1
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Knoke M, Neudert M, Zahnert T, Lailach S. Validation of the German language version of the Chronic Ear Survey and its psychometric comparison with an established German measurement instrument. HNO 2024; 72:33-42. [PMID: 37792097 PMCID: PMC10799145 DOI: 10.1007/s00106-023-01335-5] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND With the Chronic Ear Survey (CES), a validated measurement instrument for the assessment of disease-specific health-related quality of life (HRQoL) has been available internationally since 2000. The aim of this study was to provide a validated German version of this international instrument and to compare it with the German Chronic Otitis Media Outcome Test 15 (COMOT-15). METHODOLOGY The CES was translated into German via a forward-backward translation process. For validation, 79 patients with COM undergoing middle ear surgery were prospectively included. HRQoL was determined preoperatively and 6 months postoperatively using the CES and the COMOT-15. Pure tone audiometry was also performed at both measurement time points. In the control examination, an additional retrospective assessment of the preoperative situation was additionally performed using the CES and the COMOT-15 to assess the response shift. The determined psychometric characteristics were internal consistency, test-retest reliability, discrimination validity, agreement validity, responsiveness, and response shift for both measurement instruments. Convergent validity of both measurement instruments was assessed using linear regression. RESULTS On the basis of the CES, patients with COM could be reliably distinguished from patients with healthy ears. The CES showed satisfactory reliability with high internal consistency (Cronbach α 0.65-0.85) and high retest reliability (r > 0.8). The global assessment of HRQoL impairment correlated very well with the scores of the CES (r = 0.51). In addition, it showed a high sensitivity to change (standardized response mean -0.86). Compared to the COMOT-15, it showed a lower response shift (effect size -0.17 vs. 0.44). Both measurement instruments correlated only slightly with air conduction hearing threshold (r = 0.29 and r = 0.24, respectively). The concordant validity of both measurement instruments was high (r = 0.68). CONCLUSION The German version of the CES shows satisfactory psychometric characteristics, so that its use can be recommended. The CES focuses on the influence of ear symptoms on HRQoL, whereas the COMOT-15 also includes functional and psychological aspects. Due to only minor response shift effects, the CES is particularly suitable for studies with multiple repeat measurements.
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Affiliation(s)
- Michael Knoke
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Campus Charite Mitte, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - Marcus Neudert
- Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany
| | - Thomas Zahnert
- Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany
| | - Susen Lailach
- Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Germany
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2
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Bormann NL, Miskle B, Holdefer P, Arndt S, Lynch AC, Weber AN. Evidence of telescoping in females across two decades of US treatment admissions for injection drug use: 2000-2020. Drug Alcohol Depend Rep 2023; 9:100204. [PMID: 38045494 PMCID: PMC10690569 DOI: 10.1016/j.dadr.2023.100204] [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] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023]
Abstract
Background People who inject drugs (PWID) have an increased risk of soft tissue infection, drug overdose and death. Females may be particularly vulnerable due to barriers to substance use disorder (SUD) treatment entry, stigma, and telescoping, or the greater severity in substance use-related comorbidity and consequences despite a shorter history of use. We set out to identify sex differences in United States injection drug use (IDU). Methods The Treatment Episode Dataset-Admission (2000-2020) provided data to identify PWID undergoing their initial SUD treatment admission. Mann-Whitney U test, chi-square, and Spearman correlations were used for ordinal variables, categorical variables, and to assess similarity of male/female trends over the 21 years, respectively. The probabilistic index (PI) and Cramer's V provided effect sizes for Mann-Whitney U tests and chi-square tests, respectively. Results A total of 13,612,978 records existed for cases entering their initial treatment. Mapping to a history of IDU left 1,458,695 (561,793 females). Females had a higher prevalence among PWID across all 21 years; IDU trends were essentially identical between males and females (r = 0.97). Females endorsed beginning their primary substance later in life (PI = 0.47, p < 0.0001) and entered treatment after a shorter period of substance use (PI = 0.57, p < 0.0001). Conclusions We saw evidence of telescoping among PWID with a SUD entering their initial episode of treatment. Interventions should be implemented prior to the transition to IDU, and this window of opportunity is shortened in females. Utilizing gender-responsive treatment options may be a way to increase treatment-seeking earlier in the disease course.
