Factor structure of teacher ratings of the ODD symptoms in children
- Gomez, Rapson, Stavropoulos, Vasileios, Van Doorn, George
- Authors: Gomez, Rapson , Stavropoulos, Vasileios , Van Doorn, George
- Date: 2018
- Type: Text , Journal article
- Relation: Psychiatric Quarterly Vol. 89, no. 1 (2018), p. 219-234
- Full Text:
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- Description: This study used confirmatory factor analysis (CFA) to determine the best model for Oppositional Defiant Disorder (ODD) symptoms in children aged 3 to 15 years, as presented in the Disruptive Behavior Rating Scale. Teachers’ ratings of the ODD symptoms of 213 children from general community schools in Australia were obtained. The findings provided most support for a bifactor model based on Stringaris and Goodman’s [1] three-factor model (primary factors for irritable, hurtful, and headstrong). The general factor, but not the group factors in the model, showed high omega hierarchical and explained common variance. Thus, only the general factor in this model can be meaningfully interpreted. Also, the general factor was supported with regard to external validity. Specifically, this factor, but not the group factors, correlated strongly with ADHD inattention and hyperactivity/impulsivity symptom groups, and other measures of behavioural and emotional problems. The taxonomic, diagnostic, practical, and research implications of the findings are discussed. © 2017, Springer Science+Business Media, LLC.
- Authors: Gomez, Rapson , Stavropoulos, Vasileios , Van Doorn, George
- Date: 2018
- Type: Text , Journal article
- Relation: Psychiatric Quarterly Vol. 89, no. 1 (2018), p. 219-234
- Full Text:
- Reviewed:
- Description: This study used confirmatory factor analysis (CFA) to determine the best model for Oppositional Defiant Disorder (ODD) symptoms in children aged 3 to 15 years, as presented in the Disruptive Behavior Rating Scale. Teachers’ ratings of the ODD symptoms of 213 children from general community schools in Australia were obtained. The findings provided most support for a bifactor model based on Stringaris and Goodman’s [1] three-factor model (primary factors for irritable, hurtful, and headstrong). The general factor, but not the group factors in the model, showed high omega hierarchical and explained common variance. Thus, only the general factor in this model can be meaningfully interpreted. Also, the general factor was supported with regard to external validity. Specifically, this factor, but not the group factors, correlated strongly with ADHD inattention and hyperactivity/impulsivity symptom groups, and other measures of behavioural and emotional problems. The taxonomic, diagnostic, practical, and research implications of the findings are discussed. © 2017, Springer Science+Business Media, LLC.
Identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India : A qualitative inquiry
- Jagnoor, Jagnoor, Bekker, Sheree, Chamania, Shobha, Potokar, Tom, Ivers, Rebecca
- Authors: Jagnoor, Jagnoor , Bekker, Sheree , Chamania, Shobha , Potokar, Tom , Ivers, Rebecca
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 3 (2018), p. 1-11
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- Description: Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks.
- Authors: Jagnoor, Jagnoor , Bekker, Sheree , Chamania, Shobha , Potokar, Tom , Ivers, Rebecca
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 3 (2018), p. 1-11
- Full Text:
- Reviewed:
- Description: Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks.
Injuries in Australian rules football : An overview of injury rates, patterns, and mechanisms across all levels of play
- Saw, Richard, Finch, Caroline, Samra, David, Baquie, Peter, Cardoso, Tanusha, Hope, Danielle, Orchard, John
- Authors: Saw, Richard , Finch, Caroline , Samra, David , Baquie, Peter , Cardoso, Tanusha , Hope, Danielle , Orchard, John
- Date: 2018
- Type: Text , Journal article
- Relation: Sports Health Vol. 10, no. 3 (2018), p. 208-216
- Full Text:
- Reviewed:
- Description: Context: The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]). Objective: To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play. Study Design: A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries. Results: The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play. Clinical Relevance: An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game. © 2017,
- Authors: Saw, Richard , Finch, Caroline , Samra, David , Baquie, Peter , Cardoso, Tanusha , Hope, Danielle , Orchard, John
- Date: 2018
- Type: Text , Journal article
- Relation: Sports Health Vol. 10, no. 3 (2018), p. 208-216
- Full Text:
- Reviewed:
- Description: Context: The nature of Australian rules football (Australian football) predisposes both unique and common injuries compared with those sustained in other football codes. The game involves a combination of tackling, kicking, high-speed running (more than other football codes), and jumping. Two decades of injury surveillance has identified common injuries at the professional level (Australian Football League [AFL]). Objective: To provide an overview of injuries in Australian rules football, including injury rates, patterns, and mechanisms across all levels of play. Study Design: A narrative review of AFL injuries, football injury epidemiology, and biomechanical and physiological attributes of relevant injuries. Results: The overall injury incidence in the 2015 season was 41.7 injuries per club per season, with a prevalence of 156.2 missed games per club per season. Lower limb injuries are most prevalent, with hamstring strains accounting for 19.1 missed games per club per season. Hamstring strains relate to the volume of high-speed running required in addition to at times having to collect the ball while running in a position of hip flexion and knee extension. Anterior cruciate ligament injuries are also prevalent and can result from contact and noncontact incidents. In the upper limb, shoulder sprains and dislocations account for 11.5 missed games per club per season and largely resulted from tackling and contact. Concussion is less common in AFL than other tackling sports but remains an important injury, which has notably become more prevalent in recent years, theorized to be due to a more conservative approach to management. Although there are less injury surveillance data for non-AFL players (women, community-level, children), many of these injuries appear to also be common across all levels of play. Clinical Relevance: An understanding of injury profiles and mechanisms in Australian football is crucial in identifying methods to reduce injury risk and prepare players for the demands of the game. © 2017,
Knee flexion strength is significantly reduced following competition in semi-professional Australian Rules football athletes : Implications for injury prevention programs
- Charlton, Paula, Raysmith, Benjamin, Wollin, Martin, Rice, Simon, Purdam, Craig, Clark, Ross, Drew, Michael
- Authors: Charlton, Paula , Raysmith, Benjamin , Wollin, Martin , Rice, Simon , Purdam, Craig , Clark, Ross , Drew, Michael
- Date: 2018
- Type: Text , Journal article
- Relation: Physical Therapy in Sport Vol. 31, no. (2018), p. 9-14
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- Description: Objectives: To evaluate strength and flexibility measures pre- and post- Australian Football (AF) competition to determine their potential utility as secondary prevention measures. Design: Cohort study. Setting: Semi-professional AF club. Participants: Ten male AF athletes (mean ± SD; age, 21.3 ± 2.2 years; height, 186.1 ± 6.3 cm; weight, 83.5 ± 8.6 kg). Main Outcome Measures: Maximal unilateral isometric knee flexion strength performed in 45 degrees of hip flexion and 30 degrees of knee flexion, flexibility measures of hip and knee extension and ankle dorsiflexion. All outcome measures were evaluated pre-match to determine baseline measurements and repeated acutely post-match and at 26, 50 and 74 h following. Comparisons were made between baseline measures and all other time points. Results: Knee flexion strength was significantly reduced at a group level acutely (−122.8N, 95%CI −156.2 to −89.4, p = 0.000) and at 26 h (−89.6N, 95%CI −122.9 to −56.2, p = 0.000) following competition. Hamstring flexibility was significantly reduced at all time periods following competition (all p < 0.05), however these values were not clinically meaningful. Conclusions: Knowledge that unilateral isometric knee flexion strength returns to pre-competition levels by 50 h following match-play in AF athletes is valuable for planning recovery time frames and may inform implementation of secondary prevention strategies. © 2018 Elsevier Ltd
- Authors: Charlton, Paula , Raysmith, Benjamin , Wollin, Martin , Rice, Simon , Purdam, Craig , Clark, Ross , Drew, Michael
- Date: 2018
- Type: Text , Journal article
- Relation: Physical Therapy in Sport Vol. 31, no. (2018), p. 9-14
- Full Text:
- Reviewed:
- Description: Objectives: To evaluate strength and flexibility measures pre- and post- Australian Football (AF) competition to determine their potential utility as secondary prevention measures. Design: Cohort study. Setting: Semi-professional AF club. Participants: Ten male AF athletes (mean ± SD; age, 21.3 ± 2.2 years; height, 186.1 ± 6.3 cm; weight, 83.5 ± 8.6 kg). Main Outcome Measures: Maximal unilateral isometric knee flexion strength performed in 45 degrees of hip flexion and 30 degrees of knee flexion, flexibility measures of hip and knee extension and ankle dorsiflexion. All outcome measures were evaluated pre-match to determine baseline measurements and repeated acutely post-match and at 26, 50 and 74 h following. Comparisons were made between baseline measures and all other time points. Results: Knee flexion strength was significantly reduced at a group level acutely (−122.8N, 95%CI −156.2 to −89.4, p = 0.000) and at 26 h (−89.6N, 95%CI −122.9 to −56.2, p = 0.000) following competition. Hamstring flexibility was significantly reduced at all time periods following competition (all p < 0.05), however these values were not clinically meaningful. Conclusions: Knowledge that unilateral isometric knee flexion strength returns to pre-competition levels by 50 h following match-play in AF athletes is valuable for planning recovery time frames and may inform implementation of secondary prevention strategies. © 2018 Elsevier Ltd
Quality of life among individuals with rugby-related spinal cord injuries in South Africa : A descriptive cross-sectional study
- Badenhorst, Marelise, Brown, James, Lambert, Mike, van Mechelen, Willem, Verhagen, Evert
- Authors: Badenhorst, Marelise , Brown, James , Lambert, Mike , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 6 (2018), p. 1-12
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- Description: Objectives Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework. Design Descriptive cross-sectional study. Setting Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database. Participants Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study. Main outcome measure The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses. Results The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001). Conclusions On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.
