Medicine and Health Sciences Commons^™

Legal 'Highs' Available Through The Internet-Implications And Solutions?, Alison L. Jones

Alison L Jones

Prescription drugs are purchased via the Internet, but the consistent finding across many different populations is that the Internet appears to be a relatively minor source for illicit purchases of prescription medications by individual end users, the obvious exception being phosphodiesterase inhibitors for erectile dysfunction. In contrast, the world of escalating availability of illicit drugs via the Internet is paralleled by escalating availability of ‘legal highs’ via the Internet. These sites represent an important public health challenge, not least because of the ease of purchase but also because of the ‘relative anonymity’ for the purchaser.

The Management Of Tricyclic Antidepressant Poisoning: The Role Of Gut Decontamination, Extracorporeal Procedures And Fab Antibody Fragments, Paul I. Dargan, Mark G. Colbridge, Alison Jones

Alison L Jones

Although there have been descriptive, uncontrolled clinical reports of removal of tablet debris by gastric lavage, there have been no clinical studies that have demonstrated that this has any impact on outcome in patients with tricyclic antidepressant (TCA) poisoning. There is also the possibility that lavage may increase drug absorption by pushing tablets into the small intestine. Furthermore, gastric lavage in patients with TCA poisoning may induce hypoxia and a tachycardia potentially increasing the risk of severe complications such as arrhythmias and convulsions. In view of the paucity of evidence that gastric lavage removes a significant amount of drug and …

Managing Self Poisoning: "Gastric Lavage Is Perhaps More Important In Developing Countries", Alison L. Jones, Glyn Volans

Alison L Jones

In their clinical review of recent advances in the management of self poison­ing, Jones and Volans briefly discuss gastric lavage and state: “many clinical toxicologists rarely use this method now.”1 The impres­sion given could support the abandonment of gastric lavage. This could be particularly deleterious in developing countries.

Effects Of Benzodiazepines, Antidepressants And Opioids On Driving: A Systematic Review And Meta-Analysis Of Epidemiological And Experimental Evidence, Tharaka L. Dassanayake, Patricia Michie, Gregory Carter, Alison L. Jones

Alison L Jones

Background: Many individuals in the community are prescribed psychoactive drugs with sedative effects. These drugs may affect their daily functions, of which automobile driving is a major component. Objective: To examine the association of three classes of commonly used psychoactive drugs (viz. benzodiazepines and newer non-benzodiazepine hypnotics, antidepressants and opioids) with (i) the risk of traffic accidents (as indexed by epidemiological indicators of risk); and (ii) driving performance (as indexed by experimental measures of driving performance). Methods: A literature search for material published in the English language between January 1966 and January 2010 in PubMed and EMBASE databases was combined …

Building Research Capacity: An Exploratory Model Of Gps’ Training Needs And Barriers To Research Involvement, Alison Jones, Teresa A. Burgess, Elizabeth Farmer, Jeffrey Fuller, Nigel P. Stocks, Judy E. Taylor, Raechel L. Waters

Alison L Jones

Aims: To determine general practitioners’ research training needs, and the barriers to involvement in research. Method: Semi-structured interviews with 11 GPs in rural and metropolitan South Australia, analysed using a grounded theory approach. Results: General practitioners’ perceptions about their research needs were limited by their own experience and focussed at an individual level. Overlapping needs and barriers emerged, categorised as: ‘individual issues’ (a lack of research training or experience, concepts and attitudes to research, and research interest) and ‘systems issues’ (funding arrangements for general practice, access to resources, opportunity for publication and the role of The Royal Australian College of …

Responses To Pandemic (H1n1) 2009, Australia, Keith Eastwood, David N. Durrheim, Michelle Butler, Alison L. Jones

