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1.
Nutr Metab Cardiovasc Dis ; 34(1): 98-106, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38016890

RESUMEN

BACKGROUND AND AIMS: Gender differences in cardiovascular disease (CVD) have been well documented but rarely for young adults and the extent to which gender related lifestyle differences may contribute to gender differences in CVD risk experienced by young adults have not been reported. METHODS AND RESULTS: Data are from a long-running cohort study, the Mater-University of Queensland Study of Pregnancy (MUSP). We track gender differences in CVD related behaviours at 21 and 30 years (consumption of a Western Diet/Health-Oriented Diet, cigarette smoking, vigorous physical exercise, heavy alcohol consumption). At 30 years we compare males and females for CVD risk, and the extent to which lifestyle behaviours at 21 and 30 years contribute to CVD risk. At both 21 and 30 years of age, males more frequently consume a Western Diet and less often a Health Oriented Diet. By contrast, males are also much more likely to report engaging in vigorous physical activity. On most CVD markers, males exhibit much higher levels of risk than do females at both 21 and 30 years. At 30 years of age males have about five times the odds of being at high risk of CVD. Some lifestyle behaviours contribute to this additional risk. CONCLUSION: Young adult males much more frequently engage in most CVD related risk behaviours and males have a higher level of CVD risk. Gender differences in CVD risk remain high even after adjustment for CVD lifestyles, though dietary factors independently contribute to CVD risk at 30 years.


Asunto(s)
Enfermedades Cardiovasculares , Masculino , Femenino , Adulto Joven , Humanos , Adolescente , Adulto , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Estudios de Cohortes , Factores Sexuales , Dieta/efectos adversos , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Factores de Riesgo
2.
Child Psychiatry Hum Dev ; 53(4): 701-714, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-33788054

RESUMEN

A large number of early life exposures predict child maltreatment. Using data from a 30-year birth cohort study we examine 12 early life course risk factors of four types of self-reported childhood maltreatment recalled at the 30-year follow-up. Of the 7223 children in the sample at birth, 2425 responded to the Child Trauma Questionnaire at the 30-year follow-up. On adjusted analysis being a teenage mother predicts childhood physical and sexual abuse, as well as child neglect. More numerous maternal marital partner changes in the 5 years after the birth predict offspring experiences of emotional abuse, sexual abuse and childhood neglect. Policy responses should focus on the broad social context in which children are reared as the most effective approach to reducing the high level of childhood abuse and neglect.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños , Maltrato a los Niños , Adolescente , Adultos Sobrevivientes del Maltrato a los Niños/psicología , Niño , Maltrato a los Niños/psicología , Estudios de Cohortes , Humanos , Recién Nacido , Estudios Prospectivos , Encuestas y Cuestionarios
3.
BMC Psychiatry ; 21(1): 359, 2021 07 17.
Artículo en Inglés | MEDLINE | ID: mdl-34273942

RESUMEN

BACKGROUND: There is concern that rates of mental disorders may be increasing although findings disagree. Using an innovative design with a daughter-mother data set we assess whether there has been a generational increase in lifetime ever rates of major depressive disorder, generalised anxiety disorder, panic disorder, and post-traumatic stress disorder (PTSD) experienced prior to 30 years of age. METHODS: Pregnant women were recruited during 1981-1983 and administered the Composite International Diagnostic Interview (CIDI) at the 27-year follow-up (2008-11). Offspring were administered the CIDI at the 30-year follow-up (2010-2014). Comparisons for onset of diagnosis are restricted to daughter and mother dyads up to 30 years of age. To address recall bias, disorders were stratified into more (≥12 months duration) and less persistent episodes (< 12 months duration) for the purposes of comparison. Sensitivity analyses with inflation were used to account for possible maternal failure to differentially recall past episodes. RESULTS: When comparing life time ever diagnoses before 30 years, daughters had higher rates of persistent generalised anxiety disorder, and less persistent major depressive disorder, generalised anxiety disorder and PTSD. CONCLUSIONS: In the context of conflicting findings concerning generational changes in mental disorders we find an increase in generational rates of persistent generalised anxiety disorders and a range of less persistent disorders. It is not clear whether this finding reflects actual changes in symptom levels over a generation or whether there has been a generational change in recognition of and willingness to report symptoms of mental illness.