- Authors: Badenhorst, Marelise , Brown, James , Lambert, Mike , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 6 (2018), p. 1-12
- Full Text:
- Reviewed:
- Description: Objectives Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework. Design Descriptive cross-sectional study. Setting Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database. Participants Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study. Main outcome measure The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses. Results The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001). Conclusions On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.
The efficacy of different modes of analgesia in postoperative pain management and early mobilization in postoperative cardiac surgical patients : A systematic review
- Nachiyunde, Brenda, Lam, Louisa
- Authors: Nachiyunde, Brenda , Lam, Louisa
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Annals of Cardiac Anaesthesia Vol. 21, no. 4 (2018), p. 371-375
- Full Text:
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- Description: Cardiac surgery induces severe postoperative pain and impairment of pulmonary function, increases the length of stay (LOS) in hospital, and increases mortality and morbidity; therefore, evaluation of the evidence is needed to assess the comparative benefits of different techniques of pain management, to guide clinical practice, and to identify areas of further research. A systematic search of the Cochrane Central Register of Controlled Trials, DARE database, Joanna Briggs Institute, Google scholar, PUBMED, MEDLINE, EMBASE, Academic OneFile, SCOPUS, and Academic search premier was conducted retrieving 1875 articles. This was for pain management postcardiac surgery in intensive care. Four hundred and seventy-one article titles and 266 abstracts screened, 52 full text articles retrieved for critical appraisal, and ten studies were included including 511 patients. Postoperative pain (patient reported), complications, and LOS in intensive care and the hospital were evaluated. Anesthetic infiltrations and intercostal or parasternal blocks are recommended the immediate postoperative period (4-6 h), and patient-controlled analgesia (PCA) and local subcutaneous anesthetic infusions are recommended immediate postoperative and 24-72 h postcardiac surgery. However, the use of mixed techniques, that is, PCA with opioids and local anesthetic subcutaneous infusions might be the way to go in pain management postcardiac surgery to avoid oversedation and severe nausea and vomiting from the narcotics. Adequate studies in the use of ketamine for pain management postcardiac surgery need to be done and it should be used cautiously.
- Authors: Nachiyunde, Brenda , Lam, Louisa
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Annals of Cardiac Anaesthesia Vol. 21, no. 4 (2018), p. 371-375
- Full Text:
- Reviewed:
- Description: Cardiac surgery induces severe postoperative pain and impairment of pulmonary function, increases the length of stay (LOS) in hospital, and increases mortality and morbidity; therefore, evaluation of the evidence is needed to assess the comparative benefits of different techniques of pain management, to guide clinical practice, and to identify areas of further research. A systematic search of the Cochrane Central Register of Controlled Trials, DARE database, Joanna Briggs Institute, Google scholar, PUBMED, MEDLINE, EMBASE, Academic OneFile, SCOPUS, and Academic search premier was conducted retrieving 1875 articles. This was for pain management postcardiac surgery in intensive care. Four hundred and seventy-one article titles and 266 abstracts screened, 52 full text articles retrieved for critical appraisal, and ten studies were included including 511 patients. Postoperative pain (patient reported), complications, and LOS in intensive care and the hospital were evaluated. Anesthetic infiltrations and intercostal or parasternal blocks are recommended the immediate postoperative period (4-6 h), and patient-controlled analgesia (PCA) and local subcutaneous anesthetic infusions are recommended immediate postoperative and 24-72 h postcardiac surgery. However, the use of mixed techniques, that is, PCA with opioids and local anesthetic subcutaneous infusions might be the way to go in pain management postcardiac surgery to avoid oversedation and severe nausea and vomiting from the narcotics. Adequate studies in the use of ketamine for pain management postcardiac surgery need to be done and it should be used cautiously.
Evidence of direct cardiac damage following high-intensity exercise in chronic energy restriction : A case report and literature review
- Baird, Marianne, Grace, Fergal, Sculthorpe, Nicholas, Graham, Scott, Fleming, Audrey, Baker, Julien
- Authors: Baird, Marianne , Grace, Fergal , Sculthorpe, Nicholas , Graham, Scott , Fleming, Audrey , Baker, Julien
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine Vol. 96, no. 27 (2017), p. 1-7
- Full Text:
- Reviewed:
- Description: Rationale: Following prolonged endurance events such as marathons, elevated levels of cardiospecific biomarkers are commonly reported. Although transiently raised levels are generally not considered to indicate clinical myocardial damage, comprehension of this phenomenon remains incomplete. The popularity of high-intensity interval training highlights a paucity of research measuring cardiac biomarker response to this type of exercise. This a posteriori case report discusses the elevation of cardiac troponins (cTn) associated with short interval, high-intensity exercise. Patient concerns: In this case report, an apparently healthy 29-year-old recreationally active female presented clinically raised cardiac troponin I (cTnI) levels (>0.04 ng/mL), after performing high-intensity cycle ergometer sprints. As creatine kinase (CK) is expressed by multiple organs (e.g., skeletal muscle, brain, and myocardium), cTnI assays were performed to determine any changes in total serum CK levels not originating from skeletal muscle damage. Diagnosis: A posteriori the individual's daily energy expenditure indicated chronically low-energy availability. Psychometric testing suggested that the individual scored positive for disordered eating, highly for fatigue levels, and low in mental health components. Outcomes: The current case report provides novel evidence of elevated cTnI occurring as a result of performing short duration, high intensity, cycle ergometer exercise in an individual with self-reported chronically depleted energy balance. A schematic to identify potentially “at risk” individuals is presented. Lessons: Considering this as a case report, results cannot be generalized; however, the main findings suggest that individuals who habitually restrict their calorie intake below their bodies’ daily energy requirements, may have elevated biomarkers of exercise induced myocardial stress from performing high-intensity exercise.
- Authors: Baird, Marianne , Grace, Fergal , Sculthorpe, Nicholas , Graham, Scott , Fleming, Audrey , Baker, Julien
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine Vol. 96, no. 27 (2017), p. 1-7
- Full Text:
- Reviewed:
- Description: Rationale: Following prolonged endurance events such as marathons, elevated levels of cardiospecific biomarkers are commonly reported. Although transiently raised levels are generally not considered to indicate clinical myocardial damage, comprehension of this phenomenon remains incomplete. The popularity of high-intensity interval training highlights a paucity of research measuring cardiac biomarker response to this type of exercise. This a posteriori case report discusses the elevation of cardiac troponins (cTn) associated with short interval, high-intensity exercise. Patient concerns: In this case report, an apparently healthy 29-year-old recreationally active female presented clinically raised cardiac troponin I (cTnI) levels (>0.04 ng/mL), after performing high-intensity cycle ergometer sprints. As creatine kinase (CK) is expressed by multiple organs (e.g., skeletal muscle, brain, and myocardium), cTnI assays were performed to determine any changes in total serum CK levels not originating from skeletal muscle damage. Diagnosis: A posteriori the individual's daily energy expenditure indicated chronically low-energy availability. Psychometric testing suggested that the individual scored positive for disordered eating, highly for fatigue levels, and low in mental health components. Outcomes: The current case report provides novel evidence of elevated cTnI occurring as a result of performing short duration, high intensity, cycle ergometer exercise in an individual with self-reported chronically depleted energy balance. A schematic to identify potentially “at risk” individuals is presented. Lessons: Considering this as a case report, results cannot be generalized; however, the main findings suggest that individuals who habitually restrict their calorie intake below their bodies’ daily energy requirements, may have elevated biomarkers of exercise induced myocardial stress from performing high-intensity exercise.