Alison L Jones

In 2007, adults in Australia were interviewed about their willingness to comply with potential health interventions during a hypothetical influenza outbreak. After the first wave of pandemic (H1 N1) 2009 in Australia, many of the same respondents were interviewed about behavior and protection measures they actually adopted. Of the original 1,155 respondents, follow-up interviews were conducted for 830 (71.9%), Overall, 20.4% of respondents in 2009 had recently experienced influenza-like illness, 77.7% perceived pandemic (H1 N1) 2009 to be mild, and 77.8% reported low anxiety. Only 14.5% could correctly answer 4 questions about influenza virus transmission, symptoms, and infection control. Some …

Toxicology, Alison L. Jones

Alison L Jones

Introduction Poisoning is one of the commonest medical emergencies in the UK and accounts for 10%-20% of acute medical admissions. The most common causes of poisoning in the UK are outlined in Table 13.1. Assessing poisoned patients and managing them is an exciting challenge because they often have complex psychosocial issues, together with general medical problems, and have taken toxins in sizeable doses. They require the best of clinical skills to provide the best outcome. Sadly, poisoned patients do not always meet with the sympathies of admitting doctors because th? ~ay be perceived to have "self-inflicted illness." This is a …

Sources And Coverage Of Medical News On Front Pages Of Us Newspapers, William Y.Y Lai, Trevor Lane, Alison L. Jones

Alison L Jones

Background Medical news that appears on newspaper front pages is intended to reach a wide audience, but how this type of medical news is prepared and distributed has not been systematically researched. We thus quantified the level of visibility achieved by front-page medical stories in the United States and analyzed their news sources. Methodology Using the online resource Newseum, we investigated front-page newspaper coverage of four prominent medical stories, and a high-profile non-medical news story as a control, reported in the US in 2007. Two characteristics were quantified by two raters: which newspaper titles carried each target front-page story (interrater …

Paracetamol (Acetaminophen) Poisoning: No Need To Change Current Guidelines To Accident Departments, P Routledge, J Allister Vale, D Nicholas Bateman, G. Denis Johnston, Alison L. Jones, Alan Judd, Simon Thomas, Glyn Volans, L F. Prescott, A T. Proudfoot

Alison L Jones

Paracetamol is an effective, simple analgesic that is well tolerated by adults and children at thera­peutic doses. In many countries it is available without prescription. Unfortunately, its ready availabil­ity is associated with episodes of poisoning that prompt 3.3% of inquiries to US regional poisons centres, 10% of inquiries to the UK National Poisons Information Service, and up to 43% of all admissions to hospital with self poisoning in the United Kingdom.3 In the United States paracetamol alone accounted for 4.1% of deaths from poisoning reported to American poisons centres in 1997. Most deaths are associated with deliberate self poisoning, but …

Consumers' Salient Beliefs Regarding Dairy Products In The Functional Food Era: A Qualitative Study Using Concepts From The Theory Of Planned Behaviour, Deborah Nolan, Elizabeth Neale, Yasmine Probst, Karen E. Charlton, Linda C. Tapsell

L. C. Tapsell

Background Inadequate consumption of dairy products without appropriate dietary substitution may have deleterious health consequences. Social research reveals the factors that may impede compliance with dietary recommendations. This is particularly important given the recent introduction of functional dairy products. One of the challenges for public health professionals is to demonstrate the efficacy of nutrition education in improving attitudes toward nutrient rich foods. The aim of this study was to explore the salient beliefs of adult weight loss trial participants regarding both traditional and functional dairy products and to compare these with a control group not exposed to nutrition education Methods …

Erythrocyte Biomarker-Based Validation Of A Diet History Method Used In A Dietary Intervention Trial, Craig S. Patch, Karen J Murphy, Jackie Mansour, Linda C. Tapsell, Barbara J. Meyer, Trevor A Mori, Manny Noakes, P Clifton, I Puddey, P Howe

L. C. Tapsell

No abstract provided.

Fat In Food And The Obesity Epidemic, Linda C. Tapsell

L. C. Tapsell

Dietary fat is strongly implicated in the development of insulin resistance and obesity, both major public health problems today. While the amount of dietary fat is relevant, the type of fat is important in fuel utilisation, storage and appetite regulatory mechanisms. Human calorimetry research confirms the importance of dietary fat in energy balance, but more work needs to be done to uncover the impact of type of dietary fat in weight control. Population and intervention research confirm the importance of fat in dietary interventions, bearing in mind the contribution of physical activity to energy balance. The food industry has an …

Relative Bias In Diet History Measurements: A Quality Control Technique For Dietary Intervention Trials, Gina S. Martin, Linda C. Tapsell, Marijka Batterham, Kenneth G. Russell

L. C. Tapsell

Objective: Investigation of relative bias in diet history measurement during dietary intervention trials. Design: Retrospective analysis of human dietary data from two randomised controlled trials examining modified fat diets in the prevention and treatment of type II diabetes mellitus. Setting: Wollongong, Australia. Subjects: Thirty-five overweight, otherwise healthy subjects in trial 1 and 56 subjects with diabetes in trial 2. Interventions: Diet history interviews and three-day weighed food records administered at one-month intervals in trial 1 and three-month intervals in trial 2. Results: In a cross-sectional bias analysis, graphs of the association between bias and mean dietary intake showed that bias …

Functional Foods And Ingredients: Opportunities For Health And Profit, Linda C. Tapsell

L. C. Tapsell

The National Centre of Excellence in Functional Foods (NCEFF) is developing well with strategic research projects underway. This report outlines progress to date.

Does Hero Always Help? Differences In Nutrient Intake Among Obese Subjects With And Without Type 2 Diabetes Mellitus Prior To Dietary Intervention, Sze Yen Tan, Lynda J. Gillen, Marijka Batterham, Xu-Feng Huang, Cassandra J. Quick, Yasmine Probst, Serina Faraji, Linda C. Tapsell

L. C. Tapsell

Abstract presented at The 2006 Annual Scientific Meeting of the Nutrition Society of Australia, 29 November - 2 December, Sydney, Australia

Increased Intake Of Dietary Polyunsaturated Fat Does Not Promote Whole Body Or Preferential Abdominal Fat Mass Loss In Overweight Adults, Sze-Yen Tan, Marijka Batterham, Linda Tapsell

L. C. Tapsell

Objective: There is evidence that increasing the proportion of polyunsaturated fatty acids (PUFA) in a diet can enhance the rate of fat oxidation acutely. Higher PUFA in a diet has also been associated with greater abdominal fat loss in longer term studies. This study aimed to investigate if higher PUFA intake would result in greater fat mass loss over a 12-week period, mainly from the abdominal region.

Methods: Data at the 12-week time point from two weight loss studies, both comparing high PUFA versus low PUFA diets was, accessed for 141 overweight subjects from the same area. Specifically, data on …

Book Review: The Nation's Diet: The Social Science Of Food Choice, Linda C. Tapsell

L. C. Tapsell

No abstract provided.

The Challenges Of Nutrition And Aging, Linda C. Tapsell

L. C. Tapsell

From the time of birth and throughout the lifecycle, the human organism depends on food and nutrients to sustain its growth, development and functionality. With increasing knowledge of biological processes within the human body, the term ‘you are what you eat’, takes on more and more meaning. One of the new levels of understanding relates to the interaction of food components with genes to set off cascades of events that affect health and disease (1). This new understanding provides a detailed view of the dynamic relationship between genes and the environment, represented through food. Our health, our lifespan, can be …

Functional Foods: Definition And Commercialisation, Linda C. Tapsell

L. C. Tapsell

This paper outlines the framework for a working definition of functional foods utilised by the National Centre of Excellence in Functional Foods, considers trends in the areas of influence, and raises issues for the successful commercialisation of functional foods by the Australian food industry.

Rehabilitation Inpatients Are Not Meeting Their Energy And Protein Needs, K. Walton, P. G. Williams, Linda C. Tapsell, M. Batterham

L. C. Tapsell

Background & aims: This study aimed to determine the amounts of energy and protein required, ordered and consumed daily by long stay rehabilitation inpatients. Methods: A quantitative, weighed plate waste study. Thirty inpatients (16 females, 14 males; mean age 79.2 years; mean length of stay 52 days) from three rehabilitation hospitals in the Illawarra region of Australia. Data were collected over two days, including nutrition assessment details and weighed plate waste. Daily energy and protein requirements, amounts ordered and consumed were the outcome measures. Statistical analyses included paired t-tests, Wilcoxon Signed Rank tests and Spearman correlations. Results: Although adequate amounts …

Plant Sterol/Stanol Prescription Is An Effective Treatment Strategy For Managing Hypercholesterolemia In Outpatient Clinical Practice, C. Patch, Linda C. Tapsell, P. G. Williams

L. C. Tapsell

Objective To determine the effectiveness of prescribing 2 g plant sterols/stanols per day as an addition to standard practice in a dietary outpatient clinic. Design A randomized parallel design of comparative 12-week interventions. Subjects/Setting Patients referred by a general practitioner to a dietary outpatient clinic for the management of hyperlipidemia were eligible. Twenty-five patients (15 women and 10 men) completed the study. Intervention Counselling regarding diet for hyperlipidemia was based on the National Cholesterol Education Program (NCEP) guidelines. The intervention group was instructed to incorporate ~25 g/day of margarine containing plant sterols/stanols, which delivered ~2 g of plant sterols/stanols. Main …

High Protein Meals May Benefit Fat Oxidation And Energy Expenditure In Individuals With Higher Body Fat, M. Batterham, R. Cavanagh, Arthur Jenkins, Linda C. Tapsell, G. Plasqui, P. Clifton

L. C. Tapsell

Aim: Fat oxidation is impaired in obesity. The aim of this study was to determine if fat oxidation, seen in a high protein meal response, was influenced by body composition. Methods: Subjects were provided with control (14% protein, glycemic index, GI 65), high protein high GI (33% protein, GI 74), and high protein low GI (35% protein, GI 45) meals. Substrate oxidation and energy expenditure were measured in room calorimeters over 8 hours in 18 subjects. Results were compared using a repeated measures ANOVA with a customised post-hoc analysis (to compare the protein diets averaged versus control and to compare …

Activity Counts From Accelerometers Do Not Add Value To Energy Expenditure Predictions In Sedentary Overweight Individuals During Weight Loss Interventions, Sze Yen Tan, Marijka Batterham, Linda C. Tapsell

L. C. Tapsell

Background: Knowing the total energy expenditure (TEE) of overweight adults is important for prescribing weight loss interventions. However, objective measurements of TEE may not always be readily available and can be expensive. This study aimed to investigate the validity of RT3 accelerometers in predicting the TEE of sedentary overweight adults, and to identify any sensitivity to anthropometric changes. Methods: The analysis used data from a 12-week weight loss study. At baseline and 12-week, TEE was predicted using RT3 accelerometers during whole room calorimeter stays. Bias between 2 methods was compared at and between the baseline and 12-week measurement points. Multiple …

A Volunteer Feeding Assistance Program Can Improve Dietary Intakes Of Elderly Patients – A Pilot Study, K. Walton, P. Williams, J. Bracks, Q. Zheng, L. Pond, R. Smoothy, Linda C. Tapsell, M. Batterham, L. Vari

L. C. Tapsell

Malnutrition is prevalent in elderly hospitalised patients and has been associated with longer lengths of stay (LOS), higher rates of complications and increased hospital costs. Feeding assistance has traditionally been the role of nurses, however with an ageing population and an ever-increasing workload there may not be sufficient time to ensure the nutritional care of all patients. A program in which trained volunteers assist, socialise and feed nutritionally vulnerable patients at lunch on weekdays has been initiated in a major suburban hospital in Sydney. The pilot study reported here aimed to evaluate the lunchtime assistance program in terms of dietary …

What Do Stakeholders Consider The Key Issues Affecting The Quality Of Foodservice Provision For Long-Stay Patients, K. Walton, P. G. Williams, Linda C. Tapsell

