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Vuong K, Kabir A, Conway DP, Williamson M, Harris MF, Barr ML. Identifying risk factors for developing obesity: a record linkage longitudinal study in metropolitan Sydney using the 45 and Up Study. Fam Pract 2024; 41:680-692. [PMID: 38478922 PMCID: PMC11461147 DOI: 10.1093/fampra/cmae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/10/2024] Open
Abstract
BACKGROUND Primary care clinicians have key responsibilities in obesity prevention and weight management. AIMS We aimed to identify risk factors for developing obesity among people aged ≥45 years. METHODS We conducted a record linkage longitudinal study of residents of metropolitan Sydney, Australia using data from the: (1) 45 and Up Study at baseline (2005-2009) and first follow-up (2012-2015); (2) Medicare claims; (3) Pharmaceutical Benefits Scheme; and (4) deaths registry. We examined risk factors for developing obesity (body mass index [BMI]: 30-40) at follow-up, separately for people within the: (1) healthy weight range (BMI 18.5-<25) and (2) overweight range (BMI 25-<30) at baseline. Covariates included demographics, modifiable behaviours, health status, allied health use, and medication use. Crude and adjusted relative risks were estimated using Poisson regression modelling. RESULTS At follow-up, 1.1% (180/16,205) of those in the healthy weight range group, and 12.7% (1,939/15,266) of those in the overweight range group developed obesity. In both groups, the following were associated with developing obesity: current smoking at baseline, physical functioning limitations, and allied health service use through team care planning, while any alcohol consumption and adequate physical activity were found to be associated with a lower risk of developing obesity. In the healthy weight group, high psychological distress and the use of antiepileptics were associated with developing obesity. In the overweight group, female sex and full-time work were associated with developing obesity, while older age was found to be associated with a lower risk of developing obesity. CONCLUSIONS These findings may inform the targeting of preventive interventions for obesity in clinical practice and broader public health programs.
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Affiliation(s)
- Kylie Vuong
- School of Medicine and Dentistry, Griffith University, Queensland, Australia
- School of Population Health, University of New South Wales, New South Wales, Australia
| | - Alamgir Kabir
- Centre for Primary Health Care and Equity, University of New South Wales, New South Wales, Australia
| | - Damian P Conway
- Population and Community Health Directorate, South Eastern Sydney Local Health District, New South Wales, Australia
- The Kirby Institute, University of New South Wales, New South Wales, Australia
| | - Margaret Williamson
- Centre for Primary Health Care and Equity, University of New South Wales, New South Wales, Australia
| | - Mark F Harris
- Centre for Primary Health Care and Equity, University of New South Wales, New South Wales, Australia
| | - Margo L Barr
- Centre for Primary Health Care and Equity, University of New South Wales, New South Wales, Australia
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O’Bryan E, McKay CD, Eades S, Gubhaju L, Pearson O, Kerr JA, Brown A, Azzopardi PS. Cardiometabolic Risk Markers for Aboriginal and Torres Strait Islander Children and Youths: A Systematic Review of Data Quality and Population Prevalence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6228. [PMID: 37444076 PMCID: PMC10341665 DOI: 10.3390/ijerph20136228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/06/2023] [Accepted: 06/08/2023] [Indexed: 07/15/2023]
Abstract
Cardiovascular disease and type 2 diabetes mellitus are leading contributors to the health inequity experienced by Aboriginal and Torres Strait Islander peoples, and their antecedents can be identified from early childhood. We aimed to establish the quality of available data and the prevalence of cardiometabolic risk markers among Aboriginal and Torres Strait Islander children and youths (0-24-year-olds) to inform public health approaches. A systematic review of the peer-reviewed and grey literature was conducted between 1 January 2000-28 February 2021. Included studies reported population prevalence of cardiometabolic risks, including elevated blood pressure, obesity, central adiposity, dyslipidaemia, hyperglycaemia, and 'metabolic syndrome' for Aboriginal and Torres Strait Islander people aged 0-24 years. Fifteen studies provided population estimates. Data quality was limited by low response rates (10/15 studies) and suboptimal outcome measurements. Obesity is the most reported risk (13/15 studies). Aboriginal and Torres Strait Islander children have an excess risk of obesity from early childhood and prevalence increases with age: 32.1% of Aboriginal and Torres Strait Islander 18-24-year-olds had obesity and 50.8% had central adiposity. In a cohort of 486 9-14-year-olds in Darwin, 70% had ≥1 component of metabolic syndrome; 14% met the full criteria for the syndrome. The prevalence of cardiometabolic risk in Aboriginal and Torres Strait Islander young people is difficult to estimate due to limitations in measurement quality and sampling representativeness. Available data suggest that cardiometabolic risk markers are evident from early childhood. The establishment of national and state-level datasets and a core outcome set for cardiometabolic screening would provide opportunities for preventative action.
