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1.
Int J Geriatr Psychiatry ; 39(2): e6058, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38279894

RESUMEN

OBJECTIVES: Physical activity (PA) can reduce depressive symptoms but has not been tested amongst depressed older caregivers and their care-recipients. The aim of this single-blind randomized controlled trial was to investigate the effect of a 6-month tailored PA program on depressive symptoms in older caregivers. METHOD: Caregivers were included if they had scores of ≥5 on the 15-item geriatric depression scale (GDS-15). Care-recipients could have any type of physical, mental or cognitive condition requiring support. The PA intervention group completed an individualized program based on the Otago-Plus Exercise Program. The primary outcome was improvement in depressive symptoms in caregivers measured at six and 12 months. RESULTS: Two hundred and twelve participants (91 dyads and 30 caregivers only) were randomized using a 3:3:1 ratio to PA intervention, social-control, and usual-care control groups. There were no significant differences in depressive symptoms of the caregivers between the three groups at 6 months or 12 months. However, more than 50% of caregivers in all three groups no longer had a GDS-15 score ≥5 at 6 months. Further analysis revealed that caregivers in the PA group caring for someone with a standardised mini-mental state examination (SMMSE) score ≥24 had significantly less depressive symptoms than those caring for someone with a SMMSE score <24 compared with social-control (p < 0.02) and usual-care groups (p < 0.02). CONCLUSIONS: A PA intervention may be beneficial for some caregivers in reducing symptoms of depression but may not be as beneficial to caregivers of people living with cognitive impairment.


Asunto(s)
Cuidadores , Depresión , Humanos , Anciano , Depresión/psicología , Cuidadores/psicología , Método Simple Ciego , Ejercicio Físico , Terapia por Ejercicio
2.
J Asthma ; : 1-10, 2024 Apr 05.
Artículo en Inglés | MEDLINE | ID: mdl-38551488

RESUMEN

OBJECTIVE: The 'two-hit' hypothesis theorizes that early life allergic sensitization and respiratory infection interact to increase asthma risk. METHODS: We sought to determine in a high allergy risk birth cohort whether interactions between early life allergic sensitization and respiratory infection were associated with increased risk for asthma at ages 6-7 years and 18 years. Allergic sensitization was assessed at 6, 12, and 24 months by skin prick testing to 3 food and 3 aeroallergens. Respiratory infection was defined as reported "cough, rattle, or wheeze" and assessed 4-weekly for 15 months, at 18 months, and age 2 years. Regression analysis was undertaken with parent-reported asthma at age 6-7 years and doctor diagnosed asthma at 18 years as distinct outcomes. Interactions between allergic sensitization and respiratory infection were explored with adjustment made for potential confounders. RESULTS: Odds of asthma were higher in sensitized compared to nonsensitized children at age 6-7 years (OR = 14.46; 95% CI 3.99-52.4), There was no evidence for interactions between allergic sensitization and early life respiratory infection, with a greater frequency of respiratory infection up to 2 years of age associated with increased odds for asthma at age 6-7 years in both sensitized (OR = 1.13; 95% CI 1.02-1.25, n = 199) and nonsensitized children (OR = 1.31; 1.11-1.53, n = 211) (p interaction = 0.089). At age 18 years, these associations were weaker. CONCLUSIONS: Our findings do not support 'two-hit' interactions between early life allergic sensitization and respiratory infection on asthma risk. Both early life respiratory infections and allergic sensitization were risk factors and children with either should be monitored closely for development of asthma.

