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Moreno SV, Grimes C, Bolton KA, Uddin R, Siopis G, Maddison R, Islam SMS. The burden of cardiovascular disease attributable to high dietary sodium intake in Australia between 1990 and 2019. J Hypertens 2024:00004872-990000000-00418. [PMID: 38690914 DOI: 10.1097/hjh.0000000000003699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
BACKGROUND Diets high in sodium are associated with adverse cardiovascular outcomes. We aimed to quantify the burden of cardiovascular disease (CVD) attributable to high dietary sodium consumption in the Australian population. METHODS Using data from the Global Burden of Disease (GBD) 2019, we estimated the age-standardised rates (per 100 000 population) and the total numbers of years lived with a disability (YLDs), years of life lost (YLLs), disability-adjusted life years (DALYs), and deaths for CVD attributable to high sodium (≥1000 mg/day) consumption in the Australian population, by sex and age groups (≥25 years) between 1990 and 2019. The study compared Australian estimates with similar high-income countries (Group of 20 [G20] members). RESULTS From 1990 to 2019, the age-standardized rates of CVD deaths, DALYs, YLDs, and YLLs per 100 000 population in Australia attributable to high sodium decreased. However, between 2013 and 2019, the total number of CVD deaths increased, and the number of CVD YLDs increased exponentially for both sexes for the whole period between 1990 and 2019. Men had a two-fold higher rate for high sodium CVD burden, compared to females between 1990 to 2019. Individuals aged between 80 and 84 years had the highest rates of CVD burden during the same period; however, older age groups reported the greatest decline in CVD burden compared to young and middle-aged adults in Australia. The age-standardised rates for high sodium attributable CVD consistently contributed more towards DALYs than YLDs in 2019 for both sexes. When compared to G20 countries, Australians displayed the lowest age-standardized rates for CVD deaths, DALYs, YLDs, and YLLs alongside Turkey, France, and the United Kingdom in 2019. CONCLUSION While age-standardized CVD burden attributable to high sodium consumption decreased for both sexes over the past 30 years, the total number of CVD deaths showed an increase between 2013 and 2019. This study underscores the need for sustained efforts to address the rising absolute number of CVD deaths, especially among men and older people, and emphasizes the importance of continued vigilance in monitoring and implementing strategies to reduce the impact of high sodium consumption on cardiovascular health in Australia.
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Affiliation(s)
- Sebastian V Moreno
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Burwood, Victoria, Australia
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Zheng M, D'Souza NJ, Atkins L, Ghobadi S, Laws R, Szymlek-Gay EA, Grimes C, Baker P, He QQ, Campbell KJ. Breastfeeding and the Longitudinal Changes of Body Mass Index in Childhood and Adulthood: A Systematic Review. Adv Nutr 2024; 15:100152. [PMID: 37977327 PMCID: PMC10714232 DOI: 10.1016/j.advnut.2023.100152] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/01/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
Mounting evidence supports the beneficial role of breastfeeding in lowering obesity risk, but the enduring impact of breastfeeding on longitudinal changes in body mass index (BMI) (i.e., BMI trajectories) remains unclear. This systematic review summarized evidence on how breastfeeding influenced the longitudinal trajectories of BMI later in life. Literature searches were conducted in Medline, Embase, Web of Science, and ScienceDirect to identify studies that assessed how breastfeeding (versus other feeding types or duration) was associated with longitudinal trajectories of BMI or BMI z-score. Three randomized controlled trials (RCTs) and 24 longitudinal cohort studies were included. Two-thirds (18/27) of studies were rated as acceptable or high quality. Most cohort studies (9/11) showed that children who continued to breastfeed at 3 to 12 mo of age had a lower BMI trajectory or lower odds of following a high BMI trajectory than those who were formula-fed or mixed-fed. The BMI differences between breastfeeding and other feeding groups were evident from age 7 mo and remained up to 8 y, and the magnitude of between-group BMI differences increased with age. For breastfeeding duration, 12 out of 15 cohort studies found that longer breastfeeding duration was associated with lower BMI trajectories up to age 18 y. Moreover, beneficial associations were observed for both exclusive and any breastfeeding with BMI trajectory. In contrast, mixed findings were reported from 3 RCTs that compared BMI trajectories from birth to ages 12 to 24 mo between breastfeeding promotion versus control or breastfeeding versus formula-feeding groups. The current review provides further longitudinal evidence from cohort studies that breastfeeding versus formula/mixed feeding or longer breastfeeding duration was associated with lower BMI trajectories. Such associations initiated in early childhood became more apparent with age and were sustained into early adulthood. The existing evidence substantiates the importance of breastfeeding promotion and continuation to support obesity prevention.
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Affiliation(s)
- Miaobing Zheng
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia.
| | - Ninoshka J D'Souza
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Linda Atkins
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Saeed Ghobadi
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Rachel Laws
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Ewa A Szymlek-Gay
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Carley Grimes
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Philip Baker
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Qi-Qiang He
- School of Public Health, Wuhan University, Wuhan, Republic of China
| | - Karen J Campbell
- School of Exercise and Nutrition Sciences, Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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Bolton KA, Santos JA, Rosewarne E, Trieu K, Reimers J, Nowson C, Neal B, Webster J, Woodward M, Dunford E, Armstrong S, Bolam B, Grimes C. Outcomes of a state-wide salt reduction initiative in adults living in Victoria, Australia. Eur J Nutr 2023; 62:3055-3067. [PMID: 37493681 PMCID: PMC10468945 DOI: 10.1007/s00394-023-03210-z] [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: 11/22/2022] [Accepted: 07/10/2023] [Indexed: 07/27/2023]
Abstract
PURPOSE To assess any effects of a state-wide sodium reduction intervention on sodium intake, sources of dietary sodium and discretionary salt use at a population level. METHODS Data (24-h urinary sodium excretion, self-report survey, a 24-h dietary recall) were collected cross-sectionally at baseline (2016/2017) and follow-up (2020) from adults in Victoria, Australia. Intervention activities included consumer awareness advertising campaign, public debate generation via mass media, strengthening existing policy initiatives and supporting food innovation with industry. RESULTS There were 339 participants at baseline and 211 at follow-up, with 144 and 90 of participants completing a 24-h dietary recall, respectively. There was no difference in adjusted 24-h urinary sodium excretion between baseline and follow-up (134 vs 131 mmol/24 h; p = 0.260). There were no differences in the percentage of participants adding salt during cooking (63% vs 68%; p = 0.244), adding salt at the table (34% vs 37%; p = 0.400) or regularly taking action to control salt/sodium intake (22% vs 21%; p = 0.793). There were large differences in the quantity of dietary sodium sourced from retail stores (57% vs 77%, p < 0.001), and less sodium was sourced from foods at fresh food markets (13% vs 2%; p ≤ 0.001) at follow-up. No large differences were apparent for foods with different levels of processing or for food groups. CONCLUSION There was no clear population-level effect of the 4-year multi-component Victorian Salt Reduction Intervention on sodium intake with Victorian adults continuing to consume sodium above recommended levels. The findings indicate that more intensive and sustained efforts aiming at the retail and food industry with national level support are likely to be required to achieve a measurable improvement in sodium intake at a state level.
