Informing methods for preparing public health overviews of reviews: a comparison of public health overviews with Cochrane Overviews published between 1999 and 2014

Background: Overviews of systematic reviews (SRs) are useful for public health policy; however there is an absence of Cochrane Overviews covering public health (PH) topics. Objectives: We sought to analyze the methodological approaches used in existing Cochrane Overviews and Protocols for overviews (primarily clinical in nature), and compare these to the methods and approaches used in PH overviews (non-Cochrane). The intent was to identify issues that would be relevant for undertaking Cochrane overviews. Methods: We conducted a descriptive analysis of overviews published between 1999 and 2014. We searched the Cochrane Database of Systematic Reviews for Cochrane Protocols for overviews and Cochrane Overviews, and the HealthEvidence.org for PH overviews. The primary characteristics of the overviews and elements of the methodology were extracted and compared. Results: A total of 61 overviews of SRs were included in our analysis; specifically, this included 21 Cochrane Protocols for overviews, 15 Cochrane Overviews, and 27 non-Cochrane PH overviews. Amongst the overviews, the most significant differences are that PH overviews (non-Cochrane) tend to: include earlier and more reviews, greater number of participants, allow lower levels of evidence, use assessment tools other than AMSTAR (A Measurement Tool to Assess Systematic Reviews, i.e. a tool for assessing quality of SRs), not assess quality of evidence in reviews, search more databases overall, specify search limits including English-only reviews, and not consider recent primary studies for inclusion. Some of these differences clearly related to quality, however many relate to the nuances of PH interventions. Conclusions: The methodology in Cochrane overviews and PH overviews varies widely. Future PH overviews may benefit from the Cochrane methodology but the Cochrane approach requires modification to accommodate PH research methodology. Additionally, the use of databases that pre-screen and quality assess relevant PH systematic reviews may help expedite the search process.

Links between unlicensed and unregistered driving: Literature review. Report to Queensland Department of Transport and Main Roads

Vehicle registration represents an important component of the management of the road transport system in Queensland, with most vehicles required to be registered before they can be driven or parked on a public road (Department of Transport and Main Roads, 2010b). In addition to the collection of taxes for road construction and maintenance, the current registration system also: • Sets the safety standards required for vehicles to be allowed on public roads; • Allows driver behaviour to be managed by identifying vehicles, and the responsible owners of vehicles, for enforcement purposes; and • Facilitates the collection of insurance premiums for the Queensland Compulsory Third Party (CTP) insurance scheme.

Collecting in an urban context: Relationships between collections and space in the home

Collecting has become a popular hobby within Western society, with collectables including anything from ‘bottle tops’ to ‘skyscrapers’. As the nature and size of these collections can impact upon the use of space in the home, the purpose of this study is to explore the relationship between the collections, space in the home and the impacts on others. This qualitative study explores the experiences of 11 Australian collectors, investigating the motivations, practices and adaption techniques used within their urban home environment. The themes of sentimentality, sociability and spatial tensions, including physical, personal and use of space are discussed within the context of their home and family environments. Overall the practice of collecting objects is a complex, varied, sentimental and sociable activity, providing enjoyment, knowledge and friendships. Space can be a central consideration to the practice of collecting as collections shape and are shaped by the available space in a household.

Differences in composition of symptom clusters between older and younger oncology patients

Context Older oncology patients have unique needs associated with the many physical, psychological,and social changes associated with the aging process. The mechanisms underpinning and the impact of these changes are not well understood. Identification of clusters of symptoms is one approach that has been used to elicit hypotheses about the biological and/or psychological basis for variations in symptom experiences. Objectives The purposes of this study were to identify and compare symptom clusters in younger (<60 years) and older ($60 years) patients undergoing cancer treatment. Methods. Symptom data from one Australian study and two U.S. studies were combined to conduct this analysis. A total of 593 patients receiving active treatment were dichotomized into younger (<60 years) and older ($60 years) groups. Separate exploratory factor analyses (EFAs) were undertaken within each group to identify symptom clusters from occurrence ratings of the 32 symptoms assessed by the Memorial Symptom Assessment Scale. Results In both groups, a seven-factor solution was selected. Four partially concordant symptom clusters emerged in both groups (i.e., mood/cognitive, malaise, body image, and genitourinary). In the older patients, the three unique clusters reflected physiological changes associated with aging, whereas in the younger group the three unique clusters reflected treatment-related effects. Conclusion The symptom clusters identified in older patients typically included a larger and more diverse range of physical and psychological symptoms. Differences also may be reflective of variations in treatment approaches between age groups. Findings highlight the need for better understanding of variation in treatment and symptom burden between younger and older adults with cancer.

Links between unlicensed and unregistered driving (Data analysis). Report to Queensland Department of Transport and Main Roads

There is a current lack of understanding regarding the use of unregistered vehicles on public roads and road-related areas, and the links between the driving of unregistered vehicles and a range of dangerous driving behaviours. This report documents the findings of data analysis conducted to investigate the links between unlicensed driving and the driving of unregistered vehicles, and is an important initial undertaking into understanding these behaviours. This report examines de-identified data from two sources: crash data; and offence data. The data was extracted from the Queensland Department of Transport and Main Roads (TMR) databases and covered the period from 2003 to 2008.

Relationships between biophysical and psychosocial outcomes following minor stroke

This descriptive correlational study examined relationships between mild stroke functional and psychosocial outcomes over the early post-discharge period among dyads of mild stroke patients (n=38) and their spousal caregivers (n=38). We measured patients' functional scores using the modified Rankin Scale; patients' and caregivers' quality of life (QoL) using Stroke Impact Scale and Short-Form 36 respectively, mood using the Beck Depression Inventory-II, and marital function scores using the Family Assessment Device. Spousal caregivers also completed the Bakas Caregiving Outcomes Scale as a measure of caregiver strain. The average age of stroke patients was 64 years and of spousal caregivers 58 years. All stroke patients were male; all spousal caregivers female. At three months post discharge, patient functional status scores had significantly improved from discharge (p=0.026) with a corresponding increase in QoL scores (p=0.012). Functional status was significantly correlated with patient perceptions of QoL at three months (r=.014, p=0.024) and spousal caregiver perceptions of physical domain QoL (r=.-.397, p=0.014). Spousal caregivers' mood at three months post discharge was strongly correlated with their perceptions of marital satisfaction (r=.578, p=0.000) and caregiver strain (r=-.620, p=0.000). In preparing patients for discharge following mild stroke, nurses must consider the psychological and social implications of the recovery process over time for both the patient with stroke and their spousal caregivers.

The ultrastructural relationship between osteocytes and dental implants following osseointegration

Background Osteocytes, the most abundant cells in bone, havemultiple functions, including acting as mechanosensors and regulating mineralization. It is clear that osteocytes influence bone remodeling by controlling the differentiation and activity of osteoblasts and osteoclasts. Determining the relationship between titanium implants and osteocytes may therefore benefit our understanding of the process of osseointegration. Purpose The aim of this study was to visualize the ultrastructural relationship between osteocytes and the titanium implant surface following osseointegration in vivo. Materials and Methods Titanium implants were placed in the maxillary molar regions of eight female Sprague Dawley rats, 3 months old. The animals were sacrificed 8 weeks after implantation, and undecalcified tissue sections were prepared. Resin-cast samples were subsequently acid-etched with 37% phosphoric acid prior to examination using scanning electron microscopy. Results Compared with mature bone, where the osteocytes were arranged in an ordered fashion, the osteocytes appeared less organized in the newly formed bone around the titanium implant. Further, a layer of mineralization with few organic components was observed on the implant surface. This study shows for the first time that osteocytes and their dendrites are directly connected with the implant surface. Conclusions: This study shows the direct anchorage of osteocytes via dendritic processes to a titanium implant surface in vivo. This suggests an important regulatory role for osteocytes and their lacunar-canalicular network in maintaining long-term osseointegration.

Gender-specific differences of interaction between obesity and air pollution on stroke and cardiovascular diseases in Chinese adults from a high pollution range area: A large population based cross sectional study

Background Little information exists regarding the interaction effects of obesity with long-term air pollution exposure on cardiovascular diseases (CVDs) and stroke in areas of high pollution. The aim of the present study is to examine whether obesity modifies CVD-related associations among people living in an industrial province of northeast China. Methods We studied 24,845 Chinese adults, aged 18 to 74 years old, from three Northeastern Chinese cities in 2009 utilizing a cross-sectional study design. Body weight and height were measured by trained observers. Overweight and obesity were defined as a body mass index (BMI) between 25–29.9 and ≥ 30 kg/m2, respectively. Prevalence rate and related risk factors of cardiovascular and cerebrovascular diseases were investigated by a questionnaire. Three-year (2006–2008) average concentrations of particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxides (NO2), and ozone (O3) were measured by fixed monitoring stations. All the participants lived within 1 km of air monitoring sites. Two-level logistic regression (personal level and district-specific pollutant level) was used to examine these effects, controlling for covariates. Results We observed significant interactions between exposure and obesity on CVDs and stroke. The associations between annual pollutant concentrations and CVDs and stroke were strongest in obese subjects (OR 1.15–1.47 for stroke, 1.33–1.59 for CVDs), less strong in overweight subjects (OR 1.22–1.35 for stroke, 1.07–1.13 for CVDs), and weakest in normal weight subjects (OR ranged from 0.98–1.01 for stroke, 0.93–1.15 for CVDs). When stratified by gender, these interactions were significant only in women. Conclusions Study findings indicate that being overweight and obese may enhance the effects of air pollution on the prevalence of CVDs and stroke in Northeastern metropolitan China. Further studies will be needed to investigate the temporality of BMI relative to exposure and onset of disease.

Differences in trunk accelerometry between frail and non-frail elderly persons in functional tasks

Background Physical conditions through gait and other functional task are parameters to consider for frailty detection. The aim of the present study is to measure and describe the variability of acceleration, angular velocity and trunk displacement in the ten meter Extended Timed Get-Up-and-Go test in two groups of frail and non-frail elderly people through instrumentation with the iPhone4® smartphone. Secondly, to analyze the differences and performance of the variance between the study groups (frail and non-frail). This is a cross-sectional study of 30 subjects aged over 65 years, 14 frail subjects and 16 non-frail subjects. Results The highest difference between groups in the Sit-to-Stand and Stand-to-Sit subphases was in the y axis (vertical vector). The minimum acceleration in the Stand-to-Sit phase was -2.69 (-4.17 / -0.96) m/s2 frail elderly versus -8.49 (-12.1 / -5.23) m/s2 non-frail elderly, p < 0.001. In the Gait Go and Gait Come subphases the biggest differences found between the groups were in the vertical axis: -2.45 (-2.77 /-1.89) m/s2 frail elderly versus -5.93 (-6.87 / -4.51) m/s2 non-frail elderly, p < 0.001. Finally, with regards to the turning subphase, the statistically significant differences found between the groups were greater in the data obtained from the gyroscope than from the accelerometer (the gyroscope data for the mean maximum peak value for Yaw movement angular velocity in the frail elderly was specifically 25.60°/s, compared to 112.8°/s for the non-frail elderly, p < 0.05). Conclusions The inertial sensor fitted in the iPhone4® is capable of studying and analyzing the kinematics of the different subphases of the Extended Timed Up and Go test in frail and non-frail elderly people. For the Extended Timed Up and Go test, this device allows more sensitive differentiation between population groups than the traditionally used variable, namely time.

Ability to discriminate between healthy and low back pain sufferers using ultrasound during maximum lumbar extension

Objective To analyze the ability to discriminate between healthy individuals and individuals with chronic nonspecific low back pain (CNLBP) by measuring the relation between patient-reported outcomes and objective clinical outcome measures of the erector spinae (ES) muscles using an ultrasound during maximal isometric lumbar extension. Design Cross-sectional study with screening and diagnostic tests with no blinded comparison. Setting University laboratory. Participants Healthy individuals (n=33) and individuals with CNLBP (n=33). Interventions Each subject performed an isometric lumbar extension. With the variables measured, a discriminate analysis was performed using a value ≥6 in the Roland and Morris disability questionnaire (RMDQ) as the grouping variable. Then, a logistic regression with the functional and architectural variables was performed. A new index was obtained from each subject value input in the discriminate multivariate analysis. Main Outcome Measures Morphologic muscle variables of the ES muscle were measured through ultrasound images. The reliability of the measures was calculated through intraclass correlation coefficients (ICCs). The relation between patient-reported outcomes and objective clinical outcome measures was analyzed using a discriminate function from standardized values of the variables and an analysis of the reliability of the ultrasound measurement. Results The reliability tests show an ICC value >.95 for morphologic and functional variables. The independent variables included in the analysis explained 42% (P=.003) of the dependent variable variance. Conclusions The relation between objective variables (electromyography, thickness, pennation angle) and a subjective variable (RMDQ ≥6) and the capacity of this relation to identify CNLBP within a group of healthy subjects is moderate. These results should be considered by clinicians when treating this type of patient in clinical practice.

Investigation of the relationship between BMI and prostate motion in radiation therapy treatment for prostate cancer

This thesis studied the influence of patient obesity on prostate motion during radiation therapy treatment delivery, an important consideration in the accurate treatment of prostate cancer. The study highlighted the importance of daily image guidance to correct for prostate motion, increasing radiation dose to the prostate while decreasing radiation dose to surrounding healthy tissues, thereby increasing patient quality of life.

Is there a link between poverty and food security?

This paper addresses the gap in economic theory underlying the multidimensional concept of food security and observed data by deriving a composite food security index using the latent class model. The link between poverty and food security is then examined using the new food security index and the robustness of the link is compared with two unidimensional measures often used in the literature. Using Vietnam as a case study, it was found that a weak link exists for the rural but not for the urban composite food security index. The unidimensional measures on the other hand show a strong link in both the rural and urban regions. The results on the link are also different and mixed when two poverty types given by persistent and transient poverty are considered. These findings have important policy implications for a targeted approach to addressing food security.

Somewhere between haste and delay... Investigating the interactions of road users and pedestrians in a dynamic rail level crossing environment

There are currently 23,500 level crossings in Australia, broadly divided into one of two categories: active level crossings which are fully automatic and have boom barriers, alarm bells, flashing lights, and pedestrian gates; and passive level crossings, which are not automatic and aim to control road and pedestrianised walkways solely with stop and give way signs. Active level crossings are considered to be the gold standard for transport ergonomics when grade separation (i.e. constructing an over- or underpass) is not viable. In Australia, the current strategy is to annually upgrade passive level crossings with active controls but active crossings are also associated with traffic congestion, largely as a result of extended closure times. The percentage of time level crossings are closed to road vehicles during peak periods increases with the rise in the frequency of train services. The popular perception appears to be that once a level crossing is upgraded, one is free to wipe their hands and consider the job done. However, there may also be environments where active protection is not enough, but where the setting may not justify the capital costs of grade separation. Indeed, the associated congestion and traffic delay could compromise safety by contributing to the risk taking behaviour by motorists and pedestrians. In these environments it is important to understand what human factor issues are present and ask the question of whether a one size fits all solution is indeed the most ergonomically sound solution for today’s transport needs.