3.
Learn Behav ; 50(1): 99-112, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34918206

RESUMEN

David Sherry has been a pioneer in investigating the avian hippocampal formation (HF) and spatial memory. Following on his work and observations that HF is sensitive to the occurrence of reward (food), we were interested in carrying out an exploratory study to investigate possible HF involvement in the representation goal value and risk. Control sham-lesioned and hippocampal-lesioned pigeons were trained in an open field to locate one food bowl containing a constant two food pellets on all trials, and two variable bowls with one containing five pellets on 75% (High Variable) and another on 25% (Low Variable) of their respective trials (High-Variable and Low-Variable bowls were never presented together). One pairing of pigeons learned bowl locations (space); another bowl colors (feature). Trained to color, hippocampal-lesioned pigeons performed as rational agents in their bowl choices and were indistinguishable from the control pigeons, a result consistent with HF regarded as unimportant for non-spatial memory. By contrast, when trained to location, hippocampal-lesioned pigeons differed from the control pigeons. They made more first-choice errors to bowls that never contained food, consistent with a role of HF in spatial memory. Intriguingly, the hippocampal-lesioned pigeons also made fewer first choices to both variable bowls, suggesting that hippocampal lesions resulted in the pigeons becoming more risk averse. Acknowledging that the results are preliminary and further research is needed, the data nonetheless support the general hypothesis that HF-dependent memory representations of space capture properties of reward value and risk, properties that contribute to decision making when confronted with a choice.


Asunto(s)
Columbidae , Hipocampo , Animales , Hipocampo/patología , Aprendizaje , Recompensa , Percepción Espacial
4.
BMC Public Health ; 22(1): 2430, 2022 12 27.
Artículo en Inglés | MEDLINE | ID: mdl-36575509

RESUMEN

BACKGROUND: Universities are increasingly recognised as institutions where health and wellbeing can be promoted to maximise academic outcomes, career transitions, and lifelong positive health behaviours. There is concern about the mental health of university students and other factors which affect academic outcomes particularly for subgroups such as international students. There are few cohort studies of the breadth of issues that can impact on mental health and academic outcomes for both local and international students. We conducted a baseline prevalence survey of students at a large Australian university covering health, academic, and social determinants of wellbeing. The purpose was to inform the university's new student health and wellbeing framework with a view to follow-up to determine predictors of mental ill-health and academic outcomes in the subsequent year. In this paper we present the baseline prevalence data and report on selected mental health and health care access issues for local and international students. METHODS: The entire university population as of April 2019 of over 56,375 students aged 18 or above were invited to complete the online survey. Questions explored eight domains: demographic characteristics, general health and wellbeing, mental health, risk taking behaviours, psychosocial stressors, learning and academic factors, social and cultural environment, and awareness of and access to health and wellbeing services. Records of academic results were also accessed and matched with survey data for a large subset of students providing consent. RESULTS: Fourteen thousand eight hundred eighty (26.4%) students commenced our survey and were representative of the entire student population on demographic characteristics. Three quarters were aged between 18 to 25 years and one third were international students. Eighty-five percent consented to access of their academic records. Similar proportions of local and international students experienced symptoms of a depression or anxiety disorder, however international students were less aware of and less likely to access available health services both inside and external to the university. We also reported on the prevalence of: general lifestyle factors (diet, exercise, amount of daily sleep); risk-taking behaviours (including alcohol, tobacco and other drug use; unprotected sexual activity); psychosocial stressors (financial, intimate partner violence, discrimination, academic stressors, acculturative stress); subjects failed; resilience; social supports; social media use; and health services accessed online. CONCLUSIONS: This rigorous and comprehensive examination of the health status of local and international students in an Australian university student population establishes the prevalence of mental health issues and other psychosocial determinants of health and wellbeing, along with academic performance. This study will inform a university-wide student wellbeing framework to guide health and wellbeing promotion and is a baseline for a 12-month follow-up of the cohort in 2020 during the COVID-19 pandemic.