One session of high-intensity interval training (HIIT) every 5 days, improves muscle power but not static balance in lifelong sedentary ageing men : A randomized controlled trial
- Sculthorpe, Nicholas, Herbert, Peter, Grace, Fergal
- Authors: Sculthorpe, Nicholas , Herbert, Peter , Grace, Fergal
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine (United States) Vol. 96, no. 6 (2017), p. 1-8
- Full Text:
- Reviewed:
- Description: Background: Declining muscle power during advancing age predicts falls and loss of independence. High-intensity interval training (HIIT) may improve muscle power, but remains largely unstudied in ageing participants. Methods: This randomized controlled trial (RCT) investigated the efficacy of a low-frequency HIIT (LfHIIT) intervention on peak muscle power (peak power output [PPO]), body composition, and balance in lifelong sedentary but otherwise healthy males. Methods: Thirty-Three lifelong sedentary ageing men were randomly assigned to either intervention (INT; n=22, age 62.3±4.1 years) or control (n=11, age 61.6±5.0 years) who were both assessed at 3 distinct measurement points (phase A), after 6 weeks of conditioning exercise (phase B), and after 6 weeks of HIIT once every 5 days in INT (phase C), where control remained inactive throughout the study. Results: Static balance remained unaffected, and both absolute and relative PPO were not different between groups at phases A or B, but increased significantly in INT after LfHIIT (P<0.01). Lean body mass displayed a significant interaction (P<0.01) due to an increase in INT between phases B and C (P<0.05). Conclusions: 6 weeks of LfHIIT exercise feasible and effective method to induce clinically relevant improvements in absolute and relative PPO, but does not improve static balance in sedentary ageing men. Abbreviations: ACSM = American College of Sports Medicine, CON = control group, GP = general medical practitioner, HIIT = high-intensity interval training, HRR = heart rate reserve, INT = intervention group, LfHIIT = low-frequency high-intensity interval training, PAR-Q = Physical Activity Readiness Questionnaire, PPO = peak power output, rPPO = relative peak power output, rPPOFFM = rPPO relative to fat free mass, VO2 max = maximal oxygen uptake. © 2017 the Author(s).
- Authors: Sculthorpe, Nicholas , Herbert, Peter , Grace, Fergal
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine (United States) Vol. 96, no. 6 (2017), p. 1-8
- Full Text:
- Reviewed:
- Description: Background: Declining muscle power during advancing age predicts falls and loss of independence. High-intensity interval training (HIIT) may improve muscle power, but remains largely unstudied in ageing participants. Methods: This randomized controlled trial (RCT) investigated the efficacy of a low-frequency HIIT (LfHIIT) intervention on peak muscle power (peak power output [PPO]), body composition, and balance in lifelong sedentary but otherwise healthy males. Methods: Thirty-Three lifelong sedentary ageing men were randomly assigned to either intervention (INT; n=22, age 62.3±4.1 years) or control (n=11, age 61.6±5.0 years) who were both assessed at 3 distinct measurement points (phase A), after 6 weeks of conditioning exercise (phase B), and after 6 weeks of HIIT once every 5 days in INT (phase C), where control remained inactive throughout the study. Results: Static balance remained unaffected, and both absolute and relative PPO were not different between groups at phases A or B, but increased significantly in INT after LfHIIT (P<0.01). Lean body mass displayed a significant interaction (P<0.01) due to an increase in INT between phases B and C (P<0.05). Conclusions: 6 weeks of LfHIIT exercise feasible and effective method to induce clinically relevant improvements in absolute and relative PPO, but does not improve static balance in sedentary ageing men. Abbreviations: ACSM = American College of Sports Medicine, CON = control group, GP = general medical practitioner, HIIT = high-intensity interval training, HRR = heart rate reserve, INT = intervention group, LfHIIT = low-frequency high-intensity interval training, PAR-Q = Physical Activity Readiness Questionnaire, PPO = peak power output, rPPO = relative peak power output, rPPOFFM = rPPO relative to fat free mass, VO2 max = maximal oxygen uptake. © 2017 the Author(s).
Preventing musculoskeletal injuries among recreational adult volleyball players : Design of a randomised prospective controlled trial
- Gouttebarge, Vincent, Zwerver, Johannes, Verhagen, Evert
- Authors: Gouttebarge, Vincent , Zwerver, Johannes , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: BMC Musculoskeletal Disorders Vol. 18, no. 1 (2017), p. 1-6
- Full Text:
- Reviewed:
- Description: Background: Both acute and overuse injuries are common among recreational volleyball players, especially finger/wrist, ankle, shoulder and knee injuries. Consequently, an intervention ('VolleyVeilig') was developed to prevent or reduce the occurrence of finger/wrist, shoulder, knee and ankle injuries among recreational volleyball players. This article describes the design of a study evaluating the effectiveness of the developed intervention on the one-season occurrence of finger/wrist, shoulder, knee and ankle injuries among recreational adult volleyball players. Methods: A randomized prospective controlled trial with a follow-up period of one volleyball season will be conducted. Participants will be healthy recreational adult volleyball players (18 years of age or older) practicing volleyball (training and/or match) at least twice a week. The intervention ('VolleyVeilig') consists of a warm-up program based on more than 50 distinct exercises (with different variations and levels). The effect of the intervention programme on the occurrence of injuries will be compared to volleyball as usual. Outcome measures will be incidence of acute injury (expressed as number of injuries per 1000 h of play) and prevalence of overuse injuries (expressed as percentage). Discussion: This study will be one of the first randomized prospective controlled trials evaluating the effectiveness of an intervention on the occurrence of both acute and overuse injuries among recreational adult volleyball players. Outcome of this study could possibly lead to the nationwide implementation of the intervention in all volleyball clubs in The Netherlands, ultimately resulting in less injuries. Trial registration: Dutch Trial Registration NTR6202, registered February 1st 2017. Protocol: Version 3, February 2017. © 2017 The Author(s).
- Authors: Gouttebarge, Vincent , Zwerver, Johannes , Verhagen, Evert
- Date: 2017
- Type: Text , Journal article , Review
- Relation: BMC Musculoskeletal Disorders Vol. 18, no. 1 (2017), p. 1-6
- Full Text:
- Reviewed:
- Description: Background: Both acute and overuse injuries are common among recreational volleyball players, especially finger/wrist, ankle, shoulder and knee injuries. Consequently, an intervention ('VolleyVeilig') was developed to prevent or reduce the occurrence of finger/wrist, shoulder, knee and ankle injuries among recreational volleyball players. This article describes the design of a study evaluating the effectiveness of the developed intervention on the one-season occurrence of finger/wrist, shoulder, knee and ankle injuries among recreational adult volleyball players. Methods: A randomized prospective controlled trial with a follow-up period of one volleyball season will be conducted. Participants will be healthy recreational adult volleyball players (18 years of age or older) practicing volleyball (training and/or match) at least twice a week. The intervention ('VolleyVeilig') consists of a warm-up program based on more than 50 distinct exercises (with different variations and levels). The effect of the intervention programme on the occurrence of injuries will be compared to volleyball as usual. Outcome measures will be incidence of acute injury (expressed as number of injuries per 1000 h of play) and prevalence of overuse injuries (expressed as percentage). Discussion: This study will be one of the first randomized prospective controlled trials evaluating the effectiveness of an intervention on the occurrence of both acute and overuse injuries among recreational adult volleyball players. Outcome of this study could possibly lead to the nationwide implementation of the intervention in all volleyball clubs in The Netherlands, ultimately resulting in less injuries. Trial registration: Dutch Trial Registration NTR6202, registered February 1st 2017. Protocol: Version 3, February 2017. © 2017 The Author(s).
Responsible gambling among older adults : a qualitative exploration
- Subramaniam, Mythily, Satghare, Pratika, Vaingankar, Janhavi, Picco, Louisa, Browning, Colette, Chong, Siow, Thomas, Shane
- Authors: Subramaniam, Mythily , Satghare, Pratika , Vaingankar, Janhavi , Picco, Louisa , Browning, Colette , Chong, Siow , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 17, no. 1 (2017), p.
- Full Text:
- Reviewed:
- Description: Background: Responsible gambling (RG) is defined as gambling for pleasure and entertainment but with an awareness of the likelihood of losing, an understanding of the associated risks and the ability to exercise control over one's gambling activity. The current study describes a qualitative approach to explore RG among older adults (aged 60 years and above) in Singapore and reports on the cognitive and behavioural strategies employed by them to regulate their gambling. Methods: Inclusion criteria included Singapore residents aged 60 years and above, who could speak in English, Chinese, Malay or Tamil and were current or past regular gamblers. Participants were recruited using a combination of network and purposive sampling. Socio-demographic information on age, age of onset of gambling, gender, ethnicity, marital status, education and employment was collected. The South Oaks Gambling Screen (SOGS) was used to collect information on gambling activities and problems associated with gambling behaviour. Qualitative interviews were conducted with 25 older adults (60 years and above) who currently gambled. The data was analyzed using thematic network analysis. Results: This global theme of RG comprised two organising themes: self -developed strategies to limit gambling related harm and family interventions to reduce gambling harm. The basic themes included delayed gratification, perception of futility of gambling, setting limits, maintaining balance, help-seeking and awareness of disordered gambling in self or in others. Family interventions included pleading and threatening, compelling help-seeking as well as family exclusion order. Conclusions: The study highlights the significant role that families play in Asian societies in imposing RG. Education of family members both in terms of the importance of RG, and communication of the ways in which older adults can incorporate RG behaviours including the use of exclusion in specific scenarios is important. © 2017 The Author(s).
