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Mucheru D, Mollel H, Gilmore B, Kesale A, McAuliffe E. Advancing Gender Equality in Healthcare Leadership: Protocol to Co-Design and Evaluate a Leadership and Mentoring Intervention in Tanzania. Ann Glob Health 2024; 90:24. [PMID: 38550609 PMCID: PMC10976988 DOI: 10.5334/aogh.4374] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/06/2024] [Indexed: 04/02/2024] Open
Abstract
Background Women constitute almost two thirds of the health and social workforce. Yet, the proportion of women in decision-making positions remains significantly low leading to gender inequities in access to and appropriateness of healthcare. Several barriers which limit women's advancement to leadership positions have been documented and they generally constitute of gender stereotypes, discrimination and inhibiting systems; these hinderances are compounded by intersection with other social identities. Amelioration of the barriers has the potential to enhance women's participation in leadership and strengthen the existing health systems. Objective This protocol describes a proposed study aimed at addressing the organisational and individual barriers to the advancement of women to leadership positions in the Tanzanian health sector, and to evaluate the influence on leadership competencies and career advancement actions of the female health workforce. Method The study utilises a gender transformative approach, co-design and implementation science in the development and integration of a leadership and mentorship intervention for women in the Tanzanian health context. The key steps in this research include quantifying the gender ratio in healthcare leadership; identifying the individual and organisational barriers to women's leadership; reviewing existing leadership, mentorship and career advancement interventions for women; recruiting programme participants for a leadership and mentorship programme; running a co-design workshop with programme participants and stakeholders; implementing a leadership and mentorship programme; and conducting a collaborative evaluation and lessons learnt. Conclusions This research underscores the notion that progression towards gender equality in healthcare leadership is attained by fashioning a system that supports the advancement of women. We also argue that one of the pivotal indicators of progress towards the gender equality sustainable development goal is the number of women in senior and middle management positions, which we hope to further through this research.
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Affiliation(s)
- Doreen Mucheru
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland
| | - Henry Mollel
- Mbeya Campus College, Mzumbe University, Tanzania
| | - Brynne Gilmore
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland
| | | | - Eilish McAuliffe
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland
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Fealy G, Di Placido M, O'Donnell D, Drennan J, Timmins F, Barnard M, Blake C, Connolly M, Donnelly S, Doyle G, Fitzgerald K, Frawley T, Gallagher P, Guerin S, Mangiarotti E, McNulty J, Mucheru D, O'Neill D, Segurado R, Stokes D, Ryder M, Üzar Özçetin YS, Wells J, Čartolovni A. 'Ageing well': Discursive constructions of ageing and health in the public reach of a national longitudinal study on ageing. Soc Sci Med 2024; 341:116518. [PMID: 38141382 DOI: 10.1016/j.socscimed.2023.116518] [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: 09/22/2023] [Revised: 12/08/2023] [Accepted: 12/13/2023] [Indexed: 12/25/2023]
Abstract
Established in 2006, the Irish Longitudinal Study on Ageing (TILDA) investigates the health, economic and social circumstances of a nationally-representative sample of people aged fifty years and older in a series of biennial data collection waves. Irish newspapers have been reporting the results of TILDA for over a decade and a half, and their texts represent reports of scientific research distilled through the pen of journalists. In their totality, their texts constitute a public discourse on ageing and health. Using critical discourse analysis, we examined the discourse within the texts of a purposive sample of two national daily newspapers. As sites of public discourse, newspapers reflect social life and are influential in forming and legitimating public attitudes. Like other sites of discourse, their language-in-use is contextually located, is rarely neutral and may employ strategies to discursively construct, sustain and privilege particular social identities, including ageing identities. Discursively constructed as 'ageing well', our analysis of newspaper texts revealed a discernible meta-discourse on ageing and health in which ageing was framed as a life course stage that may be cultivated, diligently self-nurtured and exploited for its positive aspects. When considered in light of literature on health and social inequalities, the consequences of this broadly positive ageing discourse can, somewhat perversely, frame older adults in unintended negative ways, including homogenising them and attributing to them capacities for ageing well that they may not possess. Discursively constructing older adults as a social and economic resource can also impose unrealistic expectations on them and may legitimise exploitation and demonstrate how normative ideologies of ageism and ableism are conveyed through legitimising language. Despite these potentially unintended consequences, the available media resources associated with TILDA may represent one of the most important contributions of the study, in terms of informing positive public attitudes towards ageing.
