Socio-demographic variations in walking for transport for recreation or exercise among adult Australians.

Background: Walking is integral to strategies to promote physical activity. We identified socio-demographic variations in walking for transport, and for recreation or exercise. Methods: Representative population data (n = 3392) from Australia were collected using computer assisted telephone interviewing, to examine adults’ participation in moderate- or brisk-paced walking for transport and walking for recreation or exercise; walking “sufficient” to meet the current public health guideline (> 150 min/wk); and, the contributions of total walking to meeting the guideline for total physical activity. Results: Rates of sufficient walking for transport (10% for men, 9% for women) were lower than those for walking for recreation or exercise (14% for both genders). Few socio-demographic differences emerged. Men over age 60 y were significantly less likely (OR = 0.40) to walk for transport; men age 45 to 59 y were more likely (OR = 1.56) to walk for recreation or exercise. Walking contributed more toward meeting the current public health guideline among women (15% to 21%) than among men (6% to 8%). Conclusions: There is potential for socially equitable increases in participation, through a focus on both walking for transport and on walking for recreation or exercise; attention to gender differences would be helpful.

To choose or not to choose: exploring Australians` views about internet banking

This paper explores Australian domestic customers' choices with regard to Internet banking, examining why it is taken up by some Australians and not others. The constructivist conceptual framework and the grounded nature of the method enabled in-depth exploration of key issues not undertaken before by the mainly positivist studies. The purposeful sample of 32 participants was selected to represent the major categories of people relevant to the research. Everett Rogers' famous analysis of 'diffusion of innovations' was one theoretical framework used to illuminate the findings; the other was digital divide factors in relation to banking choices. The findings include 1) that the major motivation for people to adopt Internet banking is convenience, closely linked to time savings and ease of accessibility, as well as confidence and skill in Internet use; and 2) that, at the time of the study, digital divide factors were playing an important part in banking choices.

Measurement of the economic impact of visual impairment from age-related macular degeneration in Australia

The purpose of this report was to: (i) outline the potential value of health economic studies into age-related macular degeneration (AMD); (ii) provide an overview of health economic studies pertinent to AMD; and (iii) outline the basic frame work of cost-of-illness studies (a useful first step in applying economic methods). The detection and management of sensory loss in the elderly plays a key role in the Australian Government's Healthy Ageing Strategy. Age-related macular degeneration is currently the leading cause of blindness in elderly Australians. Although a large proportion of AMD cases remain untreatable, the introduction of photo­dynamic therapy provides a relatively expensive and possibly cost-effective innovation for others. Antioxidant therapy has also been proven effective in reducing progression of early to late disease. The discipline of economics can contribute to an understanding of AMD prevention and treatment through: (i) describing the current burden of disease; (ii) predicting the changes in the burden of disease over time, and (iii) evaluating the efficiency of different interventions. Cost-of-illness studies have been performed in many fields of medicine. Little work, however, has been done on describing the economic impact from AMD. A number of different economic evaluation methods can be used in judging the efficiency of possible interventions to reduce the disease burden of AMD. Although complementary in nature, each has specific uses and limitations. Studies of the economic impact of eye diseases are both feasible and necessary for informed health care decision-making.

Special report : the wellbeing of Australians : groups with the highest and lowest wellbeing in Australia

