effect was greatest for in iduals with incomes below the median neighborhood income.
The association between rural-urban continuum, maternal education and adverse birth outcomes in Québec, Canada
Publisher: Wiley
Date: 09-2009
DOI: 10.1111/J.1748-0361.2009.00242.X
Abstract: Rural relative to urban area and low socioeconomic status (SES) are associated with adverse birth outcomes. Whether a graded association of increasing magnitude is present across the urban-rural continuum, accounting for SES, is unclear. We examined the association between rural-urban continuum, SES and adverse birth outcomes. Singleton births from 1999 to 2003 (n = 356,147) were linked to Québec municipalities ranked on a continuum of 3 urban and 4 rural areas based on population and economic base. Maternal education was used to represent SES. Odds ratios (OR) were calculated for preterm birth (PTB), low birth weight (LBW), and small-for-gestational-age (SGA) birth, accounting for municipality and in idual-level covariates. We used stratified analyses to examine interaction between SES and rural-urban continuum. Relative to metropolitan area residence, living in small urban or rural areas was associated with adverse birth outcomes. Living in rural areas was associated with SGA birth (OR 1.11, 95% CI 1.05-1.17) and LBW (OR 1.15, 95% CI 1.05-1.26), and living in small urban areas was associated with PTB (OR 1.14, 95% CI 1.08-1.20). Upon stratification by education, living in remote rural relative to metropolitan areas was associated with adverse birth outcomes among university educated mothers only, and living in small urban areas was associated with adverse birth outcomes among mothers with lesser but not higher education. An SES gradient was present in all rural-urban areas, particularly for SGA birth. Differences in perinatal health exist across the rural-urban continuum, and maternal education has a modifying influence.
Transit use and walking as potential mediators of the association between accessibility to services and amenities and social participation among urban-dwelling older adults: Insights from the VoisiNuAge study
Publisher: Elsevier BV
Date: 03-2015
Mediation and modification of the association between hopelessness, hostility, and progression of carotid atherosclerosis
Publisher: Springer Science and Business Media LLC
Date: 02-2005
DOI: 10.1007/S10865-005-2563-Y
Abstract: Hopelessness and hostility are linked to progression of carotid atherosclerosis (PCA). The purpose of this study was to replicate such relations and to evaluate the role of biological pathways involving hyperactivation of the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenocortical (HPA) axis. PCA was evaluated by 4-year change in three ultrasound measures of intima-media thickness (IMT) in 1027 men aged 42-60 years at baseline. Effect modification and mediation of relationships between psychosocial factors and PCA were examined for the measures systolic blood pressure (SBP), fibrinogen, and waist-to-hip ratio (WHR), levels of which are indicative of activity along these pathways. Hopelessness and hostility were associated with PCA. Fibrinogen mediated to a moderate extent the association between hopelessness and PCA. SBP significantly modified the relation between hostility and PCA in participants of moderate hostility. The above biological pathways are implicated in the mechanisms connecting hopelessness, hostility, and PCA.
The global effect of extreme weather events on nutrient supply: a superposed epoch analysis
Publisher: Elsevier BV
Date: 10-2019
Illuminating the lifecourse of place in the longitudinal study of neighbourhoods and health
Publisher: Elsevier BV
Date: 03-2017
Sex, age, deprivation and patterns in life expectancy in Quebec, Canada: A population-based study
Publisher: Springer Science and Business Media LLC
Date: 25-03-2010
High folate levels in Aboriginal children after subsidised fruit and vegetables and mandatory folic acid fortification
Publisher: Elsevier BV
Date: 06-2014
Abstract: To evaluate the impact of a fruit and vegetable (F&V) subsidy program for disadvantaged Aboriginal children in Australia, implemented alongside the introduction of mandatory folic acid fortification of bread-making flour. A before-and-after evaluation was undertaken of a F&V subsidy program at three Aboriginal community-controlled health services in New South Wales. The program provided a weekly box of subsidised F&V linked to preventive health services and nutrition promotion for families. In this analysis, red blood cell (RBC) folate was assessed together with self-reported dietary intake at baseline and 12 months later in a cohort of 125 children (aged 0-17 years). No children had low RBC folate at baseline or at follow-up however, 33 children (26%) exceeded the reference range of RBC folate at baseline and 38 children (30%) exceeded the reference range at follow-up. Mean RBC folate levels increased substantially in children at follow-up (mean RBC folate z-score increased +0.55 (95%CI 0.36-0.74). Change in F&V intake (p=0.196) and mean bread intake (p=0.676) were not statistically significant predictors for change in RBC folate levels. RBC folate levels increased among these disadvantaged Aboriginal children following mandatory folic acid fortification and participation in a subsidised F&V program. Even before mandatory folic acid fortification, none of these children had low RBC folate. The effect on health of mandatory fortification of foods with folate is not clear, hence, ongoing population-based monitoring of folate levels to assess the impact of mandatory folic acid fortification is important.
Diabetes and impaired glucose tolerance in Aboriginal Australians: Prevalence and risk
Publisher: Elsevier BV
Date: 07-2002
DOI: 10.1016/S0168-8227(02)00006-2
Abstract: The prevalence and risk of having impaired glucose tolerance (IGT) and diabetes was estimated relative to body mass index (BMI) among Australian Aboriginal people. A stratified analysis was undertaken of community screening data. Measures included fasting and 2-h glucose concentrations, and BMI (five strata: /=35 kg/m(2)). Age was stratified into three groups: 15-34.9, 35-44.9, and >/=45 years. Participants were men and women, ages 15-94 years (n=2626). The prevalence of IGT and diabetes, respectively, adjusted for age and BMI, was 139 and 142 cases/1000 persons among men, and 157 and 152 cases/1000 persons among women. Odds ratios (95% CI) for IGT and diabetes for increasing BMI strata >/=22 kg/m(2) ranged from 1.7 (1.0 to 2.9) to 5.1 (2.4-10.5) for IGT, and from 2.0 (1.2-3.5) to 6.1 (3.3-11.1) for diabetes. For IGT and diabetes, across genders, the population attributable risk percentages (95% CI) for BMI >/=22 kg/m(2) were 34.1% (26.2-41.9%) for IGT, and 46.4% (38.5-54.5%) for diabetes. Diabetes and IGT have reached epidemic proportions among Australian Aboriginal people. An urgent need exists for programmes to reduce the prevalence of diabetes risk factors, especially BMI of 22 kg/m(2) or more, a limit lower than advocated for Euro-American populations.
Associations between HIV-related injection behaviour and distance to and patterns of utilisation of syringe-supply programmes
Publisher: BMJ
Date: 09-2008
Abstract: Studies indicate that needle-exchange programmes (NEPs) can reduce the incidence of HIV infection however, a positive impact of syringe-supply programmes has not been consistently demonstrated. The associations between high-risk injection behaviour and distance to and patterns of utilisation of syringe-supply programmes in injection drug users (IDUs) were investigated. Participants in a cohort of IDUs (n = 456) residing in Montreal were interviewed between 2004 and 2006. Behavioural questionnaires were administered by trained interviewers, and venous blood s les were drawn and tested for HIV antibodies. The distance from regular IDU dwelling places to nearest NEP or pharmacy was calculated using a Geographic Information System. Logistic regression was used to assess relations with high-risk injection behaviour. Associations between high-risk injection behaviour and distance to syringe-supply source were not linear. The odds of high-risk behaviour grew modestly as distance from the NEP site increased to 1600 m, followed by a flat trend to 3000 m, and thereafter decreased with distance beyond this point. The odds of high-risk behaviour dropped sharply for the relatively few IDUs residing 1 km or more from the nearest pharmacy but this measure was not strongly associated with the outcome. IDUs who exclusively acquired syringes at NEPs or pharmacies had less than half the odds of reporting high-risk injection behaviour than IDUs with inconsistent syringe-access patterns. The study confirms that Montreal NEPs were implemented where they are most needed. These results also suggest that sterile syringe acquisition patterns might influence high-risk injection behaviour.
After Hurricane Floyd Passed: Investigating the Social Determinants of Disaster Preparedness and Recovery
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2004
DOI: 10.1097/00003727-200407000-00007
Abstract: In September 1999, Hurricane Floyd struck eastern North Carolina. Investigators from the health promotion study "Health Works for Women/Health Works in the Community" responded by initiating a focused research study, "Health Works After the Flood." Participatory research involving a multilevel design and qualitative methods was applied to investigate how community preparedness, response, and recovery are affected by social factors such as social capital, social cohesion, and collective efficacy. This article presents evidence from qualitative research conducted for "Health Works After the Flood" and links these findings to observations regarding current conceptualizations of social capital and related concepts.
Associations between residential food environment and dietary patterns in urban-dwelling older adults: Results from the VoisiNuAge study
Publisher: Cambridge University Press (CUP)
Date: 12-07-2012
DOI: 10.1017/S136898001200273X
Abstract: To examine associations between the availability of residential-area food sources and dietary patterns among seniors. Cross-sectional analyses. In idual-level data from the NuAge study on nutrition and healthy ageing were merged with geographic information system data on food store availability and area-level social composition. Two dietary patterns reflecting lower- and higher-quality diets (respectively designated ‘western’ and ‘prudent’) were identified from FFQ data. Two food source relative availability measures were calculated for a 500 m road-network buffer around participants’ homes: (i) proportion of fast-food outlets (%FFO) relative to all restaurants and (ii) proportion of stores potentially selling healthful foods (%HFS, healthful food stores) relative to all food stores. Associations between dietary patterns and food source exposure were tested in linear regression models accounting for in idual (health and sociodemographic) and area-level (socio-economic and ethnicity) covariates. Montréal metropolitan area, Canada. Urban-dwelling older adults ( n 751), aged 68 to 84 years. %FFO was inversely associated with prudent diet ( β = −0·105 P 0·05) and this association remained statistically significant in models accounting for %HFS. %HFS was inversely associated with lower western diet scores ( β = −0·124 P 0·01). This latter association no longer reached significance once models were adjusted for area-level covariates. In Montréal, the food environment is related to the diet of older adults but these links are more complex than straightforward. The absence of significant relationships between healthful food stores and prudent diets, and between fast-food outlets and western diets, deserves further investigation.