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Affiliation(s)
- Gerard Fealy
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | - Matteo Di Placido
- Department of Culture, Politics and Society, University of Turin, Italy.
| | - Deirdre O'Donnell
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | - Jonathan Drennan
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | - Fiona Timmins
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | - Marlize Barnard
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | - Catherine Blake
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.
| | - Michael Connolly
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland; Our Lady's Hospice and Care Services, Dublin, Ireland.
| | - Sarah Donnelly
- UCD School of Social Policy, Social Work and Social Justice, University College Dublin, Ireland.
| | | | - Kelly Fitzgerald
- UCD School of Irish, Celtic Studies and Folklore, University College Dublin, Ireland.
| | - Timmy Frawley
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | | | - Suzanne Guerin
- UCD School of Psychology, University College Dublin, Ireland.
| | - Emanuela Mangiarotti
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland; Department of Political and Social Sciences, University of Pavia, Lombardy, Italy
| | | | - Doreen Mucheru
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | | | - Ricardo Segurado
- UCD School of Public Health, Physiotherapy and Sports Science, University College Dublin, Ireland.
| | | | - Mary Ryder
- UCD School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland.
| | | | - John Wells
- School of Health Sciences, South-East Technological University, Ireland.
| | - Anto Čartolovni
- School of Medicine, Catholic University of Croatia, Croatia.
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Mucheru D, Kroll T, Paul G, Fahy M, Dowling-Hetherington L, Moloney B, Dunne N, Jalal R, Fealy G, Lafferty A. The dual responsibility of employed family carers and how detrimental outcomes can be prevented. Work 2023:WOR220665. [PMID: 38160381 DOI: 10.3233/wor-220665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
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Mucheru D, Ashby S, Hanlon MC, McEvoy M, MacDonald-Wicks L. Factors to consider during the implementation of nutrition and physical activity trials for people with psychotic illness into an Australian community setting. BMC Health Serv Res 2020; 20:743. [PMID: 32787846 PMCID: PMC7425062 DOI: 10.1186/s12913-020-05629-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 08/05/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Research in lifestyle interventions focusing on nutrition and physical activity in people living with psychotic illness, highlights anthropometric and metabolic benefits of these interventions. However, little is known about potential factors to consider during implementation into real-world contexts. Community-managed organisations (CMOs) that provide services for people with mental illness, offer an ideal implementation context for lifestyle interventions. Successful translation of lifestyle interventions into CMOs may be achieved though considering the factors associated with program access and delivery in these settings. This study primarily aimed to identify the factors that affect program access in a local CMO from the perspective of consumers and staff. The secondary aim was to describe the elements that impact on program delivery from the perspective of staff. METHODS Thirteen semi-structured interviews were conducted with 6 consumers and 7 staff in a CMO in regional Australia. Topics explored in interviews were based on implementation concepts identified in the "Integrated Promoting Action on Research Implementation in Health Systems" (i-PARIHS) knowledge translation framework. Thematic data analysis was conducted using Nvivo software. RESULTS Emergent themes on issues that influenced program access were (1) consumer financial status, domestic responsibilities, and health; (2) the design and delivery of programs; (3) structure and practices of the organisation; (4) attitude, skills and effort of staff involved in program delivery; and (5) social connections and stigma experienced by consumers during program access. Moreover, staff perceptions on elements that impacted program delivery highlighted themes on consumer attendance and interest in prospective programs, availability and restrictions to the use of funding, as well as the organisational structure and practices. CONCLUSIONS The factors affecting program access and delivery can generally be managed or planned for during the design of lifestyle interventions and subsequent translation into the CMO context. However, resolution of issues related to consumer financial status and health requires the collaboration of various government sectors for system-wide solutions.
