Kaye Brock | The University of Sydney (original) (raw)

Papers by Kaye Brock

Research paper thumbnail of Vitamin D status and hypertension: a review

Integrated Blood Pressure Control, 2015

Integrated Blood Pressure Control Dovepress submit your manuscript | www.dovepress.com Dovepress ... more Integrated Blood Pressure Control Dovepress submit your manuscript | www.dovepress.com Dovepress 13 R e v I e w open access to scientific and medical research Open Access Full Text Article Abstract: Vitamin D is a steroid prohormone synthesized in the skin following ultraviolet exposure and also achieved through supplemental or dietary intake. While there is strong evidence for its role in maintaining bone and muscle health, there has been recent debate regarding the role of vitamin D deficiency in hypertension based on conflicting epidemiological evidence. Thus, we conducted a scoping systematic literature review and meta-analysis of all observational studies published up to early 2014 in order to map trends in the evidence of this association. Mixed-effect meta-analysis was performed to pool risk estimates from ten prospective studies (n=58,262) (pooled risk for incident hypertension, relative risk [RR] =0.76 (0.63-0.90) for top vs bottom category of 25-hydroxyvitamin D [25OHD]) and from 19 cross-sectional studies (n=90,535) (odds ratio [OR] =0.79 (0.73-0. ). Findings suggest that the better the assessed quality of the respective study design, the stronger the relationship between higher 25OHD levels and hypertension risk (RR =0.67 (0.51-0.88); OR =0.77 (0.72-0.89)). There was significant heterogeneity among the findings for both prospective and cross-sectional studies, but no evidence of publication bias was shown. There was no increased risk of hypertension when the participants were of older age or when they were vitamin D deficient. Younger females showed strong associations between high 25OHD levels and hypertension risk, especially in prospective studies (RR =0.36 (0.18-0.72); OR =0.62 (0.44-0.87)). Despite the accumulating evidence of a consistent link between vitamin D and blood pressure, these data are observational, so questions still remain in relation to the causality of this relationship. Further studies either combining existing raw data from available cohort studies or conducting further Mendelian analyses are needed to determine whether this represents a causal association. Large randomized controlled trials are also needed to determine whether vitamin supplementation may be beneficial in the prevention or the treatment of hypertension.

Research paper thumbnail of The relationship between obesity and blood pressure differs by ethnicity in Sydney school children

American journal of hypertension, 2009

The objective of this study was to investigate the relationship between obesity and high systolic... more The objective of this study was to investigate the relationship between obesity and high systolic blood pressure (SBP) in Southeast Asian (SEAsian) and Australian children living in Australia. SBP, country of birth, and obesity indices (body mass index (BMI), waist circumference (WC), and percent body fat (%TBF)) were recorded in 1,232 9-year-old children from Sydney schools and remeasured 3 years later (n = 628). The relationship between SBP and obesity (both at baseline and longitudinally) was investigated by regression analyses. Children of SEAsian origin had a significantly higher risk of high SBP with increases in obesity indices compared to those of Australian origin. At 9 years old, SBP increased 1.51 mm Hg for each of BMI increase for SEAsian children compared to 1.05 mm Hg for Australian children (P(interaction) = 0.03). These same significant analysis of variance (ANOVA) interactions were seen with WC (P(interaction) = 0.02) and %TBF (P(interaction) = 0.04) as predictors o...

Research paper thumbnail of For the patient. Hypertriglyceridemic waist as a screening tool for CVD risk in Australian indigenous women

Ethnicity & disease, 2003

Research has demonstrated that the simultaneous determination of waist circumference and fasting ... more Research has demonstrated that the simultaneous determination of waist circumference and fasting plasma triglyceride (TG) concentrations can identify men characterized by a metabolic triad of unconventional risk variables: increased levels of fasting insulin, apolipoprotein (apo) B, and a predominance of small, dense, low density lipoprotein (LDL) particles. The aim of this study was to assess the efficacy of using ''hypertriglyceridemic waist'' to identify individuals at high risk of CVD in a sample of indigenous Australian women, for whom 2 of the 3 non-traditional risk factors were measured (apo B and insulin). Subjects (Nϭ80) were divided into subgroups on the basis of waist girth and TG levels. The TG /HDL ratio increased in women with both elevated waist (above 95 cm) and TG levels (above 2.0 mmol/ L), who were also characterized by lower HDL and elevated LDL concentrations. Although there was no trend toward an increase in apo B with increasing waist girth and TG levels, apo B concentration was highest among subgroups with elevated waist and TG levels. Fasting insulin levels were higher with increasing waist girth, but not with increasing TG levels. Utilizing hypertriglyceridemic waist as a marker of high plasma insulin and apo B can be an important factor in assessing cardiovascular risk in indigenous Australian women, despite an unexpected apo B distribution. (Ethn Dis. 2003; 13:80-84)