- Authors: Subramaniam, Mythily , Satghare, Pratika , Vaingankar, Janhavi , Picco, Louisa , Browning, Colette , Chong, Siow , Thomas, Shane
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Psychiatry Vol. 17, no. 1 (2017), p.
- Full Text:
- Reviewed:
- Description: Background: Responsible gambling (RG) is defined as gambling for pleasure and entertainment but with an awareness of the likelihood of losing, an understanding of the associated risks and the ability to exercise control over one's gambling activity. The current study describes a qualitative approach to explore RG among older adults (aged 60 years and above) in Singapore and reports on the cognitive and behavioural strategies employed by them to regulate their gambling. Methods: Inclusion criteria included Singapore residents aged 60 years and above, who could speak in English, Chinese, Malay or Tamil and were current or past regular gamblers. Participants were recruited using a combination of network and purposive sampling. Socio-demographic information on age, age of onset of gambling, gender, ethnicity, marital status, education and employment was collected. The South Oaks Gambling Screen (SOGS) was used to collect information on gambling activities and problems associated with gambling behaviour. Qualitative interviews were conducted with 25 older adults (60 years and above) who currently gambled. The data was analyzed using thematic network analysis. Results: This global theme of RG comprised two organising themes: self -developed strategies to limit gambling related harm and family interventions to reduce gambling harm. The basic themes included delayed gratification, perception of futility of gambling, setting limits, maintaining balance, help-seeking and awareness of disordered gambling in self or in others. Family interventions included pleading and threatening, compelling help-seeking as well as family exclusion order. Conclusions: The study highlights the significant role that families play in Asian societies in imposing RG. Education of family members both in terms of the importance of RG, and communication of the ways in which older adults can incorporate RG behaviours including the use of exclusion in specific scenarios is important. © 2017 The Author(s).
The association between serum uric acid and blood pressure in different age groups in a healthy Chinese cohort
- Cheng, Wenjuan, Wen, Shiling, Wang, Yutang, Qian, Zhiping, Tan, Yuyao, Li, Hongying, Hou, Yueli, Hu, Haiyang, Golledge, Jonathan, Yang, Guang
- Authors: Cheng, Wenjuan , Wen, Shiling , Wang, Yutang , Qian, Zhiping , Tan, Yuyao , Li, Hongying , Hou, Yueli , Hu, Haiyang , Golledge, Jonathan , Yang, Guang
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine (United States) Vol. 96, no. 50 (2017), p.1-6
- Relation: http://purl.org/au-research/grants/nhmrc/1062671
- Full Text:
- Reviewed:
- Description: High serum uric acid (sUA) has been reported to be a risk factor for hypertension however, whether this is the case for all age groups is not clear. We examined the association between sUA concentrations and systolic and diastolic blood pressure (SBP and DBP) in different age groups in a cohort of healthy Chinese participants. A total of 1082 healthy participants aged from 41 to 70 years were included. sUA concentration was measured by the uricase-peroxidase method. SBP and DBP were assessed using mercury sphygmomanometry. Hypertension was defined as SBP ≥140 mm Hg or DBP ≥90 mm Hg. Hyperuricemia (HUA) was defined as sUA concentration of >7 mg/dL in men and >6 mg/dL in women. The association between sUA concentration and SBP and DBP was examined using Pearson's correlation test, multivariate linear regression, and logistic regression analysis. The prevalence of hypertension and HUA increased with age (P < .001). Hypertension was more common in participants that had HUA than in those that did not (38.95% vs 30.16%, P = .02). Higher sUA was significantly associated with higher SBP and DBP in the 41- to 50-year-old participants (SBP, β = 0.35, P < .001; DBP, β = .29, P < .001; after adjustment for age, sex, total cholesterol, estimated glomerular filtration rate, and fasting plasma glucose). HUA was also a risk factor for hypertension in this age group (odds ratio 1.425, 95% confidence interval, 1.217-1.668, P < .001). There was no association between sUA concentration and SBP and DBP in the other age groups. In this population of healthy Chinese participants, sUA concentration was positively associated with hypertension only in the 41- to 50-year-old group. Lowering uric acid in this age group may help to reduce the incidence of hypertension.
- Authors: Cheng, Wenjuan , Wen, Shiling , Wang, Yutang , Qian, Zhiping , Tan, Yuyao , Li, Hongying , Hou, Yueli , Hu, Haiyang , Golledge, Jonathan , Yang, Guang
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine (United States) Vol. 96, no. 50 (2017), p.1-6
- Relation: http://purl.org/au-research/grants/nhmrc/1062671
- Full Text:
- Reviewed:
- Description: High serum uric acid (sUA) has been reported to be a risk factor for hypertension however, whether this is the case for all age groups is not clear. We examined the association between sUA concentrations and systolic and diastolic blood pressure (SBP and DBP) in different age groups in a cohort of healthy Chinese participants. A total of 1082 healthy participants aged from 41 to 70 years were included. sUA concentration was measured by the uricase-peroxidase method. SBP and DBP were assessed using mercury sphygmomanometry. Hypertension was defined as SBP ≥140 mm Hg or DBP ≥90 mm Hg. Hyperuricemia (HUA) was defined as sUA concentration of >7 mg/dL in men and >6 mg/dL in women. The association between sUA concentration and SBP and DBP was examined using Pearson's correlation test, multivariate linear regression, and logistic regression analysis. The prevalence of hypertension and HUA increased with age (P < .001). Hypertension was more common in participants that had HUA than in those that did not (38.95% vs 30.16%, P = .02). Higher sUA was significantly associated with higher SBP and DBP in the 41- to 50-year-old participants (SBP, β = 0.35, P < .001; DBP, β = .29, P < .001; after adjustment for age, sex, total cholesterol, estimated glomerular filtration rate, and fasting plasma glucose). HUA was also a risk factor for hypertension in this age group (odds ratio 1.425, 95% confidence interval, 1.217-1.668, P < .001). There was no association between sUA concentration and SBP and DBP in the other age groups. In this population of healthy Chinese participants, sUA concentration was positively associated with hypertension only in the 41- to 50-year-old group. Lowering uric acid in this age group may help to reduce the incidence of hypertension.
The urban-rural divide : hypertensive disease hospitalisations in Victoria 2010–2015
- Robins, Shalley, Gardiner, Samantha, Terry, Daniel
- Authors: Robins, Shalley , Gardiner, Samantha , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 10, no. 11 (2017), p. 953-963
- Full Text:
- Reviewed:
- Description: Background Hypertension is present in 23–32 per cent of Australians, making it one of the most prevalent diseases in the country. It is the greatest risk factor for cardiovascular disease, the leading cause of death in Australia and it affects rural populations at a higher rate than urban residents. Aims The aims of this study were to investigate the differences in hypertensive disease hospitalisations across rural and urban Victoria, and to determine predicting variables. Methods Hospital admission data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other organisations. Data included various patient demographics for each hospital admission entry. The rates of hospitalisation for each Local Government Area were analysed. Further regression analysis was undertaken to examine the association between hypertensive disease hospitalisation and various predictor variables. Results From 2010–2015 11,205 hypertensive disease hospital admissions were recorded of which 64.8 per cent were female, 74.7 per cent admissions were at urban hospitals, and 65.0 per cent were public patients. Hospitalisation rates were consistently higher in rural areas than in urban areas, and rural residents on average stayed in hospital for longer. Significant predictor variables for hypertensive disease hospitalisation included various indicators of socioeconomic disadvantage, GPs per 1,000 population and GP attendance per 1,000 population. Conclusion Hypertensive disease hospitalisation in Victoria continues to rise and rates of hospitalisation of rural Victorians continue to be higher than their urban counterparts. Females were hospitalised almost twice as often as males. Further research is required to identify the specific factors that impede access to health services, particularly in the identified high-risk populations. © 2017, Australasian Medical Journal Pty Ltd. All rights reserved.
