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Lund Rasmussen C, Gába A, Stanford T, Dygrýn J, Dumuid D, Janda D, Hron K. The Goldilocks Day for healthy adiposity measures among children and adolescents. Front Public Health 2023; 11:1158634. [PMID: 37841713 PMCID: PMC10569221 DOI: 10.3389/fpubh.2023.1158634] [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: 02/04/2023] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
Background The optimal balance of time spent on daily movement behaviors ("The Goldilocks Day") associated with childhood obesity remains unknown. Objective To estimate the optimal durations of sleep, sedentary behavior (SB), light physical activity (LPA), and moderate-to-vigorous physical activity (MPVA) associated with excess adiposity in a paediatric population. Methods Accelerometer-measured 24-h movement behaviors were obtained from 659 Czech children and adolescents (8-18-year-olds). Adiposity indicators were body mass index z-score, fat mass percentage, fat-free mass index, and visceral adipose tissue. Excess adiposity was defined as exceeding the 85th percentile for an adiposity indicator. Compositional regression analyses were used investigate the associations between movement behaviors and adiposity indicators and estimating "The Goldilocks Day." Results The movement behavior composition was associated with visceral adipose tissue (Fdf1 = 3,df2 = 317 = 3.672, p = 0.013) and fat mass percentage (Fdf1 = 3,df2 = 289 = 2.733, p = 0.044) among children and adolescents. The Goldilocks Day consisted of 8.5 h of sleep, 10.8 h of SB, 3.9 h of LPA, and 0.8 h of MVPA among children and 7.5 h of sleep, 12.4 h of SB, 3.6 h of LPA, and 0.5 h of MVPA among adolescents. Conclusion Optimizing the time spent sleeping, and in sedentary and physical activities appears to be important in the prevention of excess adiposity.
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Affiliation(s)
- Charlotte Lund Rasmussen
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- School of Allied Health, Curtin University, Perth, WA, Australia
| | - Aleš Gába
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Tyman Stanford
- Alliance for Research in Exercise, Nutrition, and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Jan Dygrýn
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition, and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - David Janda
- Faculty of Physical Culture, Palacký University Olomouc, Olomouc, Czechia
| | - Karel Hron
- Department of Mathematical Analysis and Applications of Mathematics, Palacký University Olomouc, Olomouc, Czechia
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Peng K, Blais JE, Pratt NL, Guo JJ, Hillen JB, Stanford T, Ward M, Lai ECC, Shin JY, Tong X, Fan M, Cheng FWT, Wu J, Yeung WWY, Lau CS, Leung WK, Wong ICK, Li X. Impact of Introducing Infliximab Biosimilars on Total Infliximab Consumption and Originator Infliximab Prices in Eight Regions: An Interrupted Time-Series Analysis. BioDrugs 2023; 37:409-420. [PMID: 36952213 DOI: 10.1007/s40259-023-00589-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE We aimed to assess whether the introduction of the first infliximab biosimilar was associated with changes in overall infliximab consumption (originator and biosimilars) and price changes to the originator infliximab. METHODS An interrupted time series analysis using infliximab sales data from 2010 to 2020 from the IQVIA Multinational Integrated Data Analysis System for eight selected regions: Australia, Canada, Hong Kong, Korea, India, Japan, the UK, and the USA. Quarterly measures of infliximab consumption and list prices were respectively defined as the number of standard units (SU)/1000 inhabitants and as 2020 USA dollars (USD)/SU. RESULTS Following the introduction of infliximab biosimilars, overall infliximab consumption increased in Australia [immediate change: 0.145 SU/1000 inhabitants (P = 0.014); long-term change: 0.022 SU/1000 inhabitants per quarter (P < 0.001)], Canada [immediate change 0.415 (P = 0.008)], the UK [long-term change 0.024 (P < 0.001)], and Hong Kong [immediate change: 0.042 (P < 0.001)]. The list price of originator infliximab also decreased following biosimilar introduction in Australia [immediate change: - 187.84 USD/SU (P < 0.001); long-term change - 6.46 USD/SU per quarter (P = 0.043)], Canada [immediate change: - 145.58 (P < 0.001)], the UK [immediate change: - 34.95 (P = 0.010); long-term change: - 4.77 (P < 0.001)], and Hong Kong [long-term change: - 4.065 (P = 0.046)]. Consumption and price changes were inconsistent in India, Japan, Korea, and the USA. CONCLUSIONS Introduction of the first infliximab biosimilar was not consistently associated with increased consumption across regions. Additional policy and healthcare system interventions to support biosimilar infliximab adoption are needed.