Research paper thumbnail of Hypertriglyceridemic waist as a screening tool for CVD risk in indigenous Australian women

Ethnicity & disease, 2003

Research has demonstrated that the simultaneous determination of waist circumference and fasting ... more Research has demonstrated that the simultaneous determination of waist circumference and fasting plasma triglyceride (TG) concentrations can identify men characterized by a metabolic triad of unconventional risk variables: increased levels of fasting insulin, apolipoprotein (apo) B, and a predominance of small, dense, low density lipoprotein (LDL) particles. The aim of this study was to assess the efficacy of using "hypertriglyceridemic waist" to identify individuals at high risk of CVD in a sample of indigenous Australian women, for whom 2 of the 3 non-traditional risk factors were measured (apo B and insulin). Subjects (N=80) were divided into subgroups on the basis of waist girth and TG levels. The TG/HDL ratio increased in women with both elevated waist (above 95 cm) and TG levels (above 2.0 mmol/L), who were also characterized by lower HDL and elevated LDL concentrations. Although there was no trend toward an increase in apo B with increasing waist girth and TG levels...

Research paper thumbnail of Leptin and total cholesterol are predictors of weight gain in pre-pubertal children

International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 1999

The aim of this study was to identify specifically which biochemical indices predict excessive we... more The aim of this study was to identify specifically which biochemical indices predict excessive weight gain over time in a cohort of pre-pubertal children. Fifty nine healthy pre-pubertal children (age: 6.3-9.8y). Children were defined anthropometrically and biochemically at baseline. Height and weight measurements were then repeated after six (n=52) and 12 months (n=37). Weight change after six months (defined by a change in body mass index (BMI) z-score from baseline) demonstrated no correlation with fasting plasma levels of leptin, insulin, insulin:glucose (IG) ratio, cholesterol, triglyceride or high density lipoprotein (HDL) cholesterol. However, after 12 months there was a significant negative correlation between BMI z-score change and initial plasma leptin (r=-0.35, P=0.048) and this relationship strengthened when adjusted for body fat (from bio-electrical impedance; r=-0.46, P=0.009). In addition, there was a significant positive relationship between plasma total cholesterol ...

Research paper thumbnail of Culture and Sun Exposure in Immigrant East Asian Women Living in Australia

Women & Health, 2013

In this qualitative study, researchers examined cultural and attitudinal factors that might be re... more In this qualitative study, researchers examined cultural and attitudinal factors that might be related to sun-exposure behaviors among East Asian women living in Australia. Researchers asked Culture and Sun Exposure 505 Chinese (n = 20) and Korean (n = 16) immigrant women who participated in a larger cross-sectional quantitative study of vitamin D blood levels to volunteer to participate in an in-depth interview in 2010. These women reported a number of cultural factors related to their attitudes and behaviors with regard to sun exposure. They expressed preference for fair skin, a tradition of covering skin when outdoors, and no sunbathing culture. They believed that fair skin was more beautiful than tanned skin. They reported that beauty was the reason for active avoidance of sunlight exposure. Although they reported knowledge of the need for sun avoidance due to skin cancer risk, few reported knowledge about the benefits of sun exposure for adequate vitamin D levels. These findings may provide some reasons for vitamin D deficiency previously reported in these populations. Thus, researchers recommend that these attitudes of excessive sun protection and limiting sun exposure be further investigated as they may have implications for planning and delivery of health promotion programs to this growing population of immigrants in Australia.

Research paper thumbnail of Low vitamin D status is associated with physical inactivity, obesity and low vitamin D intake in a large US sample of healthy middle-aged men and women

The Journal of Steroid Biochemistry and Molecular Biology, 2010

The aim of this study was to investigate modifiable predictors of vitamin D status in healthy ind... more The aim of this study was to investigate modifiable predictors of vitamin D status in healthy individuals, aged 55-74, and living across the USA. Vitamin D status [serum 25-hydroxyvitamin D (25(OH)D)] was measured along with age and season at blood collection, demographics, anthropometry, physical activity (PA), diet, and other lifestyle factors in 1357 male and 1264 female controls selected from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort. Multivariate linear and logistic regression analyses were used to identify associations with vitamin D status. Three%, 29% and 79% of the population had serum 25(OH)D levels <25, <50 and <80 nmol/L, respectively. The major modifiable predictors of low vitamin D status were low vitamin D dietary and supplement intake, body mass index (BMI) >30 kg/m 2 , physical inactivity (PA) and low milk and calcium supplement intake. In men, 25(OH)D was determined more by milk intake on cereal and in women, by vitamin D and calcium supplement and menopausal hormone therapy (MHT) use. Thus targeting an increase in vigorous activity and vitamin D and calcium intake and decreasing obesity could be public health interventions independent of sun exposure to improve vitamin D status in middle-aged Americans.