L. C. Tapsell

This study aimed to elicit concerns of key stakeholders regarding food service provision to long stay hospital patients. Seventeen focus groups and four individual interviews were conducted involving six stakeholder groups: dietitians, nutrition assistants, patients, nurses, food service assistants and food service managers. Ninety-eight participants (20 male; 78 female) were recruited from public and private hospitals in New South Wales, Australia. Each of the focus groups and individual interviews was conducted in the hospital setting where free and open discussions could be digitally recorded. Transcripts were prepared from the digital recordings and QSR Nvivo 2.0™ qualitative analysis software was used …

A Self-Administered Dietary Assessment Website For Use In Primary Health Care: Usability Testing And Evaluation, Y. C. Probst, Linda C. Tapsell

L. C. Tapsell

A dietary assessment website for use in the primary healthcare setting has been developed. The website allows patients, referred from their GP, to self-report their dietary intake. Data from the website feeds to a dietitian who develops individualised dietary advice for the patient. The aim of this paper is to describe the usability testing of the dietary assessment website with its potential users. Testing was broken into two phases. Forty-two free-living adults with metabolic syndrome volunteered, 17 completed phase one and 10 completed phase two, with a 64% rate of completion. Phase one participants spoke aloud as they progressed through …

Development Of A Computer-Assisted Dietary Assessment Tool For Use In Primary Healthcare Practice: Perceptions Of Nutrition And Computers In A Sample Of Older Adults With Type 2 Diabetes Mellitus, Y. C. Probst, C. Krnavek, L. Lockyer, Linda C. Tapsell

L. C. Tapsell

As part of a larger study developing dietary software, this study aims to evaluate a sample of potential users for their experience and comfort with computers and assess the preferred program design and navigation features for the development of the automated diet history interview. A telephone-based questionnaire and focus groups were employed to evaluate the perceptions, beliefs and attitudes of 37 older adults with type 2 diabetes mellitus. Participants were also shown a range of existing dietary assessment programs and asked to state their perceptions of each. Data was coded and thematically analysed based on computer use, software features, dietary …

Overview Of Computerized Dietary Assessment Programs For Research And Practice In Nutrition Education, Y. Probst, Linda C. Tapsell

L. C. Tapsell

Computerized dietary assessment programs are often used for nutrition education research and practice. This article provides an informal overview of 29 dietary assessment programs mentioned in the literature covered by MEDLINE from 1996 to 2003, along with the components and capabilities of these programs derived from additional sources as needed. According to the literature, the advantages of using computers for dietary assessment include standardization of the questioning sequence, fast and easy processing, immediate results, and increased flexibility.The disadvantages include the need for typing skills and computer literacy, as well as potential bias in the responses if an interviewer is required.

The Effect Of A Calorie Controlled Diet Containing Walnuts On Substrate Oxidation During 8-Hours In A Room Calorimeter, Linda C. Tapsell, Marijka Batterham, Sze Yen Tan, Eva M. Warensjo

L. C. Tapsell

Objective Dietary macronutrient proportions affect substrate utilization, but in practice people consume foods. We hypothesized that in overweight adults, a calorie controlled diet based on core foods and including walnuts may be advantageous in promoting greater use of fat stores. Methods This crossover study tested the effects of diet-related energy expenditure and fat oxidation in 16 overweight individuals over an 8-hour period. The 2 diets included breakfast and lunch meals during the measurement period and an evening meal the night before. They comprised core foods of bread/cereals, fruit, vegetables, milk/yogurt, and meat, and either walnuts (walnut diet) or olive oil …

What To Ask In A Self-Administered Dietary Assessment Website: The Role Of Professional Judgement, Y. C. Probst, Linda C. Tapsell

L. C. Tapsell

Background: Professional judgement is a key component of questionnaire development, subjective in nature and rarely reported in this context. It is required in dietary questionnaires to delimit the size whilst retaining quality of the data. Objectives: To describe the nature and extent of professional judgement involved in developing a food database to include in a web-based self-administered dietary assessment. Methods & materials: Professional judgement was applied in tandem with a stepwise statistical analysis of hierarchically reported foods in the Australian National Nutrition Survey (NNS95). Statistical analyses determined foods commonly consumed and eaten together and three different forms of cluster analysis …