Anxiety online-A virtual clinic: Preliminary outcomes following completion of five fully automated treatment programs for anxiety disorders and symptoms
- Authors: Klein, Britt , Meyer, Denny , Austin, David , Kyrios, Michael
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Medical Internet Research Vol. 13, no. 4 (2011), p.
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- Description: Background: The development of e-mental health interventions to treat or prevent mental illness and to enhance wellbeing has risen rapidly over the past decade. This development assists the public in sidestepping some of the obstacles that are often encountered when trying to access traditional face-to-face mental health care services. Objective: The objective of our study was to investigate the posttreatment effectiveness of five fully automated self-help cognitive behavior e-therapy programs for generalized anxiety disorder (GAD), panic disorder with or without agoraphobia (PD/A), obsessive-compulsive disorder (OCD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD) offered to the international public via Anxiety Online, an open-access full-service virtual psychology clinic for anxiety disorders. Methods: We used a naturalistic participant choice, quasi-experimental design to evaluate each of the five Anxiety Online fully automated self-help e-therapy programs. Participants were required to have at least subclinical levels of one of the anxiety disorders to be offered the associated disorder-specific fully automated self-help e-therapy program. These programs are offered free of charge via Anxiety Online. Results: A total of 225 people self-selected one of the five e-therapy programs (GAD, n = 88; SAD, n = 50; PD/A, n = 40; PTSD, n = 30; OCD, n = 17) and completed their 12-week posttreatment assessment. Significant improvements were found on 21/25 measures across the five fully automated self-help programs. At postassessment we observed significant reductions on all five anxiety disorder clinical disorder severity ratings (Cohen d range 0.72-1.22), increased confidence in managing one's own mental health care (Cohen d range 0.70-1.17), and decreases in the total number of clinical diagnoses (except for the PD/A program, where a positive trend was found) (Cohen d range 0.45-1.08). In addition, we found significant improvements in quality of life for the GAD, OCD, PTSD, and SAD e-therapy programs (Cohen d range 0.11-0.96) and significant reductions relating to general psychological distress levels for the GAD, PD/A, and PTSD e-therapy programs (Cohen d range 0.23-1.16). Overall, treatment satisfaction was good across all five e-therapy programs, and posttreatment assessment completers reported using their e-therapy program an average of 395.60 (SD 272.2) minutes over the 12-week treatment period. Conclusions: Overall, all five fully automated self-help e-therapy programs appear to be delivering promising high-quality outcomes; however, the results require replication. © Britt Klein, Denny Meyer, David William Austin, Michael Kyrios.
Asian migrants' lived experience and acculturation to western health care in rural Tasmania
- Authors: Terry, Daniel , Ali, Mohammed , Lê, Quynh
- Date: 2011
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 19, no. 6 (2011), p. 318-323
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- Description: Objectives: The study was designed to explore the lived experience of Asian migrants' health care-seeking behaviour in Tasmania, to discern the acculturation process by which Asian migrants are enabled to use the health system and to identify strategies, which assist migrants to understand and use the health system better. Methods: Qualitative research was adopted. Semistructured interviews were conducted with 36 Asian migrants residing in North, South and North West Tasmania, which were recruited through purposive sampling. Results: Six main themes emerged from the interviews: the acculturation process, interactions with the health care system, access issues, culturally appropriate health care, positive health care in Tasmania and suggestions for improving health care. Conclusions: The findings indicated that Asian migrants' views affected their health care-seeking behaviours because of the lack of information, poor communication, limited access and choices in Tasmania. Interestingly, those married to local Tasmanians had the shortest trajectory to health system acculturation. The study recommended developing health and well-being for Asian migrants by increasing access to information regarding navigating the health system and improving access to and awareness of language services. In addition, ensuring adequate, appropriately written, culturally specific and congruent information should be available to assist migrants' transition into a new health care system. Lastly, greater cultural awareness within the health profession to meet the needs of culturally specific individuals and communities is required when they seek care. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.
