Adults In South Australia Research Articles

Knowledge and Awareness of HPV, the HPV Vaccine and Cancer-Related HPV Types among Indigenous Australians.

Human Papilloma Virus (HPV) infection is a common, preventable, sexually transmitted disease with oncogenic potential and increasing incidence. This study aimed to gain an understanding of the knowledge and awareness of HPV, the HPV vaccine, and HPV-related cancers, and to evaluate the relationship between participant factors and HPV knowledge, vaccination uptake, and high-risk HPV (16/18) infection, among Indigenous Australians. Data from the 12-month follow-up of a longitudinal cohort study were utilized, involving 763 Indigenous Australian adults in South Australia. The data analysis found that the mean 7-item HPV knowledge tool (HPV-KT) score was 2.3 (95% CI: 2.1-2.4), HPV vaccination prevalence was 27.0% (95% CI: 23.6-30.5) and oral HPV 16/18 infection was 4.7% (95% CI: 3.2-6.2). Multivariable log-Poisson regression models showed ratios of approximately 1.5 times higher HPV-KT scores in females, previous recreational drug users, those who had self-rated as having excellent, very good or good general health and who had heard of HPV; and participants who were not HPV vaccinated had 0.8 times (MR = 0.8, 95% CI: 0.7-0.9) lower HPV-KT scores than their counterparts. The findings suggest that culturally safe education strategies are a necessary investment to improve vaccination coverage among Indigenous Australians and to reduce the impact of HPV and related cancers.

Longitudinal study of meningococcal carriage in adolescents and young adults in South Australia 2017-2020

This analysis investigated longitudinal changes in meningococcal carriage in adolescents in South Australia over 4 years. Data from the "B Part of It" study, which included a state-wide cluster randomized controlled trial in secondary-school students (n=34,489 in 2017 and 2018) and serial cross-sectional studies in school leavers aged 17-25 years (n=4028 in 2019-2020). Individuals had oropharyngeal swabs collected annually. This study included two unique cohorts: (1) individuals enrolled in 2019, with three consecutive annual swabs taken in 2017, 2018 and 2019; and (2) individuals enrolled in 2020, with swabs taken in 2017, 2018, and 2020. Disease-associated N. meningitidis genogroups were identified using PCR and whole genome sequencing. Univariate analysis identified risk factors for recurrent carriage (≥2). Among school leavers, 50 (1.7%, total n=2980) had carriage detected at successive visits. In participants with meningococcal carriage at successive visits, 38/50 (76.0%) had the same genogroup detected by porA PCR. Of those, 19 had the same MLST type and demonstrated minimal variation, indicating they most likely had sustained carriage of the same isolate (range 226 to 490 days, mean duration 352 [SD 51] days). In the 2019 school leaver cohort, 6.7% acquired carriage in their first year out of school compared to 3.3% in their final school year. Compared to single carriage detection, recurrent carriage was potentially more likely in older adolescents (16 compared to ≤15 years; OR=1.97 (95%CI 1.0, 3.86); p=0.048). Whilst carriage is typically transient, some adolescents/young adults may have persistent carriage and are likely to be an important group in the transmission of meningococci.

Does the contribution of modifiable risk factors on oral health inequities differ by experience of negative life events among Indigenous Australian adults?

Although the prevalence of poor self-rated oral health and experience of negative life events among Indigenous adults is high, the contribution of modifiable risk factors is unknown. We aimed to estimate the contribution of modifiable risk factors in poor self-rated oral health among Indigenous Australian adults with high and low experience of negative life events using decomposition analysis. The study utilised a cross-sectional design, with data from a large convenience study of Indigenous adults in South Australia. Participants were stratified based on a median split of negative life events in the last 12 months. The outcome was the proportion of fair/poor self-rated oral health (SROH). Independent variables included experience of racism, sex, age, geographic location, car ownership, and time since last dental visit. Of the 1011 participants, the proportion with fair poor self-rated oral health was 33.5% (95% CI 30.5 to 36.4) and the proportion who had experienced 3+ negative life events in the past 12 months was 47.3% (95% CI 43.7 to 50.9). More than half the contribution in fair/poor self-rated oral health among Indigenous adults with a higher magnitude of negative life events was from experience of racism (55.3%, p<0.001), followed by residential location (19.9%), sex (9.7%) and car ownership (9.8%). The contributions of modifiable risk factors in poor self-rated oral health among Indigenous adults with different exposures to negative life events differed substantially. Targets to reduce racism will decrease oral health inequities for both groups, however Indigenous adults who have experienced substantial negative life events require additional focus on provision of culturally safe dental care.

Prevalence of drug allergy in South Australia.

Drug allergy is commonly reported in patient notes and electronic health records. The prevalence of self-reported drug allergy in the general Australian population has not previously been studied. To investigate the prevalence of self-reported drug allergy in the general adult population in South Australia. We surveyed a representative sample of the South Australian adult population regarding their own perception of drug allergy, including drug type and severity, as well as the use of medical alert devices. Data were weighted to correspond to age and sex of the South Australian population. Twenty-two percent of adults in South Australia consider themselves allergic to one or more drugs: 9.3% declared themselves to be allergic to penicillin, 5% to an antibiotic other than penicillin and 13% to one or more antibiotics. Drug allergy and penicillin allergy was significantly more prevalent in females and increased with age. Thirteen percent of those with an antibiotic allergy reported a severe reaction, of whom 27% wore a medical notification device. Of those allergic to penicillin, 75% had their index reaction more than 10 years ago and did not report severe features. Self-reported drug allergy is common in the general population, as it is in medical clinic and hospital populations. The majority of those reporting penicillin allergy would be considered low-risk and suitable for de-labelling procedures.

The COVID-19 risk perceptions, health precautions, and emergency preparedness in older CALD adults in South Australia: A cross-sectional study.

BackgroundIn Australia, the relationships of cultural contexts with health challenges in older culturally and linguistically diverse (CALD) adults during the COVID-19 remain under-investigated. This study explored the older CALD adults’ risk perceptions of COVID-19, and identified demographics and risk perceptions associated with their health precautions and emergency preparation in South Australia.MethodsA cross-sectional online survey was conducted. 155 older adults aged 60 years and over from 28 CALD communities completed the surveys. We described demographics, risk perceptions, seven items of health precautions, and five items of emergency preparedness. Data were analyzed in Stata/MP version 13.0.ResultsMean sum-score of fear was 7.3 [SD 1.9], signifying that the participants were afraid of being infected with COVID-19. Health precaution items presented a mean sum-score of 24.8, with a compliance in washing and disinfecting hands [M: 4.4], avoiding public places and events [M: 3.9] and transports [M: 3.8], but they did not present high-alignment with staying at home and avoiding meeting at risk population groups. Overall health precautions were positively influenced by ethnicity [Asian β 3.40; 95% CI 1.21, 5.59; African β 5.46; 95% CI 0.76, 10.16]; perceptions of long-term effects [β 1.82; 95% CI 0.65, 2.99]; and fear [β 0.55; 95% CI 0.08, 1.01]. Mean sum-score of emergency preparedness was 14.9, which indicated the participants’ responses, on average, did not prevent them from buying large quantities and storing essential goods.ConclusionA pandemic-related response plan is needed to ensure all older CALD adults receive and follow advice and care appropriately.

Lower workforce participation is associated with more severe persisting breathlessness

BackgroundNot being able to work has negative health, social and financial consequences. Persisting breathlessness is prevalent in working-aged people. Is it associated with lower workforce participation? This study, using the South Australian Health Omnibus, aimed to explore associations between paid workforce participation and persisting breathlessness intensity, and economic impacts on income in people of working age.MethodsThis cross-sectional study conducted face-to-face interviews with a random sample of adults in South Australia (n = 8916). Questions included key demographic data, workforce participation and the presence and intensity of persisting breathlessness. Data from working-aged respondents (20–65 years of age) were standardised to the census for regression analyses. Work was coded to paid full- or part-time work or ‘other’. Persisting breathlessness (more than three of the last six months) used the modified Medical Research Council breathlessness scale (aggregated to 0, 1, 2–4). Opportunity cost valuations compared annual income foregone by persisting breathlessness severity.ResultsOf people interviewed, 6,608 were working-aged (49.9% male; 67.5% had post-secondary qualifications; 70.9% were in paid full- or part-time work; and 1.7% had mMRC score 2–4). Workforce participation dropped in working aged people with increasing breathlessness: mMRC 0, 70.6%; mMRC 1, 51.7%; mMRC 2–4, 20.3%. In the regression model, people with the most severe breathlessness were much less likely to work (OR 0.14; 95% CI 0.09, 0.22). Annual income foregone by people with persisting breathlessness was AU$10.7 billion (AU$9.1b for full-time and AU$1.6b for part-time work; range AU$5.9b, AU$49.7b).ConclusionWorsening persisting breathlessness is associated with lower workforce participation with direct financial consequences, greatest for older males.

Performance evaluation of personal thermal comfort models for older people based on skin temperature, health perception, behavioural and environmental variables

Personal thermal comfort models hold the promise of a more accurate way to predict thermal comfort and therefore a more reliable approach for managing indoor thermal environments. They can be especially relevant as an assistive tool for people with lower thermal sensitivity or with limitations to thermal management and adaptation, such as older people. Nonetheless, although in constant development, studies on personal comfort models continue to focus on office environments and younger adults. This paper explores the development of personal comfort models to predict older people's thermal needs in their homes and evaluates the models' predictive performances in comparison with conventional generalised approaches. Machine learning and environmental, behavioural, health and skin temperature measurements were used to develop individual models for a set of older adults in South Australia. The results show that, on average, the personal thermal comfort models using all studied inputs, except for health perception, presented an optimal accuracy of 66.72%, a Cohen's Kappa of 50.08% and AUC of 0.77, a superior performance when compared with generalised approaches. Results have also highlighted the need for further research on combining physiological sensing, individualised predictive modelling and wearable comfort systems, as well as on defining thermal preference misclassification costs in the context of older people.

Risk Perception and Health Precautions Towards COVID-19 Among Older Culturally and Linguistically Diverse Adults in South Australia: A Cross-Sectional Survey.

BackgroundRisk perceptions and precaution-taking against COVID-19 are affected by individuals’ health status, psychosocial vulnerabilities and cultural dimensions. This cross-sectional study investigates risk perceptions associated with COVID-19 and specifically the problem- and emotion-focused health precautions of older, culturally and linguistically diverse (CALD) South Australians.MethodsCross-sectional research involving self-administration of an online survey. Participants were CALD adults living in South Australia, aged 60 years and above (n = 155). Multi-indicator surveys were analyzed using Stata/MP version 13.0 and multiple linear regression models fitted to examine associations between risk perceptions and problem- and emotion-focused health precautions.ResultsDread risk returned the highest mean score; COVID-19 was perceived as a catastrophe. Mean scores for fear showed that participants were worried about COVID-19 and scared of becoming infected. Participants followed health advice as they were worried [β 0.15; 95% CI 0.07, 0.23] and realized the effect of COVID-19 on them [β 0.15; 95% CI 0.02, 0.28], or worried and had trust in experts’ knowledge and managing capacity [β 0.17; 95% CI 0.06, 0.28]. Age was negatively associated with sum-score of problem-focused coping: compared to participants aged 60–69 years, 80+ years revealed a decrease in problem-focused health precautions. Variables like education (primary schooling [β 2.80; 95% CI 0.05, 5.55] and bachelor degree [β 3.16; 95% CI 0.07, 6.25] versus no formal education), self-confidence in reducing risk, and fear [β 0.84; 95% CI 0.31, 1.36] significantly affected emotional-focused health precautions.ConclusionThis local study has global implications. It showed that COVID-19 has psychosocial and environmental implications for older CALD adults. When many CALD populations have existing vulnerabilities to intersecting disadvantage, cultural-tailoring of interventions and pandemic response plans may buffer the effects of compounding disaster. Larger studies are needed to compare risk perception and health response patterns across countries and cultural groupings.

COVID-19 risk perceptions and precautions among the elderly: A study of CALD adults in South Australia.

Background: Coping with COVID-19 is a challenge for culturally and linguistically diverse (CALD) older adults. In Australia, little attention has been given to understanding associations between cultural contexts, health promotion, and socio-emotional and mental health challenges of older CALD adults during the COVID-19 pandemic. Therefore, we have collected data from older CALD adults to examine their COVID-19 risk perceptions and its association with their health precautions, behavioural dimensions and emergency preparation. Methods: A cross-sectional survey was conducted in South Australia. The CALD population aged 60 years and above were approached through 11 South Australian multicultural NGOs. Results: We provide the details of 155 older CALD South Australians' demographics, risk perceptions, health precautions (problem-and-emotion-focused), behavioural dimensions and emergency preparation. The explanatory variables included demographic characteristics (age, gender, education and ethnicity); and risk perception (cognitive [likelihood of being affected] and affective dimension [fear and general concerns], and psychometric paradigm [severity, controllability, and personal impact]. The outcome measure variables were health precautions (problem-focused and emotion-focused), behavioral adaptions and emergency preparation. Conclusions: This dataset may help the researchers who investigate multicultural health or aged care in the pandemic and or who may have interest to link with other datasets and secondary use of this primary dataset in order to develop culturally tailored pandemic-related response plan. The data set is available from Harvard Dataverse.

Socioeconomic Correlates of Eating Disorder Symptoms in an Australian Population-Based Sample

BackgroundRecent research has challenged the stereotype that eating disorders are largely limited to young, White, upper-class females. This study investigated the association between indicators of socioeconomic status and eating disorder features.Methods and FindingsData were merged from cross-sectional general population surveys of adults in South Australia in 2008 (n = 3034) and 2009 (n = 3007) to give a total sample of 6041 participants. Multivariate logistic regressions were employed to test associations between indicators of socioeconomic status (household income, educational level, employment status, indigenous status and urbanicity) and current eating disorder features (objective binge eating, subjective binge eating, purging, strict dieting and overvaluation of weight/shape). Eating disorder features occurred at similar rates across all levels of income, education, indigenous status, and urbanicity (p > 0.05). However, compared to working full-time, not working due to disability was associated with an increased risk of objective binge eating (odds ratio (OR) = 2.30, p < 0.01) and purging (OR = 4.13, p < 0.05), engagement in home-duties with an increased risk of overvaluation of weight/shape (OR = 1.39, p < 0.05), and unemployment with an increased risk of objective binge eating (OR = 2.02, p < 0.05) and subjective binge eating (OR = 2.80, p < 0.05). Furthermore, participants with a trade or certificate qualification were at a significantly increased risk of reporting strict dieting compared to participants without a tertiary qualification (OR = 1.58, p <0.01). Limitations included the small numbers of indigenous participants (n = 115) and participants who reported purging (n = 54), exclusion of excessive exercise (which is associated with eating disorders, particularly in males), and the conduct of interviews by laypersons.ConclusionsOverall, symptoms of eating disorders are distributed equally across levels of socioeconomic status. This study highlights the need for universal access to specialised services, to train healthcare workers in the detection and diagnosis of eating disorders in diverse subgroups, and to combat barriers to help-seeking experienced by people who do not conform to the demographic stereotype of an eating disorder. The increased prevalence of various eating disorder features in those who are not working could be addressed by providing support to help sufferers join the workforce, or engage in meaningful social or community activities to improve resilience against the development of eating disorders.

Oral Health Impact among Rural-dwelling Indigenous Adults in South Australia.

The aim of this study was to describe the impact of oral health conditions among a convenience sample of Indigenous Australian adults and compare findings with nationally representative data. Data were obtained from the Indigenous Oral Health Literacy Project (IOHLP) based in South Australia. Nationally representative data were obtained from the National Survey of Adult Oral Health (NSAOH). The impact of oral disease was measured using the shortened form of the oral health impact profile, OHIP-14. All data were standardised by age group and sex utilising Census data. For each OHIP-14 measure the impact was greater for IOHLP participants. There was considerable variation in the degree of difference between IOHLP and NSAOH participants for individual OHIP-14 items. High levels of effects of oral health conditions were reported by rural-dwelling Indigenous adults. This may exacerbate the health and social disadvantage experienced by this marginalised group.

Soft drink consumption and multimorbidity among adults

We aimed to examine the association between soft drink consumption and multimorbidity among adults in South Australia. Data were collected using a risk factor surveillance system between 2008 and 2013. Each month a representative random sample of South Australians are selected from the Electronic White Pages with interviews conducted using Computer Assisted Telephone Interviewing (CATI). We define multimorbidity as currently having two or more of nine chronic conditions: asthma, diabetes, hypertension, high cholesterol, cardiovascular disease (CVD), chronic obstructive pulmonary disease (COPD), mental health problems, osteoporosis, and arthritis. Among 36,663 participants aged over 16 years old, 10.5% reported daily soft drink consumption of more than half a litre and 28.5% had multimorbidity. Soft drink consumption was positively associated with all nine chronic diseases except osteoporosis. High levels of soft drink consumption were positively associated with multimorbidity and increased with the number of chronic diseases. In the multivariable analysis, after adjusting for socio-demographic and lifestyle factors, comparing those who consumed more than half a litre of soft drink per day with those not consuming soft drink, the relative risk ratios (RRRs) for multimorbidity were 1.87 (95% CI 1.61-2.17) and higher for women 2.18 (95% CI 1.78-2.66). Multimorbidity prevalence increased with age but its association with soft drink consumption was stronger in those under 60 years old. In 2008, close to one out of three participants with multimorbidity had a high level of soft drink consumption. The prevalence of high levels of soft drink consumption decreased over the five years. There is a positive association between consumption of soft drink and multimorbidity among adults in South Australia and this relationship is stronger in younger people. This has implications for population level strategies to reduce the risk of developing chronic diseases and multimorbidity.

The association between personal sun exposure, serum vitamin D and global methylation in human lymphocytes in a population of healthy adults in South Australia

BackgroundThere is a positive association between solar UV exposure and micronucleus frequency in peripheral blood lymphocytes (PBL) and this association may be stronger when serum vitamin D (25(OH)D) levels are insufficient (<50nmol/L). Micronucleus formation can result from global hypomethylation of DNA repeat sequences. The aim of this analysis was to evaluate the relationship between solar UV exposure and methylation pattern in LINE-1 repetitive elements in PBL DNA and to see if serum 25(OH)D levels modify it. MethodPersonal solar UV exposure was estimated from hours of outdoor exposure over 6 weeks recalled at the time of blood collection in 208 male and female participants living in South Australia. Methylation in LINE-1 repetitive elements was assessed in PBL using pyrosequencing. ResultsMethylation in LINE-1 decreased with increasing solar UV exposure (% decrease=0.5% per doubling of sUV; 95%CI: −0.7 to −0.2 pvalue=0.00003). Although there was no correlation between LINE-1 methylation and micronucleus frequency, there was a 4.3% increase (95%CI: 0.6–8.1 p-value=0.02) in nucleoplasmic bridges and a 4.3% increase in necrosis (CI: 1.9–6.8 p-value=0.0005) for every 1% increase in LINE-1 methylation. Serum 25(OH)D was not associated with DNA methylation; or did it modify the association of solar UV with DNA methylation. ConclusionExposure to solar UV radiation may reduce DNA methylation in circulating lymphocytes. This association does not appear to be influenced or mediated by vitamin D status.

Abstract 2514: The association between personal sun exposure, serum vitamin D and global methylation in human lymphocytes, in a population of healthy adults in South Australia.

Abstract A positive association between solar UV exposure and micronuclei (MN) frequency (biomarker of chromosome breakage or loss) was previously reported with the effect of solar UV exposure on DNA damage greater when serum vitamin D (25(OH)D) levels were insufficient (&amp;lt;50nmol/L). MN formation can result from global hypomethylation of the DNA repeat sequence, which is suggested to be a significant factor in driving oncogenesis. Therefore the aim was to evaluate the relationship between lymphocytic DNA methylation pattern in LINE-1 repetitive elements and solar UV exposure in 208 male and female participants from South Australia. Possible modifying effects of serum 25(OH)D levels were examined. Personal solar UV exposure was estimated from hours of outdoor exposure over 16 weeks recalled at the time of blood collection. DNA methylation pattern in LINE-1 repetitive elements was assessed in peripheral blood lymphocytes using pyrosequencing. DNA methylation in LINE-1 repetitive elements decreased with increasing sun exposure (% decrease=0.5% per doubling of sun exposure; 95%CI: -0.7-0.2 pvalue=0.00003). There was no correlation between LINE-1 methylation and MN frequency, however for every 1% increase in LINE-1 methylation there was a corresponding 4.3% (95% CI:0.6-8.1 p-value=0.02) increase in nucleoplasmic bridges (biomarker of dicentric chromosome formation) and a 4.3% increase in necrosis (CI:1.9-6.8 p-value=0.0005). This suggests that the reduction in LINE-1 methylation with increased solar exposure may be too small to explain increases in MN frequency and therefore other mechanisms must be considered. There was no clear relationship between 25(OH)D and DNA methylation. In conclusion, the inverse relationship between solar UV radiation and LINE-1 DNA methylation status suggests a role for solar UV exposure in influencing genomic methylation patterns, which in turn appears to be associated with specific biomarkers of cell death (necrosis) and chromosomal stability (NPBs). If this holds true, then the use of LINE-1 hypomethylation, and possibly methylation of other sequences such as Alu repeats, as a biomarker for studying the role of UV in inducing both skin and internal cancers (and other diseases) might deserve further consideration. Citation Format: Visalini Nair-Shalliker, Varinderpal Dhillon, Mark Clements, Bruce K. Armstrong, Michael Fenech. The association between personal sun exposure, serum vitamin D and global methylation in human lymphocytes, in a population of healthy adults in South Australia. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 2514. doi:10.1158/1538-7445.AM2013-2514

Appendicular Skeletal Muscle Mass: Development and Validation of Anthropometric Prediction Equations.

Sarcopenia is the loss of muscle mass and function seen with increasing age. Central to making the diagnosis of sarcopenia is the assessment of appendicular skeletal muscle mass (ASM). The objective of this study was to develop and validate novel anthropometric prediction equations (PEs) for ASM that would be useful in primary or aged care. PEs were developed using best subset regression analysis. Three best performing PEs (PE1, PE2, PE3) were selected and validated using the Bland-Altman and Sheiner and Beal methods. Community dwelling adults in South Australia. 188 healthy subjects were involved in the development study. 2275 older(age ≥ 50years) subjects were involved in the validation study. ASM was assessed using dual x-ray abosrptiometry (DEXA). Weight and height was measured and body mass index (BMI) estimated. A strong correlation between PE derived ASM and the DEXA derived ASM was seen for the three selected PEs. PE3: ASM= 10.047427 + 0.353307(weight) - 0.621112(BMI) - 0.022741(age) + 5.096201(if male) performed the best. PE3 over-estimated (P<0.001) ASM by 0.36 kg (95% CI 0.28-0.44 Kg) and the adjusted R2 was 0.869. The 95% limit of agreement was between -3.5 and 4.35 kg and the standard error of the estimate was 1.95. The root mean square error was 1.91(95% CI 1.80-2.01). PE3 also performed the best across the various age (50-65, 65-<80, 80+ years) and weight (BMI <18.5, 18.5-24.9, 25-29.9, ≥30 kg/m2) groups. A new anthropometric PE for ASM has been developed for use in primary or aged care but is specific to Caucasian population groups.

Soft drink consumption and mental health problems among adults in Australia

To examine the association between soft drink consumption and mental health problems, including self-reported doctor-diagnosed anxiety, stress-related problem and depression, suicidal ideation and psychological distress, among adults in South Australia. Data were collected using a risk factor surveillance system. Each month a representative random sample of South Australians was selected from the Electronic White Pages with interviews conducted using computer-assisted telephone interviewing. South Australia. Participants were aged 16 years and above. Among 4741 participants, 12.5% reported daily soft drink consumption of more than half a litre. High levels of soft drink consumption were positively associated with depression, stress-related problem, suicidal ideation, psychological distress and a current mental health condition, but not anxiety. Overall, 24.0% of those having suicidal ideation reported consuming more than half a litre of soft drink per day. In the multivariate analysis, after adjusting for sociodemographic and lifestyle factors, those who consumed more than half a litre of soft drink per day had approximately 60% greater risk of having depression, stress-related problem, suicidal ideation, psychological distress or a current mental health condition, compared with those not consuming soft drinks. The soft drink to total fluid consumption ratio had similar associations with mental health problems. There is a positive association between consumption of soft drinks and mental health problems among adults in South Australia.

Telomere Length in Lymphocytes of Older South Australian Men May Be Inversely Associated with Plasma Homocysteine

Deficiencies in folate (FOL) and vitamin B12 (B12) result in increased chromosomal aberrations, a validated biomarker of cancer risk. Telomeres, the regions of DNA that cap the ends of each chromosome, are critical for maintaining chromosomal stability but the impact of micronutrients on telomere structure and function remains unclear. We hypothesized that telomere length maintenance might be compromised if the status of FOL and B12 was inadequate and plasma homocysteine (HCY) was increased. We investigated the relationship between telomere length in peripheral blood lymphocytes and plasma FOL, B12, and HCY status, and tested whether any such relationship was dependent on age, gender, body mass index, and common polymorphisms in folate metabolism genes. A single blood sample was collected from 43 younger (18-32 years) and 47 older (65-83 years) adults in South Australia. The younger cohort consisted of 18 males and 25 females, whereas the older group included 24 males and 23 females. Telomere length was determined in lymphocytes by flow cytometry. Telomere length in the younger cohort was 11.52% greater than in the older cohort (p = 0.015). In the older cohort, telomere length in females was 12.5% greater than in males (p = 0.028). In older males, there was a significant inverse correlation between telomere length and HCY (r = -0.57, p = 0.004), but this effect was not observed in the younger cohort or in the older female group. These results provide evidence that telomere length of lymphocytes in older men may be adversely affected by HCY in vivo.

Public dental service utilization among adults in South Australia

Longitudinal patterns of public dental service use may reflect access issues to public dental care services. Therefore, patterns of dental service use among South Australian adult public dental patients over a 3(1/2)-year period were examined. Public dental patients (n = 898) initially receiving a course of emergency dental care (EDC) or general dental care (GDC) at baseline were followed for up to 3(1/2) years. Patient clinical records were accessed electronically to obtain information on dental visits and treatment received at those visits. Some 70.7 per cent of EDC and 51.3 per cent of GDC patients returned for dental treatment post-baseline. EDC patients returned within a significantly shorter time period post-baseline, received significantly more courses of care and were visiting more frequently than GDC patients. A greater proportion of EDC patients received oral surgery, restorative, endodontic and prosthodontic services, but fewer received periodontic services. EDC patients received significantly more oral surgery and fewer preventive services per follow-up year, on average, than GDC patients. Large proportions of EDC (52.4 per cent) and GDC (63.8 per cent) patients who returned sought emergency care post-baseline. Patients appeared to be cycling through emergency dental care because of lack of access to general care services, highlighting access problems to public dental care.

Consumer concerns about food and health

PurposeAims to investigate the relationships between consumers' food concerns and their personal values and demographic characteristics.Design/methodology/approachA questionnaire was administered in a cross sectional random population survey conducted among a sample of 1,000 adults in South Australia. The questionnaire elicited information about respondents' concerns about 20 food and health issues, the perceived importance of 23 values items derived from the Schwartz values inventory, and their demographic characteristics.FindingsPrincipal components analyses derived four food concerns factors and six personal values factors. Respondents' safety concerns scores were positively associated with devout‐tradition, order‐discipline, and moderate‐independent values. Their disease concerns score was positively linked to beauty‐nature, devout‐tradition, and order‐discipline. Multiple regression and chi‐square automatic interaction detection (CHAID) analyses showed that individual values items were strong predictors of consumers; specific concerns such as food and heart disease, and, genetic modification of foods.Research limitations/implicationsThe research was based on a cross sectional study. More refined indices of food concerns and personal values should be used in replications of this preliminary study.Practical implicationsThe findings support the use of psychographic market segmentation approaches in communication programs about food and health issues.Originality/valueThe findings suggest that personal values, may be stronger predictors of consumers' concerns about food and health issues than demographics. They also show that measurement level of values and concerns influence the observed strength of their relationships.

Phased‐in smoke‐free workplace laws: reported impact on bar patronage and smoking, particularly among young adults in South Australia

Objectives: To measure the reported impact of phased‐in smoke‐free bar laws on bar patronage and smoking behaviour, particularly among young adults.Methods: Cross‐sectional survey of a representative sample of 2,004 South Australian adults, conducted four months into Phase I of the new laws. A comparable survey was conducted in 2003.Results: Awareness of and support for the smoke‐free laws were high. Phase I of the new laws did not reduce patronage. Young adults (18–24 years) reported higher patronage of bars and greater impact of the new laws on patronage, current smoking and future likelihood of quitting.Conclusions and Implications: Smoke‐free laws are an effective public health measure to protect against second‐hand smoke. Evidence is now emerging that they may also reduce smoking among young people, as bars are social settings with potential to alter social norms about smoking and promote reduced consumption and quitting.