Do mother's education and foreign born status interact to influence birth outcomes? Clarifying the epidemiological paradox and the healthy migrant effect
Publisher: BMJ
Date: 05-2008
Abstract: The unresolved "epidemiological paradox" concerns the association between low socioeconomic status and unexpectedly favourable birth outcomes in foreign born mothers. The "healthy migrant" effect concerns the association between foreign born status per se and birth outcomes. The epidemiological paradox and healthy migrant effect were analysed for newborns in a favourable sociopolitical environment. 98,330 live births to mothers in Montreal, Canada from 1997 to 2001 were analysed. Mothers were categorised as foreign born versus Canadian born. Outcomes were: small for gestational age (SGA) birth low birth weight (LBW) and preterm birth (PTB). Multilevel logistic regression was used to examine the interaction between maternal education and foreign born status, adjusting for covariates. Not having a high school diploma was associated with LBW in Canadian (odds ratio (OR) 3.20 95% CI 2.61 to 3.91) but not foreign born (OR 1.14 95% CI 0.99 to 2.10) mothers and was more strongly associated with SGA birth in Canadian (OR 2.03 95% CI 1.84 to 2.22) than in foreign born (OR 1.26 95% CI 1.07 to 1.49) mothers. Foreign born status was associated with SGA birth (OR 1.37 95% CI 1.28 to 1.47), LBW (OR 1.51 95% CI 1.27 to 1.79) and PTB (OR 1.12 95% CI 1.03 to 1.22) in university-educated mothers only. The epidemiological paradox associated with low educational attainment was present for SGA birth and LBW but not PTB. Foreign born status was associated with adverse birth outcomes in university-educated mothers, the opposite of the healthy migrant effect.
Weighing the contributions of material and social area deprivation to preterm birth
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.SOCSCIMED.2012.04.033
Abstract: Evidence suggests that in idual socioeconomic status is a better predictor of preterm birth (PTB) than other in idual social characteristics, but it is not clear if socioeconomic (material) area context is likewise more strongly related to PTB than social area characteristics. We compared material and social area deprivation to determine which was more strongly associated with PTB. Live singleton births from Québec, Canada were obtained for 1999-2006 (N = 581,898). PTB was defined as <37 completed gestational weeks. Two composite indices representing area-level material and social deprivation were used in Cox proportional hazards regression models to compute hazard ratios (HR) and 95% confidence intervals (CI) for PTB, accounting for in idual-level characteristics including maternal education. Results indicated that PTB rates were higher for areas with high material (7.1%) and social (6.8%) deprivation than those with low material (5.5%) and social (5.9%) deprivation. Adjusted hazards of PTB were slightly greater for material deprivation than social deprivation. These findings indicate that material area deprivation is marginally more strongly associated with PTB than social deprivation, but it is not clear that interventions to prevent PTB should focus on material deprivation any more than on social area deprivation.
Mis-placed inference: Circular logic in spatial prediction of obesity
Publisher: Elsevier BV
Date: 09-2018
Obesity prevention in France: Yes, but how and why?
Publisher: Cambridge University Press (CUP)
Date: 08-2009
The adaptive nature of implementation practice: Case study of a school-based nutrition education intervention
Publisher: Elsevier BV
Date: 08-2013
DOI: 10.1016/J.EVALPROGPLAN.2012.12.004
Abstract: To describe how and why nutritionists implement and strategize particular program operations across school contexts. Instrumental case study with empirical propositions from Actor-Network Theory (ANT). Data derived from interviews with interventionists and observations of their practices. Seven primary schools from disadvantaged Montreal neighborhoods. Six nutritionists implementing the nutrition intervention in grades 4 and 5. From 133 nutrition workshops held in 2005/06, 31 workshops were observed with audio-recordings. Little Cooks--Parental Networks aims to promote healthy eating behaviors through engagement in food preparation and promotion of nutrition knowledge. The program-context interface where interventionists' practices form interactively within a given social context. Coding inspired by ANT. Interview analysis involved construction of collective implementation strategies. Observations and audio-recordings were used to qualify and quantify nutritionists' practices against variations in implementation. Nutritionists privileged intervention strategies according to particularities of the setting. Some such variation was accounted for by school-level social conditions, in idual preferences and nutritionists' past experiences. Implementation practices are strategic and aim to engage educational actors to achieve intervention goals. These results challenge implementation frameworks centered on purely technical considerations that exclude the social and interpretive nature of practice.
Community-level income inequality and mortality in Québec, Canada
Publisher: Elsevier BV
Date: 06-2009
DOI: 10.1016/J.PUHE.2009.04.012
Abstract: Evidence of the association between income inequality and mortality for small rather than large areas is conflicting. This study evaluated community-level income inequality in relation to age- and cause-specific mortality. Ecological analysis. Mortality data were extracted from the Québec, Canada registry for 1999-2003. For Québec communities (n=143), directly standardized mortality rates were calculated for all-cause (overall, working-age and post-working-age), suicide, alcohol, tobacco and cardiovascular mortality. Using 2001 Canada Census data, the tertiles of income inequality measured as the decile ratio, coefficient of variation and median share were calculated. The relative risk (RR) of death was determined using Poisson regression, accounting for median community income, family structure and rural-urban area. Income inequality was most strongly associated with alcohol-related mortality (RR(CoefficientVariation) 0.85, 95% confidence interval 0.77-0.94), followed by statistically significant but weaker inverse associations with tobacco-related and age-specific all-cause mortality. Income inequality in Québec communities is inversely associated with mortality outcomes, particularly alcohol-related mortality. These associations contrast with positive or null associations observed in studies of larger US and Canadian metropolitan areas, respectively. Community-level studies accounting for in idual-level covariates are necessary to clarify the relationship between income inequality and mortality.
The metabolic syndrome and CVD outcomes for a central Australian cohort
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.DIABRES.2013.03.020
Abstract: We investigated if the metabolic syndrome (MetS) and its component risk factors predict cardiovascular disease (CVD) for Aboriginal people from central Australia. WHO (HR 2.83), NCEP (1.80) and IDF (2.47) definitions of the MetS all had positive associations with CVD, however offered little above in idual MetS components for hyperglycaemia.
Predictors of Residential Mobility among Older Canadians and Impact on Analyses of Place and Health Relationships
Publisher: American Institute of Mathematical Sciences (AIMS)
Date: 2015
Hepatitis C Virus seroconversion among persons who inject drugs in relation to primary care physician visiting: The potential role of primary healthcare in a combined approach to Hepatitis C preventio
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.DRUGPO.2015.04.013
Abstract: Meaningful reductions in Hepatitis C Virus (HCV) transmission rates among persons who inject drugs (PWID) require a comprehensive prevention approach, including access to harm reduction measures and to healthcare-related interventions, such as HCV screening, testing and antiviral treatment. Little is known, however, about the role of visiting a primary care physician (PCP) in relation to HCV infection risk among PWID, when integrated within a combined prevention approach. This study assessed the association between PCP visiting and HCV seroconversion among PWID attending needle exchange programs (NEP). A prospective cohort study, HEPCO, was conducted among active PWID in Montréal (2004-2013). Interviews scheduled at 3- or 6-month intervals included completion of an interviewer-administered questionnaire, and collection of blood s les for HCV antibody testing. HCV-seronegative participants who reported NEP attendance at baseline and had at least one follow-up visit were eligible for this study. HCV incidence was calculated using the person-time method. Time-varying Cox regression modeling was conducted to evaluate the relationship between self-reported recent PCP visiting and HCV incidence. At baseline assessment, of 226 participants (80.5% male median age: 30.6 years), 37.2% reported having recently visited a PCP. During 449.6 person-years of follow-up, 79 participants seroconverted to HCV [incidence rate: 17.6 per 100 person-years, 95% confidence interval (CI): 14.0-21.8]. Covariate-adjusted analyses indicated that visiting a PCP was associated with a lower risk of HCV infection [Adjusted Hazard Ratio: 0.54, 95% CI: 0.31-0.93]. Other independent predictors of HCV infection included unstable housing, cocaine injection and prescription opioid injection. Among PWID attending NEP, visiting a PCP was associated with a lower risk of HCV infection. Yet, only a minority of participants reported PCP visiting. Efforts to intensify engagement with PCP among PWID could potentially contribute to lower HCV transmission when integrated within a combined approach to prevention.
Consumption patterns of sweetened food and drink products in a Catholic Middle Eastern Canadian community
Publisher: Cambridge University Press (CUP)
Date: 03-01-2014
Clinical outcomes associated with albuminuria in central Australia: A cohort study
Publisher: Springer Science and Business Media LLC
Date: 05-08-2016
Neighbourhood socioeconomic status, maternal education and adverse birth outcomes among mothers living near highways
Publisher: BMJ
Date: 08-2008
Abstract: Residential proximity to highways is a potential proxy for exposure to traffic-related pollution that has been linked to adverse birth outcomes. We evaluated whether proximity to highway interacts with in idual and neighbourhood socioeconomic status (SES) to influence birth outcomes. The study population consisted of all live singleton births in Montréal, Canada, from 1997 to 2001 (n = 99,819). Proximity was defined as residing within 200 m of a highway. Neighbourhood SES was measured for census tracts as the proportion of families below the low-income threshold. In idual SES was represented by maternal education. Using multilevel logistic regression, the odds of preterm birth (PTB), low birthweight (LBW) and small-for-gestational-age (SGA) birth were calculated for mothers residing in proximity to highways, accounting for in idual and neighbourhood SES. Effect modification between SES and proximity to highway was tested for each outcome. In wealthy neighbourhoods, proximity to highway was associated with an elevated odds of PTB (OR 1.58, 95% CI 1.23 to 2.04), LBW (OR 1.81, 95% CI 1.36 to 2.41) and SGA birth (OR 1.32, 95% CI 1.05 to 1.66). For highly educated mothers, proximity to highway was associated with PTB (OR 1.25, 95% CI 1.07 to 1.46) and LBW (OR 1.24, 95% CI 1.03 to 1.49), but the association was borderline for SGA birth (OR 1.15, 95% CI 1.00 to 1.32). Proximity to highway was not associated with birth outcomes in other maternal and neighbourhood SES categories. Counterintuitively, high SES mothers may be more likely than low SES mothers to experience adverse births associated with residential proximity to highway.
Social, environmental stress in indigenous populations: Potential biopsychosocial mechanisms
Publisher: Wiley
Date: 12-1999
A Longitudinal Typology of Neighbourhood-level Social Fragmentation: A Finite Mixture Model Approach
Publisher: Center for Open Science
Date: 31-07-2019
Abstract: Neighbourhoods are social enclaves. And, from an epidemiological vantage there is substantive research examining how social traits of neighbourhoods affect health. However, this research has often focused on the effects of social deprivation. Less attention has been given to social fragmentation (SF), a construct aligned with the notions of lesser: social cohesion, social capital, collective functioning, and social isolation. Concurrently, there has been limited research that has described the spatial and temporal patterning of neighbourhood-level social traits. With a focus on SF the main aims of this paper were to model and describe the time-varying and spatial nature of SF.Conceptually, this research was informed by ‘thinking in time’ and by the ‘lifecourse-of-place’ perspective. While, from an analytical perspective, a longitudinal (3-time points over 10-years) neighbourhood database was created for the metropolitan region of Adelaide, Australia. Latent Transition Analysis was then used to model the developmental profile of SF where neighbourhoods were proxied by ‘suburbs’, and the measurement model for SF was formed of 9-conceptually related census-based indicators. A four-class, nominal-level latent status model of SF was identified: class-A=low SF class-B=mixed-level SF/inner urban class-C=mixed-level SF eri-urban and class-D=high SF. Class-A and -D neighbourhoods were the most prevalent at all time points. And, while certain neighbourhoods were inferred to have changed their SF class across time, most neighbourhoods were characterised by intransience.
