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Prof. Robyn Lucas
ANU College of Medicine, Biology and Environment, Australian National University

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0 Autoimmune Diseases
0 Climate Change
0 Epidemiology
0 ultraviolet radiation
0 Vitamin D

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Vitamin D
ultraviolet radiation
Climate Change
Autoimmune Diseases
Epidemiology
Environmental effects on immune function

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Journal article
Published: 20 April 2021 in Food Chemistry
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Australia needs accurate vitamin D food composition data to support public health initiatives. Previously, limitations in analytical methodology have precluded development of a comprehensive database. We used liquid chromatography with triple quadrupole mass spectrometry (LC-QQQ) to analyse 149 composite samples representing 98 foods (primary samples n = 896) in duplicate for vitamin D3, 25-hydroxyvitamin D3 (25(OH)D3), vitamin D2, 25(OH)D2. The greatest concentrations of vitamin D3 were found in canned salmon and a malted chocolate drink powder (fortified); chicken eggs and chicken leg meat contained the most 25(OH)D3. Margarine (fortified) and chocolate contained the greatest concentrations of vitamin D2, with smaller amounts found in various meat products. 25(OH)D2 was detected in various foods, including meats, and was quantitated in lamb liver. These data advance knowledge of dietary vitamin D in Australia and highlight the importance of analysis of these four forms of vitamin D to accurately represent the vitamin D content of food.

ACS Style

Eleanor Dunlop; Anthony P. James; Judy Cunningham; Norbert Strobel; Robyn M. Lucas; Mairead Kiely; Caryl A. Nowson; Anna Rangan; Paul Adorno; Paul Atyeo; Lucinda J. Black. Vitamin D composition of Australian foods. Food Chemistry 2021, 358, 129836 .

AMA Style

Eleanor Dunlop, Anthony P. James, Judy Cunningham, Norbert Strobel, Robyn M. Lucas, Mairead Kiely, Caryl A. Nowson, Anna Rangan, Paul Adorno, Paul Atyeo, Lucinda J. Black. Vitamin D composition of Australian foods. Food Chemistry. 2021; 358 ():129836.

Chicago/Turabian Style

Eleanor Dunlop; Anthony P. James; Judy Cunningham; Norbert Strobel; Robyn M. Lucas; Mairead Kiely; Caryl A. Nowson; Anna Rangan; Paul Adorno; Paul Atyeo; Lucinda J. Black. 2021. "Vitamin D composition of Australian foods." Food Chemistry 358, no. : 129836.

Original article
Published: 18 April 2021 in Immunology & Cell Biology
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Brown adipose tissue (BAT) may be an important metabolic regulator of whole‐body glucose. While important roles have been ascribed to macrophages in regulating metabolic functions in BAT, little known is known of the roles of other immune cells subsets, particularly dendritic cells (DCs). Eating a high fat diet may compromise the development of hematopoietic stem and progenitor cells (HSPC) – which give rise to DCs – in bone marrow, with less known of its effects in BAT. We have previously demonstrated that ongoing exposure to low‐dose ultraviolet radiation (UVR) significantly reduced the ‘whitening’ effect of eating a high‐fat diet upon interscapular (i) BAT of mice. Here, we examined whether this observation may be linked to changes in the phenotype of HSPC and myeloid‐derived immune cells in iBAT and bone marrow of mice using 12‐colour flow cytometry. Many HSPC subsets declined in both iBAT and bone marrow with increasing metabolic dysfunction. Conversely, with rising adiposity and metabolic dysfunction, conventional DCs (cDCs) increased in both of these tissues. When compared to low‐fat diet, consumption of high‐fat diet significantly reduced proportions of myeloid, common myeloid and megakaryocyte‐erythrocyte progenitors in iBAT, and short‐term hematopoietic stem cells in bone marrow. In mice fed a high‐fat diet, exposure to low‐dose UVR significantly reduced proportions of cDCs in iBAT, independently of nitric oxide release from irradiated skin (blocked using the scavenger, cPTIO), but did not significantly modify HSPC subsets in either tissue. Further studies are needed to determine whether changes in these cell populations contribute towards metabolic dysfunction.

ACS Style

Kyle T Mincham; Kunjal Panchal; Prue H Hart; Robyn M Lucas; Martin Feelisch; Richard B Weller; Vance B Matthews; Deborah H Strickland; Shelley Gorman. Metabolic dysfunction induced by a high‐fat diet modulates hematopoietic stem and myeloid progenitor cells in brown adipose tissue of mice. Immunology & Cell Biology 2021, 1 .

AMA Style

Kyle T Mincham, Kunjal Panchal, Prue H Hart, Robyn M Lucas, Martin Feelisch, Richard B Weller, Vance B Matthews, Deborah H Strickland, Shelley Gorman. Metabolic dysfunction induced by a high‐fat diet modulates hematopoietic stem and myeloid progenitor cells in brown adipose tissue of mice. Immunology & Cell Biology. 2021; ():1.

Chicago/Turabian Style

Kyle T Mincham; Kunjal Panchal; Prue H Hart; Robyn M Lucas; Martin Feelisch; Richard B Weller; Vance B Matthews; Deborah H Strickland; Shelley Gorman. 2021. "Metabolic dysfunction induced by a high‐fat diet modulates hematopoietic stem and myeloid progenitor cells in brown adipose tissue of mice." Immunology & Cell Biology , no. : 1.