Asunto(s)
Rendimiento Académico , COVID-19 , Humanos , Adolescente , Adulto Joven , Adulto , Universidades , Pandemias , Australia/epidemiología , Estudiantes , Promoción de la Salud
5.
Pediatr Allergy Immunol ; 32(2): 288-294, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-32997845

RESUMEN

BACKGROUND: Previous research suggests that children who experience asthma may be less physically active; however, results have been inconclusive. This study aimed to investigate whether the presence of asthma or wheeze is associated with lower physical activity levels in children, and whether sex, body mass index or earlier asthma or wheeze status modifies the association. METHODS: This study was conducted in 391 HealthNuts participants in Melbourne, Australia. Asthma and wheeze data were collected via questionnaire at age 4 and 6, and physical activity was measured through accelerometry. Using adjusted linear regression models, the cross-sectional and longitudinal associations were investigated. RESULTS: There was no evidence of a difference in time spent in moderate-to-vigorous physical activity (MVPA) at age 6 years between children with and without asthma at age 4; children with asthma spent 8.3 minutes more time physically active per day (95% CI: -5.6, 22.1, P = .24) than children without asthma. Similar results were seen for children with current wheeze (5.8 minutes per day more, 95% CI: -5.9, 17.5, P = .33) or ever wheeze or asthma (7.7 minutes per day more, 95% CI: -4.8, 20.2, P = .23) at age 4 years. Comparable null results were observed in the cross-sectional analyses. Interaction with BMI could not be assessed; however, previous asthma or wheeze status and sex were not found to modify these associations. CONCLUSION: This analysis found no evidence of asthma hindering physical activity in these young children. These results are encouraging, as they indicate that the Australian asthma and physical activity public health campaigns are being effectively communicated and adopted by the public.


Asunto(s)
Asma , Ejercicio Físico , Acelerometría , Asma/epidemiología , Australia/epidemiología , Niño , Preescolar , Estudios Transversales , Humanos
6.
J Asthma ; 58(11): 1426-1443, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-32791878

RESUMEN

OBJECTIVE: To systematically review the evidence on whether having current, ever asthma and asthma control is associated with levels of total, moderate and vigorous physical activity. METHODS: We searched EMBASE, MEDLINE, and CINAHL databases, limiting searches to English language papers from inception until Oct 2019. We synthesized the evidence comparing levels of total, moderate and vigorous physical activity between adults with and without current asthma or ever asthma by random effects meta-analyses. RESULTS: A total of 25 studies were included, with 18 of these included in meta-analyses. A meta-analysis of 4 case-control studies found that adults with current asthma were less active, with 942.12 steps fewer per day, than adults without current asthma (SMD = -0.39, 95%CI: -0.54, -0.24, I2 = 0). Meta-analysis of four-high quality cross-sectional studies found that those with current or ever asthma were more likely to be inactive than those without asthma (binary OR current asthma = 0.85, 95%CI: 0.82, 0.89, I2 = 45.6%, and binary OR ever asthma = 0.83, 0.75, 0.91, I2 = 0, respectively). Meta-analysis, inclusive of all 10 cross-sectional studies with binary ORs, supported this finding. There was also some evidence that adults with current asthma and ever asthma (6 studies with categorical ORs) were less likely to exercise moderately and vigorously, but these meta-analyses were limited by high heterogeneity. No synthesis of the studies considering asthma control was possible. CONCLUSION: Adults with current or ever asthma had lower levels of total, moderate and vigorous physical activity than those without asthma and may be missing out on the health benefits of being physically active. The association between asthma control and physical activity warrants further investigation.


Asunto(s)
Asma , Ejercicio Físico , Adulto , Asma/fisiopatología , Humanos
7.
BMC Public Health ; 21(1): 1402, 2021 07 15.
Artículo en Inglés | MEDLINE | ID: mdl-34266397

