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Biomedical subjects

Wendy J Brown

Publications and source records attributed to Wendy J Brown.

At least 19 recordsLinked to original sources
PubMed2006

Retention, adherence and compliance: important considerations for home- and group-based resistance training programs for older adults.

Reports on the efficacy of physical activity intervention trials usually only include discussion of the primary outcomes. However, assessing factors such as participant retention, adherence and compliance can assist in the accurate interpretation of the overall impact of a program in terms of reach and appeal. A quasi-randomised trial was carried out to assess and compare retention and adherence rates, and compliance with, a twice weekly resistance training program provided either individually at home or in a group format. Retirement villages (n=6) were assigned to either 'Have A Try' (HAT, home-based) or 'Come Have A Try' (CHAT, group-based); both programs included nine strength and two balance exercises. The program involved a 20-week Intervention Phase a 24-week Maintenance Phase and a 20-week On-going Maintenance Phase. One hundred and nineteen participants (mean age 80+/-6 years) were recruited (HAT=38, CHAT=81). There was no difference in retention rates at the end of the Intervention Phase, but significantly more HAT than CHAT participants had dropped out of the study (p<0.01) after the Maintenance Phase and the On-going Maintenance Phase. During the Intervention Phase, over half the HAT and CHAT participants completed > or =75% of the prescribed activity sessions, but adherence was significantly greater in CHAT than HAT during the Maintenance Phase (p<0.01). Participants in CHAT were significantly more compliant than HAT participants (p<0.05). Both home- and group-based formats were successful over the short-term, but, in retirement villages, the group program had better adherence and compliance in the longer-term.

Adult↗
PubMed2006

Individual or population approaches to the promotion of physical activity...is that the question?

A recent editorial raised several issues about the role of exercise physiologists in the fight against physical inactivity in Australia. This opinion piece argues that we must strive to work together in multidisciplinary groups to improve our understanding of the mechanisms which link PA and health and the ways to persuade people to become more active. Prescription of specific exercise programs supported by exercise physiologists is one strategy for helping to activate Australians, but it is unlikely that that this alone will have a significant impact on population health. If we are to activate the 10,000,000 Australians who are currently insufficiently active for health benefit, we will need the combined efforts of governments, NGOs, teachers, planners, marketing experts, veterinarians, and ALL our health professionals, to combine forces to activate Australia.

Allied Health Occupations↗
PubMed2005

3. Is exercise good for you?

Physical activity can significantly reduce the risk of cardiovascular disease, diabetes, some forms of cancer, osteoporosis, obesity, falls and fractures, and some mental health problems. While the benefits of physical activity are clear, there is a slightly increased risk of sudden death while exercising (compared with while sedentary), especially in untrained people undertaking unaccustomed vigorous activity. Routine exercise testing yields a significant number of false-positive results, and has not been shown to prevent exercise-related acute cardiac events. There is no convincing evidence that exercise is itself associated with osteoarthritis, but significant joint injury which occurs during sport is associated with an increased risk of subsequent development of osteoarthritis.

Adult↗
PubMed2005

Occupational sitting time and overweight and obesity in Australian workers.

BACKGROUND: One of the major immediate and long-term health issues in modern society is the problem of overweight and obesity. This paper examines the role of the workplace in the problem by studying the association between occupational sitting time and overweight and obesity (body mass index [BMI] > or =25) in a sample of adult Australians in full-time employment. METHODS: Data on age, gender, occupation, physical activity, occupational sitting time, and BMI were collected in September 2003 from a sample of 1579 adult men and women in full-time employment at the time of the survey. Logistic regression was used to examine the association between occupational sitting time and overweight and obesity. RESULTS: Mean occupational sitting time was >3 hours/day, and significantly higher in men (209 minutes) than in women (189 minutes, p=0.026). Univariate analyses showed significant associations between occupational sitting time and BMI of > or =25 in men but not in women. After adjusting for age, occupation, and physical activity, the odds ratio for BMI > or =25 was 1.92 (confidence interval: 1.17-3.17) in men who reported sitting for >6 hours/day, compared with those who sat for <45 minutes/day. CONCLUSIONS: Occupational sitting time was independently associated with overweight and obesity in men who were in full-time paid work. These results suggest that the workplace may play an important role in the growing problem of overweight and obesity. Further research is needed to clearly understand the association between sitting time at work and overweight and obesity in women.

Adult↗
PubMed2005

Prospective study of physical activity and depressive symptoms in middle-aged women.

