The validity of the 21-item version of the depression anxiety stress scales as a routine outcome measure

Objective: This study aimed to test the validity of the 21-item Depression Anxiety Stress Scales (DASS-21) as a routine clinical outcome measure in the private in-patient setting. We hypothesized that it would be a suitable routine outcome instrument in this setting.

Method: All in-patients treated at a private psychiatric hospital over a period of 24 months were included in the study. Data were collected on demographics, service utilization, diagnosis and a set of four routine measures both at admission and discharge. These measures consisted of the Clinical Global Impressions (CGI) scales, Health of the Nation Outcome Scales (HoNOS), the Mental Health Questionnaire (MHQ-14) and DASS-21. The results of these measures were compared.

Results: Of 786 admissions in total, the number of fully completed (ie paired admission and discharge) data sets for the DASS-21 depression, anxiety and stress subscales were 337, 328 and 347, respectively. All subscales showed statistically significant reductions in mean scores from admission to discharge (P < 0.001) and were significantly correlated with all MHQ-14 subscales and significantly related to CGI scale categories. The total DASS-21 and total HoNOS scores were also significantly correlated.

Conclusions: The findings from the present study support the validity of DASS-21 as a routine clinical outcome measure in the private in-patient setting.

Prevalence of vitamin D insufficiency and risk factors for type 2 diabetes and cardiovascular disease among African migrant and refugee adults in Melbourne

Migration to industrialised countries poses a “double whammy” for type 2 diabetes among sub-Saharan African migrant and refugee adults. This population group has been found to be at an increased risk of obesity and type 2 diabetes, which may be further aggravated by inadequate vitamin D status. Thus, this study aimed to describe the demographics of vitamin D insufficiency, obesity, and risk factors for type 2 diabetes among sub-Saharan African migrants and refugees aged 20 years or older living in Melbourne, Australia (n=49). Data were obtained by a questionnaire, medical assessment, and fasting blood samples. The mean serum 25-hydroxyvitamin D level was 27.3 nmol/L (95% CI: 22.2, 32.4 nmol/L); with 25-hydroxyvitamin D levels <50 nmol/L occurring in 88% of participants. Participants displayed a cluster of risk factors for type 2 diabetes and cardiovascular disease: 62% were overweight or obese, 47% had insulin resistance (HOMA-IR ≥2), 25% had low density lipoprotein cholesterol levels ≥3.5 mmol/L, 24.5% had high density lipoprotein cholesterol levels ≤1.03 mmol/L, 34.6% had borderline or high levels of total cholesterol (≥5.2 mmol/L), 18.2% had borderline or high levels of triglyceride (≥1.7 mmol/L), and 16% had hypertension (systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg). These findings suggest that sub-Saharan African migrants and refugees may be at risk of type 2 diabetes and atherosclerosis-related diseases such as ischemic heart disease, stroke, and peripheral vascular disease. Well-designed vitamin D interventions that incorporate lifestyle changes are urgently needed in this sub-population.

Greater Green Triangle diabetes prevention project database

Data includes anthropometric and laboratory (lipid profile, glucose) measurements, and self-reported questionnaires including demographics, self-efficacy, social support, psychological well being (HADS, K10, SF-36 v2), diet (three-day food diaries, food frequency questionnaire), physical activity (seven-day diary, Active Australia Survey), smoking, and alcohol consumption. Most data is measured at baseline, 3 months, 12 months, and 30 months. Some blood samples are still stored at -80 degrees Celsius.

Western consumers' understanding of carbon offsets and its relationship to behavior

Purpose – The purpose of this paper is to examine Western consumers’ levels of general environmental knowledge and specific knowledge related to carbon offsets and the relationships between specific types of environmental knowledge and consumers’ related behaviors.

Design/methodology/approach – The study surveyed consumers from Australia (n ¼ 345) and the USA (n ¼ 340) who were sourced through national online panels. The analysis looks at differences between knowledge and behaviors, both across the samples as well as whether there are differences between consumers with high and low levels of environmental and carbon offset knowledge, and whether demographics impact on knowledge levels.

Findings – The results found that consumers had higher levels of general knowledge than carbon offset knowledge and the two types of knowledge were not related. ANOVA results considering country differences and demographic factors found that general knowledge was affected by education, age and gender, with carbon knowledge being affected by education. Environmental behavior was affected by age and gender as well, and no demographic factors influenced carbon-related behavior. Respondent’s location (i.e. USA or Australia) did not influence knowledge or behaviors, but interacted with education in regard to carbon knowledge and behavior.

Social implications – This research suggests that consumers are not acting on their carbon knowledge, which may be due to the debate surrounding carbon issues and/or because the information is based on complex scientific foundations, which the average consumer may have difficulty grasping, regardless of country.

Originality/value – This is one of the first pieces of academic research to explore consumers’ understanding of carbon-related information and how this knowledge impacts behavior. It also proposes a measure for evaluating carbon offset knowledge, which could be used to broaden environmental knowledge assessments.

Government under-planning for a student snowball : Go8

The government’s plans for higher education system will barely cope with growing demographics, let alone growing participation rates.

Socioeconomic status, obesity and lifestyle in men : the Geelong Osteoporosis Study

Background : Although the association between lower socioeconomic status (SES) and obesity in women in developed countries is well-documented, current evidence regarding the relationship between obesity in men and area-based SES (equivalised for advantage and disadvantage) is inconsistent. Therefore, we aimed to examine obesity, lifestyle behaviours, physical activity in different domains and demographics in men using area-based SES.

Methods : We performed a descriptive cross-sectional study of 1467 randomly selected white men (mean age 56 year (inter-quartile range (IQR) = 39–73 year)) recruited from the Barwon Statistical Division, South Western Victoria, Australia between 2001–06.

Results : Age-adjusted BMI, waist circumference, % fat and lean mass and blood pressure were inversely associated with SES, with differences between low and upper SES (P for difference <0.05), independent of country of birth. Age-adjusted lifestyle behaviours associated with obesity and/or adverse health (especially cardiovascular disease), were also associated with lower SES.

Conclusions : Subjects from lower SES had greater measures of obesity despite being more physically active at work, but were less likely to be physically active in the domains of sports and/or leisure. These findings suggest the possible influence of lifestyle behaviours and occupation upon obesity in men and should be investigated further.

Geelong Osteoporosis Study Health Database

The database contains the following clinical, questionnaire and socio-demographic data suitable for cross-sectional and longitudinal analyses:
-Body composition: dual-energy x-ray absorptiometry (DXA) measures of the lumbar spine (posterior-anterior projection), proximal femur, whole body and forearm (ultradistal forearm and distal 33%)
-Other clinical assessments: body weight, height, arm span, waist and hip circumferences, blood pressure, visual acuity, muscle strength, functional reach test and timed ‘up-&-go’ test.
-Mental health: Major axis psychiatric disorders diagnosed using a Structured Clinical Interview.
-Blood and urine collections: blood and urine collected after an overnight fast.
-Questionnaires: exposure to disease, use of medications and supplements, diet, mobility, physical activity, sleep, sun exposure, falls and fractures, alcohol and tobacco use, reproductive history, family history of fractures and disease, quality of life, pain, anxiety and depression.
-Socio-demographics: Country of birth, ethnicity, marital status, education, housing and employment status, occupation, socioeconomic Index for Areas (SEIFA) scores.

Student and staff perceptions of learning and teaching online, 2005 data

The dataset consists of data gathered from Deakin University staff and students.

Staff-derived data consists of qualitative data relating to advantages and disadvantages of teaching online; manifestation of cultural diversity in online learning environments; strategies to accommodate cultural diversity online; and using online environments to support cultural diversity

Student-derived data consists of quantitative and qualitative data relating to student perceptions of online learning; student demographics; student expectations of their university experience; students' approach to learning and online learning; perceptions of online learning and online team work; and perceptions of student and teacher roles at university.

Investigation of population heterogeneity of diet use among middle-aged Australians

The purpose of the study was to determine patterns of diet use among middle-aged Australian men and women and the relationships between these different usage patterns and demographic characteristics, health status and health habits. A cross-sectional mail survey was conducted among a random sample of 2975 people aged 40–71 years in Victoria, Australia. A total of 1031 usable questionnaires were obtained which included information about the use of diets (e.g. low-fat and low-salt) during the past 3 months along with demographic information, health status and health habits. Based on the responses about the use of thirteen diets for both sexes, latent class analysis was employed to identify the optimal number of use of diets and the assignment of participants to particular groups. Three types of diet uses were identified and provisionally named: diet use, selected diet use and non-diet use. This classification was associated with demographics, health status and health habits, and these associations differed between men and women. The findings suggest that nutrition education programmes should be tailored to the different needs of the diet use groups.

Baby boomers' reasons for choosing specific food shops

Purpose – Baby boomers (people born between 1946 and 1964) are approaching retirement and there is concern about their preparation for their future health and wellbeing. Food shopping is likely to play a major role in their future lives. The purpose of this paper is to examine their reasons for choosing to buy food from particular shops and whether demographic characteristics and health status were associated with them.

Design/methodology/approach – A questionnaire survey was conducted among a random sample of 1,037 people aged between 40 and 71 years in Victoria, Australia. Respondents were asked to indicate, from a list, their reasons for choosing to shop at particular food outlets. Regression analysis was used to examine the relationships between respondents' demographics and health status and their reasons for shopping at the food stores.

Findings – Multivariate analysis showed that the reasons the respondents reported in choosing shops fell into four groups: saving, convenience, quality and healthy foods, and user-friendly environment. Saving was negatively related to income, age, level of education and also linked with country of birth, religious affiliation, and marital status. Convenience was negatively associated with age and also related to health status and religious affiliation. Quality/healthy food products were positively related to age but negatively associated with body mass index, and also linked to country of birth. User-friendly environment was negatively associated with income and education and related to gender and religious affiliation.

Originality/value – The paper's results show that stores could provide more information, perhaps as signage, to their recycling and health information facilities, particularly in low socio-economic status areas. Furthermore, the social status and religious associations confirm the view that shopping reflects broad societal affiliations among baby boomers. Shopping centres can be used to provide support for health and environmental sustainability promotions.

TrueBlue database

Dataset includes patient demographics (gender, age, date-of-birth, language spoken at home, ATSI status), diagnosis (type-2 diabetes, heart disease), biophysical measures (height, weight, waist, BMI, cholesterol including LDL and HDL, hbA1c), depression and depression treatment, exercise, and patient goals.

Takeaway food consumption and cardio-metabolic risk factors in young adults

Background/objectives: Takeaway food consumption is positively associated with adiposity. Little is known about the associations with other cardio-metabolic risk factors. This study aimed to determine whether takeaway food consumption is associated with fasting glucose, insulin, lipids, homeostasis model assessment (HOMA) and blood pressure.

Subjects/methods: A national sample of 1896, 26–36 year olds completed a questionnaire on socio-demographics, takeaway food consumption, physical activity and sedentary behaviour. Waist circumference and blood pressure were measured, and a fasting blood sample was taken. For this analysis, takeaway food consumption was dichotomised to once a week or less and twice a week or more. Linear regression was used to calculate differences in the adjusted mean values for fasting lipids, glucose, insulin, HOMA and blood pressure. Models were adjusted for age, employment status, leisure time physical activity and TV viewing.

Results: Compared with women who ate takeaway once a week or less, women who ate takeaway twice a week or more had significantly higher adjusted mean fasting glucose (4.82 vs 4.88 mmol/l, respectively; P=0.045), higher HOMA scores (1.27 vs 1.40, respectively, P=0.034) and tended to have a higher mean fasting insulin (5.95 vs 6.45 mU/l, respectively, P=0.054). Similar associations were observed for men for fasting insulin and HOMA score, but the differences were not statistically significant. For both women and men adjustment for waist circumference attenuated the associations.

Conclusion: Consuming takeaway food at least twice a week was associated with cardio-metabolic risk factors in women but less so in men. The effect of takeaway food consumption was attenuated when adjusted for obesity.

Self-reported medication side effects in an older cohort living independently in the community - the Melbourne Longitudinal Study on Health Ageing (MELSHA) : cross-sectional analysis of prevalence and risk factors

Background Medication side effects are an important cause of morbidity, mortality and costs in older people. The aim of our study was to examine prevalence and risk factors for self-reported medication side effects in an older cohort living independently in the community.

Methods The Melbourne Longitudinal Study on Healthy Ageing (MELSHA), collected information on those aged 65 years or older living independently in the community and commenced in 1994. Data on medication side effects was collected from the baseline cohort (n = 1000) in face-to-face baseline interviews in 1994 and analysed as cross-sectional data. Risk factors examined were: socio-demographics, health status and medical conditions; medication use and health service factors. Analysis included univariate logistic regression to estimate unadjusted risk and multivariate logistic regression analysis to assess confounding and estimate adjusted risk.

Results Self-reported medication side effects were reported by approximately 6.7% (67/1000) of the entire baseline MELSHA cohort, and by 8.5% (65/761) of those on medication. Identified risk factors were increased education level, co-morbidities and health service factors including recency of visiting the pharmacist, attending younger doctors, and their doctor's awareness of their medications. The greatest increase in risk for medication side effects was associated with liver problems and their doctor's awareness of their medications. Aging and gender were not risk factors.

Conclusion Prevalence of self-reported medication side effects was comparable with that reported in adults attending General Practices in a primary care setting in Australia. The prevalence and identified risk factors provide further insight and opportunity to develop strategies to address the problem of medication side effects in older people living independently in the community setting.

Patient and practitioner compliance with silicone hydrogel and daily disposable lens replacement in the United States

Objective: The objectives of this study were to assess current recommendations for replacement frequency (RF) of silicone hydrogel (SH) and daily disposable (DD) lenses, to determine compliance with these recommendations, and to investigate the reasons given for noncompliance.

Methods: A package containing 20 patient surveys was sent to 309 eye care practitioners (ECPs) in the United States who had agreed to participate in the study. One thousand eight hundred fifty-nine completed surveys were received from 158 ECPs and 1,654 surveys were eligible for analysis. Questions related to patient demographics, lens type, lens wearing patterns, the ECP instructions for RF, and the actual patient reported RF. ECPs were asked to provide lens information and their recommendation for RF after the surveys had been completed and sealed in envelopes. All responses were anonymous.

Results: Sixty-six percent of patients were women and their mean age was 34 ± 12 years. Eighty-eight percent of lenses were worn for daily wear, 12.8 ± 3.2 hours a day, 6.2 ± 1.5 days a week. Lens type distribution was 16% DD, 45% 2 week (2W) SH, and 39% 1 month (1M) SH. ECP recommendations for RF varied according to the lens type; 1% of 1M (95% CI 0.2-1.7), 4% of DD (95% CI 2.1-7.2), and 18% of 2W (95% CI 15.1-20.7) patients were given instructions that did not conform to the manufacturers' recommended RF (MRRF). When considering only those patients who were given the correct instructions for RF, 38% were not compliant with the MRRF; noncompliance rates varied according to the lens type and were 12% for DD (95% CI 8.6-17.2), 28% for 1M (95% CI 24.9-32.1), and 52% for 2W (95% CI 47.8-55.8). The most frequent reasons for over wearing lenses were forgetting which day to replace lenses (51%) and to save money (26%). Fifty-three percent believed that a reminder system would aid compliance; the most popular methods being a cell phone reminder or text message (29%) and a nominated day each week or month (26%). Discussions between the ECPs and the patients were more extensive for patients who were compliant with the MRRF.

Conclusions: ECPs recommended RFs more frequently with DD and 1M SH lenses than with 2W SH lenses, consistent with manufacturers' recommendations. Patients were less compliant with RF than ECPs for all lens types investigated. Patients were most compliant with RF when wearing DD lenses and least compliant when wearing 2W SH lenses. Better communication facilitated greater compliance with RF. More than half of those not replacing lenses, when recommended, reported that this was because they forgot which day to replace their lenses.