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Affiliation(s)
- Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Emalie Rosewarne
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Jenny Reimers
- Victorian Health Promotion Foundation (VicHealth), Melbourne, VIC, Australia
| | - Caryl Nowson
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Bruce Neal
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- School of Public Health, Imperial College London, London, UK
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- School of Public Health, Imperial College London, London, UK
| | - Elizabeth Dunford
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
- Department of Nutrition, Gillings Global School of Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, USA
| | | | - Bruce Bolam
- School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
| | - Carley Grimes
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
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Rosewarne E, Santos JA, Di Tanna GL, Shahid M, Grimes C, Bolton KA, Webster J, Neal B, Woodward M, Coyle D, Trieu K. Changes in sodium levels in Australian packaged foods between 2014 and 2019: an interrupted time series analysis of the impact of the Victorian Salt Reduction Partnership's media advocacy strategy. Int J Behav Nutr Phys Act 2023; 20:71. [PMID: 37316889 DOI: 10.1186/s12966-023-01475-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 06/01/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND The Victorian Salt Reduction Partnership (VSRP) implemented a media advocacy strategy (intervention) to stimulate food manufacturers to reduce sodium levels across targeted Australian packaged foods between 2017 and 2019. This study assessed changes in sodium levels of targeted and non-targeted packaged foods during the intervention (2017 to 2019) compared to before the intervention (2014 to 2016) in Australia. METHODS Annually collected branded-food composition data from 2014 to 2019 were used. Interrupted time series analyses was conducted to compare the trend in sodium levels in packaged foods during the intervention (2017-2019) to the trend in the pre-intervention period (2014-2016). The difference between these trends was derived to estimate the effect of the intervention. RESULTS A total of 90,807 products were included in the analysis, of which 14,743 were targeted by the intervention. The difference in before and during intervention trends between targeted and non-targeted food categories was 2.59 mg/100 g (95% CI: -13.88 to 19.06). There was a difference in the pre-intervention slope (2014, 2015, 2016) and intervention slope (2017, 2018, 2019) for four of 17 targeted food categories. There was a decrease in sodium levels (mg/100 g) in one food category: frozen ready meals (-13.47; 95% CI: -25.40 to -1.53), and an increase in three categories: flat bread (20.46; 95% CI: 9.11 to 31.81), plain dry biscuits (24.53; 95% CI: 5.87 to 43.19), and bacon (44.54; 95% CI: 6.36 to 82.72). For the other 13 targeted categories, the difference in slopes crossed the line of null effect. CONCLUSIONS The VSRP's media advocacy strategy did not result in a meaningful reduction in sodium levels of targeted packaged food products during the intervention years compared to trends in sodium levels before the intervention. Our study suggests media advocacy activities highlighting the differences in sodium levels in packaged food products and industry meetings alone are not sufficient to lower average sodium levels in packaged foods in the absence of government leadership and measurable sodium targets.
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Affiliation(s)
- Emalie Rosewarne
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
| | - Gian Luca Di Tanna
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
| | - Maria Shahid
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
| | - Carley Grimes
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Jacqui Webster
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
| | - Bruce Neal
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
| | - Mark Woodward
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, London, UK
| | - Daisy Coyle
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
| | - Kathy Trieu
- The George Institute for Global Health, The University of New South Wales, Sydney, NSW, Australia
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Russell C, Baker P, Grimes C, Lindberg R, Lawrence MA. Global trends in added sugars and non-nutritive sweetener use in the packaged food supply: drivers and implications for public health. Public Health Nutr 2023; 26:952-964. [PMID: 35899782 PMCID: PMC10346066 DOI: 10.1017/s1368980022001598] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/22/2022] [Accepted: 07/11/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The health implications of excessive added sugar intakes have led to national policy actions to limit their consumption. Subsequently, non-nutritive sweeteners (NNS) may be used to maintain product sweetness. We aimed to assess trends in quantities of added sugars and NNS sold in packaged food and beverages worldwide, and the association between these trends and the number of national policy actions across regions to reduce added sugar consumption. DESIGN (i) Longitudinal analysis of Euromonitor sales data (2007-2019) to assess the quantity of added sugars (kg) and NNS (g) sold in packaged foods and beverages globally, across regions, and across country income categories; (ii) policy-mapping of policy actions targeting added sugar consumption globally from the NOURISHING database; and (iii) Spearman's correlations to assess the association between national policy actions across regions and changes in added sugar/NNS sales. SETTING Worldwide. PARTICIPANTS Not applicable. RESULTS Per capita volumes of NNS from beverage sales increased globally (36 %). Added sugars from beverage sales decreased in high-income countries (22 %) but increased in upper-middle-income countries (UMIC) and lower-middle-income countries (LMIC) (13-40 %). Added sugars from packaged food sales increased globally (9 %). Regions with more policy actions had a significant increase in NNS quantities from beverage sales (r = 0·68, P = 0·04). The sweetness of the packaged food supply (the sweetness of each NNS and added sugar, relative to sucrose, multiplied by sales volume) increased over time. CONCLUSIONS The increasing use of NNS to sweeten beverages globally, and in packaged food in UMIC and LMIC, may have health and dietary implications in the future. Their use as a substitute for added sugar should be considered in public health nutrition policymaking.
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Affiliation(s)
- Cherie Russell
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Australia
| | - Phillip Baker
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Carley Grimes
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Rebecca Lindberg
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Mark A Lawrence
- School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Geelong, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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Russell C, Baker P, Grimes C, Lawrence MA. Non-nutritive sweetener regulation and health: analysing applications to vary Australian and New Zealand food standards. Health Promot Int 2023; 38:7058056. [PMID: 36840531 DOI: 10.1093/heapro/daac101] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
Abstract
We aimed to understand the process of setting or varying food standards related to non-nutritive sweeteners (NNS) in Australia and New Zealand. Overconsumption of added sugars is a risk factor for non-communicable diseases. Limiting added sugar consumption is recommended by the World Health Organization. NNS are sweet substances with little to no energy that can be used to maintain the sweetness of packaged food when added sugar is reduced. The health and dietary pattern impacts of NNS are contested. Understanding how and why applications for NNS are submitted, assessed and approved within food regulatory systems is important to contextualize the increasing availability of NNS in the food supply. We completed an interpretive content analysis of applications to change the Food Standards Australia and New Zealand (FSANZ) Code, risk assessments and stakeholder submissions. Literature used in risk assessments were drawn from a mixture of documents supplied by industry and peer-reviewed studies. Risk assessments were primarily focussed on toxicological outcomes, while broader public health outcomes were not explicitly considered. Consumption data available to FSANZ were collected several years prior to dietary exposure assessments, and thus may not accurately represent current intakes. The study findings raise questions about whether the scope of what constitutes a 'risk' to public health in the setting of food standards needs to extend beyond immediate toxicological and food safety concerns, to include longer-term dietary balance considerations.