BACKGROUND: Although many studies support an inverse association between physical activity (PA) and depressive symptoms, prospective relationships between these variables have been confounded by pre-existing psychological and physical health problems. METHODS: This study examined the dose-response relationships between self-reported PA and depressive symptoms, using cross-sectional and prospective data from a population-based cohort of middle-aged women who participated in the Australian Longitudinal Study on Women's Health (ALSWH) between 1996 and 2001. Participants completed three mailed surveys (S1, 1996; S2, 1998; S3, 2001), which included questions about time spent in walking, moderate- and vigorous-intensity PA, and measures of psychological health (Center for Epidemiologic Studies Depression scale [CESD-10], and Mental health [MH] subscale of the Short Form 36 survey). Relationships between previous (S1, S2), current (S3), and habitual (S1, S2, S3) PA and "depressive symptoms" were examined, adjusting for sociodemographic and health-related variables (n=9207). RESULTS: Mean CESD-10 scores decreased, and MH scores increased with increasing levels of previous, current, and habitual activity. Odds ratios for CESD-10 scores > or =10 or MH scores < or =52 at S3 were 30% to 40% lower among women who reported the equivalent of > or =60 minutes of moderate-intensity PA per week, compared with those who reported less PA than this. Women who were in the lowest PA category at S1, but who subsequently reported > or =240 metabolic equivalent minutes (MET.mins) per week had lower odds of CESD-10 scores of > or =10 or MH scores < or =52 at S3 than those who remained in the very low PA category. CONCLUSIONS: These data suggest that there is a clear relationship between increasing PA and decreasing depressive symptoms in middle-aged women, independent of pre-existing physical and psychological health.

Australia↗
PubMed2005

Identifying the energy gap: magnitude and determinants of 5-year weight gain in midage women.

OBJECTIVE: The aims of this study were to estimate average yearly weight gain in midage women and to identify the determinants of weight gain and gaining weight at double the average rate. RESEARCH METHODS AND PROCEDURES: The study sample comprised 8071 participants (45 to 55 years old) in the Australian Longitudinal Study on Women's Health who completed mailed surveys in 1996, 1998, and 2001. RESULTS: On average, the women gained almost 0.5 kg per year [average 2.42 kg (95% confidence interval, 2.29 to 2.54) over 5 years]. In multivariate analyses, variables associated with energy balance (physical activity, sitting time, and energy intake), as well as quitting smoking, menopause/hysterectomy, and baseline BMI category were significantly associated with weight gain, but other behavioral and demographic characteristics were not. After adjustment for all of the other biological and behavioral variables, the odds of gaining weight at about twice the average rate (>5 kg over 5 years) were highest for women who quit smoking (odds ratio = 2.94; 95% confidence interval, 2.17, 3.96). There were also independent relationships between the odds of gaining >5 kg and lower levels of habitual physical activity, more time spent sitting, energy intake (but only in women with BMI > 25 at baseline), menopause transition, and hysterectomy. DISCUSSION: The average weight gain equates with an energy imbalance of only about 10 kcal or 40 kJ per day, which suggests that small sustained changes in the modifiable behavioral variables could prevent further weight gain.

Age Factors↗
PubMed2004

Physical activity promotion in primary care: bridging the gap between research and practice.

BACKGROUND: While a growing literature supports the effectiveness of physical activity interventions delivered in the primary care setting, few studies have evaluated efforts to increase physician counseling on physical activity during routine practice (i.e., outside the context of controlled research). This paper reports the results of a dissemination trial of a primary care-based physical activity counseling intervention conducted within the context of a larger, multi-strategy, Australian community-based, physical activity intervention, the 10,000 Steps Rockhampton Project. METHODS: All 23 general practices and 66 general practitioners (GPs, the Australian equivalent of family physicians) were invited to participate. Practice visits were made to consenting practices during which instruction in brief physical activity counseling was offered, along with physical activity promotion resources (print materials and pedometers). The evaluation, guided by the RE-AIM framework, included collection of process data, as well as pre- and post-intervention data from a mailed GP survey, and data from the larger project's random-digit-dialed, community-based, cross-sectional telephone survey that was conducted in Rockhampton and a comparison community. RESULTS: Ninety-one percent of practices were visited by 10,000 Steps staff and agreed to participate, with 58% of GPs present during the visits. General practitioner survey response rates were 67% (n =44/66 at baseline) and 71% (n =37/52, at 14-month follow-up). At follow-up, 62% had displayed the poster, 81% were using the brochures, and 70% had loaned pedometers to patients, although the number loaned was relatively small. No change was seen in GP self-report of the percentage of patients counseled on physical activity. However, data from the telephone surveys showed a 31% increase in the likelihood of recalling GP advice on physical activity in Rockhampton (95% confidence interval [CI]=1.11-1.54) compared to a 16% decrease (95% CI=0.68-1.04) in the comparison community. CONCLUSIONS: This dissemination study achieved high rates of GP uptake, reasonable levels of implementation, and a significant increase in the number of community residents counseled on physical activity. These results suggest that evidence-based primary care physical activity counseling protocols can be translated into routine practice, although the initial and ongoing investment of time to develop partnerships with relevant healthcare organizations, and the interest generated by the overall 10,000 Steps program should not be underestimated.