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Affiliation(s)
- Kuan Peng
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Joseph E Blais
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Nicole L Pratt
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Jeff Jianfei Guo
- James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA
| | - Jodie B Hillen
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Tyman Stanford
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
- Pharmacy Education, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Michael Ward
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ju-Young Shin
- Department of Biohealth Regulatory Science, School of Pharmacy, Sungkyunkwan University, Seoul, South Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | - Xinning Tong
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Min Fan
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Franco W T Cheng
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Jing Wu
- School of Pharmaceutical Science and Technology, Tianjin University, Tianjin, China
| | - Winnie W Y Yeung
- Division of Rheumatology and Clinical Immunology, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR, China
| | - Chak-Sing Lau
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Division of Rheumatology and Clinical Immunology, Queen Mary Hospital, Pok Fu Lam, Hong Kong SAR, China
| | - Wai Keung Leung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ian C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China.
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Pak Shek Kok, Hong Kong SAR, China.
- Aston Pharmacy School, Aston University, Birmingham, UK.
| | - Xue Li
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China.
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Pak Shek Kok, Hong Kong SAR, China.
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Tong X, Li X, Pratt NL, Hillen JB, Stanford T, Ward M, Roughead EE, Lai ECC, Shin JY, Cheng FW, Peng K, Lau CS, Leung WK, Wong IC. Monoclonal antibodies and Fc-fusion protein biologic medicines: A multinational cross-sectional investigation of accessibility and affordability in Asia Pacific regions between 2010 and 2020. Lancet Reg Health West Pac 2022; 26:100506. [PMID: 35789824 PMCID: PMC9249810 DOI: 10.1016/j.lanwpc.2022.100506] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Monoclonal antibody (mAb) and Fc-fusion protein (FcP) are highly effective therapeutic biologics. We aimed to analyse consumption and expenditure trends in 14 Asia-Pacific countries/regions (APAC) and three benchmark countries (the UK, Canada, and the US). METHODS We analysed 440 mAb and FcP biological products using the IQVIA-MIDAS global sales database. For each year between 2010 and 2020 inclusive, we used standard units (SU) sold per 1000 population and manufacture level price (standardised in 2019 US dollars) to evaluate consumption (accessibility) and expenditure (affordability). Changes of consumption and expenditure were estimated using compound annual growth rate (CAGR). Correlations between consumption, country's economic and health performance indicators were measured using Spearman correlation coefficient. FINDINGS Between 2010 and 2020, CAGRs of consumption in each region ranged from 7% to 34% and the CAGRs of expenditure ranged from 9% to 31%. The median consumption of biologics was extremely low in lower-middle-income economies (0·29 SU/1000 population) compared with upper-middle-income economies (1·20), high-income economies (40·94) and benchmark countries (109·55), although the median CAGRs of biologics consumption in lower-middle-income economies (31%) was greater than upper-middle-income (14%), high-income economies (13%) and benchmark countries (9%). Consumption was correlated with GDP per capita [Spearman's rank correlation coefficient (r) = 0·75, p < 0·001], health expenditure as a percentage of total (r = 0·83, p < 0·001) and medical doctors' density (r = 0·85, p < 0·001). INTERPRETATION There have been significant increases in mAb and FcP biologics consumption and expenditure, however accessibility of biological medicines remains unequal and is largely correlated with country's income level. FUNDING This research was funded by NHMRC Project Grant GNT1157506 and GNT1196900; Enhanced Start-up Fund for new academic staff and Internal Research Fund, Department of Medicine, LKS Faculty of Medicine, University of Hong Kong.