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Affiliation(s)
- Doreen Mucheru
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
| | - Samantha Ashby
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
| | - Mary-Claire Hanlon
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Brain and Mental Health, The University of Newcastle, Callaghan, 2308 Australia
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Hunter Cancer Research Alliance, The University of Newcastle, Callaghan, 2308 Australia
| | - Mark McEvoy
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Centre for Clinical Epidemiology & Biostatistics, Hunter Medical Research Institute, New Lambton, 2305 Australia
| | - Lesley MacDonald-Wicks
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Brain and Mental Health, The University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, 2308 Australia
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Mucheru D, Hanlon MC, McEvoy M, MacDonald-Wicks L. An appraisal of methodology reporting in lifestyle interventions among people with psychosis: A systematic review. Health Promot J Austr 2019; 31:540-552. [PMID: 31495017 DOI: 10.1002/hpja.293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 06/24/2019] [Accepted: 08/30/2019] [Indexed: 12/20/2022] Open
Abstract
ISSUE ADDRESSED Lifestyle interventions use nutrition and physical activity behaviour modification techniques to decrease obesity and cardio-metabolic risk in people with psychosis. Evidence on the specific behaviour modification strategies applied to decrease obesity is weakened by inadequate methodology reporting of lifestyle interventions. A systematic review that we conducted earlier highlighted a possible deficiency in reporting; hence we aim to critically appraise lifestyle intervention studies that target weight outcomes for people with psychosis against the methods component of the CONSORT statement for randomised trials of nonpharmacologic treatments. METHODS COMPONENT We considered randomised controlled studies which delivered lifestyle interventions to community-dwelling adults with psychotic disorders, and included those with the following outcomes of interest: weight, body mass index, waist circumference and waist-to-hip ratio. The Cochrane Library, MEDLINE/PREMEDLINE, EMBASE, CINAHL, Scopus and PsycINFO were searched for English publications between 1985 and 2018. Methodology and reporting of studies were evaluated using the CONSORT statement for randomised trials of nonpharmacologic treatments. RESULTS Thirty-two studies met the inclusion criteria. Critical appraisals revealed that reporting of lifestyle intervention studies was generally incomplete. Fewer than 50% provided the recommended information on trial design, participant characteristics, detail of interventions, outcomes, sample size, randomisation, blinding and statistical methods. CONCLUSIONS Application of guidelines, like the CONSORT statement, in future publications of lifestyle interventions for people with psychosis will improve accuracy of reporting. SO WHAT?: Enhanced reporting in lifestyle intervention studies for people with psychosis will promote guideline creation and translation of research, which is likely to positively impact physical health outcomes.
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Affiliation(s)
- Doreen Mucheru
- Faculty Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia
| | - Mary-Claire Hanlon
- Faculty Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, NSW, Australia.,Priority Research Centre for Brain and Mental Health, Mater Hospital, Waratah, NSW, Australia.,Hunter Cancer Research Alliance, The University of Newcastle, Callaghan, NSW, Australia
| | - Mark McEvoy
- Faculty Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Centre for Clinical Epidemiology & Biostatistics, Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Lesley MacDonald-Wicks
- Faculty Health and Medicine, The University of Newcastle, Callaghan, NSW, Australia.,Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, NSW, Australia.,Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia
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Mucheru D, Hanlon MC, McEvoy M, Thakkinstian A, MacDonald-Wicks L. Comparative efficacy of lifestyle intervention strategies targeting weight outcomes in people with psychosis. ACTA ACUST UNITED AC 2019; 17:1770-1825. [DOI: 10.11124/jbisrir-2017-003943] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Mucheru D, Hanlon MC, Campbell LE, McEvoy M, MacDonald-Wicks L. Cardiovascular disease lifestyle risk factors in people with psychosis: a cross-sectional study. BMC Public Health 2018; 18:742. [PMID: 29907101 PMCID: PMC6003197 DOI: 10.1186/s12889-018-5649-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/31/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND People with psychosis die on average 25 years earlier than those in the general population, with cardiovascular disease (CVD) contributing to much of the excess mortality. This cross-sectional study aimed to identify the relationship between lifestyle risk factors for CVD - poor nutrition, smoking and low physical activity levels - and dyslipidaemia, hypertension and hyperglycaemia while controlling for potential confounders in 1825 people from the Survey of High Impact Psychosis (SHIP) in Australia. We also aimed to identify clustering patterns of lifestyle risk factors and associated demographic variables. METHODS Three logistic regressions were used to predict the effect of nutrition, smoking and physical activity on dyslipidaemia, hypertension and hyperglycaemia while controlling for clozapine use, sex and age. Clustering patterns of nutrition, smoking and physical activity were examined using the two-step cluster method which is based on hierarchical cluster analysis. Demographic variables associated with different clusters were identified using measures of association. RESULTS Smoking status had a positive association with dyslipidaemia (adjusted odds ratio = 0.50; 95% confidence interval = 0.32-0.78; p = 0.002). Other cardiovascular disease lifestyle risk factors did not have a significant relationship with dyslipidaemia, hypertension and hyperglycaemia. Clustering patterns of lifestyle risk factors showed that younger men, with low education levels, and relying on a government pension, were most likely to display the poorest lifestyle risk behaviours. The largest cluster (42%) of participants was characterised by a mixed demographic profile and were most likely to display poor nutrition and low physical activity levels but less likely to smoke. CONCLUSIONS Only smoking status had a significant positive association with dyslipidaemia which could indicate that there are additional factors affecting the relationship between other cardiovascular lifestyle risk factors and dyslipidaemia, hypertension and hyperglycaemia in people with psychosis. Unknown confounders and traditional lifestyle risk factors may explain the high rates of CVD in this group. Clustering of lifestyle risk factors and their demographic profiles could help the design of intervention programs in people with psychosis.