Overview and Aim
1. This report concerns an analysis of the cumulative data from 15 surveys using the Personal Wellbeing Index to measure Subjective Wellbeing. The total number of respondents is about 30,000 but not all data were available for all analyses due to changing variables between
surveys.
2. The aim of this analysis is to determine those sub-groups with the highest and the lowest wellbeing.
Method
3. The definition of sub-groups is through the demographic variables of Income, Gender, Age, Household Composition, Relationship Status and Employment Status. Index domains are also included. While not every combination of demographic variables has been tested, the total number of combinations analysed was 3,277.
4. Extreme group mean scores are defined as lying above 79 points and below 70 points. These values are at least five standard deviations beyond the total sample mean score and are, therefore, extreme outliers. The minimum number of responses that could form such a group is
one. Data are accumulated across surveys for corresponding groups.
Results
5. The initial search for the most extreme groups identified the 20 highest and the 20 lowest groups with a minimum N=10. These are termed the ‘Exclusive’ groups since they were based only on the previously identified extreme scores. In order to determine the true mean of each of these groups, a further analysis incorporated all respondents who met the definition of group membership. For example, an Exclusive group defined as [male, 76+ years] would contain only the accumulation of scores from individual surveys that met the extreme score criterion (<70 or >79). The Inclusive group included the scores from all survey respondents who matched the group definition of male, 76+ years.
6. The results revealed a dominance by the domains of the Personal Wellbeing Index. The extreme high groups were predicted by high scores on all domains except safety and relationships. The low groups were defined by low scores on all seven domains.
7. A further search for extreme groups was undertaken that was restricted to the demographic descriptors. The 20 highest and 20 lowest groups were identified based on a minimum cell content of N=10. The corresponding Inclusive group means were then calculated as before.
8. In order to increase the reliability of the final groups, a minimum cell content of N=20 cases was imposed.
9. Six extreme high groups were identified. These are dominated by high income and the presence of a partner. Five extreme low groups were identified. These are dominated by very low income, the absence of a partner, and unemployment.
Conclusions
10. The conclusions drawn from these analyses are as follows:
10.1 The central defining characteristics of people forming the extreme high wellbeing groups is high household income and living with a partner.
10.2 The central defining risk factors for people forming the extreme low wellbeing groups are very low household income, not living with a partner, and unemployment.
10.3 None of these five demographic characteristics are sufficient to define extreme wellbeing groups on their own. They all act in combinations of at least two risk factors together.

How do school day activity patterns differ with age and gender across adolescence?

Purpose
A knowledge of how young people use their time could be instrumental in informing health interventions, modeling consumer behaviors, and planning service delivery. The aim of the present study was to describe age- and gender-related patterns in the self-reported use of time on school days in a large sample of Australian children and adolescents aged between 10 and 18 years.

Methods
A single, detailed use-of-time diary for a school day was collected from 6024 Australians aged 10–18 from several state and regional surveys conducted in the states of South Australia (SA) and Victoria between 2001 and 2006. Time–use profiles were analyzed for a range of active and sedentary state behaviors.

Results
Boys reported higher physical activity levels (PALs), moderate-to-vigorous physical activity (MVPA), and sports than girls. There were no differences in free play, and girls used more active transport. All activity-related variables decreased with age, except active transport, which peaked at 14–15 years. Boys exhibited higher levels of screen time, whereas girls had higher levels of passive transport. Screen time and its components (television, videogames, and computer use) peaked in the peripubertal years.

Conclusion
Age- and gender-related patterns of time use vary greatly within adolescence. This may reflect a mix of biological and social factors.

Differences within and between travel preference, planned travel and choice behavior of Australians traveling to Asian and oversea destinations

This study seeks to examine differences in travel preference, travel intention and destination choice behavior of an aggregated set of Australian travelers. Additionally the study seeks to relate income, age, gender, life cycle and life style of Australians to the preference, planning and choice of Asian and overseas destinations. A large representative sample of 49,000 Australian respondents is utilized. Binomial regression is used to profile travelers to Asia and overseas in general. Specific significant variables and differences are highlighted. There are consistent relationships between travel preference, planning and choice and the set of independent variables of income, life cycle and life style. Age nor gender are not consistently related to travel planning or travel choice. It is apparent that a combination of demographics, e.g. age, income and life cycle, combined with life style will provide a more valuable basis for segmentation of Asian and overseas travel markets. The study aims to profile potential Australian tourists thereby making a contribution to tourism knowledge and market segmentation practice.

The changing face of the Australian teaching profession : new generations and new ways of working and learning

Today’s workforce is characterised by an increasing mix of people with varying career aspirations, work motivators and job satisfiers. This paper discusses the intergenerational nature of today’s workforce, which is currently dominated by the age groups commonly referred to as Baby Boomers and Generation X. The Baby Boomers defined and redefined work during the last quarter of the twentieth century, but as they track towards retirement, GenXers’ valued work patterns and their career and life aspirations are increasingly dominating. This paper draws on a body of literature about a younger generation of workers and the current world of work in today’s knowledge society, and discusses possible implications for the teaching profession, particularly for attracting and retaining young people as teachers.