Asunto(s)
Trastorno Depresivo Mayor , Trastorno de Pánico , Trastornos por Estrés Postraumático , Trastornos de Ansiedad/diagnóstico , Trastornos de Ansiedad/epidemiología , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/epidemiología , Femenino , Humanos , Madres , Embarazo , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/epidemiología
4.
BMC Womens Health ; 21(1): 348, 2021 10 04.
Artículo en Inglés | MEDLINE | ID: mdl-34607596

RESUMEN

BACKGROUND: While women are taking a greater role in decisions about menopause symptom management, the legacy of the Women's Health Initiative (WHI) studies persist. Despite hormone therapy (HT) being effective in reducing all-cause mortality, many women seeking relief of menopausal symptoms exaggerate HT harms and overstate the perceived benefits or ignore the risks of alternative therapies. We aimed to explore the longitudinal impact of the widely-publicised WHI 2002 study on women's information-seeking and describe determinants of decision-making about managing menopausal symptoms. METHODS: In a longitudinal analysis of both quantitative and qualitative data, we explored consumer questions about menopause-related medicines received by two Australian medicines call centres (1996-2010) before, during, and after WHI 2002. We analysed calls by age and gender of caller and patient, their relationship, postcode, enquiry type, and motivation to help-seek. We compared calls regarding HT and herbal medicines (HM) with the rest of calls, and thematically analysed question narratives across the three time-periods. RESULTS: There were 1,829 menopause-related calls received of over this time-period, with a call surge, primarily from women in their mid-fifties, in the two months after the WHI 2002 publication. Two in three calls were motivated by negative media reports as women sought support for decision-making, primarily reassurance to cease HT. While HT safety concerns persisted for eight years post-publication, the nature of information-seeking changed over time. Callers subsequently sought reassurance to use menopause treatments together with their other medicines; and pursued HT substitutes, including HM, in response to HT product discontinuation. CONCLUSIONS: Women sought information or reassurance to support a decision, based on dynamic changes in internal (symptom or risk intolerance, attitude towards menopause and treatment preferences) and external factors (perceived source trust and changes in treatment availability). In assessing HT benefit versus risk, women tend to overestimate risk with HT safety concerns persisting over time. Decision-making in managing menopause symptoms is complex and dynamic. Reassurance to reach or justify decisions from a perceived trusted source can support informed decision-making.


Asunto(s)
Centrales de Llamados , Conducta en la Búsqueda de Información , Australia , Terapia de Reemplazo de Estrógeno , Femenino , Humanos , Menopausia , Salud de la Mujer
5.
Soc Psychiatry Psychiatr Epidemiol ; 55(5): 611-620, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31912167

RESUMEN

PURPOSE: The current longitudinal study examines the temporal association between different types of intimate partner violence (IPV) at early adulthood (21 years) and subsequent depression and anxiety disorders in young adulthood (30 years). METHODS: Participants were from the Mater-University of Queensland Study of Pregnancy. A cohort of 1529 was available for analysis. IPV was measured using the Composite Abuse Scale at 21 years. At the 21 and 30-year follow-ups, major depression disorder and anxiety disorders were measured using the Composite International Diagnostic Interview. RESULTS: We found a temporal relationship between almost all forms of IPV at 21 years and females' new cases of major depression disorder at 30 years. This association was not found for females who had previously been diagnosed with depression disorder. IPV did not predict the onset of new anxiety disorders, but it had a robust association with anxiety disorders in females with a previous anxiety diagnosis. We observed no significant link between IPV and males' subsequent major depression disorder. Interestingly, the experience of emotional abuse was a robust predictor of new cases of anxiety disorders but only for males. CONCLUSION: Our results suggest the need for sex-specific and integrated interventions addressing both IPV and mental health problems simultaneously. IPV interventions should be informed by the extend to which pre-existing anxiety and depression may lead to different psychological responses to the IPV experience. Increased risk of anxiety disorders predicted by emotional abuse experienced by males challenges beliefs about invulnerability of men in the abusive relationships and demands further attention.


Asunto(s)
Trastornos de Ansiedad/epidemiología , Trastorno Depresivo/epidemiología , Violencia de Pareja/psicología , Adulto , Trastornos de Ansiedad/psicología , Estudios de Cohortes , Trastorno Depresivo/psicología , Femenino , Humanos , Estudios Longitudinales , Masculino , Embarazo , Atención Prenatal , Queensland/epidemiología , Adulto Joven
6.
BMC Public Health ; 18(1): 404, 2018 03 27.
Artículo en Inglés | MEDLINE | ID: mdl-29587696

RESUMEN

BACKGROUND: This paper investigates gender differences in persistence of intimate partner violence (IPV), for those remaining or leaving an abusive relationship. We followed a sample of males and females to examine whether leaving an abusive partner may alter the continuity of victimization. METHODS: Data were taken from the 21 and 30-year follow-ups of the Mater Hospital and University of Queensland Study of Pregnancy (MUSP) in Australia. A cohort of 1265 respondents, including 874 females and 391 males, completed a 21-item version of the Composite Abuse Scale. RESULTS: We found proportionally similar rates of IPV victimization for males and females at both the 21 and 30 year follow-ups. Females who reported they had an abusive partner at the 21 year follow-up were more likely to subsequently change their partner than did males. Harassment and then emotional abuse appeared to have a stronger association for females leaving a partner. For males, a reported history of IPV was not significantly associated with leaving the partner. There was no significant association between leaving (or not) a previous abusive relationship and later victimization, either for male or female respondents. CONCLUSION: Changing a partner does not interrupt the continuity of victimization either for male or female respondents, and previous IPV victimization remained a determining factor of re-abuse, despite re-partnering.


Asunto(s)
Víctimas de Crimen/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Parejas Sexuales/psicología , Adulto , Australia , Estudios de Cohortes , Femenino , Humanos , Masculino , Factores Sexuales , Adulto Joven
7.
J Cancer Educ ; 32(4): 814-819, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-26932309

RESUMEN

The majority of cancer patients receiving chemotherapy will consider taking complementary and alternative medicine (CAM) during their treatment. As biologically-active CAM may detrimentally interfere with chemotherapy treatment, cancer patients require evidence-based information on chemotherapy-CAM integration consequences. This study aimed to assess if the availability of a purpose-designed brochure within a cancer service aided doctors' discussions with their patients on CAM use and helped patients understand the effects of CAM during their chemotherapy treatment. Cancer care doctors consulting in an adult day unit completed a structured post-intervention feedback survey form (n = 17), and cancer patients receiving chemotherapy treatment were provided the brochure and completed the local health service consumer testing feedback form (n = 30). All cancer care doctors perceived a need for the brochure and recommended the brochure to their patients. All doctors thought the brochure made it easier for them to discuss CAM with their patients, and 59 % believed that it saved them time during patient consultations. Ninety percent of cancer patients reported the brochure had enough information to answer their CAM questions, and all patients thought the information was easy to read and understand. An evidence-based CAM-with-chemotherapy patient brochure was perceived to have enabled cancer care doctors to discuss CAM with their patients and to have answered patients' CAM questions.


Asunto(s)
Terapias Complementarias/efectos adversos , Quimioterapia/métodos , Folletos , Educación del Paciente como Asunto , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios
8.
Matern Child Health J ; 19(4): 877-88, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25081239

RESUMEN

Little is known about the long-term mental health of women following the birth of an infant. This study describes the 21 year trajectory of women's depression following the birth of an infant and identifies early predictors of post-birth maternal depression trajectories. The sample comprises 2,991 women from the Mater and University of Queensland Study of Pregnancy. Using the Delusions-Symptoms-States-Inventory, depression was measured at 6 months, 5, 14 and 21 years after the birth. These measures were clustered and in addition bivariate and multivariate analyses were used to test for significant association between the groups and a range of maternal socio-demographic, psychological and pregnancy-related factors. Two depression trajectories were produced, a no-low depression group (79.0 %) and a high-escalating depression group (21.0 %). The strongest predictors for a high-escalating depression group were conflict in the partner-relationship (p < 0.001), anxiety (p < 0.001) and stress (p < 0.001) in the antenatal period, having many pregnancy symptoms (p < 0.001), being younger (p < 0.001) and having poorer social networks (p < 0.001). To a lesser extent not completing high school (p < 0.05), being unsure about wanting the pregnancy (p < 0.05) and not wanting contact with the infant following the birth (p < 0.05) were also predictors for high-escalating depression trajectory. Our findings suggest a sub-sample of mothers experience persistent depressive symptoms over a 21 year period following the birth of their infant. Partner conflict, inadequate social supports and poor mental health during the pregnancy, rather than factors relating to the birth event, contribute to women's depressive symptoms in the long-term. Given the identification of early markers for persistent depression, there may be opportunities for intervention for at-risk pregnant women.