Attitude of Health Personnel↗
PubMed2004

Indexes of insulin resistance and secretion in obese children and adolescents: a validation study.

OBJECTIVE: To assess the concurrent validity of fasting indexes of insulin sensitivity and secretion in obese prepubertal (Tanner stage 1) children and pubertal (Tanner stages 2-5) adolescents using estimates from the modified minimal model frequently sampled intravenous glucose tolerance test (FSIVGTT) as a criterion measure. RESEARCH DESIGN AND METHODS: Eighteen obese children and adolescents (11 girls and 7 boys, mean age 12.2 +/- 2.4 years, mean BMI 35.4 +/- 6.2 kg/m(2), mean BMI-SDS 3.5 +/- 0.5, 7 prepubertal and 11 pubertal) participated in the study. All participants underwent an insulin-modified FSIVGTT on two occasions, and 15 repeated this test a third time (mean 12.9 and 12.0 weeks apart). S(i) measured by the FSIVGTT was compared with homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR), quantitative insulin-sensitivity check index (QUICKI), fasting glucose-to-insulin ratio (FGIR), and fasting insulin (estimates of insulin sensitivity derived from fasting samples). The acute insulin response (AIR) measured by the FSIVGTT was compared with HOMA of percent beta-cell function (HOMA-beta%), FGIR, and fasting insulin (estimates of insulin secretion derived from fasting samples). RESULTS: There was a significant negative correlation between HOMA-IR and S(i) (r = -0.89, r = -0.90, and r = -0.81, P < 0.01) and a significant positive correlation between QUICKI and S(i) (r = 0.89, r = 0.90, and r = 0.81, P < 0.01) at each time point. There was a significant positive correlation between FGIR and S(i) (r = 0.91, r = 0.91, and r = 0.82, P < 0.01) and a significant negative correlation between fasting insulin and S(i) (r = -90, r = -0.90, and r = -0.88, P < 0.01). HOMA-beta% was not as strongly correlated with AIR (r = 0.60, r = 0.54, and r = 0.61, P < 0.05). CONCLUSIONS: HOMA-IR, QUICKI, FGIR, and fasting insulin correlate strongly with S(i) assessed by the FSIVGTT in obese children and adolescents. Correlations between HOMA-beta%, FGIR and fasting insulin, and AIR were not as strong. Indexes derived from fasting samples are a valid tool for assessing insulin sensitivity in prepubertal and pubertal obese children.

Adolescent↗
PubMed2003

Urinary incontinence across the lifespan.

AIMS: The objectives of the current study were (1) to measure type and severity of urinary leakage and (2) to investigate the association between these factors and age-related life events and conditions in three groups of Australian women with a history of urinary leakage. METHODS: Five hundred participants were randomly selected from women in the young (aged 18-22 in 1996), mid-age (45-50), and older (70-75) cohorts of the Australian Longitudinal Study of Women's Health (ALSWH) who had reported leaking urine in the 1996 baseline survey. Details about leaking urine (frequency, severity, situations) and associated factors (pregnancy, childbirth, body mass index [BMI]) were sought through self-report mailed follow-up surveys in 1999. RESULTS & CONCLUSIONS: Response rates were 50, 83, and 80% in the young, mid-age, and older women, respectively. Most women confirmed that they had leaked urine in the past month, and the majority of these were cases of "mixed" incontinence. Incontinence severity tended to increase with BMI for women of all ages, and increased severity scores were associated with having urine that burns or stings. Additional independent risk factors for increasing incontinence severity were heavy smoking in young women, past or present use of hormone replacement therapy in older women, and BMI and history of hysterectomy in mid-age women.

Adolescent↗
PubMed2003

Life transitions and changing physical activity patterns in young women.