Importance of the contribution of Australians to the penetration of China by the China Inland Mission in the period 1888-1953, with particular reference to the work of Australian women missionaries

Australians, in the main, are unaware of the role which Australia played in the evangelization of China in the late nineteenth and the first half of the twentieth century. Most would never have heard of the China Inland Mission (CIM), the largest of the Protestant bodies which penetrated the Middle Kingdom, and few would know of the contribution that its Australian contingent, which consistently comprised about a tenth of the CIM's numbers, made towards the Christianization of that vast country. This thesis aims to raise the level of awareness in this area. Academic researchers have not totally neglected to examine the proselytization of China, and historians of the stature of Latourette have not let it escape their attention. However, most of the studies which have not merely fleetingly focused on the subject while viewing a larger canvas, have been North American, singling out the efforts of United States and Canadian bodies in introducing Christianity to the Chinese. Here, authors like Amerding, Bacon, Creighton, Gates, Hawkes, Ho, Ko, Mensendiek, Michell and Quale have left their mark. In the case of the present thesis, the outlook from which events played out in China are viewed is firmly based in Australia rather than North America. Earlier Australian research has been scarce, and is dominated by Loane and Dixon. Loane, evidently primarily working from Australasian Council minutes, mainly concentrates on the efforts of the CIM's Home Council, examining its endeavours decade by decade against a backdrop of contemporaneous events in China, and briefly referring to aspects of the lives of a cross-section of Australasian missionaries, without providing much idea about what they actually did in the field or what they achieved there. Because of its preoccupation with the Home Council, which never admitted women into its ranks, Loane's treatise is systemically biased towards men, though the more prominent of the women, like Mary Reed and Susie Garland, are given due recognition. The current thesis looks in detail at what Australians did in the field, the level of success they achieved, and at the particular contribution of Australian women towards the evangelization of China. Dixon took upon herself the formidable task of examining the endeavours of all missions in China which contained Australian missionaries. Because of the magnitude of her task, she could not focus to any great extent on particular missions, nor pursue in any detail the work of individual Australian missionaries. Like Loane, she was unable to explore what they actually did in the field or what they achieved there. Neither could she delve to any depth into the work of Australian women missionaries, though on the basis of the information she had accumulated, she drew the conclusion that Australian women had largely only brought about some unintended feminist consequences amongst Chinese women. This sweeping generalization failed to take into account the other very real social changes for Chinese women the Australian female missionaries quite purposely helped to bring about, and this thesis makes good that omission. This thesis studies aspects of the Australian missionary endeavour which both Loane and Dixon have neglected, thereby breaking new ground, and sets out to correct erroneous impressions which Dixon's dissertation has left on the historical record. One of these impressions concerned the longevity of the effect of the Australian effort in China. She had the View, writing in 1978, that the Chinese Church was moribund (a view shared by Varg and Lacy) , and that therefore the effects attributable to the endeavours of any nationality had proved fruitless, whereas the author is able to show, using modern-day sources, that the church has burgeoned in recent years thanks to earlier missionary endeavours and later neo-evangelistic efforts like Gospel radio, and now has a complement of perhaps 50 million adherents, making it second only to the United States in the size of its Protestant evangelical population. Another impression she left was that the Australian input into the evangelization of China can be largely dismissed because no totally Australian organization emerged, leaving the direction of Australia's effort in other hands. Contrary to that impression, the author shows that the Australian impact in China was significant and that Australians enjoyed more power than Dixon ever imagined. The author also shows that Australians were accepted as the equal of other nationalities in the CIM once they had acquired the necessary field expertise, a factor which doubtless also applied in respect of other missions with Australian components in China. Marchant has suggested that it is a fiction perpetuated by mission periodicals that Christianity spread and progressed in a determined manner in China. This thesis establishes that within the CIM's bailiwick, though there was some patchiness, Christianity progressed steadily and inexorably. One mission alone, the CIM, is concentrated upon, firstly in order to render the data manageable, secondly because it was the largest mission in China and had a sizeable Australian (including female) contingent, and thirdly because it exemplified many of the problems which would have been faced by missions in that country and their Australian components. The methodology employed is multifaceted. The written testimony of the missionaries themselves, contained in CIM periodicals, Field Bulletins, Monthly Notes, Annual Reports, autobiographies, personal files, diaries and letters is used to illustrate various aspects of the CIM's work in which Australians were engaged. This approach is augmented by other sources such as China and Australasian Home Council Minutes, missionary conference reports, Candidates' Books, biographies, and other selected material from archival holdings in Australia, Singapore, the United Kingdom, America and Canada. Statistics, especially ratio analyses and growth rate comparisons are used to demonstrate the relative success of different missions, missionaries and genders. Also employed are reminiscences of missionaries and descendants obtained by personal interview, and these are aggregated to provide some general conclusions. Data from these various sources have been synthesized to serve the central objective of demonstrating the importance of the contribution of Australians to the penetration of China by the CIM in the period 1888-1953 with particular reference to the work of Australian women missionaries.