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Affiliation(s)
- Xinning Tong
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Xue Li
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong SAR, China
| | - Nicole L. Pratt
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - Jodie B. Hillen
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - Tyman Stanford
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - Michael Ward
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - Elizabeth E. Roughead
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ju-Young Shin
- Department of Biohealth Regulatory Science, School of Pharmacy, Sungkyunkwan University, Seoul, South Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul, South Korea
| | - Franco W.T. Cheng
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Kuan Peng
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Chak Sing Lau
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Wai Keung Leung
- Department of Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ian C.K. Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong SAR, China
- Research Department of Practice and Policy, School of Pharmacy, University College London, United Kingdom
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de Oliveira Costa J, Pearson SA, Donnolley N, Bailey B, Hollingworth S, Stanford T, Pratt N. Parity in female authorship in Australian pharmacoepidemiology research leveraging medicine dispensing data: How well are we doing? Pharmacoepidemiol Drug Saf 2022; 31:1010-1012. [PMID: 35560855 DOI: 10.1002/pds.5450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 05/03/2022] [Accepted: 05/10/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Juliana de Oliveira Costa
- Medicines Policy Research Unit, Centre for Big Data Research in Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Sallie-Anne Pearson
- Medicines Policy Research Unit, Centre for Big Data Research in Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Natasha Donnolley
- Medicines Policy Research Unit, Centre for Big Data Research in Health, Faculty of Medicine, UNSW Sydney, Sydney, Australia
| | - Bronwyn Bailey
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Tyman Stanford
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | - Nicole Pratt
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, Australia
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Hillen J, Ward M, Slee M, Stanford T, Roughead E, Kalisch Ellett L, Pratt N. Utilisation of disease modifying treatment and diversity of treatment pathways in relapsing remitting multiple sclerosis. Mult Scler Relat Disord 2021; 57:103412. [PMID: 34856498 DOI: 10.1016/j.msard.2021.103412] [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: 08/19/2021] [Revised: 11/10/2021] [Accepted: 11/14/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND There is minimal information on the utilisation of Disease Modifying Treatment (DMTs) for multiple sclerosis. The appropriate and safe use of medicines is informed by utilisation studies. Outcomes can inform health interventions to improve appropriate use of medicines and post marketing surveillance activities to improve safety. OBJECTIVE To evaluate utilisation and treatment patterns of disease modifying treatments (DMTs) for relapsing remitting multiple sclerosis (RRMS). METHODS A representative sample of the Australian pharmaceutical benefits scheme data were analysed (2006-2016). Demographics of incident users and trends in incident and prevalent users were determined. Individual patient treatment pathways were determined by sequential initiation of medicines in two different periods (2006-2013 and 2014-2019). RESULTS There were 20,660 patients with at least one dispensing of a DMT for RRMS during the study period (median age 41 years, 75% female). Incident and prevalent use increased by 20% and 88%, respectively. The market was responsive to 13 new listings of DMTs over the study period. Sequential treatment was found for 66% of initiators in 2006-2013 and 28.5% of initiators in 2014-2019. Diverse treatment pathways were found, with 278 and 93 unique sequences in 2006-2013 and 2014-2019, respectively. CONCLUSION The availability of new DMTs has influenced both initial treatment choice and prevalence of users. Individualised treatment patterns and exposure to multiple medicines over time will challenge traditional pharmacovigilance systems.
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Affiliation(s)
- J Hillen
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia.