Diabetes incidence in an Australian aboriginal population: An 8-year follow-up study
Publisher: American Diabetes Association
Date: 12-1999
DOI: 10.2337/DIACARE.22.12.1993
Abstract: OBJECTIVE: To examine prospectively the association between age, BMI, and subsequent incidence of type 2 diabetes in Australian aboriginal people. RESEARCH DESIGN AND METHODS: We performed a stratified analysis of incidence data from a community-based longitudinal study. Measures included fasting and 2-h postload glucose concentrations, and BMI, stratified into four categories. Subjects were 882 male and female participants in diabetes screening initiatives in two remote Australian aboriginal communities, free from diabetes at baseline, ages 15-77 years. RESULTS: There were 46 incident cases of diabetes over 2,808 person-years of follow-up. BMI modified strongly the sex- and community-adjusted association between age and diabetes incidence (P & 0.001). Adjusted for age, sex, and community, the population diabetes incidence rate was 20.3 cases/1,000 person-years, with BMI-specific rates of 10.7-47.2 cases/1,000 person-years, and relative risks (95% CI) for BMI strata beyond the reference category (& 25 kg/m2) of 3.3 (1.5-7.0), 2.7 (1.1-6.8), and 4.4 (1.7-11.6), respectively. The population's attributable risk (95% CI) associated with BMI beyond the reference category was 70.1% (58.1-82.4). CONCLUSIONS: BMI-specific diabetes incidence rates in Australian aboriginal people are among the highest in the world. Diabetes incidence in the lowest BMI category (10.7 cases/1,000 person-years) is two to five times greater than corresponding rates for non-aboriginal populations. An urgent need exists to prevent weight gain associated with diabetes. Further study is required to determine for aboriginal people an optimal range of BMI, likely lower than that suggested for non-aboriginal populations.
Living in a well-serviced urban area is associated with maintenance of frequent walking among seniors in the VoisiNuAge study
Publisher: Oxford University Press (OUP)
Date: 2012
Abstract: This paper examined whether or not closer proximity to local services and amenities was associated with maintenance of more frequent walking over time among urban-dwelling seniors over and above in idual-level characteristics. A s le of 521 adults who were part of the VoisiNuAge study and who resided in a large North American urban area reported on the frequency of walking outside the home over a 3-year period and on their health, sociodemographic characteristics, social support and resources, and perceptions of different features of their residential environment. Information about the distance between their home and 16 services and amenities was obtained from a geographic information system. Seniors were then classified into quartiles of proximity (Q1, Q2, Q3, Q4). Unadjusted and adjusted ordinal growth curve models showed that closer proximity to services and amenities was associated with greater likelihood of frequent walking at all times throughout the 3-year period. Findings are consistent with the notion that environments may act as buoys for the maintenance of important health behaviors. Future experimental and quasi-experimental research is required to explore whether or not the environment can play a causal role in influencing patterns of walking over time.
Supplier perceived value: Differences between business-to-business and business-to-government relationships
Publisher: Elsevier BV
Date: 03-2009
Cohort Profile: The Interdisciplinary Study of Inequalities in Smoking (ISIS)
Publisher: Oxford University Press (OUP)
Date: 06-05-2015
DOI: 10.1093/IJE/DYV036
Abstract: The Interdisciplinary Study of Inequalities in Smoking (ISIS) is a cohort study investigating the joint effects of residents' socio-demographic characteristics and neighbourhood attributes on the social distribution of smoking in a young adult population. Smoking is a behaviour with an increasingly steep social class gradient smoking prevalence among young adults is no longer declining at the same rate as among the rest of the population, and there is evidence of growing place-based disparities in smoking. ISIS was established to examine these pressing concerns. The ISIS s le comprises non-institutionalized in iduals aged 18-25 years, who are proficient in English and/or French and who had been living at their current address in Montréal, Canada, for at least 1 year at time of first contact. Two waves of data have been collected: baseline data were collected November 2011-September 2012 (n = 2093), and a second wave of data was collected January-June 2014 (n = 1457). Data were collected from respondents using a self-administered questionnaire, developed by the research team based on sociological theory, which includes questions concerning social, economic, cultural and biological capital, and activity space as well as smoking behaviour. Data are available upon request from [katherine.frohlich@umontreal.ca].
Associations among socioeconomic status, perceived neighborhood control, perceived individual control, and self-reported health
Publisher: Wiley
Date: 13-07-2010
DOI: 10.1002/JCOP.20391
Total n-3 and saturated fat intake in relation to insulin resistance in a Canadian First Nation at risk for the development of type 2 diabetes
Publisher: Cambridge University Press (CUP)
Date: 21-03-2014
DOI: 10.1017/S1368980013000542
Abstract: The present study sought to investigate the associations of total n -3 fatty acid and SFA intakes with insulin resistance in a Canadian First Nation s le at risk for type 2 diabetes. Fasting values for glucose and insulin were used to estimate insulin resistance by homeostasis model assessment (HOMA-IR). Intakes of n -3 fatty acids and SFA were computed from dietary food and drink data obtained using 3 d food records. Associations between HOMA-IR and dietary n -3 and SFA consumption were tested using linear regression models accounting for age, sex, community, education, physical activity, waist circumference, fibre, protein and carbohydrate intakes, and HDL-cholesterol and TAG concentrations. Rural Okanagan region of British Columbia, Canada. On-reserve First Nation in iduals (Interior Salishan) aged 18 years and over, recruited for community-based diabetes screening and determined to be normoglycaemic ( n 126). HOMA-IR was negatively associated with dietary n -3 fatty acid intake ( β = −0·22 95 % CI −0·39, −0·04 P = 0·016) and positively associated with dietary SFA intake ( β = 0·34 95 % CI 0·15, 0·53 P = 0·0 0 1). Intake of dietary n -3 fatty acids may be protective against whereas SFA intake may promote insulin resistance in this high-risk Canadian First Nation s le. Reduced dietary SFA intake and greater n -3 fatty acid intake may assist the prevention of glycaemic disease among First Nations peoples. More rigorous, controlled trials are required to test whether dietary supplementation with n -3 fatty acids in natural or supplement-based form might reduce diabetes risk in high-risk aboriginal groups.
Searching for the biological pathways between stress and health
Publisher: Annual Reviews
Date: 05-1997
DOI: 10.1146/ANNUREV.PUBLHEALTH.18.1.437
Abstract: ▪ Abstract Population-based, person-specific health surveys, with concomitant biological measures, should provide important information about the processes by which socioeconomic and psychosocial factors embed themselves in human health. Questionnaire responses allow for assessment of the perceived psychosocial environment, but biological measurements will measure the status of the psychoneuroimmunology sychoneuroendocrinology (PNI/PNE) pathways and may allow us to identify people who have “adapted” to their stress because of experience, expectations, stoicism, etc. This review sets criteria to evaluate potential physiological markers of chronic stress. Because population health surveys involve a massive number of s les, special consideration must be given to the laboratory analysis method and transportation time of the markers chosen. We reviewed five areas: glycosylated proteins, the immune system, hemostasis, peripheral benzodiazepine receptors, and the waist-hip ratio.
Time dependent uncertain free vibration analysis of composite CFST structure with spatially dependent creep effects
Publisher: Elsevier BV
Date: 11-2019
The effect of adherence on the association between depressive symptoms and mortality among HIV-infected individuals first initiating HAART
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 31-05-2007
Effectiveness of a community-directed 'healthy lifestyle' program in a remote Australian Aboriginal community
Publisher: Elsevier BV
Date: 04-2000
DOI: 10.1111/J.1467-842X.2000.TB00133.X
Abstract: To assess the sustainability and effectiveness of a community-directed program for primary and secondary prevention of obesity, diabetes and cardiovascular disease in an Aboriginal community in north-west Western Australia. Evaluation of health outcomes (body mass index, glucose tolerance, and plasma insulin and triglyceride concentrations) in a cohort of high-risk in iduals (n = 49, followed over two years) and cross-sectional community s les (n = 200 at baseline, 185 at two-year and 132 at four-year follow-ups), process (interventions and their implementation) and impact (diet and exercise behaviour). For the high-risk cohort, involvement in diet and/or exercise strategies was associated with protection from increases in plasma glucose and triglycerides seen in a comparison group however, sustained weight loss was not achieved. At the community level, significant reductions were observed in fasting insulin concentration but no change in prevalence of diabetes, overweight or obesity. Weight gain remained a problem among younger people. Sustainable improvements were observed for dietary intake and level of physical activity. These changes were related to supportive policies implemented by the community council and store management. Community control and ownership enabled embedding and sustainability of program, in association with social environmental policy changes and long-term improvements in important risk factors for chronic disease. Developmental initiatives facilitating planning, implementation and ownership of interventions by community members and organisations can be a feasible and effective way to achieve sustainable improvements in health behaviours and selected health outcomes among Aboriginal people.
Psychological distress mediates the association between daytime sleepiness and consumption of sweetened products: Cross-sectional findings in a Catholic Middle-Eastern Canadian community
Publisher: BMJ
Date: 2013
Association between Activity Space Exposure to Food Establishments and Individual Risk of Overweight
Publisher: Public Library of Science (PLoS)
Date: 22-08-2012
Constructing a health and social indicator framework for indigenous community health research
Publisher: Springer Science and Business Media LLC
Date: 07-06-2007
Establishing a Demographic, Development and Environmental Geospatial Surveillance Platform in India: Planning and Implementation
Publisher: JMIR Publications Inc.
Date: 05-10-2018
A systematic review of community readiness tool applications: Implications for reporting
Publisher: MDPI AG
Date: 24-03-2015
Associations between perceived proximity to neighborhood resources, disability, and social participation among community-dwelling older adults: Results from the VoisiNuAge Study
Publisher: Elsevier BV
Date: 12-2011
Sex-specific correlates of adult physical activity in an Australian rural community
Publisher: Wiley
Date: 26-01-2014
DOI: 10.1111/AJR.12081
Abstract: Rural Australians have a higher likelihood of chronic disease and lower levels of physical activity than urban Australians. Little is known of the factors associated with physical activity among rural-dwelling Australians. This study sought to determine the correlates of physical activity among men and women of the South Australian Riverland region. Cross-sectional survey. Regional area. There are 299 randomly selected 18-65 year olds. Determinations of insufficient and sufficient physical activity levels based on public health recommendations. Using logistic regression: in men, sufficient physical activity was associated with reporting perceived sufficient physical activity for health (odds ratio 3.194 [1.703-5.989]), and having friends who encouraged physical activity (3.641 [1.450-9.141]). Men who reported insufficient time (0.350 [0.151-0.812]) and getting enough physical activity at their job (0.374 [0.199-0.702]) were less likely to be sufficiently active. In women, sufficient physical activity was associated with not being employed (2.929 [1.063-8.066]), higher self-efficacy (2.939 [1.118-7.726]) and having a regular physical activity routine (3.404 [1.829-6.337]). Older age (0.960 [0.929-0.995]), poorer self-rated health (0.233 [0.060-0.900]) and weekend sitting time (0.823 [0.692-0.980]) were negatively associated with sufficient physical activity for women. Factors associated with physical activity in this rural adult population differed by sex. Sex-specific approaches to promote physical activity might have utility for this population. Strategies to enhance social connectedness among men and encourage physical activity outside of work can be warranted. Women can require programs to help them develop a regular physical activity routine and improve self-efficacy.