Research paper thumbnail of Vitamin D status is associated with sun exposure, vitamin D and calcium intake, acculturation and attitudes in immigrant East Asian women living in Sydney

The Journal of Steroid Biochemistry and Molecular Biology, 2013

Please cite this article in press as: K.E. Brock, et al., Vitamin D status is associated with sun... more Please cite this article in press as: K.E. Brock, et al., Vitamin D status is associated with sun exposure, vitamin D and calcium intake, acculturation and attitudes in immigrant East Asian women living in Sydney, J. Steroid Biochem. Mol. Biol. (2013), http://dx.

Research paper thumbnail of Influences of Chronic Pain on Proximal Job Retention Outcomes: A Systematic Literature Review

The Australian Journal of Rehabilitation Counselling, 2013

ABSTRACT Objective. The study examined the evidence for the influence of chronic pain on proximal... more ABSTRACT Objective. The study examined the evidence for the influence of chronic pain on proximal work participation behaviours important for job retention such as presenteeism, absenteeism and job satisfaction.Method. A comprehensive literature search was undertaken using various databases including PsycINFO, Medline, Scopus and other sources which resulted in the identification of 353 articles of which 15 articles were chosen for analysis and inclusion. Eligibility was based on a mixed methodological framework using the Consolidated Standards of Reporting Trials (CONSORT) checklist.Results. There is evidence to suggest that chronic pain influences work participation qualities including absenteeism, presenteeism and job satisfaction. Personality and work content factors mediate the relationship between chronic pain and the proximal work participation variables.Conclusion. Interventions targeting proximal work context behaviours appear to hold promise for long-term work participation by people with chronic pain. Rehabilitation interventions for job retention with chronic pain will likely be successful with attention to ongoing, changeable work participation behaviours that predict job retention.

Research paper thumbnail of Smoking and Lipid Cardiovascular Risk Factors in Vietnamese Refugees in Australia

Preventive Medicine, 1999

Vietnamese refugees; lipoprotein (a); high-density lipo-Background. The effects of smoking and se... more Vietnamese refugees; lipoprotein (a); high-density lipo-Background. The effects of smoking and sex on lipid protein cholesterol; apoprotein A-1; apoprotein B. risk factors for cardiovascular disease were examined among Vietnamese people newly arrived in Australia.

Research paper thumbnail of Parental obesity as a predictor of childhood overweight/obesity in Australian migrant children

Obesity Research & Clinical Practice, 2008

Obesity levels are increasing disproportionately in immigrant children worldwide. We investigated... more Obesity levels are increasing disproportionately in immigrant children worldwide. We investigated predictors of immigrant children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s obesity status in a well-documented 3-year follow-up study of children at 9 years (n = 1232) and 12 years (n = 628) of age living in inner city areas of Sydney (Australia). The major immigrant groups in this sample were from Europe, the Middle East and SE Asia. Having an obese parent and having either parent or child not being born in Australia and not playing organised sport were predictors of childhood obesity. If either parent was obese compared to non-obese, then the odds ratio for a 9-year-old child of being obese compared to normal weight was 4.9 (95% CI: 3.0-8.0); for 12-year olds the odds ratio was 8.0 (95% CI: 3.6-18). For the survey of 9-years old, a parent born outside Australia or if the child himself was born outside Australia was associated with an almost twofold chance of being obese (OR = 1.8, 95% CI: 1.1-3.0), and not participating in organised sports was significantly associated with childhood obesity. Nine-year olds who did not participate in organised sports outside of school hours were almost twice as likely to be obese (OR = 1.9, 95% CI: 1.2-2.9). When stratified by ethnicity, participation in sports was not related to lower obesity status in children of SE Asian origin. One reason for this could be because SE Asian had very limited participation in sports compared to their counterparts. Accordingly, we believe that health promotion messages to avoid obesity need to be targeted ethnic-specifically.:

Research paper thumbnail of Australian residence and heart disease risk in Vietnamese-born women

Obesity Research & Clinical Practice, 2007

The aim of this study was to compare the disease risk profile of Vietnamese women who have lived ... more The aim of this study was to compare the disease risk profile of Vietnamese women who have lived in Australia for 2-15 years with a newly arrived group of Vietnamese women. The design was a comparison of two cross-sectional surveys (n = 256); one newly arrived (n = 159) and one (n = 97) who had lived in Australia for 2-15 years. The main outcome measures were body mass index (BMI), waist to hip ratio (WHR), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and TC/HDL ratio (atherogenic index). The longer-stay residents had similar BMI (21.5 ± 3.5 kg/m(2) vs. 21.1 ± 3.1 kg/m(2), p = 0.2); lower waist (69.3 ± 7.5 cm vs. 71.4 ± 7.6 cm, p = 0.8), WHR (0.76 ± 0.06 vs. 0.80 ± 0.06, p = 0.0001), TC (4.7 ± 1.0 mmol/L vs. 4.9 ± 0.9 mmol/L, p = 0.001), TC/HDL (3.0 ± 2.0 vs. 4.7 ± 2.0, p = 0.006) and higher hip measurement (91.1 ± 7.4 cm vs. 89.1 ± 5.6 cm, p = 0.009) than newly arrived Vietnamese women. After adjustment for BMI and age the odds of having a higher waist and WHR was significantly less for longer-stay residents, while the odds of having larger hips was doubled. The odds of having a high atherogenic index as estimated by the TC/HDL ratio was halved for the longer-stay residents (p = 0.15). We conclude that Vietnamese women we surveyed who have lived in Australia for 2-15 years have the same BMI, but lower levels of abdominal obesity and lower atherogenic index than newly arrived Vietnamese women surveyed.:

Research paper thumbnail of Worry in Older Community-Residing Adults

The International Journal of Aging and Human Development, 2011

With rising longevity, increasing numbers of older people are experiencing changes in their every... more With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly (n = 310). Findings showed that that those people under 75 years of age had a higher risk of worrying (OR = 1.8, 95% CI = 1.0-3.1) compared to the older age groups. Women worried more than men and an important finding was that those with chronic health conditions such as arthritis of the hip and knee were more prone to worry than those who were healthy or had acute conditions (OR = 3.5, 95% CI = 1.4-8.9). This latter finding suggests the importance placed on the role of the hip and knee in maintaining functional capacity to perform life skills.

Research paper thumbnail of Developing a Self-Reported Tool on Fall Risk Based on Toileting Responses on In-Hospital Falls

Geriatric Nursing, 2012

The aim of this cohort study was to determine the predictive value of a 2-item self-reported ques... more The aim of this cohort study was to determine the predictive value of a 2-item self-reported questionnaire regarding in-hospital toileting behavior for predicting falls in older inpatients and to compare its performance with an existing state-based falls assessment scale. Between we assessed aged care inpatients for risk of falls using the standard STRATIFY fall screening tool and the 2-item self-reported questionnaire developed for this study. The participants were then followed up, with the primary outcome being the occurrence of falls. Results indicated that participants who were unable to answer the 2-item questionnaire appropriately or sensibly were 14.1 times (confidence interval [CI]: 4.4e45, p \. 001) to 17.0 times (CI: 6.7e43, p \ .001) more likely to fall than those who gave an appropriate negative or positive answer. Participants who were assessed to be at high risk of falls on the STRATIFY scale were 9.5 times (odds ratio: 9.5, CI: 1.3e72, p 5 .03) more likely to fall than those who were low risk. In conclusion, a simple bedside questionnaire regarding patients' toileting behavior with a careful appraisal of answers for appropriate and inappropriate answers may be used as a quick screening tool of fall risk. (Geriatr Nurs 2012;33:9-16)

Research paper thumbnail of Food, activity and family—environmental vs biochemical predictors of weight gain in children

European Journal of Clinical Nutrition, 2003

Objective: To identify whether measures of energy intake and expenditure predict excessive weight... more Objective: To identify whether measures of energy intake and expenditure predict excessive weight gain over time in children and to describe how these measures relate to similar measures in parents. Design: Prospective, descriptive study over 12 months with no intervention. Setting: University teaching hospital. Subjects: Children aged between 6.0 and 9.0 y. Recruitment was through advertisement. A total of 59 children (30 F), 41 mothers and 29 fathers. In all, 41 (69%) of the children were reviewed at 12 months (20 F). Results: No significant correlations were identified between body mass index (BMI) z-score change in children over 12 months for any dietary variable or for any measures of energy expenditure, including hours of television viewing or percent time spent in low-, moderate-or high-intensity activity. The BMI z-score change over 12 months was significantly correlated with LDL cholesterol and Apo B/ApoA-1 ratio, independent of percent body fat (r ¼ 0.45, P ¼ 0.01; r ¼ 0.37, P ¼ 0.03). A significant positive correlation was found for mothers and girls for percent time in moderate to high activity (r ¼ 0.44, P ¼ 0.03) and between fathers and children for percent time spent in low activity (r ¼ 0.43, P ¼ 0.005). Conclusions: The study has been unable to identify environmental predictors that indicate propensity to faster weight gain over time in this cohort of children, but has extended the evidence on lifestyle-influenced biochemical predictors that do. An overall lack of vigorous activity in this age group, and correlations between parental and child activity and inactivity have been identified.

Research paper thumbnail of Predictors of vitamin D biochemical status in a large sample of middle-aged male smokers in Finland

European Journal of Clinical Nutrition, 2010

Research paper thumbnail of Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience

BMC Public Health, 2011

Background: The reproductive and mental health of women contributes significantly to their overal... more Background: The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences.