RESUMEN

BACKGROUND: The home environment is the most important location in young children's lives, yet few studies have examined the relationship between the outdoor home environment and child physical activity levels, and even fewer have used objectively measured exposures and outcomes. This study examined relationships between objectively assessed home yard size and greenness, and child physical activity and outdoor play. METHODS: Data were drawn from the HealthNuts study, a longitudinal study of 5276 children in Melbourne, Australia. We used cross-sectional data from a sample at Wave 3 (2013-2016) when participants were aged 6 years (n = 1648). A sub-sample of 391 children had valid accelerometer data collected from Tri-axial GENEActive accelerometers worn on their non-dominant wrist for 8 consecutive days. Yard area and greenness were calculated using geographic information systems. Objective outcome measures were minutes/day in sedentary, light, and moderate-vigorous physical activity (weekday and weekend separately). Parent-reported outcome measures were minutes/day playing outdoors (weekend and weekday combined). Multi-level regression models (adjusted for child's sex, mother's age at the birth of child, neighbourhood socioeconomic index, maternal education, and maternal ethnicity) estimated effects of yard size and greenness on physical activity. RESULTS: Data were available on outdoor play for 1648 children and usable accelerometer data for 391. Associations between yard size/greenness and components of physical activity were minimal. For example, during weekdays, yard size was not associated with daily minutes in sedentary behaviour (ß: 2.4, 95% CI: - 6.2, 11.0), light physical activity (ß: 1.4, 95% CI: - 5.7, 8.5) or MVPA (ß: -2.4, 95% CI: - 6.5, 1.7), with similar patterns at weekends. There was no relationship between median annual yard greenness and physical activity or play. CONCLUSION: In our study of young children residing in higher socio-economic areas of Melbourne yard characteristics did not appear to have a major impact on children's physical activity. Larger studies with greater variation in yard characteristics and identification of activity location are needed to better understand the importance of home outdoor spaces and guide sustainable city planning.


Asunto(s)
Acelerometría , Ejercicio Físico , Australia/epidemiología , Niño , Preescolar , Estudios Transversales , Humanos , Estudios Longitudinales
8.
Pediatr Allergy Immunol ; 30(7): 739-751, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31283849

RESUMEN

BACKGROUND: Physical activity may be a potentially modifiable risk factor for asthma and driver of lung function development. This systematic review aimed to summarize the available evidence concerning the longitudinal effect of physical activity on the development of asthma, the persistence of asthma symptoms and lung function outcomes in children and adolescents. METHODS: PubMed and Embase electronic databases were searched for all original articles that investigated the longitudinal association between physical activity and asthma outcomes or lung function outcomes in children and adolescents. The search and data extraction were conducted by two independent researchers. The methodological quality of the included studies was assessed using two critical assessment tools. RESULTS: The literature search retrieved 2298 publications from the electronic databases. All articles were screened, and 2289 were subsequently excluded, resulting in nine longitudinal studies eligible for inclusion in this review. Two studies found no association with incident wheeze, and two of four found no association with various asthma outcomes. Three studies investigated the effect on lung function: one observed an association in boys only, one observed an association in girls only, and one found no associations. CONCLUSION: The evidence was highly inconsistent for the relationship between physical activity and asthma and lung function outcomes. Hence, we conclude that there is insufficient evidence to suggest that physical activity has a long-term effect on the risk of asthma development in youth. Furthermore, there is insufficient evidence to determine the longitudinal effects of physical activity on lung function in children.


Asunto(s)
Asma/prevención & control , Ejercicio Físico , Pulmón/fisiología , Adolescente , Niño , Humanos , Calidad de Vida , Riesgo
9.
Med J Aust ; 211(2): 65-70, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31049990

RESUMEN

OBJECTIVE: To examine the utility of apnoea screening questionnaires, alone and in combination with the Epworth sleepiness scale (ESS), for detecting obstructive sleep apnoea (OSA) in primary care. DESIGN, SETTING: Prospective validation study in an Australian general population cohort. PARTICIPANTS: 424 of 772 randomly invited Tasmanian Longitudinal Health Study, 6th decade follow-up participants with OSA symptoms (mean age, 52.9 years; SD, 0.9 year) who completed OSA screening questionnaires and underwent type 4 sleep studies. MAIN OUTCOME MEASURES: Clinically relevant OSA, defined as moderate to severe OSA (15 or more oxygen desaturation events/hour), or mild OSA (5-14 events/hour) and excessive daytime sleepiness (ESS ≥ 8); diagnostic test properties of the Berlin (BQ), STOP-Bang and OSA-50 questionnaires, alone or combined with an ESS ≥ 8. RESULTS: STOP-Bang and OSA-50 correctly identified most participants with clinically relevant OSA (sensitivity, 81% and 86% respectively), but with poor specificity (36% and 21% respectively); the specificity (59%) and sensitivity of the BQ (65%) were both low. When combined with the criterion ESS ≥ 8, the specificity of each questionnaire was high (94-96%), but sensitivity was low (36-51%). Sensitivity and specificity could be adjusted according to specific needs by varying the STOP-Bang cut-off score when combined with the ESS ≥ 8 criterion. CONCLUSIONS: For people likely to trigger OSA assessment in primary care, the STOP-Bang, BQ, and OSA-50 questionnaires, combined with the ESS, can be used to rule in, but not to rule out clinically relevant OSA. Combined use of the STOP-Bang with different cut-off scores and the ESS facilitates a flexible balance between sensitivity and specificity.