Associations between disability prevalence and local-area characteristics in a general community-living population
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.RESPE.2013.05.020
Abstract: Disability is understood to arise from person-environment interactions. Hence, heterogeneity in local-area characteristics should be associated with local-area variation in disability prevalence. This study evaluated the associations of disability prevalence with local-area socioeconomic status and contextual features. Disability prevalence was obtained from the Canada census of 2001 for the entire province of Québec at the level of dissemination areas (617 in iduals on average) based on responses from 20% of the population. Data on local-area characteristics were urban-rural denomination, social and material deprivation, active and collective commuting, residential stability, and housing quality. Associations between local-area characteristics and disability prevalence were assessed using multilevel logistic regressions. Disability was associated with local-area socioeconomic status and contextual characteristics, and heterogeneity in these factors accounted for urban-rural differences in disability prevalence. Associations between contextual features and disability prevalence were confounded by local-area socioeconomic status. Some associations between local-area socioeconomic status and disability prevalence were moderated by contextual characteristics. The importance of this effect modification is greater when expressed in terms of the absolute magnitude of disability than in the relative likelihood of disability. Explanation of rural-urban differences by the contribution of other local-area characteristics is consistent with the conceptualization of urban-rural categories as the reflection of spatially varying ensembles of compositional and contextual factors. Although local-area socioeconomic status explains most variability in disability prevalence, this study shows that contextual characteristics are relevant to analyses of the spatial patterning of disability as they predict spatial variations of disability, sometimes in interaction with socioeconomic status. This study demonstrates that absolute and relative perspectives on effect modification may lead to differing conclusions.
Health outcomes of a subsidised fruit and vegetable program for Aboriginal children in northern New South Wales
Publisher: AMPCo
Date: 07-2013
DOI: 10.5694/MJA13.10445
Abstract: To evaluate the impact of a fruit and vegetable subsidy program on short-term health outcomes of disadvantaged Aboriginal children. A before-and-after study involving clinical assessments, health record audits and blood testing of all children aged 0-17 2013s (n = 167) from 55 participating families at baseline and after 12 months at three Aboriginal community-controlled health services in New South Wales. All assessments were completed between December 2008 and September 2010. A weekly box of subsidised fruit and vegetables linked to preventive health services and nutrition promotion at an Aboriginal Medical Service. Change in episodes of illness, health service and emergency department attendances, antibiotic prescriptions and anthropometry. There was a significant decrease in oral antibiotics prescribed (- 0.5 prescriptions/2013 95% CI, - 0.8 to - 0.2) during 12 months of participation in the program compared with the 12 months before the program. The proportion of children classified as overweight or obese at baseline was 28.3% (38/134) and the proportion in each weight category did not change (P = 0.721) after 12 months. A small but significant increase in mean haemoglobin level (3.1 g/L 95% CI, 1.4-4.8 g/L) was shown, although the proportion with iron deficiency (baseline, 41% follow-up, 37% P = 0.440) and anaemia (baseline, 8% follow-up, 5% P = 0.453) did not change significantly. it and vegetable subsidy program was associated with improvements in some indicators of short-term health status among disadvantaged Aboriginal children. A controlled trial is warranted to investigate the sustainability and feasibility of healthy food subsidy programs in Australia.
Environmental risk conditions and pathways to cardiometabolic diseases in indigenous populations
Publisher: Annual Reviews
Date: 21-04-2011
DOI: 10.1146/ANNUREV.PUBLHEALTH.012809.103557
Abstract: This review examines environments in relation to cardiometabolic diseases in Indigenous populations in developed countries. Environmental factors are framed in terms of context (features of places) and composition (features of populations). Indigenous peoples are seen to have endured sociopolitical marginalization and material disadvantage spanning generations. Past adverse collective experiences, modified by culture, are reflected by current heterogeneity in environmental context and composition. As risk conditions, unfavorable contextual and compositional exposures influence the expression of cardiometabolic risk for in iduals. Minimal research has evaluated heterogeneity in risk conditions against heterogeneity in cardiometabolic diseases between or within Indigenous populations. Thus far, the features of populations, not of places themselves, have been implicated in relation to cardiometabolic diseases. Behavioral, psychosocial, and stress-axis pathways may explain the relationships between risk conditions and cardiometabolic diseases. Implications of environmental factors and their pathways as well as important research needs are discussed in relation to ecological prevention to reduce cardiometabolic diseases.
Nutritional impacts of a fruit and vegetable subsidy programme for disadvantaged Australian Aboriginal children
Publisher: Cambridge University Press (CUP)
Date: 07-06-2013
DOI: 10.1017/S0007114513001700
Abstract: Healthy food subsidy programmes have not been widely implemented in high-income countries apart from the USA and the UK. There is, however, interest being expressed in the potential of healthy food subsidies to complement nutrition promotion initiatives and reduce the social disparities in healthy eating. Herein, we describe the impact of a fruit and vegetable (F& V) subsidy programme on the nutritional status of a cohort of disadvantaged Aboriginal children living in rural Australia. A before-and-after study was used to assess the nutritional impact in 174 children whose families received weekly boxes of subsidised F& V organised through three Aboriginal medical services. The nutritional impact was assessed by comparing 24 h dietary recalls and plasma carotenoid and vitamin C levels at baseline and after 12 months. A general linear model was used to assess the changes in biomarker levels and dietary intake, controlled for age, sex, community and baseline levels. Baseline assessment in 149 children showed low F& V consumption. Significant increases ( P 0·05) in β-cryptoxanthin (28·9 nmol/l, 18 %), vitamin C (10·1 μmol/l, 21 %) and lutein–zeaxanthin (39·3 nmol/l, 11 %) levels were observed at the 12-month follow-up in 115 children, although the self-reported F& V intake was unchanged. The improvements in the levels of biomarkers of F& V intake demonstrated in the present study are consistent with increased F& V intake. Such dietary improvements, if sustained, could reduce non-communicable disease rates. A controlled study of healthy food subsidies, together with an economic analysis, would facilitate a thorough assessment of the costs and benefits of subsidising healthy foods for disadvantaged Aboriginal Australians.
Effectiveness of community-directed diabetes prevention and control in a rural Aboriginal population in British Columbia, Canada
Publisher: Elsevier BV
Date: 03-1999
DOI: 10.1016/S0277-9536(98)00403-1
Abstract: This report presents the process and summative evaluation results from a community-based diabetes prevention and control project implemented in response to the increasing prevalence and impact of non-insulin-dependent diabetes mellitus (NIDDM) in the Canadian Aboriginal population. The 24-month project targeted the registered Indian population in British Columbia's rural Okanagan region. A participatory approach was used to plan strategies by which diabetes could be addressed in ways acceptable and meaningful to the intervention community. The strategies emphasised a combination of changing behaviours and changing environments. The project was quasi-experimental. A single intervention community was matched to two comparison communities. Workers in the intervention community conducted interviews of in iduals with or at risk for diabetes during a seven-month pre-intervention phase (n = 59). Qualitative analyses were conducted to yield strategies for intervention. Implementation began in the eighth month of the project. Trend measurements of diabetes risk factors were obtained for 'high-risk' cohorts (persons with or at familial risk for NIDDM) (n = 105). Cohorts were tracked over a 16-month intervention phase, with measurements at baseline, the midpoint and completion of the study. Cross-sectional population surveys of diabetes risk factors were conducted at baseline and the end of the intervention phase (n = 295). Surveys of community systems were conducted three times. The project yielded few changes in quantifiable outcomes. Activation of the intervention community was insufficient to enable in idual and collective change through dissemination of quality interventions for diabetes prevention and control. Theory and previous research were not sufficiently integrated with information from pre-intervention interviews. Interacting with these limitations were the short planning and intervention phases, just 8 and 16 months, respectively. The level of penetration of the interventions mounted was too limited to be effective. Attention to process is warranted and to the feasibility of achieving effects within 24 months.
Using Geographic Information Systems for Enhancing Research Relevant to Policy on Diet, Physical Activity, and Weight
Publisher: Elsevier BV
Date: 04-2009
DOI: 10.1016/J.AMEPRE.2009.01.011
Abstract: Geographic Information Systems (GIS) was a theme for one of the four workgroups convened for the Measures of the Food and Built Environment meeting held in Bethesda, Maryland in November 2007. This summary of group discussions frames several critical conceptual, methodologic, and data challenges regarding the use of GIS to enhance research relevant to policy on diet, physical activity, and weight. Broad recommendations are offered in five areas: (1) theoretical and conceptual development in framing place effects on health (2) contextualizing people and spatial behavior in built environments and improving empirical representations of place (3) geospatial data availability, quality, and standards (4) privacy and confidentiality and, (5) building capacity in GIS personnel and infrastructure. These topics are inter-related. Although our discussion focuses on issues relevant to the role of the built environment in diet and physical activity outcomes, our recommendations also are salient to health and environment research generally.
AIDS and shared sovereignty in Tanzania from 1987 to 2000: A case study
Publisher: Elsevier BV
Date: 04-2005
DOI: 10.1016/J.SOCSCIMED.2004.08.031
Abstract: After more than 15 years of foreign assistance to support HIV/AIDS prevention in Sub-Saharan Africa, HIV rates in the sub-continent remain high with only a few ex les of reduced HIV incidence. This case study used the frame of "shared sovereignty" between nation-states and official development assistance agencies to analyze 13 years of technical assistance for HIV/AIDS programs in Tanzania from 1987 to 2000. The study draws on 21 key informant interviews and a systematic review of key program documents from the National AIDS Control Programme (NACP) and 14 other international agencies. Applying Jamison et al.'s (Lancet 351 (1998) 514) shared sovereignty framework, the analysis focused on fulfilled shared functions in moving Tanzania's NACP from dependence to independence. The analysis revealed an uneven and inconsistent level of technical assistance to the NACP with a rotation of multilateral and bilateral donors over the period of study. The Tanzanian government was often ambivalent toward agencies providing assistance towards its HIV/AIDS programs and toward its own NACP. Results are discussed in terms of implications for future strategic planning to mitigate the effects of HIV/AIDS. Determining roles, shared accountability and responsibility in a shared sovereignty framework remain a challenge in the governance of HIV/AIDS programs in Tanzania.
