Phenotypic virulence characterization of avian pathogenic Escherichia coli (APEC) isolates from broiler breeders with colibacillosis in Mississippi.

AIMS: In this study, we evaluated the phenotypic virulence characteristics of avian pathogenic Escherichia coli (APEC) isolates from broiler breeders with colibacillosis in Mississippi. Also, the relationship between phenotypic and genotypic virulence patterns was determined. METHODS AND RESULTS: Twenty-eight APEC isolated from lesions of broiler breeders diagnosed with colibacillosis were used for embryo lethality assay and chick challenge study. The percentage of embryo mortality following embryo lethality assay and pathogenicity score following the chick challenge study were used to categorize the isolates based on virulence. Pearson correlation analysis was performed to determine the relationship between embryo mortality, chick pathogenicity, and the presence of virulence-associated genes in the isolates. Overall, 39.3% of the isolates were highly virulent and 3.5% were avirulent, following both assays. There existed a positive correlation between embryo mortality and chick pathogenicity (r = 0.73, P < .01), as well as percentage embryo mortality and pathogenicity score with the presence of some virulence genes. CONCLUSIONS: Even though all the APEC were isolated from lesions of diseased breeders, the virulence potential varied from being avirulent to highly virulent. Further, we identified a positive relationship between phenotypic virulence and the frequency of virulence-associated genes.

Investigating the relationships between social capital, chronic health conditions and health status among Australian adults: findings from an Australian national cohort survey.

BACKGROUND: Social capital is a collective attribute of communities that determines health and well-being of populations. The collective resources in a high social capital community have been reported to result in better health outcomes. While evidence supports the links between social capital and various health outcomes, it is not clear about underlying mechanisms connecting multiple dimensions of social capital to health. METHODS: Using the two-wave data from a nationally representative cohort study of Australian adults (N = 16,637), this study examined the effects of two dimensions of social capital (i.e., structural and cognitive social capital) on physical and mental health in the Australian adult population. Based on prior literature and theoretical reasoning, it was anticipated that the structural and cognitive social capital would influence self-assessed health status (physical and mental health). Additionally, these two dimensions of social capital were hypothesized to moderate the relationships between chronic health conditions and these two aspects of health status. RESULTS: Analyses showed that the effects of chronic health conditions on mental health status were moderated by the structural social capital (ß = .652, SE = .249, p = .009). Additionally, it was found that perceived community cohesion was predictive of mental health (ß = .295, SE = .103, p = .004). Our analysis also indicated that perceptions of disadvantaged neighbourhood environment contributed to poorer mental health status (ß = -.461, SE = .144, p = .001). However, none of the social capital variables significantly predicted physical health status. CONCLUSIONS: Findings suggest that the structural dimension of social capital would function as a buffer against the malicious effects of chronic health conditions, impairments and disabilities. Specifically, community participation (structural social capital) is indispensable to develop an effective community-based program to improve health and well-being of those with chronic health conditions or disabilities, as increasing active participation may generate beneficial effects in this vulnerable population. Subjective perceptions about communities can also play an important role in improving better health outcomes. Further research is needed to examine underlying mechanisms linking the multiple dimensions of social capital to health outcomes among individuals who are vulnerable to external stressors.

Sleep Timing During Adolescence: A Latent Transition Analysis Approach.

Objective/Background: This paper utilized a person-centered approach to examine individual differences in sleep timing cross-sectionally and prospectively in adolescents. Participants: Data from Waves 5 and 6 of the Longitudinal Study of Australian Children were used. At Wave 5, the sample included 3,552 Australian adolescents aged 12-13 years (51% males, 49% females); 84% provided data at two-year follow-up (Wave 6). Methods: Through structured interviews, adolescents provided information on sleep timing (bedtimes, sleep-onset times, and wake times) on weekends and weekdays, and relevant covariates. Latent profile analysis identified sleep profiles at Waves 5 and 6 separately; latent transition analysis examined stability and change in profiles across time. Results: Six sleep timing profiles were identified at age 12-13 years: Early Larks (n = 228; 6.4%); Larks (n = 1257; 35.4%); Intermediate (n = 1311; 36.9%); Owls (n = 351; 9.9%); Variable Owls (n = 308; 8.7%); and, Late Owls (n = 97; 2.7%). Six similar profiles were identified at age 14-15 years. The latent transition analysis indicated that the Early Larks, Larks, and Intermediate profiles were more stable over time compared with the Owls, Variable Owls, and Late Owls profiles. Higher body mass index (BMI) and longer screen time predicted transitions from Larks and Early Larks to the Owls, Variable Owls, and Late Owls profiles. Conclusions: Many adolescents showed healthy sleep timing, which continued with age. However, the Variable Owls, Owls, and Late Owls profiles reflected less healthy and more variable sleep patterns that may require targeted interventions.

