ORCID Profile
0000-0001-7988-1186
Current Organisation
Australian Institute of Health and Welfare
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Publisher: Springer Science and Business Media LLC
Date: 18-02-2009
DOI: 10.1038/EJCN.2009.6
Abstract: To investigate patterns of, and associations between, physical activity at work and in leisure time, television viewing and computer use. 4531 men and 4594 women with complete plausible data, age 44-45 years, participating in the 1958 British birth cohort study. Physical activity, television viewing and computer use (hours/week) were estimated using a self-complete questionnaire and intensity (MET hours/week) derived for physical activity. Relationships were investigated using linear regression and chi(2) tests. From a target s le of 11,971, 9223 provided information on physical activity, of whom 75 and 47% provided complete and plausible activity data on work and leisure time activity respectively. Men and women spent a median of 40.2 and 34.2 h/week, respectively in work activity, and 8.3 and 5.8 h/week in leisure activity. Half of all participants watched television for > or =2 h/day, and half used a computer for <1 h/day. Longer work hours were not associated with a shorter duration of leisure activity, but were associated with a shorter duration of computer use (men only). In men, higher work MET hours were associated with higher leisure-time MET hours, and shorter durations of television viewing and computer use. Watching more television was related to fewer hours or MET hours of leisure activity, as was longer computer use in men. Longer computer use was related to more hours (or MET hours) in leisure activities in women. Physical activity levels at work and in leisure time in mid-adulthood are low. Television viewing (and computer use in men) may compete with leisure activity for time, whereas longer duration of work hours is less influential. To change active and sedentary behaviours, better understanding of barriers and motivators is needed.
Publisher: Wiley
Date: 08-2021
DOI: 10.1111/AJR.12779
Abstract: To describe effects of employing primary care doctors in hospital care and their roles in improving the quality of care and health outcomes of rural and remote patients. A systematic scoping review. Peer‐reviewed publications were sourced from 3 online journal databases (PUBMED, SCOPUS and Web of Science). All study designs from peer‐reviewed journals that discussed effects of employing primary care doctors in hospital care Interventions: employing primary care doctors in hospital care. Positive and negative consequences of employing primary care doctors in hospital care, and the roles of primary care doctors in improving the quality of care and health outcomes. A total of 12 articles met the inclusion and exclusion criteria. Positive outcomes included improved access to specialised treatment, improved continuity of care, reduced waiting list and admission rates, improved skills, competence and confidence of primary care doctors, and increased satisfaction from both health providers and patients/families. Negative consequences reported included increased prescriptions and poorly documented history and physical examinations. Employing primary care doctors in hospital care can fill the gaps in the delivery of acute care, emergency medicine and maternity care. Primary care doctors bring advanced clinical skills and a patient‐centred approach to the hospital care. They also improve the quality of referrals leading to freed‐up clinical capacity of tertiary hospitals to treat more serious conditions. The provision of acute or emergency care and secondary care in rural and remote areas should be directed towards patient‐oriented not provider‐oriented policies.
Publisher: Public Library of Science (PLoS)
Date: 31-03-2016
Publisher: Oxford University Press (OUP)
Date: 13-05-2003
DOI: 10.1093/JAC/DKG254
Publisher: BMJ
Date: 2007
Publisher: Royal College of Psychiatrists
Date: 09-2012
DOI: 10.1192/BJP.BP.111.096032
Abstract: Cortisol levels may be altered in childhood in association with maltreatment (neglect, abuse and witnessing abuse) and other adversities, yet little is known about whether effects on cortisol persist into later life. To establish whether childhood psychosocial adversities predict cortisol levels in mid-adulthood. Childhood psychosocial adversities were ascertained in the 1958 British birth cohort and cortisol was measured in two saliva s les, one 45 min after awaking ( T 1 ) and the other 3 h later the same day ( T 2 ), from 6524 participants aged 45 years. No association was seen for abuse or household dysfunction in childhood and adult cortisol levels. In women but not men, T 1 cortisol was lowered by 7.9% per unit increase in childhood neglect score (range 0–3) T 1 to T 2 cortisol decline was less steep. High levels of maltreatment (abuse, neglect, witnessed abuse) were associated with % lower T 1 cortisol in both men and women, and 24% higher T 2 cortisol for men after adjustment for concurrent depressive/anxiety symptoms. In a non-clinical population, cumulative maltreatments in childhood were associated with flattened morning cortisol secretion in mid-adult life.