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Affiliation(s)
- Cherie Russell
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia
| | - Phillip Baker
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia.,Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Australia
| | - Carley Grimes
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia.,Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Australia
| | - Mark A Lawrence
- School of Exercise and Nutrition Sciences, Faculty of Health, Deakin University, Geelong, Australia.,Institute for Physical Activity and Nutrition, Faculty of Health, Deakin University, Geelong, Australia
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Santos JA, Bolton KA, Rosewarne E, Trieu K, Di Tanna GL, Woodward M, Webster J, Grimes C. Agreement between 24-hour urine and 24-hour food recall in measuring salt intake in primary school children in Australia. Nutr J 2022; 21:68. [PMCID: PMC9664040 DOI: 10.1186/s12937-022-00823-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Monitoring salt consumption in children is essential for informing and implementing public health interventions to reduce children’s salt intake. However, collection of 24-hour urines, considered as the most reliable approach, can be especially challenging to school children. This study aimed to assess the agreement between 24-hour urine (24hrU) and 24-hour food recall (24hrFR) in: (1) estimating salt intake in children; (2) classifying salt intakes above the recommended upper level set for children, and; (3) estimating change in mean salt intake over time.
Methods
This study utilised data from two cross-sectional surveys of school children aged 8 to 12 years living in the state of Victoria, Australia. A single 24hrU and 24hrFR were collected from each participant. Suspected inaccurate urine collections and implausible energy intakes were excluded based on pre-defined criteria. The agreement between the two methods was assessed using Bland-Altman methodology, the intraclass correlation coefficient (ICC), and the kappa statistic. The difference between the measured change in salt intake over time using 24hrU and 24hrFR was derived using mixed effects linear regression analysis.
Results
A total of 588 participants provided a 24hrU and 24hrFR. Overall, there was no meaningful difference in mean estimated salt intake between the two methods (− 0.2 g/day, 95% CI − 0.5 to 0.1). The Bland-Altman plot showed wide 95% limits of agreement (− 7.2 to 6.8). The ICC between the two methods was 0.13 (95% CI 0.05 to 0.21). There was poor interrater reliability in terms of classifying salt intake above the recommended upper level for children, with an observed agreement of 63% and kappa statistic of 0.11. The change in mean salt intake over time was 0.2 g/day (− 0.4 to 0.7) based on 24hrU, and 0.5 g/day (− 0.0 to 1.1) based on 24hrFR, with a difference-in-differences of 0.4 g/day (− 0.3 to 1.1).
Conclusions
24hrFR appears to provide a reasonable estimate of mean salt intake as measured by 24hrU in Australian school children. However, similar to previous observations in adults, and of studies exploring other alternative methods for estimating salt intake, 24hrFR is a poor predictor of individual-level salt intake in children.
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Hooper M, Veon F, LeWitt T, Grimes C, Nguyen M, Pang Y, Borders T, Choi J, Guitart J, Burns M, Zhou X. 224 Risk factors and outcomes for sepsis in cutaneous T cell lymphoma compared to in other non-Hodgkin lymphomas. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Russell C, Baker P, Grimes C, Lawrence MA. What are the benefits and risks of nutrition policy actions to reduce added sugar consumption? An Australian case study. Public Health Nutr 2022; 25:1-18. [PMID: 35067254 PMCID: PMC9991626 DOI: 10.1017/s1368980022000234] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/03/2021] [Accepted: 01/19/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to critically analyse Australia's current and proposed policy actions to reduce added sugar consumption. Over-consumption of added sugar is a significant public health nutrition issue. The competing interests, values and beliefs among stakeholders mean they have disparate views regarding which policy actions are preferable to reduce added sugar consumption. DESIGN Semi-structured interviews using purposive, snowball sampling and policy mapping. Policy actions were classified by two frameworks: NOURISHING (e.g. behaviour change communication, food environment and food system) and the Orders of Change (e.g. first order: technical adjustments, second order: reforming the system, third order: transforming the system). SETTING Australia. PARTICIPANTS Twenty-two stakeholders from the food industry, food regulation, government, public health groups and academia. RESULTS All proposed and existing policy actions targeted the food environment/behaviour change; most were assessed as first-order changes, and reductionist (nutrient specific) in nature. Influences on policy actions included industry power, stakeholder fragmentation, government ideology/political will and public pressure. Few stakeholders considered potential risks of policy actions, particularly of non-nutritive sweetener substitution or opportunity costs for other policies. CONCLUSIONS Most of Australia's policy actions to reduce added sugar consumption are reductionist. Preferencing nutrient specific, first-order policy actions could reflect the influence of vested interests, a historically dominant reductionist orientation to nutrition science and policy, and the perceived difficulty of pursuing second- or third-order changes. Pursuing only first-order policy actions could lead to 'regrettable' substitutions and creates an opportunity cost for more comprehensive policy aimed at adjusting the broader food system.
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Affiliation(s)
- Cherie Russell
- School of Exercise and Nutrition Sciences, Deakin University, Geelong3220, Australia
| | - Phillip Baker
- School of Exercise and Nutrition Sciences, Deakin University, Geelong3220, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Carley Grimes
- School of Exercise and Nutrition Sciences, Deakin University, Geelong3220, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Mark Andrew Lawrence
- School of Exercise and Nutrition Sciences, Deakin University, Geelong3220, Australia
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
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Rosewarne E, Santos JA, Hoek A, Grimes C, Nowson C, Webster J, Bolton KA. Are there socio-demographic differences in salt behaviours and fruit and vegetable consumption in Australian adults? A nationally representative cross-sectional survey. Nutr J 2021; 20:77. [PMID: 34496816 PMCID: PMC8425065 DOI: 10.1186/s12937-021-00734-0] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 08/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diets low in fruit and vegetables and high in salt are among the top dietary risk factors for non-communicable diseases (NCDs). Using a nationally representative sample of Australians, this study aimed to describe self-reported intake of fruit and vegetables, and knowledge, attitudes and behaviours related to salt intake, and determine if there were socio-demographic differences between population subgroups. METHODS A 2016 cross-sectional survey of Australian adults aged 18 years and over, which comprised 160 questions, including socio-demographic and health-related questions. Descriptive statistics (mean, 95% confidence interval, %) were calculated. Weighted-adjusted logistic regression models were used to determine if there were socio-demographic differences in salt behaviours and fruit and vegetable consumption. RESULTS A total of 1217 participants completed the survey (51% female). Less than 8% of participants reported consuming the recommended 2 or more serves of fruit and 5 or more serves of vegetables. Almost 60% of participants frequently added salt during cooking/meal preparation and 42% of respondents frequently placed a salt-shaker on the table at mealtimes. There were no consistent patterns between socio-demographic factors and measures of fruit and vegetable consumption and salt behaviours. Differences in at least one measure were found for sex, age, location, education level and weight category. CONCLUSIONS There were no consistent patterns between socio-demographic factors and salt behaviours and fruit and vegetable intake. Less than recommended intakes of fruit and vegetables and frequent discretionary salt use are placing Australians at risk of diet-related NCDs. Broad population-based policies and programs to improve fruit and vegetable intake and salt behaviours are needed to improve Australian's diets.