Research paper thumbnail of Vitamin D status and hypertension: a review

Integrated Blood Pressure Control, 2015

Integrated Blood Pressure Control Dovepress submit your manuscript | www.dovepress.com Dovepress ... more Integrated Blood Pressure Control Dovepress submit your manuscript | www.dovepress.com Dovepress 13 R e v I e w open access to scientific and medical research Open Access Full Text Article Abstract: Vitamin D is a steroid prohormone synthesized in the skin following ultraviolet exposure and also achieved through supplemental or dietary intake. While there is strong evidence for its role in maintaining bone and muscle health, there has been recent debate regarding the role of vitamin D deficiency in hypertension based on conflicting epidemiological evidence. Thus, we conducted a scoping systematic literature review and meta-analysis of all observational studies published up to early 2014 in order to map trends in the evidence of this association. Mixed-effect meta-analysis was performed to pool risk estimates from ten prospective studies (n=58,262) (pooled risk for incident hypertension, relative risk [RR] =0.76 (0.63-0.90) for top vs bottom category of 25-hydroxyvitamin D [25OHD]) and from 19 cross-sectional studies (n=90,535) (odds ratio [OR] =0.79 (0.73-0. ). Findings suggest that the better the assessed quality of the respective study design, the stronger the relationship between higher 25OHD levels and hypertension risk (RR =0.67 (0.51-0.88); OR =0.77 (0.72-0.89)). There was significant heterogeneity among the findings for both prospective and cross-sectional studies, but no evidence of publication bias was shown. There was no increased risk of hypertension when the participants were of older age or when they were vitamin D deficient. Younger females showed strong associations between high 25OHD levels and hypertension risk, especially in prospective studies (RR =0.36 (0.18-0.72); OR =0.62 (0.44-0.87)). Despite the accumulating evidence of a consistent link between vitamin D and blood pressure, these data are observational, so questions still remain in relation to the causality of this relationship. Further studies either combining existing raw data from available cohort studies or conducting further Mendelian analyses are needed to determine whether this represents a causal association. Large randomized controlled trials are also needed to determine whether vitamin supplementation may be beneficial in the prevention or the treatment of hypertension.

Research paper thumbnail of The relationship between obesity and blood pressure differs by ethnicity in Sydney school children

American journal of hypertension, 2009

The objective of this study was to investigate the relationship between obesity and high systolic... more The objective of this study was to investigate the relationship between obesity and high systolic blood pressure (SBP) in Southeast Asian (SEAsian) and Australian children living in Australia. SBP, country of birth, and obesity indices (body mass index (BMI), waist circumference (WC), and percent body fat (%TBF)) were recorded in 1,232 9-year-old children from Sydney schools and remeasured 3 years later (n = 628). The relationship between SBP and obesity (both at baseline and longitudinally) was investigated by regression analyses. Children of SEAsian origin had a significantly higher risk of high SBP with increases in obesity indices compared to those of Australian origin. At 9 years old, SBP increased 1.51 mm Hg for each of BMI increase for SEAsian children compared to 1.05 mm Hg for Australian children (P(interaction) = 0.03). These same significant analysis of variance (ANOVA) interactions were seen with WC (P(interaction) = 0.02) and %TBF (P(interaction) = 0.04) as predictors o...

Research paper thumbnail of For the patient. Hypertriglyceridemic waist as a screening tool for CVD risk in Australian indigenous women

Ethnicity & disease, 2003

Research has demonstrated that the simultaneous determination of waist circumference and fasting ... more Research has demonstrated that the simultaneous determination of waist circumference and fasting plasma triglyceride (TG) concentrations can identify men characterized by a metabolic triad of unconventional risk variables: increased levels of fasting insulin, apolipoprotein (apo) B, and a predominance of small, dense, low density lipoprotein (LDL) particles. The aim of this study was to assess the efficacy of using ''hypertriglyceridemic waist'' to identify individuals at high risk of CVD in a sample of indigenous Australian women, for whom 2 of the 3 non-traditional risk factors were measured (apo B and insulin). Subjects (Nϭ80) were divided into subgroups on the basis of waist girth and TG levels. The TG /HDL ratio increased in women with both elevated waist (above 95 cm) and TG levels (above 2.0 mmol/ L), who were also characterized by lower HDL and elevated LDL concentrations. Although there was no trend toward an increase in apo B with increasing waist girth and TG levels, apo B concentration was highest among subgroups with elevated waist and TG levels. Fasting insulin levels were higher with increasing waist girth, but not with increasing TG levels. Utilizing hypertriglyceridemic waist as a marker of high plasma insulin and apo B can be an important factor in assessing cardiovascular risk in indigenous Australian women, despite an unexpected apo B distribution. (Ethn Dis. 2003; 13:80-84)

Research paper thumbnail of Hypertriglyceridemic waist as a screening tool for CVD risk in indigenous Australian women

