Medicine and Health Sciences Commons^™

Association Between Ideal Cardiovascular Health Metrics And Depression In Chinese Population : A Cross-Sectional Study, Zhikun Li, Xin Yang, Anxin Wan, Jing Qui, Wei Wang, Qiaofeng Song, Xizhu Wang

Research outputs 2014 to 2021

The study aimed to examine the association between ideal cardiovascular health (CVH) metrics and depression. We conducted a population-based, cross-sectional study of 6,851 participants aged 20 years or older (3,525 men and 3,326 women) living in Tangshan City, China. Information on the seven CVH metrics (including smoking, body mass index, dietary intake, physical activity, blood pressure, total cholesterol and fasting blood glucose) was collected via questionnaires, physical examination and laboratory test. Depression status was assessed using the Epidemiologic Studies Depression Scale (CES-D) and a score of 16 or above was considered depression. The relationship between CVH metrics and depression was …

Alzheimer's Disease Cerebrospinal Fluid Biomarkers Are Not Influenced By Gravity Drip Or Aspiration Extraction Methodology, Alan Rembach, Lisbeth A. Evered, Qiao-Xin Li, Tabitha Nash, Lesley Vidaurre, Christopher J. Fowler, Kelly K. Pertile, Rebecca L. Rumble, Brett O. Trounson, Sarah Maher, Francis Mooney, Maree Farrow, Kevin Taddei, Stephanie Rainey-Smith, Simon Laws, S. Lance Macaulay, William Wilson, David G. Darby, Ralph N. Martins, David Ames, Steven Collins, Brendon Silbert, Colin L. Masters, James D. Doecke

Research outputs 2014 to 2021

Introduction Cerebrospinal fluid (CSF) biomarkers, although of established utility in the diagnostic evaluation of Alzheimer’s disease (AD), are known to be sensitive to variation based on pre-analytical sample processing. We assessed whether gravity droplet collection versus syringe aspiration was another factor influencing CSF biomarker analyte concentrations and reproducibility. Methods Standardized lumbar puncture using small calibre atraumatic spinal needles and CSF collection using gravity fed collection followed by syringe aspirated extraction was performed in a sample of elderly individuals participating in a large long-term observational research trial. Analyte assay concentrations were compared. Results For the 44 total paired samples of gravity …

Inflamation And Oxidative Stress : The Molecular Connectivity Between Insulin Resistance, Obesity And Alzheimer's Disease, Guiseppe Verdile, Kevin N. Keane, Vinicius F. Cruzat, Sandra Medic, Miheer Sabale, Joanne Rowles, Nadeeja Wijesekara, Ralph Martins, Paul E. Fraser, Philip Newsholme

Research outputs 2014 to 2021

Type 2 diabetes (T 2 DM), Alzheimer’s disease (AD), and insulin resistance are age-related conditions and increased prevalence is of public concern. Recent research has provided evidence that insulin resistance and impaired insulin signalling may be a contributory factor to the progression of diabetes, dementia, and other neurological disorders. Alzheimer’s disease (AD) is the most common subtype of dementia. Reduced release (for T 2 DM) and decreased action of insulin are central to the development and progression of both T 2 DM and AD. A literature search was conducted to identify molecular commonalities between obesity, diabetes, and AD. Insulin resistance …

Do Patients With Long-Term Side Effects Of Cancer Treatment Benefit From General Practitioner Support? A Literature Review, Irene M. Ngune, Moyez Jiwa, Alexandra Mcmanus, Jeff Hughes

Research outputs 2014 to 2021

Background: Alongside specialist cancer clinics, general practitioners have an important role in cancer patients ’ follow-up care, yet no literature summarises the nature, extent and impact of their involvement. This paper addresses this issue through a review of the literature. Methods: Studies were sourced from six academic databases - AustHealth ( n = 202), CINAHL ( n = 500), the Cochrane Library (reviews and trials; n = 200), Embase ( n = 368), PHCRIS ( n = 132) and PubMed/Medline ( n = 410). Studies that focused on interventions designed for patients receiving follow-up care and reported cancer care provided …

The Specialist Breast Care Nurse's Role In The Indentification And Minimisation Of Distress In A Members' Only, Breast Cancer Focused Online Support Community, Cynthia Witney, Joyce M. Hendricks Phd, Vicki C. Cope Ms