- Authors: Robins, Shalley , Gardiner, Samantha , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 10, no. 11 (2017), p. 953-963
- Full Text:
- Reviewed:
- Description: Background Hypertension is present in 23–32 per cent of Australians, making it one of the most prevalent diseases in the country. It is the greatest risk factor for cardiovascular disease, the leading cause of death in Australia and it affects rural populations at a higher rate than urban residents. Aims The aims of this study were to investigate the differences in hypertensive disease hospitalisations across rural and urban Victoria, and to determine predicting variables. Methods Hospital admission data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other organisations. Data included various patient demographics for each hospital admission entry. The rates of hospitalisation for each Local Government Area were analysed. Further regression analysis was undertaken to examine the association between hypertensive disease hospitalisation and various predictor variables. Results From 2010–2015 11,205 hypertensive disease hospital admissions were recorded of which 64.8 per cent were female, 74.7 per cent admissions were at urban hospitals, and 65.0 per cent were public patients. Hospitalisation rates were consistently higher in rural areas than in urban areas, and rural residents on average stayed in hospital for longer. Significant predictor variables for hypertensive disease hospitalisation included various indicators of socioeconomic disadvantage, GPs per 1,000 population and GP attendance per 1,000 population. Conclusion Hypertensive disease hospitalisation in Victoria continues to rise and rates of hospitalisation of rural Victorians continue to be higher than their urban counterparts. Females were hospitalised almost twice as often as males. Further research is required to identify the specific factors that impede access to health services, particularly in the identified high-risk populations. © 2017, Australasian Medical Journal Pty Ltd. All rights reserved.
The y chromosome : A blueprint for men's health?
- Maan, Akhlaq, Eales, James, Akbarov, Artur, Rowland, Joshua, Xu, Xiaoguang, Jobling, Mark, Charchar, Fadi, Tomaszewski, Maciej
- Authors: Maan, Akhlaq , Eales, James , Akbarov, Artur , Rowland, Joshua , Xu, Xiaoguang , Jobling, Mark , Charchar, Fadi , Tomaszewski, Maciej
- Date: 2017
- Type: Text , Journal article , Review
- Relation: European Journal of Human Genetics Vol. 25, no. 11 (2017), p. 1181-1188
- Full Text:
- Reviewed:
- Description: The Y chromosome has long been considered a genetic wasteland' on a trajectory to completely disappear from the human genome. The perception of its physiological function was restricted to sex determination and spermatogenesis. These views have been challenged in recent times with the identification of multiple ubiquitously expressed Y-chromosome genes and the discovery of several unexpected associations between the Y chromosome, immune system and complex polygenic traits. The collected evidence suggests that the Y chromosome influences immune and inflammatory responses in men, translating into genetically programmed susceptibility to diseases with a strong immune component. Phylogenetic studies reveal that carriers of a common European lineage of the Y chromosome (haplogroup I) possess increased risk of coronary artery disease. This occurs amidst upregulation of inflammation and suppression of adaptive immunity in this Y lineage, as well as inferior outcomes in human immunodeficiency virus infection. From structural analysis and experimental data, the UTY (Ubiquitously Transcribed Tetratricopeptide Repeat Containing, Y-Linked) gene is emerging as a promising candidate underlying the associations between Y-chromosome variants and the immunity-driven susceptibility to complex disease. This review synthesises the recent structural, experimental and clinical insights into the human Y chromosome in the context of men's susceptibility to disease (with a particular emphasis on cardiovascular disease) and provides an overview of the paradigm shift in the perception of the Y chromosome. © 2017 The Author(s).
- Authors: Maan, Akhlaq , Eales, James , Akbarov, Artur , Rowland, Joshua , Xu, Xiaoguang , Jobling, Mark , Charchar, Fadi , Tomaszewski, Maciej
- Date: 2017
- Type: Text , Journal article , Review
- Relation: European Journal of Human Genetics Vol. 25, no. 11 (2017), p. 1181-1188
- Full Text:
- Reviewed:
- Description: The Y chromosome has long been considered a genetic wasteland' on a trajectory to completely disappear from the human genome. The perception of its physiological function was restricted to sex determination and spermatogenesis. These views have been challenged in recent times with the identification of multiple ubiquitously expressed Y-chromosome genes and the discovery of several unexpected associations between the Y chromosome, immune system and complex polygenic traits. The collected evidence suggests that the Y chromosome influences immune and inflammatory responses in men, translating into genetically programmed susceptibility to diseases with a strong immune component. Phylogenetic studies reveal that carriers of a common European lineage of the Y chromosome (haplogroup I) possess increased risk of coronary artery disease. This occurs amidst upregulation of inflammation and suppression of adaptive immunity in this Y lineage, as well as inferior outcomes in human immunodeficiency virus infection. From structural analysis and experimental data, the UTY (Ubiquitously Transcribed Tetratricopeptide Repeat Containing, Y-Linked) gene is emerging as a promising candidate underlying the associations between Y-chromosome variants and the immunity-driven susceptibility to complex disease. This review synthesises the recent structural, experimental and clinical insights into the human Y chromosome in the context of men's susceptibility to disease (with a particular emphasis on cardiovascular disease) and provides an overview of the paradigm shift in the perception of the Y chromosome. © 2017 The Author(s).
Wnt signaling pathway inhibitor Sclerostin inhibits angiotensin II-induced aortic aneurysm and atherosclerosis
- Krishna, Smriti, Seto, Sai-Wang, Jose, Roby, Li, Jiaze, Morton, Susan, Biros, Erik, Wang, Yutang, Nsengiyumva, Vianne, Lindeman, Jan, Loots, Gabriela, Rush, Catherine, Craig, Jeffrey, Golledge, Jonathan
- Authors: Krishna, Smriti , Seto, Sai-Wang , Jose, Roby , Li, Jiaze , Morton, Susan , Biros, Erik , Wang, Yutang , Nsengiyumva, Vianne , Lindeman, Jan , Loots, Gabriela , Rush, Catherine , Craig, Jeffrey , Golledge, Jonathan
- Date: 2017
- Type: Text , Journal article
- Relation: Arteriosclerosis Thrombosis and Vascular Biology Vol. 37, no. 3 (2017), p. 553-566
- Full Text:
- Reviewed:
- Description: Objective-Sclerostin (SOST) has been identified as an important regulator of bone formation; however, it has not been previously implicated in arterial disease. The aim of this study was to assess the role of SOST in aortic aneurysm (AA) and atherosclerosis using human samples, a mouse model, and in vitro investigations. Approach and Results-SOST protein was downregulated in human and mouse AA samples compared with controls. Transgenic introduction of human SOST in apolipoprotein E-deficient (ApoE(-/-)) mice (SOSTTg. ApoE(-/-)) and administration of recombinant mouse Sost inhibited angiotensin II-induced AA and atherosclerosis. Serum concentrations of several proinflammatory cytokines were significantly reduced in SOSTTg. ApoE(-/-) mice. Compared with controls, the aortas of mice receiving recombinant mouse Sost and SOSTTg. ApoE(-/-) mice showed reduced matrix degradation, reduced elastin breaks, and preserved collagen. Decreased inflammatory cell infiltration and a reduction in the expression of wingless-type mouse mammary virus integration site/beta-catenin responsive genes, including matrix metalloproteinase-9, osteoprotegerin, and osteopontin, were observed in the aortas of SOSTTg. ApoE(-/-) mice. SOST expression was downregulated and the winglesstype mouse mammary virus integration site/beta-catenin pathway was activated in human AA samples. The cytosinephosphate- guanine islands in the SOST gene promoter showed significantly higher methylation in human AA samples compared with controls. Incubation of vascular smooth muscle cells with the demethylating agent 5-azacytidine resulted in upregulation of SOST, suggesting that SOST is epigenetically regulated. Conclusions-This study identifies that SOST is expressed in the aorta and downregulated in human AA possibly because of epigenetic silencing. Upregulating SOST inhibits AA and atherosclerosis development, with potential important implications for treating these vascular diseases.