Asunto(s)
Apnea Obstructiva del Sueño/diagnóstico , Encuestas y Cuestionarios , Australia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Atención Primaria de Salud , Estudios Prospectivos , Curva ROC , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad
10.
Thorax ; 73(4): 376-384, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29306902

RESUMEN

OBJECTIVE: We assessed associations between physical activity and lung function, and its decline, in the prospective population-based European Community Respiratory Health Survey cohort. METHODS: FEV1 and FVC were measured in 3912 participants at 27-57 years and 39-67 years (mean time between examinations=11.1 years). Physical activity frequency and duration were assessed using questionnaires and used to identify active individuals (physical activity ≥2 times and ≥1 hour per week) at each examination. Adjusted mixed linear regression models assessed associations of regular physical activity with FEV1 and FVC. RESULTS: Physical activity frequency and duration increased over the study period. In adjusted models, active individuals at the first examination had higher FEV1 (43.6 mL (95% CI 12.0 to 75.1)) and FVC (53.9 mL (95% CI 17.8 to 89.9)) at both examinations than their non-active counterparts. These associations appeared restricted to current smokers. In the whole population, FEV1 and FVC were higher among those who changed from inactive to active during the follow-up (38.0 mL (95% CI 15.8 to 60.3) and 54.2 mL (95% CI 25.1 to 83.3), respectively) and who were consistently active, compared with those consistently non-active. No associations were found for lung function decline. CONCLUSION: Leisure-time vigorous physical activity was associated with higher FEV1 and FVC over a 10-year period among current smokers, but not with FEV1 and FVC decline.


Asunto(s)
Ejercicio Físico , Volumen Espiratorio Forzado , Actividades Recreativas , Enfermedades Pulmonares/diagnóstico , Enfermedades Pulmonares/fisiopatología , Pulmón/fisiopatología , Capacidad Vital , Adulto , Anciano , Europa (Continente) , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Estudios Prospectivos , Sensibilidad y Especificidad , Encuestas y Cuestionarios
13.
J Asthma ; 54(9): 938-945, 2017 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-28635546

RESUMEN

OBJECTIVE: To investigate the impact of physical activity on asthma in middle-aged adults, in one longitudinal analysis, and one multi-centre cross-sectional analysis. METHODS: The Respiratory Health in Northern Europe (RHINE) is a population-based postal questionnaire cohort study. Physical activity, height and weight were self-reported in Bergen, Norway, at RHINE II (1999-2001) and all centres at RHINE III (2010-2012). A longitudinal analysis of Bergen data investigated the association of baseline physical activity with follow-up asthma, incident asthma and symptoms, using logistic and zero-inflated Poisson regression (n = 1782). A cross-sectional analysis of all RHINE III centres investigated the association of physical activity with concurrent asthma and symptoms (n = 13,542) using mixed-effects models. Body mass index (BMI) was categorised (<20, 20-24.99, 25-29.99, 30+ kg/m2) and physical activity grouped by amount and frequency of lighter (no sweating/heavy breathing) and vigorous (sweating/heavy breathing) activity. RESULTS: In the Bergen longitudinal analysis, undertaking light activity 3+ times/week at baseline was associated with less follow-up asthma (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.22, 0.89), whilst an effect from undertaking vigorous activity 3+ times/week was not detected (OR 1.22, 95% CI 0.44, 2.76). The associations were attenuated with BMI adjustment. In the all-centre cross-sectional analysis an interaction was found, with the association between physical activity and asthma varying across BMI categories. CONCLUSION: These findings suggest potential longer-term benefit from lighter physical activity, whilst improvement in asthma outcomes from increasing activity intensity was not evident. Additionally, it appears the benefit from physical activity may differ according to BMI.