Association of genetic variation with systolic and diastolic blood pressure among African Americans: the Candidate Gene Association Resource study
- Authors: Fox, Ervin , Young, J. Hunter , Li, Yali , Dreisbach, Albert , Charchar, Fadi
- Date: 2011
- Type: Text , Journal article
- Relation: Human molecular genetics Vol. 20, no. 11 (June 2011), p. 2273
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- Description: The prevalence of hypertension in African Americans (AAs) is higher than in other US groups; yet, few have performed genome-wide association studies (GWASs) in AA. Among people of European descent, GWASs have identified genetic variants at 13 loci that are associated with blood pressure. It is unknown if these variants confer susceptibility in people of African ancestry. Here, we examined genome-wide and candidate gene associations with systolic blood pressure (SBP) and diastolic blood pressure (DBP) using the Candidate Gene Association Resource (CARe) consortium consisting of 8591 AAs. Genotypes included genome-wide single-nucleotide polymorphism (SNP) data utilizing the Affymetrix 6.0 array with imputation to 2.5 million HapMap SNPs and candidate gene SNP data utilizing a 50K cardiovascular gene-centric array (ITMAT-Broad-CARe [IBC] array). For Affymetrix data, the strongest signal for DBP was rs10474346 (P= 3.6 × 10−8) located near GPR98 and ARRDC3. For SBP, the strongest signal was rs2258119 in C21orf91 (P= 4.7 × 10−8). The top IBC association for SBP was rs2012318 (P= 6.4 × 10−6) near SLC25A42 and for DBP was rs2523586 (P= 1.3 × 10−6) near HLA-B. None of the top variants replicated in additional AA (n = 11 882) or European-American (n = 69 899) cohorts. We replicated previously reported European-American blood pressure SNPs in our AA samples (SH2B3, P= 0.009; TBX3-TBX5, P= 0.03; and CSK-ULK3, P= 0.0004). These genetic loci represent the best evidence of genetic influences on SBP and DBP in AAs to date. More broadly, this work supports that notion that blood pressure among AAs is a trait with genetic underpinnings but also with significant complexity.
Attitude and behaviour of junior rugby union players towards tackling during training and match play
- Authors: Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Safety Science Vol. 50, no. 4 (April 2012), p. 1157
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Challenges in the development of standards for synthetic turf for Australian football and cricket
- Authors: Twomey, Dara , Otago, Leonie , Saunders, Natalie
- Date: 2011
- Type: Text , Journal article
- Relation: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology Vol. 225, no. 2 (June 2011 2011), p. 93-101
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- Description: Given the escalating drought conditions in Australia, synthetic surfaces have recently been explored as a viable surface option for community-level Australian football-cricket ovals. The vast majority of Australian football ovals are transformed into cricket pitches during the football off-season and hence the characteristics of both sports had to be duly considered in the development of standards that could be tested in a laboratory setting, for a synthetic turf surface. This paper describes the data collection and test methods undertaken in the development of the standards for synthetic surface use in Australian football and cricket. The paper also discusses the issues and challenges encountered during the development of standards for multi-sport synthetic surfaces to ensure player safety while maintaining the performance characteristics of both sports. Surface property and ball interaction tests were undertaken on natural playing surfaces, both in situ and in the laboratory to determine the properties of the current playing surface for each sport. This paper highlights the importance of careful consideration of the characteristics of both games and the use of equipment from both sports in the testing methods. The standards described in this paper have now been accepted by the Australian Football League and Cricket Australia and the product approval process and use of synthetic surfaces for Australian football and cricket is imminent.
Factors that make the health care professions an attractive career option in East Malaysia
- Authors: Birks, Melanie , Coyle, Meaghan , Porter, Joanne , Mills, Jane
- Date: 2011
- Type: Text , Journal article
- Relation: Singapore Nursing Journal Vol. 38, no. 1 (2011), p.18-22
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- Description: A shortage of health care professionals, particularly nurses, has led to the development of strategies to increase recruitment to these disciplines. This paper describes the findings of a study of factors that attract nurses and related health care professionals to their chosen discipline. A survey design was employed, in which a questionnaire was administered at a research seminar with the intent of demonstrating the conduct of research in real time. Seventy-six health care professionals participated in this survey. Most respondents were female and employed as nurses. The mean age of participants was 39 years. The ability to help others, training being provided and job security were rated highly by respondents as factors attracting them to their profession, along with the ability that to combine work and family commitments. While the findings reported here reflect some similarities with those of earlier studies, the demographically different sample may account for many of the differences.