Using experienced activity spaces to measure foodscape exposure
Publisher: Elsevier BV
Date: 11-2010
DOI: 10.1016/J.HEALTHPLACE.2010.06.016
Abstract: Researchers are increasingly interested in understanding how food environments influence eating behavior and weight-related health outcomes. Little is known about the dose-response relationship between foodscapes and behavior or weight, with measures of food exposure having mainly focused on fixed anchor points including residential neighborhoods, schools, or workplaces. Recent calls have been made to extend the consideration of environmental influences beyond local neighborhoods and also to shift away from place-based, to people-based, measures of exposure. This report presents analyses of novel activity-space measures of exposure to foodscapes, combining travel survey data with food store locations in Montreal and Quebec City, Canada. The resulting in idual activity-space experienced foodscape exposure measures differ from traditional residential-based measures, and show variations by age and income levels. Furthermore, these activity-space exposure measures once modeled, can be used as predictors of health outcomes. Hence, travel surveys can be used to estimate environmental exposure for health survey participants.
Partnerships and coalitions for community-based research
Publisher: SAGE Publications
Date: 2001
Differences in associations between active transportation and built environmental exposures when expressed using different components of individual activity spaces
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.HEALTHPLACE.2015.03.003
Abstract: This study assessed relationships between built environmental exposures measured within components of in idual activity spaces (i.e., travel origins, destinations and paths in-between), and use of active transportation in a metropolitan setting. In iduals (n=37,165) were categorised as using active or sedentary transportation based on travel survey data. Generalised Estimating Equations analysis was used to test relationships with active transportation. Strength and significance of relationships between exposures and active transportation varied for different components of the activity space. Associations were strongest when including travel paths in expression of the built environment. Land use mix and greenness were negatively related to active transportation.
I know it's bad for me and yet i do it: Exploring the factors that perpetuate smoking in aboriginal health workers - A qualitative study
Publisher: Springer Science and Business Media LLC
Date: 25-04-2012
Abstract: Aboriginal Health Workers (AHWs) have a mandate to deliver smoking cessation support to Aboriginal people. However, a high proportion of AHWs are smokers and this undermines their delivery of smoking cessation programs. Smoking tobacco is the leading contributor to the burden of disease in Aboriginal Australians and must be prevented. Little is known about how to enable AHWs to quit smoking. An understanding of the factors that perpetuate smoking in AHWs is needed to inform the development of culturally relevant programs that enable AHWs to quit smoking. A reduction of smoking in AHWs is important to promote their health and also optimise the delivery of smoking cessation support to Aboriginal clients. We conducted a fundamental qualitative description study that was nested within a larger mixed method participatory research project. The in idual and contextual factors that directly or indirectly promote (i.e. perpetuate) smoking behaviours in AHWs were explored in 34 interviews and 3 focus groups. AHWs, other health service staff and tobacco control personnel shared their perspectives. Data analysis was performed using a qualitative content analysis approach with collective member checking by AHW representatives. AHWs were highly stressed, burdened by their responsibilities, felt powerless and undervalued, and used smoking to cope with and support a sense of social connectedness in their lives. Factors directly and indirectly associated with smoking were reported at six levels of behavioural influence: personal factors (e.g. stress, nicotine addiction), family (e.g. breakdown of family dynamics, grief and loss), interpersonal processes (e.g. socialisation and connection, domestic disputes), the health service (e.g. job insecurity and financial insecurity, demanding work), the community (e.g. racism, social disadvantage) and policy (e.g. short term and insecure funding). An extensive array of factors perpetuated smoking in AHWs. The multitude of personal, social and environmental stressors faced by AHWs and the accepted use of communal smoking to facilitate socialisation and connection were primary drivers of smoking in AHWs in addition to nicotine dependence. Culturally sensitive multidimensional smoking cessation programs that address these factors and can be tailored to local needs are indicated.
Assessing change in perceived community leadership readiness in the Obesity Prevention and Lifestyle program
Publisher: Wiley
Date: 28-09-2016
DOI: 10.1071/HE16050
Interactive effects of reward sensitivity and residential fast-food restaurant exposure on fast-food consumption
Publisher: Elsevier BV
Date: 03-2010
Abstract: Local fast-food environments have been increasingly linked to obesity and related outcomes. In iduals who are more sensitive to reward-related cues might be more responsive to such environments. This study aimed to assess the moderating role of sensitivity to reward on the relation between residential fast-food restaurant exposure and fast-food consumption. Four hundred fifteen in iduals (49.6% men mean age: 34.7 y) were s led from 7 Montreal census tracts stratified by socioeconomic status and French/English language. The frequency of fast-food restaurant visits in the previous week was self-reported. Sensitivity to reward was self-reported by using the Behavioral Activation System (BAS) scale. Fast-food restaurant exposure within 500 m of the participants' residence was determined by using a Geographic Information System. Main and interactive effects of the BAS and fast-food restaurant exposure on fast-food consumption were tested with logistic regression models that accounted for clustering of observations and participants' age, sex, education, and household income. Regression results showed a significant interaction between BAS and fast-food restaurant exposure (P < 0.001). Analysis of BAS tertiles indicated that the association between neighborhood fast-food restaurant exposure and consumption was positive for the highest tertile (odds ratio: 1.49 95% CI: 1.20, 1.84 P < 0.001) but null for the intermediate (odds ratio: 1.03 95% CI: 0.80, 1.34 P = 0.81) and lowest (odds ratio: 0.84 95% CI: 0.51, 1.37 P = 0.49) tertiles. Reward-sensitive in iduals may be more responsive to unhealthful cues in their immediate environment.
Local Context Influence, Activity Space, and Foodscape Exposure in Two Canadian Metropolitan Settings: Is Daily Mobility Exposure Associated with Overweight?
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1155/2012/912645
Abstract: It has become increasingly common to attribute part of the obesity epidemic to changes in the environment. Identification of a clear and obvious role for contextual risk factors has not yet been demonstrated. The objectives of this study were to explain differences in local overweight risk in two different urban settings and to explore sex-specific associations with estimated mobility patterns. Overweight was modeled within a multilevel framework using built environmental and socioeconomic contextual indicators and in idual-level estimates of activity space exposure to fast-food restaurants (or exposure to visited places). Significant variations in local levels in overweight risk were observed. Physical and socioeconomic contexts explained more area-level differences in overweight among men than among women and among inhabitants of Montreal than among inhabitants of Quebec City. Estimated activity space exposure to fast-food outlets was significantly associated with overweight for men in Montreal. Local-level analyses are required to improve our understanding of contextual influences on obesity, including multiple influences in people's daily geographies.
Impact evaluation of a public bicycle share program on cycling: A case example of BIXI in Montreal, Quebec
Publisher: American Public Health Association
Date: 03-2013
Abstract: Objectives. We examined associations between residential exposure to BIXI (BIcycle-taXI)—a public bicycle share program implemented in Montreal, Quebec, in 2009, which increases accessibility to cycling by making available 5050 bicycles at 405 bicycle docking stations—and likelihood of cycling (BIXI and non-BIXI) in Montreal over the first 2 years of implementation. Methods. Three population-based s les of adults participated in telephone surveys. Data collection occurred at the launch of the program (spring 2009), and at the end of the first (fall 2009) and second (fall 2010) seasons of implementation. Difference in differences models assessed whether greater cycling was observed for those exposed to BIXI compared with those not exposed at each time point. Results. We observed a greater likelihood of cycling for those exposed to the public bicycle share program after the second season of implementation (odds ratio = 2.86 95% confidence interval = 1.85, 4.42) after we controlled for weather, built environment, and in idual variables. Conclusions. The implementation of a public bicycle share program can lead to greater likelihood of cycling among persons living in areas where bicycles are made available.
Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: A concept mapping approach
Publisher: Oxford University Press (OUP)
Date: 07-12-2013
DOI: 10.1093/HER/CYS111
Abstract: Aboriginal Australians, including Aboriginal Health Workers (AHWs), smoke at rates double the non-Aboriginal population. This study utilized concept mapping methodology to identify and prioritize culturally relevant strategies to promote smoking cessation in AHWs. Stakeholder participants included AHWs, other health service employees and tobacco control personnel. Smoking cessation strategies (n = 74) were brainstormed using 34 interviews, 3 focus groups and a stakeholder workshop. Stakeholders sorted strategies into meaningful groups and rated them on perceived importance and feasibility. A concept map was developed using multi-dimensional scaling and hierarchical cluster analyses. Ten unique clusters of smoking cessation strategies were depicted that targeted in iduals, family and peers, community, workplace and public policy. Smoking cessation resources and services were represented in addition to broader strategies addressing social and environmental stressors that perpetuate smoking and make quitting difficult. The perceived importance and feasibility of clusters were rated differently by participants working in health services that were government-coordinated compared with community-controlled. For health service workers within vulnerable populations, these findings clearly implicate a need for contextualized strategies that mitigate social and environmental stressors in addition to conventional strategies for tobacco control. The concept map is being applied in knowledge translation to guide development of smoking cessation programs for AHWs.
Theoretical Investigation of Nonlinear Time-Dependent Behavior of Two-Way High-Strength Concrete Walls
Publisher: Hindawi Limited
Date: 20-04-2020
DOI: 10.1155/2020/4587089
Abstract: High-strength concrete (HSC) walls have been increasingly used in the past decades. However, the time-dependent behavior of HSC wall panels in two-way action was not investigated, and the time effect of creep is not included in the design codes in most countries. For this purpose, the nonlinear long-term behavior of two-way HSC wall is investigated in this paper. A theoretical model is developed using time-stepping analysis considering geometric nonlinearity and creep of concrete. A rheological material model that is based on the generalized Maxwell chain is adopted to model the concrete creep. Von Karman plate theory is used to derive the incremental governing equations. The equations are solved numerically at each time step based on a Fourier series expansion of the deformations and loads and numerical multiple shooting method. It shows that the model can effectively predict the time-dependent behavior of two-way HSC panels, where the out-of-plane deflection and internal bending moments increase with time due to the combined effects of creep and geometric nonlinearity, which may ultimately lead to creep buckling failures. A parametric study shows that the long-term behavior of the panel is very sensitive to the in-plane load level and eccentricity, slenderness ratio, aspect ratio, and edge support conditions.
Associations among park use, age, social participation, and neighborhood age composition in Montreal
Publisher: Informa UK Limited
Date: 30-06-2010
Integrating an ecological approach into an Aboriginal community-based chronic disease prevention program: A longitudinal process evaluation
Publisher: Springer Science and Business Media LLC
Date: 11-05-2011
Abstract: Public health promotes an ecological approach to chronic disease prevention, however, little research has been conducted to assess the integration of an ecological approach in community-based prevention programs. This study sought to contribute to the evidence base by assessing the extent to which an ecological approach was integrated into an Aboriginal community-based cardiovascular disease (CVD) and type 2 diabetes prevention program, across three-intervention years. Activity implementation forms were completed by interview with implementers and participant observation across three intervention years. A standardised ecological coding procedure was applied to assess participant recruitment settings, intervention targets, intervention strategy types, extent of ecologicalness and organisational partnering. Inter-rater reliability for two coders was assessed at Kappa = 0.76 (p .0.001), 95% CI (0.58, 0.94). 215 activities were implemented across three intervention years by the health program (HP) with some activities implemented in multiple years. Participants were recruited most frequently through organisational settings in years 1 and 2, and organisational and community settings in year 3. The most commonly utilised intervention targets were the in idual (IND) as a direct target, and interpersonal (INT) and organisational (ORG) environments as indirect targets policy (POL), and community (COM) were targeted least. Direct (HP→ IND) and indirect intervention strategies (i.e., HP→ INT→ IND, HP→ POL → IND) were used most often networking strategies, which link at least two targets (i.e., HP→[ORG-ORG]→IND), were used the least. The program did not become more ecological over time. The quantity of activities with IND, INT and ORG targets and the proportion of participants recruited through informal cultural networking demonstrate community commitment to prevention. Integration of an ecological approach would have been facilitated by greater inter-organisational collaboration and centralised planning. The upfront time required for community stakeholders to develop their capacity to mobilise around chronic disease is at odds with short-term funding cycles that emphasise organisational accountability.