Asunto(s)
Asma/fisiopatología , Ejercicio Físico , Asma/diagnóstico , Asma/epidemiología , Estudios de Cohortes , Estudios Transversales , Europa (Continente)/epidemiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad
15.
Euro Surveill ; 22(20)2017 May 18.
Artículo en Inglés | MEDLINE | ID: mdl-28552101

RESUMEN

Australia was alerted to a possible increase in allergy-related adverse events following immunisation (AEFI) with 2015 seasonal trivalent influenza vaccines (TIV) by the Victorian state vaccine safety service, SAEFVIC. We describe SAEFVIC's initial investigation and upon conclusion of the 2015 influenza vaccination programme, to define the signal event and implications for vaccine programmes. Allergy-related AEFI were defined as anaphylaxis, angioedema, urticaria or generalised allergic reaction. Investigations compared 2015 TIV AEFI reports to previous years as proportions and reporting risk (RR) per 100,000, stratified by influenza vaccine brand. The initial investigation showed an increased proportion of allergy-related AEFI compared with 2014 (25% vs 12%), predominantly in adults, with insufficient clinical severity to alter the programme risk-benefit. While overall TIV AEFI RR in 2015 was similar to previous years (RR: 1.07, 95% confidence interval (CI): 0.88-1.29), we identified a near-doubling RR for allergy-related AEFI in 2015 (RR: 1.78, 95% CI: 1.14-- 2.80) from 2011 to 2014 with no difference by vaccine brand or severity increase identified. This increase in generalised allergy-related AEFI, across all used vaccine brands, supports evidence of variable reactogenicity arising from influenza vaccine strain variations. This investigation underlines the importance of effective seasonal influenza vaccine pharmacovigilance.


Asunto(s)
Sistemas de Registro de Reacción Adversa a Medicamentos/estadística & datos numéricos , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Subtipo H1N1 del Virus de la Influenza A/inmunología , Vacunas contra la Influenza/efectos adversos , Gripe Humana/prevención & control , Vacunación Masiva/efectos adversos , Adolescente , Adulto , Anciano , Australia/epidemiología , Niño , Preescolar , Femenino , Humanos , Programas de Inmunización , Incidencia , Vacunas contra la Influenza/administración & dosificación , Masculino , Vacunación Masiva/estadística & datos numéricos , Persona de Mediana Edad , Vigilancia de la Población , Estaciones del Año , Victoria/epidemiología , Adulto Joven
16.
Int J Geriatr Psychiatry ; 31(3): 294-301, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26153792

RESUMEN

OBJECTIVE: Depression is an adverse outcome frequently seen in carers. With the increasing ageing population and reliance on informal carers, this study aims to identify factors associated with depression in carers in the older age group, using factors that have not been previously investigated. METHODS: We conducted a cross-sectional analysis of 202 older carers using the Geriatric Depression scale, demographics, personality traits, attitudes to ageing and other carer characteristics. RESULTS: Increased hours spent caring and higher levels of neuroticism were all factors associated with depression. The care-recipient diagnosis, other personality traits, attitudes to ageing, leisure-physical activity (PA) and domestic-PA were not significantly associated with depression. CONCLUSIONS: These findings have important implications for interventions to target at-risk carers.