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Affiliation(s)
- Eamon O’Bryan
- Global Adolescent Health Group, Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC 3010, Australia
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Christopher D. McKay
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Sandra Eades
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
- Curtin Medical School, Curtin University, Perth, WA 6102, Australia
| | - Lina Gubhaju
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3010, Australia
| | - Odette Pearson
- Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA 5000, Australia
| | - Jessica A. Kerr
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch 8011, New Zealand
- Centre for Adolescent Health, Population Health Theme, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
| | - Alex Brown
- Telethon Kids Institute, Perth, WA 6009, Australia
- National Centre for Indigenous Genomics, The John Curtin School of Medical Research, Australian National University, Canberra, ACT 2601, Australia
| | - Peter S. Azzopardi
- Global Adolescent Health Group, Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, VIC 3010, Australia
- Aboriginal Health Equity Theme, South Australian Health and Medical Research Institute, Adelaide, SA 5000, Australia
- Centre for Adolescent Health, Population Health Theme, Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3052, Australia
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Jones RP. A Model to Compare International Hospital Bed Numbers, including a Case Study on the Role of Indigenous People on Acute 'Occupied' Bed Demand in Australian States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11239. [PMID: 36141510 PMCID: PMC9517562 DOI: 10.3390/ijerph191811239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 06/16/2023]
Abstract
Comparing international or regional hospital bed numbers is not an easy matter, and a pragmatic method has been proposed that plots the number of beds per 1000 deaths versus the log of deaths per 1000 population. This method relies on the fact that 55% of a person's lifetime hospital bed utilization occurs in the last year of life-irrespective of the age at death. This is called the nearness to death effect. The slope and intercept of the logarithmic relationship between the two are highly correlated. This study demonstrates how lines of equivalent bed provision can be constructed based on the value of the intercept. Sweden looks to be the most bed-efficient country due to long-term investment in integrated care. The potential limitations of the method are illustrated using data from English Clinical Commissioning Groups. The main limitation is that maternity, paediatric, and mental health care do not conform to the nearness to death effect, and hence, the method mainly applies to adult acute care, especially medical and critical care bed numbers. It is also suggested that sensible comparison can only be made by comparing levels of occupied beds rather than available beds. Occupied beds measure the expressed bed demand (although often constrained by access to care issues), while available beds measure supply. The issue of bed supply is made complex by the role of hospital size on the average occupancy margin. Smaller hospitals are forced to operate at a lower average occupancy; hence, countries with many smaller hospitals such as Germany and the USA appear to have very high numbers of available beds. The so-called 85% occupancy rule is an "urban myth" and has no fundamental basis whatsoever. The very high number of "hospital" beds in Japan is simply an artefact arising from "nursing home" beds being counted as a "hospital" bed in this country. Finally, the new method is applied to the expressed demand for occupied acute beds in Australian states. Using data specific to acute care, i.e., excluding mental health and maternity, a long-standing deficit of beds was identified in Tasmania, while an unusually high level of occupied beds in the Northern Territory (NT) was revealed. The high level of demand for beds in the NT appears due to an exceptionally large population of indigenous people in this state, who are recognized to have elevated health care needs relative to non-indigenous Australians. In this respect, indigenous Australians use 3.5 times more occupied bed days per 1000 deaths (1509 versus 429 beds per 1000 deaths) and 6 times more occupied bed days per 1000 population (90 versus 15 beds per 1000 population) than their non-indigenous counterparts. The figure of 1509 beds per 1000 deaths (or 4.13 occupied beds per 1000 deaths) for indigenous Australians is indicative of a high level of "acute" nursing care in the last months of life, probably because nursing home care is not readily available due to remoteness. A lack of acute beds in the NT then results in an extremely high average bed occupancy rate with contingent efficiency and delayed access implications.
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Affiliation(s)
- Rodney P Jones
- Healthcare Analysis and Forecasting, Wantage OX12 0NE, UK
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Applying an authentic partnership approach to facilitate optimal health of Aboriginal children. Prim Health Care Res Dev 2022; 23:e47. [PMID: 35968994 PMCID: PMC9381162 DOI: 10.1017/s1463423622000329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
The aim of this development paper is to inform the ongoing implementation of the partnership approach with Aboriginal families in Australia. As almost all Community Health Nurses employed by the Health Department of Western Australia, Country Health Service are non-Aboriginal, there are a number of factors that may, potentially, limit their capacity to work effectively with the primary caregivers of Aboriginal children. Historically, much that has been written about the health and development of Aboriginal people in Australia has been negative and derogatory with wide criticism for their non-participation with health services and healthy lifestyle activities. Not only has this “deficit discourse” approach proved to be unhelpful in terms of improving the health and well-being of Aboriginal people but also there is mounting evidence that it has been detrimental to mental and physical health and capacity to achieve autonomy in all aspects of life. In response to the voices of Aboriginal people, the partnership approach to care has been promoted for use by Community Health Nurses in Western Australia. However, the implementation of the approach is not always genuinely strength based, and it does not always focus on mutual goal setting within authentic partnership relationships. The partnership approach has the potential to improve the lives of Aboriginal people if it is implemented with appropriate cultural sensitivity, shared responsibility, dignity and respect.