Research outputs 2014 to 2021

Objectives: To show how a specialist breast care nurse (SBCN) can use the distress thermometer to determine an online community member’s distress level and then use the information in their posts and blogs to identify the cause(s) and deal with them appropriately. To highlight the use of a structured written emotional expression (SWEE) format online, as a way of minimising distress. Method: A survey of online community members together with analysis of the content of members’ posts and blogs to determine whether their distress thermometer score had decreased since the SBCN had been online to deal with member distress. Results: …

Strategy For Improvement Of Maternal Health In Nepal, Gehendra Mahara, Xiuhua Gua, Wei Wang

Research outputs 2014 to 2021

Maternal death is a public health problem in like Nepal. Still women have been facing the pregnancy related problems due to inaccessible and poor quality health service as well as a less available health service from skilled health workers. This is due to lack of essential knowledge about pregnancy and its complications. The main aim of this article is to evaluate and synthesize the current public health issues of maternal health of women in Nepal. Syntheses the problems, challenges and issues regarding maternal health and what can be done for the improvement of those problems with the evidence base practice. …

Reduced Cardiovascular Capacity And Resting Metabolic Rate In Men With Prostate Cancer Undergoing Androgen Deprivation: A Comprehensive Cross-Sectional Investigation, Bradley Wall, Daniel A. Galvao, Naeem Fatehee, Dennis Taaffe, Nigel Spry, David Joseph, Robert Newton

Research outputs 2014 to 2021

Objectives. To investigate if androgen deprivation therapy exposure is associated with additional risk factors for cardiovascular disease and metabolic treatment-related toxicities. Methods. One hundred and seven men (42-89 years) with prostate cancer undergoing androgen deprivation therapy completed a maximal graded objective exercise test to determine maximal oxygen uptake, assessments for resting metabolic rate, body composition, blood pressure and arterial stiffness, and blood biomarker analysis. A cross-sectional analysis was undertaken to investigate the potential impact of therapy exposure with participants stratified into two groups according to duration of androgen deprivation therapy (≥3 months). Results. Maximal oxygen uptake (26.1 ± 6.0 mL/kg/min …

Support After Brain Tumor Means Different Things: Family Caregivers' Experiences Of Support And Relationship Changes, T. Ownsworth, E. Goadby, Suzanne K. Chambers

Research outputs 2014 to 2021

Shorter hospital stays and greater emphasis on outpatient care means that family members have the primary responsibility for supporting a person with brain tumor to manage the physical, cognitive, behavioral, and emotional effects of the illness and its treatment. Given the integral role of family caregivers, it is essential to understand their experience of the impact of brain tumor and their own support needs. Accordingly, this qualitative study aimed to investigate family caregivers' experiences of support and relationship changes in the context of brain tumor. In-depth interviews were conducted with 11 family caregivers (8 spouse/partner, 3 parents) of people with …

Effective, Clinically Feasible And Sustainable: Key Design Features Of Psycho-Educational And Supportive Care Interventions To Promote Individualised Self-Management In Cancer Care, P. Schofield, Suzanne Chambers

Research outputs 2014 to 2021

As the global burden of cancer increases healthcare services will face increasing challenges in meet the complex needs of these patients, their families and the communities in which they live. This raises the question of how to meet patient need where direct clinical contact may be constrained or not readily available. Patients and families require resources and skills to manage their illness outside of the hospital setting within their own communities. Aim. To propose a framework for the development and delivery of psycho-educational and supportive care interventions drawing on theoretical principles of behaviour change and evidence-based interventions, and based on …

Psychological Distress And Quality Of Life In Lung Cancer: The Role Of Health-Related Stigma, Illness Appraisals And Social Constraints, Suzanne Chambers, P. Baade, P. Youl, J. Aitken, S. Occhipinti, S. Vinod, P.C. Valery, G. Garvey, K.M. Fong, D. Ball, H. Zorbas, J. Dunn, D.L. O'Connell