Preprint content
Published: 02 March 2021
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Brown adipose tissue (BAT) may be an important metabolic regulator of whole-body glucose. While important roles have been ascribed to macrophages in regulating metabolic functions in BAT, little known is known of the roles of other immune cells subsets, particularly dendritic cells (DCs). Eating a high fat diet may compromise the development of hematopoietic stem and progenitor cells (HSPC) – which give rise to DCs – in bone marrow, with less known of its effects in BAT. We have previously demonstrated that ongoing exposure to low-dose ultraviolet radiation (UVR) significantly reduced the ‘whitening’ effect of eating a high-fat diet upon interscapular (i)BAT of mice. Here, we examined whether this observation may be linked to changes in the phenotype of HSPC and myeloid-derived immune cells in iBAT and bone marrow of mice using 12-colour flow cytometry. Many HSPC subsets declined in both iBAT and bone marrow with increasing metabolic dysfunction. Conversely, with rising adiposity and metabolic dysfunction, conventional (c)DCs increased in both of these tissues. When compared to low-fat diet, consumption of high-fat diet significantly reduced proportions of myeloid, common myeloid and megakaryocyte-erythrocyte progenitors in iBAT, and short-term hematopoietic stem cells in bone marrow. In mice fed a high-fat diet, exposure to low-dose UVR significantly reduced proportions of cDCs in iBAT, independently of nitric oxide release from irradiated skin (blocked using the scavenger, cPTIO), but did not significantly modify HSPC subsets in either tissue. Further studies are needed to determine whether changes in these cell populations contribute towards metabolic dysfunction.

ACS Style

Kyle T Mincham; Kunjal Panchal; Prue H Hart; Robyn M Lucas; Martin Feelisch; Richard B Weller; Vance B Matthews; Deborah H Strickland; Shelley Gorman. Metabolic dysfunction induced by high-fat diet modulates hematopoietic stem and myeloid progenitor cells in brown adipose tissue of mice. 2021, 1 .

AMA Style

Kyle T Mincham, Kunjal Panchal, Prue H Hart, Robyn M Lucas, Martin Feelisch, Richard B Weller, Vance B Matthews, Deborah H Strickland, Shelley Gorman. Metabolic dysfunction induced by high-fat diet modulates hematopoietic stem and myeloid progenitor cells in brown adipose tissue of mice. . 2021; ():1.

Chicago/Turabian Style

Kyle T Mincham; Kunjal Panchal; Prue H Hart; Robyn M Lucas; Martin Feelisch; Richard B Weller; Vance B Matthews; Deborah H Strickland; Shelley Gorman. 2021. "Metabolic dysfunction induced by high-fat diet modulates hematopoietic stem and myeloid progenitor cells in brown adipose tissue of mice." , no. : 1.

Journal article
Published: 01 March 2021 in European Journal of Clinical Nutrition
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Vitamin D deficiency is a public health concern worldwide. Maintaining vitamin D sufficiency during growth periods is essential. We aimed to determine the prevalence and predictors of vitamin D deficiency in Australian adolescents and young adults. We used data from adolescents (12–17 years, n = 692) and young adults (18–24 years, n = 400) who participated in the nationally representative 2011–2013 Australian Health Survey. Serum 25-hydroxyvitamin D concentrations were measured using a method certified to international standards, with prevalence reported for 125 nmol/L. Independent predictors of vitamin D deficiency were determined using a survey-weighted Poisson regression model. Overall, 17% of adolescents and 32% of young adults were vitamin D deficient. In models adjusted for sex, age, region of birth, socioeconomic status, BMI and season (and education, smoking status and physical activity in young adults only), the prevalence ratio (PR) for vitamin D deficiency was more than double in participants born outside Australia (adolescents: PR 2.46; 95% confidence interval (CI) = 1.59, 3.81; young adults: PR 2.12; 95% CI = 1.46, 3.07), and also varied by season (adolescents: spring vs summer PR 2.47; 95% CI = 1.22, 5.01 and winter vs summer PR 2.01; 95% CI = 1.03, 3.92; young adults: winter vs summer; PR 3.32; 95% CI = 1.69, 6.53). Other predictors of vitamin D deficiency were overweight compared with healthy weight (adolescents) and lower physical activity (young adults). Strategies based on safe sun exposure and dietary approaches are needed to achieve and maintain adequate vitamin D status, particularly in young adults.

ACS Style

Kahlea Horton-French; Eleanor Dunlop; Robyn M. Lucas; Gavin Pereira; Lucinda J. Black. Prevalence and predictors of vitamin D deficiency in a nationally representative sample of Australian adolescents and young adults. European Journal of Clinical Nutrition 2021, 1 -10.

AMA Style

Kahlea Horton-French, Eleanor Dunlop, Robyn M. Lucas, Gavin Pereira, Lucinda J. Black. Prevalence and predictors of vitamin D deficiency in a nationally representative sample of Australian adolescents and young adults. European Journal of Clinical Nutrition. 2021; ():1-10.

Chicago/Turabian Style

Kahlea Horton-French; Eleanor Dunlop; Robyn M. Lucas; Gavin Pereira; Lucinda J. Black. 2021. "Prevalence and predictors of vitamin D deficiency in a nationally representative sample of Australian adolescents and young adults." European Journal of Clinical Nutrition , no. : 1-10.