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Potential Determinants of Cardio-Metabolic Risk among Aboriginal and Torres Strait Islander Children and Adolescents: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159180. [PMID: 35954531 PMCID: PMC9368168 DOI: 10.3390/ijerph19159180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022]
Abstract
Prevention initiatives during childhood and adolescence have great potential to address the health inequities experienced by Aboriginal and Torres Strait Islander (Indigenous) populations in Australia by targeting modifiable risk factors for cardio-metabolic diseases. We aimed to synthesize existing evidence about potential determinants of cardio-metabolic risk markers—obesity, elevated blood pressure, elevated blood glucose, abnormal lipids, or a clustering of these factors known as the metabolic syndrome (MetS)—for Indigenous children and adolescents. We systematically searched six databases for journal articles and three websites for relevant grey literature. Included articles (n = 47) reported associations between exposures (or interventions) and one or more of the risk markers among Indigenous participants aged 0–24 years. Data from 18 distinct studies about 41 exposure–outcome associations were synthesized (by outcome: obesity [n = 18]; blood pressure [n = 9]; glucose, insulin or diabetes [n = 4]; lipids [n = 5]; and MetS [n = 5]). Obesity was associated with each of the other cardio-metabolic risk markers. Larger birth size and higher area-level socioeconomic status were associated with obesity; the latter is opposite to what is observed in the non-Indigenous population. There were major gaps in the evidence for other risk markers, as well as by age group, geography, and exposure type. Screening for risk markers among those with obesity and culturally appropriate obesity prevention initiatives could reduce the burden of cardio-metabolic disease.
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Poitras ME, T Vaillancourt V, Canapé A, Boudreault A, Bacon K, Hatcher S. Culturally safe interventions in primary care for the management of chronic diseases of urban Indigenous People: a scoping review. Fam Med Community Health 2022; 10:fmch-2022-001606. [PMID: 35523458 PMCID: PMC9083425 DOI: 10.1136/fmch-2022-001606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objectives Chronic conditions represent an important source of major health issues among Indigenous People. The same applies to those, who live off-reserve and in urban areas. However, very few healthcare services are considered culturally safe, resulting in some avoidance of the public healthcare system. Our goal was to review the literature on culturally safe practices available to urban Indigenous People who suffer from chronic diseases. Design We conducted a scoping review to determine what culturally safe healthcare services are currently offered for the management of chronic conditions in urban Indigenous populations, to contribute to a tailored, holistic and safe space in mainstream healthcare systems. Eligibility criteria Peer-reviewed original research articles had to be published by 27 October 2020, in English or French. Information source: In October 2020, we searched five academic databases (EBSCO, PsycArticles, SocINDEX, MEDLINE and PsycINFO) and also reviewed grey literature and the websites of organisations or governments. The data were extracted and collected in an EXCEL spreadsheet. Two reviewers independently screened 326 titles and abstracts, followed by an independent evaluation of 48 full text articles. A total of 19 studies were included in this scoping review, as well as 5 websites/documents from the grey literature. Results In total, 19 studies were included in our analysis. We found that Elders, family and the assistance of an interpreter are crucial elements to include to make urban Indigenous feel safe when they seek healthcare services. With this scoping review, we report interventions that are successful in terms of healthcare delivery for this population. Our findings provide insight on what services should be in place in mainstream healthcare settings to create a culturally safe experience for urban Indigenous People. Conclusions In recent years, there appears to be a growing awareness of the need to provide culturally safe health services. This scoping review identified multiple strategies to promote cultural safety in this context, as well as barriers and facilitators to their implementation. These elements, which have been extensively documented in the literature, should be included in the chronic diseases management interventions to be developed by urban and primary care settings.
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Affiliation(s)
- Marie-Eve Poitras
- Department of Family and Emergency Medicine, Université de Sherbrooke, Chicoutimi, Quebec, Canada .,Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Quebec, Canada
| | - Vanessa T Vaillancourt
- Department of Family and Emergency Medicine, Université de Sherbrooke, Chicoutimi, Quebec, Canada
| | | | - Amélie Boudreault
- Department of Family and Emergency Medicine, Université de Sherbrooke, Chicoutimi, Quebec, Canada
| | - Kate Bacon
- Patient-Partner, Chicoutimi, Quebec, Canada
| | - Sharon Hatcher
- Department of Family and Emergency Medicine, Université de Sherbrooke, Chicoutimi, Quebec, Canada.,Centre intégré universitaire de santé et de services sociaux du Saguenay-Lac-Saint-Jean du Québec, Chicoutimi, Quebec, Canada
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Deacon-Crouch M, Skinner I, Tucci J, Begg S, Wallace R, Skinner T. Association between indigenous status and Body Mass Index (BMI) in Australian adults: Does sleep duration affect the relationship? PLoS One 2022; 17:e0263233. [PMID: 35171935 PMCID: PMC8849483 DOI: 10.1371/journal.pone.0263233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 01/08/2022] [Indexed: 11/19/2022] Open
Abstract
Background Overweight/obesity is a well-defined risk factor for a variety of chronic cardiovascular and metabolic diseases. Sleep duration has been associated with overweight/obesity and other cardio metabolic and neurocognitive problems. Notably, overweight/obesity and many of the associated comorbidities are prevalent in Indigenous Australians. Generally, sleep duration has been associated with BMI for Australian adults but information about Australian Indigenous adults’ sleep is scant. A recent report established that sleep is a weak predictor of obesity for Indigenous Australian adults. Aim To determine whether sleep remains a predictor of obesity when physical activity, diet and smoking status are accounted for; and to determine whether sleep duration plays a mediating role in the relationship between Indigenous status and BMI. Methods Statistical analyses of 5,886 Australian adults: 5236 non-Indigenous and 650 Indigenous people aged over 18 years who participated in the Australian Health Survey 2011–2013. Demographic and lifestyle characteristics were described by χ2 and t-tests. ANOVA was used to determine the variables that significantly predicted BMI and sleep duration. Stepwise regression analyses were performed to determine the strongest significant predictors of BMI. Sleep duration was self-reported; BMI was calculated from measurement. Results The study revealed two main findings: (i) short sleep duration was an independent predictor of obesity (adjusted-R2 = 0.056, p <0.0001); and (ii) controlling for sleep duration and other possible confounders, Indigenous status was a significant predictor of BMI overweight/obesity. Sleep duration played a weak, partial mediator role in this relationship. Increased BMI was associated with lower socioeconomic status and level of disadvantage of household locality for non-remote Indigenous and non-Indigenous people. Conclusion Indigenous status strongly predicted increased BMI. The effect was not mediated by the socioeconomic indicators but was partially mediated by sleep duration.
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Affiliation(s)
- Melissa Deacon-Crouch
- Rural Department of Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- * E-mail:
| | - Isabelle Skinner
- Rural Department of Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Joseph Tucci
- Department of Pharmacy and Biomedical Science, La Trobe Institute for Molecular Science, La Trobe University, Victoria, Australia
| | - Steve Begg
- Rural Department of Community Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Ruth Wallace
- College of Indigenous Futures, Education & the Arts, Charles Darwin University, Northern Territory, Australia
| | - Timothy Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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Serna-Gutiérrez A, Castro-Juarez AA, Romero-Martínez M, Alemán-Mateo H, Díaz-Zavala RG, Quihui-Cota L, Álvarez-Hernández G, Gallegos-Aguilar AC, Esparza-Romero J. Prevalence of overweight, obesity and central obesity and factors associated with BMI in indigenous yaqui people: a probabilistic cross-sectional survey. BMC Public Health 2022; 22:308. [PMID: 35164732 PMCID: PMC8845338 DOI: 10.1186/s12889-022-12702-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/12/2022] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND The Yaquis are an Indigenous group who inhabit in the state of Sonora in northwestern Mexico. This group has experienced changes in their lifestyle, moving from a traditional lifestyle to a more modern one, resulting in an increase of obesity and its comorbidities. However, few studies have been done in this group. The aim of this study was to determine the prevalence of overweight, obesity and central obesity and to identify the factors associated with body mass index (BMI) in a representative sample of Indigenous Yaqui people from Sonora, Mexico. METHODS A cross-sectional survey with multistage sampling was conducted among adults (N = 351) with residence in Yaqui traditional villages (Vícam, Pótam, Loma de Guamúchil, Loma de Bácum, Tórim, Ráhum, Huiribis or Belem). Anthropometric measurements were taken to diagnose overweight, obesity and central obesity. Food frequency and physical activity (PA) questionnaires designed for the Yaqui population were applied, as well as sociodemographic and clinical history questionnaires. The factors associated with BMI were assessed using multiple linear regression considering the complex design of the sampling. RESULTS The prevalence of overweight, obesity and central obesity in the population were 36.5%, 35.0% and 76.0%, respectively. Having higher values of the modernization index (β = 0.20, p = 0.049) was associated with a higher BMI, while having a higher consumption of a "prudent" dietary pattern (traditional dishes, fruits, vegetables and low-fat dairy) (β = -0.58, p = 0.009) and performing a greater number of hours per week of vigorous PA (β = -0.14, p = 0.017) were associated with a lower BMI. CONCLUSIONS The prevalence of the studied abnormalities is high. The evidence presented in this study suggests that interventions are needed and more research is required to determine the appropriate components of such interventions, in order to meet the needs of the Yaqui people.
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Affiliation(s)
- Araceli Serna-Gutiérrez
- Sociocultural Department, Technological Institute of Sonora, 85137, Cd. Obregón, Sonora, México
| | - Alejandro Arturo Castro-Juarez
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), 83304, Hermosillo, Sonora, México
| | - Martín Romero-Martínez
- Evaluation and Surveys Research Center, National Institute of Public Health, 62100, Cuernavaca, Morelos, México
| | - Heliodoro Alemán-Mateo
- Department of Nutrition and Metabolism, Nutrition Coordination, Research Center for Food and Development (CIAD. A.C.), 83304, Hermosillo, Sonora, México
| | - Rolando Giovanni Díaz-Zavala
- Nutrition Health Promotion Center, Department of Chemical and Biological Sciences, University of Sonora, 83000, Hermosillo, Sonora, México
| | - Luis Quihui-Cota
- Department of Nutrition and Metabolism, Nutrition Coordination, Research Center for Food and Development (CIAD. A.C.), 83304, Hermosillo, Sonora, México
| | | | - Ana Cristina Gallegos-Aguilar
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), 83304, Hermosillo, Sonora, México
| | - Julián Esparza-Romero
- Diabetes Research Unit, Department of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), 83304, Hermosillo, Sonora, México. .,Diabetes Research Unit, Deparment of Public Nutrition and Health, Nutrition Coordination, Research Center for Food and Development (CIAD, A.C.), Carretera Gustavo Enrique Astiazarán Rosas No. 46, Col. La Victoria, 83304, Hermosillo, Sonora, México.
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Perry C, Dimitropoulos Y, Skinner J, Bourke C, Miranda K, Cain E, Beaufils D, Christie V, Rambaldini B, Gwynne K. Availability of drinking water in rural and remote communities in New South Wales, Australia. Aust J Prim Health 2022; 28:125-130. [PMID: 35101161 DOI: 10.1071/py21119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/13/2021] [Indexed: 11/23/2022]
Abstract
Many rural communities in New South Wales (NSW), Australia, have poor-quality water supplies. The lack of a palatable alternative increases the risk of the high consumption of sugar-sweetened beverages, a significant contributor to adverse health outcomes. This disproportionately effects Aboriginal people living in these towns, who are also profoundly affected by the social determinants of health. Therefore, examining health inequalities linked to water access is important. This study investigated the availability of drinking water fountains in rural and remote communities in NSW. Telephone interviewer-assisted surveys were conducted with 32 representatives from local government councils or Local Aboriginal Land Councils in NSW from communities with a population of <5000 and an Aboriginal population of at least 3%. The results were analysed descriptively. Towns and communities with a higher population of Aboriginal people and lower median weekly income were less likely to have access to free refrigerated and filtered water within the community or at local schools compared with towns and communities with a lower Aboriginal population and higher median weekly income. The availability of free, clean and refrigerated water in rural and remote communities is critical to reducing the consumption of sugar-sweetened beverages and the promotion of water as the preferred drink.
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Affiliation(s)
- Christina Perry
- Gallatin School of Individualized Study, New York University, New York, USA
| | - Yvonne Dimitropoulos
- Poche Centre for Indigenous Health, The University of Sydney, NSW 2006, Australia; and Corresponding author
| | - John Skinner
- Poche Centre for Indigenous Health, The University of Sydney, NSW 2006, Australia
| | - Chris Bourke
- Austrailan Healthcare and Hospitals Association, ACT 2600, Australia
| | - Kate Miranda
- Australian Dental Association, NSW 2065, Australia
| | - Elyse Cain
- New South Wales Council of Social Service, NSW 2011, Australia
| | | | - Vita Christie
- Poche Centre for Indigenous Health, The University of Sydney, NSW 2006, Australia
| | - Boe Rambaldini
- Poche Centre for Indigenous Health, The University of Sydney, NSW 2006, Australia
| | - Kylie Gwynne
- Garfield Barwick Chambers, NSW 2000, Australia; and Faculty of Medicine, Health and Human Sciences, Macquarie University, NSW 2109, Australia
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Stoś K, Rychlik E, Woźniak A, Ołtarzewski M, Jankowski M, Gujski M, Juszczyk G. Prevalence and Sociodemographic Factors Associated with Overweight and Obesity among Adults in Poland: A 2019/2020 Nationwide Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1502. [PMID: 35162521 PMCID: PMC8834843 DOI: 10.3390/ijerph19031502] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 02/01/2023]
Abstract
Detailed characteristics of the weight status of the population is necessary for the effective prevention of health disorders, e.g., through personalized nutrition education. This study aimed to characterize weight status and identify sociodemographic factors associated with overweight/obesity in a representative sample of adult inhabitants of Poland. This cross-sectional study was carried out from July 2019 to February 2020 on a representative nationwide sample of individuals aged 18+ in Poland. The study consisted of two parts: questionnaire survey and anthropometric measurements. The body mass index was calculated. Data on 1831 adults (50.3% females; mean age 51.7 ± 19.9 years) were included in this analysis. The prevalence of overweight was 42.2% (52.4% among males and 32.0% among females). Of the 1831 participants, 16.4% were obese (16.5% of males and 16.2% of females). Out of 11 factors analyzed in this study, only 5 were significantly associated with overweight/obesity. Males, older participants, occupationally active individuals, those living in rural areas and individuals with at least one chronic disease had greater odds of overweight/obesity. This study demonstrated a high prevalence of overweight and obesity among adults in Poland. This is the most up-to-date representative study on nutritional status carried out before the COVID-19 pandemic.
