| 2018 |
Ewald B, Stacey F, Johnson N, Plotnikoff RC, Holliday E, Brown W, James EL, 'Physical activity coaching by Australian Exercise Physiologists is cost effective for patients referred from general practice', Australian and New Zealand Journal of Public Health, 42 12-15 (2018) [C1]
© 2017 The Authors Objective: Interventions to promote physical activity for sedentary patients seen in general practice may be a way to reduce the burden of chronic disease. Coac... [more] © 2017 The Authors Objective: Interventions to promote physical activity for sedentary patients seen in general practice may be a way to reduce the burden of chronic disease. Coaching by an exercise physiologist is publicly funded in Australia, but cost effectiveness has not been documented. Methods: In a three-arm randomised controlled trial, face-to-face coaching and telephone coaching over 12 weeks were compared with a control group using the outcome of step count for one week at baseline, three months and twelve months. Program costs and time-based costs were considered. Quality of life was measured as a secondary outcome. Results: At 12 months, the intervention groups were more active than controls by 1,002 steps per day (95%CI 244, 1,759). This was achieved at a cost of AUD$245 per person. There was no change in reported quality of life or utility values. Conclusion: Coaching achieved a modest increase in activity equivalent to 10 minutes walking per day, at a cost of AUD$245 per person. Face-to-face and telephone counselling were both effective. Implication for public health: Persistence of increases nine months after the end of coaching suggests it creates long-term change and is a good value health intervention.
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| 2017 |
Ewald BD, Oldmeadow C, Attia JR, 'Daily step count and the need for hospital care in subsequent years in a community-based sample of older australians', Medical Journal of Australia, 206 126-130 (2017) [C1]
© 2017 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved. Objectives: To determine the extent to which physical activity reduces the number of hospital bed-days for A... [more] © 2017 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved. Objectives: To determine the extent to which physical activity reduces the number of hospital bed-days for Australians over 55, using an objective measure of activity. Design, setting and participants: 9784 Newcastle residents aged 55 years or more were invited to participate. 3253 responders were eligible and wore pedometers for one week during 2005e2007; their hospital data from recruitment to 31 March 2015 were analysed (mean follow-up time: 8.2 years). Complete data for 2110 people were available for analysis. Main outcome measures: Mean annual hospital bed-days, according to individual step count. Results: There was a statistically significant reduction in the number of hospital bed-days associated with higher step counts; the incidence rate ratio per extra 1000 steps per day at baseline was 0.91 (95% CI, 0.90e0.94). The disease-specific reductions were significant for admissions for cancer and diabetes, but not for cardiovascular disease. The difference between 4500 and 8800 steps per day (the upper and lower quartile boundaries for step count) was 0.36 bed-days per person per year, after adjusting for age, sex, number of medications, number of comorbidities, smoking and alcohol status, and education. When analysis was restricted to hospital admissions after the first 2 years of follow-up, the difference was 0.29 bed-days per person per year. Conclusions: More active people require less hospital care, and an achievable extra 4300 steps per day would result in an average of one less day in hospital for each 3 years of life.
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| 2017 |
Dahal R, Upadhyay A, Ewald B, 'One Health in South Asia and its challenges in implementation from stakeholder perspective', Veterinary Record, 181 626 (2017) [C1]
One Health is a concept which fosters collaborative relationships between human health, animal health and environmental health partners. Diseases are emerging and re-emerging in S... [more] One Health is a concept which fosters collaborative relationships between human health, animal health and environmental health partners. Diseases are emerging and re-emerging in South Asia due to poor sanitation, close proximity of people to livestock, deforestation, porous borders, climate change, changes in human behaviour and unhygienic food preparation and consumption practices. This review was completed in two stages. First, we conducted a review of peer-reviewed literature and grey literature available in Google search engine related to One Health in four countries (Bangladesh, Bhutan, India and Nepal). Second, we used a structured questionnaire completed by the key stakeholders working on One Health for the collection of information related to the challenges in implementing One Health. Most of the One Health activities in South Asia are determined by donor preferences. Bangladesh and India did considerable work in advancing One Health with limited support from the government agencies. Weak surveillance mechanisms, uncertain cost-effectiveness of One Health compared with the existing approach, human resources and laboratory capacity are some of the factors hindering implementation of the One Health concept. Implementation of One Health is growing in the South Asia region with limited or no government acceptance. To institutionalise it, there is a need for leadership, government support and funding.
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| 2017 |
James EL, Ewald BD, Johnson NA, Stacey FG, Brown WJ, Holliday EG, et al., 'Referral for Expert Physical Activity Counseling: A Pragmatic RCT', American Journal of Preventive Medicine, 53 490-499 (2017) [C1]
© 2017 American Journal of Preventive Medicine Introduction Primary care physicians are well placed to offer physical activity counseling, but insufficient time is a barrier. Refe... [more] © 2017 American Journal of Preventive Medicine Introduction Primary care physicians are well placed to offer physical activity counseling, but insufficient time is a barrier. Referral to an exercise specialist is an alternative. In Australia, exercise specialists are publicly funded to provide face-to-face counseling to patients who have an existing chronic illness. This trial aimed to (1) determine the efficacy of primary care physicians¿ referral of insufficiently active patients for counseling to increase physical activity, compared with usual care, and (2) compare the efficacy of face-to-face counseling with counseling predominantly via telephone. Study design Three-arm pragmatic RCT. Setting/participants Two hundred three insufficiently active ( < 7,000 steps/day) primary care practice patients (mean age 57 years; 70% female) recruited in New South Wales, Australia, in 2011¿2014. Intervention (1) Five face-to-face counseling sessions by an exercise specialist, (2) one face-to-face counseling session followed by four telephone calls by an exercise specialist, or (3) a generic mailed physical activity brochure (usual care). The counseling sessions operationalized social cognitive theory via a behavior change counseling framework. Main outcome measures Change in average daily step counts between baseline and 12 months. Data were analyzed in 2016. Results Forty (20%) participants formally withdrew; completion rates at 3 and 6 months were 64% and 58%, respectively. Intervention attendance was high (75% received five sessions). The estimated mean difference between usual care and the combined intervention groups at 12 months was 1,002 steps/day (95% CI=244, 1,759, p=0.01). When comparing face-to-face with predominantly telephone counseling, the telephone group had a non-significant higher mean daily step count (by 619 steps) at 12 months. Conclusions Provision of expert physical activity counseling to insufficiently active primary care patients resulted in a significant increase in physical activity (approximately 70 minutes of walking per week) at 12 months. Face-to-face only and counseling conducted predominantly via telephone were both effective. This trial provides evidence to expand public funding for expert physical activity counseling and for delivery via telephone in addition to face-to-face consultations. Trial registration This trial is registered at www.anzctr.org.au/ ACTRN12611000884909.
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| 2015 |
Ewald BD, 'Communicating the health effects of air pollution', Medical Journal of Australia, 202 572-574 (2015) [C3]
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| 2015 |
Ewald B, Cowan T, 'Making the cycling environment safer: An investigation based on hospital admissions', Public Health Research and Practice, 25 (2015)
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| 2014 |
Ewald B, Attia J, McElduff P, 'How many steps are enough? dose-response curves for pedometer steps and multiple health markers in a community-based sample of older Australians', Journal of Physical Activity and Health, 11 509-518 (2014) [C1]
Background: Although an overall public health target of 10,000 steps per day has been advocated, the dose-response relationship for each health benefit of physical activity may di... [more] Background: Although an overall public health target of 10,000 steps per day has been advocated, the dose-response relationship for each health benefit of physical activity may differ. Methods: A representative community sample of 2458 Australian residents aged 55-85 wore a pedometer for a week in 2005-2007 and completed a health assessment. Age-standardized steps per day were compared with multiple markers of health using locally weighted regression to produce smoothed dose-response curves and then to select the steps per day matching 60% or 80% of the range in each health marker. Results: There is a linear relationship between activity level and markers of inflammation throughout the range of steps per day; this is also true for BMI in women and high density lipoprotein in men. For other markers, including waist:hip ratio, fasting glucose, depression, and SF-36 scores, the benefit of physical activity is mostly in the lower half of the distribution. Conclusions: Older adults have no plateau in the curve for some health outcomes, even beyond 12,000 steps per day. For other markers, however, there is a threshold effect, indicating that most of the benefit is achieved by 8000 steps per day, supporting this as a suitable public health target for older adults. © 2014 Human Kinetics, Inc.
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| 2014 |
Agho KE, Hall J, Ewald B, 'Determinants of the Knowledge of and Attitude towards Tuberculosis in Nigeria', JOURNAL OF HEALTH POPULATION AND NUTRITION, 32 520-538 (2014) [C1]
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| 2014 |
James EL, Ewald B, Johnson N, Brown W, Stacey FG, Mcelduff P, et al., 'Efficacy of GP referral of insufficiently active patients for expert physical activity counseling: protocol for a pragmatic randomized trial (The NewCOACH trial)', BMC FAMILY PRACTICE, 15 (2014) [C3]
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| 2013 |
Magin P, Holliday S, Dunlop A, Ewald B, Dunbabin J, Henry J, et al., 'Discomfort sharing the general practice waiting room with mentally ill patients: a cross-sectional study', FAMILY PRACTICE, 30 190-196 (2013) [C1]
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| 2013 |
Ewald B, 'Making sense of equivalence and non-inferiority trials', Australian Prescriber, 36 170-173 (2013)
New drugs are usually compared to a placebo. Sometimes it may be unethical to give patients a placebo, so the new drug is compared with standard treatment. Trials which compare tr... [more] New drugs are usually compared to a placebo. Sometimes it may be unethical to give patients a placebo, so the new drug is compared with standard treatment. Trials which compare treatments may not be designed to show that one treatment is superior. These are known as non-inferiority or equivalence trials. Non-inferiority trials aim to show that the new drug is no worse than standard treatment. Equivalence trials aim to show the new treatment is no better and no worse. An equivalence boundary should be set before the trial. This is the definition of what would be the minimum important difference between the treatments. There are several traps in the interpretation of trials of non-inferiority or equivalence. The results can be influenced by many factors including the size of the equivalence boundary and whether an intention-to-treat or 'per protocol' analysis is used.
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| 2012 |
Ewald BD, james E, Johnson N, brown W, stacey F, plotnikoff R, 'Efficacy of referral for physical activity counseling: protocol for an rct to compare face to face and telephone counseling.', Journal of Science and Medicine in Sport, 15 (2012)
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| 2012 |
Holliday SM, Magin PJ, Dunbabin JS, Ewald BD, Henry J-M, Goode SM, et al., 'Waiting room ambience and provision of opioid substitution therapy in general practice', Medical Journal of Australia, 196 391-394 (2012) [C1]
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| 2012 |
Wilson AJ, Robertson J, Ewald BD, Henry D, 'What the public learns about screening and diagnostic tests through the media', Medical Journal of Australia, 197 324-326 (2012) [C2]
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| 2011 |
Ramsay EN, Roughead EE, Ewald BD, Pratt NL, Ryan P, 'A self-controlled case series to assess the effectiveness of beta blockers for heart failure in reducing hospitalisations in the elderly', BMC Medical Research Methodology, 11 1-7 (2011) [C1]
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| 2011 |
Tudor-Locke C, Craig CL, Aoyagi Y, Bell RC, Croteau KA, De Bourdeaudhuij I, et al., 'How many steps/day are enough? For older adults and special populations', International Journal of Behavioral Nutrition & Physical Activity, 8 (2011) [C1]
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| 2010 |
Johnson NA, Inder KJ, Ewald BD, James EL, Bowe SJ, 'Association between participation in outpatient cardiac rehabilitation and self-reported receipt of lifestyle advice from a healthcare provider: Results of a population based cross-sectional survey', Rehabilitation Research and Practice, Article 541741 (2010) [C1]
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| 2010 |
Ewald BD, james E, Johnson N, paras L, 'Efficacy of exercise physiologist counselling in primary care patients. A pilot study to determine feasibility and acceptability. B. Ewald, E James, N. Johnson, L. Paras Journal of Science and Medicine in Sport vol 12, e225-e226', Journal of Science and Medicine in Sport, 12 e225-e226 (2010)
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| 2010 |
McEvoy MA, Smith WT, D'Este CA, Duke JM, Peel R, Schofield PW, et al., 'Cohort Profile: The Hunter Community Study', International Journal of Epidemiology, 39 1452-1463 (2010) [C1]
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| 2010 |
Ewald BD, McEvoy MA, Attia JR, 'Pedometer counts superior to physical activity scale for identifying health markers in older adults', British Journal of Sports Medicine, 44 756-761 (2010) [C1]
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| 2010 |
Schulzke SM, Pillow J, Ewald BD, Patole SK, 'Flow-cycled versus time-cycled synchronized ventilation for neonates', Cochrane Database of Systematic Reviews, CD008246 (2010) [C1]
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| 2009 |
Ewald DP, Eisman JA, Ewald BD, Winzenberg TM, Seibel MJ, Ebeling PR, et al., 'Population rates of bone densitometry use in Australia, 2001-2005, by sex and rural versus urban location', Medical Journal of Australia, 190 126-128 (2009) [C1]
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| 2009 |
Gow RM, Ewald BD, Lai L, Gardin L, Lougheed J, 'The Measurement of the QT and QTc on the neonatal and infant electrocardiogram: A comprehensive reliability assessment', Annals of Noninvasive Electrocardiology, 14 165-175 (2009) [C1]
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| 2009 |
Ewald BD, Duke JM, Thakkinstian A, Attia JR, Smith WT, 'Physical activity of older Australians measured by pedometry', Australasian Journal on Ageing, 28 127-133 (2009) [C1]
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| 2008 |
Ewald BD, Webb CE, Durrheim DN, Russell RC, 'Is there a risk of malaria transmission in NSW?', NSW Public Health Bulletin, 19 127-131 (2008) [C1]
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| 2008 |
Ewald BD, Durrheim DN, 'Australian Bat Lyssavirus: Examination of post-exposure treatment in NSW', NSW Public Health Bulletin, 19 104-107 (2008) [C1]
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| 2008 |
Ewald BD, Ewald D, Thakkinstian A, Attia JR, 'Meta-analysis of B type natriuretic peptide and N-terminal pro B natriuretic peptide in the diagnosis of clinical heart failure and population screening for left ventricular systolic dysfunction', Internal Medicine Journal, 38 101-113 (2008) [C1]
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| 2008 |
Ewald BD, 'Method of cut point selection biases diagnostic research', Internal Medicine Journal, 38 615 (2008) [C3]
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| 2007 |
Wylks CE, Ewald BD, Guest C, 'The epidemiology of pertussis in the Australian Capital Territory, 1999 to 2005: Epidemics of testing, disease or false positives?', Communicable Diseases Intelligence, 31 383-391 (2007) [C1]
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| 2007 |
Ewald B, 'Post hoc choice of cut points introduced bias to diagnostic research (vol 59, pg 798, 2006)', JOURNAL OF CLINICAL EPIDEMIOLOGY, 60 756-756 (2007)
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| 2007 |
Ewald BD, 'Erratum for 'Post hoc choice of cut points introduced bias to diagnostic research'', Journal of Clinical Epidemiology, 60 756 (2007) [C3]
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| 2006 |
Ewald BD, 'Post hoc choice of cut points introduced bias to diagnostic research', Journal of Clinical Epidemiology, 59 798-801 (2006) [C1]
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| 2006 |
Le TA, Sohn AH, Nguyen PT, Vo TC, Tran Nguyen TH, Ewald BD, Dibley MJ, 'Microbiology of surgical site infections and associated antimicrobial use among Vietnamese orthopedic and neurosurgical patients', Infection Control and Hospital Epidemiology, 27 855-862 (2006) [C1]
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| 2005 |
Thu LTA, Dibley MJ, Ewald BD, Tien NP, Lam LD, 'Incidence of surgical site infections and accompanying risk factors in Vietnamese orthopaedic patients', Journal of Hospital Infection, 60 360-367 (2005) [C1]
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| 2005 |
Ewald B, Carapetis J, 'Varicella vaccine [1] (multiple letters)', Australian Prescriber, 28 113-114 (2005) |
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| 2004 |
Attia JR, Nair BR, Sibbritt DW, Ewald BD, Paget NS, Wellard RF, et al., 'Generating pre-test probabilities: a neglected area in clinical decision making', Medical Journal of Australia, 180 449-454 (2004) [C1]
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| 2004 |
Ewald BD, Attia JR, 'Which test to detect microalbuminuria in diabetic patients?', Australian Family Physician, 33 565-568 (2004) [C1]
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| 2003 |
Ewald BD, 'B-type natriuretic peptide: a new diagnostic tool for congestive heart failure', Australian Prescriber, 26 64-65 (2003) [C2] |
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| 2003 |
Ewald B, 'Abnormal laboratory results - B-type natriuretic peptide: A new diagnostic tool for congestive heart failure', Australian Prescriber, 26 64-65 (2003)
B-type natriuretic peptide is released from the ventricle of patients with heart failure. High concentrations help to distinguish heart failure from other causes of dyspnoea. The ... [more] B-type natriuretic peptide is released from the ventricle of patients with heart failure. High concentrations help to distinguish heart failure from other causes of dyspnoea. The test is sensitive in congestive heart failure but it cannot distinguish if the dysfunction is diastolic or systolic. B-type natriuretic peptide is not used as a routine test in Australia, but if it becomes available it may be helpful in ruling out the diagnosis of congestive heart failure. It is also being investigated as a screening tool for heart disease in the community.
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| 2002 |
Ewald BD, Pekarsky B, 'PBS/RPBS cost implications of trends and guideline recommendations in the pharmacological management of hypertension', MEDICAL JOURNAL OF AUSTRALIA, 176 189-190 (2002)
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| 2002 |
Ewald BD, Pekarsky B, 'Cost analysis of ambulatory blood pressure monitoring in initiating antihypertensive drug treatment in Australian general practice', Medical Journal of Australia, 176 580-583 (2002) [C1]
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| 2002 |
McElduff P, Attia JR, Ewald BD, Cockburn JD, Heller R, 'Estimating the contribution of individual risk factors to disease in a person with more than one risk factor', The Journal of Clinical Epidemiology, 55 588-592 (2002) [C1]
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| 2002 |
Pekarsky B, Ewald B, 'Can we afford intensive management of diabetes?', Australian Prescriber, 25 102-103 (2002)
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| 1998 |
Ewald BD, Thompson S, 'Immunisation coverage in Alice Springs', NT Communicable Diseases Bulletin, Sept (1998) |
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