Research outputs 2014 to 2021

Objective: Health-related stigma is associated with negative psychological and quality of life outcomes in lung cancer patients. This study describes the impact of stigma on lung cancer patients' psychological distress and quality of life and explores the role of social constraints and illness appraisal as mediators of effect. Methods: A self-administered cross-sectional survey examined psychological distress and quality of life in 151 people (59% response rate) diagnosed with lung cancer from Queensland and New South Wales. Health-related stigma, social constraints and illness appraisals were assessed as predictors of adjustment outcomes. Results: Forty-nine percent of patients reported elevated anxiety; 41% were …

Infant Feeding Practices Of Emirati Women In The Rapidly Developing City Of Abu Dhabi, United Arab Emirates, Hazel Gardner, Katherine Green, Andrew Gardner

Research outputs 2014 to 2021

Rapid economic and cultural transition in the United Arab Emirates (UAE) has been accompanied by new challenges to public health; most notably a rapid rise in chronic disease. Breastfeeding is known to improve health outcomes in adulthood, is associated with reduced risk of developing chronic disease, and is therefore an important public health issue for this rapidly increasing population. Factors associated with infant feeding practices were examined in a cohort of 125 Emirati women and their infants, with data collected at birth and 3, 6 and 15 months postpartum by questionnaires and interviews. Participants were recruited in the Corniche Hospital, …

Improving Sexual Health In Men With Prostate Cancer: Randomised Controlled Trial Of Exercise And Psychosexual Therapies, Prue Cormie, Suzanne K. Chambers, Robert U. Newton, Robert A. Gardiner, Nigel Spry, Dennis R. Taaffe, David Joseph, M Akhlil Hamid, Peter Chong, David Hughes, Kyra Hamilton, Daniel A. Galvão

Research outputs 2014 to 2021

Background: Despite being a critical survivorship care issue, there is a clear gap in current knowledge of the optimal treatment of sexual dysfunction in men with prostate cancer. There is sound theoretical rationale and emerging evidence that exercise may be an innovative therapy to counteract sexual dysfunction in men with prostate cancer. Furthermore, despite the multidimensional aetiology of sexual dysfunction, there is a paucity of research investigating the efficacy of integrated treatment models. Therefore, the purpose of this study is to: 1) examine the efficacy of exercise as a therapy to aid in the management of sexual dysfunction in men …

Positive Correlation Between The Expression Of Heag1 And Hif-1Α In Breast Cancers: An Observational Study, Qingxuan Lai, Ting Wang, Qingqing Guo, Yuxiang Zhang, Youxin Wang, Li Yuan, Rui Ling, Yan He, Wei Wang

Research outputs 2014 to 2021

Objectives: To explore the expression patterns of Eag1 (ether á go-go 1) and HIF-1α (hypoxia-inducible factor 1α) in a cohort of patients with breast cancer. Setting: Department of general surgery in an upper first-class hospital in Xi'an, China. Participants: A total of 112 female Han Chinese patients with a diagnosis of invasive ductal carcinoma were included. Patients with main internal diseases, such as cardiovascular, endocrine, gastroenterological, haematological, infectious diseases, etc, were excluded. Primary and secondary outcome measures: Expression profiles of Eag1 and HIF-1α. Results: Eag1 and HIF-1α were overexpressed in the tumour tissues compared with the pair-matched control tissues, p=0.002 …

Low Back Pain Beliefs Are Associated To Age, Location Of Work, Education And Pain-Related Disability In Chinese Healthcare Professionals Working In China: A Cross Sectional Survey, B K. Tan, Anne J. Smith, Peter B. O'Sullivan, Gang Chen, Angus F. Burnett, Andrew M. Briggs

Research outputs 2014 to 2021

Background: Low back pain (LBP) is the leading cause of disability worldwide. Evidence pointing towards a more efficacious model of care using a biopsychosocial approach for LBP management highlights the need to understand the pain-related beliefs of patients and those who treat them. The beliefs held by healthcare professionals (HCPs) are known to influence the treatment advice given to patients and consequently management outcomes. Back pain beliefs are known to be influenced by factors such as culture, education, health literacy, place of work, personal experience of LBP and the sequelae of LBP such as disability. There is currently a knowledge …

Reaching Perinatal Women Online: The Healthy You, Healthy Baby Website And App, Lydia Hearn, Margaret Miller, Leanne Lester

Research outputs 2014 to 2021

Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, today's Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to …