Cigarette smoking, steroid hormones, and bone mineral density in young women
Publisher: Springer Science and Business Media LLC
Date: 04-1992
DOI: 10.1007/BF00301626
Abstract: In capsaicin-pretreated mice, the nociceptive responses induced by intrathecally (i.t.) administered substance P (SP) were enhanced by N-methyl-D-aspartate (NMDA)-type receptor antagonists, dizocilpine (MK801) and D-2-amino-5-phosphonopentanoate (D-AP5) in a dose-dependent manner. Similar enhancement of SP-induced nociception was also observed in mice lacking the NMDA-type glutamate receptor NR2A/epsilon(1) subunit gene (GluRepsilon(1)(-/-) mice). On the other hand, GluRepsilon(1)(-/-) mice showed a marked enhancement of the peripheral nociceptive responses induced by intraplantar (i.pl.) injection of SP and bradykinin (BK). As the nociceptive responses to SP and BK (i.pl.) were both antagonized by CP-99994, an neurokinin(1) (NK(1)) antagonist (i.t.), these results suggest that GluRepsilon(1) receptor may play an inhibitory role in the downstream mechanisms of primary nociceptive SP neurones, possibly through activation of unidentified inhibitory neurones.
Aboriginal Health Workers experience multilevel barriers to quitting smoking: A qualitative study
Publisher: Springer Science and Business Media LLC
Date: 23-05-2012
Abstract: Long-term measures to reduce tobacco consumption in Australia have had differential effects in the population. The prevalence of smoking in Aboriginal peoples is currently more than double that of the non-Aboriginal population. Aboriginal Health Workers are responsible for providing primary health care to Aboriginal clients including smoking cessation programs. However, Aboriginal Health Workers are frequently smokers themselves, and their smoking undermines the smoking cessation services they deliver to Aboriginal clients. An understanding of the barriers to quitting smoking experienced by Aboriginal Health Workers is needed to design culturally relevant smoking cessation programs. Once smoking is reduced in Aboriginal Health Workers, they may then be able to support Aboriginal clients to quit smoking. We undertook a fundamental qualitative description study underpinned by social ecological theory. The research was participatory, and academic researchers worked in partnership with personnel from the local Aboriginal health council. The barriers Aboriginal Health Workers experience in relation to quitting smoking were explored in 34 semi-structured interviews (with 23 Aboriginal Health Workers and 11 other health staff) and 3 focus groups (n = 17 participants) with key informants. Content analysis was performed on transcribed text and interview notes. Aboriginal Health Workers spoke of burdensome stress and grief which made them unable to prioritise quitting smoking. They lacked knowledge about quitting and access to culturally relevant quitting resources. Interpersonal obstacles included a social pressure to smoke, social exclusion when quitting, and few role models. In many workplaces, smoking was part of organisational culture and there were challenges to implementation of Smokefree policy. Respondents identified inadequate funding of tobacco programs and a lack of Smokefree public spaces as policy level barriers. The normalisation of smoking in Aboriginal society was an overarching challenge to quitting. Aboriginal Health Workers experience multilevel barriers to quitting smoking that include personal, social, cultural and environmental factors. Multidimensional smoking cessation programs are needed that reduce the stress and burden for Aboriginal Health Workers provide access to culturally relevant quitting resources and address the prevailing normalisation of smoking in the family, workplace and community.
Response to the Letter by Kawada et al. regarding the manuscript entitled The metabolic syndrome and CVD outcomes for a central Australian cohort
Publisher: Elsevier BV
Date: 11-2013
Field validation of listings of food stores and commercial physical activity establishments from secondary data
Publisher: Springer Science and Business Media LLC
Date: 10-11-2008
Abstract: Food- and activity-related establishments are increasingly viewed as neighbourhood resources that potentially condition health-related behaviour. The primary objective of the current study was to establish, using ground truthing (on-site verification), the validity of measures of availability of food stores and physical activity establishments that were obtained from commercial database and Internet searches. A secondary objective was to examine differences in validity results according to neighbourhood characteristics and commercial establishment categories. Lists of food stores and physical activity-related establishments in 12 census tracts within the Montreal metropolitan region were compiled using a commercial database (n = 171 establishments) and Internet search engines (n = 123 establishments). Ground truthing through field observations was performed to assess the presence of listed establishments and identify those absent. Percentage agreement, sensitivity (proportion of establishments found in the field that were listed), and positive predictive value (proportion of listed establishments found in the field) were calculated and contrasted according to data sources, census tracts characteristics, and establishment categories. Agreement with field observations was good (0.73) for the commercial list, and moderate (0.60) for the Internet-based list. The commercial list was superior to the Internet-based list for correctly listing establishments present in the field (sensitivity), but slightly inferior in terms of the likelihood that a listed establishment was present in the field (positive predictive value). Agreement was higher for food stores than for activity-related establishments. Commercial data sources may provide a valid alternative to field observations and could prove a valuable tool in the evaluation of commercial environments relevant to eating behaviour. In contrast, this study did not find strong evidence in support of commercial and Internet data sources to represent neighbourhood opportunities for active lifestyle.
Health inequalities and place: A theoretical conception of neighbourhood
Publisher: Elsevier BV
Date: 11-2007
DOI: 10.1016/J.SOCSCIMED.2007.05.037
Abstract: In the past 10 years, interest in studying the relationship between area of residence and health has grown. During this period empirical relations between place and health have been observed at a variety of spatial scales, from census tracts to administrative units in metropolitan areas to whole regions, and for a variety of health outcomes. Despite the richness of the data, there are relatively few publications offering theoretical explanations for these observations, and a sound conception of place itself is still lacking. Using place as a relational space linked to where people live, work and play, this paper conceptualises the nature of neighbourhoods as they contribute to the local production of health inequalities in everyday life. In reference to Giddens' structuration theory, we propose that neighbourhoods essentially involve the availability of, and access to, health-relevant resources in a geographically defined area. Taking inspiration from the work of Godbout on informal reciprocity, we further propose that such availability and access are regulated according to four different sets of rules: proximity, prices, rights, and informal reciprocity. Our theoretical framework suggests that these rules give rise to five domains, the physical, economic, institutional, local sociability, and community organisation domains which cut across neighbourhood environments through which residents may acquire resources that shape their lifecourse trajectory in health and social functioning.
Environments and Cardiometabolic Diseases in Aboriginal Populations
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.HLC.2010.01.005
Abstract: This review establishes the relevance and frames the relationship of environmental factors to cardiometabolic risk factors and disease in Aboriginal populations. Environmental factors operate at the level of communities or populations. They include contextual measures of places and compositional measures of populations which together constitute "risk conditions" affecting in idual risk factors. Environmental factors have been implicated by contrasting Aboriginal and non-Aboriginal populations in cardiometabolic risk factors and outcomes, or by geographic contrasts of Aboriginal populations in remote, rural and urban regions. It is unclear whether heterogeneity in contextual or compositional factors between and within Aboriginal populations is associated with heterogeneity in cardiometabolic risk factors and outcomes. Empirical literature that links environmental factors and cardiometabolic outcomes in Aboriginal populations is critically reviewed for three postulated pathways of influence: (1) behaviour (2) psychosocial factors and (3) stress response axes. These pathways, represented as interdependent, can explain how and why environments are associated with cardiometabolic outcomes. The need remains, however, to develop a robust quantitative evidence base in cardiometabolic research aimed at enhancing knowledge of the specific environmental factors related to the cardiometabolic health of Aboriginal populations as well as explicating the underlying mechanisms by which environmental risk conditions 'get under the skin'.
Neighborhood Deprivation and Maternal Psychological Distress During Pregnancy: A Multilevel Analysis
Publisher: Springer Science and Business Media LLC
Date: 15-11-2015
DOI: 10.1007/S10995-014-1623-8
Abstract: Maternal psychosocial distress is conceptualized as an important factor underlying the association between neighborhood deprivation and pregnancy outcomes. However, empirical studies to examine effects of neighborhood deprivation on psychosocial distress during pregnancy are scant. Based on a large multicenter cohort of pregnant women in Montreal, we examined (1) the extent to which psychosocial distress is clustered at the neighborhood-level, (2) the extent to which the clustering is explained by neighborhood material or social deprivation, and (3) whether associations between neighborhood deprivation and psychosocial distress persist after accounting for neighborhood composition (in idual-level characteristics) using multilevel analyses. For 5,218 women residing in 740 neighborhoods, a prenatal interview at 24-26 gestational weeks measured both general and pregnancy-related psychological distress using well-validated scales: perceived stress, social support, depressive symptoms, optimism, commitment to the pregnancy, pregnancy-related anxiety, and maternal locus-of-control. Neighborhood deprivation indices were linked to study participants by their residential postal code. Neighborhood-level clustering (intraclass correlation) ranged from 1 to 2 % for perceived stress (lowest), optimism, pregnancy-related anxiety, and commitment to pregnancy to 4-6 % for perceived social support, depressive symptoms, and maternal locus of control (highest). Neighborhood material deprivation explained far more of the clustering (23-75 %) than did social deprivation (no more than 4 %). Although both material and social deprivation were associated with psychological distress in unadjusted analyses, the associations disappeared after accounting for in idual-level socioeconomic characteristics. Our results highlight the importance of accounting for in idual-level socioeconomic characteristics in studies of potential neighborhood effects on maternal mental health.
Association of individual network social capital with abdominal adiposity, overweight and obesity
Publisher: Oxford University Press (OUP)
Date: 24-12-2009
Opiate receptor blockade by naltrexone and mood state after acute physical activity
Publisher: BMJ
Date: 06-1992
Abstract: Acute mood changes occur with various forms of physical activity. Increased levels of endogenous opioids (endorphins) in response to exercise may mediate activity-induced shifts in mood state. Thirteen female and six male aerobics class participants aged 20-46 years received the opiate receptor antagonist naltrexone and a placebo in randomized, double-blind crossover fashion on two separate occasions at the same 75-min high-intensity aerobics class. Mood states were assessed before and after each class, which were spaced 5 days apart, using the Profile of Mood States questionnaire (POMS), a mood adjective checklist, and a Visual Analogue Scale (VAS) which measured mood in relation to several emotional extremes. Mood changes over the course of each aerobics class were compared in the naltrexone and placebo groups. For men and women, significant differences between conditions were observed in overall mood by both the POMS (P less than 0.005) and VAS (P less than 0.02). There were significant differences between conditions for most subscales of each mood instrument (P less than 0.05) with the placebo, mood states became calmer, more relaxed and pleasant, tending away from depression, anger and confusion. Positive mood shifts did not occur when subjects were preloaded with naltrexone, suggesting that activity-generated mood changes are mediated through endorphinergic mechanisms.