Publisher: Wiley
Date: 14-02-2007
DOI: 10.1111/J.1464-5491.2006.02055.X
Abstract: Information on the population at risk of developing Type 2 diabetes in the UK is scarce. We used data from the 1958 British birth cohort to estimate geographical and socio-economic variations in HbA(1c) in mid life. Participants (n = 7799) born in England, Scotland and Wales and currently living in the UK. In iduals were classified according to the presence of Type 2 diabetes and by thresholds of HbA(1c). HbA(1c)> or = 5.5 was used as an indicator for possible subclinical alterations in glucose metabolism. The majority of the population had HbA(1c) or = 7.0%. In iduals from manual socio-economic groups and those living in the East of England and Scotland had a higher prevalence of HbA(1c) at or above the upper normal range (5.5%). Estimates from this nationwide s le suggest that a proportion of Britons are likely to have subclinical alterations in glucose metabolism by their mid 40s, and this proportion is greater in some socio-economic groups and geographical regions than in others.
Publisher: Springer Science and Business Media LLC
Date: 18-03-2010
DOI: 10.1007/S10654-010-9438-4
Abstract: This study examined associations between exposure to shift-work and risk factors for cardiovascular disease (CVD) and whether the associations are explained by socio-economic circumstances, occupational factors or health behaviours. Biological risk factors for CVD were measured in 7,839 participants of the 1958 British birth cohort at age 45 years who were in paid employment. Regular (>or=1/week) shift-workers included 46% working evenings (1800-2200), 28% weekends, 13% nights (2200-0400) and 14% early mornings (0400-0700). Adverse levels of several CVD risk factors were found in association with increasing participation in any shift-work. Men regularly working all four shift-work types had increased CVD risk factors of approximately 0.1-0.2 standard deviations (e.g. 0.8 kg/m(2) for body mass index 1.2 cm for waist circumference) than those not regularly working shifts for women, there was a positive linear trend for triglyceride levels, but a negative trend for diastolic blood pressure. Separate analyses of shift-work types showed associations primarily for night/morning working rather than evening/weekend working. Men had adverse levels of all CVD risk factors except blood pressure and total-cholesterol in association with night or early morning work and women had adverse triglyceride levels. Adjustment for socioeconomic, occupational factors and health behaviours explained most associations except for adiposity and C-reactive protein. Our results highlight night and early morning working associations with an adverse profile of CVD risk factors, which are partly explained by socioeconomic, other occupational factors and health behaviours.
Publisher: Oxford University Press (OUP)
Date: 16-01-2010
DOI: 10.1093/IJE/DYP365
Abstract: Workplace factors (night work, long working hours, psychosocial work stress) have been reported to be associated with increased risk of cardiovascular disease (CVD). We investigated whether (i) workplace factors are associated with CVD risk factors independently of each other, (ii) workplace factors interact, thereby modifying associations and (iii) associations are explained by early life exposures. A total of 7916 employed participants in the 1958 British birth cohort underwent a clinical assessment at age 45 years. Regression analysis was used to examine associations between workplace factors and CVD risk factor levels with adjustment for early life exposures. Night work was associated with adverse levels of most CVD risk factors. Working > or =48 h/week was positively associated with body mass index (BMI) and waist circumference (WC). Low job control was positively associated with glycosylated haemoglobin (HbA1c) and inflammatory factors, and inversely associated with high-density lipoprotein (HDL)-cholesterol. Low demands were positively associated with systolic blood pressure (SBP), triglycerides and inflammatory factors and inversely associated with HDL-cholesterol. Several associations were weakened when workplace factors were adjusted for each other. Night workers in low-demand jobs had higher BMI [0.78 kg/m(2) 95% confidence interval (CI) 0.35, 1.21], WC (1.49 cm 0.45, 2.52) and SBP (1.38 mmHg -0.04, 2.81). HDL was lower for low control plus night work (-0.04 mmol/l -0.08, -0.01) or long hours (-0.12 -0.18, -0.69). Adjustment for early life exposures explained 30-50% of most associations, e.g. night work/low demands associations reduced by 50% for BMI and WC, and by 39% for SBP. Associations between workplace factors and CVD risk factors in mid-adulthood arise in part from social and health disadvantage originating earlier in life.
