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Barnett LM, Verswijveren SJJM, Colvin B, Lubans DR, Telford RM, Lander NJ, Schott N, Tietjens M, Hesketh KD, Morgan PJ, Hinkley T, Downing KL, Telford RD, Cohen KE, Ridgers ND, Abbott G. Motor skill competence and moderate- and vigorous-intensity physical activity: a linear and non-linear cross-sectional analysis of eight pooled trials. Int J Behav Nutr Phys Act 2024; 21:14. [PMID: 38326890 PMCID: PMC10848369 DOI: 10.1186/s12966-023-01546-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/01/2023] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Few studies have examined the relationship between motor skill competence and device-measured physical activity in large samples and none have used non-linear modelling. This study assessed the linear and non-linear associations between motor skill competence and physical activity in children using pooled data from eight studies. METHODS Cross-sectional ActiGraph accelerometer and motor skills competence data from 988 children (50.8% boys) aged 3-11 years were included. Total, object control and locomotor skill competence were assessed using the Test of Gross Motor Skill Development. Linear mixed models were fitted to examine linear associations between motor skill competence and physical activity. Then, restricted cubic splines models were used to assess potential non-linear relationships. Interactions by sex and age were assessed. RESULTS There was evidence of positive linear associations between total skill, and object control and locomotor skills, with moderate- and vigorous-intensity physical activity; however, the associations with total skill competence and object control better fitted a non-linear model. Non-linear models indicated associations were positive but relatively weak in the low to mid ranges of TGMD/object control scores but at high ranges (~ > 70 out of 100/ and ~ 35 out of 50) the association strength increased for both moderate- and vigorous-intensity physical activity. There were sex interactions for locomotor skills only, specifically for vigorous activity with boys having a stronger positive association than girls. CONCLUSIONS There appears to be a threshold for object control skill proficiency that children need to reach to enhance their physical activity levels which provides support for a motor skill "proficiency barrier". This provides a tangible benchmark for children to achieve in motor competence programs.
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Affiliation(s)
- L M Barnett
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia.
- Institute for Physical Activity and Nutrition (IPAN), School of Health and Social Development, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia.
| | - S J J M Verswijveren
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
| | - B Colvin
- School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, VIC, 3125, Australia
| | - D R Lubans
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Keskussairaalantie 4, 40600, Jyväskylä, Finland
| | - R M Telford
- University of Canberra, Research Institute for Sport and Exercise, Bruce, ACT, 2617, Australia
- The Australian National University, National Centre for Epidemiology and Population Health, ANU College of Health & Medicine, 62 Mills Rd, Acton, ACT, 2601, Australia
| | - N J Lander
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
| | - N Schott
- Department of Sport Psychology and Human Movement Sciences Organization, University of Stuttgart, Institute for Sport and Movement Science, Allmandring 28, Stuttgart, 70569, Germany
| | - M Tietjens
- University of Muenster, Institute of Sport and Exercise Sciences, Horstmarer Landweg 62 b, 48149, Münster, Germany
| | - K D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
| | - P J Morgan
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | | | - K L Downing
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
| | - R D Telford
- University of Canberra, Research Institute for Sport and Exercise, Bruce, ACT, 2617, Australia
| | - K E Cohen
- Centre for Active Living and Learning, College of Human and Social Futures, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - N D Ridgers
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
- University of South Australia, Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, Frome Road, Adelaide, SA, 5001, Australia
| | - G Abbott
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Hwy, Burwood, 3125, Australia
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2
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Staudacher HM, Mahoney S, Canale K, Opie RS, Loughman A, So D, Beswick L, Hair C, Jacka FN. Clinical trial: A Mediterranean diet is feasible and improves gastrointestinal and psychological symptoms in irritable bowel syndrome. Aliment Pharmacol Ther 2024; 59:492-503. [PMID: 37969059 DOI: 10.1111/apt.17791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/17/2023] [Accepted: 10/20/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND Diet is fundamental to the care of irritable bowel syndrome (IBS). However, some approaches are not appropriate for individuals experiencing psychological symptoms. AIMS To assess feasibility of a Mediterranean diet in IBS and its impact on gastrointestinal and psychological symptoms. METHODS We recruited adults with Rome IV IBS and mild or moderate anxiety and/or depressive symptoms to an unblinded 6-week randomised controlled trial. Patients were randomised to Mediterranean diet counselling or habitual diet. We collected gastrointestinal and psychological symptom data, dietary data and stool samples for metagenomic sequencing. RESULTS We randomised 59 individuals (29 Mediterranean diet, 30 control); 48 completed the study. The Mediterranean Diet Adherence Screener score was higher in the Mediterranean diet group than controls at week 6 (7.5 [95% CI: 6.9-8.0] vs. 5.7 [5.2-6.3], p < 0.001), and there was a greater score increase than controls (2.1 [95% CI: 1.3-2.9] vs. 0.5 [95% CI: 0.1-1.0], p = 0.004), demonstrating Mediterranean diet feasibility. There was a greater proportion of gastrointestinal symptom responders in the Mediterranean diet group than controls (24/29, 83% vs. 11/30, 37%, p < 0.001) and depression responders (15/29, 52% vs. 6/30 20%, p = 0.015). There was no difference in FODMAP intake at week 6 (p = 0.51). Gastrointestinal adverse events were similar (p = 0.588). There were no differences in change in microbiome parameters between groups. CONCLUSIONS A Mediterranean diet is feasible in IBS and leads to improvement in gastrointestinal and psychological symptoms. Although this study was unblinded, these findings together with the broader benefits of the Mediterranean diet, provide strong impetus for future research in IBS. Australia New Zealand Clinical Trials Registry: ACTRN12620001362987.
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Affiliation(s)
- Heidi M Staudacher
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Sophie Mahoney
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Kim Canale
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Rachelle S Opie
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Amy Loughman
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Daniel So
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
- Department of Nutritional Sciences, King's College London, London, UK
| | - Lauren Beswick
- Department of Gastroenterology, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Chris Hair
- Department of Gastroenterology, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Felice N Jacka
- Food & Mood Centre, The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine and Barwon Health, Deakin University, Geelong, Victoria, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
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3
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D'Cruz AFL, Downing KL, Sciberras E, Hesketh KD. Are physical activity and sleep associated with emotional self-regulation in toddlers? a cross-sectional study. BMC Public Health 2024; 24:61. [PMID: 38166760 PMCID: PMC10763404 DOI: 10.1186/s12889-023-17588-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Toddlerhood (2-3 years) is a crucial period for the development of physical activity, sleep, and emotional self-regulation skills. Although there is growing evidence of positive associations between physical activity, sleep, and emotional self-regulation in school-aged children, the associations in toddlers remain unclear. Thus, this study aimed to examine the association between physical activity, sleep, and emotional self-regulation in toddlers. METHODS Baseline data from 1350 toddlers (2.2 ± 0.33 year) from the Let's Grow randomised controlled trial were used. Toddlers' total physical activity (TPA) and moderate- to vigorous-intensity physical activity (MVPA) were assessed via 4 + days of accelerometry and a 3-item parent-report scale. Parent-reported total sleep quantity was calculated using the sum of average night-time sleep and daytime nap durations. Sleep behaviour data including bedtime routine, bedtime resistance, sleep onset-delay, sleep duration, and night waking were collected using relevant subsections from the Child Sleep Habits Questionnaire (CSHQ) and Brief Infant Sleep Questionnaire revised (BISQ-R). A 4-item parent-report scale adapted from the Fast Track Project Child Behaviour Questionnaire was used to assess toddlers' emotional self-regulation. Linear regression models were used, adjusting for child age, sex, and parental education. RESULTS Accelerometer-derived TPA, MVPA and parent-reported TPA were not associated with emotional self-regulation. Higher parent-reported MVPA (B = -0.01 CI95 -0.03, -0.003) was associated with poorer emotional self-regulation. Higher sleep duration was associated with better emotional self-regulation (B = 0.06 CI95 0.04, 0.08). The five sleep behaviours assessed were also positively associated with emotional self-regulation (all p < 0.01), with fewer problem sleep behaviours being associated with better emotional self-regulation. CONCLUSIONS This cross-sectional study suggests that sleep may be important for emotional self-regulation in toddlers, but the role of physical activity remains unclear. These findings suggest that interventions targeting sleep duration and sleep behaviours during the early toddler years may benefit the positive development of emotional self-regulation skills in this population.
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Affiliation(s)
- Abhigale F L D'Cruz
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
| | - Katherine L Downing
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Emma Sciberras
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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Holloway-Kew KL, Rufus-Membere PG, Anderson KB, Harland JW, Diez-Perez A, Kotowicz MA, Pasco JA. Mean Bone Material Strength Index Values for Women are Lower Than Those for Men: Data from a Single Geographical Location. Calcif Tissue Int 2023; 113:511-514. [PMID: 37666992 PMCID: PMC10618326 DOI: 10.1007/s00223-023-01133-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/21/2023] [Indexed: 09/06/2023]
Abstract
Bone material strength index (BMSi) values are obtained using impact microindentation, which assesses the ability of bone to resist indentation. Differences in BMSi between men and women are unclear, and to date, BMSi sex differences have not been compared for individuals from the same population. Therefore, we compared BMSi values for men and women drawn from the same geographical location in Australia. Participants (n = 220) were from the Geelong Osteoporosis Study. BMSi was measured, following international published guidelines, using an OsteoProbe for participants at recent follow-up phases (women 2022-2023 and men 2016-2022). Women (n = 55) were age matched to men (n = 165) in a 1:3 ratio. A two-sample t test was used to determine the intergroup difference in mean BMSi. Linear regression was also performed, adjusting for weight and height. Median (IQR) ages for men and women were 67.0 (61.7-71.5) and 67.4 (62.0-71.2) years (p = 0.998). Men were heavier (81.0 ± 10.9 vs 71.0 ± 13.9 kg, p < 0.001) and taller (173.9 ± 6.4 vs 161.5 ± 7.5 cm, p < 0.001) than women. Mean (± SD) BMSi for women (75.7 ± 7.4) was lower than for men (82.8 ± 6.8) (p < 0.001). The difference persisted after adjustment for weight and height (mean ± SE: 76.5 ± 1.1 vs 82.5 ± 0.6, p < 0.001). Given the higher fracture risk observed for women, the higher mean BMSi values in men are consistent with cross sectional data suggesting this measure may be useful in fracture prediction.
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Affiliation(s)
- Kara L Holloway-Kew
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.
| | - Pamela G Rufus-Membere
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Kara B Anderson
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Jacob W Harland
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
| | - Adolfo Diez-Perez
- Department of Internal Medicine, Hospital del Mar-IMIM, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - Mark A Kotowicz
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine, The University of Melbourne, Western Health, St Albans, Australia
| | - Julie A Pasco
- IMPACT, The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine, The University of Melbourne, Western Health, St Albans, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Lobo EH, Johnson T, Frølich A, Kensing F, Rasmussen LJ, Hosking SM, Page AT, Livingston PM, Islam SMS, Grundy J, Abdelrazek M. Utilization of social media communities for caregiver information support in stroke recovery: An analysis of content and interactions. PLoS One 2022; 17:e0262919. [PMID: 35081150 PMCID: PMC8791510 DOI: 10.1371/journal.pone.0262919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 01/07/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Caregivers often use the internet to access information related to stroke care to improve preparedness, thereby reducing uncertainty and enhancing the quality of care.
Method
Social media communities used by caregivers of people affected by stroke were identified using popular keywords searched for using Google. Communities were filtered based on their ability to provide support to caregivers. Data from the included communities were extracted and analysed to determine the content and level of interaction.
Results
There was a significant rise in the use of social media by caregivers of people affected by stroke. The most popular social media communities were charitable and governmental organizations with the highest user interaction–this was for topics related to stroke prevention, signs and symptoms, and caregiver self-care delivered through video-based resources.
Conclusion
Findings show the ability of social media to support stroke caregiver needs and practices that should be considered to increase their interaction and support.
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Affiliation(s)
- Elton H. Lobo
- School of Information Technology, Deakin University, Geelong, VIC, Australia
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Tara Johnson
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Faculty of Health, Deakin University, Geelong, VIC, Australia
| | - Anne Frølich
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Innovation and Research Centre for Multimorbidity, Slagelse Hospital, Slagelse, Region Zealand, Denmark
| | - Finn Kensing
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | - Lene J. Rasmussen
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | | | - Amy T. Page
- Pharmacy Department, Alfred Health, Melbourne, VIC, Australia
- Centre for Medicine Use and Safety, Monash University, Melbourne, VIC, Australia
| | | | | | - John Grundy
- Faculty of Information Technology, Monash University, Melbourne, VIC, Australia
| | - Mohamed Abdelrazek
- School of Information Technology, Deakin University, Geelong, VIC, Australia
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Mravunac M, Szymlek-Gay EA, Daly RM, Roberts BR, Formica M, Gianoudis J, O'Connell SL, Nowson CA, Cardoso BR. Greater Circulating Copper Concentrations and Copper/Zinc Ratios are Associated with Lower Psychological Distress, But Not Cognitive Performance, in a Sample of Australian Older Adults. Nutrients 2019; 11:nu11102503. [PMID: 31627408 PMCID: PMC6836146 DOI: 10.3390/nu11102503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/10/2019] [Accepted: 10/10/2019] [Indexed: 02/06/2023] Open
Abstract
Dyshomeostasis of copper and zinc is linked to neurodegeneration. This study investigated the relationship between circulating copper and zinc and copper/zinc ratios and cognitive function, symptoms of depression and anxiety, and neurotrophic factors in older Australian adults. In this cross-sectional study (n = 139), plasma copper, serum zinc, and neurotrophic factors (brain-derived neurotrophic factor (BDNF), vascular endothelial growth factor, and insulin-like growth factor-1) were assessed. Cognition was assessed using the Cogstate battery and the Behavior Rating Inventory (BRI) of Executive Function (Adult version). Symptoms of anxiety and depression were assessed with the Hospital Anxiety and Depression Scale. Copper (β = −0.024; 95% CI = −0.044, −0.004; p = 0.019) and copper/zinc ratio (β = −1.99; 95% CI = −3.41, −0.57; p = 0.006) were associated with lower depressive symptoms, but not cognition. Plasma copper had a modest positive association with BDNF (β = −0.004; 95% CI = 0.000, 0.007; p = 0.021). Zinc was not associated with any of the outcomes. In conclusion, greater circulating copper concentrations and higher copper/zinc ratios were associated with lower depressive symptoms (but not cognition), with copper also positively associated with BDNF concentration, in a sample of community-dwelling older adults.
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Affiliation(s)
- Michelle Mravunac
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
| | - Ewa A Szymlek-Gay
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
- Nutrition Society of Australia, PO Box 576, Crows Nest, NSW 1585, Australia.
| | - Robin M Daly
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
| | - Blaine R Roberts
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia.
| | - Melissa Formica
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
| | - Jenny Gianoudis
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
| | - Stella L O'Connell
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
| | - Caryl A Nowson
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
- Nutrition Society of Australia, PO Box 576, Crows Nest, NSW 1585, Australia.
| | - Barbara R Cardoso
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC 3220, Australia.
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia.
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill, VIC 3128, Australia.
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7
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Sajjad MA, Holloway-Kew KL, Mohebbi M, Kotowicz MA, de Abreu LLF, Livingston PM, Khasraw M, Hakkennes S, Dunning TL, Brumby S, Page RS, Sutherland AG, Venkatesh S, Williams LJ, Brennan-Olsen SL, Pasco JA. Association between area-level socioeconomic status, accessibility and diabetes-related hospitalisations: a cross-sectional analysis of data from Western Victoria, Australia. BMJ Open 2019; 9:e026880. [PMID: 31122981 PMCID: PMC6537986 DOI: 10.1136/bmjopen-2018-026880] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 03/07/2019] [Accepted: 03/08/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Hospitalisation rates for many chronic conditions are higher in socioeconomically disadvantaged and less accessible areas. We aimed to map diabetes hospitalisation rates by local government area (LGA) across Western Victoria, Australia, and investigate their association with socioeconomic status (SES) and accessibility/remoteness. DESIGN Cross-sectional study METHODS: Data were acquired from the Victorian Admitted Episodes Dataset for all hospitalisations (public and private) with a diagnosis of type 1 or type 2 diabetes mellitus during 2011-2014. Crude and age-standardised hospitalisation rates (per 1000 population per year) were calculated by LGA for men, women and combined data. Associations between accessibility (Accessibility/Remoteness Index of Australia, ARIA), SES (Index of Relative Socioeconomic Advantage and Disadvantage, IRSAD) and diabetes hospitalisation were investigated using Poisson regression analyses. RESULTS Higher LGA-level accessibility and SES were associated with higher rates of type 1 and type 2 diabetes hospitalisation, overall and for each sex. For type 1 diabetes, higher accessibility (ARIA category) was associated with higher hospitalisation rates (men incidence rate ratio [IRR]=2.14, 95% CI 1.64 to 2.80; women IRR=2.45, 95% CI 1.87 to 3.19; combined IRR=2.30, 95% CI 1.69 to 3.13; all p<0.05). Higher socioeconomic advantage (IRSAD decile) was also associated with higher hospitalisation rates (men IRR=1.25, 95% CI 1.09 to 1.43; women IRR=1.32, 95% CI 1.16 to 1.51; combined IRR=1.23, 95% CI 1.07 to 1.42; all p<0.05). Similarly, for type 2 diabetes, higher accessibility (ARIA category) was associated with higher hospitalisation rates (men IRR=2.49, 95% CI 1.81 to 3.43; women IRR=2.34, 95% CI 1.69 to 3.25; combined IRR=2.32, 95% CI 1.66 to 3.25; all p<0.05) and higher socioeconomic advantage (IRSAD decile) was also associated with higher hospitalisation rates (men IRR=1.15, 95% CI 1.02 to 1.30; women IRR=1.14, 95% CI 1.01 to 1.28; combined IRR=1.13, 95% CI 1.00 to 1.27; all p<0.05). CONCLUSION Our observations could indicate self-motivated treatment seeking, and better specialist and hospital services availability in the advantaged and accessible areas in the study region. The determinants for such variations in hospitalisation rates, however, are multifaceted and warrant further research.
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Affiliation(s)
| | | | - Mohammadreza Mohebbi
- Biostatistics Unit, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Mark A Kotowicz
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Department of Medicine -Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | | | | | - Mustafa Khasraw
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Sharon Hakkennes
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Trisha L Dunning
- School of Nursing and Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Susan Brumby
- National Centre for Farmer Health, Western District Health Service, Hamilton, Victoria, Australia
- School of Medicine, Deakin University, Waurn Ponds, Victoria, Australia
| | - Richard S Page
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
- Barwon Centre of Orthopaedic Research and Education (B-CORE), St John of God Hospital and Barwon Health, Geelong, Victoria, Australia
| | - Alasdair G Sutherland
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
- South West Healthcare, Warrnambool, Victoria, Australia
| | - Svetha Venkatesh
- Applied Artificial Intelligence Institute, Deakin University, Geelong, Victoria, Australia
| | - Lana J Williams
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Sharon L Brennan-Olsen
- Department of Medicine -Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne, Melbourne, Victoria, Australia
| | - Julie A Pasco
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Department of Medicine -Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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8
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Holloway KL, Mohebbi M, Betson AG, Hans D, Hyde NK, Brennan-Olsen SL, Kotowicz MA, Pasco JA. Prediction of major osteoporotic and hip fractures in Australian men using FRAX scores adjusted with trabecular bone score. Osteoporos Int 2018; 29:101-108. [PMID: 28940052 DOI: 10.1007/s00198-017-4226-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 09/14/2017] [Indexed: 12/23/2022]
Abstract
UNLABELLED There was no significant difference between the areas under receiver operating characteristics (AUROCs) and diagnostic indexes (sensitivity, specificity, positive predictive value, negative predictive value) for either major osteoporotic or hip fracture FRAX scores when comparing the unadjusted and trabecular bone score (TBS)-adjusted scores. INTRODUCTION FRAX 10-year probability of fracture can be calculated with adjustment for the TBS. Studies have shown that TBS can improve FRAX assessments in some populations. This study aimed to determine if TBS-adjusted FRAX score is better than the unadjusted score for predicting major osteoporotic fracture (MOF) and hip fracture in Australian men. METHODS This study involved 591 men aged 40-90 years, enrolled in the Geelong Osteoporosis Study. Incident MOF (n = 50) and hip fractures (n = 14) were ascertained using radiological reports. Median follow-up time was 9.5 years (IQR7.5-11.4). Diagnostic indexes were calculated using cut points of ≥20% for MOF and ≥3% for the hip. AUROC curves were also determined for adjusted and unadjusted scores as continuous variables. RESULTS Sensitivity was higher in the TBS-adjusted scores (MOF 4%, hip 78.6%) than the unadjusted scores (MOF 2%, hip 57.1%), with a decrease in specificity (MOF 98.9 vs 99.3%; hip 79.9 vs 83.9%). When considering TBS-adjusted and unadjusted FRAX as continuous scores, AUROCs were 0.738 and 0.740, respectively, for MOF and 0.849 and 0.848 for the hip. CONCLUSIONS Prediction of fractures by MOF or hip FRAX was not substantially improved by TBS adjustment. There was no difference in AUROCs or diagnostic indexes for cut-off points of ≥20 for MOF and ≥3% for hip FRAX.