Lipids and psychosocial status in aboriginal persons with and at risk for Type 2 diabetes: Implications for tertiary prevention
Publisher: Elsevier BV
Date: 04-2001
DOI: 10.1016/S0738-3991(00)00153-1
Abstract: This study assessed psychosocial correlates of dyslipidemia, towards enabling improved tertiary prevention of macrovascular complications of diabetes mellitus (DM). We tested the hypothesis that psychosocial measures are related to high-density lipoprotein cholesterol (HDL-C) and triglyceride concentrations in a rural aboriginal population in British Columbia, Canada. Persons s led were on-reserve registered Indians (n=198) with and at risk for Type 2 DM. Relationships between HDL-C and psychosocial variables were associated with glycemic status. For persons with diabetes and impaired glucose tolerance (n=44), quality of life and mastery were positively related (P<0.001), and depression inversely related (P<0.001), to HDL-C. An apparent lack of effect of behavior suggests the influence of emotional pathways involving autonomic-neuroendocrine axes. We recommend assessing mental health, and promoting mastery and diabetes quality of life through empowerment oriented diabetes management strategies, in negotiating culturally acceptable treatment of diabetic dyslipidemia for aboriginal people.
Climatic and community sociodemographic factors associated with remote Indigenous Australian smoking rates: an ecological study of health audit data
Publisher: BMJ
Date: 07-2019
DOI: 10.1136/BMJOPEN-2019-032173
Abstract: Australian Indigenous smoking rates are highest in remote communities but likely vary between communities few studies have assessed community features in relation to Indigenous smoking rates. This ecological study evaluated the associations between smoking rates, and community sociodemographic and climatic characteristics for a large s le of remote Indigenous communities. Records (n=2689) from an audit of community health centres in the Northern Territory and Queensland were used to estimate smoking rates dichotomised at the median for 70 predominantly Indigenous remote communities. Community characteristics were similarly dichotomised. Cross-tabulations were used to calculate the odds of a community classified as high for a sociodemographic or climatic factor also being high for smoking rate. Additional cross-tabulations, stratified by sociodemographic, region (coastal or central) and geographic connectivity levels, were performed to assess potential confounding. Community smoking rates ranged from 25% to 96% (median 60.2%). Moderately strong relationships were observed between community smoking rate and population size (OR 6.25,(95% CI 2.18 to 17.95)), education level (OR 3.67 (1.35–10.01)), income (2.86 (11.07–7.67)) and heat (2.86 (1.07–7.67)). Smoking rates in Australian remote Indigenous communities are universally high. Smoking rates are associated with greater community-level socioeconomic status and size, most likely reflecting greater means of accessing tobacco with mass of smokers sufficient to sustain a normative influence. Severe heat was also associated with high smoking rates suggesting such a stressor might support smoking as a coping mechanism. Community sociodemographic and climatic factors bear consideration as context-level correlates of community smoking rates.
Comparison of two indices of availability of fruits/vegetable and fast food outlets
Publisher: Springer Science and Business Media LLC
Date: 27-06-2013
Adherence to activity monitoring devices or smartphone applications for improving physical activity in adults with cardiovascular disease: A systematic review protocol
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2018
Not all social capital is good capital
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.HEALTHPLACE.2009.05.005
Abstract: Limited empirical research on social capital has investigated the potential downside of social capital on health and well-being. We hypothesized that social capital and mastery might vary according to education with lower-educated persons experiencing fewer advantages. This study used a stratified cluster design to recruit a volunteer s le of 332 adult residents from 7 metropolitan census tracts. The survey included a position generator to collect social capital network data. Generalized estimating equations were used to account for the clustering of respondents in census tracts. Results indicated a differential association between in idual social capital and mastery according to educational attainment. Among persons with a high school degree or more, higher social capital was associated with a higher sense of mastery among less-educated persons, higher in idual social capital was associated with lower mastery. Differences in the pathways by which lower- and upper-educated groups access social capital may play a role in social capital's negative association with psychological well-being.
The joint influence of area income, income inequality, and immigrant density on adverse birth outcomes: A population-based study
Publisher: Springer Science and Business Media LLC
Date: 14-07-2009
International NGOs and the role of network centrality in humanitarian aid operations: A case study of coordination during the 2000 Mozambique floods
Publisher: Wiley
Date: 12-2003
DOI: 10.1111/J.0361-3666.2003.00235.X
Abstract: In February 2000, Mozambique suffered its worst flooding in almost 50 years: 699 people died and hundreds of thousands were displaced. Over 49 countries and 30 international non-governmental organisations provided humanitarian assistance. Coordination of disaster assistance is critical for effective humanitarian aid operations, but limited attention has been directed toward evaluating the system-wide structure of inter-organisational coordination during humanitarian operations. Network analysis methods were used to examine the structure of inter-organisational relations among 65 non-governmental organisations (NGOs) involved in the flood operations in Mozambique. Centrality scores were used to estimate NGO-specific potential for aid coordination and tested against NGO beneficiary numbers. The average number of relief- and recovery-period beneficiaries was significantly greater for NGOs with high relative to low centrality scores (p < 0.05). This report addresses the significance of these findings in the context of the Mozambican 2000 floods and the type of data required to evaluate system-wide coordination.
Use of a new public bicycle share program in Montreal, Canada
Publisher: Elsevier BV
Date: 07-2011
DOI: 10.1016/J.AMEPRE.2011.03.002
Abstract: Cycling contributes to physical activity and health. Public bicycle share programs (PBSPs) increase population access to bicycles by deploying bicycles at docking stations throughout a city. Minimal research has systematically examined the prevalence and correlates of PBSP use. To determine the prevalence and correlates of use of a new public bicycle share program called BIXI (name merges the word BIcycle and taXI) implemented in May 2009 in Montreal, Canada. A total of 2502 adults were recruited to a telephone survey in autumn 2009 via random-digit dialing according to a stratified random s ling design. The prevalence of BIXI bicycle use was estimated. Multivariate logistic regression allowed for identification of correlates of use. Data analysis was conducted in spring and summer 2010. The unweighted mean age of respondents was 47.4 (SD=16.8) years and 61.4% were female. The weighted prevalence for use of BIXI bicycles at least once was 8.2%. Significant correlates of BIXI bicycle use were having a BIXI docking station within 250 m of home, being aged 18-24 years, being university educated, being on work leave, and using cycling as the primary mode of transportation to work. A newly implemented public bicycle share program attracts a substantial fraction of the population and is more likely to attract younger and more educated people who currently use cycling as a primary transportation mode.
Gender-specific associations between perceived and objective neighbourhood crime and metabolic syndrome
Publisher: Public Library of Science (PLoS)
Date: 26-07-2018
Unintended messages in online advertising to youth: Illicit drug imagery in a canadian sports marketing campaign
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.1016/J.JADOHEALTH.2014.12.006
Abstract: We assessed the potential for harmful messages in online advertisements targeted to youth, using the ex le of the Canadian "Light It Up" marketing c aign from a large sports corporation. We undertook a cluster randomized controlled trial of 20 secondary school classes in Montreal, Canada. Classes were randomly allocated to view a "Light It Up" advertisement (n = 205) or a neutral comparison advertisement (n = 192). The main outcome measures were self-reports of illicit drug messages in the advertisements. Of the students, 22.9% reported that the "Light It Up" advertisement contained illicit drug messages compared with 1.0% for the comparison advertisement (relative risk, 22.0 95% confidence interval, 6.5-74.9). Although meant to promote sports, youth in this study believed that the "Light It Up" advertisement was related to illicit drugs. The c aign illustrates how advertisements may inadvertently market unwanted behaviors to children.
Erratum: Corrigendumto: Identifying multi-level culturally appropriate smoking cessation strategies for Aboriginal health staff: a concept mapping approach (Health education research (2013) 28 1 (31-45))
Publisher: Oxford University Press (OUP)
Date: 09-11-2017
DOI: 10.1093/HER/CYX061
Socioeconomic disparities in low birth weight outcomes according to maternal birthplace in Québec, Canada
Publisher: Informa UK Limited
Date: 02-2009
DOI: 10.1080/13557850802071132
Abstract: Studies in the USA suggest that the association between maternal birthplace, socioeconomic status (SES), and low birth weight (LBW) can vary across different immigrant groups. Less is known outside the USA about these associations. Our study assesses the association of maternal birthplace and SES on the likelihood of LBW infants in Québec, Canada. Using 2000 Quebec birth registry data, logistic regression was used to examine differentials in LBW according to maternal birthplace and SES. Singleton infants born to Québec mothers (n=47,988) were grouped into nine regions based on maternal birthplace: (1) Canada (2) the USA and western Europe (3) eastern Europe (4) Latin America (5) the Caribbean (6) Sub-Saharan Africa (7) north Africa and Middle East (8) South Asia and (9) East Asia and Pacific. SES was classified into four categories according to maternal educational attainment: (1) low SES (<11 years) (2) medium-low SES (11-12 years) (3) medium-high SES (13-14 years) and (4) high SES (more than 14 years). Covariates included maternal age, gestational duration, and parity. LBW was defined as between 500 and 2499 g. Compared to a LBW prevalence of 4.5 for Canadian-born mothers, South Asian- and Caribbean-born mothers had prevalence percentages of 9.2 and 8.2, respectively. After adjusting for SES and other covariates, the likelihood (odds ratio (OR), 95% confidence intervals (CI)) of LBW outcomes remained greater for South Asian- (OR 2.84 95% CI, 1.90-4.24) and Caribbean-born mothers (OR 1.52 95% CI 1.11-2.10). After pooling these two groups and testing for moderation by SES, we found that high SES immigrant mothers (OR 3.82 95% CI 2.33-6.25) had a higher likelihood of LBW infants than low SES mothers (OR 2.00 95% CI 1.22-3.33) compared to high SES Canadian-born mothers. In Québec, the association between foreign-born status and LBW varies according to maternal birthplace.