The relevance of the Heart Foundation of Australia's dietary recommendations for adult Australians : a comparison of views of general practitioners, cardiologists and dietitians

PURPOSE: To compare the views of general practitioners, cardiologists and dietitians about the relevance of the Heart Foundation of Australia's dietary recommendations for adult cardiac patients.

BASIC PROCEDURES: Quantitative-cross sectional study. Postal questionnaires were self-completed by 248 Victorian general practitioners (30% response), 189 Australia-wide cardiologists (47% response) and 180 Victorian dietitians (45% response). Responses were represented as percentages and analyses of variance were conducted to explore the impact of the independent variables: age, work status and gender on the dependent variable: dietary recommendation.

MAIN FINDINGS: Approximately half of the recommendations were viewed as strongly important to implement; these related to lean meats, limiting takeaways and cakes/biscuits, and adjusting energy intake. Others of importance were eating fruits, vegetables and fish. However, most of these goals were seen as difficult to achieve. Dietitians appeared to share responses of doctors, except for greater importance of eating fruit and vegetables and a greater difficulty in limiting cakes and biscuits. There was a high level of agreement among the three groups (mean 87%) about patients having difficulty implementing adjusting energy intake.

CONCLUSIONS: There is agreement amongst these professionals that many of the recommendations lack importance, specifically those pertaining to unsaturated oils, low fat dairy products, cholesterol rich foods, intake of legumes and grains and the restriction of salt. This may reflect a need for further nutrition education.

Association between hyperglycaemia and fracture risk in non-diabetic middle-aged and older Australians : a national, population-based prospective study (AusDiab)

Summary : The association between pre-diabetes and fracture risk remains unclear. In this large cohort of middle-aged and older Australian men and women without diabetes, elevated 2-h plasma glucose and pre-diabetes were associated with a reduced 5-year risk of low trauma and all fractures in women, independently of BMI, fasting insulin and other lifestyle factors.

Introduction : We aimed to (1) examine associations between fasting and 2-h plasma glucose (FPG and 2-h PG), fasting insulin and risk of low trauma and all fractures in non-diabetic adults and (2) compare fracture risk between adults with pre-diabetes (impaired glucose tolerance or impaired fasting glucose) and those with normal glucose tolerance (NGT).

Methods : Six thousand two hundred fifty-five non-diabetic men and women aged ≥40 years with NGT (n = 4,855) and pre-diabetes (n = 1,400) were followed for 5 years in the AusDiab Study. Fractures were self-reported.

Results : Five hundred thirty-nine participants suffered at least one fracture (368 women, 171 men), of which the majority (318) occurred after a low-energy trauma (258 women, 60 men). In women, a 2-h PG ≥7.2 mmol/L (highest quartile) was associated with a decreased risk of low trauma and all fractures independent of age and BMI [OR (95% CI) for low trauma fractures, 0.59 (0.40–0.88)], but also fasting insulin, smoking, physical activity, history of fracture, dietary calcium and alcohol intake or menopausal status. There was no effect of 2-h PG on fracture risk in men [OR (95% CI), 1.39 (0.60–3.26)] or any relationship between fracture risk and quartiles of FPG or insulin in either sex. Compared to women with NGT, those with pre-diabetes had a reduced risk of fracture [OR (95% CI) for all fractures, 0.70 (0.52–0.95); for low trauma fractures, 0.75 (0.53–1.05)].

Conclusion : Elevated 2-h PG levels and pre-diabetes were inversely associated with low trauma and/or all fractures in non-diabetic women, independent of BMI and fasting insulin levels.

Using clinical trial data and linked administrative health data to reduce the risk of adverse events associated with the uptake of newly released drugs by older Australians : a model process

Background
The study was undertaken to evaluate the contribution of a process which uses clinical trial data plus linked de-identified administrative health data to forecast potential risk of adverse events associated with the use of newly released drugs by older Australian patients.

Methods
The study uses publicly available data from the clinical trials of a newly released drug to ascertain which patient age groups, gender, comorbidities and co-medications were excluded in the trials. It then uses linked de-identified hospital morbidity and medications dispensing data to investigate the comorbidities and co-medications of patients who suffer from the target morbidity of the new drug and who are the likely target population for the drug. The clinical trial information and the linked morbidity and medication data are compared to assess which patient groups could potentially be at risk of an adverse event associated with use of the new drug.

Results
Applying the model in a retrospective real-world scenario identified that the majority of the sample group of Australian patients aged 65 years and over with the target morbidity of the newly released COX-2-selective NSAID rofecoxib also suffered from a major morbidity excluded in the trials of that drug, indicating a substantial potential risk of adverse events amongst those patients. This risk was borne out in post-release morbidity and mortality associated with use of that drug.

Conclusions
Clinical trial data and linked administrative health data can together support a prospective assessment of patient groups who could be at risk of an adverse event if they are prescribed a newly released drug in the context of their age, gender, comorbidities and/or co-medications. Communication of this independent risk information to prescribers has the potential to reduce adverse events in the period after the release of the new drug, which is when the risk is greatest.

Note: The terms 'adverse drug reaction' and 'adverse drug event' have come to be used interchangeably in the current literature. For consistency, the authors have chosen to use the wider term 'adverse drug event' (ADE).

Malondialdehyde plasma concentration correlates with declarative and working memory in patients with recurrent depressive disorder

Oxidative stress has been implicated in the cognitive decline, especially in memory impairment. The purpose of this study was to determine the concentration of malondialdehyde (MDA) in patients with recurrent depressive disorders (rDD) and to define relationship between plasma levels of MDA and the cognitive performance. The study comprised 46 patients meeting criteria for rDD. Cognitive function assessment was based on: The Trail Making Test , The Stroop Test, Verbal Fluency Test and Auditory-Verbal Learning Test. The severity of depression symptoms was assessed using the Hamilton Depression Rating Scale (HDRS). Statistically significant differences were found in the intensity of depression symptoms, measured by the HDRS on therapy onset versus the examination results after 8 weeks of treatment (P < 0.001). Considering the 8-week pharmacotherapy period, rDD patients presented better outcomes in cognitive function tests. There was no statistically significant correlation between plasma MDA levels, and the age, disease duration, number of previous depressive episodes and the results in HDRS applied on admission and on discharge. Elevated levels of MDA adversely affected the efficiency of visual-spatial and auditory-verbal working memory, short-term declarative memory and the delayed recall declarative memory. 1. Higher concentration of plasma MDA in rDD patients is associated with the severity of depressive symptoms, both at the beginning of antidepressants pharmacotherapy, and after 8 weeks of its duration. 2. Elevated levels of plasma MDA are related to the impairment of visual-spatial and auditory-verbal working memory and short-term and delayed declarative memory.

Conceptual understanding of screen media parenting: report of a working group

Screen media (television, computers, and videogames) use has been linked to multiple child outcomes, including obesity. Parents can be an important influence on children's screen use. There has been an increase in the number of instruments available to assess parenting in feeding and physical activity contexts, however few measures are available to assess parenting practices regarding children's screen media use.

A working group of screen media and parenting researchers convened at the preconference workshop to the 2012 International Society for Behavioral Nutrition and Physical Activity (ISBNPA) annual meeting, “Parenting Measurement: Current Status and Consensus Reports,” to identify and prioritize issues in assessing screen media parenting practices.

The group identified that screen media use can pose different risks for children, depending on their age and developmental stage, across physiologic, psychosocial, and development outcomes. With that in mind, a conceptual framework of how parents may influence their child's screen-viewing behaviors was proposed to include the screen media content, context of viewing, and amount viewed.

A research agenda was proposed to prioritize a validation of the framework and enhance the ability of researchers to best assess parenting influences across the three domains of content, context and amount of children's screen media use.