Dr Sarah Hiles
Lecturer
School of Psychological Sciences
- Email:sarah.hiles@newcastle.edu.au
- Phone:(02) 4042 0060
Career Summary
Biography
Dr Sarah Hiles is a lecturer in the School of Psychological Sciences. Her research focus is health psychology and psychosomatic medicine: the intersection between mental and physical health. Sarah's research career started with a focus on relationships between depression, inflammatory biomarkers and cardiometabolic risk factors. Most recently, she has taken a new direction, working on projects in severe asthma and COPD.
At the heart of her research is a desire to conduct studies that lay a solid evidence-base from which we can efficiently create effective and economical interventions. Her research demonstrates the places we should focus on to get "bang for buck" when we conduct clinical trials or implement scientific innovations into the clinic or public policy.
Sarah is a former EU Marie Sklodowska-Curie Research Fellow and an Australian Endeavour Research Fellow. She spent her fellowships working in a premier psychiatric epidemiology research group at VU University Medical Centre in Amsterdam, The Netherlands.
Sarah was awarded her PhD in 2014 at the University of Newcastle, under the supervision of Professors Amanda Baker and John Attia. Her thesis explored the epidemiological evidence for the inflammatory hypothesis of depression.
Qualifications
- Doctor of Philosophy, University of Newcastle
- Bachelor of Psychology, University of Newcastle
Keywords
- Anxiety
- Asthma
- Biostatistics
- Cohort study
- Depression
- Epidemiology
- Inflammatory biomarkers
- Lifestyle
- Meta-analysis
- Psychology
- Risk factors
- Suicide
Fields of Research
Code | Description | Percentage |
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320103 | Respiratory diseases | 20 |
420201 | Behavioural epidemiology | 20 |
520304 | Health psychology | 60 |
Professional Experience
UON Appointment
Title | Organisation / Department |
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Lecturer | University of Newcastle School of Psychology Australia |
Academic appointment
Dates | Title | Organisation / Department |
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1/2/2017 - 30/6/2017 | Research Associate | School of Medicine & Public Health, Faculty of Health & Medicine, University of Newcastle | Australia Australia |
Awards
Award
Year | Award |
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2018 |
Priority Research Centre for Healthy Lungs Early Career Award (Translational Clinical) PRC For Healthy Lungs, University of Newcastle |
2018 |
Jennie Thomas Medical Research Travel Grant Hunter Medical Research Institute (HMRI) |
2018 |
School of Nursing and Midwifery School Collaboration and Engagement Excellence Award School of Nursing and Midwifery, University of Newcastle |
2018 |
School of Nursing and Midwifery Early Career Research and Innovation Excellence Award School of Nursing and Midwifery, University of Newcastle |
2018 |
Priority Research Centre for Healthy Lungs Travel Grant PRC For Healthy Lungs, University of Newcastle |
2017 |
Centre of Excellence in Severe Asthma Travel Grant Centre for Research Excellence in Severe Asthma |
2016 |
Young Investigator Scholar American Psychosomatic Society |
2012 |
Best Research Higher Degree Publication Faculty of Health, University of Newcastle |
2012 |
Hunter Medical Research Institute (HMRI) PhD Student Travel Award Hunter Medical Research Institute (HMRI) |
2010 |
Highly commended presentation Australasian Society for Psychiatric Research |
2010 |
Travel Award, Annual Meeting of the Psychoneuroimmunology Research Society Psychoneuroimmunology Research Society (PNIRS) |
2009 |
Australian Postgraduate Award Australian Government |
2009 |
Vice Chancellor’s Scholarship for Outstanding Candidates The University of Newcastle |
Invitations
PhD Examiner
Year | Title / Rationale |
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2016 | The interplay between biological stress and cellular aging. An epidemiological perspective |
Publications
For publications that are currently unpublished or in-press, details are shown in italics.
Chapter (1 outputs)
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2013 |
Baker A, Hiles S, Thornton L, Searl A, Kelly P, Kay-Lambkin F, 'From Comorbidity to Multiple Health Behaviour Change', Emerging Perspectives on Substance Misuse, Wiley, Oxford 152-169 (2013) [B1]
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Journal article (32 outputs)
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2023 |
Mandelli L, Milaneschi Y, Hiles S, Serretti A, Penninx BW, 'Unhealthy lifestyle impacts on biological systems involved in stress response: Hypothalamic-pituitary-Adrenal axis, inflammation and autonomous nervous system', International Clinical Psychopharmacology, 38 127-135 (2023) [C1] An unhealthy lifestyle has a critical role in the pathogenesis and course of several chronic disorders. It has been hypothesized that lifestyle may also impact biological systems ... [more] An unhealthy lifestyle has a critical role in the pathogenesis and course of several chronic disorders. It has been hypothesized that lifestyle may also impact biological systems involved in stress response. A global index of unhealthy lifestyle was calculated based on the cumulative presence of five self-reported lifestyle habits (smoking, excessive alcohol use, drug use, low physical activity and short sleep) in 2783 participants (18-65 years) from the Netherlands Study of Depression and Anxiety. The functioning of biological stress systems was based on multiple physiological measures of cortisol, inflammatory cytokines and autonomic cardiac activity. The unhealthy lifestyle index was associated with hyperactivity of hypothalamus-pituitary-Adrenal axis and increased inflammation, indicating that with increasing unhealthy habits, the level of biological stress increases. No association with the autonomic nervous system activity was observed; however, the use of drugs increased parasympathetic cardiac activity and significantly impacted on ANS. Results were not impacted by a recent episode of depression or anxiety disorder. An unhealthy lifestyle may unfavorably impact on biological systems involved in stress response, which may underlie progression of several psychiatric as well as somatic chronic disorders.
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2022 |
Hiles S, Clark V, Gibson P, McDonald V, 'Stress-induced asthma Key insights for prevention and management', Medicine Today: the peer reviewed journal of clinical practice, 23 16-23 (2022) [C1]
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2021 |
Hiles SA, Urroz PD, Gibson PG, Bogdanovs A, McDonald VM, 'A feasibility randomised controlled trial of Novel Activity Management in severe ASthma-Tailored Exercise (NAMASTE): yoga and mindfulness', BMC Pulmonary Medicine, 21 (2021) [C1] Background: Physical inactivity is common in severe asthma and associated with poor health outcomes. New approaches are needed to address physical inactivity in this group. Object... [more] Background: Physical inactivity is common in severe asthma and associated with poor health outcomes. New approaches are needed to address physical inactivity in this group. Objective: To examine whether yoga and mindfulness improves health-related quality of life (HRQoL) compared with a minimal active control group and collect feasibility data to inform future studies. Methods: Over 12-weeks, adults with severe asthma were recruited. Participants were randomised 2:1 to parallel yoga or control groups. All participants received an activity tracker. The yoga group received tailored group classes twice a week for 16-weeks with a qualified yoga instructor. The control group set activity goals with a research officer and received eight progress calls. Outcomes were assessed at 16-weeks. Primary outcome was St George¿s Respiratory Questionnaire (SGRQ). Secondary outcomes included asthma control, physical activity, breathlessness, and inflammation. Face-to-face qualitative interviews were conducted to determine acceptability. Results: There were 15 participants randomised to yoga (mean 67¿years; 60% female) and 9 to control (68¿years; 56% female). Planned comparisons indicated the yoga group had greater SGRQ improvement than the control group. There was little change in secondary outcomes. Moderate-vigorous activity increased substantially in the control group. Participants found the intervention acceptable; key barriers and facilitators were social connection, the setting, addressing breathing and asthma symptoms, changing their mindset, and the intersection of different elements. Conclusion: A yoga and mindfulness intervention was feasible, acceptable to patients and improved HRQoL. The findings will inform design of much needed future research into physical activity interventions for severe asthma. World Health Organization International Clinical Trials Registry Platform The study was registered under the Australian New Zealand Clinical Trials Registry (ANZCTR) on the 26th of November 2018, Trial ID ACTRN12618001914257.
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2021 |
Varker T, Jones KA, Arjmand HA, Hinton M, Hiles SA, Freijah I, et al., 'Dropout from guideline-recommended psychological treatments for posttraumatic stress disorder: A systematic review and meta-analysis', Journal of Affective Disorders Reports, 4 (2021) [C1] Background: Many patients drop out of guideline-recommended treatments for posttraumatic stress disorder (PTSD), yet there has been little systematic investigation of this issue. ... [more] Background: Many patients drop out of guideline-recommended treatments for posttraumatic stress disorder (PTSD), yet there has been little systematic investigation of this issue. We aimed to examine dropout proportions from randomized controlled trials (RCTs) of guideline-recommended treatments for PTSD and whether proportions differed by type of treatment or trauma, PTSD severity or chronicity, or medication being permitted. Methods: Systematic review and meta-analysis of RCTs of guideline-recommended treatments for PTSD. Results: Eighty-five trials, with data for 6804 participants were included in the meta-analyses. The mean dropout proportion for guideline-recommended treatment was 20.9% (95%CI 17.2, 24.9) with evidence of high heterogeneity across studies. Military trauma was associated with higher dropout than civilian trauma. The civilian trauma group had similar dropout rates from guideline-recommended treatments, and active, waitlist or treatment as usual controls. In the military trauma group, dropout was higher from guideline-recommended treatments compared to active, waitlist or treatment as usual controls. Within this group, dropout from trauma-focused treatment was significantly higher than from non-trauma focused treatments overall, with the greatest difference in dropout rates occurring between randomization and treatment initiation. Limitations: Most RCTs exclude participants who have comorbid substance use disorder, suicidal behaviour, or history of psychosis, which limits the generalizability of findings. Conclusion: Dropout from guideline-recommended treatment for PTSD is higher in populations who have experienced military trauma and this population dropout from treatment in higher proportions when it is trauma-focused. The reasons for disparate rates of dropouts from recommended PTSD treatments require further investigation.
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2021 |
Hiles SA, Gibson PG, Agusti A, McDonald VM, 'Treatable Traits That Predict Health Status and Treatment Response in Airway Disease', Journal of Allergy and Clinical Immunology: In Practice, 9 1255-1264.e2 (2021) [C1] Background: A strategy based on the assessment and management of treatable traits (TTs) has been proposed as a new paradigm in airway disease. There is a potentially long list of ... [more] Background: A strategy based on the assessment and management of treatable traits (TTs) has been proposed as a new paradigm in airway disease. There is a potentially long list of TTs with likely different clinical impact. Objective: To identify TTs most strongly associated with poorer health-related quality of life (HRQOL) and treatments that most substantially improved HRQOL. Methods: We pooled data from 2 parallel-group clinical trials of multidimensional assessment and individualized management targeted to TTs versus usual care in patients with chronic obstructive pulmonary disease or severe asthma (intervention N = 45; control N = 46). Following multidimensional assessment, 22 TTs were identified and the intervention group received treatments tailored to their identified TT. We used Bayesian Model Averaging to examine associations between TTs and HRQOL (St George's Respiratory Questionnaire) at baseline, as well as between each TT treatment and the observed change in HRQOL postintervention. Results: TTs most substantially associated with poorer baseline HRQOL were frequent chest infections, breathing pattern disorder, inadequate inhaler technique, systemic inflammation (C-reactive protein >3 mg/L), and depression. In both trials, TT treatment led to a large, significant improvement in HRQOL compared with usual care (Cohen's d = 1.19; P < .001). Receiving a statin for systemic inflammation and oral corticosteroid for eosinophilic airway inflammation was associated with the largest HRQOL improvements. Treatments for exercise intolerance, anxiety, and obesity were associated with smaller improvements in HRQOL. Conclusions: This study contributes to identifying clinically impactful TTs by showing that TTs across pulmonary, extrapulmonary, and behavioral domains were associated with HRQOL impairment and treatment response.
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2020 |
Hiles SA, Gibson PG, McDonald VM, 'Disease burden of eosinophilic airway disease: Comparing severe asthma, COPD and asthma-COPD overlap', RESPIROLOGY, 26 52-61 (2020) [C1]
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2020 |
Cousins JL, Wark PAB, Hiles SA, McDonald VM, 'Understanding clinicians perceived barriers and facilitators to optimal use of acute oxygen therapy in adults', International Journal of COPD, 15 2275-2287 (2020) [C1]
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2020 |
Cousins JL, Wood-Baker R, Wark PAB, Yang IA, Gibson PG, Hutchinson A, et al., 'Management of acute COPD exacerbations in Australia: do we follow the guidelines?', ERJ OPEN RESEARCH, 6 (2020) [C1]
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2019 |
McGill K, Hiles SA, Handley TE, Page A, Lewin TJ, Whyte I, Carter GL, 'Is the reported increase in young female hospital-treated intentional self-harm real or artefactual?', Australian and New Zealand Journal of Psychiatry, 53 663-672 (2019) [C1] Background: The Australian Institute of Health and Welfare has reported an increased rate of hospital-treated intentional self-harm in young females (2000¿2012) in Australia. Thes... [more] Background: The Australian Institute of Health and Welfare has reported an increased rate of hospital-treated intentional self-harm in young females (2000¿2012) in Australia. These reported increases arise from institutional data that are acknowledged to underestimate the true rate, although the degree of underestimation is not known. Objective: To consider whether the reported increase in young females¿ hospital-treated intentional self-harm is real or artefactual and specify the degree of institutional underestimation. Methods: Averages for age- and gender-standardised event rates for hospital-treated intentional self-harm (national: Australian Institute of Health and Welfare; state: New South Wales Ministry of Health) were compared with sentinel hospital event rates for intentional self-poisoning (Hunter Area Toxicology Service, Calvary Mater Newcastle) in young people (15¿24 years) for the period 2000¿2012. A time series analysis of the event rates for the sentinel hospital was conducted. Results: The sentinel hospital event rates for young females of 444 per 100,000 were higher than the state (378 per 100,000) and national (331 per 100,000) rates. There was little difference in young male event rates ¿ sentinel unit: 166; state: 166 and national: 153 per 100,000. The sentinel hospital rates showed no change over time for either gender. Conclusion: There was no indication from the sentinel unit data of any increase in rates of intentional self-poisoning for young females. The sentinel and state rates were higher than the national rates, demonstrating the possible magnitude of underestimation of the national data. The reported increases in national rates of hospital-treated self-harm among young females might be due to artefactual factors, such as changes in clinical practice (greater proportion admitted), improved administrative coding of suicidal behaviours or possibly increased hospital presentations of community self-injury cases, but not intentional self-poisoning. A national system of sentinel units is needed for the accurate and timely monitoring of all hospital-treated self-harm.
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2019 |
Cordova-Rivera L, Gibson PG, Gardiner PA, Hiles SA, McDonald VM, 'Extrapulmonary associations of health status in severe asthma and bronchiectasis: Comorbidities and functional outcomes', Respiratory Medicine, 154 93-101 (2019) [C1] Background: Severe asthma and bronchiectasis are heterogeneous diseases that contribute to disability beyond the pulmonary system. The magnitude of the impact that these extrapulm... [more] Background: Severe asthma and bronchiectasis are heterogeneous diseases that contribute to disability beyond the pulmonary system. The magnitude of the impact that these extrapulmonary features has on health-related quality of life (HRQoL) is unknown. Methods: We analysed the cross-sectional relationships between HRQoL (St. George's Respiratory Questionnaire; SGRQ) and extrapulmonary characteristics, including physical activity (steps/day), anxiety and depression, isometric leg strength, systemic inflammation, and several comorbidities in adults with severe asthma (n = 70) and bronchiectasis (n = 61). Results: Participants with severe asthma and bronchiectasis had similar SGRQ total scores (mean scores 43.7 and 37.8 for severe asthma and bronchiectasis; p > 0.05), and similar pulmonary and extrapulmonary characteristics. The associations between extrapulmonary variables and HRQoL did not differ according to diagnosis (all interactions p > 0.05). Greater anxiety and depressive symptoms, fewer steps/day and greater systemic inflammation were statistically associated with poorer HRQoL in both diseases (p < 0.05). Lower isometric leg strength in severe asthma, and greater Charlson Comorbidity Index in bronchiectasis were also associated with poorer HRQoL (p < 0.05). In the multivariable regression model performed in the combined disease groups, anxiety and depression, steps/day, systemic inflammation and isometric leg strength remained independently associated with HRQoL. Associations between extrapulmonary characteristics and SGRQ domains were stronger for the activity and impact domains, than symptoms. Conclusion: In severe asthma and bronchiectasis, extrapulmonary features including physical activity and leg strength have a significant impact on HRQoL, especially within the activity and impact domains. These features should be considered as part of the assessment of these conditions, and they may represent additional treatment targets to improve HRQoL.
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2019 |
Schuch FB, Stubbs B, Meyer J, Heissel A, Zech P, Vancampfort D, et al., 'Physical activity protects from incident anxiety: A meta-analysis of prospective cohort studies', Depression and Anxiety, 36 846-858 (2019) [C1] Background: Prospective cohorts have suggested that physical activity (PA) can decrease the risk of incident anxiety. However, no meta-analysis has been conducted. Aims: To examin... [more] Background: Prospective cohorts have suggested that physical activity (PA) can decrease the risk of incident anxiety. However, no meta-analysis has been conducted. Aims: To examine the prospective relationship between PA and incident anxiety and explore potential moderators. Methods: Searches were conducted on major databases from inception to October 10, 2018 for prospective studies (at least 1 year of follow-up) that calculated the odds ratio (OR) of incident anxiety in people with high PA against people with low PA. Methodological quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects meta-analysis was conducted and heterogeneity was explored using subgroup and meta-regression analysis. Results: Across 14 cohorts of 13 unique prospective studies (N = 75,831, median males = 50.1%) followed for 357,424 person-years, people with high self-reported PA (versus low PA) were at reduced odds of developing anxiety (adjusted odds ratio [AOR] = 0.74; 95% confidence level [95% CI] = 0.62, 0.88; crude OR = 0.80; 95% CI = 0.69, 0.92). High self-reported PA was protective against the emergence of agoraphobia (AOR = 0.42; 95% CI = 0.18, 0.98) and posttraumatic stress disorder (AOR = 0.57; 95% CI = 0.39, 0.85). The protective effects for anxiety were evident in Asia (AOR = 0.31; 95% CI = 0.10, 0.96) and Europe (AOR = 0.82; 95% CI = 0.69, 0.97); for children/adolescents (AOR = 0.52; 95% CI = 0.29, 0.90) and adults (AOR = 0.81; 95% CI = 0.69, 0.95). Results remained robust when adjusting for confounding factors. Overall study quality was moderate to high (mean NOS = 6.7 out of 9). Conclusion: Evidence supports the notion that self-reported PA can confer protection against the emergence of anxiety regardless of demographic factors. In particular, higher PA levels protects from agoraphobia and posttraumatic disorder.
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2019 |
McDonald VM, Fingleton J, Agusti A, Hiles SA, Clark VL, Holland AE, et al., 'Treatable traits: a new paradigm for 21st century management of chronic airway diseases: Treatable Traits Down Under International Workshop report.', The European respiratory journal, 53 (2019) [C1]
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2019 |
McDonald VM, Hiles SA, Godbout K, Harvey ES, Marks GB, Hew M, et al., 'Treatable traits can be identified in a severe asthma registry and predict future exacerbations', Respirology, 24 37-47 (2019) [C1] Background and objective: A new taxonomic and management approach, termed treatable traits, has been proposed for airway diseases including severe asthma. This study examined whet... [more] Background and objective: A new taxonomic and management approach, termed treatable traits, has been proposed for airway diseases including severe asthma. This study examined whether treatable traits could be identified using registry data and whether particular treatable traits were associated with future exacerbation risk. Methods: The Australasian Severe Asthma Web-Based Database (SAWD) enrolled 434 participants with severe asthma and a comparison group of 102 participants with non-severe asthma. Published treatable traits were mapped to registry data fields and their prevalence was described. Participants were characterized at baseline and every 6 months for 24 months. Results: In SAWD, 24 treatable traits were identified in three domains: pulmonary, extrapulmonary and behavioural/risk factors. Patients with severe asthma expressed more pulmonary and extrapulmonary treatable traits than non-severe asthma. Allergic sensitization, upper-airway disease, airflow limitation, eosinophilic inflammation and frequent exacerbations were common in severe asthma. Ten traits predicted exacerbation risk; among the strongest were being prone to exacerbations, depression, inhaler device polypharmacy, vocal cord dysfunction and obstructive sleep apnoea. Conclusion: Treatable traits can be assessed using a severe asthma registry. In severe asthma, patients express more treatable traits than non-severe asthma. Traits may be associated with future asthma exacerbation risk demonstrating the clinical utility of assessing treatable traits.
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2019 |
Hiles SA, McDonald VM, Guilhermino M, Brusselle GG, Gibson PG, 'Does maintenance azithromycin reduce asthma exacerbations? An individual participant data meta-analysis.', The European respiratory journal, 54 (2019) [C1]
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2018 |
Hiles SA, Harvey ES, McDonald VM, Peters M, Bardin P, Reynolds PN, et al., 'Working while unwell: Workplace impairment in people with severe asthma', CLINICAL AND EXPERIMENTAL ALLERGY, 48 650-662 (2018) [C1]
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2018 |
Wassink-Vossen S, Collard RM, Penninx BW, Hiles SA, Oude Voshaar RC, Naarding P, 'The reciprocal relationship between physical activity and depression: Does age matter?', European Psychiatry, 51 9-15 (2018) [C1] Background: The level of physical activity (PA) and the prevalence of depression both change across the lifespan. We examined whether the association between PA and depression is ... [more] Background: The level of physical activity (PA) and the prevalence of depression both change across the lifespan. We examined whether the association between PA and depression is moderated by age. As sense of mastery and functional limitations have been previously associated with low PA and depression in older adults, we also examined whether these are determinants of the differential effect of age on PA and depression. Methods: 1079 patients with major depressive disorder (aged 18¿88 years) were followed-up after two-years; depression diagnosis and severity as well as PA were re-assessed. Linear and logistic regression analyses were used to test reciprocal prospective associations between PA and depression outcomes. In all models the interaction with age was tested. Results: PA at baseline predicted remission of depressive disorder at follow-up (OR = 1.43 [95% CI: 1.07¿1.93], p =.018). This effect was not moderated by age. PA predicted improvement of depression symptom severity in younger (B = -2.03; SE =.88; p =.022), but not in older adults (B = 2.24; SE = 1.48; p =.128) (p =.015 for the interaction PA by age in the whole sample). The level of PA was relatively stable over time. Depression, sense of mastery and functional limitation were for all ages not associated with PA at follow-up. Conclusions: Age did not moderate the impact of PA on depressive disorder remission. Only in younger adults, sufficient PA independently predicts improvement of depressive symptom severity after two-year follow-up. Level of PA rarely changed over time, and none of the determinants tested predicted change in PA, independent of age.
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2018 |
McDonald VM, Hiles SA, Jones KA, Clark VL, Yorke J, 'Health-related quality of life burden in severe asthma', MEDICAL JOURNAL OF AUSTRALIA, 209 S28-S33 (2018) [C1]
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2017 |
Hiles SA, Lamers F, Milaneschi Y, Penninx BWJH, 'Sit, step, sweat: Longitudinal associations between physical activity patterns, anxiety and depression', Psychological Medicine, 47 1466-1477 (2017) [C1] Background Physical inactivity has been identified as a risk factor for depression and, less often, as a long-term consequence of depression. Underexplored is whether similar bi-d... [more] Background Physical inactivity has been identified as a risk factor for depression and, less often, as a long-term consequence of depression. Underexplored is whether similar bi-directional longitudinal relationships are observed for anxiety disorders, particularly in relation to three distinct indicators of activity levels - sports participation, general physical activity and sedentary behavior. Method Participants were from the Netherlands Study of Depression and Anxiety (NESDA; N = 2932, 18-65 years old; 57% current anxiety or depressive disorder, 21% remitted disorder, 22% healthy controls). At baseline, 2, 4, and 6 years, participants completed a diagnostic interview and self-report questionnaires assessing psychopathology symptom severity, physical activity indicators, and sociodemographic and health covariates. Results Consistently across assessment waves, people with anxiety and/or depressive disorders had lower sports participation and general physical activity compared to healthy controls. Greater anxiety or depressive symptoms were associated with lower activity according to all three indicators. Over time, a diagnosis or greater symptom severity at one assessment was associated with poorer sports participation and general physical activity 2 years later. In the opposite direction, only low sports participation was associated with greater symptom severity and increased odds of disorder onset 2 years later. Stronger effects were observed for chronicity, with lower activity according to all indicators increasing the odds of disorder chronicity after 2 years. Conclusions Over time, there seems to a mutually reinforcing, bidirectional relationship between psychopathology and lower physical activity, particularly low sports participation. People with anxiety are as adversely affected as those with depression.
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2017 |
Clark VL, Gibson PG, Genn G, Hiles SA, Pavord ID, McDonald VM, 'Multidimensional assessment of severe asthma: A systematic review and meta-analysis', Respirology, 22 1262-1275 (2017) [C1] The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective strategy to manage severe asthma, although it is... [more] The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective strategy to manage severe asthma, although it is supported by few prospective studies. We aimed to systematically review the literature published on MDA in severe asthma, to identify the traits included in MDA and to determine the effect of MDA on asthma-related outcomes. We identified 26 studies and classified these based on study type (cohort/cross-sectional studies; experimental/outcome studies; and severe asthma disease registries). Study type determined the comprehensiveness of the assessment. Assessed traits were classified into three domains (airways, co-morbidities and risk factors). The airway domain had the largest number of traits assessed (mean ± SD = 4.2 ± 1.7) compared with co-morbidities (3.6 ± 2.2) and risk factors (3.9 ± 2.1). Bronchodilator reversibility and airflow limitation were assessed in 92% of studies, whereas airway inflammation was only assessed in 50%. Commonly assessed co-morbidities were psychological dysfunction, sinusitis (both 73%) and gastro-oesophageal reflux disease (GORD; 69%). Atopic and smoking statuses were the most commonly assessed risk factors (85% and 86%, respectively). There were six outcome studies, of which five concluded that MDA is effective at improving asthma-related outcomes. Among these studies, significantly more traits were assessed than treated. MDA studies have assessed a variety of different traits and have shown evidence of improved outcomes. This promising model of care requires more research to inform which traits should be assessed, which traits should be treated and what effect MDA has on patient outcomes.
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2016 |
Hu MX, Lamers F, Hiles SA, Penninx BWJH, de Geus EJC, 'Basal autonomic activity, stress reactivity, and increases in metabolic syndrome components over time', Psychoneuroendocrinology, 71 119-126 (2016) [C1] Context: Basal autonomic nervous system (ANS) functioning has been linked to the metabolic syndrome (MetS), but the role of ANS reactivity in response to stress remains unclear. O... [more] Context: Basal autonomic nervous system (ANS) functioning has been linked to the metabolic syndrome (MetS), but the role of ANS reactivity in response to stress remains unclear. Objective: To examine cross-sectionally and longitudinally to what extent ANS basal level and stress reactivity are related to MetS. Design: 2-year and 6-year data from a prospective cohort: the Netherlands Study of Depression and Anxiety. Setting: Participants were recruited from the general community, primary care, and mental health care organizations. Participants: 1922 respondents (mean age = 43.7 years). Main outcome measures: Indicators of ANS functioning were heart rate (HR), respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). ANS stress reactivity was measured during a cognitively challenging stressor and a personal-emotional stressor. MetS components included triglycerides, high-density lipoprotein cholesterol, blood pressure, glucose and waist circumference. Results: Cross-sectional analyses indicated that higher basal HR, lower basal values of RSA and PEP, and higher RSA reactivity during cognitive challenge were related to less favorable values of almost all individual MetS components. Longitudinal analyses showed that higher basal HR and shorter basal PEP predicted 4-year increase in many MetS abnormalities. Higher RSA stress reactivity during cognitive challenge predicted 4-year increase in number of MetS components. Conclusion: Higher basal sympathetic, lower basal parasympathetic activity, and increased parasympathetic withdrawal during stress are associated with multiple MetS components, and higher basal sympathetic activity predicts an increase in metabolic abnormalities over time. These findings support a role for ANS dysregulation in the risk for MetS and, consequently, the development of cardiovascular disease.
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2016 |
Lai JS, Oldmeadow C, Hure AJ, McEvoy M, Hiles SA, Boyle M, Attia J, 'Inflammation mediates the association between fatty acid intake and depression in older men and women', Nutrition Research, 36 234-245 (2016) [C1] Antioxidants and fatty acids are associated with depression and inflammation, and inflammation appears to predict depression risk; hence, the associations between these nutrients ... [more] Antioxidants and fatty acids are associated with depression and inflammation, and inflammation appears to predict depression risk; hence, the associations between these nutrients and depression may be mediated by inflammation. We hypothesized that inflammatory markers interleukin (IL)-6 and C-reactive protein (CRP) mediate the associations between antioxidant and fatty acid intakes, and depression. Participants were from the Hunter Community Study, a longitudinal cohort of adults aged 55-85 years. Dietary intake was assessed using the Older Australian's Food Frequency Questionnaire. Fasting blood samples were drawn for analysis of nutrient and inflammatory biomarkers. Depressive symptoms were assessed using the 20-item Center for Epidemiologic Studies-Depression scale at baseline and at 5-year follow-up. Linear mixed models were used to investigate longitudinal associations between dietary intakes and depression, and mediation analyses were carried out to determine if IL-6 and/or CRP were the mediators. Analyses were conducted on men and women separately and adjusted for potential confounders. Fruit and monounsaturated fat intakes were negatively associated with depression, whereas total fat and saturated fat intakes were positively associated with depression in both sexes. Omega-3 polyunsaturated fat was inversely associated with depression in men only. IL-6 was a significant mediator of the association between fruits with low carotenoid content and depression in women. CRP significantly mediated the relationship between total fat, saturated fat, and monounsaturated fat intakes and depression in women, and saturated fat intake and depression in men. Our findings raise the possibility that the association between fatty acid intake and depression is partially mediated by inflammatory markers.
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2015 |
Hiles SA, Baker AL, de Malmanche T, McEvoy M, Boyle M, Attia J, 'Unhealthy lifestyle may increase later depression via inflammation in older women but not men', Journal of Psychiatric Research, 63 65-74 (2015) [C1] Depression and inflammatory markers have a reliable cross-sectional association although less is known about the prospective relationship. The current study investigated whether p... [more] Depression and inflammatory markers have a reliable cross-sectional association although less is known about the prospective relationship. The current study investigated whether pro-inflammatory markers are prospectively associated with depression, and whether indicators of unhealthy lifestyle, physical health and psychosocial functioning may drive this association. Participants were drawn from the Hunter Community Study, a community-dwelling cohort of individuals aged 55-85 years (N=1410). Participants completed baseline physiological assessment, health-related questionnaires, and blood sampling for the analysis of inflammatory markers, C-reactive protein (CRP) and interleukin (IL)-6. Participants completed the same depressive symptom questionnaire again after 3.5-5.5 years. Depression outcomes at follow-up were analysed dichotomously using established scale cut-off scores and continuously as a "residual score", representing the variation in follow-up depressive symptoms not explained by baseline symptoms and age. Analyses were conducted on males and females separately. At baseline, indicators of unhealthy lifestyle, physical health and psychosocial functioning were associated with depressive symptoms and inflammatory markers. For males, there were no relationships between inflammatory markers and follow-up depression outcomes. In females, IL-6 was significantly associated with depression outcomes in univariate, but not multivariate analyses. However, IL-6 significantly mediated the association between the predictors of waist-to-hip ratio, smoking and psychological coping at baseline, and follow-up depression outcomes. The results support the inflammatory hypothesis of depression, although females may be more vulnerable to effects. The findings raise the possibility that unhealthy lifestyle and psychosocial stress may drive inflammation and subsequent depressive symptoms.
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2015 |
Hiles S, Bergen H, Hawton K, Lewin T, Whyte I, Carter G, 'General hospital-treated self-poisoning in England and Australia: Comparison of presentation rates, clinical characteristics and aftercare based on sentinel unit data', Journal of Psychosomatic Research, 78 356-362 (2015) [C1] Objective: Hospital-treated deliberate self-poisoning (DSP) is common and the existing national monitoring systems are often deficient. Clinical Practice Guidelines (UK and Austra... [more] Objective: Hospital-treated deliberate self-poisoning (DSP) is common and the existing national monitoring systems are often deficient. Clinical Practice Guidelines (UK and Australia) recommend universal psychosocial assessment within the general hospital as standard care. We compared presentation rates, patient characteristics, psychosocial assessment and aftercare in UK and Australia. Methods: We used a cross sectional design, for a ten year study of all DSP presentations identified through sentinel units in Oxford, UK (n. = 3042) and Newcastle, Australia (n. = 3492). Results: Oxford had higher presentation rates for females (standardised rate ratio 2.4: CI 99% 1.9, 3.2) and males (SRR 2.5: CI 99% 1.7, 3.5). Female to male ratio was 1.6:1, 70% presented after-hours, 95% were admitted to a general hospital and co-ingestion of alcohol occurred in a substantial minority (Oxford 24%, Newcastle 32%). Paracetamol, minor tranquilisers and antidepressants were the commonest drug groups ingested, although the overall pattern differed. Psychosocial assessment rates were high (Oxford 80%, Newcastle 93%). Discharge referral for psychiatric inpatient admission (Oxford 8%, Newcastle 28%), discharge to home (Oxford 80%, Newcastle 70%) and absconding (Oxford 11%, Newcastle 2%) differed between the two units. Conclusions: Oxford has higher age-standardised rates of DSP than Newcastle, although many other characteristics of patients are similar. Services can provide a high level of assessment as recommended in clinical guidelines. There is some variation in after-care. Sentinel service monitoring routine care of DSP patients can provide valuable comparisons between countries.
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2015 |
Hiles SA, Baker AL, de Malmanche T, McEvoy M, Boyle M, Attia J, 'The role of inflammatory markers in explaining the association between depression and cardiovascular hospitalisations', Journal of Behavioral Medicine, 38 609-619 (2015) [C1] This study investigated whether inflammation may explain the relationship between depression and incident cardiovascular hospitalisations. Participants (55¿85¿years) completed bas... [more] This study investigated whether inflammation may explain the relationship between depression and incident cardiovascular hospitalisations. Participants (55¿85¿years) completed baseline depression and physical assessment. Those without self-reported cardiovascular events were followed prospectively for hospital admissions for angina, myocardial infarction and cerebral infarction (median 937¿days). Across 5140 person-years of risk (N¿=¿1692), there were 47 incident cardiovascular hospitalisations (2.8¿%). Controlling for age and gender, interleukin (IL)-6, C-reactive protein (CRP), body mass index (BMI) and waist-to-hip ratio were associated with future cardiovascular events. Mediation analysis showed that CRP accounted for 8.1¿% and IL-6 10.9¿% of the effect of depression on cardiovascular events, and including the indirect effect in the model substantially reduced the direct relationship between depression and cardiovascular hospitalisations. BMI and waist-to-hip ratio accounted for indirect effects of 7.7 and 10.4¿%, respectively. Inflammatory markers partly explain the association between depression and cardiovascular events, although other shared factors also likely contribute.
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2014 |
Lai JS, Hiles S, Bisquera A, Hure AJ, McEvoy M, Attia J, 'A systematic review and meta-analysis of dietary patterns and depression in community-dwelling adults', AMERICAN JOURNAL OF CLINICAL NUTRITION, 99 181-197 (2014) [C1]
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2014 |
Handley TE, Hiles SA, Inder KJ, Kay-Lambkin FJ, Kelly BJ, Lewin TJ, et al., 'Predictors of Suicidal Ideation in Older People: A Decision Tree Analysis', AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY, 22 1325-1335 (2014) [C1]
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2012 |
Baker AL, Hiles SA, Thornton LK, Hides L, Lubman DI, 'A systematic review of psychological interventions for excessive alcohol consumption among people with psychotic disorders', Acta Psychiatrica Scandinavica, 126 243-255 (2012) [C1]
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2012 |
Hiles SA, Baker AL, De Malmanche T, Attia JR, 'Interleukin-6, C-reactive protein and interleukin-10 after antidepressant treatment in people with depression: A meta-analysis', Psychological Medicine, 42 2015-2026 (2012) [C1]
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2012 |
Baker AL, Thornton LK, Hiles SA, Hides L, Lubman DI, 'Psychological interventions for alcohol misuse among people with co-occurring depression or anxiety disorders: A systematic review', Journal of Affective Disorders, 139 217-229 (2012) [C1]
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2012 |
Hiles SA, Baker AL, De Malmanche T, Attia JR, 'A meta-analysis of differences in IL-6 and IL-10 between people with and without depression: Exploring the causes of heterogeneity', Brain, Behavior, and Immunity, 26 1180-1188 (2012) [C1]
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2011 |
Walker AK, Hiles SA, Sominsky Bar L, McLaughlin EA, Hodgson DM, 'Neonatal lipopolysaccharide exposure impairs sexual development and reproductive success in the Wistar rat', Brain, Behavior, and Immunity, 25 674-684 (2011) [C1]
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Show 29 more journal articles |
Conference (16 outputs)
Year | Citation | Altmetrics | Link | ||||
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2020 |
Hiles S, Urroz P, Bogdanovs A, Gibson P, Mcdonald V, 'RANDOMISED CONTROLLED TRIAL OF YOGA AND MINDFULNESS FOR SEVERE ASTHMA', RESPIROLOGY (2020)
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2020 |
Cousins J, Wark P, Hiles S, Wood-Baker R, Yang I, Gibson P, et al., 'ANTIBIOTIC USE IN ACUTE HOSPITALISED COPD PATIENTS', RESPIROLOGY (2020)
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2020 |
Cousins J, Wark P, Hiles S, Mcdonald V, 'CLINICIANS' PERCEIVED BARRIERS AND FACILITATORS TO OPTIMAL ACUTE OXYGEN USE', RESPIROLOGY (2020)
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2013 |
Lai JS, Hiles S, Hure AJ, McEvoy M, Attia J, 'SYSTEMATIC REVIEW AND META-ANALYSIS OF DIETARY PATTERNS AND DEPRESSION: OBSERVATIONAL STUDIES', ANNALS OF NUTRITION AND METABOLISM (2013) [E3]
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Show 13 more conferences |
Grants and Funding
Summary
Number of grants | 13 |
---|---|
Total funding | $317,669 |
Click on a grant title below to expand the full details for that specific grant.
20212 grants / $20,000
2022 Women in Research Fellowship $15,000
Funding body: The University of Newcastle - Research and Innovation Division
Funding body | The University of Newcastle - Research and Innovation Division |
---|---|
Scheme | Women in Research Fellowship |
Role | Lead |
Funding Start | 2021 |
Funding Finish | 2022 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
Understanding Breathlessness in Asthma$5,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Doctor Vanessa Clark, Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Doctor Sarah Hiles, Conjoint Associate Professor Anne Vertigan, Doctor Rebecca McLoughlin |
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2021 |
Funding Finish | 2021 |
GNo | G2100080 |
Type Of Funding | C3300 – Aust Philanthropy |
Category | 3300 |
UON | Y |
20201 grants / $12,162
The causes and impacts of dyspnea in asthma$12,162
Funding body: John Hunter Hospital Charitable Trust
Funding body | John Hunter Hospital Charitable Trust |
---|---|
Project Team | Professor Vanessa McDonald, Conjoint Professor Peter Gibson, Doctor Vanessa Clark, Doctor Sarah Hiles, Conjoint Associate Professor Anne Vertigan |
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2020 |
Funding Finish | 2020 |
GNo | G2000380 |
Type Of Funding | C3200 – Aust Not-for Profit |
Category | 3200 |
UON | Y |
20191 grants / $1,500
Priority Research Centre for Healthy Lungs Travel Grant$1,500
Funding body: PRC For Healthy Lungs, University of Newcastle
Funding body | PRC For Healthy Lungs, University of Newcastle |
---|---|
Project Team | Hiles, S. A. |
Scheme | Travel Grant |
Role | Lead |
Funding Start | 2019 |
Funding Finish | 2019 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
20184 grants / $40,567
Novel activity management in severe asthma - tailored exercise (NAMASTE): yoga and mindfulness$17,307
Funding body: John Hunter Hospital Charitable Trust
Funding body | John Hunter Hospital Charitable Trust |
---|---|
Project Team | Professor Vanessa McDonald, Doctor Sarah Hiles, Conjoint Professor Peter Gibson |
Scheme | Research Grant |
Role | Investigator |
Funding Start | 2018 |
Funding Finish | 2018 |
GNo | G1800318 |
Type Of Funding | C3200 – Aust Not-for Profit |
Category | 3200 |
UON | Y |
HMRI Ignite Equipment Grant - BioRadio Respiratory Inductive Plethysmography$10,000
Funding body: Hunter Medical Research Institute (HMRI)
Funding body | Hunter Medical Research Institute (HMRI) |
---|---|
Project Team | Hiles, S. A., McDonald, V. M. & Vertigan, A. |
Scheme | HMRI Ignite Equipment Grant |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2019 |
GNo | |
Type Of Funding | External |
Category | EXTE |
UON | N |
Jennie Thomas Medical Research Travel Grant$9,960
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Doctor Sarah Hiles |
Scheme | Jennie Thomas Medical Research Travel Grant |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2018 |
GNo | G1800706 |
Type Of Funding | C3300 – Aust Philanthropy |
Category | 3300 |
UON | Y |
Centre of Excellence in Severe Asthma Travel Grant$3,300
Funding body: Centre for Research Excellence in Severe Asthma
Funding body | Centre for Research Excellence in Severe Asthma |
---|---|
Project Team | Hiles, S. A. |
Scheme | Centre for Research Excellence in Severe Asthma: Travel Grant |
Role | Lead |
Funding Start | 2018 |
Funding Finish | 2019 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
20171 grants / $3,300
Centre of Excellence in Severe Asthma Travel Grant$3,300
Funding body: Centre for Research Excellence in Severe Asthma
Funding body | Centre for Research Excellence in Severe Asthma |
---|---|
Project Team | Hiles, S. A. |
Scheme | Centre for Research Excellence in Severe Asthma: Travel Grant |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2018 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
20152 grants / $213,140
Genetic and Lifestyle Origins of Inflammation in Depression – GLOID$196,140
Funding body: European Commission, European Union
Funding body | European Commission, European Union |
---|---|
Project Team | Prof. Brenda WJH Penninx; Dr Sarah A Hiles |
Scheme | Horizon 2020 |
Role | Lead |
Funding Start | 2015 |
Funding Finish | 2016 |
GNo | |
Type Of Funding | International - Competitive |
Category | 3IFA |
UON | N |
Endeavour Research Fellowship$17,000
Funding body: Australian Government Department of Education
Funding body | Australian Government Department of Education |
---|---|
Project Team | Dr Sarah A Hiles |
Scheme | Endeavour Research Fellowship |
Role | Lead |
Funding Start | 2015 |
Funding Finish | 2015 |
GNo | |
Type Of Funding | Aust Competitive - Commonwealth |
Category | 1CS |
UON | N |
20131 grants / $6,000
HMRI PhD Student Travel Award$6,000
Funding body: Hunter Medical Research Institute
Funding body | Hunter Medical Research Institute |
---|---|
Project Team | Doctor Sarah Hiles |
Scheme | Research Grant |
Role | Lead |
Funding Start | 2013 |
Funding Finish | 2013 |
GNo | G1300227 |
Type Of Funding | Contract - Aust Non Government |
Category | 3AFC |
UON | Y |
20101 grants / $21,000
A longitudinal investigation of the temporal relationships between depression and immune functioning in an older Hunter cohort$21,000
Funding body: John Hunter Charitable Trust Grant
Funding body | John Hunter Charitable Trust Grant |
---|---|
Project Team | Dr Sarah A Hiles, Prof Amanda Baker, Dr Michael J Boyle, Dr Theo De Malmanche, Prof Brian Kelly, Prof John Attia |
Scheme | John Hunter Charitable Trust Grant |
Role | Lead |
Funding Start | 2010 |
Funding Finish | 2010 |
GNo | |
Type Of Funding | External |
Category | EXTE |
UON | N |
Research Supervision
Number of supervisions
Past Supervision
Year | Level of Study | Research Title | Program | Supervisor Type |
---|---|---|---|---|
2023 | PhD | Prescription of Acute Oxygen Therapy in Patients at Risk of Type 2 Respiratory Failure | PhD (Nursing), College of Health, Medicine and Wellbeing, The University of Newcastle | Co-Supervisor |
Research Projects
Medication use 2024 -
This project will examine relationships between mood, thinking patterns and medication use. Results will be posted here at the conclusion of the project.
Edit
Research Collaborations
The map is a representation of a researchers co-authorship with collaborators across the globe. The map displays the number of publications against a country, where there is at least one co-author based in that country. Data is sourced from the University of Newcastle research publication management system (NURO) and may not fully represent the authors complete body of work.
Country | Count of Publications | |
---|---|---|
Australia | 38 | |
Netherlands | 14 | |
United Kingdom | 5 | |
Canada | 4 | |
New Zealand | 4 | |
More... |
News
News • 14 Dec 2018
Yoga and mind study aiming to relieve severe asthma
Respiratory researchers at the University of Newcastle and Hunter Medical Research Institute are investigating how yoga and mindfulness classes can improve the quality of life for people with severe asthma.
Dr Sarah Hiles
Position
Lecturer
School of Psychological Sciences
College of Engineering, Science and Environment
Contact Details
sarah.hiles@newcastle.edu.au | |
Phone | (02) 4042 0060 |
Fax | (02) 4042 0046 |
Office
Building | W - Behavioural Sciences Building |
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Location | Callaghan University Drive Callaghan, NSW 2308 Australia |