Identifying Environmental Determinants Relevant to Health and Wellbeing in Remote Australian Indigenous Communities: A Scoping Review of Grey Literature
Publisher: MDPI AG
Date: 15-04-2021
Abstract: The high prevalence of preventable infectious and chronic diseases in Australian Indigenous populations is a major public health concern. Existing research has rarely examined the role of built and socio-political environmental factors relating to remote Indigenous health and wellbeing. This research identified built and socio-political environmental indicators from publicly available grey literature documents locally-relevant to remote Indigenous communities in the Northern Territory (NT), Australia. Existing planning documents with evidence of community input were used to reduce the response burden on Indigenous communities. A scoping review of community-focused planning documents resulted in the identification of 1120 built and 2215 socio-political environmental indicators. Indicators were systematically classified using an Indigenous indicator classification system (IICS). Applying the IICS yielded indicators prominently featuring the “community infrastructure” domain within the built environment, and the “community capacity” domain within the socio-political environment. This research demonstrates the utility of utilizing existing planning documents and a culturally appropriate systematic classification system to consolidate environmental determinants that influence health and disease occurrence. The findings also support understanding of which features of community-level built and socio-political environments amenable to public health and social policy actions might be targeted to help reduce the prevalence of infectious and chronic diseases in Indigenous communities.
The prevalence and correlates of tobacco use among 7-9th grade students in Bangladesh
Publisher: Elsevier BV
Date: 09-2019
Preterm birth during an extreme weather event in québec, canada: A ́natural experiment́
Publisher: Springer Science and Business Media LLC
Date: 17-07-2011
DOI: 10.1007/S10995-010-0645-0
Abstract: To clarify the relationship between preterm birth (PTB) and extreme weather events, we evaluated PTB during a January 1998 ice storm that had led to a provincial emergency in the middle of winter in the province of Québec, Canada. Singleton live births for three periods (1993-1997, 1998, 1999-2003) were obtained (N = 855,320). PTB was defined as gestational age <37 completed weeks. Births in the Triangle of Darkness, the area most strongly affect by the storm, were geocoded. Multivariate logistic regression was used to calculate the likelihood of PTB for the Triangle relative to metropolitan Montréal, adjusting for maternal age, education, civil status, maternal birthplace, and previous deliveries. Associations for 1998 relative to other periods were evaluated. Short-term (January-February) and long-term (March-October) exposure periods were examined. The proportion PTB for 1998 January-February births in the Triangle (8.7%) was high compared with 1998 March-October births (6.0%) and with the corresponding proportions for 1993-1997 (6.2%) and 1999-2003 (6.9%). Covariate-adjusted odds of PTB for January-February 1998 were 27% higher for the Triangle relative to metropolitan Montréal, though precision was low. Furthermore, adjusted odds were 28% higher for 1998 relative to 1999-2003, despite increasing rates of PTB over time. Odds were not elevated over a long-term exposure period. This study suggests a weak association between PTB and exposure to extreme weather for the two months following an ice storm, but not for later periods after the storm.
Gender-specific situational correlates of syringe sharing during a single injection episode
Publisher: Springer Science and Business Media LLC
Date: 18-02-2011
DOI: 10.1007/S10461-009-9530-5
Abstract: Factors associated with syringe sharing differ between women and men however, it is uncertain whether these hold within the setting of a single injection episode. A questionnaire eliciting information about the last injection episode with others present was administered to participants in a cohort of Montréal injection drug users (IDUs). Logistic regression was used to identify correlates of syringe sharing and to test potential gender differences in relation to syringe sharing. Data from 467 participants revealed significant differences between men and women with regard to situational factors however, the relationships between situational factors and syringe sharing did not vary according to gender. In multivariate models including both genders, syringe sharing was associated with various attributes of other IDUs who were present as well as alcohol use during that specific episode. These results highlight the relevance of situational factors in injection drug use activity, regardless of gender.
Is educational inequality protective? [1]
Publisher: American Public Health Association
Date: 2007
Availability of body art facilities and body art piercing do not predict hepatitis C acquisition among injection drug users in Montreal, Canada: Results from a cohort study
Publisher: Elsevier BV
Date: 11-2010
DOI: 10.1016/J.DRUGPO.2010.05.001
Abstract: Cross-sectional associations suggest that body art piercing (BAP) is a risk factor for hepatitis C (HCV) infection among injection drug users. The temporal basis of the relationship has not been established. Associations between HCV seropositivity, HCV incidence, recent BAP and BAP facility availability were evaluated among IDUs followed biannually between 2004 and 2008 in Montreal, Canada. A geographic information system was used to determine the availability of BAP facilities for each participant. Statistical models included in idual and neighbourhood covariates. Logistic regression was used for analysis of HCV seropositivity. Cox proportional hazards regression was used for analysis of HCV incidence. Of 784 IDUs, 73% were seropositive for HCV. In multivariable logistic regression, HCV seropositivity was associated with BAP availability (OR: 1.32 95% confidence interval (CI): 1.1, 1.6) but not recent BAP. Of 145 initially HCV-negative participants, 52 seroconverted to HCV for an incidence of 27.7/100 person-years (95%CI: 20.9, 36.0). Crude hazard ratios (HR) for the association between HCV infection and BAP variables were: recent BAP, HR 0.98 (95%CI: 0.4, 2.7) and BAP facilities availability, HR 1.43 (95%CI: 1.1, 1.9). After accounting for in idual and neighbourhood factors, crude associations between HCV infection and recent BAP and BAP facilities availability were: HR recent BAP, 0.96, 95%CI: 0.3, 2.7 and HR BAP facility availability, 1.21, 95%CI: 0.9, 1.7. BAP facility availability is a marker of neighbourhood disadvantage associated with HCV seropositivity. Longitudinal analyses accounting for behaviour risk factors and neighbourhood characteristics do not support a temporal association between BAP acquisition, BAP facility availability, and HCV infection among IDUs.
Bone mineral density and adipose tissue distribution in Young women: Relationship to smoking status
Publisher: Informa UK Limited
Date: 1995
DOI: 10.1080/03014469500003682
Abstract: Interrelationships between anthropometric variables and bone mineral density (BMD) may allow simple and inexpensive identification of those at risk for low bone density and osteoporosis. Risk appraisal is particularly important in young women, as lifestyle modifications may slow the rate of bone loss through adulthood and decrease the risk of osteoporosis later in life. Though weight, height and body mass index are frequently assessed in relation to bone, adipose tissue distribution has rarely been considered. Smoking is associated with low bone density and abdominally localized adipose tissue. The relationship between smoking, adipose tissue distribution and BMD in women has not been examined. Regional and whole-body BMD were assessed by dual-energy X-ray absorptiometry, and adipose tissue distribution using the anthropometric indicator, waist-to-hip girth ratio (WHR), in 52 women (25 smokers, and 27 nonsmokers) aged 20-35 years. There were significant (p < 0.05) positive correlations between WHR and BMD for smokers and nonsmokers separately (r = 0.44-0.57), and for the s le overall (r = 0.30-0.51). Most relationships remained significant after adjustment for weight. Smokers did not differ significantly from nonsmokers in relationships between WHR and BMD. The results indicate a positive relationship between BMD and abdominal relative to gluteal-femoral adiposity. This relationship is independent of smoking status. The biological determinants underlying a relationship between BMD and WHR require consideration before inferences regarding BMD can reasonably be considered on the basis of WHR.
The lifecourse of place: Looking past paradigms and metaphors to the just nature of place-health – A rejoinder to Andrews'
Publisher: Elsevier BV
Date: 02-2017
Diabetes and Canada's aboriginal peoples: the need for primary prevention
Publisher: Elsevier BV
Date: 06-1995
DOI: 10.1016/0020-7489(94)00045-L
Abstract: The high prevalence of non-insulin-dependent diabetes mellitus (NIDDM) in Canada's native communities corresponds with high diabetes prevalence rates in other populations of indigenous peoples that have undergone changes associated with acculturation. Behavioural risk factors can be particularly amenable to public health action. There exists a need to develop, implement and test in collaboration with native people, interventions aimed at reducing the incidence and impact of NIDDM, by reducing the risk of its onset, and by early detection and treatment. Intervention programmes should be conceived with sensitivity to the overall health, social, economic, educational and cultural environment within a community. Although this review focuses specifically on diabetes in Canada, many of the points relating to the need for primary prevention of the disease will be appropriate in other situations.
Contributions of Multiple Built Environment Features to 10-Year Change in Body Mass Index and Waist Circumference in a South Australian Middle-Aged Cohort
Publisher: MDPI AG
Date: 30-01-2020
Abstract: Residential areas may shape health, yet few studies are longitudinal or concurrently test relationships between multiple residential features and health. This longitudinal study concurrently assessed the contributions of multiple environmental features to 10-year change in clinically measured body mass index (BMI) and waist circumference (WC). Longitudinal data for adults (18+ years of age, n = 2253) from the north-west of Adelaide, Australia were linked to built environment measures representing the physical activity and food environment (expressed for residence-based 1600 m road-network buffers) and area education. Associations were concurrently estimated using latent growth models. In models including all environmental exposure measures, area education was associated with change in BMI and WC (protective effects). Dwelling density was associated with worsening BMI and WC but also highly correlated with area education and moderately correlated with count of fast food outlets. Public open space (POS) area was associated with worsening WC. Intersection density, land use mix, greenness, and a retail food environment index were not associated with change in BMI or WC. This study found greater dwelling density and POS area exacerbated increases in BMI and WC. Greater area education was protective against worsening body size. Interventions should consider dwelling density and POS, and target areas with low SES.
Towards a brain-to-society systems model of individual choice
Publisher: Springer Science and Business Media LLC
Date: 07-11-2008
Appraising and Funding Participatory Research in Health Promotion
Publisher: SAGE Publications
Date: 07-2006
DOI: 10.2190/R031-N661-H762-7015
Abstract: Participatory action research combines research, education and social action. Each of these elements reflects health education research and practice. Indeed, health education, health promotion and participatory research have converged in these respects. Participatory research is well suited to the philosophies and theories underpinning community-based health education and health promotion. The nature of participatory research is such that funding agencies, especially those awarding research funds, tend to be challenged in their attempts to assess proposals. This is true at least for those agencies operating under traditional criteria for reviewing standards, which may not be appropriate for participatory research. As well, it may reflect a broader lack of common understanding about the processes and expectations, the apparent untidiness of projects (comparing with traditional research) which by their nature offer no standard methods, deadlines, procedures or predetermined outcome measures. The Study of Participatory Research in Health Promotion [1], commissioned by the Royal Society of Canada, attempted to clarify the topic by providing a working definition and a set of guidelines for use by funding agencies when appraising projects purporting to be participatory research. The guidelines emphasize how the nominal ways of conducting health research in populations need to adapt to meet the educational and policy expectations of participatory research. The study also examined current practical ex les of participatory research in the field of health promotion in Canada. This summary of the results of the project provides detailed guidelines flowing from a review of experience in the field and consultation with groups engaged in participatory research.
Local descriptive norms for overweight/obesity and physical inactivity, features of the built environment, and 10-year change in glycosylated haemoglobin in an Australian population-based biomedical cohort
Publisher: Elsevier BV
Date: 10-2016
Glycated hemoglobin as an indicator of social environmental stress among indigenous versus westernized populations
Publisher: Elsevier BV
Date: 11-1999
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