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Affiliation(s)
- Emalie Rosewarne
- The George Institute for Global Health, The University of New South Wales, Sydney, 2006, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, The University of New South Wales, Sydney, 2006, Australia
| | - Annet Hoek
- The George Institute for Global Health, The University of New South Wales, Sydney, 2006, Australia
| | - Carley Grimes
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, 3220, Australia
| | - Caryl Nowson
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, 3220, Australia
| | - Jacqui Webster
- The George Institute for Global Health, The University of New South Wales, Sydney, 2006, Australia
| | - Kristy A Bolton
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, 3220, Australia
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11
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Love P, Booth A, Margerison C, Nowson C, Grimes C. Food and nutrition education opportunities within Australian primary schools. Health Promot Int 2020; 35:1291-1301. [DOI: 10.1093/heapro/daz132] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Schools are regarded as a key setting for obesity prevention, providing an opportunity to reach a large number of children, frequently and over a prolonged period, through formal and informal opportunities to learn about health behaviours. However, the low value placed on health versus academic achievement is a barrier to effective implementation of food and nutrition (F&N) education. This study used a qualitative exploratory approach to explore the views of teachers and key health and education sector stakeholders regarding opportunities for F&N education within the Australian primary school setting. To the best of our knowledge, this is the first study to explore this topic from the perspectives of state-level coordination and development through to local-level implementation and support within the Australian primary school context. Only 2.6% of the Victorian Curriculum related to F&N education, taught through two (of seven) learning outcomes: Health and Physical Education, and Technologies. While stakeholders considered child health a priority, and schools an ideal setting for F&N education, barriers included a lack of strategic policy alignment, limited leadership and coordination, a ‘crowded curriculum’ and poor availability of shelf-ready resources with explicit curriculum links. A cross-curriculum approach was considered essential for F&N education to become embedded as a core component of the curriculum.
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Affiliation(s)
- Penelope Love
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong Campus, Victoria 3216, Australia
| | - Alison Booth
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood Campus, Victoria 3125, Australia
| | - Claire Margerison
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood Campus, Victoria 3125, Australia
| | - Caryl Nowson
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong Campus, Victoria 3216, Australia
| | - Carley Grimes
- Faculty of Health, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood Campus, Victoria 3125, Australia
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Khokhar D, Nowson C, Margerison C, Bolam B, Grimes C. Comparison of salt-related knowledge, attitudes and behaviours between parents and caregivers of children under 18 years of age and other adults who do not care for children under 18 years of age in Victoria, Australia. BMJ Nutr Prev Health 2019; 2:51-62. [PMID: 33235958 PMCID: PMC7664484 DOI: 10.1136/bmjnph-2018-000018] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/23/2019] [Accepted: 05/29/2019] [Indexed: 11/18/2022] Open
Abstract
Background/Aims Salt intake among Australian adults exceeds recommendations, increasing the risk of cardiovascular disease. Knowledge, attitudes and behaviours (KABs) are modifiable factors that may influence salt consumption. It is not known whether salt-related KABs among parents and caregivers of children under 18 years of age differ from other adults who do not care for children under 18 years of age. Therefore, we aimed to determine whether salt-related KABs differed between parents and caregivers and other adults. This information can be used to inform messages included in salt reduction consumer awareness campaigns. Methods Adults, aged 18–65 years, were recruited from four shopping centres, Facebook and a consumer research panel in the state of Victoria, Australia. Participants indicated if they were a parent or a caregiver of a child/children <18 years (‘parents/caregivers’) or not (‘other adults’). Regression models, adjusted for covariates, assessed differences in KABs between the two groups. Construct scores for KABs were developed, with high scores for knowledge indicative of high salt-related knowledge, for attitude indicative of lower importance of using salt to enhance the taste of food, and for behaviours indicative of higher frequency of engaging in behaviours to reduce salt in the diet. Results A total of 840 parents/caregivers and 1558 other adults completed the survey. Just over half of the parents/caregivers and other adults were female, with a mean (SD) age of 41.1 (10.3) years and 44.3 (15.3) years, respectively. Mean construct scores for salt-related KABs were similar between the two groups. Parents/caregivers were less likely to be aware of the relationship between salt and sodium (OR=0.73, p=0.002) and more likely to report difficulty in interpreting sodium information displayed on food labels (OR=1.36, p=0.004). Parents/caregivers were more likely to be concerned about a range of food-related issues, including the amount of saturated fat, sugar and salt in food. Parents/caregivers were more likely to report that they were trying to reduce their salt intake (OR=1.27, p=0.012) and more likely to report adding salt at the table (OR=1.28, p=0.008). Conclusions There were some differences in salt-related KABs between parents/caregivers and other adults. These findings provide insight into particular messages that could be focused on in consumer awareness campaigns that seek to improve parents’/caregivers’ KABs related to salt intake. Specifically, messages targeted at parents/caregivers should include practical guidance to reduce table salt and resources to assist in interpreting sodium information on food labels and the relationship of sodium to salt.
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Affiliation(s)
- Durreajam Khokhar
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC 3220, Australia
| | - Caryl Nowson
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC 3220, Australia
| | - Claire Margerison
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC 3220, Australia
| | - Bruce Bolam
- Department of Health and Human Services, 50 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Carley Grimes
- Institute for Physical Activity and Nutrition, Deakin University, Locked Bag 20000, Waurn Ponds, Geelong, VIC 3220, Australia
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Trieu K, Jan S, Woodward M, Grimes C, Bolam B, Nowson C, Reimers J, Davidson C, Webster J. Protocol for the Process Evaluation of a Complex, Statewide Intervention to Reduce Salt Intake in Victoria, Australia. Nutrients 2018; 10:nu10080998. [PMID: 30720790 PMCID: PMC6115992 DOI: 10.3390/nu10080998] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 07/24/2018] [Accepted: 07/27/2018] [Indexed: 01/05/2023] Open
Abstract
Systematic reviews of trials consistently demonstrate that reducing salt intake lowers blood pressure. However, there is limited evidence on how interventions function in the real world to achieve sustained population-wide salt reduction. Process evaluations are crucial for understanding how and why an intervention resulted in its observed effect in that setting, particularly for complex interventions. This project presents the detailed protocol for a process evaluation of a statewide strategy to lower salt intake in Victoria, Australia. We describe the pragmatic methods used to collect and analyse data on six process evaluation dimensions: reach, dose or adoption, fidelity, effectiveness, context and cost, informed by Linnan and Steckler's framework and RE-AIM. Data collection methods include routinely collected administrative data; surveys of processed foods, the population, food industry and organizations; targeted campaign evaluation and semi-structured interviews. Quantitative and qualitative data will be triangulated to provide validation or context for one another. This process evaluation will contribute new knowledge about what components of the intervention are important to salt reduction strategies and how the interventions cause reduced salt intake, to inform the transferability of the program to other Australian states and territories. This protocol can be adapted for other population-based, complex, disease prevention interventions.