Ethnicity & disease, 2003

Research has demonstrated that the simultaneous determination of waist circumference and fasting ... more Research has demonstrated that the simultaneous determination of waist circumference and fasting plasma triglyceride (TG) concentrations can identify men characterized by a metabolic triad of unconventional risk variables: increased levels of fasting insulin, apolipoprotein (apo) B, and a predominance of small, dense, low density lipoprotein (LDL) particles. The aim of this study was to assess the efficacy of using "hypertriglyceridemic waist" to identify individuals at high risk of CVD in a sample of indigenous Australian women, for whom 2 of the 3 non-traditional risk factors were measured (apo B and insulin). Subjects (N=80) were divided into subgroups on the basis of waist girth and TG levels. The TG/HDL ratio increased in women with both elevated waist (above 95 cm) and TG levels (above 2.0 mmol/L), who were also characterized by lower HDL and elevated LDL concentrations. Although there was no trend toward an increase in apo B with increasing waist girth and TG levels...

Research paper thumbnail of Leptin and total cholesterol are predictors of weight gain in pre-pubertal children

International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity, 1999

The aim of this study was to identify specifically which biochemical indices predict excessive we... more The aim of this study was to identify specifically which biochemical indices predict excessive weight gain over time in a cohort of pre-pubertal children. Fifty nine healthy pre-pubertal children (age: 6.3-9.8y). Children were defined anthropometrically and biochemically at baseline. Height and weight measurements were then repeated after six (n=52) and 12 months (n=37). Weight change after six months (defined by a change in body mass index (BMI) z-score from baseline) demonstrated no correlation with fasting plasma levels of leptin, insulin, insulin:glucose (IG) ratio, cholesterol, triglyceride or high density lipoprotein (HDL) cholesterol. However, after 12 months there was a significant negative correlation between BMI z-score change and initial plasma leptin (r=-0.35, P=0.048) and this relationship strengthened when adjusted for body fat (from bio-electrical impedance; r=-0.46, P=0.009). In addition, there was a significant positive relationship between plasma total cholesterol ...

Research paper thumbnail of Culture and Sun Exposure in Immigrant East Asian Women Living in Australia

Women & Health, 2013

In this qualitative study, researchers examined cultural and attitudinal factors that might be re... more In this qualitative study, researchers examined cultural and attitudinal factors that might be related to sun-exposure behaviors among East Asian women living in Australia. Researchers asked Culture and Sun Exposure 505 Chinese (n = 20) and Korean (n = 16) immigrant women who participated in a larger cross-sectional quantitative study of vitamin D blood levels to volunteer to participate in an in-depth interview in 2010. These women reported a number of cultural factors related to their attitudes and behaviors with regard to sun exposure. They expressed preference for fair skin, a tradition of covering skin when outdoors, and no sunbathing culture. They believed that fair skin was more beautiful than tanned skin. They reported that beauty was the reason for active avoidance of sunlight exposure. Although they reported knowledge of the need for sun avoidance due to skin cancer risk, few reported knowledge about the benefits of sun exposure for adequate vitamin D levels. These findings may provide some reasons for vitamin D deficiency previously reported in these populations. Thus, researchers recommend that these attitudes of excessive sun protection and limiting sun exposure be further investigated as they may have implications for planning and delivery of health promotion programs to this growing population of immigrants in Australia.

Research paper thumbnail of Low vitamin D status is associated with physical inactivity, obesity and low vitamin D intake in a large US sample of healthy middle-aged men and women

The Journal of Steroid Biochemistry and Molecular Biology, 2010

The aim of this study was to investigate modifiable predictors of vitamin D status in healthy ind... more The aim of this study was to investigate modifiable predictors of vitamin D status in healthy individuals, aged 55-74, and living across the USA. Vitamin D status [serum 25-hydroxyvitamin D (25(OH)D)] was measured along with age and season at blood collection, demographics, anthropometry, physical activity (PA), diet, and other lifestyle factors in 1357 male and 1264 female controls selected from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) cohort. Multivariate linear and logistic regression analyses were used to identify associations with vitamin D status. Three%, 29% and 79% of the population had serum 25(OH)D levels <25, <50 and <80 nmol/L, respectively. The major modifiable predictors of low vitamin D status were low vitamin D dietary and supplement intake, body mass index (BMI) >30 kg/m 2 , physical inactivity (PA) and low milk and calcium supplement intake. In men, 25(OH)D was determined more by milk intake on cereal and in women, by vitamin D and calcium supplement and menopausal hormone therapy (MHT) use. Thus targeting an increase in vigorous activity and vitamin D and calcium intake and decreasing obesity could be public health interventions independent of sun exposure to improve vitamin D status in middle-aged Americans.