Asunto(s)
Cuidadores/psicología , Trastorno Depresivo/diagnóstico , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Evaluación Geriátrica/métodos , Estado de Salud , Humanos , Actividades Recreativas , Masculino , Persona de Mediana Edad , Trastornos Neuróticos/complicaciones , Personalidad , Escalas de Valoración Psiquiátrica , Análisis de Regresión , Factores de Riesgo , Factores de Tiempo
17.
J Asthma ; 53(9): 882-92, 2016 11.
Artículo en Inglés | MEDLINE | ID: mdl-27144654

RESUMEN

OBJECTIVE: Despite the benefits of a physically active lifestyle, some studies suggest fear of exacerbations by both children and their parents limit physical activity in children with asthma. We undertook a systematic review to quantify the difference in objectively measured physical activity levels of children and adolescents with and without asthma. DATA SOURCES: MEDLINE, PubMed and EMBASE. STUDY SELECTION: English language observational studies of children and adolescents to the age of 18 that compared objectively measured physical activity (accelerometer or pedometer devices) between those with asthma and without asthma. RESULTS: Overall 22,285 articles were retrieved with 12 studies being included in the review: 1 cohort, 1 case-control and 10 cross-sectional. A meta-analysis of accelerometry data from the single cohort study and 8 cross-sectional studies produced an overall mean difference of 0.01 (95% CI: -0.09-0.11) activity counts per minute in children and adolescents without asthma compared to those with asthma. CONCLUSION: We did not find any evidence that children and adolescents with and without asthma engaged in different amounts of physical activity when measured objectively by accelerometers. Children and adolescents with asthma may not require differentially targeted policies to encourage more physical activity, however further longitudinal studies are needed.


Asunto(s)
Asma , Ejercicio Físico , Adolescente , Niño , Preescolar , Factores de Confusión Epidemiológicos , Humanos
18.
BMC Public Health ; 16(Suppl 3): 1029, 2016 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-28185594

RESUMEN

BACKGROUND: Obstructive sleep apnoea is a common disorder with under-rated clinical impact, which is increasingly being recognised as having a major bearing on global disease burden. Men are especially vulnerable and become a priority group for preventative interventions. However, there is limited information on prevalence of the condition in Australia, its co-morbidities, and potential risk factors. METHODS: We used data from 13,423 adult men included in the baseline wave of Ten to Men, an Australian national study of the health of males, assembled using stratified cluster sampling with oversampling from rural and regional areas. Those aged 18-55 years self-completed a paper-based questionnaire that included a question regarding health professional-diagnosed sleep apnoea, physical and mental health status, and health-related behaviours. Sampling weights were used to account for the sampling design when reporting the prevalence estimates. Odds ratios were used to describe the association between health professional-diagnosed sleep apnoea and potential correlates while adjusting for age, country of birth, and body-mass index (BMI). RESULTS: Prevalence of self-reported health professional-diagnosed sleep apnoea increased from 2.2 % in age 18-25 years to 7.8 % in the age 45-55 years. Compared with those without sleep apnoea, those with sleep apnoea had significantly poorer physical, mental, and self-rated health as well as lower subjective wellbeing and poorer concentration/remembering (p < 0.001 for all). Sleep apnoea was significantly associated with older age (p < 0.001), unemployment (p < 0.001), asthma (p = 0.011), chronic obstructive pulmonary disease/chronic bronchitis (p = 0.002), diabetes (p < 0.001), hypercholesterolemia (p < 0.001), hypertension (p < 0.001), heart attack (p < 0.001), heart failure (p < 0.001), angina (p < 0.001), depression (p < 0.001), post-traumatic stress disorder (p < 0.001), other anxiety disorders (p < 0.001), schizophrenia (p = 0.002), overweight/obesity (p < 0.001), insufficient physical activity (p = 0.006), smoking (p = 0.005), and high alcohol consumption (p < 0.001). CONCLUSION: Health professional-diagnosed sleep apnoea is relatively common, particularly in older males. Associations between sleep apnoea and cardiovascular, metabolic, respiratory, and psychiatric disorders have important clinical and public health implications. As men are especially vulnerable to sleep apnoea as well as some of its chronic co-morbidities, they are potentially a priority group for health interventions. Modifiable lifestyle related factors such as smoking, alcohol consumption, level of physical activity and BMI are possible key foci for interventions.