Pulmonary Function In Patients With Huntington's Disease, Alvaro Reyes, Travis Cruickshank, Mel Ziman, Ken Nosaka

Research outputs 2014 to 2021

Background: Huntington's disease (HD) is a neurodegenerative disorder characterized by progressive motor, cognitive and psychiatric disturbances. Chest muscle rigidity, respiratory muscle weakness, difficulty in clearing airway secretions and swallowing abnormalities have been described in patients with neurodegenerative disorders including HD. However limited information is available regarding respiratory function in HD patients. The purpose of this study was to investigate pulmonary function of patients with HD in comparison to healthy volunteers, and its association with motor severity.Methods: Pulmonary function measures were taken from 18 (11 male, 7 female) manifest HD patients (53 ± 10 years), and 18 (10 male, 8 female) …

Positive Patient Experiences In An Australian Integrative Oncology Centre, Bonnie J. Furzer, Anna S. Petterson, Kemi E. Wright, Karen E. Wallman, Timothy R. Ackland, David J. Joske

Research outputs 2014 to 2021

Background: The purpose of this study was to explore the experiences of cancer patients' utilising complementary and integrative therapies (CIT) within integrative oncology centres across Western Australia.Methods: Across four locations 135 patients accessed CIT services whilst undergoing outpatient medical treatment for cancer. Of the 135 patients, 66 (61 ± 12 y; female n = 45; male n = 21) agreed to complete a personal accounts questionnaire consisting of open-ended questions designed to explore patients' perceptions of CIT. All results were transcribed into nVivo (v9) and using thematic analysis, key themes were identified.Results: Of the 66 participants, 100% indicated they would …

Protocol For The Rt Prepare Trial: A Multiple-Baseline Study Of Radiation Therapists Delivering Education And Support To Women With Breast Cancer Who Are Referred For Radiotherapy, Georgia Halkett, Moira O'Connor, Sanchia Aranda, Michael Jefford, Nigel Spry, Therese Shaw, Rachael Moorin, Penelope Schofield

Research outputs 2014 to 2021

Introduction: There is limited evidence to guide the preparation of patients for radiotherapy. This paper describes the protocol for an evaluation of a radiation therapist led education intervention delivered to patients with breast cancer in order to reduce psychological distress. Methods: A multiple-baseline study is being used. Usual care data is being collected prior to the start of the intervention at each of three sites. The intervention is delivered by radiation therapists consulting with patients prior to their treatment planning and on the first day of treatment. The intervention focuses on providing sensory and procedural information to patients and reducing …

Monitoring Changes In Circulating Tumour Cells As A Prognostic Indicator Of Overall Survival And Treatment Response In Patients With Metastatic Melanoma, Dragana Klinac, Elin S. Gray, James B. Freeman, Anna Reid, Samantha Bowyer, Michael Millward, Mel Ziman

Research outputs 2014 to 2021

Background: New effective treatments for metastatic melanoma greatly improve survival in a proportion of patients. However biomarkers to identify patients that are more likely to benefit from a particular treatment are needed. We previously reported on a multimarker approach for the detection of heterogenous melanoma circulating tumour cells (CTCs). Here we evaluated the prognostic value of this multimarker quantification of CTCs and investigated whether changes in CTC levels during therapy can be used as a biomarker of treatment response and survival outcomes.Methods: CTCs were captured by targeting the melanoma associated markers MCSP and MCAM as well as the melanoma stem …

Serum Concentrations Of The Biomarkers Ca125, Ca15-3, Ca72-4, Tpsa And Papp-A In Natural And Stimulated Ovarian Cycles, Melissa J. Stemp, Peter Roberts, Allison Mcclements, Vincent Chapple, Jay Natalwala, Michael L. Black, Phillip L. Matson

Research outputs 2014 to 2021

Objective: Biomarkers associated with cancer screening (CA125, CA15-3, CA72-4, total prostate specific antigen [tPSA]) and the monitoring of pregnancy (pregnancy associated plasma protein-A [PAPP-A]) were measured during natural and stimulated ovarian cycles in disease-free non-pregnant women to determine if they could reflect normal events relating to ovulation and/or endometrial changes. Methods: A total of 73 blood samples (10 women) collected throughout the natural menstrual cycle, and 64 blood samples (11 women) taken during stimulated ovarian cycles, were analysed on the Roche Cobas e411 automated analyser. Results: Detectable levels of tPSA were measured in at least one point in the cycle …