Research paper thumbnail of Vitamin D status is associated with sun exposure, vitamin D and calcium intake, acculturation and attitudes in immigrant East Asian women living in Sydney

The Journal of Steroid Biochemistry and Molecular Biology, 2013

Please cite this article in press as: K.E. Brock, et al., Vitamin D status is associated with sun... more Please cite this article in press as: K.E. Brock, et al., Vitamin D status is associated with sun exposure, vitamin D and calcium intake, acculturation and attitudes in immigrant East Asian women living in Sydney, J. Steroid Biochem. Mol. Biol. (2013), http://dx.

Research paper thumbnail of Influences of Chronic Pain on Proximal Job Retention Outcomes: A Systematic Literature Review

The Australian Journal of Rehabilitation Counselling, 2013

ABSTRACT Objective. The study examined the evidence for the influence of chronic pain on proximal... more ABSTRACT Objective. The study examined the evidence for the influence of chronic pain on proximal work participation behaviours important for job retention such as presenteeism, absenteeism and job satisfaction.Method. A comprehensive literature search was undertaken using various databases including PsycINFO, Medline, Scopus and other sources which resulted in the identification of 353 articles of which 15 articles were chosen for analysis and inclusion. Eligibility was based on a mixed methodological framework using the Consolidated Standards of Reporting Trials (CONSORT) checklist.Results. There is evidence to suggest that chronic pain influences work participation qualities including absenteeism, presenteeism and job satisfaction. Personality and work content factors mediate the relationship between chronic pain and the proximal work participation variables.Conclusion. Interventions targeting proximal work context behaviours appear to hold promise for long-term work participation by people with chronic pain. Rehabilitation interventions for job retention with chronic pain will likely be successful with attention to ongoing, changeable work participation behaviours that predict job retention.

Research paper thumbnail of Smoking and Lipid Cardiovascular Risk Factors in Vietnamese Refugees in Australia

Preventive Medicine, 1999

Vietnamese refugees; lipoprotein (a); high-density lipo-Background. The effects of smoking and se... more Vietnamese refugees; lipoprotein (a); high-density lipo-Background. The effects of smoking and sex on lipid protein cholesterol; apoprotein A-1; apoprotein B. risk factors for cardiovascular disease were examined among Vietnamese people newly arrived in Australia.

Research paper thumbnail of Parental obesity as a predictor of childhood overweight/obesity in Australian migrant children

Obesity Research & Clinical Practice, 2008

Obesity levels are increasing disproportionately in immigrant children worldwide. We investigated... more Obesity levels are increasing disproportionately in immigrant children worldwide. We investigated predictors of immigrant children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s obesity status in a well-documented 3-year follow-up study of children at 9 years (n = 1232) and 12 years (n = 628) of age living in inner city areas of Sydney (Australia). The major immigrant groups in this sample were from Europe, the Middle East and SE Asia. Having an obese parent and having either parent or child not being born in Australia and not playing organised sport were predictors of childhood obesity. If either parent was obese compared to non-obese, then the odds ratio for a 9-year-old child of being obese compared to normal weight was 4.9 (95% CI: 3.0-8.0); for 12-year olds the odds ratio was 8.0 (95% CI: 3.6-18). For the survey of 9-years old, a parent born outside Australia or if the child himself was born outside Australia was associated with an almost twofold chance of being obese (OR = 1.8, 95% CI: 1.1-3.0), and not participating in organised sports was significantly associated with childhood obesity. Nine-year olds who did not participate in organised sports outside of school hours were almost twice as likely to be obese (OR = 1.9, 95% CI: 1.2-2.9). When stratified by ethnicity, participation in sports was not related to lower obesity status in children of SE Asian origin. One reason for this could be because SE Asian had very limited participation in sports compared to their counterparts. Accordingly, we believe that health promotion messages to avoid obesity need to be targeted ethnic-specifically.:

Research paper thumbnail of Australian residence and heart disease risk in Vietnamese-born women

Obesity Research & Clinical Practice, 2007

The aim of this study was to compare the disease risk profile of Vietnamese women who have lived ... more The aim of this study was to compare the disease risk profile of Vietnamese women who have lived in Australia for 2-15 years with a newly arrived group of Vietnamese women. The design was a comparison of two cross-sectional surveys (n = 256); one newly arrived (n = 159) and one (n = 97) who had lived in Australia for 2-15 years. The main outcome measures were body mass index (BMI), waist to hip ratio (WHR), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C) and TC/HDL ratio (atherogenic index). The longer-stay residents had similar BMI (21.5 ± 3.5 kg/m(2) vs. 21.1 ± 3.1 kg/m(2), p = 0.2); lower waist (69.3 ± 7.5 cm vs. 71.4 ± 7.6 cm, p = 0.8), WHR (0.76 ± 0.06 vs. 0.80 ± 0.06, p = 0.0001), TC (4.7 ± 1.0 mmol/L vs. 4.9 ± 0.9 mmol/L, p = 0.001), TC/HDL (3.0 ± 2.0 vs. 4.7 ± 2.0, p = 0.006) and higher hip measurement (91.1 ± 7.4 cm vs. 89.1 ± 5.6 cm, p = 0.009) than newly arrived Vietnamese women. After adjustment for BMI and age the odds of having a higher waist and WHR was significantly less for longer-stay residents, while the odds of having larger hips was doubled. The odds of having a high atherogenic index as estimated by the TC/HDL ratio was halved for the longer-stay residents (p = 0.15). We conclude that Vietnamese women we surveyed who have lived in Australia for 2-15 years have the same BMI, but lower levels of abdominal obesity and lower atherogenic index than newly arrived Vietnamese women surveyed.:

Research paper thumbnail of Worry in Older Community-Residing Adults

The International Journal of Aging and Human Development, 2011

With rising longevity, increasing numbers of older people are experiencing changes in their every... more With rising longevity, increasing numbers of older people are experiencing changes in their everyday family and social life, changes in their financial status, and a greater number of chronic conditions affecting their health. We took the opportunity to explore these relationships with worry in a group of volunteer community-living elderly (n = 310). Findings showed that that those people under 75 years of age had a higher risk of worrying (OR = 1.8, 95% CI = 1.0-3.1) compared to the older age groups. Women worried more than men and an important finding was that those with chronic health conditions such as arthritis of the hip and knee were more prone to worry than those who were healthy or had acute conditions (OR = 3.5, 95% CI = 1.4-8.9). This latter finding suggests the importance placed on the role of the hip and knee in maintaining functional capacity to perform life skills.

Research paper thumbnail of Developing a Self-Reported Tool on Fall Risk Based on Toileting Responses on In-Hospital Falls

Geriatric Nursing, 2012

The aim of this cohort study was to determine the predictive value of a 2-item self-reported ques... more The aim of this cohort study was to determine the predictive value of a 2-item self-reported questionnaire regarding in-hospital toileting behavior for predicting falls in older inpatients and to compare its performance with an existing state-based falls assessment scale. Between we assessed aged care inpatients for risk of falls using the standard STRATIFY fall screening tool and the 2-item self-reported questionnaire developed for this study. The participants were then followed up, with the primary outcome being the occurrence of falls. Results indicated that participants who were unable to answer the 2-item questionnaire appropriately or sensibly were 14.1 times (confidence interval [CI]: 4.4e45, p \. 001) to 17.0 times (CI: 6.7e43, p \ .001) more likely to fall than those who gave an appropriate negative or positive answer. Participants who were assessed to be at high risk of falls on the STRATIFY scale were 9.5 times (odds ratio: 9.5, CI: 1.3e72, p 5 .03) more likely to fall than those who were low risk. In conclusion, a simple bedside questionnaire regarding patients' toileting behavior with a careful appraisal of answers for appropriate and inappropriate answers may be used as a quick screening tool of fall risk. (Geriatr Nurs 2012;33:9-16)

Research paper thumbnail of Food, activity and family—environmental vs biochemical predictors of weight gain in children

European Journal of Clinical Nutrition, 2003

Objective: To identify whether measures of energy intake and expenditure predict excessive weight... more Objective: To identify whether measures of energy intake and expenditure predict excessive weight gain over time in children and to describe how these measures relate to similar measures in parents. Design: Prospective, descriptive study over 12 months with no intervention. Setting: University teaching hospital. Subjects: Children aged between 6.0 and 9.0 y. Recruitment was through advertisement. A total of 59 children (30 F), 41 mothers and 29 fathers. In all, 41 (69%) of the children were reviewed at 12 months (20 F). Results: No significant correlations were identified between body mass index (BMI) z-score change in children over 12 months for any dietary variable or for any measures of energy expenditure, including hours of television viewing or percent time spent in low-, moderate-or high-intensity activity. The BMI z-score change over 12 months was significantly correlated with LDL cholesterol and Apo B/ApoA-1 ratio, independent of percent body fat (r ¼ 0.45, P ¼ 0.01; r ¼ 0.37, P ¼ 0.03). A significant positive correlation was found for mothers and girls for percent time in moderate to high activity (r ¼ 0.44, P ¼ 0.03) and between fathers and children for percent time spent in low activity (r ¼ 0.43, P ¼ 0.005). Conclusions: The study has been unable to identify environmental predictors that indicate propensity to faster weight gain over time in this cohort of children, but has extended the evidence on lifestyle-influenced biochemical predictors that do. An overall lack of vigorous activity in this age group, and correlations between parental and child activity and inactivity have been identified.

Research paper thumbnail of Predictors of vitamin D biochemical status in a large sample of middle-aged male smokers in Finland

European Journal of Clinical Nutrition, 2010

Research paper thumbnail of Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience

BMC Public Health, 2011

Background: The reproductive and mental health of women contributes significantly to their overal... more Background: The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences.