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Biomedical subjects

Anne W Taylor

Publications and source records attributed to Anne W Taylor.

At least 19 recordsLinked to original sources
PubMed2006

Central obesity is associated with nonatopic but not atopic asthma in a representative population sample.

BACKGROUND: Epidemiologic studies have consistently demonstrated the association between high body mass index (BMI) and asthma, yet the relationship between asthma and the alternative central obesity phenotypes, waist circumference (WC) and waist-to-hip ratio (WHR), has not been assessed in a representative population sample. OBJECTIVE: To determine the strength of the association of WC and WHR with current asthma and whether the association is modified by atopic status in a representative population sample. METHODS: The North West Adelaide Health Study, a biomedical population study of n = 4060, assessed current asthma, respiratory symptoms, and participant demographics by self-completed questionnaire. Clinic assessment included measures of WC and WHR, spirometry, and skin prick tests to a panel of allergens. RESULTS: Logistic regression analysis showed a significant, marginal increased adjusted risk of asthma associated with obese levels of WC and WHR and BMI > or =35.0 kg/m2 in female subjects only. When the association was considered stratified according to atopic status, the relationship between obese levels of WC and WHR with asthma held only for the nonatopic population in both males (WC: odds ratio [OR] 5.7, 95% confidence interval [CI] 1.1-28.8; WHR: OR 6.2, 95% CI, 1.1-32.9) and females (WC: OR 2.3, 95% CI, 1.2-4.4; WHR: OR 3.0, 95% CI, 1.5-5.9). BMI > or =35.0 kg/m2 showed an inconsistent pattern in the association with asthma. CONCLUSION: Central obesity was significantly associated with an increased risk of nonatopic asthma only. The causal pathway is unknown, but this study suggests the involvement of different pathophysiological mechanisms requiring further investigation. CLINICAL IMPLICATIONS: Asthma should be considered in older, nonatopic, centrally obese, symptomatic individuals.

Adolescent↗
PubMed2006

Bipolar disorders in Australia. A population-based study of excess costs.

OBJECTIVE: To estimate the excess costs associated with bipolar disorders in Australia, based on prevalence (using the Mood Disorder Questionnaire (MDQ)) and associated excess burden-of-illness costs. METHODS: Using data from the 2004 South Australian Health Omnibus Survey (HOS), a weighted cross-sectional survey of 3,015 adults, excess costs were estimated from health service utilisation. RESULTS: There was a 2.5% lifetime prevalence of bipolar disorders, delineated by the MDQ. Those persons (MDQ positive) reported a significantly greater use of services and a poorer health status and quality of life than those who were MDQ negative. Using the service provision perspective, excess costs of bipolar disorders in Australia were approx $3.97-$4.95 billion. CONCLUSIONS: These results from an Australian population demonstrate the significant economic burden of bipolar disorders. Our findings emphasise the need for further evaluation of the cost-effectiveness of different treatments, or alternative means of reducing the burden borne by individuals, the health system and the general community.

Adult↗
PubMed2006

Psychological factors and quality of life in arthritis: a population-based study.

Previous studies using clinic or convenience samples have indicated that not only patients with arthritis are at increased risk of depression, but there may also be a link between depression and disability in people with arthritis. We examined the prevalence of psychological distress in a population sample with and without arthritis and the association with health-related quality of life. The WANTS Health and Well-being Survey was a population household telephone interview survey of adults (age > or =18 years) in three states of Australia. Data obtained were weighted to provide population-representative estimates. The survey included questions regarding arthritis, SF-12, the Kessler 10 index of psychological distress and presence of mental health conditions. A total of 7,473 interviews providing information on arthritis were completed, with 1,364 (18.3%) reporting arthritis. Self-reported mental health conditions were more frequent in those with arthritis (14.9 vs 12.0%, p = 0.004), and a higher proportion were at a medium or high risk for anxiety or depression (39.0 vs 31.0%, p < 0.001). People with arthritis had significantly lower scores on the SF-12 physical component summaries compared to those without arthritis. Among those with arthritis, those with coexisting psychological distress had significantly lower scores on the SF-12 physical component summary than those without psychological distress. Psychological distress is common among people with arthritis in the community. In arthritis, psychological distress makes a significant additional negative impact on the physical well-being. Physicians need to recognize and address this additional impact on physical functioning in patients with arthritis.