- Authors: Krishna, Smriti , Seto, Sai-Wang , Jose, Roby , Li, Jiaze , Morton, Susan , Biros, Erik , Wang, Yutang , Nsengiyumva, Vianne , Lindeman, Jan , Loots, Gabriela , Rush, Catherine , Craig, Jeffrey , Golledge, Jonathan
- Date: 2017
- Type: Text , Journal article
- Relation: Arteriosclerosis Thrombosis and Vascular Biology Vol. 37, no. 3 (2017), p. 553-566
- Full Text:
- Reviewed:
- Description: Objective-Sclerostin (SOST) has been identified as an important regulator of bone formation; however, it has not been previously implicated in arterial disease. The aim of this study was to assess the role of SOST in aortic aneurysm (AA) and atherosclerosis using human samples, a mouse model, and in vitro investigations. Approach and Results-SOST protein was downregulated in human and mouse AA samples compared with controls. Transgenic introduction of human SOST in apolipoprotein E-deficient (ApoE(-/-)) mice (SOSTTg. ApoE(-/-)) and administration of recombinant mouse Sost inhibited angiotensin II-induced AA and atherosclerosis. Serum concentrations of several proinflammatory cytokines were significantly reduced in SOSTTg. ApoE(-/-) mice. Compared with controls, the aortas of mice receiving recombinant mouse Sost and SOSTTg. ApoE(-/-) mice showed reduced matrix degradation, reduced elastin breaks, and preserved collagen. Decreased inflammatory cell infiltration and a reduction in the expression of wingless-type mouse mammary virus integration site/beta-catenin responsive genes, including matrix metalloproteinase-9, osteoprotegerin, and osteopontin, were observed in the aortas of SOSTTg. ApoE(-/-) mice. SOST expression was downregulated and the winglesstype mouse mammary virus integration site/beta-catenin pathway was activated in human AA samples. The cytosinephosphate- guanine islands in the SOST gene promoter showed significantly higher methylation in human AA samples compared with controls. Incubation of vascular smooth muscle cells with the demethylating agent 5-azacytidine resulted in upregulation of SOST, suggesting that SOST is epigenetically regulated. Conclusions-This study identifies that SOST is expressed in the aorta and downregulated in human AA possibly because of epigenetic silencing. Upregulating SOST inhibits AA and atherosclerosis development, with potential important implications for treating these vascular diseases.
Assessing the completeness of coded and narrative data from the Victorian Emergency Minimum Dataset using injuries sustained during fitness activities as a case study
- Gray, Shannon, Finch, Caroline
- Authors: Gray, Shannon , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Emergency Medicine Vol. 16, no. 1 (2016), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Background: Injury surveillance systems support the ongoing systematic collection, analysis and interpretation of health information vital to the prevention, planning and evaluation of injury prevention strategies. One key measure of the success of such systems is their reliability. Data completeness is a major component of system reliability, and is an indicator of a system's data quality. The Victorian Emergency Minimum Dataset (VEMD) is a state-wide record of injury presentations to emergency departments in Victoria, Australia. For each case, it provides information on the injury cause, place of occurrence, activity at time of injury, body region affected and nature of injury, as well as a free-text narrative of the injury event. The aim of this study was to assess the completeness of data in the VEMD using injuries sustained in fitness facilities as a case study. Methods: Analysis of VEMD coded parent injury variables (nature of injury, injured body region, cause of injury, place where injury occurred, activity at time of injury) and detailed narratives were reviewed for completeness over the ten-year period July 2003 to June 2012, inclusive. Narratives were text analysed manually to determine which items of injury information they contained and compared to the parent injury variables. Results: There were 2936 identified cases related to injuries sustained during fitness activities. Two percent of cases had all coded injury variables unspecified. Overall, 95.8 % of narratives had at least one piece of injury information missing. The nature of injury and body region variables were coded in 92.6 and 96.6 % of cases, yet were only mentioned in 27.1 and 75.4 % of narratives, respectively. The cause variable was allocated a specified code in 47.7 % of cases and was mentioned in 45.9 % of narratives. The cause was missing in both in 42.8 % of cases. In approximately half of all cases, the activity and place were specified in both the coded injury variable and narrative; they were missing in both in 7.4 and 13.6 % of cases, respectively. Conclusions: The reliability of the VEMD as an injury surveillance system, varied depending on the injury variable being examined. © 2016 The Author(s).
- Authors: Gray, Shannon , Finch, Caroline
- Date: 2016
- Type: Text , Journal article
- Relation: BMC Emergency Medicine Vol. 16, no. 1 (2016), p. 1-8
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text:
- Reviewed:
- Description: Background: Injury surveillance systems support the ongoing systematic collection, analysis and interpretation of health information vital to the prevention, planning and evaluation of injury prevention strategies. One key measure of the success of such systems is their reliability. Data completeness is a major component of system reliability, and is an indicator of a system's data quality. The Victorian Emergency Minimum Dataset (VEMD) is a state-wide record of injury presentations to emergency departments in Victoria, Australia. For each case, it provides information on the injury cause, place of occurrence, activity at time of injury, body region affected and nature of injury, as well as a free-text narrative of the injury event. The aim of this study was to assess the completeness of data in the VEMD using injuries sustained in fitness facilities as a case study. Methods: Analysis of VEMD coded parent injury variables (nature of injury, injured body region, cause of injury, place where injury occurred, activity at time of injury) and detailed narratives were reviewed for completeness over the ten-year period July 2003 to June 2012, inclusive. Narratives were text analysed manually to determine which items of injury information they contained and compared to the parent injury variables. Results: There were 2936 identified cases related to injuries sustained during fitness activities. Two percent of cases had all coded injury variables unspecified. Overall, 95.8 % of narratives had at least one piece of injury information missing. The nature of injury and body region variables were coded in 92.6 and 96.6 % of cases, yet were only mentioned in 27.1 and 75.4 % of narratives, respectively. The cause variable was allocated a specified code in 47.7 % of cases and was mentioned in 45.9 % of narratives. The cause was missing in both in 42.8 % of cases. In approximately half of all cases, the activity and place were specified in both the coded injury variable and narrative; they were missing in both in 7.4 and 13.6 % of cases, respectively. Conclusions: The reliability of the VEMD as an injury surveillance system, varied depending on the injury variable being examined. © 2016 The Author(s).
Clinical significance of individual GAD symptoms in later life
- Miloyan, Beyon, Pachana, Nancy
- Authors: Miloyan, Beyon , Pachana, Nancy
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Geriatric Psychiatry and Neurology Vol. 29, no. 2 (2016), p. 92-98
- Full Text:
- Reviewed:
- Description: Background: There are age-related differences in the manifestation of generalized anxiety disorder (GAD) symptoms and their associated impact on psychosocial and functional status. However, it remains unclear whether specific symptoms (or symptom patterns) are of comparable clinical significance across different functional domains. Methods: A sample of 865 self-reported worriers (aged 60 years and older) who endorsed GAD screening questions in the Alcohol Use Disorder and Associated Disabilities Interview Schedule, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were derived from Wave 1 of the National Epidemiological Survey of Alcohol and Related Conditions. Results: Being easily fatigued was significantly associated with occupational disability and a functional disability variable (restricting usual activity in any way). Irritability was significantly associated with social friction (arguments with friends, family, or colleagues) and a functional disability variable (found was unable to do something wanted to do), and poor self-perceived health was also associated with the same functional disability variable. Excessive worry, despite being among the least reported symptoms, was significantly associated with distress. Conclusions: These findings suggest that individual GAD symptoms are differentially associated with aspects of clinical significance relevant to daily life, such as social, occupational, and functional ability. The differential impact of individual symptoms on functional status may be diluted when using symptom sum scores. A nuanced approach to assessing the clinical significance of individual GAD symptoms in older adults may be fruitful for efforts aimed at early detection and treatment. © 2015 SAGE Publications.
- Authors: Miloyan, Beyon , Pachana, Nancy
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Geriatric Psychiatry and Neurology Vol. 29, no. 2 (2016), p. 92-98
- Full Text:
- Reviewed:
- Description: Background: There are age-related differences in the manifestation of generalized anxiety disorder (GAD) symptoms and their associated impact on psychosocial and functional status. However, it remains unclear whether specific symptoms (or symptom patterns) are of comparable clinical significance across different functional domains. Methods: A sample of 865 self-reported worriers (aged 60 years and older) who endorsed GAD screening questions in the Alcohol Use Disorder and Associated Disabilities Interview Schedule, Diagnostic and Statistical Manual of Mental Disorders, fourth edition, were derived from Wave 1 of the National Epidemiological Survey of Alcohol and Related Conditions. Results: Being easily fatigued was significantly associated with occupational disability and a functional disability variable (restricting usual activity in any way). Irritability was significantly associated with social friction (arguments with friends, family, or colleagues) and a functional disability variable (found was unable to do something wanted to do), and poor self-perceived health was also associated with the same functional disability variable. Excessive worry, despite being among the least reported symptoms, was significantly associated with distress. Conclusions: These findings suggest that individual GAD symptoms are differentially associated with aspects of clinical significance relevant to daily life, such as social, occupational, and functional ability. The differential impact of individual symptoms on functional status may be diluted when using symptom sum scores. A nuanced approach to assessing the clinical significance of individual GAD symptoms in older adults may be fruitful for efforts aimed at early detection and treatment. © 2015 SAGE Publications.