Publisher: Springer Science and Business Media LLC
Date: 17-07-2017
Publisher: Elsevier BV
Date: 05-2004
Publisher: Springer US
Date: 2005
Publisher: BMJ
Date: 14-06-2009
Abstract: To examine the relationships between exposure to workplace factors (night work, extended working hours, psychosocial work stress) and cortisol secretion, and to test whether workplace factors interact, resulting in combined effects. Multiple linear and logistic regression was used to test relationships between workplace factors and cortisol secretion in the 1958 British birth cohort at 45 years. Salivary cortisol was measured twice on the same day to capture the post-waking decline, facilitating the analysis of different cortisol patterns: (1) time 1 (T1, 45 minutes post-waking) (2) time 2 (T2, 3 h after T1) (3) average 3 h exposure from T1 to T2 cortisol and (4) T1 to T2 change. To identify altered diurnal cortisol patterns we calculated: (1) flat T1-T2 change in cortisol (2) top 5% T1 (3) bottom 5% T1 and (4) T1 hypo-secretion or hyper-secretion. Models were adjusted for socioeconomic position at birth and in adulthood, qualifications, marital status, dependent children, and smoking status. 25% of men and 8% of women were exposed to >1 workplace factor (night work, extended work hours, job strain). Night work was associated with a 4.28% (95% CI 1.21 to 7.45) increase in average 3 h cortisol secretion independently of job strain or work hours. Night workers not exposed to job strain had elevated T1 cortisol (5.81%, 95% CI 1.61 to 10.19), although for T2 cortisol it was night workers exposed to low job control who had elevated levels (11.72%, 95% CI 4.40 to 19.55). Men (but not women) working >48 h/week had lower average 3 h cortisol secretion (4.55%, 95% CI -8.43 to -0.50). There were no main effects for psychosocial work stress. All associations for T2 and average 3 h cortisol secretion weakened slightly after adjustment for confounding factors, but associations for T1 cortisol were unaffected by adjustment. Our study suggests that night work in particular is associated with elevated cortisol secretion and that cortisol dysregulation may exist in subgroups with specific combinations of stressors.
Publisher: Elsevier BV
Date: 04-2015
Publisher: Oxford University Press (OUP)
Date: 15-12-2002
DOI: 10.1086/342691
Abstract: The incidence of Clostridium difficile-associated diarrhea (CDAD) has increased dramatically in hospitals worldwide during the past 2 decades. In Western Australia, this increase was most obvious during the 1980s, when there was also an increase in the use of third-generation cephalosporin antibiotics. A study of the epidemiology of CDAD and the use of third-generation cephalosporins during 1993-2000 was undertaken. From 1993 through 1998, the incidence of CDAD remained relatively stable (2-3 cases per 1000 discharges annually). Then, a significant decrease in the incidence occurred, from 2.09 cases per 1000 discharges (95% confidence interval [CI], 1.71-2.47) in 1998 to 0.87 cases per 1000 discharges (95% CI, 0.63-1.11) in 1999 (P<.0001) this decrease persisted into 2000. A decrease in third-generation cephalosporin use occurred during the period of the study because of changes in the prescribing policy. These findings suggest that a reduction in the use of third-generation cephalosporins can reduce the occurrence of CDAD.
Publisher: Cold Spring Harbor Laboratory
Date: 11-06-2021
DOI: 10.1101/2021.06.08.21258597
Abstract: The future health workforce needs to be equipped with the knowledge, skills, and motivation to deliver sustainable healthcare and promote planetary health. The aim of this study was to design, implement and evaluate a new suite of planetary health learning activities piloted by medical students for a range of medical professionals. The study consisted of three components: curriculum mapping, development of learning activities and evaluation. Curriculum mapping involved searching program learning outcomes using relevant search terms. Two learning activities were co-developed with medical students comprising of an e-learning component and an inquiry-based small group workshop presented to 99 2 nd year students. Evaluation consisted of pre- and post-learning knowledge quizzes and a student feedback survey. A total of 30 learning outcomes were identified with the majority located in the first two years of the four-year program. The overall evaluation response rate was 49.5%, and 19% completed the feedback survey. The mean pre- and post-lesson scores, respectively, were 7.09 (SD=1.84) and 9.53 (SD=1.69) out of a possible score of 12, increasing by 2.37 points on average (95% confidence interval [CI] 1.66-3.09). Overall, the new activities were rated as excellent/good by 84.2% of respondents. The e-learning module rated more highly as a meaningful learning experience than the workshop (89% v. 63.2%). The most common criticism was the length of time it took to complete the e-learning. Students already had a good understanding of planetary health ‘facts’ and the e-learning lesson served to confirm, review and update their knowledge. Students embraced the opportunity to engage in interactive learning through the problem-solving group work activity. There is very little vertical alignment of environmental and climate issues across all four years of the medical program in our institution and a variety of learning approaches should be considered when revising the curriculum.