Review Of Kidney Disease Among Indigenous People, Sasha A. Stumpers, Neil J. Thomson

Research outputs 2013

Kidney disease is a significant health problem for all Australians, but severe kidney disease is more common among Indigenous people than among non- Indigenous people. In particular, the prevalence of chronic kidney disease (CKD) and the overall levels of end-stage kidney disease (ESKD) among Aboriginal and Torres Strait Islander peoples are consistently reported as significantly higher than among other Australians. Information on CKD among Indigenous Australians is available from self-reported survey data, as well as from community-based studies and screening programs [10-20] but the main focus in the literature has been on ESKD. The incidence of ESKD is especially high …

Assisted Vaginal Deliveries In Mothers Admitted As Public Or Private Patients In Western Australia, Kristjana Einarsdottir, Fatima Haggar, Sarah Stock, Anthony Gunnell, Fiona Stanley

Research outputs 2013

Background: Mothers delivering as private patients in Australia have a high rate of assisted deliveries, which could lead to adverse infant outcomes in this group of patients. We investigated whether the risk of adverse infant outcomes after assisted deliveries was different for mothers admitted as public or private patients for delivery, when compared with unassisted deliveries.

Methods and findings: We included 158,241 vaginal, singleton, term birth admissions in our study where the infant was live born and without birth defects. The study population was identified from statutory birth and hospital data collections held by the Western Australian (WA) Department of …

Characteristics And Quality Of Life Of Patients Presenting To Cancer Support Centres: Patient Rated Outcomes And Use Of Complementary Therapies, Bonnie J. Furzer, Kemi E. Wright, Anna S. Petterson, Karen E. Wallman, Timothy R. Ackland, David Jl Joske

Research outputs 2013

Background: In order to effectively target and provide individualised patient support strategies it is crucial to have a comprehensive picture of those presenting for services. The purpose of this study was to determine the characteristics and patient rated outcomes of individuals presenting to SolarisCare cancer support centres and their choices regarding complementary and integrated therapies (CIT).Methods: A cohort with a current or previous cancer diagnosis aged 18 - 87 years presenting to a SolarisCare centre during a 5-day period completed a questionnaire. Four SolarisCare centres participated in the trial including regional and metropolitan locations. Outcomes included medical and demographic characteristics, …

Having A Greater Proportion Of Registered Nurses In A Respiratory Care Centre Is Associated With Fewer Urinary Infections And Increased Successful Ventilator Weaning, Diane E. Twigg

Research outputs 2013

This study explored the impact of skill mix model changes on patient outcomes in a critical care environment, specifically, a respiratory care centre based in a southern Taiwan medical centre. It identified that the cost of ventilator-dependent patients in Taiwan in 1999 was 3.5 billion New Taiwan dollars, equivalent to US$ 121 million. In this context, controlling the costs of healthcare while maintaining quality care became critical. This research examined two skill mix staffing models, a mixed registered nurse (RN) and nursing aid model and a 100% RN model, and their impact on patient outcomes. Patient outcomes were pressure ulcers, …

Prediction Models For Solitary Pulmonary Nodules Based On Curvelet Textural Features And Clinical Parameters, Jing-Jing Wang, Hai-Feng Wu, Tao Sun, Xia Li, Wei Wang, Li-Xin Tao, Da Huo, Ping-Xin Lv, Wen He, Xiu-Hua Guo

Research outputs 2013

Lung cancer, one of the leading causes of cancer-related deaths, usually appears as solitary pulmonary nodules (SPNs) which are hard to diagnose using the naked eye. In this paper, curvelet-based textural features and clinical parameters are used with three prediction models [a multilevel model, a least absolute shrinkage and selection operator (LASSO) regression method, and a support vector machine (SVM)] to improve the diagnosis of benign and malignant SPNs. Dimensionality reduction of the original curvelet-based textural features was achieved using principal component analysis. In addition, non-conditional logistical regression was used to find clinical predictors among demographic parameters and morphological features. …