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Affiliation(s)
- Katarzyna Stoś
- Department of Nutrition and Nutritional Value of Food, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland; (A.W.); (M.O.)
| | - Ewa Rychlik
- Department of Nutrition and Nutritional Value of Food, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland; (A.W.); (M.O.)
| | - Agnieszka Woźniak
- Department of Nutrition and Nutritional Value of Food, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland; (A.W.); (M.O.)
| | - Maciej Ołtarzewski
- Department of Nutrition and Nutritional Value of Food, National Institute of Public Health NIH—National Research Institute, 00-791 Warsaw, Poland; (A.W.); (M.O.)
| | - Mateusz Jankowski
- Centre of Postgraduate Medical Education, School of Public Health, 01-826 Warsaw, Poland;
| | - Mariusz Gujski
- Department of Public Health, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.G.); (G.J.)
| | - Grzegorz Juszczyk
- Department of Public Health, Medical University of Warsaw, 02-097 Warsaw, Poland; (M.G.); (G.J.)
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Fatima Y, Al Mamun A, Bucks RS, Charles Skinner T. Late bedtime and body mass index gain in indigenous Australian children in the longitudinal study of indigenous children. Acta Paediatr 2020; 109:2084-2090. [PMID: 32266735 DOI: 10.1111/apa.15219] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/08/2020] [Accepted: 02/04/2020] [Indexed: 12/01/2022]
Abstract
AIM To explore sleep patterns in indigenous Australian children and assess the role of sleep timing in longitudinal changes in body mass index (BMI). METHODS Latent profile analysis was conducted with the Australian Longitudinal Study of Indigenous Children (LSIC) cohort data (wave 5), to determine distinct patterns of bed and wake timing, taking account of weekday sleep duration, weekday and weekend bedtimes, and weekday wake times. Multilevel models with a random intercept were used to investigate the role of baseline sleep pattern in predicting longitudinal changes in BMI. RESULTS Baseline data for 1258 children (50.7% males), mean age 6.32 ± 1.52 years, indicated the presence of five classes of sleep patterns: early/long sleepers (4.5%), normative sleepers (25.5%), late sleepers (49.9%), consistent late sleepers (11.1%) and early risers (9%). Late sleeping was significantly associated with longitudinal gains in BMI. Compared with early sleepers, consistent late sleepers experienced 1.03 unit gain in BMI at follow-up (95% CI: 0.001-2.05, P = .05). CONCLUSION This study underscores the importance of looking beyond sleep duration and highlights the positive outcomes of early bedtimes in children. As sleep timing is modifiable, this offers the opportunity for improvement in sleep and protecting against future weight gain in indigenous children.
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Affiliation(s)
- Yaqoot Fatima
- Centre for Rural and Remote Health James Cook University Mount Isa QLD Australia
- Institute for Social Science Research University of Queensland Brisbane QLD Australia
| | - Abdullah Al Mamun
- Institute for Social Science Research University of Queensland Brisbane QLD Australia
| | - Romola S. Bucks
- School of Psychology University of Western Australia Crawley WA Australia
| | - Timothy Charles Skinner
- Centre for Rural and Remote Health James Cook University Mount Isa QLD Australia
- Institut for Psykologi Center for Sundhed of Samfund Københavns Universitet Copenhagen Denmark
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12
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Deacon-Crouch M, Begg S, Skinner T. Is sleep duration associated with overweight/obesity in Indigenous Australian adults? BMC Public Health 2020; 20:1229. [PMID: 32787811 PMCID: PMC7424988 DOI: 10.1186/s12889-020-09287-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022] Open
Abstract
Background Associations between high BMI and sleep duration and chronic illness are recognised. Short sleep is an accepted predictor of high BMI for children, including Indigenous Australian children. Short sleep has also been associated with high BMI in Australian adults, although not specifically in Indigenous Australian adults. This study aims to determine whether the relationship between sleep duration and BMI observed in non-Indigenous adults holds for Indigenous adults. Methods Data collected from 5204 non-Indigenous and 646 Indigenous participants aged over 18 years in a nationally representative Australian Health Survey 2011–2013 were analysed. Sleep duration was self-reported as the time between going to bed and time waking up; BMI was derived from measurement and categorised into normal weight (BMI = 18.5–24.9) and overweight/obese (BMI ≥ 25). Logistic regression was performed for the non-Indigenous and Indigenous groups separately to examine the association between sleep duration and BMI in each group. Results Proportionally more Indigenous people were classified as overweight/obese than non-Indigenous (χ2 = 21.81, p < 0.001). Short sleep was reported by similar proportions in both groups (Indigenous 15% vs non-Indigenous 17%) whereas long sleep of > 9 h was reported by proportionally more Indigenous than non-Indigenous people (41% vs 26%). Without accounting for possible confounders, the association between sleep duration and BMI for the Indigenous group was not significant but a possible dose-response relationship was evident, with the odds of overweight/obesity being greatest for those who typically slept < 7 h (OR = 1.77, 95% CI 0.38–3.94) and < 6 h (OR = 1.55, 95%CI = 0.58–4.14). The same model for the non-Indigenous group was significant, with the odds of overweight/obesity being greatest for those who typically slept < 6 h (OR = 1.67, 95%CI 1.25–2.25). The risk of overweight/obesity diminished for both groups with sleep > 7 h. Accounting for a range of socioeconomic and personal confounders attenuated the strength of these relationships marginally. Conclusion Adding to reports relating sleep duration and BMI for Australian adults, this study provides evidence for an inverse relationship in non-Indigenous adults and suggests a similar trend for Indigenous adults. This trend was non-significant but is consistent with previous results for Indigenous children.