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Affiliation(s)
- Nicholas L. Bormann
- Department of Psychiatry and Psychology, Mayo Clinic, 404 W Fountain St, Albert Lea, Rochester, MN 56007, USA
| | - Benjamin Miskle
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Pharmacy, University of Iowa, Iowa City, IA, USA
| | - Paul Holdefer
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Stephan Arndt
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Alison C. Lynch
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Family Medicine, University of Iowa, Iowa City, IA, USA
| | - Andrea N. Weber
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Internal Medicine, University of Iowa, Iowa City, IA, USA
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3
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Hla TK, Cannon JW, Bowen AC, Wyber R. Getting to grips with invasive group A streptococcal infection surveillance in Australia: are we experiencing an epidemic? Med J Aust 2023; 219:242-245. [PMID: 37598382 DOI: 10.5694/mja2.52056] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 08/22/2023]
Affiliation(s)
- Thel K Hla
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA
- University of Western Australia, Perth, WA
| | - Jeffrey W Cannon
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA
| | - Asha C Bowen
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA
- Perth Children's Hospital, Perth, WA
| | - Rosemary Wyber
- Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, WA
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, ACT
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4
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Knoke M, Neudert M, Zahnert T, Lailach S. [Validation of the German language version of the Chronic Ear Survey and its psychometric comparison with an established German language measurement instrument. German version]. HNO 2023; 71:572-582. [PMID: 37540235 PMCID: PMC10462509 DOI: 10.1007/s00106-023-01334-6] [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] [Accepted: 06/26/2023] [Indexed: 08/05/2023]
Abstract
BACKGROUND With the Chronic Ear Survey (CES), a validated measurement instrument for the assessment of disease-specific health-related quality of life (HRQoL) has been available internationally since 2000. The aim of this study was to provide a validated German version of this international instrument and to compare it with the German Chronic Otitis Media Outcome Test 15 (COMOT-15). METHODOLOGY The CES was translated into German via a forward-backward translation process. For validation, 79 patients with COM undergoing middle ear surgery were prospectively included. HRQoL was determined preoperatively and 6 months postoperatively using the CES and the COMOT-15. Pure tone audiometry was also performed at both measurement time points. In the control examination, an additional retrospective assessment of the preoperative situation was additionally performed using the CES and the COMOT-15 to assess the response shift. The determined psychometric characteristics were internal consistency, test-retest reliability, discrimination validity, agreement validity, responsiveness, and response shift for both measurement instruments. Convergent validity of both measurement instruments was assessed using linear regression. RESULTS On the basis of the CES, patients with COM could be reliably distinguished from patients with healthy ears. The CES showed satisfactory reliability with high internal consistency (Cronbach α 0.65-0.85) and high retest reliability (r > 0.8). The global assessment of HRQoL impairment correlated very well with the scores of the CES (r = 0.51). In addition, it showed a high sensitivity to change (standardized response mean -0.86). Compared to the COMOT-15, it showed a lower response shift (effect size -0.17 vs. 0.44). Both measurement instruments correlated only slightly with air conduction hearing threshold (r = 0.29 and r = 0.24, respectively). The concordant validity of both measurement instruments was high (r = 0.68). CONCLUSION The German version of the CES shows satisfactory psychometric characteristics, so that its use can be recommended. The CES focuses on the influence of ear symptoms on HRQoL, whereas the COMOT-15 also includes functional and psychological aspects. Due to only minor response shift effects, the CES is particularly suitable for studies with multiple repeat measurements.
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Affiliation(s)
- Michael Knoke
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Campus Charité Mitte, Augustenburger Platz 1, 13353, Berlin, Deutschland.
| | - Marcus Neudert
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Deutschland
| | - Thomas Zahnert
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Deutschland
| | - Susen Lailach
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Carl Gustav Carus Dresden, Dresden, Deutschland
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5
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Hay PJ, Rankin R, Ramjan L, Conti J. Current approaches in the recognition and management of eating disorders. Med J Aust 2023; 219:127-134. [PMID: 37356068 DOI: 10.5694/mja2.52008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 06/27/2023]
Abstract
Eating disorders are now well acknowledged mental health problems that are common and present in people from diverse sociodemographic backgrounds. The past decade has seen a rapid expansion in research into eating disorder interventions. In response to the increasing burden of eating disorders, the Australian Government Department of Health and Aged Care has implemented significant policy changes to improve patient access to Medicare and inpatient treatment facilities. There are several international clinical practice guidelines and a robust evidence base particularly for first line care with specific psychological therapies, including guidelines for the management of eating disorders in individuals with a high weight. Medications play an important adjunct role in care, and novel neuromodulating treatments, such as psychostimulants, are under study. There is emerging evidence for increased person-centred care, with more choice in the form of alternatives to hospital inpatient programs and more respectful consideration of care for all who experience an eating disorder, including people with high weight.
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Affiliation(s)
- Phillipa J Hay
- Translational Health Research Institute, Western Sydney University, Sydney, NSW
- South Western Sydney Local Health District, Sydney, NSW
| | - Rebekah Rankin
- Translational Health Research Institute, Western Sydney University, Sydney, NSW
| | | | - Janet Conti
- Translational Health Research Institute, Western Sydney University, Sydney, NSW
- Western Sydney University, Sydney, NSW
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6
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Rosendahl C, Clark S. General practice and melanoma management in Australia: controversies and implications for generalist GP training. Med J Aust 2023; 218:397-398. [PMID: 37055031 DOI: 10.5694/mja2.51928] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/13/2023] [Indexed: 04/15/2023]
Affiliation(s)
- Cliff Rosendahl
- The University of Queensland Medical School, the University of Queensland, Brisbane, QLD
- Tehran University of Medical Sciences, Tehran, Iran
| | - Simon Clark
- Tehran University of Medical Sciences, Tehran, Iran
- The University of Queensland, Brisbane, QLD
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7
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Abstract
BACKGROUND UK Biobank (UKB) is a large prospective cohort capturing numerous health outcomes, but limited occupational information (job title, self-reported manual work and occupational walking/standing). AIMS To create and evaluate validity of a linkage between UKB and a job exposure matrix for physical work exposures based on the US Occupational Information Network (O*NET) database. METHODS Job titles and UK Standard Occupational Classification (SOC) codes were collected during UKB baseline assessment visits. Using existing crosswalks, UK SOC codes were mapped to US SOC codes allowing linkage to O*NET variables capturing numerous dimensions of physical work. Job titles with the highest O*NET scores were assessed to evaluate face validity. Spearman's correlation coefficients were calculated to compare O*NET scores to self-reported UKB measures. RESULTS Among 324 114 participants reporting job titles, 323 936 were linked to O*NET. Expected relationships between scores and self-reported measures were observed. For static strength (0-7 scale), the median O*NET score was 1.0 (e.g. audiologists), with a highest score of 4.88 for stone masons and a positive correlation with self-reported heavy manual work (Spearman's coefficient = 0.50). For time spent standing (1-5 scale), the median O*NET score was 2.72 with a highest score of 5 for cooks and a positive correlation with self-reported occupational walking/standing (Spearman's coefficient = 0.56). CONCLUSIONS While most jobs were not physically demanding, a wide range of physical work values were assigned to a diverse set of jobs. This novel linkage of a job exposure matrix to UKB provides a potentially valuable tool for understanding relationships between occupational exposures and disease.
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Affiliation(s)
- E L Yanik
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Department of Surgery, Washington University School of Medicine, St.Louis, MO, USA
| | - M J Stevens
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - E Clare Harris
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - K E Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - A M Dale
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Y Ma
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - G A Colditz
- Department of Surgery, Washington University School of Medicine, St.Louis, MO, USA
| | - B A Evanoff
- Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA
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8
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Lewkowski K, Heyworth J, Ytterstad E, Williams W, Goulios H, Fritschi L. The prevalence of tinnitus in the Australian working population. Med J Aust 2021; 216:189-193. [PMID: 34854090 DOI: 10.5694/mja2.51354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 05/05/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To estimate the prevalence of tinnitus in Australian working people; to identify occupational and demographic factors associated with tinnitus. DESIGN Cross-sectional national telephone survey of self-reported frequency and duration of tinnitus. SETTING, PARTICIPANTS Australian Workplace Exposure Survey (AWES) - Hearing; 4970 currently employed people aged 18-64 years, recruited by random digit dialling, representative by sex of the workforce population, 7 June 2016 - 20 March 2017. MAIN OUTCOME MEASURES Prevalence of occasional, intermittent, and constant tinnitus, and of any tinnitus, by occupational group, sex, and other demographic characteristics; estimated numbers of working people with constant or any tinnitus, by occupational group and sex. RESULTS Of 4970 respondents, 1317 reported experiencing tinnitus (26.5%): 713 people had occasional tinnitus (14.3%), 259 intermittent tinnitus (5.2%), and 345 constant tinnitus (6.9%). The sample prevalence of constant tinnitus was greater among men (7.5%; 95% CI, 6.2-8.7%) than women (3.3%; 95% CI, 2.3-4.3%), and was higher in older age groups. After rake weighting our survey responses, we estimated that 2.4 million workers (24.8%; 95% CI, 23.2-26.4%) experience tinnitus, including 529 343 with constant tinnitus (5.5%; 95% CI, 4.6-6.3%). The estimated prevalence of constant tinnitus was highest for automotive workers (16.7%; 95% CI, 9.5-23.8%), drivers (13.0%; 95% CI, 7.3-18.6%), farmers (12.1%; 95% CI, 5.9-18.4%), and workers in other trades (10.4%; 95% CI, 4.6-16.2%). CONCLUSIONS The prevalence of tinnitus in the Australian workforce is high, particularly in certain occupations. Workplace practices and conditions that increase the risk of tinnitus should be examined, and targeted workplace prevention strategies developed.
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Affiliation(s)
| | | | - Elinor Ytterstad
- University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Warwick Williams
- National Acoustics Laboratory, Macquarie University, Sydney, NSW
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9
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McBryde ES, Meehan MT, Caldwell JM, Adekunle AI, Ogunlade ST, Kuddus MA, Ragonnet R, Jayasundara P, Trauer JM, Cope RC. Modelling direct and herd protection effects of vaccination against the SARS-CoV-2 Delta variant in Australia. Med J Aust 2021; 215:427-432. [PMID: 34477236 PMCID: PMC8662033 DOI: 10.5694/mja2.51263] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/24/2021] [Accepted: 08/25/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To analyse the outcomes of COVID-19 vaccination by vaccine type, age group eligibility, vaccination strategy, and population coverage. DESIGN Epidemiologic modelling to assess the final size of a COVID-19 epidemic in Australia, with vaccination program (Pfizer, AstraZeneca, mixed), vaccination strategy (vulnerable first, transmitters first, untargeted), age group eligibility threshold (5 or 15 years), population coverage, and pre-vaccination effective reproduction number ( R eff v ¯ ) for the SARS-CoV-2 Delta variant as factors. MAIN OUTCOME MEASURES Numbers of SARS-CoV-2 infections; cumulative hospitalisations, deaths, and years of life lost. RESULTS Assuming R eff v ¯ = 5, the current mixed vaccination program (vaccinating people aged 60 or more with the AstraZeneca vaccine and people under 60 with the Pfizer vaccine) will not achieve herd protection unless population vaccination coverage reaches 85% by lowering the vaccination eligibility age to 5 years. At R eff v ¯ = 3, the mixed program could achieve herd protection at 60-70% population coverage and without vaccinating 5-15-year-old children. At R eff v ¯ = 7, herd protection is unlikely to be achieved with currently available vaccines, but they would still reduce the number of COVID-19-related deaths by 85%. CONCLUSION Vaccinating vulnerable people first is the optimal policy when population vaccination coverage is low, but vaccinating more socially active people becomes more important as the R eff v ¯ declines and vaccination coverage increases. Assuming the most plausible R eff v ¯ of 5, vaccinating more than 85% of the population, including children, would be needed to achieve herd protection. Even without herd protection, vaccines are highly effective in reducing the number of deaths.
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Affiliation(s)
- Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD
| | - Michael T Meehan
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD
| | - Jamie M Caldwell
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD.,University of Hawai'i at Mānoa, Honolulu, HI, United States of America
| | - Adeshina I Adekunle
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD.,Australian Department of Defence, Melbourne, VIC
| | - Samson T Ogunlade
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD
| | - Md Abdul Kuddus
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD.,University of Rajshahi, Rajshahi, Bangladesh
| | | | | | | | - Robert C Cope
- Biological Data Sciences Institute, Australian National University, Canberra, ACT
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10
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Darke S, Chrzanowska A, Campbell G, Zahra E, Lappin J. Barbiturate-related hospitalisations, drug treatment episodes, and deaths in Australia, 2000-2018. Med J Aust 2021; 216:194-198. [PMID: 34658038 DOI: 10.5694/mja2.51306] [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] [Received: 04/14/2021] [Revised: 06/22/2021] [Accepted: 06/29/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the characteristics and population rates of barbiturate-related hospitalisations, treatment episodes, and deaths in Australia, 2000-2018. DESIGN, SETTING Analysis of national data on barbiturate-related hospitalisations (National Hospital Morbidity Database, 1999-2000 to 2017-18), drug treatment episodes (Alcohol and Other Drug Treatment Services National Minimum Data Set, 2002-03 to 2017-18), and deaths (National Coronial Information System, 2000-01 to 2016-17). MAIN OUTCOME MEASURES Population rates directly age-standardised to the 2001 Australian standard population; average annual percentage change (AAPC) in rates estimated by Joinpoint regression. RESULTS We identified 1250 barbiturate-related hospitalisations (791 cases of deliberate self-harm [63%]), 993 drug treatment episodes (195 cases with barbiturates as the principal drug of concern [20%]), and 511 deaths during the respective analysis periods. The barbiturate-related hospitalisation rate declined from 0.56 in 1999-2000 to 0.14 per 100 000 population in 2017-18 (AAPC, -6.0%; 95% CI, -7.2% to -4.8%); the declines in hospitalisations related to accidental poisoning (AAPC, -5.8%; 95% CI, -9.1% to -2.4%) and intentional self-harm (AAPC, -5.6%; 95% CI, -6.9% to -4.2%) were each statistically significant. Despite a drop from 0.67 in 2002-03 to 0.23 per 100 000 in 2003-04, the drug treatment episode rate did not decline significantly (AAPC, -6.7%; 95% CI, -16% to +4.0%). The population rate of barbiturate-related deaths increased from 0.07 in 2000-01 to 0.19 per 100 000 population in 2016-17 (AAPC, +9.3%; 95% CI, +6.2-12%); the rate of intentional self-harm deaths increased (AAPC, +11%; 95% CI, +7.4-15%), but not that of accidental deaths (AAPC, -0.3%; 95% CI, -4.1% to +3.8%). CONCLUSIONS While prescribing and community use of barbiturates has declined, the population rate of intentional self-harm using barbiturates has increased. The major harm associated with these drugs is now suicide.
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Affiliation(s)
- Shane Darke
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
| | - Agata Chrzanowska
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
| | | | - Emma Zahra
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
| | - Julia Lappin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW
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11
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Schultz R. Investigating the health impacts of the Ranger uranium mine on Aboriginal people. Med J Aust 2021; 215:157-159.e1. [PMID: 34333775 DOI: 10.5694/mja2.51198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Rosalie Schultz
- Environment and Ecology Special Interest Group, Public Health Association of Australia, Canberra, ACT.,Centre for Remote Health, Flinders University, Alice Springs, NT
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12
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Lefevre A, Hopper I, McNeil JJ, Owen A. Complementary medicine use by community-dwelling older Australians. Med J Aust 2020; 214:140-141. [PMID: 33305398 DOI: 10.5694/mja2.50884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/17/2020] [Indexed: 11/17/2022]
Affiliation(s)
| | | | | | - Alice Owen
- CCRE Therapeutics, Monash University, Melbourne, VIC
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13
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Trauer JM, Marais BJ, Ragonnet R, Savulescu J, McBryde ES. Time for a clear national COVID-19 strategy. Med J Aust 2020; 214:94-94.e1. [PMID: 33295024 DOI: 10.5694/mja2.50894] [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: 11/17/2022]
Affiliation(s)
- James M Trauer
- Monash University, Melbourne, VIC.,Alfred Hospital, Melbourne, VIC
| | - Ben J Marais
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW.,Children's Hospital at Westmead, Sydney, NSW
| | | | - Julian Savulescu
- University of Oxford, Oxford, United Kingdom.,University of Melbourne, Melbourne, VIC
| | - Emma S McBryde
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, QLD
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14
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Santini ZI, Torres-Sahli M, Hinrichsen C, Meilstrup C, Madsen KR, Rayce SB, Baker MM, Ten Have M, Schotanus-Dijkstra M, Koushede V. Measuring positive mental health and flourishing in Denmark: validation of the mental health continuum-short form (MHC-SF) and cross-cultural comparison across three countries. Health Qual Life Outcomes 2020; 18:297. [PMID: 32887631 PMCID: PMC7650216 DOI: 10.1186/s12955-020-01546-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 03/17/2020] [Accepted: 08/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Mental Health Continuum-Short Form (MHC-SF) is a measure of positive mental health and flourishing, which is widely used in several countries but has not yet been validated in Denmark. This study aimed to examine its qualitative and quantitative properties in a Danish population sample and compare scores with Canada and the Netherlands. METHODS Three thousand five hundred eight participants aged 16-95 filled out an electronic survey. Both the unidimensional and multidimensional aspects of the Danish MHC-SF were studied through bifactor modelling. Cognitive interviews examined face validity and usability. RESULTS The general score of the Danish MHC-SF was reliable for computing unit-weighted composite scores, as well as using a bifactor model to compute general factor scores or measurement models in an SEM context. Nonetheless, subscale scores were unreliable, explaining very low variance beyond that explained by the general factor. The participants of the qualitative interviews observed problems with wording and content of the items, especially from the social subscale. The general score correlated with other scales as expected. We found substantial variation in flourishing prevalence rates between the three cultural settings. CONCLUSIONS The Danish MHC-SF produced reliable general scores of well-being. Most of the issues observed regarding the subscale scores have been shown in previous research in other contexts. The further analysis of indices of the bifactor model and the inclusion of qualitative interviews allowed for a better understanding of the possible sources of problems with the questionnaire's subscales. The use of subscales, the substantive understanding of the general score, as well as the operationalization of the state of flourishing, require further study.
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Affiliation(s)
- Ziggi Ivan Santini
- The Danish National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen, Denmark.
| | - Manuel Torres-Sahli
- School of Social Sciences, Loughborough University, Loughborough, Leicestershire, LE11 3TU, UK
| | - Carsten Hinrichsen
- The Danish National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen, Denmark
| | - Charlotte Meilstrup
- The Danish National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen, Denmark
| | - Katrine R Madsen
- The Danish National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455, Copenhagen, Denmark
| | - Signe Boe Rayce
- Vive - The Danish Center for Social Science Research, Herluf Trolles Gade 11, 1052, Copenhagen, Denmark
| | | | - Margreet Ten Have
- The Netherlands Institute of Mental Health and Addiction (Trimbos Institute), Utrecht, the Netherlands
| | - Marijke Schotanus-Dijkstra
- Department of Psychology, Centre for eHealth and Well-being Research, Health and Technology, University of Twente, Enschede, AE, 7500, The Netherlands
| | - Vibeke Koushede
- Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, 1353, Copenhagen, Denmark
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15
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O'Brien DP, Athan E, Blasdell K, De Barro P. Tackling the worsening epidemic of Buruli ulcer in Australia in an information void: time for an urgent scientific response. Med J Aust 2019; 208:287-289. [PMID: 29642808 DOI: 10.5694/mja17.00879] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 12/27/2017] [Indexed: 11/17/2022]
Affiliation(s)
| | - Eugene Athan
- Geelong Centre for Emerging Infectious Diseases, Geelong, VIC
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16
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Rodriquez EJ, Kim EN, Sumner AE, Nápoles AM, Pérez-Stable EJ. Allostatic Load: Importance, Markers, and Score Determination in Minority and Disparity Populations. J Urban Health 2019; 96:3-11. [PMID: 30671711 DOI: 10.1007/s11524-019-00345-5] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Allostatic load is a physiological measure of the cumulative burden of stress on the body assessed by markers of physiological dysregulation. It is a multisystem construct that quantifies biological risk which leads to poor health and maladaptive trajectories. In this overview, which is based on a presentation made at the Flip the Script: Understanding African American Women's Resilience in the Face of Allostatic Load meeting at Ohio State University in August 2018, we build upon previous reviews by discussing four key aspects of allostatic load, specifically its: (1) importance, (2) operationalization, (3) use in minority health and health disparities research, and (4) value in such research. Operationalized in various ways, allostatic load is composed of 10 original markers and additional markers deriving from research among minority and disparity populations. The markers represent four biological systems: (1) cardiovascular, (2) metabolic, (3) inflammatory, and (4) neuroendocrine. System-specific racial/ethnic and sex-based differences have been observed. An overall score can be determined using sample-generated or empirically derived clinically relevant cut points. In summary, allostatic load provides an overall and a body system-specific mechanistic link between exposures to stressors and health outcomes that may help explain health disparities among minority populations.
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17
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McManus H, Callander D, Donovan B, Russell DB, O'Connor CC, Davies SC, Lewis DA, Hellard ME, Chen MY, Petoumenos K, Varma R, Cogle A, Boyd MA, Grulich A, Pollard J, Medland N, Fairley CK, Guy RJ. Early initiation of antiretroviral therapy for people newly diagnosed with HIV infection in Australia: trends and predictors, 2004-2015. Med J Aust 2019; 210:269-275. [PMID: 30773651 DOI: 10.5694/mja2.50006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 04/26/2018] [Accepted: 11/01/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine trends in and predictors of early treatment for people newly diagnosed with human immunodeficiency virus (HIV) infection in Australia. DESIGN, SETTING Retrospective cohort analysis of routinely collected longitudinal data from 44 sexual health clinics participating in the Australian Collaboration for Coordinated Enhanced Sentinel Surveillance (ACCESS) program. PARTICIPANTS Patients diagnosed with HIV infections, January 2004 - June 2015. MAIN OUTCOME MEASURES Commencement of antiretroviral therapy within 6 months of HIV diagnosis (early treatment); demographic, clinical, and risk group characteristics of patients associated with early treatment; trends in early treatment, by CD4+ cell count at diagnosis. RESULTS 917 people were diagnosed with HIV infections, their median age was 34 years (interquartile range [IQR]: 27-43 years), and 841 (92%) were men; the median CD4+ cell count at diagnosis was 510 cells/μL (IQR, 350-674 cells/μL). The proportion of patients who received early treatment increased from 17% (15 patients) in 2004-06 to 20% (34 patients) in 2007-09, 34% (95 patients) in 2010-12, and 53% (197 patients) in 2013-15 (trend, P < 0.001). The probability of early treatment, which increased with time, was higher for patients with lower CD4+ cell counts and higher viral loads at diagnosis. CONCLUSIONS The proportion of people newly diagnosed with HIV in sexual health clinics in Australia who received treatment within 6 months of diagnosis increased from 17% to 53% during 2004-2015, reflecting changes in the CD4+ cell count threshold in treatment guidelines. Nevertheless, further strategies are needed to maximise the benefits of treatment to prevent viral transmission and morbidity.
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Affiliation(s)
- Hamish McManus
- The Kirby Institute, University of New South Wales, Sydney, NSW
| | | | - Basil Donovan
- The Kirby Institute, University of New South Wales, Sydney, NSW.,Sydney Sexual Health Centre, Sydney Hospital, Sydney, NSW
| | | | | | - Stephen C Davies
- Northern Sydney Sexual Health Service, Royal North Shore Hospital, Sydney, NSW
| | - David A Lewis
- Western Sydney Sexual Health Centre, University of Sydney, Sydney
| | | | - Marcus Y Chen
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC
| | | | - Rick Varma
- The Kirby Institute, University of New South Wales, Sydney, NSW.,Sydney Sexual Health Centre, South Eastern Sydney Local Health District, Sydney, NSW
| | - Aaron Cogle
- National Association of People with HIV Australia, Melbourne, NSW
| | - Mark Alastair Boyd
- University of Adelaide, Adelaide, SA.,Lyell McEwin Hospital, Adelaide, SA
| | - Andrew Grulich
- The Kirby Institute, University of New South Wales, Sydney, NSW
| | | | - Nick Medland
- The Kirby Institute, University of New South Wales, Sydney, NSW.,Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, VIC.,Melbourne Sexual Health Centre, Monash University Central Clinical School, Melbourne, VIC
| | - Rebecca J Guy
- The Kirby Institute, University of New South Wales, Sydney, NSW
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Chew BH, Vos RC, Pouwer F, Rutten GEHM. The associations between diabetes distress and self-efficacy, medication adherence, self-care activities and disease control depend on the way diabetes distress is measured: Comparing the DDS-17, DDS-2 and the PAID-5. Diabetes Res Clin Pract 2018; 142:74-84. [PMID: 29802952 DOI: 10.1016/j.diabres.2018.05.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/09/2018] [Accepted: 05/09/2018] [Indexed: 02/08/2023]
Abstract
AIMS To examine whether diabetes distress (DD), when measured by three different instruments, was associated differently with self-efficacy, self-care activity, medication adherence and disease control in people with Type 2 diabetes mellitus. METHODS A cross-sectional study in three health clinics. DD was assessed with the 17-item Diabetes Distress Scale, the 2-item DDS-2 (DDS-2) and the 5-item Problem Areas in Diabetes Scale (PAID-5). Dependent variables included self-efficacy, self-care activities, medication adherence, HbA1c, systolic and diastolic blood pressure (SBP, DBP). Multiple linear and logistic regression were used in analyses. RESULTS In total 338 participants (56% women), with a mean age of 61 years and diabetes duration of 9.8 years, were included. DDS-2 was an independent determinant of SBP (β = 1.89, 95% CI 0.14, 3.64), DBP (β = 1.19, 95% CI 0.16, 2.21) and blood pressure target (OR = 2.09, 95% CI 1.12, 3.83). PAID-5 was an independent determinant of medication adherence (adjusted β = -0.05, 95% CI -0.08, -0.01) and self-care activities (OR = 0.50, 95% CI 0.26, 0.99). CONCLUSIONS Associations of DD with important aspects of diabetes care are substantially influenced by confounders and depend on the way DD is measured. Our findings call for a judicious use of different DD measures in clinical practice and research. The study is registered on ClinicalTrials.gov (NCT02730754).
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Affiliation(s)
- Boon-How Chew
- Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia; University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
| | - Rimke C Vos
- University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
| | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Guy E H M Rutten
- University of Utrecht, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Huispost Str. 6.131, P.O. Box 85500, 3508 GA Utrecht, The Netherlands
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19
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da Silva ME, Orssatto LBDR, Bezerra ES, Silva DAS, Moura BM, Diefenthaeler F, Freitas CR. Reducing measurement errors during functional capacity tests in elders. Aging Clin Exp Res 2018; 30:595-603. [PMID: 28836137 DOI: 10.1007/s40520-017-0820-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 08/03/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Accuracy is essential to the validity of functional capacity measurements. AIM To evaluate the error of measurement of functional capacity tests for elders and suggest the use of the technical error of measurement and credibility coefficient. METHODS Twenty elders (65.8 ± 4.5 years) completed six functional capacity tests that were simultaneously filmed and timed by four evaluators by means of a chronometer. A fifth evaluator timed the tests by analyzing the videos (reference data). RESULTS The means of most evaluators for most tests were different from the reference (p < 0.05), except for two evaluators for two different tests. There were different technical error of measurement between tests and evaluators. The Bland-Altman test showed difference in the concordance of the results between methods. Short duration tests showed higher technical error of measurement than longer tests. In summary, tests timed by a chronometer underestimate the real results of the functional capacity. DISCUSSION Difference between evaluators' reaction time and perception to determine the start and the end of the tests would justify the errors of measurement. CONCLUSION Calculation of the technical error of measurement or the use of the camera can increase data validity.
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20
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Wolff-Hughes DL, Troiano RP, Boyer WR, Fitzhugh EC, McClain JJ. Use of population-referenced total activity counts percentiles to assess and classify physical activity of population groups. Prev Med 2016; 87:35-40. [PMID: 26876630 PMCID: PMC4884522 DOI: 10.1016/j.ypmed.2016.02.019] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 01/16/2016] [Accepted: 02/06/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Population-referenced total activity counts per day (TAC/d) percentiles provide public health practitioners a standardized measure of physical activity (PA) volume obtained from an accelerometer that can be compared across populations. The purpose of this study was to describe the application of TAC/d population-referenced percentiles to characterize the PA levels of population groups relative to US estimates. METHODS A total of 679 adults participating in the 2011 NYC Physical Activity Transit survey wore an ActiGraph accelerometer on their hip for seven consecutive days. Accelerometer-derived TAC/d was classified into age- and gender-specific quartiles of US population-referenced TAC/d to compare differences in the distributions by borough (N=5). RESULTS Males in Brooklyn, Manhattan, and Staten Island had significantly greater TAC/d than US males. Females in Brooklyn and Queens had significantly greater levels of TAC/d compared to US females. The proportion of males in each population-referenced TAC/d quartile varied significantly by borough (χ(2)(12)=2.63, p=0.002), with disproportionately more men in Manhattan and the Bronx found to be in the highest and lowest US population-referenced TAC/d quartiles, respectively. For females, there was no significant difference in US population-reference TAC/d quartile by borough (χ(2)(12)=1.09, p=0.36). CONCLUSIONS These results demonstrate the utility of population-referenced TAC/d percentiles in public health monitoring and surveillance. These findings also provide insights into the PA levels of NYC residents relative to the broader US population, which can be used to guide health promotion efforts.
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Affiliation(s)
- Dana L Wolff-Hughes
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States.
| | - Richard P Troiano
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States
| | - William R Boyer
- Department of Kinesiology, Recreation & Sports Studies, The University of Tennessee, Knoxville, TN, United States
| | - Eugene C Fitzhugh
- Department of Kinesiology, Recreation & Sports Studies, The University of Tennessee, Knoxville, TN, United States
| | - James J McClain
- Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States
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21
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Kahn HS, Bullard KM. Beyond Body Mass Index: Advantages of Abdominal Measurements for Recognizing Cardiometabolic Disorders. Am J Med 2016; 129:74-81.e2. [PMID: 26302146 DOI: 10.1016/j.amjmed.2015.08.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/06/2015] [Accepted: 08/06/2015] [Indexed: 01/29/2023]
Abstract
BACKGROUND The clinical recognition of cardiometabolic disorders might be enhanced by anthropometry based on the sagittal abdominal diameter (SAD; also called "abdominal height") or waist circumference rather than on weight. Direct comparisons of body mass index (BMI, weight/height(2)) with SAD/height ratio (SADHtR) or waist circumference/height ratio (WHtR) have not previously been tested in nationally representative populations. METHODS Nonpregnant adults without diagnosed diabetes (ages 20-64 years; n = 3071) provided conventional anthropometry and supine SAD (by sliding-beam caliper) in the 2011-2012 US National Health and Nutrition Examination Survey. Population-weighted, logistic models estimated how strongly each anthropometric indicator was associated with 5 cardiometabolic disorders: Dysglycemia (glycated hemoglobin ≥5.7%), HyperNonHDLc (non-high-density-lipoprotein [HDL] cholesterol ≥4.14 mmol/L, or taking anticholesteremic medications), Hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg, or taking antihypertensive medications), HyperALT (alanine transaminase ≥p75 [75th percentile, sex-specific]), and HyperGGT (gamma-glutamyltransferase ≥p75 [sex-specific]). RESULTS After scaling each indicator, adjusted odds ratios (aORs) tended to be highest for SADHtR and lowest for BMI when identifying each disorder except dysglycemia. When SADHtR entered models simultaneously with BMI, the aORs for BMI no longer directly identified any condition, whereas SADHtR identified persons with HyperNonHDLc by aOR 2.78 (95% confidence interval [CI], 1.71-4.51), Hypertension by aOR 2.51 (95% CI, 1.22-5.15), HyperALT by aOR 2.89 (95% CI, 1.56-5.37), and HyperGGT by aOR 5.43 (95% CI, 3.01-9.79). WHtR competed successfully against BMI with regard to Dysglycemia, HyperNonHDLc, and HyperGGT. c-Statistics of SADHtR and WHtR were higher than those of BMI (P <.001) for identifying HyperNonHDLc and HyperGGT. CONCLUSIONS Among nonelderly adults, SADHtR or WHtR recognized cardiometabolic disorders better than did the BMI.
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22
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LaMonte MJ, Hovey KM, Millen AE, Genco RJ, Wactawski-Wende J. Accuracy of self-reported periodontal disease in the Women's Health Initiative Observational Study. J Periodontol 2014; 85:1006-18. [PMID: 24354649 PMCID: PMC6004791 DOI: 10.1902/jop.2013.130488] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [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] [Indexed: 01/26/2023]
Abstract
BACKGROUND This study examines the accuracy of self-reported periodontal disease in a cohort of older females. METHODS The study comprised 972 postmenopausal females aged 53 to 83 years who completed baseline (1997 to 2001) and follow-up (2002 to 2006) whole-mouth oral examinations. Examinations included: 1) probing depth, 2) clinical attachment level, and 3) oral radiographs for alveolar crestal height in a study ancillary to the Women's Health Initiative Observational Study (WHI-OS) conducted in Buffalo, New York, called the OsteoPerio study. Participants also self-reported any history of diagnosis of periodontal/gum disease on a WHI-OS study-wide questionnaire administered during the time interval between the two OsteoPerio examinations. RESULTS Participants reporting diagnosis of periodontal/gum disease on the WHI-OS questionnaire (n = 259; 26.6%) had worse oral hygiene habits, periodontal disease risk factors, and clinical periodontal measures compared with those not reporting periodontal/gum disease. Frequency of reported periodontal/gum disease was 13.5%, 24.7%, and 56.2% across OsteoPerio baseline examination categories of none/mild, moderate, and severe periodontal disease, respectively (trend: P <0.001), defined by criteria of the Centers for Disease Control and Prevention/American Academy of Periodontology (CDC/AAP). Sensitivity, specificity, and positive and negative predictive values for reported periodontal disease status were 56.2%, 78.8%, 32.8%, and 90.7%, respectively, when CDC/AAP-defined severe periodontal disease at baseline was the criterion measure (prevalence of 15%) and were 76.0%, 77.4%, 22.0%, and 97.4%, respectively, when tooth loss to periodontitis (prevalence of 7%) was the criterion. CONCLUSION A simple question for self-reported periodontal disease characterizes periodontal disease prevalence with moderate accuracy in postmenopausal females who regularly visit their dentist, particularly in those with more severe disease.
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Affiliation(s)
- Michael J. LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
| | - Kathleen M. Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
| | - Amy E. Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
| | - Robert J. Genco
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, State University of New York
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY
- Department of Gynecology–Obstetrics, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York
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Ding D, Rogers K, Macniven R, Kamalesh V, Kritharides L, Chalmers J, Bauman A. Revisiting lifestyle risk index assessment in a large Australian sample: should sedentary behavior and sleep be included as additional risk factors? Prev Med 2014; 60:102-6. [PMID: 24380793 DOI: 10.1016/j.ypmed.2013.12.021] [Citation(s) in RCA: 40] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 12/14/2013] [Accepted: 12/21/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Most studies on multiple health behaviors include physical inactivity, alcohol, diet, and smoking (PADS), with few including emerging lifestyle risks such as sleep or sitting. We examined whether adding sitting and sleep to a conventional lifestyle risk index improves the prediction of cross-sectional health outcomes (self-rated health, quality of life, psychological distress, and physical function). We also explored the demographic characteristics of adults with these multiple risk behaviors. METHODS We used baseline data of an Australian cohort study (n=191,853) conducted in 2006-2008 in New South Wales. Lifestyle risk index was operationalized as 1) PADS, 2) PADS+sitting, 3) PADS+sleep, and 4) PADS+sitting+sleep. We estimated receiver operating characteristic curve for self-reported binary health outcomes and calculated the area under the curve to illustrate how well each index classified the outcome. We used multiple logistic regression to determine the demographic characteristics of adults with multiple lifestyle risks. RESULTS Adding sleep duration but not sitting time to the PADS index significantly improved the classification of all health outcomes. Men, those aged 45-54years, those with 10 years of education or less, and those living in regional/remote areas had higher odds of multiple risk behaviors. CONCLUSIONS Future research on multiple health behaviors might benefit from including sleep as an additional behavior. In Australia, unhealthy lifestyles tend to cluster in adults with certain demographic characteristics.
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Affiliation(s)
- Ding Ding
- Prevention Research Collaboration, Sydney School of Public Health, the University of Sydney, Camperdown, NSW, Australia.
| | - Kris Rogers
- Prevention Research Collaboration, Sydney School of Public Health, the University of Sydney, Camperdown, NSW, Australia
| | - Rona Macniven
- Prevention Research Collaboration, Sydney School of Public Health, the University of Sydney, Camperdown, NSW, Australia
| | - Venugopal Kamalesh
- Faculty of Health, School of Medicine, Deakin University, Waurn Ponds, VIC
| | - Leonard Kritharides
- Concord Clinical School, ANZAC Research Institute, the University of Sydney, Camperdown, NSW, Australia
| | - John Chalmers
- The George Institute for Global Health, the University of Sydney, Camperdown, NSW, Australia
| | - Adrian Bauman
- Prevention Research Collaboration, Sydney School of Public Health, the University of Sydney, Camperdown, NSW, Australia
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