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Biomedical subjects

A Dobson

Publications and source records attributed to A Dobson.

At least 19 recordsLinked to original sources

Socio-demographic inequalities in the diets of mid-aged Australian women.

OBJECTIVES: This study reports on the distributions of food and nutrient intakes by socio-demographic factors for a large population sample of mid-aged Australian women participating in the Australian Longitudinal Study on Women's Health. DESIGN: This cross-sectional population-based study used the Cancer Council of Victoria food frequency questionnaires to derive estimates of food and nutrient intakes. SETTING: Nationwide community-based survey. SUBJECTS: A total of 10561 women aged 50-55 y, at the time of the survey in 2001. RESULTS: Analysis showed favourable patterns of food intake, with frequent consumption of many foods that are promoted as components of a healthy diet (eg, fresh fruit, leafy green and other vegetables, bread, cereals, milk and meat). Intakes of both foods and nutrients varied significantly across socio-demographic groups, with unmarried women, and women in 'labouring' occupations (eg, cleaner, factory worker, kitchenhand) having poorer nutrient intake. CONCLUSIONS: Although many mid-aged women in this sample had generally healthful diets, women in certain socio-demographic groups (particularly unmarried women and those in labouring occupations) had nutrient intakes of concern. As well as helping to address the dearth of current data on dietary intakes in the Australian population, the results highlight the need for continued targeted public health strategies aimed at improving diet of women from the various socio-economic backgrounds.

Australia↗

Emerging infectious pathogens of wildlife.

The first part of this paper surveys emerging pathogens of wildlife recorded on the ProMED Web site for a 2-year period between 1998 and 2000. The majority of pathogens recorded as causing disease outbreaks in wildlife were viral in origin. Anthropogenic activities caused the outbreaks in a significant majority of cases. The second part of the paper develops some matrix models for quantifying the basic reproductive number, R(0), for a variety of potential types of emergent pathogen that cause outbreaks in wildlife. These analyses emphasize the sensitivity of R(0) to heterogeneities created by either the spatial structure of the host population, or the ability of the pathogens to utilize multiple host species. At each stage we illustrate how the approach provides insight into the initial dynamics of emergent pathogens such as canine parvovirus, Lyme disease, and West Nile virus in the United States.

Animal Diseases↗

Ecological forecasts: an emerging imperative.

Planning and decision-making can be improved by access to reliable forecasts of ecosystem state, ecosystem services, and natural capital. Availability of new data sets, together with progress in computation and statistics, will increase our ability to forecast ecosystem change. An agenda that would lead toward a capacity to produce, evaluate, and communicate forecasts of critical ecosystem services requires a process that engages scientists and decision-makers. Interdisciplinary linkages are necessary because of the climate and societal controls on ecosystems, the feedbacks involving social change, and the decision-making relevance of forecasts.

Agriculture↗

Forecasting agriculturally driven global environmental change.

During the next 50 years, which is likely to be the final period of rapid agricultural expansion, demand for food by a wealthier and 50% larger global population will be a major driver of global environmental change. Should past dependences of the global environmental impacts of agriculture on human population and consumption continue, 10(9) hectares of natural ecosystems would be converted to agriculture by 2050. This would be accompanied by 2.4- to 2.7-fold increases in nitrogen- and phosphorus-driven eutrophication of terrestrial, freshwater, and near-shore marine ecosystems, and comparable increases in pesticide use. This eutrophication and habitat destruction would cause unprecedented ecosystem simplification, loss of ecosystem services, and species extinctions. Significant scientific advances and regulatory, technological, and policy changes are needed to control the environmental impacts of agricultural expansion.

Agriculture↗

An international biodiversity observation year.

The International Geophysical Year (IGY), which took place between July 1957 and December 1958, helped us to rethink the world. At a time when there was a major paradigm shift in our understanding of the physical world, the international collaboration of the IGY helped to reset the discipline. The International Biodiversity Observation Year (IBOY) is now occurring at a time when our dependence on, and understanding of, biodiversity is being acknowledged as a paradigm shift in our present view of the world. Although the benefits of IGY were initially intellectual with practical effects remaining unknown until many years later, the benefits of greater knowledge of biodiversity will support efforts towards sustainability and affect the quality of life, both now and in the future. By providing the framework for international collaborations between scientists involved in every aspect of life on Earth, IBOY has the potential to redefine our current understanding of biodiversity in a manner similar to how IGY helped redefine the geophysical world.

Journal Article↗

The application of statistical process control charts to the detection and monitoring of hospital-acquired infections.

The monitoring of infection control indicators including hospital-acquired infections is an established part of quality maintenance programmes in many health-care facilities. However, surveillance data use can be frustrated by the infrequent nature of many infections. Traditional methods of analysis often provide delayed identification of increasing infection occurrence, placing patients at preventable risk. The application of Shewhart, Cumulative Sum (CUSUM) and Exponentially Weighted Moving Average (EWMA) statistical process control charts to the monitoring of indicator infections allows continuous real-time assessment. The Shewhart chart will detect large changes, while CUSUM and EWMA methods are more suited to recognition of small to moderate sustained change. When used together, Shewhart and EWMA methods are ideal for monitoring bacteraemia and multiresistant organism rates. Shewhart and CUSUM charts are suitable for surgical infection surveillance.

Australia↗

Extravascular lung water in the exercising horse.

Seven Standardbred horses were exercised on a treadmill at speeds (approximately 12 m/s) producing maximal heart rate, hypoxemia, and a mean pulmonary arterial pressure of approximately 75 mmHg. Extravascular lung water was measured by using transients in temperature and electrical impedance of the blood caused by a bolus injection of cold saline solution. Lung water was approximately 3 ml/kg body wt when standing but did not increase significantly with exertion. We conclude that any increase in fluid extravasation from the pulmonary hypertension accumulates in the lung at a level that is less than that detectable by this method. At maximal exertion, the volume of blood measured between the jugular vein and the carotid artery increased by approximately 8 ml/kg, and the actively circulating component of the systemic blood volume increased by approximately 17 ml/kg with respect to corresponding values obtained when walking before exertion. These volume increases, reflecting recruitment and dilatation of capillaries, increase the area for respiratory gas exchange and offset the reduced transit times that would otherwise be imposed by the approximately eightfold increase in cardiac output at maximal exertion.

Animals↗

Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project populations.

BACKGROUND: From the mid-1980s to mid-1990s, the WHO MONICA Project monitored coronary events and classic risk factors for coronary heart disease (CHD) in 38 populations from 21 countries. We assessed the extent to which changes in these risk factors explain the variation in the trends in coronary-event rates across the populations. METHODS: In men and women aged 35-64 years, non-fatal myocardial infarction and coronary deaths were registered continuously to assess trends in rates of coronary events. We carried out population surveys to estimate trends in risk factors. Trends in event rates were regressed on trends in risk score and in individual risk factors. FINDINGS: Smoking rates decreased in most male populations but trends were mixed in women; mean blood pressures and cholesterol concentrations decreased, bodymass index increased, and overall risk scores and coronary-event rates decreased. The model of trends in 10-year coronary-event rates against risk scores and single risk factors showed a poor fit, but this was improved with a 4-year time lag for coronary events. The explanatory power of the analyses was limited by imprecision of the estimates and homogeneity of trends in the study populations. INTERPRETATION: Changes in the classic risk factors seem to partly explain the variation in population trends in CHD. Residual variance is attributable to difficulties in measurement and analysis, including time lag, and to factors that were not included, such as medical interventions. The results support prevention policies based on the classic risk factors but suggest potential for prevention beyond these.

Adult↗

Clinical measures of obesity and weight loss in men.

OBJECTIVES: (1) To determine the relationship between waist circumference and body weight in overweight men both before and after participation in a weight loss program; and (2) to make recommendations for the appropriate use of these measures at various stages of weight loss. DESIGN: Weight and waist circumference measures were taken in two diverse groups of men both before and 1-2 y after commencing a men's 'waist loss' program. Regression analyses were used to assess the relationship between weight and waist measures. SUBJECTS: One group of 42 retired Caucasian men from New South Wales, and one group of 45 indigenous men from the Torres Strait region of Northern Australia. RESULTS: There were differences in the relationships of weight and waist circumference before the program and change in weight and change in waist circumference after weight loss. These differences were similar in both groups of men (indigenous men and retired Caucasian men), with a 1 cm waist loss being on average equivalent to about 3/4 kg, but with wide variability, suggesting inter-individual variation in fat losses from different depots. This variation suggests that neither weight nor waist alone is a sufficient measure of fat loss for men. CONCLUSIONS: Weight and waist circumference should both be used at various stages in the clinical situation to assess change in body fat in men involved in obesity reduction.

Abdomen↗

Relationships between body mass index and well-being in young Australian women.

OBJECTIVE: To explore relationships between body mass index (BMI, kg/m2) and indicators of health and well-being in young Australian women. DESIGN: Population based cohort study--baseline cross sectional data. SUBJECTS: 14,779 women aged 18-23 who participated in the baseline survey of the Australian Longitudinal Study on Women's Health in 1996. MEASUREMENTS: Self-reported height, weight, medical conditions, symptoms and SF-36. RESULTS: The majority of women (68%) had a BMI in the range 18.5- <25; 12% had a BMI <18.5; 14% had a BMI in the range 25- <30 and 6% had a BMI > or =30. After adjustment for area of residence, age, education, smoking and exercise, women in the highest BMI category (> or =30) were more likely to report hypertension, asthma, headaches, back pain, sleeping difficulties, irregular periods, and more visits to their medical practitioner. They were also more likely to have given birth at least once, and less likely to report 'low iron'. Women with low BMI (<18.5) were more likely to report irregular periods and 'low iron'. Mean scores on the SF-36 sub-scales for physical functioning, general health and vitality were highest for women with BMI in the range 18.5-25. CONCLUSION: Acknowledging the limits of the cross-sectional nature of the data, the results show that the deleterious effects of overweight can be seen at a comparatively young age, and that BMI <25 is associated with fewer indicators of morbidity in young women. However, as BMI <18.5 is associated with low iron and irregular periods, care should be taken when developing strategies to prevent overweight in young women, not to encourage women with healthy weight to strive for a lower BMI.

Adolescent↗

Joint modelling of longitudinal measurements and event time data.

This paper formulates a class of models for the joint behaviour of a sequence of longitudinal measurements and an associated sequence of event times, including single-event survival data. This class includes and extends a number of specific models which have been proposed recently, and, in the absence of association, reduces to separate models for the measurements and events based, respectively, on a normal linear model with correlated errors and a semi-parametric proportional hazards or intensity model with frailty. Special cases of the model class are discussed in detail and an estimation procedure which allows the two components to be linked through a latent stochastic process is described. Methods are illustrated using results from a clinical trial into the treatment of schizophrenia.

Journal Article↗

Estimating the responsiveness of an instrument using more than two repeated measures.

The responsiveness of a measuring instrument is its ability to detect change over time. A commonly used index of responsiveness is the effect size for paired differences. This paper generalizes the effect size for paired differences to more than two repeated observations per subject. The sampling distribution of the generalized responsiveness statistic, Rt, is simulated for a range of plausible parameter values and for a range of sample sizes varying both the number of subjects (n) and the number of observations per subject (t). The coverage properties of confidence intervals constructed by four methods are compared. Confidence intervals based on jackknife estimates of the standard error and bias of Rt have good coverage properties even when n and t are small. The methods are used to determine which of two standard quality-of-life measures is more responsive to improvements in quality of life following surgery for early-stage breast cancer.

Bias↗