| | - M Ward
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia; Pharmacy Education, Clinical and Health Sciences, University of South Australia, Australia
| | - M Slee
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - T Stanford
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - E Roughead
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - L Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
| | - N Pratt
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Australia
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Brenton L, Waters MJ, Stanford T, Giglio S. Clinical evaluation of the APAS® Independence: Automated imaging and interpretation of urine cultures using artificial intelligence with composite reference standard discrepant resolution. J Microbiol Methods 2020; 177:106047. [PMID: 32920021 DOI: 10.1016/j.mimet.2020.106047] [Citation(s) in RCA: 3] [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] [Received: 07/05/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study reports the outcome of the first evaluation of the APAS® Independence for automated reading and preliminary interpretation of urine cultures in the routine clinical microbiology laboratory. In a 2-stage evaluation involving 3000 urine samples, two objectives were assessed; 1) the sensitivity and specificity of the APAS® Independence compared to microbiologists using colony enumeration as the primary determinant, and 2) the variability between microbiologists in enumerating bacterial cultures using traditional culture reading techniques, performed independently to APAS® Independence interpretation. METHODS Routine urine samples received into the laboratory were processed and culture plates were interpreted by standard methodology and with the APAS® Independence. Results were compared using typical discrepant result resolution and with a composite reference standard, which provided an alternative assessment of performance. RESULTS The significant growth sensitivity of the APAS® Independence was determined to be 0.919 with a 95% confidence interval of (0.879, 0.948), and the growth specificity was 0.877 with a 95% confidence interval of (0.827, 0.916). Variability between microbiologists was demonstrated with microbiologist bi-plate enumerations in agreement with the consensus 88.6% of the time. CONCLUSION The APAS® Independence appears to offer microbiology laboratories a mechanism to standardise the processing and assessment of urine cultures whilst augmenting the skills of specialist microbiology staff.
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Affiliation(s)
| | | | - Tyman Stanford
- LBT Innovations, Adelaide, Australia; Clever Culture Systems, Switzerland
| | - Steven Giglio
- LBT Innovations, Adelaide, Australia; Clever Culture Systems, Switzerland
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Sanders I, Short CE, Bogomolova S, Stanford T, Plotnikoff R, Vandelanotte C, Olds T, Edney S, Ryan J, Curtis RG, Maher C. Characteristics of Adopters of an Online Social Networking Physical Activity Mobile Phone App: Cluster Analysis. JMIR Mhealth Uhealth 2019; 7:e12484. [PMID: 31162130 PMCID: PMC6746062 DOI: 10.2196/12484] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 04/07/2019] [Accepted: 04/11/2019] [Indexed: 01/20/2023] Open
Abstract
Background To date, many online health behavior programs developed by researchers have not been translated at scale. To inform translational efforts, health researchers must work with marketing experts to design cost-effective marketing campaigns. It is important to understand the characteristics of end users of a given health promotion program and identify key market segments. Objective This study aimed to describe the characteristics of the adopters of Active Team, a gamified online social networking physical activity app, and identify potential market segments to inform future research translation efforts. Methods Participants (N=545) were Australian adults aged 18 to 65 years who responded to general advertisements to join a randomized controlled trial (RCT) evaluating the Active Team app. At baseline they provided demographic (age, sex, education, marital status, body mass index, location of residence, and country of birth), behavioral (sleep, assessed by the Pittsburgh Quality Sleep Index) and physical activity (assessed by the Active Australia Survey), psychographic information (health and well-being, assessed by the PERMA [Positive Emotion, Engagement, Relationships, Meaning, Achievement] Profile; depression, anxiety and stress, assessed by the Depression, Anxiety, and Stress Scale [DASS-21]; and quality of life, assessed by the 12-Item Short Form Health Survey [SF-12]). Descriptive analyses and a k-medoids cluster analysis were performed using the software R 3.3.0 (The R Foundation) to identify key characteristics of the sample. Results Cluster analyses revealed four clusters: (1) younger inactive women with poor well-being (218/545), characterized by a higher score on the DASS-21, low mental component summary score on the SF-12, and relatively young age; (2) older, active women (153/545), characterized by a lower score on DASS-21, a higher overall score on the SF-12, and relatively older age; (3) young, active but stressed men (58/545) with a higher score on DASS-21 and higher activity levels; and (4) older, low active and obese men (30/545), characterized by a high body mass index and lower activity levels. Conclusions Understanding the characteristics of population segments attracted to a health promotion program will guide the development of cost-effective research translation campaigns. Trial Registration Australian New Zealand Clinical Trial Registry ACTRN12617000113358; https://www.anzctr.org .au/Trial/Registration/TrialReview.aspx?id=371463 International Registered Report Identifier (IRRID) RR2-10.1186/s12889-017-4882-7
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Affiliation(s)
- Ilea Sanders
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Camille E Short
- Freemasons Foundation Centre for Men's Health, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia
| | - Svetlana Bogomolova
- Ehrenberg-Bass Institute, School of Marketing, University of South Australia, Adelaide, Australia
| | - Tyman Stanford
- School of Mathematical Sciences, The University of Adelaide, Adelaide, Australia
| | - Ronald Plotnikoff
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, Australia
| | - Corneel Vandelanotte
- Physical Activity Research Group, Central Queensland University, Adelaide, Australia
| | - Tim Olds
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Sarah Edney
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Jillian Ryan
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Rachel G Curtis
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Carol Maher
- Alliance for Research in Exercise, Nutrition and Activity, School of Health Sciences, University of South Australia, Adelaide, Australia
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Ross C, Marshman G, Grillo M, Stanford T. Biological therapies for psoriasis: Adherence and outcome analysis from a clinical perspective. Australas J Dermatol 2015; 57:137-40. [DOI: 10.1111/ajd.12294] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 11/02/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Christopher Ross
- Department of Dermatology; Flinders Medical Centre; Bedford Park South Australia Australia
| | - Gillian Marshman
- Department of Dermatology; Flinders Medical Centre; Bedford Park South Australia Australia
| | - Marianne Grillo
- Department of Dermatology; Flinders Medical Centre; Bedford Park South Australia Australia
| | - Tyman Stanford
- Discipline of Statistics; School of Mathematics; University of Adelaide; Adelaide South Australia Australia
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Brennan SL, Stanford T, Wluka AE, Page RS, Graves SE, Kotowicz MA, Nicholson GC, Pasco JA. Utilisation of primary total knee joint replacements across socioeconomic status in the Barwon Statistical Division, Australia, 2006-2007: a cross-sectional study. BMJ Open 2012; 2:e001310. [PMID: 23035014 PMCID: PMC3488757 DOI: 10.1136/bmjopen-2012-001310] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Accepted: 08/02/2012] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES There are few Australian data that examine the association between total knee joint replacement (TKR) utilisation and socioeconomic status (SES). This study examined TKR surgeries with a diagnosis of osteoarthritis (OA) performed for residents of Barwon Statistical Division (BSD) for 2006-2007. DESIGN Cross-sectional. SETTING BSD, South-eastern Victoria, Australia PARTICIPANTS All patients who underwent a TKR for OA, 2006-2007, and whose residential postcode was identified as within the BSD of Australia, and for whom SES data were available, were eligible for inclusion. PRIMARY OUTCOME MEASURE Primary TKR data ascertained from the Australian Orthopaedic Association National Joint Replacement Registry. Residential addresses were matched with the Australian Bureau of Statistics census data, and the Index of Relative Socioeconomic Disadvantage was used to determine SES, categorised into quintiles whereby quintile 1 indicated the most disadvantaged and quintile 5 the least disadvantaged. Age-specific and sex-specific rates of TKR utilisation per 1000 person-years were reported for 10-year age bands. RESULTS Females accounted for 62.7% of the 691 primary TKR surgeries performed during 2006-2007. The greatest utilisation rates of TKR in males was 7.6 observed in those aged >79 years, and in 10.2 in females observed in those aged 70-79 years. An increase in TKR was observed for males in SES quintile four compared to quintile 1 in which the lowest utilisation which was observed (p=0.04). No differences were observed in females across SES quintiles. CONCLUSIONS Further investigation is warranted on a larger scale to examine the role that SES may play in TKR utilisation, and to determine whether any social disparities in TKR utilisation reflect health system biases or geographic differences.
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Affiliation(s)
- Sharon Lee Brennan
- NorthWest Academic Centre, Department of Medicine, The University of Melbourne, St Albans, Victoria, Australia
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Brennan SL, Stanford T, Wluka AE, Henry MJ, Page RS, Graves SE, Kotowicz MA, Nicholson GC, Pasco JA. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7: Australian Orthopaedic Association National Joint Replacement Registry. BMC Musculoskelet Disord 2012; 13:63. [PMID: 22546041 PMCID: PMC3403966 DOI: 10.1186/1471-2474-13-63] [Citation(s) in RCA: 19] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2011] [Accepted: 04/30/2012] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. METHODS Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006-7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. RESULTS Females accounted for 46.9% of the 642 primary THR performed during 2006-7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70-79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. CONCLUSIONS Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.
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Affiliation(s)
- Sharon L Brennan
- Barwon Epidemiology and Biostatistics Unit, Barwon Health, Deakin University, Kitchener House, PO Box 281, Geelong, Victoria, 3220, Australia
- North West Academic Centre, Department of Medicine, The University of Melbourne Western Health, 176 Furlong Rd, St Albans, VIC, 3021, Australia
| | - Tyman Stanford
- Data Management and Analysis Centre, Discipline of Public Health, University of Adelaide, MDP DX650, Adelaide, SA, 5005, Australia
| | - Anita E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University, Alfred Centre, 89 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Margaret J Henry
- Barwon Epidemiology and Biostatistics Unit, Barwon Health, Deakin University, Kitchener House, PO Box 281, Geelong, Victoria, 3220, Australia
| | - Richard S Page
- Barwon Orthopaedic Research Unit, Barwon Health, Ryrie Street, Geelong, VIC, 3220, Australia
| | - Stephen E Graves
- Australian Orthopaedic Association Joint Replacement Registry, MDP DX650, Adelaide, SA, 5005, Australia
| | - Mark A Kotowicz
- Department of Endocrinology and Diabetes, Barwon Health, Ryrie Street, Geelong, VIC, 3220, Australia
| | - Geoffrey C Nicholson
- Rural Clinical School, The University of Queensland, Locked Bag 9009, Toowoomba, DC QLD, 4350, Australia
| | - Julie A Pasco
- Barwon Epidemiology and Biostatistics Unit, Barwon Health, Deakin University, Kitchener House, PO Box 281, Geelong, Victoria, 3220, Australia
- North West Academic Centre, Department of Medicine, The University of Melbourne Western Health, 176 Furlong Rd, St Albans, VIC, 3021, Australia
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11
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Grace PM, Stanford T, Gentgall M, Rolan PE. Utility of saccadic eye movement analysis as an objective biomarker to detect the sedative interaction between opioids and sleep deprivation in opioid-naive and opioid-tolerant populations. J Psychopharmacol 2010; 24:1631-40. [PMID: 20142307 DOI: 10.1177/0269881109352704] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [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: 12/29/2022]
Abstract
Analysis of saccadic eye movements (SEMs) has previously been used to detect drug- and sleep-deprivation-induced sedation, but never in combination. We compared the effects of sleep deprivation and opioids on 10 opioid-naive with nine opioid-tolerant participants. The naive-participant study evaluated the effects of sleep deprivation alone, morphine alone and the combination; the tolerant-participant study compared day-to-day effects of alternate-daily-dosed buprenorphine and the combination of buprenorphine on the dosing day with sleep deprivation. Psychomotor impairment was measured using SEMs, a 5-minute pupil adaptation test (PAT), pupil light reflex (PLR) and alertness visual analogue scale (AVAS). The PAT and PLR did not detect sleep deprivation, in contrast to previous studies. Whilst consistently detecting sleep deprivation, the AVAS also detected buprenorphine in the tolerant study, but not morphine in the naive study. SEMs detected morphine alone and sleep deprivation alone as well as an additive interaction in the naive study and the effect of sleep deprivation in the tolerant study. The alternate-day buprenorphine dosing did not alter SEMs. The current study revealed greater SEMs, but not AVAS impairment in tolerant versus naive participants. The current study demonstrates that objective measures provide additional information to subjective measures and thus should be used in combination.
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Affiliation(s)
- Peter M Grace
- Discipline of Pharmacology, School of Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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12
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Meyer T, Qi X, Stanford T, Constantinidis C. Effects of training on the organization of spatial and feature visual responses in the lateral prefrontal cortex. J Vis 2010. [DOI: 10.1167/8.6.1170] [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] Open
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13
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Sexton SA, Walter WL, Jackson MP, De Steiger R, Stanford T. Ceramic-on-ceramic bearing surface and risk of revision due to dislocation after primary total hip replacement. ACTA ACUST UNITED AC 2009; 91:1448-53. [PMID: 19880888 DOI: 10.1302/0301-620x.91b11.22100] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Dislocation is a common reason for revision following total hip replacement. This study investigated the relationship between the bearing surface and the risk of revision due to dislocation. It was based on 110 239 primary total hip replacements with a diagnosis of osteoarthritis collected by the Australian Orthopaedic Association National Joint Replacement Registry between September 1999 and December 2007. A total of 862 (0.78%) were revised because of dislocation. Ceramic-on-ceramic bearing surfaces had a lower risk of requiring revision due to dislocation than did metal-on-polyethylene and ceramic-on-polyethylene surfaces, with a follow-up of up to seven years. However, ceramic-on-ceramic implants were more likely to have larger prosthetic heads and to have been implanted in younger patients. The size of the head of the femoral component and age are known to be independent predictors of dislocation. Therefore, the outcomes were stratified by the size of the head and age. There is a significantly higher rate of revision for dislocation in ceramic-on-ceramic bearing surfaces than in metal-on-polyethylene implants when smaller sizes (< or = 28 mm) of the head were used in younger patients (< 65 years) (hazard ratio = 1.53, p = 0.041) and also with larger (> 28 mm) and in older patients (> or = 65 years) (hazard ratio = 1.73, p = 0.016).
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Affiliation(s)
- S A Sexton
- Sydney Hip and Knee Surgeons, Mater Clinic, 3-9 Gillies Street, Sydney, NSW 2060, Australia.
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14
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Bollt EM, Stanford T, Lai YC, Zyczkowski K. Validity of threshold-crossing analysis of symbolic dynamics from chaotic time series. Phys Rev Lett 2000; 85:3524-3527. [PMID: 11030937 DOI: 10.1103/physrevlett.85.3524] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2000] [Revised: 08/07/2000] [Indexed: 05/23/2023]
Abstract
A practical and popular technique to extract the symbolic dynamics from experimentally measured chaotic time series is the threshold-crossing method, by which an arbitrary partition is utilized for determining the symbols. We address to what extent the symbolic dynamics so obtained can faithfully represent the phase-space dynamics. Our principal result is that such a practice can lead to a severe misrepresentation of the dynamical system. The measured topological entropy is a Devil's staircase-like, but surprisingly nonmonotone, function of a parameter characterizing the amount of misplacement of the partition.
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Affiliation(s)
- EM Bollt
- Mathematics Department, 572 Holloway Road, U.S. Naval Academy, Annapolis, Maryland 21402-5002, USA
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15
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Plemons J, Stanford T. Scaling and root planing: effective therapeutic modalities. Interview by Phillip Bonner. Dent Today 1996; 15:62, 64-5. [PMID: 9567842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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16
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Stanford T. Eliminating complacency. Emergency 1988; 20:42-3, 56-8. [PMID: 10285238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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17
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Stanford T. SOPS--who needs them? Emergency 1986; 18:40-1, 43. [PMID: 10278496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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18
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Stanford T, Pollack RH. Configuration color vision tests: the interaction between aging and the complexity of figure-ground segregation. J Gerontol 1984; 39:568-71. [PMID: 6332128 DOI: 10.1093/geronj/39.5.568] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A cross-sectional study comparing response time and the percentage of items correctly identified in three color vision tests (Pflügertrident, HRR-AO pseudoisochromatic plates, and AO pseudoisochromatic plates) was carried out on 72 women (12 in each decade) ranging from ages 20 to 79 years. Overall, time scores increased across the age groups. Analysis of the correctness scores indicated that the AO pseudoisochromatic plates requiring the identification of numbers was more difficult than the other tests which consisted of geometric forms or the letter E. This differential difficulty increased as a function of age. There was no indication of color defect per se which led to the conclusion that figure complexity may be the key variable determining performance. The results were similar to those obtained by Lee and Pollack (1978) in their study of the Embedded Figures Test.
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