Genome-wide association study identifies loci influencing concentrations of liver enzymes in plasma
- Authors: Chambers, John , Zhang, Weihua , Sehmi, Joban , Li, Xinzhong , Wass, Mark N , van der Harst, Pim , Holm, Hilma , Sanna, Serena , Kavousi, Maryam , Charchar, Fadi
- Date: 2011
- Type: Text , Journal article
- Relation: Nature genetics Vol. 43, no. 11 (2011), p. 1131-1138
- Full Text: false
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- Description: Concentrations of liver enzymes in plasma are widely used as indicators of liver disease. We carried out a genome-wide association study in 61,089 individuals, identifying 42 loci associated with concentrations of liver enzymes in plasma, of which 32 are new associations (P = 10−8 to P = 10−190). We used functional genomic approaches including metabonomic profiling and gene expression analyses to identify probable candidate genes at these regions. We identified 69 candidate genes, including genes involved in biliary transport (ATP8B1 and ABCB11), glucose, carbohydrate and lipid metabolism (FADS1, FADS2, GCKR, JMJD1C, HNF1A, MLXIPL, PNPLA3, PPP1R3B, SLC2A2 and TRIB1), glycoprotein biosynthesis and cell surface glycobiology (ABO, ASGR1, FUT2, GPLD1 and ST3GAL4), inflammation and immunity (CD276, CDH6, GCKR, HNF1A, HPR, ITGA1, RORA and STAT4) and glutathione metabolism (GSTT1, GSTT2 and GGT), as well as several genes of uncertain or unknown function (including ABHD12, EFHD1, EFNA1, EPHA2, MICAL3 and ZNF827). Our results provide new insight into genetic mechanisms and pathways influencing markers of liver function. 137 authors
Implementation and dissemination research: the time has come!
- Authors: Finch, Caroline
- Date: 2011
- Type: Text , Editorial , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 10 (August 2011), p. 763-764
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: In a provocative statement in a very recent issue of the American Journal of Preventive Medicine, Kessler and Glasgow have called for a 10-year moratorium on effi cacy randomised controlled trials (RCTs) in health and health services research. The authors argue that much intervention research has had minimal impact on both policy and practice because the very nature of effi cacy studies means that focus has had to be on a limited number of specifi c causal and preventive factors; this ignores both the complexity of real-world implementation and the multilevel ecological context in which interventions need to be conducted. I have also previously discussed those same limitations as they apply to sports injury prevention studies, most recently as part of my keynote address at the 2011 International Olympic Committee World Conference on The Prevention of Injury and Illness in Sport, to be published in a forthcoming issue of BJSM.
Implementing an exercise-training programme to prevent lower-limb injuries : Considerations for the development of a randomised controlled trial intervention delivery plan
- Authors: Finch, Caroline , White, Peta , Twomey, Dara , Ullah, Shahid
- Date: 2011
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 10 (2011), p. 791-796
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objective To identify important considerations for the delivery of an exercise training intervention in a randomised controlled trial to maximise subsequent participation in that randomised controlled trial and intervention uptake. Design A cross-sectional survey, with a theoretical basis derived from the Health Belief Model (HBM) and the Reach, Efficacy/Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Participants 374 male senior Australian Football players, aged 17-38 years. Main outcome measurements Beliefs about lowerlimb injury causation/prevention, and the relative value of exercise training for performance and injury prevention. The data are interpreted within HBM constructs and implications for subsequent intervention implementation considered within the RE-AIM framework. Ordinal logistic regression compared belief scores across player characteristics. Results 74.4% of players agreed that doing specific exercises during training would reduce their risk of lower-limb injury and would be willing to undertake them. However, 64.1% agreed that training should focus more on improving game performance than injury prevention. Younger players (both in terms of age and playing experience) generally had more positive views. Players were most supportive of kicking (98.9%) and ball-handling (97.0%) skills for performance and warm-up runs and cool-downs (both 91.5%) for injury prevention. Fewer than three-quarters of all players believed that balance (69.2%), landing (71.3%) or cutting/stepping (72.8) training had injury-prevention benefits. Conclusions Delivery of future exercise training programmes for injury prevention aimed at these players should be implemented as part of routine football activities and integrated with those as standard practice, as a means of associating them with training benefits for this sport.