Perspectives
Published: 20 January 2021 in Photochemical & Photobiological Sciences
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This assessment by the Environmental Effects Assessment Panel (EEAP) of the United Nations Environment Programme (UNEP) provides the latest scientific update since our most recent comprehensive assessment (Photochemical and Photobiological Sciences, 2019, 18, 595–828). The interactive effects between the stratospheric ozone layer, solar ultraviolet (UV) radiation, and climate change are presented within the framework of the Montreal Protocol and the United Nations Sustainable Development Goals. We address how these global environmental changes affect the atmosphere and air quality; human health; terrestrial and aquatic ecosystems; biogeochemical cycles; and materials used in outdoor construction, solar energy technologies, and fabrics. In many cases, there is a growing influence from changes in seasonality and extreme events due to climate change. Additionally, we assess the transmission and environmental effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is responsible for the COVID-19 pandemic, in the context of linkages with solar UV radiation and the Montreal Protocol.

ACS Style

R. E. Neale; P. W. Barnes; T. M. Robson; P. J. Neale; C. E. Williamson; R. G. Zepp; S. R. Wilson; S. Madronich; A. L. Andrady; A. M. Heikkilä; G. H. Bernhard; A. F. Bais; P. J. Aucamp; A. T. Banaszak; J. F. Bornman; L. S. Bruckman; S. N. Byrne; B. Foereid; D.-P. Häder; L. M. Hollestein; W.-C. Hou; S. Hylander; M. A. K. Jansen; A. R. Klekociuk; J. B. Liley; J. Longstreth; R. M. Lucas; J. Martinez-Abaigar; K. McNeill; C. M. Olsen; K. K. Pandey; L. E. Rhodes; S. A. Robinson; K. C. Rose; T. Schikowski; K. R. Solomon; B. Sulzberger; J. E. Ukpebor; Q.-W. Wang; S.-Å. Wängberg; C. C. White; S. Yazar; A. R. Young; P. J. Young; L. Zhu; M. Zhu. Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2020. Photochemical & Photobiological Sciences 2021, 20, 1 -67.

AMA Style

R. E. Neale, P. W. Barnes, T. M. Robson, P. J. Neale, C. E. Williamson, R. G. Zepp, S. R. Wilson, S. Madronich, A. L. Andrady, A. M. Heikkilä, G. H. Bernhard, A. F. Bais, P. J. Aucamp, A. T. Banaszak, J. F. Bornman, L. S. Bruckman, S. N. Byrne, B. Foereid, D.-P. Häder, L. M. Hollestein, W.-C. Hou, S. Hylander, M. A. K. Jansen, A. R. Klekociuk, J. B. Liley, J. Longstreth, R. M. Lucas, J. Martinez-Abaigar, K. McNeill, C. M. Olsen, K. K. Pandey, L. E. Rhodes, S. A. Robinson, K. C. Rose, T. Schikowski, K. R. Solomon, B. Sulzberger, J. E. Ukpebor, Q.-W. Wang, S.-Å. Wängberg, C. C. White, S. Yazar, A. R. Young, P. J. Young, L. Zhu, M. Zhu. Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2020. Photochemical & Photobiological Sciences. 2021; 20 (1):1-67.

Chicago/Turabian Style

R. E. Neale; P. W. Barnes; T. M. Robson; P. J. Neale; C. E. Williamson; R. G. Zepp; S. R. Wilson; S. Madronich; A. L. Andrady; A. M. Heikkilä; G. H. Bernhard; A. F. Bais; P. J. Aucamp; A. T. Banaszak; J. F. Bornman; L. S. Bruckman; S. N. Byrne; B. Foereid; D.-P. Häder; L. M. Hollestein; W.-C. Hou; S. Hylander; M. A. K. Jansen; A. R. Klekociuk; J. B. Liley; J. Longstreth; R. M. Lucas; J. Martinez-Abaigar; K. McNeill; C. M. Olsen; K. K. Pandey; L. E. Rhodes; S. A. Robinson; K. C. Rose; T. Schikowski; K. R. Solomon; B. Sulzberger; J. E. Ukpebor; Q.-W. Wang; S.-Å. Wängberg; C. C. White; S. Yazar; A. R. Young; P. J. Young; L. Zhu; M. Zhu. 2021. "Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2020." Photochemical & Photobiological Sciences 20, no. 1: 1-67.

Original article
Published: 10 January 2021 in Acta Ophthalmologica
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Purpose To investigate the relationship between time spent outdoors, at particular ages in childhood and adolescence, and myopia status in young adulthood using serum 25‐hydroxyvitamin D [25(OH)D] concentration as a biomarker of time spent outdoors. Methods Participants of the Raine Study Generation 2 cohort had 25(OH)D concentrations measured at the 6‐, 14‐, 17‐ and 20‐year follow‐ups. Participants underwent cycloplegic autorefraction at age 20 years, and myopia was defined as a mean spherical equivalent −0.50 dioptres or more myopic. Logistic regression was used to analyse the association between risk of myopia at age 20 years and age‐specific 25(OH)D concentrations. Linear mixed‐effects models were used to analyse trajectory of 25(OH)D concentrations from 6 to 20 years. Results After adjusting for sex, race, parental myopia, body mass index and studying status, myopia at 20 years was associated with lower 25(OH)D concentration at 20 years (per 10 nmol/L decrease, odds ratio (aOR)=1.10, 95% CI: 1.02, 1.18) and a low vitamin D status [25(OH)D < 50 nmol/L] at 17 years (aOR = 1.71, 95% CI: 1.06, 2.76) and 20 years (aOR = 1.71, 95% CI: 1.14, 2.56), compared to those without low vitamin D status. There were no associations between 25(OH)D at younger ages and myopia. Individuals who were myopic at 20 years had a 25(OH)D concentration trajectory that declined, relative to non‐myopic peers, with increasing age. Differences in 25(OH)D trajectory between individuals with and without myopia were greater among non‐Caucasians compared to Caucasians. Conclusions Myopia in young adulthood was most strongly associated with recent 25(OH)D concentrations, a marker of time spent outdoors.