Asunto(s)
Depresión Posparto/epidemiología , Depresión/epidemiología , Adolescente , Adulto , Depresión/etiología , Depresión Posparto/etiología , Femenino , Humanos , Estudios Longitudinales , Madres/psicología , Periodo Posparto/psicología , Embarazo , Resultado del Embarazo/psicología , Escalas de Valoración Psiquiátrica , Queensland/epidemiología , Factores de Riesgo , Factores Socioeconómicos , Adulto Joven
9.
J Psychoactive Drugs ; 47(2): 107-16, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25950590

RESUMEN

Cannabis is generally used to enhance mood (quality of life), but it is not known whether it has this effect in the medium to longer term. Little is currently known about the temporal sequence between cannabis use and the quality of life (QOL). Data are taken from a prospective longitudinal study of pregnant women recruited at their first antenatal visit in Brisbane, Australia. Offspring data from the follow-ups with 14-year-olds and 21-year-olds are used here. Indicators of QOL, happiness, and satisfaction at 14 years are considered as predictors of subsequent cannabis use. The association between cannabis use and QOL at 21 years, adjusting for prior QOL (14 years), is also examined. Socio-demographic characteristics were included as potential confounders relevant to QOL assessments. In this cohort, lower QOL in the early teenage years predicted subsequent onset of cannabis use in young adulthood. After adjustment for socio-demographic characteristics and for QOL pre-cannabis use, participants who used cannabis more frequently had a lower QOL at the 21-years follow-up. Frequent use of cannabis does not appear to enhance the user's QOL and appears to be associated with a reduced QOL into young adulthood.


Asunto(s)
Fumar Marihuana , Calidad de Vida/psicología , Adolescente , Conducta del Adolescente , Edad de Inicio , Australia/epidemiología , Demografía , Femenino , Felicidad , Humanos , Estudios Longitudinales , Fumar Marihuana/epidemiología , Fumar Marihuana/prevención & control , Fumar Marihuana/psicología , Satisfacción Personal , Embarazo , Estudios Prospectivos , Factores Socioeconómicos , Adulto Joven
10.
Community Ment Health J ; 51(2): 204-10, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-24951962

RESUMEN

This meta-analysis examined depression as a consequence of diabetes by conducting a meta-analysis, using data from longitudinal studies. Databases were systematically searched for relevant studies. Incidence of depression is presented as cumulative incident proportion (CIP). Pooled effect sizes were calculated using random-effects model. The data were reconstructed to compute relative risk (RR) and CIP. The 16 studies selected for review generated 16 datasets of which 11 studies reporting binary estimates (RR) and 5 studies reporting time-to-event estimates [hazard ratio (HR)]. Both RR and HR were significant at 1.27 (95% CI 1.17-1.38) and 1.23 (95% CI 1.08-1.40) for incident depression associated with diabetes mellitus. Our observations also revealed greater cumulative incidence of depression in diabetes than in non diabetes groups. Our study shows that diabetes is a significant risk factor for the onset of depression.