Publisher: American Diabetes Association
Date: 04-2007
DOI: 10.2337/DC06-1881
Abstract: OBJECTIVE—Birth weight has been associated with the risk of type 2 diabetes in several studies. We investigated whether prenatal influences on birth weight (gestational age, parity, preecl sia, prepregnancy BMI, smoking during pregnancy, and socioeconomic position [SEP]) were associated with glucose metabolism in midlife and the role of birth weight for gestational age (BGA) and adult adiposity in mediating these associations. RESEARCH DESIGN AND METHODS—Data from 7,518 participants of the 1958 British Birth Cohort with information on A1C at age 45 years were analyzed. Associations between prenatal exposures and A1C ≥6% were examined using a series of logistic regression models. The basic model consisted of all prenatal factors (except parity) adjusted for sex and family history of type 2 diabetes. Further adjustments included BGA only, concurrent adiposity only (BMI and waist circumference), and BGA plus adiposity. RESULTS—In the basic model, preecl sia (odds ratio 1.78 [95% CI 1.14–2.80]), prepregnancy BMI ≥25 kg/m2 (1.90 [1.45–2.47]), maternal smoking (1.33 [1.04–1.71]), and manual SEP (1.87 [1.36–2.58]) were independently associated with A1C at 45 years of age. Adjustment for BGA had little impact on the prenatal factors/A1C associations, whereas adjustment for adult adiposity at 45 years substantially reduced associations for prepregnancy BMI, smoking during pregnancy, and SEP. CONCLUSIONS—Prenatal exposures were related to blood glucose levels in mid-adulthood. Associations for several prenatal factors were largely mediated through adult adiposity but surprisingly not through birth weight. Prenatal exposures are likely to have the strongest effect on glucose metabolism indirectly through their influence on adiposity.
Publisher: European Centre for Disease Control and Prevention (ECDC)
Date: 12-03-2015
DOI: 10.2807/1560-7917.ES2015.20.10.21059
Abstract: We describe an Australia-wide Clostridium difficile outbreak in 2011 and 2012 involving the previously uncommon ribotype 244. In Western Australia, 14 of 25 cases were community-associated, 11 were detected in patients younger than?65 years, 14 presented to emergency/outpatient departments, and 14 to non-tertiary/community hospitals. Using whole genome sequencing, we confirm ribotype 244 is from the same C. difficile clade as the epidemic ribotype 027. Like ribotype 027, it produces toxins A, B, and binary toxin, however it is fluoroquinolone-susceptible and thousands of single nucleotide variants distinct from ribotype 027. Fifteen outbreak isolates from across Australia were sequenced. Despite their geographic separation, all were genetically highly related without evidence of geographic clustering, consistent with a point source, for ex le affecting the national food chain. Comparison with reference laboratory strains revealed the outbreak clone shared a common ancestor with isolates from the United States and United Kingdom (UK). A strain obtained in the UK was phylogenetically related to our outbreak. Follow-up of that case revealed the patient had recently returned from Australia. Our data demonstrate new C. difficile strains are an on-going threat, with potential for rapid spread. Active surveillance is needed to identify and control emerging lineages.
Publisher: Informa UK Limited
Date: 13-01-2022
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/SH17181
Abstract: Introduction Despite a range of interventions, annual numbers of new diagnoses of HIV infection among men who have sex with men (MSM) in Australia have not declined in recent years. Peer-based sexual health clinics targeting MSM, such as the M Clinic in Perth (WA, Australia), have been put in place to provide safe sex counselling and to increase testing rates among MSM and who are at high risk of HIV infection. The aim of this study was to assess the incidence of HIV, chlamydia and gonorrhoea among men attending the M Clinic. Methods: This was a historical cohort study of repeated M Clinic clients from January 2011 to June 2015 inclusive. Testing and risk factor data from M Clinic client software were used to estimate the incidence of HIV, chlamydia and gonorrhoea and associated factors. Results: The incidence of HIV, chlamydia and gonorrhoea was 1.87, 13.58 and 6.48 per 100 person-years respectively. Older men had a higher incidence of HIV infection but a lower incidence of chlamydia and gonorrhoea than younger men. Conclusions: The HIV incidence was higher than found in similar studies in other Australian sexual health clinics, but the incidence of chlamydia and gonorrhoea was similar. The high HIV incidence among clients of the M Clinic points to the importance of making pre-exposure HIV prophylaxis available to clients of the M Clinic and similar services.