Trajectories of Psychological Distress in Australians Living in Urban Poverty: The Impact of Interpersonal Trauma.

Childhood maltreatment and interpersonal trauma experience is an important factor underpinning the apparent perpetuation of the cycle of social disadvantage experienced by homeless adults. This paper aimed to examine longitudinal patterns of psychological distress in a sample of 1,504 socially disadvantaged adult participants from the Journeys Home Study in Australia. The current paper utilized the "conservation of resources" theory and the concept of "risk factor caravans" to investigate the nature and implications of childhood trauma in the context of homelessness. Growth mixture modeling revealed four distinct trajectories of psychological distress as measured by the Kessler 6 across six time points (covering a period of 2.5 years): chronic, escalating, attenuating, and resistant. Our results also indicated that experiences of different types of trauma during childhood were associated with these psychological distress trajectories. In particular, adults experiencing chronic psychological distress were significantly more likely than those exhibiting distress resistance to have experienced multiple and varied childhood maltreatment, adjusted odds ratio (AOR) = 3.30, 95% CI [0.37, 6.05], p = .002. Furthermore, adult experiences of assault were found to be associated with psychological distress. These findings have important implications for mental health, as well as interventions aimed at breaking the cycle of urban poverty. Specific focus on interpersonal trauma vulnerabilities is important. Prioritizing socioecological stability, with mental health needs assessed on an individual level, may be most appropriate. This work also highlights the need to direct future attention to barriers to access and facilitation of social support services.

The Work-Family Interface and Sleep Quality.

OBJECTIVE: This article investigated whether work-to-family conflict (WFC) and work-to-family enrichment (WFE) were associated with employee sleep quality. WFC and WFE reflect the potential for experiences at work to negatively and positively influence nonworking life respectively, and may have implications for sleep quality. In this article, we examined whether WFC and WFE were linked with sleep quality via hedonic balance (i.e., positive affect relative to negative affect). PARTICIPANTS: The sample included 3,170 employed Australian parents involved in the Household Income and Labour Dynamics in Australia (HILDA) Survey. METHODS: Information on WFC, WFE, hedonic balance, sleep quality, and relevant covariates was collected through a structured interview and self-completion questionnaire. RESULTS: WFC was associated with poorer sleep quality (ß = .27, p < .001), and this relationship was stronger in males than females and in dual parent-single income families. WFC was also found to be indirectly associated with poor sleep quality via a lower hedonic balance (ß = .17, 99% confidence interval [.14, .20]). WFE was not directly associated with sleep quality, but was indirectly associated with better sleep quality via a higher hedonic balance (ß = -.04 [-.07, -.02]). CONCLUSIONS: These results indicate that aspects of the work-family interface are associated with employee sleep quality. Furthermore, affective experiences were found to link WFC and WFE with sleep quality. Workplace interventions that target WFC and WFE may have implications for employee sleep.

Physical Texturing for Superhydrophobic Polymeric Surfaces: A Design Perspective.

Surface wetting on the textured surface is classically explained by the theories of Cassie-Baxter or Wenzel. However, in recent years, an increasing number of complex surface topographies with superhydrophobic properties have been achieved without prediction or simulation using these theories. One example is biomimetic surfaces. In many instances, theories were used to explain surface properties found in nature but have not led to or predicted the complex topographies. Although new wetting theories continue to emerge, there is not yet a set of design rules to guide the selection of surface topographies to achieve superhydrophobicity. By grouping known surface topographies into common geometrical descriptions and length scale, this paper suggests a set of surface topography classifications to provide selection guidelines for engineering superhydrophobic surfaces. Two key outcomes emerged from the design analysis: first, categorization of frequently reported surface patterns shows that there exists a set of commonly used descriptions among diverse designs; second, the degree of hydrophobicity improvement within a class of topography design can be used to predict the limit of improvement in superhydrophobicity for a given material. The presentation of topography descriptors by categories of design and performance may serve as a prologue to an eventually complete set of design guidelines for superhydrophobic performance.

The Emergence and Collapse of Knowledge Boundaries.

The dynamics of knowledge transfer is an important topic for engineering managers. In this paper, we study knowledge boundaries - barriers to knowledge transfer - in groups of experts, using topic modeling, a natural language processing technique, applied to transcript data from the U.S. Food and Drug Administration's Circulatory Systems Advisory Panel. As predicted by prior theory, we find that knowledge boundaries emerge as the group faces increasingly challenging problems. Beyond this theory, we find that knowledge boundaries cease to structure communications between communities of practice when the group's expert ability is insufficient to solve its task, such as in the presence of high novelty. We conjecture that the amount of expert knowledge that the group can collectively bring to bear is a determining factor in boundary formation. This implies that some of the factors underlying knowledge boundary formation may aid - rather than hinder - knowledge aggregation. We briefly explore this conjecture using qualitative exploration of several relevant meetings. Finally, we discuss implications of these results for organizations attempting to leverage their expertise given the state of their collective knowledge.

Social climate profiles in adolescent sports: Associations with enjoyment and intention to continue.

This study explored whether adolescent sports participants' perceptions of the social climate fall into distinct profiles, and whether these profiles are related to enjoyment and intention to continue. A Latent Profile Analysis using 313 Australian sports participants (Mage = 13.03 years) revealed four distinct profiles: positive social climate (45.1%), diminished social climate (19.8%), positive coach relationship quality (19.8%), and positive friendship quality (15.3%). Individuals within the positive social climate and the positive coach relationship quality profiles reported relatively higher levels of enjoyment and intention to continue than individuals in the diminished social climate and the positive friendship quality profiles. Indirect path analyses found the social climate profiles were linked with intention to continue through enjoyment. Results highlight the value of investigating multiple dimensions of the social climate and suggest that the coach may be of particular importance in this age group. Findings have implications for understanding youth sports participation and preventing dropout.

Exploration of Sedentary Behavior in Residential Substance Abuse Populations: Results From an Intervention Study.

BACKGROUND: There is a growing body of research linking sedentary behavior with increased risk of chronic disease and all-cause mortality. It is increasingly recommended that service providers address the multiple behavioral risk factors associated with these chronic diseases as part of routine substance abuse treatment. OBJECTIVES: The study objective was to investigate rates of physical activity and sedentary behavior in a residential substance abuse population. In addition, efficacy of a sedentary behavior intervention, "Sit Switch," was examined for feasibility in this context. METHODS: Participants (n = 54) were residents of The Salvation Army Recovery Service Centres located in Canberra and on the Gold Coast, Australia. Actigraph GT3X+ accelerometers were used to measure rates and patterns of sedentariness and physical activity. A nonrandomized controlled study of a single-session group intervention aimed at decreasing prolonged sitting ("Sit Switch") was conducted. Education, motivational-interviewing, and goal setting components underpinned the "Sit Switch" intervention. RESULTS: Individuals were highly sedentary, spending 73% of daily activity at sedentary intensity engaged in inadequate levels of moderate physical activity (6.6%/day). The single session educational program did not lead to any significant changes in sedentary behavior. Conclusion/Importance: High levels of sedentariness and low levels of physical activity engagement are evident in residents in substance abuse treatment programs. It is strongly recommended that sedentariness, a modifiable risk behavior with independent consequences for cardiovascular disease and cancer, be addressed within residential programs.

Trajectories and Predictors of Health-Related Quality of Life during Childhood.

OBJECTIVE: To identify distinct trajectories of health-related quality of life (HRQOL) during childhood, along with their predictors. STUDY DESIGN: A nationally representative sample of 2700 children aged 4-5 years at baseline was followed up every 24 months through to age 12-13 years. Parents reported the children's HRQOL and data on potential predictors at each wave (5 in total) as part of the Longitudinal Study of Australian Children. RESULTS: Growth mixture modeling identified 5 distinct trajectories of HRQOL during childhood. Eighty-five percent of children had consistently high levels of HRQOL from age 4-5 years to 12-13 years (healthy); 8% of children had a significant and continuous decrease in HRQOL over time (high risk); and a further 5.3% of children had decreases in HRQOL from age 4-5 years to 8-9 years, followed by increases through to 12-13 years (rebound). Finally, a small percentage (1.6%) of children had extremely low levels of HRQOL at age 4-5 years that increased over time (recovery). Maternal smoking, lower household income, living in a non-English speaking household, and nonparticipation in organized sports were predictive of poorer HRQOL trajectories when compared with children in the healthy trajectory. CONCLUSION: There are distinct trajectories of HRQOL during childhood. Most children (85%) have a healthy, stable pattern, but the remaining children have trajectories indicative of poor HRQOL. Participation in sports, maternal smoking, lower family income, and language spoken at home distinguish among these trajectories. Of these, participation in organized sports has received relatively little attention as a preventative health priority.

Measuring mental well-being: A validation of the Short Warwick-Edinburgh Mental Well-Being Scale in Norwegian and Swedish.

AIMS: Mental health, currently one of the biggest challenges worldwide, requires attention and research. The aim of this study was to examine the psychometric properties of the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), and validate the scale for use in Norway and Sweden. SWEMWBS, which includes both hedonic and eudemonic principles of mental well-being, could facilitate useful future studies. METHOD: Data were collected among Norwegian and Swedish hotel managers (N=600) through self-rated online questionnaires. Tests used to examine the psychometric properties of the scale included descriptive statistics, correlations, reliability analyses, and explorative factor analyses in SPSS, as well as confirmatory factor analyses in AMOS. Robustness tests were run for gender and country subsamples. RESULTS: The scale showed adequate internal consistency and reliability. Results of the confirmatory factor analysis showed moderate fit in Norway and Sweden. In addition, the scale showed acceptable construct, criterion-related, and discriminant validity. CONCLUSION: The psychometric properties of the SWEMWBS were acceptable in both the Norwegian and the Swedish translations of the scale.

Dementia attitudes and help-seeking intentions: an investigation of responses to two scenarios of an experience of the early signs of dementia.

OBJECTIVES: To investigate associations between dementia-attitudes and help-seeking intentions. METHOD: An online survey of 611 Australian adults (45-60 years) assessed dementia-related attitudes and help-seeking intentions in response to two scenarios of an experience of early dementia: for themselves (Scenario 1); and for a significant other (proxy help-seeking) (Scenario 2). Logistic regression models examined the relationship between four dementia-related attitudes (labelled Personal Avoidance, Fear of Labelling, Fear of Discrimination and Person Centredness) and help-seeking intentions. RESULTS: Most participants indicated they would seek help from a general practitioner (GP) for themselves (82.2%) or for a proxy (78.7%) in response to the scenarios. Whilst only 7.2% indicated they would seek help from no-one, 21.3% would delay seeking help. In response to Scenario 1, Personal Avoidance and Fear of Labelling were associated with intentions to delay help-seeking. Fear of both Labelling and Discrimination were associated with intentions to seek help from no-one. In response to Scenario 2, Personal Avoidance was associated with intentions to delay proxy help-seeking and a reduced likelihood of seeking help by phone or and with Fear of Discrimination, via a GP. Fear of Labelling was also associated with an intention to delay proxy help-seeking. CONCLUSION: Efforts to improve help-seeking for dementia should address attitudes relating to stigma including negative labelling and a desire for the avoidance of people with dementia. Fears relating to discrimination indicate a need to build public confidence regarding the capacity of the health and workforce sectors to support people with dementia ethically and appropriately.

Sports participation and parent-reported health-related quality of life in children: longitudinal associations.

OBJECTIVE: To investigate the longitudinal association between sports participation and parent-reported health-related quality of life (HRQOL) in children. STUDY DESIGN: Cohort study that used data drawn from the Longitudinal Study of Australian Children in waves 3 (2008) and 4 (2010). Participants were a nationally representative sample of 4042 Australian children ages 8.25 (SD = 0.44) years at baseline and followed-up 24 months later. RESULTS: After we adjusted for multiple covariates, children who continued to participate in sports between the ages of 8 and 10 years had greater parent-reported HRQOL at age 10 (Eta2 = .02) compared with children who did not participate in sports (P ≤ .001), children who commenced participation after 8 years of age (P = .004), and children who dropped out of sports before reaching 10 years of age (P = .04). Children who participated in both team and individual sports (P = .02) or team sports alone (P = .04) had greater HRQOL compared with children who participated in individual sports alone (Eta2 = .01). The benefits of sports participation were strongest for girls (P < .05; Eta2 = .003). CONCLUSIONS: Children's participation in developmentally appropriate team sports helps to protect HRQOL and should be encouraged at an early age and maintained for as long as possible.

Lack of sleep could increase obesity in children and too much television could be partly to blame.

AIM: To examine the bidirectional relationship between short sleep duration and body mass index (BMI). A secondary aim was to investigate whether reduced physical activity and increased screen time (television and computer use) mediated these associations. METHODS: This study utilised data from the Longitudinal Study of Australian Children, which is an observational cohort study of Australian children. The sample included 2984 (52.4% boys) children followed from 4 to 5 years of age until 8 to 9 years of age. Sleep duration, screen time and covariates were reported by parents, with BMI measured objectively. Cross-lagged modelling investigated the bidirectional association between sleep duration and BMI; lagged panel mediation modelling examined physical activity and screen time as potential mediators. RESULTS: Short sleep duration at 4 to 5 years of age was significantly associated with higher BMI at 8 to 9 years of age (ß= -.07, p = .044). The relationship between short sleep duration at 4 to 5 years of age and higher BMI at 8 to 9 years of age was partially mediated by increased television viewing at 6 to 7 years of age (ß = -.01, 95% confidence interval [-.02, -.002]). CONCLUSION: Short sleep duration could be a risk factor for obesity in children. Increased television viewing may be one mechanism underlying this longitudinal relationship.

Trust, continuity and agency: keys to understanding older patients' attitudes to general practice trainees.

BACKGROUND: Populations are ageing and therefore non-communicable diseases are becoming leading causes of global morbidity, which need to be the focus of primary care services and training. Some older patients are uncomfortable with general practitioner (GP) trainees managing their chronic conditions, reducing clinical experience opportunities for trainees. This Australian cross-sectional study explored the factors underlying patients' attitudes to trainees in an agency theory framework. METHODS: Fifty patients aged 60 and over from each of 38 training practices were offered a questionnaire after their consultation. Principal component analysis of the results was undertaken. Factor scores were calculated. Binary logistic modelling was used to identify relationships between participant characteristics, behaviours, attitude items and factor scores. RESULTS: The response rate was 47.9% (n = 911). Three factors were identified: 'Interpersonal Trust' (IPT); 'Institution/system Trust' (ST); and 'Interpersonal Continuity' (IPC). Lower self-rated health (SRH) was associated with higher IPT factor scores (P = 0.023); higher SRH with higher ST scores (P = 0.001); and chronic illness with higher IPC scores (P = 0.005). Higher ST scores were associated with greater comfort with trainees' involvement in chronic care (P < 0.001) and frequency of trainee visits (P < 0.001), while higher IPC scores were negatively associated (P < 0.001 and P = 0.003, respectively). High IPT scores were associated with lower satisfaction with trainee visits (P = 0.001). DISCUSSION: These results indicate that better SRH, via higher institution/ST, is associated with favourable attitudes and attendance with trainees. In addition, chronic illness, via a higher need for IPC, is associated with lower comfort and attendance. These findings are consistent with agency theory, which shows potential as a framework for future interventions and research into older patient-trainee interactions.

Cross-sectional survey of older patients' views regarding multidisciplinary care for chronic conditions in general practice.

The ageing population and increasing prevalence of chronic illness have contributed to the need for significant primary care reform, including increased use of multidisciplinary care and task substitution. This cross-sectional study explores conditions under which older patients would accept having health professionals other than their general practitioner (GP) involved in their care for chronic disease management (CDM). Ten practices were randomly sampled from a contiguous major city and inner regional area. Questionnaires were distributed to consecutive patients aged 60 years and over in each practice. Agency theory was used to inform analyses. Statistical analysis was undertaken using Wald's test, growth modelling and linear regression, controlling for the clustered design. The response rate was 53% (n=272). Most respondents (79%) had at least one chronic health condition. Respondents were more comfortable with GP than with practice nurse management in the CDM scenario (Wald's test=105.49, P<0.001). Comfort with practice nurse CDM was positively associated with increased contact with their GP at the time of the visit (ß=0.41, P<0.001), negatively associated with the number of the respondent's chronic conditions (ß=-0.13, P=0.030) and not associated with the frequency of other health professional visits. Agency theory suggests that patients employ continuity of care to optimise factors important in CDM: information symmetry and goal alignment. Our findings are consistent with the theory and lend support to ensuring that interpersonal continuity of care is not lost in health care reform. Further research exploring patients' acceptance of differing systems of care is required.