Early post-operative mortality after major lower limb amputation : A systematic review of population and regional based studies
- Van Netten, Jaap, Fortington, Lauren, Hinchliffe, Robert, Hijmans, Juha
- Authors: Van Netten, Jaap , Fortington, Lauren , Hinchliffe, Robert , Hijmans, Juha
- Date: 2016
- Type: Text , Journal article
- Relation: European Journal of Vascular and Endovascular Surgery Vol. 51, no. 2 (2016), p. 248-258
- Full Text:
- Reviewed:
- Description: Objective Lower limb amputation is often associated with a high risk of early post-operative mortality. Mortality rates are also increasingly being put forward as a possible benchmark for surgical performance. The primary aim of this systematic review is to investigate early post-operative mortality following a major lower limb amputation in population/regional based studies, and reported factors that might influence these mortality outcomes. Methods Embase, PubMed, Cinahl and Psycinfo were searched for publications in any language on 30 day or in hospital mortality after major lower limb amputation in population/regional based studies. PRISMA guidelines were followed. A self developed checklist was used to assess quality and susceptibility to bias. Summary data were extracted for the percentage of the population who died; pooling of quantitative results was not possible because of methodological differences between studies. Results Of the 9,082 publications identified, results were included from 21. The percentage of the population undergoing amputation who died within 30 days ranged from 7% to 22%, the in hospital equivalent was 4-20%. Transfemoral amputation and older age were found to have a higher proportion of early post-operative mortality, compared with transtibial and younger age, respectively. Other patient factors or surgical treatment choices related to increased early post-operative mortality varied between studies. Conclusions Early post-operative mortality rates vary from 4% to 22%. There are very limited data presented for patient related factors (age, comorbidities) that influence mortality. Even less is known about factors related to surgical treatment choices, being limited to amputation level. More information is needed to allow comparison across studies or for any benchmarking of acceptable mortality rates. Agreement is needed on key factors to be reported. © 2015 European Society for Vascular Surgery.
- Authors: Van Netten, Jaap , Fortington, Lauren , Hinchliffe, Robert , Hijmans, Juha
- Date: 2016
- Type: Text , Journal article
- Relation: European Journal of Vascular and Endovascular Surgery Vol. 51, no. 2 (2016), p. 248-258
- Full Text:
- Reviewed:
- Description: Objective Lower limb amputation is often associated with a high risk of early post-operative mortality. Mortality rates are also increasingly being put forward as a possible benchmark for surgical performance. The primary aim of this systematic review is to investigate early post-operative mortality following a major lower limb amputation in population/regional based studies, and reported factors that might influence these mortality outcomes. Methods Embase, PubMed, Cinahl and Psycinfo were searched for publications in any language on 30 day or in hospital mortality after major lower limb amputation in population/regional based studies. PRISMA guidelines were followed. A self developed checklist was used to assess quality and susceptibility to bias. Summary data were extracted for the percentage of the population who died; pooling of quantitative results was not possible because of methodological differences between studies. Results Of the 9,082 publications identified, results were included from 21. The percentage of the population undergoing amputation who died within 30 days ranged from 7% to 22%, the in hospital equivalent was 4-20%. Transfemoral amputation and older age were found to have a higher proportion of early post-operative mortality, compared with transtibial and younger age, respectively. Other patient factors or surgical treatment choices related to increased early post-operative mortality varied between studies. Conclusions Early post-operative mortality rates vary from 4% to 22%. There are very limited data presented for patient related factors (age, comorbidities) that influence mortality. Even less is known about factors related to surgical treatment choices, being limited to amputation level. More information is needed to allow comparison across studies or for any benchmarking of acceptable mortality rates. Agreement is needed on key factors to be reported. © 2015 European Society for Vascular Surgery.
Management of type 2 diabetes in China : the happy life club, a pragmatic cluster randomised controlled trial using health coaches
- Browning, Colette, Chapman, Anna, Yang, Hui, Liu, Shuo, Zhang, Tuohong, Enticott, Joanne, Thomas, Shane
- Authors: Browning, Colette , Chapman, Anna , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Enticott, Joanne , Thomas, Shane
- Date: 2016
- Type: Text , Journal article
- Relation: BMJ Open Vol. 6, no. 3 (2016), p.
- Full Text:
- Reviewed:
- Description: Objective: To assess the effectiveness of a coach-led motivational interviewing (MI) intervention in improving glycaemic control, as well as clinical, psychosocial and self-care outcomes of individuals with type 2 diabetes mellitus (T2DM) compared with usual care. Design: Pragmatic cluster randomised controlled trial (RCT). Setting: Community Health Stations (CHSs) in Fengtai district, Beijing, China. Participants: Of the 41 randomised CHSs (21 intervention and 20 control), 21 intervention CHSs (372 participants) and 18 control CHSs (296 participants) started participation. Intervention: Intervention participants received telephone and face-to-face MI health coaching in addition to usual care from their CHS. Control participants received usual care only. Medical fees were waived for both groups. Outcome measures: Outcomes were assessed at baseline, 6 and 12 months. Primary outcome measure was glycated haemoglobin (HbA1c). Secondary outcomes included a suite of anthropometric, blood pressure (BP), fasting blood, psychosocial and self-care measures. Results: At 12 months, no differential treatment effect was found for HbA1c (adjusted difference 0.02, 95% CI -0.40 to 0.44, p=0.929), with both treatment and control groups showing significant improvements. However, two secondary outcomes: psychological distress (adjusted difference -2.38, 95% CI -4.64 to -0.12, p=0.039) and systolic BP (adjusted difference -3.57, 95% CI -6.08 to -1.05, p=0.005) were robust outcomes consistent with significant differential treatment effects, as supported in sensitivity analyses. Interestingly, in addition to HbA1c, both groups displayed significant improvements in triglycerides, LDL cholesterol and HDL cholesterol. Conclusions: In line with the current Chinese primary healthcare reform, this study is the first large-scale cluster RCT to be implemented within real-world CHSs in China, specifically addressing T2DM. Although a differential treatment effect was not observed for HbA1c, numerous outcomes (including HbA1c) improved in both groups, supporting the establishment of regular, free clinical health checks for people with T2DM in China. Trial registration number: ISRCTN01010526; Preresults.
- Authors: Browning, Colette , Chapman, Anna , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Enticott, Joanne , Thomas, Shane
- Date: 2016
- Type: Text , Journal article
- Relation: BMJ Open Vol. 6, no. 3 (2016), p.
- Full Text:
- Reviewed:
- Description: Objective: To assess the effectiveness of a coach-led motivational interviewing (MI) intervention in improving glycaemic control, as well as clinical, psychosocial and self-care outcomes of individuals with type 2 diabetes mellitus (T2DM) compared with usual care. Design: Pragmatic cluster randomised controlled trial (RCT). Setting: Community Health Stations (CHSs) in Fengtai district, Beijing, China. Participants: Of the 41 randomised CHSs (21 intervention and 20 control), 21 intervention CHSs (372 participants) and 18 control CHSs (296 participants) started participation. Intervention: Intervention participants received telephone and face-to-face MI health coaching in addition to usual care from their CHS. Control participants received usual care only. Medical fees were waived for both groups. Outcome measures: Outcomes were assessed at baseline, 6 and 12 months. Primary outcome measure was glycated haemoglobin (HbA1c). Secondary outcomes included a suite of anthropometric, blood pressure (BP), fasting blood, psychosocial and self-care measures. Results: At 12 months, no differential treatment effect was found for HbA1c (adjusted difference 0.02, 95% CI -0.40 to 0.44, p=0.929), with both treatment and control groups showing significant improvements. However, two secondary outcomes: psychological distress (adjusted difference -2.38, 95% CI -4.64 to -0.12, p=0.039) and systolic BP (adjusted difference -3.57, 95% CI -6.08 to -1.05, p=0.005) were robust outcomes consistent with significant differential treatment effects, as supported in sensitivity analyses. Interestingly, in addition to HbA1c, both groups displayed significant improvements in triglycerides, LDL cholesterol and HDL cholesterol. Conclusions: In line with the current Chinese primary healthcare reform, this study is the first large-scale cluster RCT to be implemented within real-world CHSs in China, specifically addressing T2DM. Although a differential treatment effect was not observed for HbA1c, numerous outcomes (including HbA1c) improved in both groups, supporting the establishment of regular, free clinical health checks for people with T2DM in China. Trial registration number: ISRCTN01010526; Preresults.