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Affiliation(s)
- Melissa Deacon-Crouch
- Department of Rural Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia.
| | - Stephen Begg
- Rural Department of Community Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Timothy Skinner
- Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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13
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Pulok MH, van Gool K, Hall J. Inequity in healthcare use among the indigenous population living in non-remote areas of Australia. Public Health 2020; 186:35-43. [PMID: 32768622 DOI: 10.1016/j.puhe.2020.06.051] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/10/2020] [Accepted: 06/24/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Although several studies have examined the gap in healthcare use between indigenous and non-indigenous people, empirical evidence on inequity in healthcare use within indigenous populations is limited. This study aims to fill this gap in the literature by investigating income-related inequity (unequal use for equal need) in healthcare use among indigenous Australians living in non-remote areas. STUDY DESIGN This is a cross-sectional study. METHODS This study used data from the Australian Aboriginal and Torres Strait Islander Health Survey, 2012-13. Logistic regression analysis was used to determine the association of income with the probability of a general practitioner (GP) visit, a specialist visit and inpatient admission. The horizontal inequity (HI) index and decomposition analysis were also used to quantify and explain inequity in healthcare use. RESULTS No consistent association was found between income and the probability of GP visit or inpatient admission after controlling for health need. However, the likelihood of visiting a specialist was about three times (odds ratio = 2.96, P = 0.028) higher for the richest compared with the poorest population subgroups. The inequity index was 0.016 (P < 0.001), indicating a pro-rich inequity for the probability of visiting a specialist. Income inequality, unequal distribution of private health insurance and inequality in education were the main factors explaining the pro-rich inequity in specialist utilisation. CONCLUSIONS Although there was no income-related inequity in GP visits or inpatient admissions, wealthier indigenous Australians had a higher probability of visiting a specialist than their poorer counterparts, after adjusting for need. Specific policies and initiatives are required to address the inequity faced by low-income indigenous people in Australia.
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Affiliation(s)
- M H Pulok
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), NSW, Australia; Nova Scotia Health Authority, Halifax, NS, Canada.
| | - K van Gool
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), NSW, Australia
| | - J Hall
- Centre for Health Economics Research and Evaluation (CHERE), University of Technology Sydney (UTS), NSW, Australia
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14
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Sjöholm P, Pahkala K, Davison B, Juonala M, Singh G. Socioeconomic status, remoteness and tracking of nutritional status from childhood to adulthood in an Australian Aboriginal Birth Cohort: the ABC study. BMJ Open 2020; 10:e033631. [PMID: 31992605 PMCID: PMC7045147 DOI: 10.1136/bmjopen-2019-033631] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVES To determine prevalences of underweight and overweight as well as low and high waist-to-height ratio (WHtR) in three prospective follow-ups and to explore tracking of these measures of nutritional status from childhood to adolescence and adulthood. The influence of socioeconomic status, remoteness, maternal body mass index (BMI) and birth weight on weight status was assessed. DESIGN Longitudinal birth cohort study of Indigenous Australians. SETTING Data derived from three follow-ups of the Aboriginal Birth Cohort study with mean ages of 11.4, 18.2 and 25.4 years for the participants. PARTICIPANTS Of the 686 Indigenous babies recruited to the study between 1987 and 1990, 315 had anthropometric measurements for all three follow-ups and were included in this study. PRIMARY AND SECONDARY OUTCOME MEASURES BMI categories (underweight, normal weight, overweight and obesity),WHtR categories (low and high), sex, areal socioeconomic disadvantage as defined by the Indigenous Relative Socioeconomic Outcomes index, urban/remote residence, maternal BMI and birth weight. Logistic regression was used to calculate ORs for belonging to a certain BMI category in adolescence and adulthood according to BMI category in childhood and adolescence. RESULTS Underweight was common (38% in childhood and 24% in adulthood) and the prevalence of overweight/obesity increased with age (12% in childhood and 35% in adulthood). Both extremes of weight status as well as low and high WHtR tracked from childhood to adulthood. Underweight was more common and overweight was less common in remote and more disadvantaged areas. Birth weight and maternal BMI were associated with later weight status. There were significant sex differences for prevalences and tracking of WHtR but not for BMI. CONCLUSIONS Socioeconomic factors, remoteness and gender must be addressed when assessing nutrition-related issues in the Indigenous communities due to the variation in nutritional status and its behaviour over time within the Indigenous population.