ACS Style

Gareth Lingham; David A. Mackey; Kun Zhu; Robyn M. Lucas; Lucinda J. Black; Wendy H. Oddy; Patrick Holt; John P. Walsh; Paul G. Sanfilippo; Wendy Chan She Ping‐Delfos; Seyhan Yazar. Time spent outdoors through childhood and adolescence – assessed by 25‐hydroxyvitamin D concentration – and risk of myopia at 20 years. Acta Ophthalmologica 2021, 1 .

AMA Style

Gareth Lingham, David A. Mackey, Kun Zhu, Robyn M. Lucas, Lucinda J. Black, Wendy H. Oddy, Patrick Holt, John P. Walsh, Paul G. Sanfilippo, Wendy Chan She Ping‐Delfos, Seyhan Yazar. Time spent outdoors through childhood and adolescence – assessed by 25‐hydroxyvitamin D concentration – and risk of myopia at 20 years. Acta Ophthalmologica. 2021; ():1.

Chicago/Turabian Style

Gareth Lingham; David A. Mackey; Kun Zhu; Robyn M. Lucas; Lucinda J. Black; Wendy H. Oddy; Patrick Holt; John P. Walsh; Paul G. Sanfilippo; Wendy Chan She Ping‐Delfos; Seyhan Yazar. 2021. "Time spent outdoors through childhood and adolescence – assessed by 25‐hydroxyvitamin D concentration – and risk of myopia at 20 years." Acta Ophthalmologica , no. : 1.

Review
Published: 18 September 2020
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To review evidence relevant to Australia and similar high-income countries regarding continuing smokers’ motivation, dependence and quitting behaviour as smoking prevalence declines, to assess whether population “hardening” (decreasing propensity to quit) or “softening” (the converse) is occurring. MEDLINE, PsychINFO, Scopus, Web of Science and Cochrane Library were searched to July 2019, using terms related to smoking and hardening, for reviews and large, population-based repeat cross-sectional studies. There were additional searches of reference lists and citations of key research articles. Two reviewers screened half the titles and abstracts each, and two reviewers screened all full texts independently using tested criteria. Four reviewers independently and systematically extracted data from eligible publications, with one reviewer per study, checked by another reviewer. Of 265 titles identified, three reviews and ten repeat cross-sectional studies (not included in the reviews) were included. All three reviews concluded that hardening has not occurred among the general smoking population over time. Of the ten repeated cross-sectional studies, five examined motivation, nine examined dependence, five examined hardcore smoking, and two examined quit outcomes over time. All found a lack of hardening and most found softening within the smoking population, consistent across hardening indicators, definitions, countries (and tobacco control environments) and time periods examined. Declining smoking prevalence has been accompanied by softening within the population of smokers, characterised by increasing motivation to quit and reduced dependency. Based on the weight of the available evidence from high-income countries, the “hardening hypothesis” should be rejected.

ACS Style

Miranda Harris; Melonie Martin; Amelia Yazidjoglou; Laura Ford; Robyn M Lucas; Emily Banks. Review of evidence regarding attributes and behaviours of smokers as smoking prevalence falls, including evidence relevant to the ‘hardening hypothesis’. 2020, 1 .

AMA Style

Miranda Harris, Melonie Martin, Amelia Yazidjoglou, Laura Ford, Robyn M Lucas, Emily Banks. Review of evidence regarding attributes and behaviours of smokers as smoking prevalence falls, including evidence relevant to the ‘hardening hypothesis’. . 2020; ():1.

Chicago/Turabian Style

Miranda Harris; Melonie Martin; Amelia Yazidjoglou; Laura Ford; Robyn M Lucas; Emily Banks. 2020. "Review of evidence regarding attributes and behaviours of smokers as smoking prevalence falls, including evidence relevant to the ‘hardening hypothesis’." , no. : 1.