Adolescent↗
PubMed2006

Factors associated with gamblers: a population-based cross-sectional study of South Australian adults.

OBJECTIVE: To determine, using a random telephone survey, the prevalence of various gambling activities among South Australian adults, the prevalence of adult problem gamblers using the South Oaks Gambling Screen (SOGS) instrument, and to examine the problem gamblers by demographic and health-related risk factors. METHOD: A random representative sample of South Australian adults selected from the Electronic White Pages. Overall, 6045 interviews were conducted (73.1% response rate) using Computer Assisted Telephone Interviewing (CATI) technology. RESULTS: Overall, 75.6% (95% CI: 74.5-76.7) of respondents had participated in at least one gambling activity during the last 12 months and 2.0% (95% CI: 1.7-2.4) were identified to be problem gamblers. A wide range of factors was associated with problem gambling at a univariate level, when compared to frequent gamblers. The logistic regression analysis highlighted that problem gamblers were more likely to speak a language other than English, be employed part time and a smoker when compared to frequent gamblers. Problem gamblers were also more likely to have a mental health condition (according to the Kessler 10), have had suicidal thoughts and know of services for gambling problems. CONCLUSION: There is a wide range of characteristics associated with problem gambling in South Australia. All of these factors need addressing during policy development to assist problem gamblers.

Adult↗
PubMed2006

A population view of mental illness in South Australia: broader issues than location.

INTRODUCTION: There is growing evidence in Australia and elsewhere to indicate that prevalence rates of mental illness are no higher in rural and remote areas than in urban areas. However, it is generally perceived that people from rural and remote areas are at heightened risk of mental illness, because many psychosocial determinants of health are magnified by factors related to remoteness. In this study we attempt to unpack the factors guiding prevalence rates of mental illness to determine if remoteness per se is an important determinant of mental illness. METHODS: Analysis of data from a cross-sectional, population-based, computer-assisted telephone interview survey in 2000. Respondents included 2545 South Australian adults, aged 18 years or more. The mental illness measure was self-reported, medically confirmed depression, anxiety or stress related problems in the previous 12 months and receiving treatment. Remoteness was determined using the Accessibility and Remoteness Index of Australia (ARIA). Psychosocial measures consisted of major stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviours. RESULTS: Unadjusted odds of mental illness were lower among residents of accessible and remote/very remote areas than for those from highly accessible areas (OR [odds ratio] 0.67, 95% CI 0.50-0.91 and OR 0.73, 0.54-1.00). After controlling for the joint effects of stressful life events, perceived control of life events, socio-demographic characteristics and lifestyle behaviors, odds of mental illness did not vary by ARIA category (highly accessible [reference category]; accessible: OR 0.90 95% CI 0.60-1.31; moderately accessible: OR 0.80, 95% CI 0.45-1.43; remote/very remote: OR 0.70, 95% CI 0.44-1.03). The most important predictors of mental illness in the multivariate logistic model were female sex; smoking; low consumption of vegetables; low exercise; a physical condition; perceived lack of control with life in general, personal life, job security or health; and major stressful events such as family or domestic violence and the death of someone close. CONCLUSIONS: Remoteness per se was not associated with mental illness, either directly or indirectly, as an important confounder in stressful life event/mental illness associations. Psychosocial factors were more important determinants of mental illness.

Adolescent↗
PubMed2006

Measuring social capital in a known disadvantaged urban community--health policy implications.