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Affiliation(s)
- K L Holloway
- Deakin University, Geelong, Australia.
- Epi-Centre for Healthy Ageing (ECHA), IMPACT Strategic Research Centre, Deakin University,, Health Education and Research Building, PO Box 281, Geelong, VIC, 3220, Australia.
| | - M Mohebbi
- Deakin University, Geelong, Australia
| | | | - D Hans
- Center of Bone Diseases, Bone & Joint Department, Lausanne University Hospital, Lausanne, Switzerland
| | - N K Hyde
- Deakin University, Geelong, Australia
| | - S L Brennan-Olsen
- Deakin University, Geelong, Australia
- The Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia
- Australian Institute for Musculoskeletal Science, The University of Melbourne, Melbourne, Australia
| | - M A Kotowicz
- Deakin University, Geelong, Australia
- Barwon Health, Geelong, Australia
| | - J A Pasco
- Deakin University, Geelong, Australia
- Barwon Health, Geelong, Australia
- Melbourne Medical School-Western Campus, The University of Melbourne, Melbourne, Australia
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Livingstone KM, McNaughton SA. Diet quality is associated with obesity and hypertension in Australian adults: a cross sectional study. BMC Public Health 2016; 16:1037. [PMID: 27716133 PMCID: PMC5045600 DOI: 10.1186/s12889-016-3714-5] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Accepted: 09/23/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Poor diet, characterized by a low diet quality score, has been associated with greater prevelence of obesity and hypertension. However, the evidence is inconsistent across diet quality scores and by sex. The aim was to investigate the relationship between diet quality and obesity and hypertension. METHODS Adults (n = 4908; age 45.2 ± 0.24 years) were included from the cross-sectional Australian Health Survey 2011-2013. Two 24-h dietary recalls were used to derive the dietary guideline index (DGI) and recommended food score (RFS). Logistic regression investigated relationships between diet quality score and odds ratio of obesity, hypertension and obesity-associated hypertension. RESULTS In the highest tertile of DGI, but not RFS, individuals were less likely to be obese (men: OR 0.64, CI: 0.45, 0.92, P-trend = 0.014; women: 0.68, 0.48, 0.96, P-trend = 0.025) and to have central adiposity (men: 0.68, 0.48, 0.97, P-trend = 0.030; women: 0.53, 0.37, 0.77, P-trend = 0.001) compared with the lowest tertile. Men, but not women, in the highest tertile of DGI and RFS were less likely to be hypertensive (DGI: 0.56, 0.37, 0.85, P-trend = 0.006; RFS: 0.62, 0.41, 0.94, P-trend = 0.021) compared with the lowest tertile. In men with obesity, but not normal weight men or women, those in the highest tertile of DGI were less likely to be hypertensive (0.53, 0.36, 0.78, P-trend = 0.001) compared with the highest tertile. CONCLUSIONS Higher diet quality, as estimated using DGI, was associated with lower odds ratio of obesity in men and women. Odds ratio of hypertension was lower in men, but not women, with a high diet quality score compared with a low score, while obesity-associated hypertension was only associated with diet quality score in men with obesity. Longitudinal studies are needed to evaluate whether diet quality predicts risk of obesity and hypertension.
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Affiliation(s)
- Katherine M. Livingstone
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Melbourne Burwood Campus, 221 Burwood Highway, Geelong, VIC 3125 Australia
| | - Sarah A. McNaughton
- Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Melbourne Burwood Campus, 221 Burwood Highway, Geelong, VIC 3125 Australia
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