Journal article
Published: 24 May 2020 in BMC Medical Research Methodology
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Background Recent changes in communication technologies, including increased reliance on mobile phones and the internet, may present challenges and/or opportunities to re-engaging inactive study cohorts. We evaluate our ability to recruit participants for the Kidskin Young Adult Myopia Study (KYAMS), a follow-up of the Kidskin Study. Methods KYAMS participants were recruited from the Kidskin Study, a sun exposure-intervention study for 5–6 year-olds running from 1995 to 1999 with most recent follow-up in 2005. From 2015 to 2019, the KYAMS used mail-outs, phone calls and social media to contact Kidskin Study participants. Multivariable logistic regression was used to identify variables associated with successful contact of a Kidskin Study participant or family member and KYAMS participation. Results Of 1695 eligible participants, 599 (35.5%) participants (or a family member) were contacted and 303 (17.9%) participated in the KYAMS. KYAMS participation was more likely in those who participated in the 2005 follow-up (odds ratio [OR] = 5.09, 95% confidence interval [CI]: 3.67–7.06) and had a mobile phone number on record (OR = 2.25, CI: 1.57–3.23). Of those contacted, participants who were the first point of contact (OR = 4.84, CI: 2.89–8.10) and who were contacted by letter in the first (OR = 6.53, CI: 3.35–12.75) or second (OR = 5.77, CI: 2.85–11.67) round were more likely to participate in the KYAMS, compared to contact by landline phone. Conclusions We recruited approximately one-fifth of Kidskin Study participants for the KYAMS. Participants were more likely to participate in the KYAMS if they were contacted directly, rather than through a family member, and if they were contacted by invitation letter. Trial registration ACTRN12617000812392.

ACS Style

Gareth Lingham; David A. Mackey; Nicola Seed; Lisa Ryan; Elizabeth Milne; Robyn M. Lucas; Maria Franchina; Samantha Sze-Yee Lee; Seyhan Yazar. Re-engaging an inactive cohort of young adults: evaluating recruitment for the Kidskin Young Adult Myopia Study. BMC Medical Research Methodology 2020, 20, 1 -9.

AMA Style

Gareth Lingham, David A. Mackey, Nicola Seed, Lisa Ryan, Elizabeth Milne, Robyn M. Lucas, Maria Franchina, Samantha Sze-Yee Lee, Seyhan Yazar. Re-engaging an inactive cohort of young adults: evaluating recruitment for the Kidskin Young Adult Myopia Study. BMC Medical Research Methodology. 2020; 20 (1):1-9.

Chicago/Turabian Style

Gareth Lingham; David A. Mackey; Nicola Seed; Lisa Ryan; Elizabeth Milne; Robyn M. Lucas; Maria Franchina; Samantha Sze-Yee Lee; Seyhan Yazar. 2020. "Re-engaging an inactive cohort of young adults: evaluating recruitment for the Kidskin Young Adult Myopia Study." BMC Medical Research Methodology 20, no. 1: 1-9.

Perspective
Published: 04 May 2020 in Photochemical & Photobiological Sciences
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This assessment provides an update of the interactive effects of solar ultraviolet (UV) radiation, stratospheric ozone, and climate change on human health, terrestrial and aquatic ecosystems, biochemical cycles, air quality, and material damage.

ACS Style

G. H. Bernhard; R. E. Neale; P. W. Barnes; P. J. Neale; R. G. Zepp; S. R. Wilson; A. L. Andrady; A. F. Bais; R. L. McKenzie; P. J. Aucamp; P. J. Young; J. B. Liley; R. M. Lucas; S. Yazar; L. E. Rhodes; S. N. Byrne; L. M. Hollestein; C. M. Olsen; A. R. Young; T. M. Robson; J. F. Bornman; M. A. K. Jansen; S. A. Robinson; C. L. Ballaré; C. E. Williamson; K. C. Rose; A. T. Banaszak; D.-P. Häder; S. Hylander; S.-Å. Wängberg; A. T. Austin; W.-C. Hou; N. D. Paul; S. Madronich; B. Sulzberger; K. R. Solomon; H. Li; T. Schikowski; J. Longstreth; K. K. Pandey; A. M. Heikkilä; C. C. White. Environmental effects of stratospheric ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2019. Photochemical & Photobiological Sciences 2020, 19, 542 -584.

AMA Style

G. H. Bernhard, R. E. Neale, P. W. Barnes, P. J. Neale, R. G. Zepp, S. R. Wilson, A. L. Andrady, A. F. Bais, R. L. McKenzie, P. J. Aucamp, P. J. Young, J. B. Liley, R. M. Lucas, S. Yazar, L. E. Rhodes, S. N. Byrne, L. M. Hollestein, C. M. Olsen, A. R. Young, T. M. Robson, J. F. Bornman, M. A. K. Jansen, S. A. Robinson, C. L. Ballaré, C. E. Williamson, K. C. Rose, A. T. Banaszak, D.-P. Häder, S. Hylander, S.-Å. Wängberg, A. T. Austin, W.-C. Hou, N. D. Paul, S. Madronich, B. Sulzberger, K. R. Solomon, H. Li, T. Schikowski, J. Longstreth, K. K. Pandey, A. M. Heikkilä, C. C. White. Environmental effects of stratospheric ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2019. Photochemical & Photobiological Sciences. 2020; 19 (5):542-584.

Chicago/Turabian Style

G. H. Bernhard; R. E. Neale; P. W. Barnes; P. J. Neale; R. G. Zepp; S. R. Wilson; A. L. Andrady; A. F. Bais; R. L. McKenzie; P. J. Aucamp; P. J. Young; J. B. Liley; R. M. Lucas; S. Yazar; L. E. Rhodes; S. N. Byrne; L. M. Hollestein; C. M. Olsen; A. R. Young; T. M. Robson; J. F. Bornman; M. A. K. Jansen; S. A. Robinson; C. L. Ballaré; C. E. Williamson; K. C. Rose; A. T. Banaszak; D.-P. Häder; S. Hylander; S.-Å. Wängberg; A. T. Austin; W.-C. Hou; N. D. Paul; S. Madronich; B. Sulzberger; K. R. Solomon; H. Li; T. Schikowski; J. Longstreth; K. K. Pandey; A. M. Heikkilä; C. C. White. 2020. "Environmental effects of stratospheric ozone depletion, UV radiation and interactions with climate change: UNEP Environmental Effects Assessment Panel, update 2019." Photochemical & Photobiological Sciences 19, no. 5: 542-584.