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Affiliation(s)
- Kathy Trieu
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia.
- Sydney School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia.
- Sydney School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, NSW 2006, Australia.
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia.
- The George Institute for Global Health, University of Oxford, Oxford OX1 3QX, UK.
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21218, USA.
| | - Carley Grimes
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3220, Australia.
| | - Bruce Bolam
- Department of Health and Human Services, Melbourne, VIC 3000, Australia.
| | - Caryl Nowson
- Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC 3220, Australia.
| | - Jenny Reimers
- Victorian Health Promotion Foundation, Carlton, VIC 3053, Australia.
| | - Chelsea Davidson
- National Heart Foundation (Victorian Division), Melbourne, VIC 3000, Australia.
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2042, Australia.
- Sydney School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, NSW 2006, Australia.
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Petersen KS, Wu JHY, Webster J, Grimes C, Woodward M, Nowson CA, Neal B. Estimating mean change in population salt intake using spot urine samples. Int J Epidemiol 2018; 46:1542-1550. [PMID: 28338706 DOI: 10.1093/ije/dyw239] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/27/2016] [Indexed: 11/14/2022] Open
Abstract
Background Spot urine samples are easier to collect than 24-h urine samples and have been used with estimating equations to derive the mean daily salt intake of a population. Whether equations using data from spot urine samples can also be used to estimate change in mean daily population salt intake over time is unknown. We compared estimates of change in mean daily population salt intake based upon 24-h urine collections with estimates derived using equations based on spot urine samples. Methods Paired and unpaired 24-h urine samples and spot urine samples were collected from individuals in two Australian populations, in 2011 and 2014. Estimates of change in daily mean population salt intake between 2011 and 2014 were obtained directly from the 24-h urine samples and by applying established estimating equations (Kawasaki, Tanaka, Mage, Toft, INTERSALT) to the data from spot urine samples. Differences between 2011 and 2014 were calculated using mixed models. Results A total of 1000 participants provided a 24-h urine sample and a spot urine sample in 2011, and 1012 did so in 2014 (paired samples n = 870; unpaired samples n = 1142). The participants were community-dwelling individuals living in the State of Victoria or the town of Lithgow in the State of New South Wales, Australia, with a mean age of 55 years in 2011. The mean (95% confidence interval) difference in population salt intake between 2011 and 2014 determined from the 24-h urine samples was -0.48g/day (-0.74 to -0.21; P < 0.001). The corresponding result estimated from the spot urine samples was -0.24 g/day (-0.42 to -0.06; P = 0.01) using the Tanaka equation, -0.42 g/day (-0.70 to -0.13; p = 0.004) using the Kawasaki equation, -0.51 g/day (-1.00 to -0.01; P = 0.046) using the Mage equation, -0.26 g/day (-0.42 to -0.10; P = 0.001) using the Toft equation, -0.20 g/day (-0.32 to -0.09; P = 0.001) using the INTERSALT equation and -0.27 g/day (-0.39 to -0.15; P < 0.001) using the INTERSALT equation with potassium. There was no evidence that the changes detected by the 24-h collections and estimating equations were different (all P > 0.058). Separate analysis of the unpaired and paired data showed that detection of change by the estimating equations was observed only in the paired data. Conclusions All the estimating equations based upon spot urine samples identified a similar change in daily salt intake to that detected by the 24-h urine samples. Methods based upon spot urine samples may provide an approach to measuring change in mean population salt intake, although further investigation in larger and more diverse population groups is required.
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Affiliation(s)
- Kristina S Petersen
- George Institute for Global Health, University of Sydney, Camperdown, NSW, Australia
| | - Jason H Y Wu
- George Institute for Global Health, University of Sydney, Camperdown, NSW, Australia
| | - Jacqui Webster
- George Institute for Global Health, University of Sydney, Camperdown, NSW, Australia
| | - Carley Grimes
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition Research, Locked Bag 20000, Waurn Ponds, Geelong, VIC 3220, Australia
| | - Mark Woodward
- George Institute for Global Health, University of Sydney, Camperdown, NSW, Australia.,George Institute for Global Health, University of Oxford, Oxford, UK.,Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Caryl A Nowson
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition Research, Locked Bag 20000, Waurn Ponds, Geelong, VIC 3220, Australia
| | - Bruce Neal
- George Institute for Global Health, University of Sydney, Camperdown, NSW, Australia.,Royal Prince Alfred Hospital, Sydney, NSW, Australia.,Imperial College London, London, UK
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15
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Decker E, Williams S, Leong M, Hare S, Grimes C. Use of patient focus groups to improve patient information in enhanced recovery in colorectal surgery. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Zheng M, Lamb KE, Grimes C, Laws R, Bolton K, Ong KK, Campbell K. Rapid weight gain during infancy and subsequent adiposity: a systematic review and meta-analysis of evidence. Obes Rev 2018; 19:321-332. [PMID: 29052309 PMCID: PMC6203317 DOI: 10.1111/obr.12632] [Citation(s) in RCA: 222] [Impact Index Per Article: 37.0] [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: 06/29/2017] [Revised: 08/29/2017] [Accepted: 09/18/2017] [Indexed: 12/27/2022]
Abstract
The contribution of rapid weight gain (RWG) during infancy to later adiposity has received considerable investigation. The present systematic review and meta-analysis aimed to update the literature on association between RWG and subsequent adiposity outcomes. Electronic searches were undertaken in EMBASE, MEDLINE, psycINFO, PubMed and ScienceDirect. Studies that examined the associations between RWG (a change in weight z-scores > 0.67) during infancy (from birth to age 2 years) and subsequent adiposity outcomes were included. Random effects meta-analysis was conducted to obtain the weighted-pooled estimates of the odds of overweight/obesity for those with RWG. Seventeen studies were eligible for inclusion with the majority of studies (15/17) being of high/acceptable quality and reporting positive associations between RWG during infancy and later adiposity outcomes. RWG in infancy was associated with overweight/obesity from childhood to adulthood (pooled odds ratio = 3.66, 95% confidence interval: 2.59-5.17, I2 > 75%). Subgroup analyses revealed that RWG during infancy was associated with higher odds of overweight/obesity in childhood than in adulthood, and RWG from birth to 1 year was associated with higher odds of overweight/obesity than RWG from birth to 2 years. The present study supports that RWG during infancy is a significant predictor of adiposity in later life.