BACKGROUND: To assess the social capital profile of a known disadvantaged area a large cross-sectional survey was undertaken. The social capital profile of this area was compared to data from the whole of the state. The overall health status of the disadvantaged area was assessed in relation to a wide variety of social capital related variables. Univariate and multivariate analysis were undertaken. RESULTS: In the univariate analysis many statistically significant differences were found between the respondents in the disadvantaged area and the state estimates including overall health status, perceived attributes of the neighbourhood, levels of trust, community involvement and social activities. In the multivariate analysis very few variables were found to be statistically significantly associated with poorer health status. The variables that jointly predicted poorer health status in the disadvantaged area were older age, lower income, low sport participation, non-seeking help from neighbours and non-attendance at public meetings. CONCLUSION: Measuring social capital on a population level is complex and the use of epidemiologically-based population surveys does not produce overly valuable results. The inter-relational/dependence dichotomy of social capital is not yet fully understood making meaningful measurement in the broader population extremely difficult and hence is of questionable value for policy decision making.

Journal Article↗
PubMed2006

The North West Adelaide Health Study: detailed methods and baseline segmentation of a cohort for selected chronic diseases.

The North West Adelaide Health Study is a population-based biomedical cohort study investigating the prevalence of a number of chronic conditions and health-related risk factors along a continuum. This methodology may assist with evidence-based decisions for health policy makers and planners, and inform health professionals who are involved in chronic disease prevention and management, by providing a better description of people at risk of developing or already diagnosed with selected chronic conditions for more accurate targeting groups for health gain and improved health outcomes. Longitudinal data will provide information on progression of chronic conditions and allow description of those who move forward and back along the continuum over time. Detailed methods are provided regarding the random recruitment and examination of a representative sample of participants (n = 4060), including the rationale for various processes and valuable lessons learnt. Self-reported and biomedical data were obtained on risk factors (smoking, alcohol consumption, physical activity, family history, body mass index, blood pressure, cholesterol) and chronic conditions (asthma, chronic obstructive pulmonary disease, diabetes) to classify participants according to their status along a continuum. Segmenting this population sample along a continuum showed that 71.5% had at least one risk factor for developing asthma, chronic obstructive pulmonary disease or diabetes. Almost one-fifth (18.8%) had been previously diagnosed with at least one of these chronic conditions, and an additional 3.9% had at least one of these conditions but had not been diagnosed. This paper provides a novel opportunity to examine how a cohort study was born. It presents detailed methodology behind the selection, recruitment and examination of a cohort and how participants with selected chronic conditions can be segmented along a continuum that may assist with health promotion and health services planning.

Journal Article↗
PubMed2006

Trends in asthma prevalence and population changes in South Australia, 1990-2003.

OBJECTIVES: To examine changes in asthma prevalence in the context of other population changes between 1990 and 2003, for specific age and sex groups. DESIGN: Cross-sectional survey based on household interviews, repeated annually. SETTING AND PARTICIPANTS: Representative samples of the South Australian population between 1990 and 2003 (around 3000 people per year). MAIN OUTCOME MEASURES: Current prevalence of doctor-diagnosed asthma and other health and demographic variables potentially associated with asthma, and asthma management. RESULTS: Response rate was over 71%. Between 1990 and 2003, asthma prevalence increased significantly, doubling in females (from 7.3% in 1990 to 14.6% in 2003), with a smaller increase in males (from 7.8% to 9.4%). Asthma also increased in all age groups, but the largest relative increases occurred in people aged 55 years and older. Logistic regression analyses showed that obesity was a major predictive variable for every age group studied. The prevalence of asthma morbidity (waking at night and days lost from usual activities because of asthma) among those with asthma showed no significant changes between 1990 and 2003. Asthma action plans (introduced on a population basis in 1992) peaked in their distribution at 42% in 1994, and then declined to half that percentage in 2003. The increase in asthma prevalence occurred at the same time as increases in population prevalence of obesity (10.3% to 18.7%) and diabetes (3.1% to 6.9%), and decline in recent vigorous exercise (42.4% to 32.7%). CONCLUSIONS: The increase in asthma prevalence over a decade was large, but concentrated among specific sex and age groups. The increase accompanied population increases in obesity and diabetes and a decline in vigorous exercise.