Lack of caregiver supervision : A contributing factor in Australian unintentional child drowning deaths, 2000-2009
- Authors: Petrass, Lauren , Blitvich, Jennifer , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 194, no. 5 (2011), p. 228-231
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/565904
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- Description: Objectives: To establish how frequently supervision was explicitly identified as a factor in coroner-certified unintentional drowning deaths of children in Australia, and to determine the percentage of cases where failure of supervision may have been a contributing factor; also, to identify the proportion of cases with coroners' recommendations relating to supervision and unintentional child drownings. Design and setting: Retrospective case-series analysis of unintentional drowning deaths of children (aged 0-14 years) in Australia from 1 July 2000 to 30 June 2009, based on data from the National Coroners Information System (NCIS). Main outcome measures: Number of unintentional child drownings and the extent to which supervisory factors were formally reported by coroners as a contributing factor; proportion of cases with coroners' findings that also had coroners' recommendations. Results: 339 relevant child drownings were identified within the 9-year period. Supervision (or lack thereof) was identified as a contributing factor in 71.7%. However, specific detail about the nature and extent of supervision varied across these cases. The availability of text documents describing the findings (police reports, coroners' findings, autopsy reports, toxicology reports), and the level of detail within these documents, also varied considerably across jurisdictions. Despite almost half (47.2%) of the closed cases having coroners' findings attached, only 15% of these also included specific coroners' recommendations. Conclusion: Lack of adequate supervision, or lack thereof, is a significant problem associated with fatal drownings of children in Australia. There is a need to improve the standard and consistency of information contained in text documents within the NCIS to provide more useful information for preventing child drowning deaths.
Mild traumatic brain injury among a cohort of rugby union players: predictors of time to injury
- Authors: Hollis, Stephanie , Stevenson, Mark , McIntosh, Andrew , Li, Ling , Heritier, Stephane , Shores, E Arthur , Collins, Michael , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 12 (2011), p. 997-999
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- Description: This study reports the time to sustain a mild traumatic brain injury (mTBI) among a cohort of community rugby union players. Demographic and player characteristics were collected and players followed up for between one and three playing seasons. 7% of the cohort sustained an mTBI within 10 h of game time, increasing twofold to 14% within 20 h. The mean time to first mTBI was 8 h with an SD of 6.2 (median 6.8 h; IQR: 2.9–11.7 h). Players reporting a recent history of concussion were 20% more likely to sustain an mTBI after 20 h of game time compared with those with no recent history of concussion. Players were likely to sustain an mTBI in shorter time if they trained for <3 h/week (HR=1.48, p=0.03) or had a body mass index <27 (HR=1.77, p=0.007). The findings highlight modifiable characteristics to reduce the likelihood of shortened time to mTBI.
Multilocus sequence typing of Streptococcus pneumoniae by use of mass spectrometry
- Authors: Dunne, Eileen , Ong, Engkok , Moser, Ralf , Siba, Peter , Phuanukoonnon, Suparat , Greenhill, Andrew , Robins-Browne, Roy , Mulholland, Edward , Satzke, Catherine
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Clinical Microbiology Vol. 49, no. 11 (2011), p. 3756-3760
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- Description: Multilocus sequence typing (MLST) is an important tool for the global surveillance of bacterial pathogens that is performed by comparing the sequences of designated housekeeping genes. We developed and tested a novel mass spectrometry-based method for MLST of Streptococcus pneumoniae. PCR amplicons were subjected to in vitro transcription and base-specific cleavage, followed by analysis of the resultant fragments by using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Comparison of the cleavage fragment peak patterns to a reference sequence set permitted automated identification of alleles. Validation experiments using 29 isolates of S. pneumoniae revealed that the results of MALDI-TOF MS MLST matched those obtained by traditional sequence-based MLST for 99% of alleles and that the MALDITOF MS method accurately identified two single-nucleotide variations. The MADLI-TOF MS method was then used for MLST analysis of 43 S. pneumoniae isolates from Papua New Guinean children. The majority of the isolates present in this population were not clonal and contained seven new alleles and 30 previously unreported sequence types.