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Affiliation(s)
- Miaobing Zheng
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences
| | - Karen E Lamb
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences
| | - Carley Grimes
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences
| | - Rachel Laws
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences
| | - Kristy Bolton
- Deakin University, Geelong, Australia, School of Exercise and Nutrition Sciences
| | - Ken K. Ong
- Medical Research Council Epidemiology Unit, and Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Karen Campbell
- Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences
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17
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Pai S, Melamed G, Yurteri-Kaplan L, Grimes C, Muir T, Antosh D. 88: Rate of post-operative urinary tract infection with use of 50% dextrose versus 20% mannitol for intraoperative cystoscopy during surgery for pelvic organ prolapse. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.12.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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18
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Ashour O, Rashid M, Shaaban G, Grimes C, Hare S, Kukreja N. Evaluating Patient Reported Outcomes After Elective Colorectal and Emergency Surgery at a Single Acute NHS Trust. A Pilot Study. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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19
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Madueke-Laveaux O, Advincula A, Landau-Cahana R, Walters R, Grimes C, Kim J, Simpson K, Truong M, Young C, Ryntz T. A Comparison of Carbon Dioxide (CO 2 ) Absorption Rates in Gynecologic Laparoscopy with a Valveless Insufflation System Versus Standard Insufflation System at Intra-Abdominal Pressures of 10 mmHg and 15 mmHg – A Randomized Controlled Trial. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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20
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O'Halloran S, Lacy K, Grimes C, Campbell K, Nowson C. Sodium intake assessment in a sample of Australian preschool children attending long day care. Journal of Nutrition & Intermediary Metabolism 2017. [DOI: 10.1016/j.jnim.2017.04.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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21
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O'Halloran S, Lacy K, Grimes C, Campbell K, Nowson C. Dietary intake and sources of potassium and the relationship to dietary sodium in a sample of Australian preschool children. Journal of Nutrition & Intermediary Metabolism 2017. [DOI: 10.1016/j.jnim.2017.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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22
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Khokhar D, Nowson C, Margerison C, Bolam B, Grimes C. Knowledge, attitudes and behaviours related to salt intake among Victorian parents. Journal of Nutrition & Intermediary Metabolism 2017. [DOI: 10.1016/j.jnim.2017.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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23
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Beckford K, Grimes C, Margerison C, Riddell L, Skeaff S, Nowson C. Relationship between urinary iodine excretion, milk and bread intake in a sample of Victorian schoolchildren. Journal of Nutrition & Intermediary Metabolism 2017. [DOI: 10.1016/j.jnim.2017.04.181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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24
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Achard D, Francoz D, Grimes C, Desrochers A, Nichols S, Babkine M, Fecteau G. Cerebrospinal Fluid Analysis in Recumbent Adult Dairy Cows With or Without Spinal Cord Lesions. J Vet Intern Med 2017; 31:940-945. [PMID: 28382682 PMCID: PMC5435069 DOI: 10.1111/jvim.14705] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/14/2017] [Accepted: 02/28/2017] [Indexed: 11/28/2022] Open
Abstract
Background Diagnosis of central nervous system (CNS) lesions in recumbent dairy cattle (RDC) is challenging because neurologic examination is limited and medical imaging often is challenging or unrewarding. Cerebrospinal fluid (CSF) analysis is useful in the diagnosis of CNS disorders in cattle. However, its utility in identifying spinal cord lesions in RDC remains to be evaluated. Hypothesis/Objectives We hypothesized that CSF analysis would discriminate between RDC with and without spinal cord lesions. Animals Twenty‐one RDC with spinal cord lesions (RDC+) and 19 without (RDC−) were evaluated. Methods Spinal cord lesions were confirmed at necropsy. Signalment, clinical findings, and CSF results were compared retrospectively. Total nucleated cell count and differential, protein concentration, and red blood cell count in RDC+ and RDC− were compared. Results Neoplasia, trauma, and infectious processes were the most frequent spinal cord lesions identified. Cerebrospinal fluid protein concentrations and TNCC were significantly higher in RDC+ compared to RDC− (P = .0092 and P = .0103, respectively). Additionally, CSF protein concentrations and TNCC in RDC− were lower than previously published reference ranges. Using an interpretation rule based on CSF protein concentration and TNCC, it was possible to accurately identify 13 RDC with spinal cord lesions and 6 RDC without lesions. It was not possible to determine spinal cord status in the remaining 18 RDC. Conclusions and Clinical Importance Cerebrospinal fluid analysis is valuable in the evaluation of spinal cord status in RDC. The prognosis associated with these findings remains to be determined.
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Affiliation(s)
- D Achard
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - D Francoz
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - C Grimes
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - A Desrochers
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - S Nichols
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - M Babkine
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - G Fecteau
- Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
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Antosh D, High R, Brown H, Oliphant S, Abed H, Grimes C. 12: Prophylactic salpingectomy during vaginal hysterectomy: A feasibility study. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Grimes C, Patankar S, Ryntz T, Simpson K, Truong M, Young C, Madueke Laveaux S, Philip N, Walters R, Advincula A, Pitter M, Kim J. 13: Evaluating ureteral patency in the post-indigo carmine era: A randomized controlled trial. Am J Obstet Gynecol 2017. [DOI: 10.1016/j.ajog.2016.12.165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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27
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Javard R, Grimes C, Bau-Gaudreault L, Dunn M. Acute-Phase Proteins and Iron Status in Cats with Chronic Kidney Disease. J Vet Intern Med 2017; 31:457-464. [PMID: 28140480 PMCID: PMC5354007 DOI: 10.1111/jvim.14661] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/01/2016] [Accepted: 12/28/2016] [Indexed: 12/12/2022] Open
Abstract
Background The role of inflammation in the development and progression of chronic kidney disease (CKD) in cats is not well characterized. Hepcidin is a recently discovered acute‐phase protein (APP) that plays an important role in iron metabolism and contributes to the development of anemia in humans with CKD. Objectives To compare serum APP concentrations, iron status, and erythropoietin (EPO) concentrations in healthy cats and cats with naturally occurring CKD. Animals A total of 18 healthy control cats and 38 cats with CKD. Methods Prospective study. After complete physical examination and routine blood analysis, the following tests were performed: serum amyloid A (SAA), haptoglobin (HAP), EPO, serum iron and ferritin concentration as well as total iron‐binding capacity (TIBC). Serum hepcidin‐25 concentration was measured by ELISA kit designed for use in humans. Results Mean SAA and hepcidin concentrations were significantly higher and mean total iron and TIBC were significantly lower in the CKD group (P < .05). There was a significant positive correlation between serum creatinine concentration (CRT) and 2 of the APPs (SAA and hepcidin; P < .05). Increases in SAA and hepcidin were associated with decreases in TIBC and hematocrit in the CKD group. Fourteen (37%) of the cats with CKD were anemic, and these cats had significantly lower TIBC (P < .05), suggesting a functional iron deficiency. There was no association between survival time and APP, iron status, or EPO concentrations. Conclusions Our data suggest that CKD in cats is associated with systemic inflammation and altered iron metabolism. With further validation in cats, hepcidin assays may help better characterize these relationships.