Adolescent↗
PubMed2006

Do people with risky behaviours participate in biomedical cohort studies?

BACKGROUND: Analysis was undertaken on data from randomly selected participants of a bio-medical cohort study to assess representativeness. The research hypotheses was that there was no difference in participation and non-participations in terms of health-related indicators (smoking, alcohol use, body mass index, physical activity, blood pressure and cholesterol readings and overall health status) and selected socio-demographics (age, sex, area of residence, education level, marital status and work status). METHODS: Randomly selected adults were recruited into a bio-medical representative cohort study based in the north western suburbs of the capital of South Australia--Adealide. Comparison data was obtained from cross-sectional surveys of randomly selected adults in the same age range and in the same region. The cohort participants were 4060 randomly selected adults (18+ years). RESULTS: There were no major differences between study participants and the comparison population in terms of current smoking status, body mass index, physical activity, overall health status and proportions with current high blood pressure and cholesterol readings. Significantly more people who reported a medium to very high alcohol risk participated in the study. There were some demographic differences with study participants more likely to be in the middle level of household income and education level. CONCLUSION: People with risky behaviours participated in this health study in the same proportions as people without these risk factors.

Adult↗
PubMed2006

The continuing use of complementary and alternative medicine in South Australia: costs and beliefs in 2004.

OBJECTIVE: To survey the use, cost, beliefs and quality of life of users of complementary and alternative medicine (CAM). DESIGN: A representative population survey conducted in 2004 with longitudinal comparison to similar 1993 and 2000 surveys. PARTICIPANTS: 3015 South Australian respondents over the age of 15 years (71.7% participation). RESULTS: In 2004, CAMs were used by 52.2% of the population. Greatest use was in women aged 25-34 years, with higher income and education levels. CAM therapists had been visited by 26.5% of the population. In those with children, 29.9% administered CAMs to them and 17.5% of the children had visited CAM therapists. The total extrapolated cost in Australia of CAMs and CAM therapists in 2004 was AUD$1.8 billion, which was a decrease from AUD$2.3 billion in 2000. CAMs were used mostly to maintain general health. The users of CAM had lower quality-of-life scores than non-users. Among CAM users, 49.7% used conventional medicines on the same day and 57.2% did not report the use of CAMs to their doctor. About half of the respondents assumed that CAMs were independently tested by a government agency; of these, 74.8% believed they were tested for quality and safety, 21.8% for what they claimed, and 17.9% for efficacy. CONCLUSIONS: Australians continue to use high levels of CAMs and CAM therapists. The public is often unaware that CAMs are not tested by the Therapeutic Goods Administration for efficacy or safety.

Adolescent↗
PubMed2006

Health status assessed by the SF-36 along the diabetes continuum in an Australian population.

OBJECTIVE: To examine the association of health status with stage along the diabetes continuum. DESIGN, SETTING AND PARTICIPANTS: Self-reported health status (SF-36) was assessed in the North West Adelaide Health Study, a representative population cohort (n = 4060) aged 18 years and over in metropolitan South Australia. Impaired fasting glucose (IFG), undiagnosed diabetes, diagnosed diabetes, glycaemic control and cardiovascular disease were determined from fasting blood and self-reported data. RESULTS: The prevalence of diagnosed diabetes was 5.6% (95% CI: 4.9-6.3), with an additional 1.0% (95% CI: 0.7-1.4) previously undiagnosed. When compared to those with normal glucose, those with diabetes were significantly impaired on all SF-36 dimensions except Mental Health, and those with IFG (4.3%) were significantly impaired in terms of Physical Functioning and Bodily Pain when controlling for the effects of age, sex and cardiovascular disease. Poor glycaemic control (HbA1c >or= 7.0%) was also associated with impaired health status. CONCLUSIONS: Health status is impaired not only among those with diagnosed diabetes but also those with IFG and undiagnosed diabetes.