Asunto(s)
Trastorno Depresivo/epidemiología , Trastorno Depresivo/psicología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/psicología , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Incidencia , Estudios Longitudinales , Persona de Mediana Edad , Análisis de Regresión , Factores de Riesgo , Adulto Joven
11.
Gynecol Oncol ; 132(1): 130-6, 2014 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24125750

RESUMEN

OBJECTIVE: Most women with ovarian cancer relapse and undergo further chemotherapy however evidence regarding the benefits of this for women with platinum-resistant disease is limited. Our objective was to determine whether there was a quality of life improvement or treatment response among women treated for platinum-resistant recurrent ovarian cancer. METHODS: We combined data from 2 studies where women treated with chemotherapy for recurrent ovarian cancer (n=172) completed a quality of life questionnaire every 3 months. Cancers were classified as platinum-resistant if they progressed within 6 months of completing first-line chemotherapy. Mixed effects models were used to analyze change in quality of life during the first 6 months after second-line chemotherapy. RESULTS: One-quarter of women (n=44) were classified as having platinum-resistant disease. Overall, their quality of life did not significantly increase or decrease, following commencement of second-line chemotherapy (least square mean scores=107, 105, 103 at chemotherapy start, 3 and 6 months later, respectively), although 26% of these women reported a meaningful increase and 31% reported a meaningful decline. One-third of the platinum-resistant group responded (11% complete and 21% partial response) to second-line chemotherapy, and this figure increased to 54% among the subset (36%) re-treated with platinum-based agents with or without other agents. Preliminary analyses suggest that quality of life may be higher at chemotherapy initiation in women whose disease responded (median score 121 vs 110). CONCLUSIONS: Overall, quality of life appears to be maintained in women with platinum-resistant ovarian cancer who receive further chemotherapy and some women respond to re-treatment.


Asunto(s)
Antineoplásicos/uso terapéutico , Neoplasias Ováricas/tratamiento farmacológico , Platino (Metal)/uso terapéutico , Calidad de Vida , Adulto , Anciano , Progresión de la Enfermedad , Resistencia a Antineoplásicos , Femenino , Humanos , Persona de Mediana Edad , Neoplasias Ováricas/mortalidad , Estudios Prospectivos
12.
Qual Life Res ; 22(8): 2113-21, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-23341173

RESUMEN

PURPOSE: To assess the quality of life (QOL) of persons who inject drugs. METHODS: Some 483 current injecting drug users visiting a large NSP over a 2-week period in October 2009 were interviewed using a structured questionnaire. QOL was measured using the WHOQOL-BREF. Data were collected on age, gender, injecting patterns, current drug treatment status and hepatitis C status. Participant QOL profiles were compared to published domain scores for a range of other population groups. RESULTS: People who inject drugs (PWID) experience a very poor QOL irrespective of socio-demographic characteristics, injecting patterns, hepatitis C sero-status and drug treatment status. Sample participants (PWID) experience a QOL below that experienced by many population groups in the community affected by disabling chronic illnesses. CONCLUSIONS: Injecting drug use is associated with a poor QOL. Some PWID may be self-medicating for chronic non-malignant pain, and it is likely that these people had a low QOL prior to the decision to inject. Despite this caveat, it remains likely that injecting drug use does little to enhance the QOL of the user.


Asunto(s)
Consumidores de Drogas/psicología , Calidad de Vida , Abuso de Sustancias por Vía Intravenosa/psicología , Adolescente , Adulto , Anciano , Australia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vigilancia de la Población , Factores Socioeconómicos , Encuestas y Cuestionarios , Adulto Joven
13.
Eur Child Adolesc Psychiatry ; 22(11): 693-700, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23949103

RESUMEN

With marital breakdown and discord relatively common, we examined whether family structure and the quality of marital relationship have a long-term impact on offspring's psychopathology in early adulthood. This study aimed to examine the association of family structure and marital discord in the family with a wide range of offspring's mental health and problem behaviours at 21 years. Data were from the Mater-University of Queensland Study of Pregnancy, a population based birth cohort study, which commenced in Brisbane, Australia in 1981. Mothers and children were followed up at birth, 6 months and 5, 14 and 21 years after the initial interview. Marital status and marital quality were assessed at the 14 year follow-up. Young Adult Self-Report sub-scales of mental health and problem behaviours were measured at the 21-year follow-up. Type of family structure and the quality of marital relationship (at the 14-year follow-up) predicted offspring's psychopathology at 21 years. When a selected group of confounding factors were included in the multivariate analyses, children who lived with a step-father, un-partnered mother, or in families where parents had conflict in marital relationship reported higher symptoms of psychopathology at 21 years. The association between marital problems and young adult psychopathology does not appear to be confounded by a wide range of confounding variables. Further research is needed to explore the mechanism of these associations to develop preventive programmes.


Asunto(s)
Hijos Adultos/psicología , Conflicto Familiar/psicología , Matrimonio/psicología , Padres/psicología , Psicopatología , Adolescente , Adulto , Australia , Escolaridad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Análisis Multivariante , Embarazo , Estudios Prospectivos , Calidad de Vida , Factores de Tiempo , Adulto Joven
14.
J Interpers Violence ; 38(1-2): NP1320-NP1342, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35466762

RESUMEN

BACKGROUND: The long-term mental and physical health consequences of childhood maltreatment have been well documented. Less known are the longer-term consequences of childhood maltreatment, specifically the extent to which childhood maltreatment predicts adult life success. OBJECTIVES: To prospectively assess the extent to which childhood experiences of physical, sexual, emotional abuse and childhood neglect predict life success at 30 years of age. PARTICIPANTS AND SETTING: Data are from the Mater-University of Queensland Study of Pregnancy (MUSP), a pre-birth cohort study which follows children from conception to 30 years of age. METHODS: Details of childhood maltreatment are from two sources; child safety agency notifications (and substantiations) linked to the survey data with self-reports of childhood experiences of maltreatment obtained at the 30-year follow-up using the Child Trauma Questionnaire (CTQ). Life success is a 9-item composite measure (alpha = 0.76) obtained at the 30-year follow-up. We use logistic regression models (with control for covariates) to examine the association between overall as well as specific forms of childhood maltreatment on adult life success. We further test these models using different cut-offs and propensity analyses to adjust for loss to follow-up. RESULTS: Childhood maltreatment whether measured by agency report or self-report predicts overall low life success; agency substantiation OR = 1.88(1.14,3.08) & self-report OR = 2.60 (2.10,3.25). Self-report physical abuse, OR = 2.37(1.72,3.28); sexual abuse, OR = 2.85(2.05,3.96); emotional abuse, OR = 2.53(1.85,3.45) and neglect, OR = 2.36(1.83,3.03) all predict higher levels of low life success. CONCLUSIONS: Our findings suggest that the long-term consequences of childhood maltreatment extend to a wide range of day-to-day circumstances and extend into mid- to later life.


Asunto(s)
Maltrato a los Niños , Delitos Sexuales , Adulto , Niño , Embarazo , Femenino , Humanos , Autoinforme , Maltrato a los Niños/psicología , Estudios de Cohortes , Encuestas y Cuestionarios
15.
Respir Med ; 208: 107124, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36682602

RESUMEN

BACKGROUND: Use of tobacco and cannabis is common and has been reported to predict lung function. Less is known about co-use of tobacco and cannabis and their impact on changes in lung function to early adulthood. RESEARCH QUESTION: The study examines whether cigarette smoking or cannabis use and co-use are each associated with lung function in a population sample of young adults. STUDY DESIGN AND METHODS: Data are from a prospective cohort study of cigarette smoking, cannabis use and co-use at 21 and 30 years of age and lung function (FVC, FEV1, FEV1/FVC) measured at 30 years. Lung function results are transformed using Global Lung Function Formulae. Subjects are the children of pregnant women who were recruited into the cohort study over the period 1981-3. Respondents were administered a spirometry assessment at 21 and 30 years of age. These respondents completed a smoking and cannabis use questionnaire at 21- and 30-year follow-ups. RESULTS: Cigarette smoking (with or without cannabis use) is associated with reduced airflow. There is no consistent association between cannabis use and measures of lung function. The co-use of tobacco and cannabis appears to entail no additional risk to lung function beyond the risks associated with tobacco use alone. INTERPRETATION: Persistent cigarette smoking is associated with reduced airflow even in young adults. Cannabis use does not appear to be related to lung function even after years of use.


Asunto(s)
Cannabis , Embarazo , Adulto Joven , Niño , Humanos , Femenino , Adulto , Estudios Longitudinales , Estudios de Cohortes , Nicotiana , Estudios Prospectivos , Volumen Espiratorio Forzado , Pulmón
16.
J Psychiatr Res ; 155: 542-549, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36194992

RESUMEN

A range of adult health outcomes have been linked to early childhood adversities. These early adversities include parental marital breakdown and family economic disadvantage. Childhood experiences of maltreatment have also been linked to a variety of adult health outcomes. As both childhood adversities and child maltreatment often co-occur, we examine whether childhood adversities at 3 stages of the child's early life course predict any of nine adult mental health outcomes controlling for past experiences of child trauma (maltreatment). Data are from a long running birth cohort study, the Mater-University of Queensland Study of Pregnancy (MUSP). We use bivariate and multinomial logistic regression with adjustment for confounding, to predict adult outcomes. Experiences of recent life events in pregnancy appear to be unrelated to adult mental health. Recent life events experienced at the 5-year follow-up independently predicts lifetime ever depression and cannabis use disorder. Experiences of recent life events at 14-years of age predict lifetime ever depression, cannabis and amphetamine use in adulthood. Our findings support early childhood interventions which should be supplemented with a focus on later childhood and the adolescent period of development. Interventions should also focus on the broader social and demographic context within which children are born. Efforts to reduce the occurrence and consequences of childhood maltreatment should be given primary attention in order to reduce the childhood factors contributing to adult mental illness.


Asunto(s)
Maltrato a los Niños , Trastornos Mentales , Adolescente , Adulto , Anfetaminas , Cohorte de Nacimiento , Niño , Maltrato a los Niños/psicología , Preescolar , Estudios de Cohortes , Femenino , Humanos , Acontecimientos que Cambian la Vida , Trastornos Mentales/epidemiología , Embarazo
17.
J Interpers Violence ; 36(1-2): 915-937, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-29294920

RESUMEN

Although much available research indicates that intimate partner violence (IPV) is male perpetrated, growing recent evidence suggests a gender symmetry model of family violence. This article examines gender differences in IPV in current and prior relationships reported by young adults. Data comprised 2,060 young adults (62.1% females) who participated in the 30-year follow-up of the Mater Hospital and University of Queensland Study of Pregnancy (MUSP) in Brisbane, Australia. The Composite Abuse Scale was used to measure IPV during the last 12 months in the respondents' most recent relationship. Similar proportions of males and females reported leaving their prior relationships. Both males and females who were not currently in a relationship reported experiencing much higher rates of IPV than those who were in a relationship. There were no differences in the past experience of IPV between males and females who were not currently in a relationship, but males in a current relationship reported they experienced most forms of IPV more often than did females. IPV typically involves both male and female perpetrators and victims. It does appear that the majority of relationships involving higher rates of IPV were dissolved. IPV was more likely to have occurred in relationships that ended than in relationships that persisted. Males more often remain in an abusive relationship and report experiencing higher rates of IPV in their current relationships compared with females.


Asunto(s)
Violencia Doméstica , Violencia de Pareja , Australia/epidemiología , Femenino , Humanos , Masculino , Embarazo , Caracteres Sexuales , Factores Sexuales , Adulto Joven
18.
Support Care Cancer ; 18(8): 943-9, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-19777270

RESUMEN

PURPOSE: To examine the importance of possible outcomes of first-line versus repeated chemotherapy to ovarian cancer patients and to compare doctors' treatment intentions with patients' beliefs about cure. METHODS: Women with newly diagnosed (74) or relapsed (48) ovarian cancer were prospectively followed over 2 years. The level of importance they ascribed to four chemotherapy outcomes and their beliefs about cure were assessed. Their doctors independently specified intent of successive treatments. RESULTS: Approximately half (54%) of newly diagnosed ovarian cancer patients (65% with residual disease >2 cm and 49% with no or < or =2 cm residual disease) ranked 'tumour shrinkage (or decrease in blood levels of CA125)' as 'most important' during first-line chemotherapy. Approximately two thirds (65-70%) of all women whose disease had relapsed also ranked 'tumour shrinkage' as 'most important' during repeated chemotherapy. Few women (<8%) rated symptom relief or absence of side-effects as most important. While both patients' and doctors' belief about cure decreased over successive treatments, patients grew more optimistic relative to doctors over time. Women's reports of advice by doctors about cure were consistent with doctors' stated intent for repeat chemotherapy. However, discordance between doctors' actual treatment intent and patients' beliefs about cure increased from 24% at first-line to 83% by fourth-line chemotherapy. CONCLUSIONS: Women prioritise tumour response as the most important outcome of chemotherapy for ovarian cancer. This priority predominates in women with residual and relapsed disease despite declining likelihood of cure. Women may still hope for a cure while acknowledging their doctor's advice that their disease is incurable.


Asunto(s)
Antineoplásicos/uso terapéutico , Actitud Frente a la Salud , Neoplasias Ováricas/tratamiento farmacológico , Adulto , Anciano , Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Actitud del Personal de Salud , Antígeno Ca-125/sangre , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Recurrencia Local de Neoplasia , Neoplasias Ováricas/patología , Neoplasias Ováricas/psicología , Estudios Prospectivos , Enfermo Terminal/psicología , Resultado del Tratamiento
19.
Int J Gynecol Cancer ; 20(5): 757-65, 2010 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-20973265

RESUMEN

OBJECTIVE: As treatment costs for gynecological cancer escalate, real-world data on use of resources and costs becomes increasingly important. This study investigated medical costs, quality of life, and survival end points for women with ovarian cancer in Australia. METHODS: Women with primary epithelial ovarian cancer referred for chemotherapy (n =85) were recruited through 7 hospitals in Australia. Overall survival, progression-free interval, and quality-adjusted life years were assessed by stage using the Cox proportional hazards models. Direct medical costs, including those for surgeries, hospitalizations, supportive care, chemotherapy, and adverse effects (while on chemotherapy), were calculated over 2.5 years and assessed by nonparametric bootstrapping. RESULTS: Quality-adjusted life years decreased with increased disease stage at diagnosis and ranged from 2.3 for women with stage I or II disease to 1.3 for those with stage IV disease. A total of AU $4.1 million (2008) were spent on direct medical costs for 85 women over approximately 2.5 years. Medical costs were significantly higher for women with stage III or IV disease compared with that for women with stage I or II disease ($50,945 vs $31,958, P < 0.01) and/or women who experienced surgical complications and/or adverse effects requiring hospitalization while on chemotherapy ($57,821 vs $34,781, P < 0.01). Costs after first-line chemotherapy were significantly higher for women with advanced disease (mean, $20,744) compared with those for women with early disease (mean, $5525; P < 0.01). CONCLUSIONS: Whereas for women with early-stage ovarian cancer, costs are concentrated in the period of primary treatment, cumulated costs are especially high for women with recurrent disease rising rapidly after first-line therapy.


Asunto(s)
Costos y Análisis de Costo , Neoplasias Ováricas/economía , Neoplasias Ováricas/terapia , Antineoplásicos/economía , Australia , Estudios de Cohortes , Femenino , Procedimientos Quirúrgicos Ginecológicos/economía , Humanos , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Calidad de Vida , Análisis de Supervivencia , Resultado del Tratamiento
20.
J Interpers Violence ; 35(23-24): 5500-5525, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-29294851

RESUMEN

Poverty and socioeconomic disadvantage place demands on intimate relationships and provide fertile ground for disagreements and conflicts. It is not known whether poverty also leads to intimate partner violence (IPV). This study investigates the association between income and forms of IPV victimization for both males and females. We also examine whether income inequalities are related to IPV and whether the gender balance of household income contributes to IPV victimization. Data are from a cohort of 2,401 young offspring (60.3% females) who participated at the 30-year follow-up of the Mater-University of Queensland Study of Pregnancy in Brisbane, Australia. Participants completed questionnaires including their income details and the Composite Abuse Scale. Within low-income families, both partners experience higher levels of IPV. Females' income is not independently related to experiencing IPV either for females or males. Females and males experience a higher rate of IPV when the husband earns a low income. When considering partners' relative income, families in which both partners earned a low income experienced higher levels of almost all forms of IPV. Income (im)balance in which females earn more or partners both have higher income was less often associated with the experience OF IPV IPV appears to be mutually experienced in the setting of the poverty. Objective economic hardship and scarcity create a context which facilitates IPV for both partners in a relationship.


Asunto(s)
Víctimas de Crimen , Violencia de Pareja , Australia , Femenino , Humanos , Renta , Masculino , Embarazo , Parejas Sexuales
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