No longer lost in translation : The art and science of sports injury prevention implementation research
- Authors: Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 16 (December 2011), p. 1253-1257
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
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- Description: It is now understood that sports injury interventions will not have significant public health impact if they are not widely accepted and adopted by target sports participants. Although there has been increasing recognition of the need for intervention studies conducted within the real-world context of sports delivery, very few studies have been conducted in this important area. A major reason for this is that there are significant challenges in conducting implementation research; the more traditional sports medicine approaches may not be fully appropriate and new ways of thinking about how to design, conduct and report such research is needed. Moreover, real-world implementation of sports injury interventions and evaluation of their effectiveness needs to start to take into account the broad ecological context in which they are introduced, as well as considering the best way to translate this knowledge to reach the audiences who most need to benefit from such research. This overview paper provides perspectives and guidance on the design, conduct and evaluation of sports injury intervention implementation studies, including better understanding of the complexity of the ecological settings for intervention delivery. Some conceptual approaches that could be adopted in future implementation studies are discussed; particular emphasis is given to Intervention Mapping as a tool to assist intervention development, Diffusion of Innovations Theory to guide the planning of intervention strategies and the RE-AIM (reach, effectiveness, adoption, implementation and maintenance) framework for programme evaluation and programme design. Finally, a broad agenda for this emerging important field of sports medicine research is outlined.
Predictors of support service use by rural and regional men with cancer
- Authors: Corboy, Denise , McLaren, Suzanne , McDonald, John
- Date: 2011
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 19, no. 4 (2011), p. 185-190
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- Description: Objective: The current study examined how sociodemographic, psychological, physical and social support variables predict participation in formal support services. Design: Cross-sectional study. Setting: Participants were recruited from oncology clinics, cancer specialist clinics and cancer support groups. Participants: Seventy-six men living outside major Australian cities, the majority with prostate cancer (n=55). Main outcome measures: Participants completed the Brief Symptom Inventory, the List of Physical Complaints, the Social Support Subscale of the Coping Resources Inventory and questionnaires related to levels of awareness of, and participation in support services. Results: Most (82%) of the men were aware of at least one formal service offering emotional support, and 49% of the men had used such a service. Telephone- and Internet-based services were the most used type of support. The only predictor of participation in a formal service was lower age. Conclusions: Use of a support service was not predicted by psychological or physical symptoms, levels of social support or distance from service centres. Attitudes to different types of services, and support services in general, might be more predictive of actual use. The current findings point to the potential of telephone- and Internet-based support as an acceptable means of formal support for rural and regional men who experience cancer-related distress. © 2011 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.
Reliability of equipment for measuring the ground hardness and traction
- Authors: Twomey, Dara , Otago, Leonie , Ullah, Shahid , Finch, Caroline
- Date: 2011
- Type: Text , Journal article
- Relation: Proceedings of the Institution of Mechanical Engineers, Part P: Journal of Sports Engineering and Technology Vol. 225, no. 3 (2011), p. 131-137
- Full Text: false
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- Description: The aim of this paper is to report the inter-rater reliabilities and intra-rater reliabilities of the Clegg hammer, penetrometer, and studded-boot apparatus used for measuring the mechanical properties of natural turf, and to determine whether the level of experience influences the reliability. Three experienced and three novice testers measured the surface hardness and rotational traction at nine locations on a community-level Australian football oval. A repeated-measures analysis of variance tested for significant differences between the six testers for all equipment, and intra-class correlation coefficients (ICCs) were calculated to determine the inter-rater reliabilities and intra-rater reliabilities. The ICCs for the reliability between the six testers ranged between 0.77 and 0.87 for the Clegg hammer, ranged between 0.55 and 0.73 for the penetrometer, and equalled 0.51 for the studded-boot apparatus. The inter-rater reliabilities and intra-rater reliabilities were greater for the experienced testers than for the novice testers for the Clegg hammer and penetrometer but the novice testers produced greater inter-rater reliabilities for the studded-boot apparatus. This study highlights the potential variability that can exist between testers using the ground hardness and traction equipment, which has implications for future research involving multiple testers both in agronomic-based studies and in linking the surface properties to the injury risk across multiple venues. © Authors 2011.