Health-Related Quality Of Life And Life Satisfaction In Colorectal Cancer Survivors: Trajectories Of Adjustment, Jeff Dunn, Shu Kay Ng, William Breitbart, Joanne Aitken, Pip Youl, Peter D. Baade, Suzanne K. Chambers

Research outputs 2013

Background: This longitudinal study describes the five year trajectories of health-related quality of life (HR-QOL) and life satisfaction in long term colorectal cancer survivors.Patients and methods: A population-based sample of 1966 colorectal cancer survivors were surveyed at six time points from five months to five years post-diagnosis. Predictor variables were: socio-demographic variables, optimism; cancer threat appraisal; perceived social support. Quality of life was assessed with the Functional Assessment of Cancer Therapy-Colorectal (HR-QOL); and the Satisfaction with Life Scale. Growth mixture models were applied to identify trajectory classes and their predictors.Results: Distinct adjustment trajectories were identified for HR-QOL and life satisfaction. …

Systematic Review Of Research Into The Psychological Aspects Of Prostate Cancer In Asia: What Do We Know?, Suzanne Kathleen Chambers, Melissa Karen Hyde, David Fu-Keung Ip, Jeffrey Charles Dunn, Robert Alexander Gardiner

Research outputs 2013

Background: To review the peer reviewed literature on the psychological aspects of the prostate cancer experience of men in Asia. Materials and Methods: Medline and PsycINFO, CINAHL, ProQuest, and Web of Science (1999 – November Week 4, 2012) were searched. Inclusion criteria were: included men with prostate cancer and/or their partners or caregivers who identify as Asian recruited in an Asian country; and assessed health-related quality of life, psychological and social adjustment relating to prostate cancer and published in English after 1st January 1999 and prior to 30th November, 2012. Study aims; design; quality; level of evidence, and key results …

Exercise Medicine For Prostate Cancer, Robert U. Newton, Daniel A. Galvao

Research outputs 2013

Since initial reports in the mid-1980s, there has been increasing interest in the application of exercise as medicine for the prevention and management of cancer. A large number of high-quality, randomised, controlled trials with cancer survivors have confirmed both aerobic and resistance exercise to be highly beneficial for improving body composition, quality of life, mental health functional capacity and reducing risk of cancer recurrence and development of other chronic diseases. Such benefits have ultimately been realised in reduced cancer mortality between 30 and 60 % in large cohort retrospective studies. Treatments for prostate cancer are increasingly effective with quite high …

Factors Associated With Myopia In School Children In China: The Beijing Childhood Eye Study, Qi Sheng You, Li Juan Wu, Jia Li Duan, Yan Xia Luo, Li Juan Liu, Xia Li, Qi Gao, Wei Wang, Liang Xu, Jost Jonas, Xiu Hua Guo

Research outputs 2012

Purpose: To assess factors associated with myopia in school children in rural and urban parts of Greater Beijing. Methods: The Beijing Pedriatic Eye Study was a population-based cross-sectional study, in which one school of each level (primary, junior high, senior high) was randomly selected from nine randomly selected districts out of 18 districts of Greater Beijing. The children underwent non-cylcoplegic refractometry and their parents an interview. Results: Of 16,771 eligible students, 15,066 (89.8%) children (7,769 (51.6%) girls) participated, with 8,860 (58.8%) participants living in the rural region. Mean age was 13.263.4 years (range:7–18 years). In multivariate analysis, prevalence of myopia …

Multigene Interactions And The Prediction Of Depression In The Wisconsin Longitudinal Study, N S Roetker, J A Yonker, C. Lee, V Chang, J J Basson, C L Roan, T S Hauser, R M Hauser, Craig Atwood

Research outputs 2012

Objectives: Single genetic loci offer little predictive power for the identification of depression. This study examined whether an analysis of gene-gene (G x G) interactions of 78 single nucleotide polymorphisms (SNPs) in genes associated with depression and agerelated diseases would identify significant interactions with increased predictive power for depression. Design: A retrospective cohort study. Setting: A survey of participants in the Wisconsin Longitudinal Study. Participants: A total of 4811 persons (2464 women and 2347 men) who provided saliva for genotyping; the group comes from a randomly selected sample of Wisconsin high school graduates from the class of 1957 as well …