Adolescent↗
PubMed2006

How valid are self-reported height and weight? A comparison between CATI self-report and clinic measurements using a large cohort study.

OBJECTIVE: To examine the relationship between self-reported and clinical measurements for height and weight in adults aged 18 years and over and to determine the bias associated with using household telephone surveys. METHOD: A representative population sample of adults aged 18 years and over living in the north-west region of Adelaide (n = 1,537) were recruited to the biomedical cohort study in 2002/03. A computer-assisted telephone interviewing (CATI) system was used to collect self-reported height and weight. Clinical measures were obtained when the cohort study participants attended a clinic for biomedical tests. RESULT: Adults over-estimated their height (by 1.4 cm) and under-estimated their weight (by 1.7 kg). Using the self-report figures the prevalence of overweight/ obese was 56.0% but this prevalence estimate increased to 65.3% when clinical measurements were used. The discrepancy in self-reported height and weight is partly explained by 1) a rounding effect (rounding height and weight to the nearest 0 or 5) and 2) older persons (65+ years) considerably over-estimating their height. CONCLUSION: Self-report is important in monitoring overweight and obesity; however, it must be recognised that prevalence estimates obtained are likely to understate the problem. IMPLICATIONS: The public health focus on obesity is warranted, but self-report estimates, commonly used to highlight the obesity epidemic, are likely to be underestimations. Self-report would be a more reliable measure if people did not round their measurements and if older persons more accurately knew their height.

Adolescent↗
PubMed2006

Postmenopausal hormone therapy: who now takes it and do they differ from non-users?

BACKGROUND: Considerable changes in hormone therapy use have taken place in the last few years. AIMS: To determine current usage of postmenopausal hormone therapy and assess the trend and rate of change in hormone therapy usage over the last 13 years. Additionally, to assess differences between current users and non-users for health-related and risk factor variables. METHODS: Questions regarding hormone therapy use have been included in an annual face to face population health survey of South Australians eight times since 1991. In 2004, additional questions on health status and quality of life were included. RESULTS: In 2004, current use of hormone therapy was 15.4, 19.8 and 31.2% in all women over 40, 50 and 50-59 years, respectively. Ever use of hormone therapy among all women over 50 years was 46.5% with a mean duration of use of 7.46 years. Hormone therapy users did not differ from non-users in chronic disease indicators, body mass index, complementary medicine or therapist use, other health service use, socioeconomic status or quality of life. Increased hormone therapy use was associated with higher income, better educated, employed and married women in their sixth decade. Current use has varied over the years, with an increase to 2000, but a drop in 2003 and 2004. CONCLUSION: Apart from menopausal symptoms, there is no evidence to support differences between users and non-users in terms of quality of life or health characteristics, requiring more appropriate selection of women for hormone therapy.

Age Factors↗
PubMed2006

Coexistent chronic conditions and asthma quality of life: a population-based study.

OBJECTIVE: Reports of the prevalence and impact of comorbid conditions among people with asthma have been limited to certain population groups or convenience samples. Our aim was to examine the prevalence of major comorbidity in asthma and associations with quality of life and functional status in the general population. STUDY DESIGN/SETTING: The WANTS Health and Well-being Survey is a cross-sectional representative population household telephone interview survey in three Australian states. PARTICIPANTS: Representative sample of noninstitutionalized adults in three Australian states. MEASUREMENT AND RESULTS: From the available sample of 10,080 patients, 7,619 interviews were completed (participation rate, 74.8%), with 834 people reporting current doctor-diagnosed asthma (11.2%). People with asthma were more likely to report one of the selected comorbid conditions: diabetes, arthritis, heart disease, stroke, cancer, osteoporosis (adjusted odds ratio, 1.9; 95% confidence interval, 1.5 to 2.2). Among people with asthma, there were statistically and clinically significant decreases in usual activity levels and in Short Form-12 physical component summary scores when another chronic condition was also present. For those with any of the chronic conditions, the additional presence of asthma was associated with significant further impairment in quality of life in those aged > 35 years but not in younger adults. CONCLUSION: The significant reduction in quality of life associated with comorbidity in asthma has implications for disease management and organization of care, as well as for the design and external validity of single-disease clinical trials.

Activities of Daily Living↗
PubMed2005

Changes in mental health literacy about depression: South Australia, 1998 to 2004.

OBJECTIVE: To identify changes in mental health literacy in regard to depression between 1998 and 2004. DESIGN AND SETTING: Face-to-face interviews with a random and representative sample of the South Australian population in 2004, compared with a similarly conducted survey in 1998 that used the same vignette, questions and methodology. PARTICIPANTS: 3015 randomly selected participants, aged 15 years and over. MAIN OUTCOME MEASURES: Responses to both open-ended and direct questions about symptoms and treatment options for depression. RESULTS: The 3015 interviews conducted represented a response rate of 65.9%. Compared with 1998, in 2004 there was a significant increase in the proportion of people recognising depression in the vignette, acknowledging personal experience of depression, and perceiving professional assistance to be more helpful and less harmful. However, although more people nominated psychiatrists or psychologists as therapists of choice, the difference between 1998 and 2004 was not significant. CONCLUSIONS: There has been a significant increase in mental health literacy, at least as regards depression, in the South Australian community between 1998 and 2004. The lack of significant change in psychiatrists and/or psychologists being perceived as therapists of choice is of concern and suggests that community education about their expertise may be appropriate.

Adolescent↗
PubMed2005

Spirometric criteria for asthma: adding further evidence to the debate.

BACKGROUND: Objective assessments of pulmonary function are considered essential for the diagnosis of asthma. The degree of reversibility of FEV(1) considered supportive of asthma varies between international asthma guidelines. OBJECTIVE: We sought to compare the relative performance of international guideline reversibility criteria for identifying impairment in persons with a significant bronchodilator response (SBR) without an asthma diagnosis. METHODS: The North West Adelaide Health (Cohort) Study, a population biomedical study of 4060 subjects, conducted spirometry according to American Thoracic Society criteria. SBR was defined as postbronchodilator FEV(1) responses of at least 12% or 15% of baseline values, 9% of predicted values, or 400 mL. A self-completed questionnaire assessed current asthma (CA), respiratory symptoms, and participant demographics. RESULTS: The prevalence of CA was 9.4% (n = 380), whereas 1.3% (>/=400 mL) to 4.5% (>/=9% of predicted value) of participants demonstrated an SBR in the absence of CA. With the exception of the 9% predicted criterion, prebronchodilator mean FEV(1) (percent predicted) in those demonstrating an SBR but no CA was significantly worse than that in the CA group. Significantly more respiratory symptoms were experienced by the SBR groups than the group without asthma. Logistic regression analyses identified different characteristics of those classified by the following criteria: 12% and 15%, age of 40 years or greater and household income of less than $40,000; 9% predicted, household income of less than $40,000; 400 mL, male sex (odds ratio, 4.5; 95% CI, 2.1-9.3). CONCLUSIONS: Different criteria identify different persons, but SBR by any criteria was associated with significant respiratory impairment, some of which might be attributable to asthma. Postbronchodilator change as a percentage of predicted value was the least biased of the criteria.

Adult↗
PubMed2005

Bipolar I and II disorders in a random and representative Australian population.

OBJECTIVE: To assess the prevalence of bipolar I and II disorders in an Australian population. METHOD: The Mood Disorder Questionnaire (MDQ) was administered to 3015 respondents in a random and representative sample in South Australia. Health status, quality of life and demographic data were also collected. RESULTS: There was a 2.5% lifetime prevalence of bipolar I and II disorders delineated by the MDQ. Those people had a significantly greater use of services and a poorer health status and quality of life than those who were MDQ-negative. CONCLUSIONS: These results in an Australian population are consistent with other international studies showing a greater prevalence of bipolar disorders than hitherto appreciated.

Adult↗