Environmental dynamism as a moderator of the relationship between bricolage and firm performance

Many firms initially face significant resource constraints during attempts to develop and grow (Shepherd et al., 2000). One promising theory that explicitly links to ways entrepreneurial firms respond to resource constraints is bricolage (Lévi-Strauss, 1966). Bricolage is defined as “making do by applying combinations of the resources at hand to new problems and opportunities” (Baker & Nelson, 2005, p. 333). Bricolage aligns with notions of resourcefulness: using what’s on hand, through making do, and recombining resources for new or novel purposes. Through a bias for action and a refusal to enact limitations on the resources that are available to create solutions, bricoleurs can tackle unexpected complex challenges, take advantage of opportunities, and go where most other firms won’t, in their attempts at firm development. Bricolage studies have previously not empirically examined the impact of bricolage on firm performance. Our work contributes to the emerging behavioral theory of bricolage by offering the first empirical test evaluating the impact of bricolage on early stage firm performance (i.e. venture emergence in nascent firms and sales in young firms). Using new product development (NPD) theories of speed of development, co-creation and innovativeness, we theorise that bricolage has a positive effect on early stage firm performance. We then introduce environmental dynamism as a moderator which influences this relationship.

The relationship between appetite and food preferences in British and Australian children

Background: Appetitive traits and food preferences are key determinants of children’s eating patterns but it is unclear how these behaviours relate to one another. This study explores relationships between appetitive traits and preferences for fruits and vegetables, and energy dense, nutrient poor (noncore) foods in two distinct samples of Australian and British preschool children. Methods: This study reports secondary analyses of data from families participating in the British GEMINI cohort study (n=1044) and the control arm of the Australian NOURISH RCT (n=167). Food preferences were assessed by parent-completed questionnaire when children were aged 3-4 years and grouped into three categories; vegetables, fruits and noncore foods. Appetitive traits; enjoyment of food, food responsiveness, satiety responsiveness, slowness in eating, and food fussiness were measured using the Children’s Eating Behaviour Questionnaire when children were 16 months (GEMINI) or 3-4 years (NOURISH). Relationships between appetitive traits and food preferences were explored using adjusted linear regression analyses that controlled for demographic and anthropometric covariates. Results: Vegetable liking was positively associated with enjoyment of food (GEMINI; β=0.20 ± 0.03, p<0.001, NOURISH; β=0.43 ± 0.07, p<0.001) and negatively related to satiety responsiveness (GEMINI; β=-0.19 ± 0.03, p<0.001, NOURISH; β=-0.34 ± 0.08, p<0.001), slowness in eating (GEMINI; β=-0.10 ± 0.03, p=0.002, NOURISH; β=-0.30 ± 0.08, p<0.001) and food fussiness (GEMINI; β=-0.30 ± 0.03, p<0.001, NOURISH; β=-0.60 ± 0.06, p<0.001). Fruit liking was positively associated with enjoyment of food (GEMINI; β=0.18 ± 0.03, p<0.001, NOURISH; β=0.36 ± 0.08, p<0.001), and negatively associated with satiety responsiveness (GEMINI; β=-0.13 ± 0.03, p<0.001, NOURISH; β=-0.24 ± 0.08, p=0.003), food fussiness (GEMINI; β=-0.26 ± 0.03, p<0.001, NOURISH; β=-0.51 ± 0.07, p<0.001) and slowness in eating (GEMINI only; β=-0.09 ± 0.03, p=0.005). Food responsiveness was unrelated to liking for fruits or vegetables in either sample but was positively associated with noncore food preference (GEMINI; β=0.10 ± 0.03, p=0.001, NOURISH; β=0.21 ± 0.08, p=0.010). Conclusion: Appetitive traits linked with lower obesity risk were related to lower liking for fruits and vegetables, while food responsiveness, a trait linked with greater risk of overweight, was uniquely associated with higher liking for noncore foods.