BACKGROUND: Physical activity (PA) patterns are likely to change in young adulthood in line with changes in lifestyle that occur in the transition from adolescence to adulthood. The aim of this study was to ascertain whether key life events experienced by young women in their early twenties are associated with increasing levels of inactivity. METHODS: This was a 4-year follow-up of 7281 participants (aged 18 to 23 years at baseline) in the Australian Longitudinal Study of Women's Health, with self-reported measures of PA, life events, body mass index (BMI), and sociodemographic variables. RESULTS: The cross-sectional data indicated no change in PA between baseline (57% "active") and follow-up (56% "active"). However, for almost 40% of the sample, PA category changed between baseline and follow-up, with approximately 20% of the women changing from being "active" to "inactive," and another 20% changing from being "inactive" to "active." After adjustment for age, other sociodemographic variables, BMI, and PA at baseline, women who reported getting married, having a first or subsequent child, or beginning paid work were more likely to be inactive at follow-up than those who did not report these events. CONCLUSIONS: The results suggest that life events such as getting married, having children, and starting work are associated with decreased levels of PA in young adult women. Strategies are needed to promote maintenance of activity at the time when most women experience these key life-stage transitions.

Adolescent↗
PubMed2003

Physical and mental health: changes during menopause transition.

OBJECTIVE: To measure changes in physical and mental health in six groups of women defined by menopausal status or use of hormone replacement therapy (HRT). DESIGN: Longitudinal study with 2 years follow-up. PARTICIPANTS: Eight thousand six hundred and twenty three women participating in the Australian Longitudinal Study on Women's Health, aged 45-50 years in 1996. MAIN OUTCOME MEASURES: Changes in the eight dimensions of the Short Form General Health Survey (SF-36) adjusted for baseline scores, lifestyle, behavioural and demographic factors. RESULTS: At baseline, mean scores for five of the eight dimensions of the SF-36 were highest (indicating better state of health or well-being) in premenopausal women. There were declines (that is, worsening health) in the SF-36 dimensions in most groups of women. Declines were largest in physical functioning (adjusted mean change of -4.9, standard error (SE) 0.7) and physical role limitation (-5.7, SE: 1.3) in women who remained peri-menopausal throughout the study period and in women taking HRT at the time of either survey (physical functioning: -5.3 (0.7), role physical limitation: -7.5 (1.2)). They were smallest in women who remained pre-menopausal (physical functioning: -3.2 (0.7); role physical limitation: -2.1 (1.1)). CONCLUSIONS: Physical aspects of general health and well-being decline during the menopausal transition. Sensitive measures and careful analysis are needed to understand why these changes are worse for peri-menopausal women and those taking HRT.

Female↗
PubMed2003

Managing urinary incontinence across the lifespan.

In the 1996 baseline surveys of the Australian Longitudinal Study of Women's Health (ALSWH), 36.1% of mid-age women (45-50) and 35% of older women (70-75) reported leaking urine. This study aimed to investigate (a) the range of self-management strategies used to deal with urinary incontinence (UI); (b) the reasons why many women who report leaking urine do not seek help for UI; and (c) the types of health professionals consulted and treatment provided, and perceptions of satisfaction with these, among a sample of women in each age group who reported leaking urine "often" at baseline. Five hundred participants were randomly selected from women in each of the mid-age and older cohorts of the ALSWH who had reported leaking urine "often" in a previous survey. Details about UI (frequency, severity, and situations), self-management behaviors and help-seeking for UI, types of health professional consulted, recommended treatment for the problem, and satisfaction with the service provided by health care professionals and the outcomes of recommended treatments were sought through a self-report mailed follow-up survey. Most respondents had leaked urine in the last month (94% and 91% of mid-age and older women, respectively), and 72.2% and 73.1% of mid-aged and older women, respectively, had sought help or advice about their UI. In both age groups, the likelihood of having sought help significantly increased with severity of incontinence. The most common reasons for not seeking help were that the women felt they could manage the problem themselves or they did not consider it to be a problem. Many women in both cohorts had employed avoidance techniques in an attempt to prevent leaking urine, including reducing their liquid consumption, going to the toilet "just in case," and rushing to the toilet the minute they felt the need to.

Aged↗
PubMed2002

Mediators of physical activity behavior change among women with young children.