Setting our minds to implementation
- Authors: Verhagen, Evert , Finch, Caroline
- Date: 2011
- Type: Text , Editorial , Journal article
- Relation: British Journal of Sports Medicine Vol. 45, no. 13 (2011), p.1015-1016
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Full Text: false
- Reviewed:
- Description: It is now well accepted that to prevent sports injuries we need more intervention studies. Therefore, it is somewhat alarming that most sports injury studies still only focus on the fi rst two steps of the four-step prevention sequence of van Mechelen et al: only counting injuries and describing causal factors. This has clearly been shown by Klügl et al, who reviewed approximately 5274 original sports injury publications, of which only 492 studies intended to establish the preventive value of a measure or programme. This review showed that although the number of efficacy/effectiveness studies has slowly increased over the years, this is still lagging behind the approximately 4000 descriptive and aetiological studies.
Walking to wellness in an ageing sedentary university community: design, method and protocol,
- Authors: Mackey, Martin , Bohle, Philip , Taylor, Philip , Biase, Tia , McLoughlin, Christopher , Purnell, Katherine
- Date: 2011
- Type: Text , Journal article
- Relation: Contemporary Clinical Trials Vol. 32, no. 2 (2011), p. 273-279
- Full Text: false
- Reviewed:
- Description: BACKGROUND: Older workers are less physically active and have a higher rate and cost of injury than younger workers and so have reduced work-ability. Concurrently, sedentary behaviour in the workplace, in transport and in the home is increasing and has harmful health effects. Walking is a familiar, convenient, and free form of health-enhancing physical activity that can be integrated into working life and sustained into older age however workplace walking programs targeted at older workers have not been evaluated. PURPOSE: We designed a randomised-controlled trial to evaluate the impact of a phased individually-tailored 10-week walking program on work-day steps, health status and work-ability of employees at an Australian university with an ageing sedentary workforce. METHODS: A convenience sample of 154 academic and administrative employees aged 45-70 years will be recruited and randomly allocated to either an experimental (walking) group or control (maintain usual activity) group. Participants will be provided with a pedometer and complete measures for step count, % body fat, waist circumference, blood pressure, self-reported physical activity, psychological wellbeing and work-ability, at baseline and end-intervention. 'Walkers' will select approaches tailored to their individual preference, psychological characteristics or life circumstances. Two distinct intervention phases will target adoption (weeks 2-5) and adherence (weeks 7-12) using 'Stages of Behaviour Change' principles. An ANOVA will test for effect of treatment on outcome with the baseline value entered as a covariate. DISCUSSION: This study will test whether tailoring worksite walking is an effective means of promoting health-enhancing physical activity in ageing sedentary workers.
Bloodstream infections caused by resistant bacteria in surgical patients admitted to Modilon Hospital, Madang
- Authors: Asa, Henao , Laman, Moses , Greenhill, Andrew , Siba, Peter , Davis, Timothy , Maihua, John , Manning, Laurens
- Date: 2012
- Type: Text , Journal article
- Relation: Papua and New Guinea Medical Journal Vol. 55, no. 1-4 (2012), p. 5-11
- Full Text: false
- Reviewed:
- Description: In view of the dearth of information relating to antibiotic resistance in community- and hospital-acquired bacterial infections in Papua New Guinea (PNG), we carried out a prospective, hospital-based observational study of surgical patients between October 2008 and October 2009. In a sample of 115 patients (median age 30 years; 55% males) suspected of having a bloodstream infection, blood cultures were positive in 11 (10%) and a significant pathogen was isolated in 9 (8%). Staphylococcus aureus was isolated in 4 patients (44%) and 3 were methicillin resistant; all these isolates were considered community acquired because cultures were performed within 48 hours of admission. Of the remaining 5 isolates, 4 were Gram-negative organisms with at least intermediate resistance to chloramphenicol that were grown from blood taken > 48 hours post-admission and thus considered nosocomially acquired. These data suggest two distinct patterns of bacterial infection in PNG surgical inpatients that have implications for national antibiotic prescription guidelines.