Dataset
Published: 20 March 2020 in Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature
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Read the full review for this F1000Prime recommended article: Social support networks and the crisis of bereavement.

ACS Style

Robyn Lucas; Walker Kn; MacBride A; Vachon Ml. Faculty Opinions recommendation of Social support networks and the crisis of bereavement. Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature 2020, 11, 1 .

AMA Style

Robyn Lucas, Walker Kn, MacBride A, Vachon Ml. Faculty Opinions recommendation of Social support networks and the crisis of bereavement. Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature. 2020; 11 (1):1.

Chicago/Turabian Style

Robyn Lucas; Walker Kn; MacBride A; Vachon Ml. 2020. "Faculty Opinions recommendation of Social support networks and the crisis of bereavement." Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature 11, no. 1: 1.

Journal article
Published: 17 March 2020 in Multiple Sclerosis and Related Disorders
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Background The association between childhood vaccinations and infections and risk of multiple sclerosis is unclear; few studies have considered age at vaccination/infection. Objective To explore age-related associations between childhood vaccinations, infection and tonsillectomy and risk of a first clinical diagnosis of CNS demyelination. Methods Data on case (n = 275, 76.6% female; mean age 38.6 years) and age- and sex-matched control (n = 529) participants in an incident population-based case-control study included self-reported age at time of childhood vaccinations, infections, and tonsillectomy. Conditional logistic regression models were used to calculate adjusted odds ratios (AOR) and 95% confidence intervals (CI). Results Poliomyelitis vaccination prior to school-age was associated with increased risk of a first clinical diagnosis of CNS demyelination (AOR = 2.60, 95%CI 1.02–6.68), based on a very small unvaccinated reference group. Late (11–15 years) rubella vaccination (compared to none) was associated with lower odds of being a case (AOR = 0.47, 95%CI 0.27–0.83). Past infectious mononucleosis at 11–15 years (AOR = 2.84, 95%CI 1.0–7.57) and 16–20 years (AOR = 1.92, 95%CI 1.12–3.27) or tonsillectomy in adolescence (11–15 years: AOR = 2.45, 95%CI 1.12–5.35), including after adjustment for IM, were associated with increased risk of a first clinical diagnosis of CNS demyelination. Conclusions Age at vaccination, infection or tonsillectomy may alter the risk of subsequent CNS demyelination. Failing to account for age effects may explain inconsistencies in past findings.

ACS Style

A.M. Hughes; A.-L. Ponsonby; K. Dear; T. Dwyer; B.V. Taylor; I. van der Mei; P.C. Valery; R.M. Lucas. Childhood infections, vaccinations, and tonsillectomy and risk of first clinical diagnosis of CNS demyelination in the Ausimmune Study. Multiple Sclerosis and Related Disorders 2020, 42, 102062 .

AMA Style

A.M. Hughes, A.-L. Ponsonby, K. Dear, T. Dwyer, B.V. Taylor, I. van der Mei, P.C. Valery, R.M. Lucas. Childhood infections, vaccinations, and tonsillectomy and risk of first clinical diagnosis of CNS demyelination in the Ausimmune Study. Multiple Sclerosis and Related Disorders. 2020; 42 ():102062.

Chicago/Turabian Style

A.M. Hughes; A.-L. Ponsonby; K. Dear; T. Dwyer; B.V. Taylor; I. van der Mei; P.C. Valery; R.M. Lucas. 2020. "Childhood infections, vaccinations, and tonsillectomy and risk of first clinical diagnosis of CNS demyelination in the Ausimmune Study." Multiple Sclerosis and Related Disorders 42, no. : 102062.

Ophthalmology
Published: 09 March 2020 in BMJ Open
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IntroductionEye diseases and visual impairment more commonly affect elderly adults, thus, the majority of ophthalmic cohort studies have focused on older adults. Cohort studies on the ocular health of younger adults, on the other hand, have been few. The Raine Study is a longitudinal study that has been following a cohort since their birth in 1989–1991. As part of the 20-year follow-up of the Raine Study, participants underwent a comprehensive eye examination. As part of the 27- and 28-year follow-ups, eye assessments are being conducted and the data collected will be compared with those of the 20-year follow-up. This will provide an estimate of population incidence and updated prevalence of ocular conditions such as myopia and keratoconus, as well as longitudinal change in ocular parameters in young Australian adults. Additionally, the data will allow exploration of the environmental, health and genetic factors underlying inter-subject differential long-term ocular changes.Methods and analysisParticipants are being contacted via telephone, email and/or social media and invited to participate in the eye examination. At the 27-year follow-up, participants completed a follow-up eye screening, which assessed visual acuity, autorefraction, ocular biometry and ocular sun exposure. Currently, at the 28-year follow-up, a comprehensive eye examination is being conducted which, in addition to all the eye tests performed at the 27-year follow-up visit, includes tonometry, optical coherence tomography, funduscopy and anterior segment topography, among others. Outcome measures include the incidence of refractive error and pterygium, an updated prevalence of these conditions, and the 8-year change in ocular parameters.Ethics and disseminationThe Raine Study is registered in the Australian New Zealand Clinical Trials Registry. The Gen2 20-year, 27-year and 28-year follow-ups are approved by the Human Research Ethics Committee of the University of Western Australia. Findings resulting from the study will be published in health or medical journals and presented at conferences.Trial registration numberACTRN12617001599369; Active, not recruiting.