Publisher: Cold Spring Harbor Laboratory
Date: 23-02-2021
DOI: 10.1101/2021.02.21.21252172
Abstract: Clostridioides difficile infection (CDI) is the most common cause of healthcare facility-associated (HCFA) infectious diarrhoea in high-income countries. Antibiotic use is the most important modifiable risk factor for CDI. The most recent systematic review covered studies published until 31 st December 2012. To update the evidence for epidemiological associations between specific antibiotic classes and HCFA-CDI for the period 1 st January 2013 to 31 st December 2020. PubMed, Scopus, Web of Science Core Collection, WorldCat, and Proquest Dissertations and Theses. Eligible studies were those conducted among adult hospital inpatients, measured exposure to in idual antibiotics or antibiotic classes, included a comparison group, and measured the occurrence of HCFA-CDI as an outcome. The Newcastle–Ottawa Scale for the Assessment of Quality was used to appraise study quality. To assess the association between each antibiotic class and HA-CDI, a pooled random effects meta-analysis was undertaken. Metaregression and sub-group analysis was used to investigate study characteristics identified a priori as potential sources of heterogeneity. Carbapenems, and 3 rd and 4 th generation cephalosporin antibiotics remain most strongly associated with HCFA-CDI, with cases more than twice as likely to have recent exposure to these antibiotics prior to developing CDI. Modest associations were observed for fluoroquinolones clindamycin, and beta-lactamase inhibitor combination penicillin antibiotics. In idual study effect sizes were variable and heterogeneity was observed for most antibiotic classes. Availability of a single reviewer to select, extract and critically appraise the studies. This review provides the most up to date synthesis of evidence in relation to the risk of HCFA-CDI associated with exposure to specific antibiotic classes. Studies were predominantly conducted in North America or Europe and more studies outside of these settings are needed. Prospero CRD42020181817
Publisher: Wiley
Date: 02-2021
DOI: 10.1111/AJR.12688
Publisher: BMJ
Date: 03-2005
Publisher: Cold Spring Harbor Laboratory
Date: 27-10-2020
DOI: 10.1101/2020.10.22.20218040
Abstract: Regional Australians have a poorer quality of diet compared to people living in metropolitan areas. Food-related cultural capital is one potential mechanism linking social determinants and nutrition. Relationships between food-related cultural capital and diet were investigated as an explanation for nutritional inequalities in regional New South Wales (NSW). A cross-sectional survey of rural NSW adults was conducted from 12 th October 2019 to 31 st March 2020 focusing on diet, socio-economic factors and cultural capital. Three dietary outcomes were assessed: fruit consumption, vegetable consumption, and a healthy diet score. Food-related cultural capital was analysed as objectivised and total incorporated cultural capital separately. The survey was distributed online with social media promotion. Regional south-eastern and western NSW 448 adults (median age 57 years) of whom 93% were female. In unadjusted analysis, both total incorporated and objectivised cultural capital had strong correlations with all three diet outcomes, with low cultural capital associated with poorer nutrition. After adjusting for sociodemographic confounders, low total incorporated cultural capital showed modest associations with low fruit consumption (OR = 1.69, 95%CI = 1.00 – 2.87), low vegetable consumption (OR = 2.94, 95%CI = 1.69 – 5.11) and low diet score (OR = 3.35, 95% CI = 1.59 – 4.71). Food-related cultural capital, particularly incorporated cultural capital, was independently associated with healthy food consumption in regional NSW. This new finding presents potential avenues to improve the diet of rural Australians through diet-related education, promoting food participation and reducing barriers to healthy food access.