Does seating location impact voting behavior on Food and Drug Administration advisory committees?

Food and Drug Administration (FDA) advisory committees have a significant influence on patterns of clinical practice worldwide. Recent guidance to the committees by the FDA has focused on attempting to eliminate sources of bias due to committee voting procedures. Nevertheless, major sources of social influence have not been addressed. We analyzed transcripts of Circulatory Systems Devices Panel meetings from 1997 to 2005 in which the panel cast votes on premarket approval and for which a voting minority existed. Committee members who are assigned to speak later are significantly more likely to be in the voting minority (P < 0.001). This effect holds for meetings with sequential voting (P = 0.0058) and for meetings with simultaneous voting (P = 0.045). A weaker effect shows that, for meetings with sequential voting, committee members who vote later are significantly more likely to be in the voting minority (P = 0.018). Speaking order and voting order are both determined by seating location. We therefore conclude that voting behavior on FDA expert advisory committees is strongly associated with seating location. This suggests the presence of a possible social dynamic that is not addressed by existing FDA committee procedures.

Personality change predicts self-reported mental and physical health.

OBJECTIVE: Personality dimensions are known to predict mortality and other health outcomes, but almost no research has assessed the effects of changes in personality traits on physical and mental health outcomes. In this article, we examined the effects of changes in the Big Five personality dimensions on health as assessed by the Short Form Health Survey (SF-36). METHOD: Respondents were 11,105 Australian adults aged 20-79 years (52.7% female). Latent difference score modeling was used to examine whether personality change over a 4-year period was associated with mental and physical health, and whether these effects were moderated by birth cohort. RESULTS: Increases in Conscientiousness and Extraversion were found to be associated with improved mental and physical health, whereas increased Neuroticism was linked with poorer health. The nature of these associations varied significantly by birth cohort. CONCLUSION: The findings have implications for understanding how changes in personality traits over time are related to health, and could be used to aid the development of effective health promotion strategies targeted to specific personality traits and birth cohorts.

Patterns of health behaviours predict obesity in Australian children.

AIMS: The study aims to examine whether patterns of health behaviours (based on sleep duration, physical activity, screen time and diet) were associated with obesity in Australian children. METHODS: This paper included 1833 children aged 6-7 years (51.6% male) recruited in 2006 as part of the Longitudinal Study of Australian Children. Latent class analysis was performed to identify the presence of distinct behavioural profiles on the basis of sleep duration, physical activity, screen time and eating habits. Logistic regression was performed to examine the association between the behavioural profiles and obesity assessed at baseline and 2-year follow-up. RESULTS: Three behavioural profiles, healthy (27.7%), sedentary (24.8%) and short sleepers/unhealthy eaters (47.5%), were identified. Compared with the healthy profile, the sedentary profile (odds ratio = 1.59, 95% confidence interval (1.06-2.38)) and short sleepers/unhealthy eaters (odds ratio = 1.47 (1.03-2.13)) had elevated odds of obesity at 2-year follow-up. CONCLUSIONS: The present study identified distinct profiles of health behaviours in this sample of Australian children. These findings add to existing findings that many health behaviours co-occur and that obesity interventions should target patterns of behaviours in children.

Short and long sleep duration are associated with prevalent cardiovascular disease in Australian adults.

A growing number of studies from a range of different countries have observed an association between sleep duration and cardiovascular disease. The objective of this paper was to examine the associations between sleep duration and prevalent cardiovascular disease in a large sample of Australian adults, and identify the sociodemographic and health-related factors moderating these associations. Participants included 218,155 Australian adults aged 45years and over. The results indicated that 6h versus 7h sleep was associated with increased odds of heart disease [odds ratio (OR)=1.11 (1.06-1.17)], diabetes [OR=1.15 (1.09-1.22)], stroke [OR=1.25 (1.14-1.38)] and high blood pressure [OR=1.08 (1.04-1.11)]. Long sleep (≥9h sleep) was also related to elevated odds of heart disease [OR=1.14 (1.09-1.19)], diabetes [OR=1.25 (1.19-1.31)], stroke [OR=1.50 (1.38-1.62)] and high blood pressure [OR=1.04 (1.01-1.08)] compared to 7h sleep. Some of these relationships varied by age, and were not evident in adults aged 75years and over. The magnitude of some associations varied significantly by body mass index, smoking and physical activity. These findings provide further insight into the nature of the relationship between sleep and cardiovascular health.