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Affiliation(s)
- Doreen Mucheru
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
| | - Mary-Claire Hanlon
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Priority Research Centre for Brain and Mental Health, The University of Newcastle, Callaghan, 2308 Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, 2308 Australia
| | - Linda E. Campbell
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Faculty of Science, The University of Newcastle, Callaghan, 2308 Australia
- Priority Research Centre GrowUpWell, The University of Newcastle, Callaghan, 2308 Australia
| | - Mark McEvoy
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Centre for Clinical Epidemiology & Biostatistics, Hunter Medical Research Institute, New Lambton, 2305 Australia
| | - Lesley MacDonald-Wicks
- Faculty Health and Medicine, The University of Newcastle, Callaghan, 2308 Australia
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton, 2305 Australia
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, 2308 Australia
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Mucheru D, Hanlon MC, Campbell LE, McEvoy M, MacDonald-Wicks L. Social Dysfunction and Diet Outcomes in People with Psychosis. Nutrients 2017; 9:nu9010080. [PMID: 28106815 PMCID: PMC5295124 DOI: 10.3390/nu9010080] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 12/26/2016] [Accepted: 01/11/2017] [Indexed: 11/16/2022] Open
Abstract
This analysis aimed to examine the association of social dysfunction with food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption in people with psychosis from the Hunter New England (HNE) catchment site of the Survey of High Impact Psychosis (SHIP). Social dysfunction and dietary information were collected using standardised tools. Independent binary logistic regressions were used to examine the association between social dysfunction and food security status, fruit intake, vegetable intake, meal frequency and breakfast consumption. Although social dysfunction did not have a statistically significant association with most diet variables, participants with obvious to severe social dysfunction were 0.872 (95% CI (0.778, 0.976)) less likely to eat breakfast than those with no social dysfunction p < 0.05. Participants with social dysfunction were therefore, 13% less likely to have breakfast. This paper highlights high rates of social dysfunction, significant food insecurity, and intakes of fruits and vegetables below recommendations in people with psychosis. In light of this, a greater focus needs to be given to dietary behaviours and social dysfunction in lifestyle interventions delivered to people with psychosis. Well-designed observational research is also needed to further examine the relationship between social dysfunction and dietary behaviour in people with psychosis.
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MESH Headings
- Adolescent
- Adult
- Australia
- Breakfast
- Cohort Studies
- Cross-Sectional Studies
- Diet, Healthy/economics
- Diet, Healthy/psychology
- Feeding Behavior/psychology
- Female
- Food Supply/economics
- Humans
- Male
- Middle Aged
- Nutrition Surveys
- Patient Compliance/psychology
- Phobia, Social/economics
- Phobia, Social/etiology
- Phobia, Social/prevention & control
- Phobia, Social/psychology
- Psychotic Disorders/economics
- Psychotic Disorders/physiopathology
- Psychotic Disorders/psychology
- Psychotic Disorders/therapy
- Retrospective Studies
- Social Behavior Disorders/economics
- Social Behavior Disorders/etiology
- Social Behavior Disorders/prevention & control
- Social Behavior Disorders/psychology
- Social Isolation/psychology
- Socioeconomic Factors
- Stress, Psychological/economics
- Stress, Psychological/etiology
- Stress, Psychological/prevention & control
- Stress, Psychological/psychology
- Young Adult
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Affiliation(s)
- Doreen Mucheru
- Faculty Health and Medicine, The University of Newcastle, Callaghan 2308, Australia.
| | - Mary-Claire Hanlon
- Faculty Health and Medicine, The University of Newcastle, Callaghan 2308, Australia.
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton 2305, Australia.
- Priority Research Centre for Brain and Mental Health, Mater Hospital, Waratah 2298, Australia.
- Department of Radiation Oncology, Calvary Mater Newcastle, Waratah 2298, Australia.
- Hunter Cancer Research Alliance, The University of Newcastle, Callaghan 2308, Australia.
| | - Linda E Campbell
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton 2305, Australia.
- Faculty of Science, The University of Newcastle, Callaghan 2308, Australia.
- Priority Research Centre GrowUpWell, The University of Newcastle, Callaghan 2308, Australia.
| | - Mark McEvoy
- Faculty Health and Medicine, The University of Newcastle, Callaghan 2308, Australia.
- Centre for Clinical Epidemiology & Biostatistics, Hunter Medical Research Institute, New Lambton 2305, Australia.
| | - Lesley MacDonald-Wicks
- Faculty Health and Medicine, The University of Newcastle, Callaghan 2308, Australia.
- Brain and Mental Health Program, Hunter Medical Research Institute, New Lambton 2305, Australia.
- Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan 2308, Australia.
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