Publisher: Elsevier BV
Date: 2015
Publisher: American Academy of Pediatrics (AAP)
Date: 05-2008
Abstract: OBJECTIVE. Child abuse has been associated with poorer physical health in adulthood, but less is known about childhood adversity more broadly, including neglect and family problems, or the pathways from adversity to adult disease. We have examined how different stressful emotional or neglectful childhood adversities are related to adiposity and glucose control in midadulthood, taking into account childhood factors, and whether the relationships are mediated by adult health behaviors and socioeconomic position. METHODS. This was a prospective longitudinal study of 9310 members of the 1958 British birth cohort who participated in a biomedical interview at 45 years of age. Primary outcomes consisted of continuous measures of BMI, waist circumference, and glycosylated hemoglobin at 45 years and categorical indicators: total obesity (BMI ≥ 30), central obesity (waist circumference: ≥102 cm for men and ≥88 cm for women), and glycosylated hemoglobin level of ≥6. RESULTS. The risk of obesity increased by 20% to 50% for several adversities (physical abuse, verbal abuse, witnessed abuse, humiliation, neglect, strict upbringing, physical punishment, conflict or tension, low parental aspirations or interest in education, hardly takes outings with parents, and father hardly reads to child). Adversities with the strongest associations with adiposity (eg, physical abuse) tended to be associated with glycosylated hemoglobin levels of ≥6, but in most cases associations were explained by adjustment for adulthood mediators such as adiposity. Effects of other adversities reflecting less severe emotional neglect and family environment were largely explained by childhood socioeconomic factors. CONCLUSIONS. Some childhood adversities increase the risk of obesity in adulthood and thereby increase the risk for type 2 diabetes. Research is needed to understand the interrelatedness of adversities, the social context of their occurrence, and trajectories from adversity to adult disease.
Publisher: Wiley
Date: 11-2014
DOI: 10.1111/PPE.12155
Abstract: Infants born moderate to late preterm are twice as likely to be rehospitalised within the first few weeks following discharge from the birth admission. It is not understood how rehospitalisation risk changes with age or how risks have changed over time. A retrospective birth cohort study of all live, singleton births in Western Australia 1 January 1980-31 December 2010, without congenital anomalies, followed to 18 years of age. Rehospitalisation rates for gestational age categories (<28, 28-31, 32-33, 34-36, 37-38 and ≥42 weeks) were compared with term births (39-41 weeks) using negative binomial regression. To assess whether rehospitalisation risk changed with age or over time, analyses were conducted for different age intervals and for 5-year birth cohorts. Rehospitalisation rates were higher up to 18 years for all preterm and early term categories including early term (37-38 weeks) [130.2/1000 person-years at risk (pyr) 95% confidence interval 129.1, 131.4] late preterm (34-36 weeks) (164.2/1000 pyr 161.1, 167.4), and post-term (≥42 weeks) (115.3/1000 pyr 111.7, 119.0) compared with term births (109.1/1000 pyr 108.5, 109.7). The effect of gestational age on rehospitalisation was highest during the first year of life and declined by adolescence [e.g. 34-36 weeks: rate ratio = 2.10 (2.04, 2.15) for 29 days-1 year 1.14 (1.11, 1.18) for 12-18 years]. The risk of rehospitalisation up to 1 year of age has declined since 1980, except for those born <32 weeks. Rehospitalisation risk is greater for singleton children born at all gestational ages compared with those born full term. This effect of gestational age on rehospitalisation is highest in the first year post-discharge, but has almost disappeared by adolescence.
Publisher: Oxford University Press (OUP)
Date: 31-03-2021
DOI: 10.1093/JAC/DKAB091
Abstract: Antibiotic use is the most important modifiable risk factor for healthcare facility-associated Clostridioides difficile infection (HCFA-CDI). Previous systematic reviews cover studies published until 31 December 2012. To update the evidence for associations between antibiotic classes and HCFA-CDI to 31 December 2020. PubMed, Scopus, Web of Science Core Collection, WorldCat and Proquest Dissertations & Theses were searched for studies published since 1 January 2013. Eligible studies were those conducted among adult hospital inpatients, measured exposure to in idual antibiotics or antibiotic classes, included a comparison group and measured the occurrence of HCFA-CDI as an outcome. The Newcastle–Ottawa Scale was used to appraise study quality. To assess the association between each antibiotic class and HCFA-CDI, a pooled random-effects meta-analysis was undertaken. Meta-regression and subgroup analysis was used to investigate study characteristics identified a priori as potential sources of heterogeneity. Carbapenems and third- and fourth-generation cephalosporin antibiotics remain the most strongly associated with HCFA-CDI, with cases more than twice as likely to have recent exposure to these antibiotics prior to developing HCFA-CDI. Modest associations were observed for fluoroquinolones, clindamycin and β-lactamase inhibitor combination penicillin antibiotics. In idual study effect sizes were variable and heterogeneity was observed for most antibiotic classes. This review provides the most up-to-date synthesis of evidence in relation to the risk of HCFA-CDI associated with exposure to specific antibiotic classes. Studies were predominantly conducted in North America or Europe and more studies outside of these settings are needed.
Publisher: Public Library of Science (PLoS)
Date: 17-06-2016
Publisher: American Diabetes Association
Date: 19-08-2011
DOI: 10.2337/DC10-1482
Abstract: Long-term implications of childhood obesity and BMI change over the life course for risk of type 2 diabetes remain uncertain. The objective was to establish whether there are effects on adult glucose metabolism of 1) sensitive periods of BMI gain or 2) long duration of overweight and obesity. Participants in the 1958 British birth cohort with child to adult BMI and glycosylated hemoglobin (HbA1c) at 45 years (n = 7,855). Prevalence of type 2 diabetes or HbA1c ≥7 was 2%. BMI gains in child- and adulthood were associated with higher HbA1c: for every SD of 5-year BMI increase from 0 to 7 years, there was a 75% (95% CI 1.42–2.16) increased risk of HbA1c ≥7, increasing to a 4.7-fold (3.12–7.00) risk for the interval 23–33 years. Associations for BMI gain in adulthood were related to attained BMI but were independent for the longer period birth (or 7 years) to 45 years. Duration of obesity was also associated with HbA1c compared with the never obese, those with childhood onset had a 23.9-fold risk (13.5–42.1) of HbA1c ≥7% odds ratios were 16.0 (10.6–24.2) and 2.99 (1.77–5.03), respectively, for young and midadulthood onset. Similar trends by onset age were found in mean HbA1c levels and for onset of overweight. Those with the earliest age of onset had higher BMI and waist circumference at 45 years, which markedly explained the associations for onset age and HbA1c. Excessive BMI gain across the life span and earlier onset of overweight/obesity are associated with impaired glucose metabolism, in part through attained adult BMI.
Publisher: Public Library of Science (PLoS)
Date: 26-06-2015
Publisher: Oxford University Press (OUP)
Date: 08-12-2013
DOI: 10.1093/JAC/DKT477
Abstract: To update the evidence for associations between antibiotic classes and hospital-acquired Clostridium difficile infection (HA-CDI). Electronic databases of journal articles, scholarly theses and conference proceedings using subject headings and keywords related to CDI and antibiotic exposure were searched. Observational epidemiological studies measuring associations between antibiotic classes and HA-CDI were eligible for inclusion. Pooled ORs and 95% CIs were calculated using a random effects model. Study factors identified a priori were examined as sources of heterogeneity. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Of 569 citations identified, 13 case-control and 1 cohort study (15,938 patients) were included. The strongest associations were found for third-generation cephalosporins (OR = 3.20, 95% CI = 1.80-5.71 n = 6 studies I(2) = 79.2%), clindamycin (2.86, 2.04-4.02 n = 6 I(2) = 28.5%), second-generation cephalosporins (2.23, 1.47-3.37 n = 6 I(2) = 48.4%), fourth-generation cephalosporins (2.14, 1.30-3.52 n = 2 I(2) = 0.0%), carbapenems (1.84, 1.26-2.68 n = 6 I(2) = 0.0%), trimethoprim/sulphonamides (1.78, 1.04-3.05 n = 5 I(2) = 70%), fluoroquinolones (1.66, 1.17-2.35 n = 10 I(2) = 64%) and penicillin combinations (1.45, 1.05-2.02 n = 6 I(2) = 54%). The study population and the timing of measurement of antibiotic exposure were the most common sources of heterogeneity. Study quality scored high for seven studies, moderate for six studies and low for one study. The risk of HA-CDI remains greatest for cephalosporins and clindamycin, and their importance as inciting agents should not be minimized. The importance of fluoroquinolones should not be overemphasized, particularly if fluoroquinolone-resistant epidemic strains of C. difficile are absent.
Publisher: Cold Spring Harbor Laboratory
Date: 16-11-2020
DOI: 10.1101/2020.11.12.20230771
Abstract: There is limited data on the effects of social isolation on rural mental health. The aim of this study was to describe the prevalence of psychological distress in a rural area of Australia while exploring the association between psychological distress and social isolation at the in idual and area level. An online cross-sectional survey of 408 adult volunteers was conducted across rural south-eastern New South Wales from October 2019 to April 2020. The Kessler 10 was used to measure psychological distress, while area-level social fragmentation was assessed using the family (ANSFI fam ) and mobility (ANSFI mob ) components of the Australian Neighbourhood Social Fragmentation Index. The number of different occupations of people known socially was used to assess in idual-level social isolation. Spatial analysis was performed to identify any spatial autocorrelation. The prevalence of high psychological distress in the s le was 29%. Using logistic regression models, there was little evidence of a relationship between high psychological distress and ANSFI fam (odds ratio (OR)=0.98, 95% confidence interval (CI)=0.93–1.03), or ANSFI mob (OR=1.04, 95%CI=0.99–1.09). High psychological distress also did not appear to be associated with number of occupations known socially (OR=1.00, 95%CI=0.99–1.00). There was no significant spatial autocorrelation of psychological distress or social fragmentation at the postal area level. The results suggest that social fragmentation or isolation may not have a significant effect on psychological distress in a rural setting. Nevertheless, further investigation of the effects of social isolation on mental health in rural areas is warranted.
Publisher: Elsevier BV
Date: 08-2013
Publisher: American Medical Association (AMA)
Date: 27-03-2006
DOI: 10.1001/ARCHINTE.166.6.682
Abstract: The Cambridge Risk Score (CRS) was developed to screen for type 2 diabetes mellitus risk. We assessed the ability of the CRS to predict glycosylated hemoglobin (HbA(1c)) levels and determined whether the CRS was better than body mass index (BMI) at predicting HbA(1c) levels in midlife. We included 7452 participants without known diabetes in a biomedical survey of the 1958 British Birth Cohort at 45 years of age. Receiver operator characteristic curves were used to compare the ability of the CRS and BMI to identify in iduals with elevated HbA(1c) levels using thresholds of 7.0% or more, 6.0% or more, and 5.5% or more. Of the total s le, 0.9% (95% confidence interval [CI], 0.7%-1.1%) had HbA(1c) levels of 7.0% or more 3.8% (95% CI, 3.2%-4.5%), 6.0% or more and 24.4% (95% CI, 23.1%-25.9%), 5.5% or more. The CRS detected in iduals with elevated HbA(1c) levels with reasonable accuracy (area under the curve, 0.84 for HbA(1c) level >or=7.0% 0.76 for HbA(1c) level >or=6.0%). Similar area under the curve values were obtained using BMI alone (0.84 for HbA(1c) level >or=7.0% 0.79 for HbA(1c) level >or=6.0%). When tested using the lower HbA(1c) threshold of 5.5% or more, the CRS and BMI did not perform well (areas under the curve, 0.65 and 0.63 for CRS and BMI, respectively). Both measures indicated that approximately 20% of the cohort were at increased risk of diabetes. Owing to the low prevalence of diabetes at 45 years of age, only 2% to 3% of those considered at risk had elevated HbA(1c) levels. For a population in mid-adult life, the CRS identified in iduals with elevated HbA(1c) levels reasonably well. However, the CRS had no advantage compared with BMI alone in identifying diabetes risk.
Publisher: Springer Netherlands
Date: 2010
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-0011
Publisher: Springer Netherlands
Date: 2010
Publisher: Elsevier BV
Date: 11-2015
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.ATHEROSCLEROSIS.2010.03.015
Abstract: To establish whether maternal smoking in pregnancy is associated with risk factors for cardiovascular disease (CVD) in mid-adulthood and whether associations are explained by postnatal influences. Participants were 8815 men and women in the 1958 British birth cohort, with data on CVD risk factors measured at 45 y. Maternal smoking was recorded at birth. Offspring of smokers had a higher adult BMI, waist circumference, blood pressure, HbA1c and triglycerides on average than offspring of non-smokers females had lower HDL cholesterol levels. Total cholesterol was unrelated to maternal smoking. Associations were abolished after adjustment for postnatal influences across life, except for BMI and waist circumference: offspring of smokers had a BMI greater by 0.83 kg/m(2) on average than offspring of non-smokers and a 1.8 cm larger waist circumference. Mean BMI and waist circumference increased with number of cigarettes that the mother smoked, but were not elevated in offspring whose mother had quit smoking before or early in pregnancy. Adults exposed to tobacco in utero had a more adverse CVD risk profile in mid-adulthood which appeared to reflect a lifetime accumulation of postnatal influences whereas their higher BMI and central adiposity may be due in part to intrauterine mechanisms.
Publisher: American Diabetes Association
Date: 15-09-2011
DOI: 10.2337/DC11-ER10A
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2013
Publisher: Wiley
Date: 27-09-2013
DOI: 10.1002/CAR.2235
Publisher: Rural and Remote Health
Date: 30-08-2019
DOI: 10.22605/RRH5328
Publisher: Public Library of Science (PLoS)
Date: 07-03-2012
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Claudia Slimings.