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Affiliation(s)
- R Javard
- Companion Animal Research Group, Department of Clinical Sciences, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - C Grimes
- Department of Pathology and Microbiology, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - L Bau-Gaudreault
- Department of Pathology and Microbiology, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - M Dunn
- Companion Animal Research Group, Department of Clinical Sciences, University of Montreal, Saint-Hyacinthe, QC, Canada
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Dang D, Hennebery R, Grimes C, Naresh A. 26: Attitudes towards HPV vaccination in young women. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.09.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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29
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Von Bargen E, Grimes C, Mishra K, Wang R, Haviland M, Carnevale J, Estes A, Truong M, Hacker M, Elkadry E. 22: Prevalence of occult pre-malignant or malignant pathology at the time of uterine morcellation for benign disease. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.01.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Mishra K, Grimes C, Von Bargen E, Carnevale J, Has P, Wang R, Elkadry E. 76: Surgeon factors influence performance of prophylactic salpingectomy during benign hysterectomy. Am J Obstet Gynecol 2016. [DOI: 10.1016/j.ajog.2016.01.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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31
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Nowson C, Lim K, Grimes C, O'Halloran S, Land MA, Webster J, Shaw J, Chalmers J, Smith W, Flood V, Woodward M, Neal B. Dietary Salt Intake and Discretionary Salt Use in Two General Population Samples in Australia: 2011 and 2014. Nutrients 2015; 7:10501-12. [PMID: 26694459 PMCID: PMC4690097 DOI: 10.3390/nu7125545] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/14/2015] [Accepted: 11/30/2015] [Indexed: 02/07/2023] Open
Abstract
The limited Australian measures to reduce population sodium intake through national initiatives targeting sodium in the food supply have not been evaluated. The aim was, thus, to assess if there has been a change in salt intake and discretionary salt use between 2011 and 2014 in the state of Victoria, Australia. Adults drawn from a population sample provided 24 h urine collections and reported discretionary salt use in 2011 and 2014. The final sample included 307 subjects who participated in both surveys, 291 who participated in 2011 only, and 135 subjects who participated in 2014 only. Analysis included adjustment for age, gender, metropolitan area, weekend collection and participation in both surveys, where appropriate. In 2011, 598 participants: 53% female, age 57.1(12.0)(SD) years and in 2014, 442 participants: 53% female, age 61.2(10.7) years provided valid urine collections, with no difference in the mean urinary salt excretion between 2011: 7.9 (7.6, 8.2) (95% CI) g/salt/day and 2014: 7.8 (7.5, 8.1) g/salt/day (p = 0.589), and no difference in discretionary salt use: 35% (2011) and 36% (2014) reported adding salt sometimes or often/always at the table (p = 0.76). Those that sometimes or often/always added salt at the table and when cooking had 0.7 (0.7, 0.8) g/salt/day (p = 0.0016) higher salt excretion. There is no indication over this 3-year period that national salt reduction initiatives targeting the food supply have resulted in a population reduction in salt intake. More concerted efforts are required to reduce the salt content of manufactured foods, together with a consumer education campaign targeting the use of discretionary salt.
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Affiliation(s)
- Caryl Nowson
- School of Exercise and Nutrition Sciences, Deakin University, Centre for Physical Activity and Nutrition Research, Locked Bag 20000, Waurn Ponds, Geelong VIC 3220 Melbourne, Australia.
| | - Karen Lim
- School of Exercise and Nutrition Sciences, Deakin University, Centre for Physical Activity and Nutrition Research, Locked Bag 20000, Waurn Ponds, Geelong VIC 3220 Melbourne, Australia.
| | - Carley Grimes
- School of Exercise and Nutrition Sciences, Deakin University, Centre for Physical Activity and Nutrition Research, Locked Bag 20000, Waurn Ponds, Geelong VIC 3220 Melbourne, Australia.
| | - Siobhan O'Halloran
- School of Exercise and Nutrition Sciences, Deakin University, Centre for Physical Activity and Nutrition Research, Locked Bag 20000, Waurn Ponds, Geelong VIC 3220 Melbourne, Australia.
| | - Mary Anne Land
- George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney 2050, Australia.
| | - Jacqui Webster
- WHO Collaborating Centre on Population Salt Reduction, George Institute for Global Health, University of Sydney, Sydney 2050, Australia.
| | - Jonathan Shaw
- Clinical Diabetes and Epidemiology, Baker IDI Heart & Diabetes Institute, Melbourne 3004, Australia.
| | - John Chalmers
- George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney 2050, Australia.
| | - Wayne Smith
- Environmental Health Branch, New South Wales Health, Sydney 2059, Australia.
| | - Victoria Flood
- Faculty of Health Sciences, University of Sydney, Sydney 2141, Australia.
- St Vincent's Health Network, Sydney, 2010, Australia.
| | - Mark Woodward
- George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney 2050, Australia.
- Medical Sciences Division, University of Oxford, Oxford OX1 3BD, UK.
| | - Bruce Neal
- George Institute for Global Health, University of Sydney and Royal Prince Alfred Hospital, Sydney 2050, Australia.
- Sydney Medical School, University of Sydney, Sydney 2050, Australia.
- School of Public Health, Faculty of Medicine, Imperial College London, London SW7 2AZ, UK.
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Brown H, Antosh D, Gleason J, Oliphant S, Grimes C. Creation of a Collaborative Research Network for Junior Investigators. J Minim Invasive Gynecol 2015. [DOI: 10.1016/j.jmig.2014.12.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Grimes C, Aughwane P, Klein M. A reaction to silicone spray. Endoscopy 2010; 42 Suppl 2:E128. [PMID: 20405377 DOI: 10.1055/s-0029-1243985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- C Grimes
- Department of Surgery, Chase Farm Hospital, Enfield, Middlesex EN2 8JL, UK.
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Grimes C, Chin D, Bailey C, Gergely S, Harris A. Comment On. Ann R Coll Surg Engl 2010. [DOI: 10.1308/003588410x125188364439524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Hwang L, Williams M, Grimes C, Fang S, Oujesky B. High Hiv Incidence among Drug Users in Hepatitis B Vaccination Project from Inner City Neighborhoods. Am J Epidemiol 2006. [DOI: 10.1093/aje/163.suppl_11.s194-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lindley AA, Benson JE, Grimes C, Cole TM, Herman AA. The relationship in neonates between clinically measured head circumference and brain volume estimated from head CT-scans. Early Hum Dev 1999; 56:17-29. [PMID: 10530903 DOI: 10.1016/s0378-3782(99)00033-x] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine if the frontal-occipital head circumference correlates with brain volume on CT and to investigate correlations between the volumes of different brain subdivisions in live neonates. METHODS Records were studied from 27 neonates with anatomically normal head CT-scans which were ordered for clinical reasons, and which were performed at Johns Hopkins Hospital. Clinical data were abstracted from medical records. Brain volumes were estimated by digitizing the structures of interest on each slice of head CT-scans. RESULTS In this sample of 27 infants with a mean birth weight of 3000.4 +/- 668 g, mean head circumference of 33.5 +/- 1.8 cm, and mean gestational age of 37 weeks and 4 days +/- 24 days, the mean of total brain volume was 333.0 +/- 78.3 ml. The correlation between clinically measured head circumference and total brain volume was 0.55 (P < 0.003). Regression of total brain volume on head circumference and its second and third powers accounted for 43% of the variation in total brain volume. Other predictor variables, namely infant race, sex, gestational age, and maternal age, were not significant in this regression once head circumference was included. The slope of the cubic function of head circumference as a predictor of brain volume was greatest below the mean head circumference of 33.5 cm. Brain volume leveled off at head circumferences greater than the mean. CONCLUSION Head circumference is a powerful predictor of total brain volume in the neonate: below the approximate head-circumference mean of 33.5 cm, smaller head circumference indicates smaller total brain volume.