Tripartite motif-containing 55 identified as functional candidate for spontaneous cardiac hypertrophy in the rat locus cardiac mass 22
- Prestes, Priscilla, Marques, Francine, Lopez-Campos, Guillermo, Booth, Scott, McGlynn, Maree, Lewandowski, Paul, Delbridge, Lea, Harrap, Stephen, Charchar, Fadi
- Authors: Prestes, Priscilla , Marques, Francine , Lopez-Campos, Guillermo , Booth, Scott , McGlynn, Maree , Lewandowski, Paul , Delbridge, Lea , Harrap, Stephen , Charchar, Fadi
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Hypertension Vol. 34, no. 5 (May 2016), p. 950-958
- Relation: http://purl.org/au-research/grants/nhmrc/1034371
- Full Text:
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- Description: Background:Left ventricular (LV) hypertrophy is a risk factor for cardiovascular death, but the genetic factors determining LV size and predisposition to hypertrophy are not well understood. We have previously linked the quantitative trait locus cardiac mass 22 (Cm22) on chromosome 2 with cardiac hypertrophy independent of blood pressure in the spontaneously hypertensive rat. From an original cross of spontaneously hypertensive rat with F344 rats, we derived a normotensive polygenic model of spontaneous cardiac hypertrophy, the hypertrophic heart rat (HHR) and its control strain, the normal heart rat (NHR).Methods and results:To identify the genes and molecular mechanisms underlying spontaneous LV hypertrophy we sequenced the HHR genome with special focus on quantitative trait locus Cm22. For correlative analyses of function, we measured global RNA transcripts in LV of neonatal HHR and NHR and 198 neonatal rats of an HHRxNHR F2 crossbred population. Only one gene within locus Cm22 was differentially expressed in the parental generation: tripartite motif-containing 55 (Trim55), with mRNA downregulation in HHR (P<0.05) and reduced protein expression. Trim55 mRNA levels were negatively correlated with LV mass in the F2 cross (r=-0.16, P=0.025). In exon nine of Trim55 in HHR, we found one missense mutation that functionally alters protein structure. This mutation was strongly associated with Trim55 mRNA expression in F2 rats (F=10.35, P<0.0001). Similarly, in humans, we found reduced Trim55 expression in hearts of subjects with idiopathic dilated cardiomyopathy.Conclusion:Our study suggests that the Trim55 gene, located in Cm22, is a novel candidate gene for polygenic LV hypertrophy independent of blood pressure.
- Authors: Prestes, Priscilla , Marques, Francine , Lopez-Campos, Guillermo , Booth, Scott , McGlynn, Maree , Lewandowski, Paul , Delbridge, Lea , Harrap, Stephen , Charchar, Fadi
- Date: 2016
- Type: Text , Journal article
- Relation: Journal of Hypertension Vol. 34, no. 5 (May 2016), p. 950-958
- Relation: http://purl.org/au-research/grants/nhmrc/1034371
- Full Text:
- Reviewed:
- Description: Background:Left ventricular (LV) hypertrophy is a risk factor for cardiovascular death, but the genetic factors determining LV size and predisposition to hypertrophy are not well understood. We have previously linked the quantitative trait locus cardiac mass 22 (Cm22) on chromosome 2 with cardiac hypertrophy independent of blood pressure in the spontaneously hypertensive rat. From an original cross of spontaneously hypertensive rat with F344 rats, we derived a normotensive polygenic model of spontaneous cardiac hypertrophy, the hypertrophic heart rat (HHR) and its control strain, the normal heart rat (NHR).Methods and results:To identify the genes and molecular mechanisms underlying spontaneous LV hypertrophy we sequenced the HHR genome with special focus on quantitative trait locus Cm22. For correlative analyses of function, we measured global RNA transcripts in LV of neonatal HHR and NHR and 198 neonatal rats of an HHRxNHR F2 crossbred population. Only one gene within locus Cm22 was differentially expressed in the parental generation: tripartite motif-containing 55 (Trim55), with mRNA downregulation in HHR (P<0.05) and reduced protein expression. Trim55 mRNA levels were negatively correlated with LV mass in the F2 cross (r=-0.16, P=0.025). In exon nine of Trim55 in HHR, we found one missense mutation that functionally alters protein structure. This mutation was strongly associated with Trim55 mRNA expression in F2 rats (F=10.35, P<0.0001). Similarly, in humans, we found reduced Trim55 expression in hearts of subjects with idiopathic dilated cardiomyopathy.Conclusion:Our study suggests that the Trim55 gene, located in Cm22, is a novel candidate gene for polygenic LV hypertrophy independent of blood pressure.
Who consults chiropractors in Victoria, Australia? : Reasons for attending, general health and lifestyle habits of chiropractic patients
- Charity, Melanie, Britt, Helena, Walker, Bruce, Gunn, Jane, Forsdike, Kirsty, Polus, Barbara, French, Simon
- Authors: Charity, Melanie , Britt, Helena , Walker, Bruce , Gunn, Jane , Forsdike, Kirsty , Polus, Barbara , French, Simon
- Date: 2016
- Type: Text , Journal article
- Relation: Chiropractic and Manual Therapies Vol. 24, no. 1 (2016), p. 1-9
- Full Text:
- Reviewed:
- Description: Background: COAST (Chiropractic Observational and Analysis STudy) reported the clinical practices of chiropractors. The aims of this study were to: 1) describe the chiropractic patient demographic and health characteristics; 2) describe patient-stated reasons for visiting a chiropractor; 3) describe chiropractic patient lifestyle characteristics; 4) compare, where possible, chiropractic patient characteristics to the general Australian population. Methods: Fifty-two chiropractors in Victoria, Australia, provided information for up to 100 consecutive encounters. If patients attended more than once during the 100 encounters, only data from their first encounter were included in this study. Where possible patient characteristics were compared with the general Australian population. Results: Data were collected from December 2010 to September 2012. Data were provided for 4464 encounters, representing 3287 unique individuals. The majority of chiropractic encounters were for musculoskeletal conditions or for wellness/maintenance. The majority of patient comorbidities were musculoskeletal, circulatory or endocrine/metabolic in nature. Eight hundred chiropractic patients (57 %, 95 % CI: 53-61) described their self-reported health as excellent or very good and 138 patients (10 %, 95 % CI: 8-12) as fair or poor. Seventy-one percent of adult male patients (18 years and older), and 53 % of adult female patients, were overweight or obese. Fourteen percent (n = 188, 95 % CI: 12-16) were current smokers and 27 % (n = 359, 95 % CI: 24-31) did not meet Australian alcohol consumption guidelines. Less than half of the chiropractic patients participated in vigorous exercise at least twice per week. Approximately 20 % ate one serving of vegetables or less each day, and approximately 50 % ate one serve of fruit or less each day. Compared to the general Australian population, chiropractic patients were less likely to smoke, less likely to be obese and more likely to describe their health in positive terms. However, many patients were less likely to meet alcohol consumption guidelines, drinking more than is recommended. Conclusions: In general, chiropractic patients had more positive health and lifestyle characteristics than the Australian population. However, there were a significant proportion of chiropractic patients who did not meet guideline recommendations about lifestyle habits and there is an opportunity for chiropractors to reinforce public health messages with their patients. © 2016 The Author(s).
- Authors: Charity, Melanie , Britt, Helena , Walker, Bruce , Gunn, Jane , Forsdike, Kirsty , Polus, Barbara , French, Simon
- Date: 2016
- Type: Text , Journal article
- Relation: Chiropractic and Manual Therapies Vol. 24, no. 1 (2016), p. 1-9
- Full Text:
- Reviewed:
- Description: Background: COAST (Chiropractic Observational and Analysis STudy) reported the clinical practices of chiropractors. The aims of this study were to: 1) describe the chiropractic patient demographic and health characteristics; 2) describe patient-stated reasons for visiting a chiropractor; 3) describe chiropractic patient lifestyle characteristics; 4) compare, where possible, chiropractic patient characteristics to the general Australian population. Methods: Fifty-two chiropractors in Victoria, Australia, provided information for up to 100 consecutive encounters. If patients attended more than once during the 100 encounters, only data from their first encounter were included in this study. Where possible patient characteristics were compared with the general Australian population. Results: Data were collected from December 2010 to September 2012. Data were provided for 4464 encounters, representing 3287 unique individuals. The majority of chiropractic encounters were for musculoskeletal conditions or for wellness/maintenance. The majority of patient comorbidities were musculoskeletal, circulatory or endocrine/metabolic in nature. Eight hundred chiropractic patients (57 %, 95 % CI: 53-61) described their self-reported health as excellent or very good and 138 patients (10 %, 95 % CI: 8-12) as fair or poor. Seventy-one percent of adult male patients (18 years and older), and 53 % of adult female patients, were overweight or obese. Fourteen percent (n = 188, 95 % CI: 12-16) were current smokers and 27 % (n = 359, 95 % CI: 24-31) did not meet Australian alcohol consumption guidelines. Less than half of the chiropractic patients participated in vigorous exercise at least twice per week. Approximately 20 % ate one serving of vegetables or less each day, and approximately 50 % ate one serve of fruit or less each day. Compared to the general Australian population, chiropractic patients were less likely to smoke, less likely to be obese and more likely to describe their health in positive terms. However, many patients were less likely to meet alcohol consumption guidelines, drinking more than is recommended. Conclusions: In general, chiropractic patients had more positive health and lifestyle characteristics than the Australian population. However, there were a significant proportion of chiropractic patients who did not meet guideline recommendations about lifestyle habits and there is an opportunity for chiropractors to reinforce public health messages with their patients. © 2016 The Author(s).