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Affiliation(s)
- Pauline Sjöholm
- Department of Medicine, University of Turku, Turku, Finland
- Department of Anesthesiology, Vaasa Central Hospital, Vaasa, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Paavo Nurmi Centre, Sports & Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland
| | - Belinda Davison
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland
- Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Gurmeet Singh
- Menzies School of Health Research, Casuarina, Northern Territory, Australia
- Northern Territory Medical Program, Flinders University, Darwin, Northern Territory, Australia
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Niyonsenga T, Carroll SJ, Coffee NT, Taylor AW, Daniel M. Are changes in depressive symptoms, general health and residential area socio-economic status associated with trajectories of waist circumference and body mass index? PLoS One 2020; 15:e0227029. [PMID: 31914169 PMCID: PMC6948738 DOI: 10.1371/journal.pone.0227029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/11/2019] [Indexed: 11/18/2022] Open
Abstract
Objective This study sought to assess whether changes in depressive symptoms, general health, and area-level socio-economic status (SES) were associated to changes over time in waist circumference and body mass index (BMI). Methods A total of 2871 adults (18 years or older), living in Adelaide (South Australia), were observed across three waves of data collection spanning ten years, with clinical measures of waist circumference, height and weight. Participants completed the Centre for Epidemiologic Studies Depression (CES-D) and Short Form 36 health questionnaires (SF-36 general health domain). An area-level SES measure, relative location factor, was derived from hedonic regression models using residential property features but blind to location. Growth curve models with latent variables were fitted to data. Results Waist circumference, BMI and depressive symptoms increased over time. General health and relative location factor decreased. Worsening general health and depressive symptoms predicted worsening waist circumference and BMI trajectories in covariate-adjusted models. Diminishing relative location factor was negatively associated with waist circumference and BMI trajectories in unadjusted models only. Conclusions Worsening depressive symptoms and general health predict increasing adiposity and suggest the development of unhealthful adiposity might be prevented by attention to negative changes in mental health and overall general health.
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Affiliation(s)
- Theo Niyonsenga
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
- * E-mail:
| | - Suzanne J. Carroll
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
| | - Neil T. Coffee
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
- School of Architecture and Built Environment, Healthy Cities Research Group, The University of Adelaide, South Australia, Australia
| | - Anne W. Taylor
- Discipline of Medicine, The University of Adelaide, South Australia, Australia
| | - Mark Daniel
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australia
- Department of Medicine, St Vincent’s Hospital, The University of Melbourne, Fitzroy, Australia
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Deacon-Crouch M, Begg S, Tucci J, Skinner I, Skinner T. The mediating role of sleep in the relationship between Indigenous status and body mass index in Australian school-aged children. J Paediatr Child Health 2019; 55:915-920. [PMID: 30471159 DOI: 10.1111/jpc.14308] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 09/02/2018] [Accepted: 10/23/2018] [Indexed: 01/24/2023]
Abstract
AIM Associations between sleep duration and obesity and between obesity and chronic illness are established. Current rates of obesity for all Australian people are rising. Recent reports indicate that high body mass index (BMI) is a leading contributor to overall burden of disease for Indigenous Australians. Understanding the factors that contribute to higher rates of obesity in Indigenous people is critical to developing effective interventions for reducing morbidity and premature mortality in this population. To explore the effect of sleep duration on the relationship between Indigenous status and BMI in Australian children. METHODS 716 non-Indigenous and 186 Indigenous children aged 5-12 years in the Australian Health Survey 2011-2013. Primary carers were interviewed regarding children's sleep times; BMI was derived from measurement. RESULTS Analysis of covariance revealed that regardless of a number of demographic and socio-economic status markers, sleep duration and Indigenous status were independent predictors of BMI. However when both predictors were considered together, only sleep duration remained predictive of BMI. CONCLUSIONS Sleep duration plays an important mediating role in the relationship between Indigenous status and BMI in this Australian sample. Modification of sleep duration for Indigenous children may lead to longer-term positive health outcomes.
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Affiliation(s)
- Melissa Deacon-Crouch
- Department of Rural Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Stephen Begg
- Department of Community and Allied Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Joseph Tucci
- Department of Pharmacy and Applied Science, La Trobe Institute for Molecular Science, La Trobe University, Bendigo, Victoria, Australia
| | - Isabelle Skinner
- Mount Isa Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia
| | - Timothy Skinner
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
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