BACKGROUND: Women with children are less likely to engage in adequate physical activity (PA) than women without children. This study aimed to evaluate the efficacy of two strategies for promoting increased PA among mothers of preschool-aged children, and to explore the mediators of any resulting change in PA behavior. DESIGN: Controlled intervention trial incorporating repeated data collection from 554 women, randomized to one of three experimental conditions. Intervention Group 1 served as a control, while women in Groups 2 and 3 were given print information about overcoming PA barriers. Women in Group 3 were also invited to discuss the development of local strategies for the promotion of PA among mothers of young children. The primary strategies included increasing partner support, social advocacy, and capacity building, and were implemented through collaboration among participants, researchers, and community organizations. MAIN OUTCOME MEASURES: Adequate physical activity (PA), self-efficacy (SE) and partner support (PS). RESULTS: Following the intervention, women in Group 3 were significantly more likely to meet guidelines for PA than controls (odds ratio [OR]=1.71, confidence interval [CI]=1.05-2.77)] after controlling for age and PA at baseline. After controlling for baseline PA, residualized change in SE (OR=1.86, CI=1.17-2.94) and PS (OR=2.29, CI=1.46-3.58) significantly predicted meeting guidelines. After controlling for residual change in PS and SE, the significant intervention effect was attenuated (Group 3 OR=1.40, CI=0.76-2.36), indicating that partner support and self-efficacy may be mediators of physical activity behavior change. CONCLUSIONS: The findings indicate that community participation approaches that facilitate increased self-efficacy and partner support can be effective in increasing PA among mothers of young children.

Adult↗
PubMed2002

Proteins in the chlamydial inclusion membrane.

The chlamydiae are obligate intracellular pathogens that occupy a nonacidified vacuole (the inclusion) during their entire developmental cycle. Several proteins have recently been identified that are localized to the inclusion membrane. The following is a discussion of how inclusion membrane proteins might participate in the chlamydial developmental process.

Bacterial Proteins↗
PubMed2002

Relationships between nutrition screening checklists and the health and well-being of older Australian women.

OBJECTIVES: To examine associations between nutrition screening checklists and the health of older women. DESIGN: Cross-sectional postal survey including measures of health and health service utilisation. as well as the Australian Nutrition Screening Initiative (ANSI), adapted from the Nutrition Screening Initiative (NSI). SETTING: Australia, 1996. SUBJECTS: In total, 12,939 women aged 70-75 years randomly selected as part of the Australian Longitudinal Study on Women's Health. RESULTS: Responses to individual items in the ANSI checklist, and ANSI and NSI scores, were associated with measures of health and health service utilisation. Women with high ANSI and NSI scores had poorer physical and mental health, higher health care utilisation and were less likely to be in the acceptable weight range. The performance of an unweighted score (TSI) was also examined and showed similar results. Whereas ANSI classified 30% of the women as 'high-risk', only 13% and 12% were classified as 'high-risk' by the NSI and TSI, respectively. However, for identifying women with body mass index outside the acceptable range, sensitivity, specificity and positive predictive values for all of these checklists were less than 60%. CONCLUSIONS: Higher scores on both the ANSI and NSI are associated with poorer health. The simpler unweighted method of scoring the ANSI (TSI) showed better discrimination for the identification of 'at risk' women than the weighted ANSI method. The predictive value of individual items and the checklist scores need to be examined longitudinally.

Aged↗
PubMed2002

Changes in physical symptoms during the menopause transition.

This article analyzes physical symptoms experienced by mid-age Australian women in different stages of the menopause transition. A total of 8,623 women, aged 45 to 50 years in 1996, who participated the mid-age cohort of the Australian Longitudinal Study on Women's Health, completed Survey 1 in 1996 and Survey 2 in 1998. Women were assigned to 1 of 6 menopause groups according to their menopausal status at Surveys 1 and 2, and compared on symptoms experienced at Surveys 1 and 2, adjusted for lifestyle, behavioral and demographic factors. At Survey 1, the most commonly reported symptoms were headaches, back pain, stiff joints, tiredness, and difficulty sleeping. Perimenopausal women were more likely than premenopausal or postmenopausal women to report these symptoms. Hot flushes and night sweats were more common among postmenopausal women. Compared with those who remained premenopausal, women who were in the early stages of menopause or perimenopausal were more likely to report tiredness, stiff joints, difficulty sleeping, and hot flushes at Survey 2. Women who remained perimenopausal were also more likely to report back pain and leaking urine. Compared with premenopausal women, odds ratios for night sweats increased for women in consecutive stages of the menopause transition and remained high in the postmenopausal women.

Adolescent↗