Cancer incidence and soil arsenic exposure in a historical gold mining area in Victoria, Australia : A geospatial analysis
- Authors: Pearce, Dora , Dowling, Kim , Sim, Malcolm
- Date: 2012
- Type: Text , Journal article
- Relation: Journal of Exposure Science and Environmental Epidemiology Vol. 22, no. 3 (2012), p. 248-257
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- Description: Soil and mine waste around historical gold mining sites may have elevated arsenic concentrations. Recent evidence suggests some systemic arsenic absorption by residents in the goldfields region of Victoria, Australia. Victorian Cancer Registry and geochemical data were accessed for an ecological geographical correlation study, 1984-2003. Spatial empirical Bayes smoothing was applied when estimating standardised incidence ratios (SIRs) for cancers in 61 statistical local areas. The derived soil arsenic exposure metric ranged from 1.4 to 1857 mg/kg. Spatial autoregressive modelling detected increases in smoothed SIRs for all cancers of 0.05 (95% confidence interval (CI), 0.02-0.08) and 0.04 (0.01-0.07) per 2.7-fold increase in the natural log-transformed exposure metric for males and females, respectively, in more socioeconomically disadvantaged areas; for melanoma in males (0.05 (0.01-0.08) adjusted for disadvantage) and females (0.05 (0.02-0.09) in disadvantaged areas). Excess risks were estimated for all cancers (relative risk 1.21 (95% CI, 1.15-1.27) and 1.08 (1.03-1.14)), and melanoma (1.52 (1.25-1.85) and 1.29 (1.08-1.55)), for males and females, respectively, in disadvantaged areas in the highest quintile of the exposure metric relative to the lowest. Our findings suggest small but significant increases in past cancer risk associated with increasing soil arsenic in socioeconomically disadvantaged areas and demonstrate the robustness of this geospatial approach. Journal of Exposure Science and Environmental Epidemiology advance online publication, 21 March 2012.
Changes in knee joint biomechanics following balance and technique training and a season of Australian football
- Authors: Donnelly, Cyril , Elliot, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
- Date: 2012
- Type: Text , Journal article
- Relation: British Journal of Sports Medicine Vol. 46, no. 13 (October 2012 2012), p. 917-922
- Full Text: false
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- Description: Purpose: Determine if balance and technique training (BTT) implemented adjunct to normal Australian football (AF) training reduces external knee loading during sidestepping. Additionally, the authors determined if an athlete's knee joint kinematics and kinetics change over a season of AF. Methodology: Eight amateur-level AF clubs (n=1,001 males) volunteered to participate in either 28 weeks of BTT or a ‘sham’ training (ST) adjunct to their normal preseason and regular training. A subset of 34 athletes (BTT, n=20; ST, n=14) were recruited for biomechanical testing in weeks 1–7 and 18–25 of the 28-week training intervention. During biomechanical testing, participants completed a series running, preplanned (PpSS) and unplanned sidestepping (UnSS) tasks. A linear mixed model (a=0.05) was used to determine if knee kinematics and peak moments during PpSS and UnSS were influenced by BTT and/or a season of AF Results: Both training groups significantly (p=0.025) decreased their peak internal-rotation knee moments during PpSS, and significantly (p=0.022) increased their peak valgus knee moments during UnSS following their respective training interventions. Conclusions: BTT was not effective in changing an athlete's knee joint biomechanics during sidestepping when conducted in ‘real-world’ training environments. Following normal AF training, the players had different changes to their knee joint biomechanics during both preplanned and unplanned sidestepping. When performing an unplanned sidestepping task in the latter half of a playing season, athletes are at an increased risk of ACL injury. The authors therefore recommend both sidestepping tasks are performed during biomechanical testing when assessing the effectiveness of prophylactic training protocols.