ACS Style

Samantha Sze-Yee Lee; Gareth Lingham; Seyhan Yazar; Paul Sanfilippo; Jason Charng; Fred Chen; Alex W Hewitt; Fletcher Ng; Christopher Hammond; Leon M Straker; Peter Eastwood; Stuart MacGregor; Kathryn A Rose; Robyn M Lucas; Jeremy A Guggenheim; Seang-Mei Saw; Minas T Coroneo; Mingguang He; David A Mackey. Rationale and protocol for the 7- and 8-year longitudinal assessments of eye health in a cohort of young adults in the Raine Study. BMJ Open 2020, 10, e033440 .

AMA Style

Samantha Sze-Yee Lee, Gareth Lingham, Seyhan Yazar, Paul Sanfilippo, Jason Charng, Fred Chen, Alex W Hewitt, Fletcher Ng, Christopher Hammond, Leon M Straker, Peter Eastwood, Stuart MacGregor, Kathryn A Rose, Robyn M Lucas, Jeremy A Guggenheim, Seang-Mei Saw, Minas T Coroneo, Mingguang He, David A Mackey. Rationale and protocol for the 7- and 8-year longitudinal assessments of eye health in a cohort of young adults in the Raine Study. BMJ Open. 2020; 10 (3):e033440.

Chicago/Turabian Style

Samantha Sze-Yee Lee; Gareth Lingham; Seyhan Yazar; Paul Sanfilippo; Jason Charng; Fred Chen; Alex W Hewitt; Fletcher Ng; Christopher Hammond; Leon M Straker; Peter Eastwood; Stuart MacGregor; Kathryn A Rose; Robyn M Lucas; Jeremy A Guggenheim; Seang-Mei Saw; Minas T Coroneo; Mingguang He; David A Mackey. 2020. "Rationale and protocol for the 7- and 8-year longitudinal assessments of eye health in a cohort of young adults in the Raine Study." BMJ Open 10, no. 3: e033440.

Journal article
Published: 11 February 2020 in International Journal of Environmental Research and Public Health
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The aim of this pilot study was to assess whether the installation of ultraviolet radiation (UVR) meters in secondary schools has the potential to improve adolescents’ sun protection-related knowledge, attitudes, and behaviours and reduce their exposure to UVR during school hours. Data were collected from students at two schools via online pre- and post-intervention surveys, measurement of sunscreen usage, polysulfone UVR exposure badges, and photographs of the schoolyards to assess hat and shade use. Several operational issues limited the quantity and quality of data that could be collected, and findings were mixed. While there were no significant changes in either self-reported or observed sun protection behaviours, there were significant improvements in UVR knowledge among students at the intervention school, and reactions to the meter were highly favourable. Students reported consulting the meter regularly and using it to make decisions about their sun protection behaviours. Overall, the study results offer some support for the use of UVR meters in areas frequented by adolescents and provide insights into the process issues that are likely to need to be addressed when attempting to trial sun protection interventions in schools.

ACS Style

Simone Pettigrew; Ashleigh Parnell; Mark Strickland; Rachel Neale; Robyn Lucas. The Potential of Ultraviolet Radiation Meters in Secondary Schools as a Sun Protection Intervention Mechanism for Adolescents. International Journal of Environmental Research and Public Health 2020, 17, 1137 .

AMA Style

Simone Pettigrew, Ashleigh Parnell, Mark Strickland, Rachel Neale, Robyn Lucas. The Potential of Ultraviolet Radiation Meters in Secondary Schools as a Sun Protection Intervention Mechanism for Adolescents. International Journal of Environmental Research and Public Health. 2020; 17 (4):1137.

Chicago/Turabian Style

Simone Pettigrew; Ashleigh Parnell; Mark Strickland; Rachel Neale; Robyn Lucas. 2020. "The Potential of Ultraviolet Radiation Meters in Secondary Schools as a Sun Protection Intervention Mechanism for Adolescents." International Journal of Environmental Research and Public Health 17, no. 4: 1137.

Paper
Published: 22 January 2020 in Photochemical & Photobiological Sciences
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Sun exposure impacts health, but measurement is difficult. Compared to parents’ reports of sun exposure during childhood, young adults’ recall of childhood sun-related behaviours was of limited value.

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Gareth Lingham; Elizabeth Milne; Seyhan Yazar; David A. Mackey; Donna Cross; Robyn M. Lucas. Recalling our day in the sun: comparing long-term recall of childhood sun exposure with prospectively collected parent-reported data. Photochemical & Photobiological Sciences 2020, 19, 382 -389.

AMA Style

Gareth Lingham, Elizabeth Milne, Seyhan Yazar, David A. Mackey, Donna Cross, Robyn M. Lucas. Recalling our day in the sun: comparing long-term recall of childhood sun exposure with prospectively collected parent-reported data. Photochemical & Photobiological Sciences. 2020; 19 (3):382-389.