Asunto(s)
Comorbilidad , Estado de Salud , Estilo de Vida , Apnea Obstructiva del Sueño/epidemiología , Adolescente , Adulto , Australia/epidemiología , Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus/epidemiología , Humanos , Estudios Longitudinales , Masculino , Salud del Hombre , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Oportunidad Relativa , Prevalencia , Enfermedades Respiratorias/epidemiología , Factores de Riesgo , Apnea Obstructiva del Sueño/etiología , Encuestas y Cuestionarios , Adulto Joven
19.
Int Psychogeriatr ; 27(11): 1893-901, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26073317

RESUMEN

BACKGROUND: Attitudes to aging have been investigated in non-carer populations and found to have important relationships with physical and mental health. However, these have not been explored in an older carer sample, although it is becoming increasingly important to clarify variables which are linked with positive carer outcomes. This is one of the first studies to report on older carers, their attitudes to aging, and the relationship with carer-related factors. METHODS: A cross-sectional study of 202 carers with a mean age of 70.8 years was conducted in Victoria, Australia, using carer demographic data, carer factors such as depression (using the Geriatric Depression Scale), burden (using the Zarit Burden Inventory, ZBI), physical health, personality, and attitudes to aging (using the Attitudes to Aging Questionnaire, AAQ). Spearman rank correlation and hierarchical regression analyses were used. RESULTS: This study showed that carers had overall positive attitudes to aging inspite of their caring role. It also identified that carer factors including depression and burden contributed a significant amount of the variance to attitudes to aging in terms of physical change and psychosocial loss. Personality traits, specifically neuroticism, and extraversion, were also important contributors to attitudes to aging. CONCLUSIONS: Results from this study demonstrated that inspite of moderate levels of depression and spending significant time caring, carers reported positive attitudes to aging. Treating depression, decreasing burden, and investigating the benefits of caring may assist older carers maintain their well-being.


Asunto(s)
Envejecimiento/psicología , Actitud del Personal de Salud , Cuidadores/psicología , Anciano , Anciano de 80 o más Años , Cuidadores/estadística & datos numéricos , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Personalidad , Inventario de Personalidad , Escalas de Valoración Psiquiátrica , Encuestas y Cuestionarios , Victoria
20.
J Am Chem Soc ; 135(38): 14000-3, 2013 Sep 25.
Artículo en Inglés | MEDLINE | ID: mdl-24015927

RESUMEN

Photoactivation of "snap-top" stoppers over the pore openings of mesoporous silica nanoparticles releases intact cargo molecules from the pores. The on-command release can be stimulated by either one UV photon or two coherent near-IR photons. Two-photon activation is particularly desirable for use in biological systems because it enables good tissue penetration and precise spatial control. Stoppers were assembled by first binding photolabile coumarin-based molecules to the nanoparticle surface. Then, after the particles were loaded with cargo, bulky ß-cyclodextrin (CD) molecules were noncovalently associated with the substituted coumarin molecule, blocking the pores and preventing the cargo from escaping. One-photon excitation at 376 nm or two-photon excitation at 800 nm cleaves the bond holding the coumarin to the nanopore, releasing both the CD cap and the cargo. The dynamics of both the cleavage of the cap and the cargo release was monitored using fluorescence spectroscopy. This system traps intact cargo molecules without the necessity of chemical modification, releases them with tissue-penetrating near-IR light, and has possible applications in photostimulated drug delivery.


Asunto(s)
Cumarinas/química , Nanopartículas/efectos de la radiación , Fotones , Dióxido de Silicio/efectos de la radiación , Sistemas de Liberación de Medicamentos , Rayos Infrarrojos , Nanopartículas/química , Dióxido de Silicio/química , Rayos Ultravioleta , beta-Ciclodextrinas/química
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