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Affiliation(s)
- A A Lindley
- Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA.
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Stackhouse MA, Buchsbaum DJ, Kancharla SR, Grizzle WE, Grimes C, Laffoon K, Pederson LC, Curiel DT. Specific membrane receptor gene expression targeted with radiolabeled peptide employing the erbB-2 and DF3 promoter elements in adenoviral vectors. Cancer Gene Ther 1999; 6:209-19. [PMID: 10359206 DOI: 10.1038/sj.cgt.7700049] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Radioimmunotherapy is limited by a variety of factors, including poor tumor penetration of monoclonal antibodies and low levels of intratumoral antigen expression. To address these limitations, a gene therapy strategy was devised to genetically induce tumor cells to express enhanced levels of membrane receptors with high affinity for a radiolabeled peptide. We designated this approach as genetic radioisotope targeting strategy. To this end, an adenoviral vector (AdCMVGRPr) encoding the murine gastrin-releasing peptide receptor (GRPr) was used to achieve a high level of binding of radiolabeled bombesin (BBN). To achieve genetic induction of membrane GRPr specifically to tumor cells, we constructed two adenoviral vectors encoding the GRPr gene under the control of the tumor-specific regulatory elements, DF3 (AdDF3GRPr) or erbB-2 (AderbGRPr). We investigated the binding of [125I]BBN to the GRPr following infection with AdDF3GRPr and AderbGRPr in a panel of human breast, pancreatic, and cholangiocarcinoma tumor cell lines. [125I]BBN binding and GRPr expression increased with increasing multiplicities of infection of AdCMVGRPr in all of the cell lines tested. Breast cancer cell lines expressing erbB-2 showed significant GRPr expression using AderbGRPr. A similar result was observed in breast and cholangiocarcinoma cells infected with AdDF3GRPr expressing MUC1 as detected by immunohistochemistry but was not seen in the pancreatic cell lines tested. Thus, adenoviral vectors with tissue-specific promoter elements can be used to achieve a selective expression of membrane receptors that can be targeted with a radiolabeled peptide. The use of such a transcriptional targeting approach may restrict gene expression to tumors and limit the radiation dose deposited in normal tissues in vivo.
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Affiliation(s)
- M A Stackhouse
- Department of Radiation Oncology, Comprehensive Cancer Center, University of Alabama, Birmingham 35294, USA.
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Costa MJ, Grimes C, Tackett E, Naib ZM. Cervicovaginal cytology in an indigent population. Comparison of results for 1964, 1981 and 1989. Acta Cytol 1991; 35:51-6. [PMID: 1994635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
To evaluate the usefulness of cervicovaginal cytology in decreasing the incidence of cervical carcinoma in an indigent population, the cytologic findings from 10,000 consecutive smears in 1964 (when cytology screening started) were compared to the results of 10,000 consecutive smears in 1981 and 1989. There was a marked (statistically significant) decrease in invasive cervical squamous carcinoma at all ages between the first and later periods. Squamous carcinoma in situ showed a significant decrease beginning in patients under 40 in 1981. The number of atypias and mild dysplasias showed a proportional increase, from 2% in 1964 to 13.4% in 1981 to 21.8% in 1989, predominantly in young patients. These results reaffirm that cervicovaginal cytology remains the most inexpensive and effective diagnostic tool for the elimination of cervical cancer.
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Affiliation(s)
- M J Costa
- Department of Pathology, Grady Memorial Hospital, Atlanta, Georgia 30335-3801
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Whitten C, Grimes C, Isler R, Curci M, Dibbins A. CT of an actively-hemorrhaging liver laceration in a 9-year-old child. Pediatr Radiol 1990; 20:558-9. [PMID: 2216594 DOI: 10.1007/bf02011392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A 9-year-old female with blunt abdominal trauma following a motor vehicle accident was referred from the Emergency Room for abdominal CT imaging. CT demonstrated the unusual and heretofore unreported finding of an actively hemorrhaging liver laceration.
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Affiliation(s)
- C Whitten
- Department of Radiology, Maine Medical Center, Portland
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Levenson MJ, Bellucci RJ, Grimes C, Ingerman M, Parisier SC. Otosclerosis surgery in a resident training program. Arch Otolaryngol Head Neck Surg 1987; 113:29-31. [PMID: 3790280 DOI: 10.1001/archotol.1987.01860010033009] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Controversy exists regarding the appropriateness of offering all residents training in stapes surgery due to dwindling case loads in residency programs nationally. A recent study indicated poorer results for stapes surgery performed by residents than results obtained by practicing otologists. One hundred consecutive stapedectomies performed by residents over a three-year period at our institution were reviewed retrospectively, with the objective of determining whether these results should be generalized.
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Abstract
Although orbital or subperiosteal abscess may originate from a number of sources, paranasal ethmoidal sinus disease is the most common source of infection, particularly in children. Prompt diagnosis and treatment are necessary to prevent severe visual loss and even death. The authors review the five-group classification of orbital abscess and summarize data regarding source, bacteriology, treatment and visual results from 13 series reporting 148 patients. Four new cases are presented in detail. Diagnostic procedures, including laboratory testing, sinus radiography, ultrasound and CT scanning, are discussed and recommendations are given for medical and surgical management.
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Abstract
Despite a dramatic reduction in incidence of laryngeal tuberculosis over the last three decades, tuberculous involvement still has to be considered in the differential diagnosis of laryngeal lesions. The majority of the 20 cases in our series consists of patients in whom the working diagnosis of carcinoma of the larynx was initially made. These patients presented with the chief complaint of hoarseness of several months duration, frequently associated with dysphagia, but in most cases with chest symptoms that were not prominent despite the fact that most of these patients had far advanced pulmonary tuberculosis. This presentation consists of a detailed analysis of 20 cases, and a discussion of the incidence, pathogenesis, clinical presentation and management of laryngeal tuberculosis.
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Abstract
The Melkersson-Rosenthal syndrome (MRS) is a rare condition characterized by the triad of familial relapsing peripheral facial palsy, facial edema, and lingua plicata. Within a well-documented family aggregate of MRS, an index case simultaneously demonstrated all the elements of the triad, as well as gingival changes similar to those of cheilitis granulomatosa. When the incomplete or oligosymptomatic forms are considered, the MRS may be more common than previously thought.
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Feldman A, Grimes C, Grimes L. Hearing Screening in the Educational Setting. Semin Hear 1981. [DOI: 10.1055/s-0028-1089934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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