Chicago/Turabian Style

Gareth Lingham; Elizabeth Milne; Seyhan Yazar; David A. Mackey; Donna Cross; Robyn M. Lucas. 2020. "Recalling our day in the sun: comparing long-term recall of childhood sun exposure with prospectively collected parent-reported data." Photochemical & Photobiological Sciences 19, no. 3: 382-389.

Journal article
Published: 09 December 2019 in Multiple Sclerosis and Related Disorders
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BackgroundObesity is common in the United States and is associated with a higher risk of relapse and comorbidities, and increased disease progression, in people with MS.MethodsWe examined the prevalence of overweight and obesity in the MS Sunshine Study, a matched case-control study of multiple sclerosis in Southern California (470 cases, 519 controls). We reported the proportion of participants who adopted a specific diet for nutrition or weight loss purposes, and identified independent predictors of dieting.ResultsIn the total population, 32% and 37% were overweight and obese, respectively. Case participants were no more likely to adopt a specific diet for nutrition or weight loss purposes than control participants (10% and 11%, respectively). Being obese, younger, female or non-Hispanic were independently associated with dieting.ConclusionDespite the evidence that obesity can worsen MS prognosis, and the high prevalence of overweight/obesity, case participants were no more likely to adopt a specific diet than control participants. Improved nutrition education may help people with MS make healthy dietary changes for nutrition or weight loss purposes.

ACS Style

R.D. Russell; A. Langer-Gould; E.G. Gonzales; J.B. Smith; V. Brennan; G. Pereira; R.M. Lucas; A. Begley; Lucinda Black. Obesity, dieting, and multiple sclerosis. Multiple Sclerosis and Related Disorders 2019, 39, 101889 .

AMA Style

R.D. Russell, A. Langer-Gould, E.G. Gonzales, J.B. Smith, V. Brennan, G. Pereira, R.M. Lucas, A. Begley, Lucinda Black. Obesity, dieting, and multiple sclerosis. Multiple Sclerosis and Related Disorders. 2019; 39 ():101889.

Chicago/Turabian Style

R.D. Russell; A. Langer-Gould; E.G. Gonzales; J.B. Smith; V. Brennan; G. Pereira; R.M. Lucas; A. Begley; Lucinda Black. 2019. "Obesity, dieting, and multiple sclerosis." Multiple Sclerosis and Related Disorders 39, no. : 101889.

Review
Published: 13 November 2019 in British Journal of Ophthalmology
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Myopia is an increasingly common condition that is associated with significant costs to individuals and society. Moreover, myopia is associated with increased risk of glaucoma, retinal detachment and myopic maculopathy, which in turn can lead to blindness. It is now well established that spending more time outdoors during childhood lowers the risk of developing myopia and may delay progression of myopia. There has been great interest in further exploring this relationship and exploiting it as a public health intervention aimed at preventing myopia in children. However, spending more time outdoors can have detrimental effects, such as increased risk of melanoma, cataract and pterygium. Understanding how spending more time outdoors prevents myopia could advance development of more targeted interventions for myopia. We reviewed the evidence for and against eight facets of spending time outdoors that may protect against myopia: brighter light, reduced peripheral defocus, higher vitamin D levels, differing chromatic spectrum of light, higher physical activity, entrained circadian rhythms, less near work and greater high spatial frequency (SF) energies. There is solid evidence that exposure to brighter light can reduce risk of myopia. Peripheral defocus is able to regulate eye growth but whether spending time outdoors substantially changes peripheral defocus patterns and how this could affect myopia risk is unclear. Spectrum of light, circadian rhythms and SF characteristics are plausible factors, but there is a lack of solid evidence from human studies. Vitamin D, physical activity and near work appear unlikely to mediate the relationship between time spent outdoors and myopia.

ACS Style

Gareth Lingham; David A Mackey; Robyn Lucas; Seyhan Yazar. How does spending time outdoors protect against myopia? A review. British Journal of Ophthalmology 2019, 104, 593 -599.

AMA Style

Gareth Lingham, David A Mackey, Robyn Lucas, Seyhan Yazar. How does spending time outdoors protect against myopia? A review. British Journal of Ophthalmology. 2019; 104 (5):593-599.

Chicago/Turabian Style

Gareth Lingham; David A Mackey; Robyn Lucas; Seyhan Yazar. 2019. "How does spending time outdoors protect against myopia? A review." British Journal of Ophthalmology 104, no. 5: 593-599.

Review
Published: 02 November 2019 in Multiple Sclerosis and Related Disorders
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Due to the considerable burden of multiple sclerosis (MS)-related symptoms and the need to identify effective interventions to prevent disease progression, various nutraceutical interventions have been trialed as adjunctive treatments. The aim of this review was to investigate the efficacy and safety of nutraceutical interventions for clinical and biological outcomes in people with MS. In accordance with PRISMA reporting guidelines, a systematic literature search was conducted using three electronic literature databases. Risk of bias was assessed using the Jadad scale. Thirty-seven randomized controlled trials, investigating fourteen nutraceuticals, were included in the review. Trials that investigated alpha lipoic acid (n = 4/6), ginkgo biloba (n = 3/5), vitamin A (n = 2/2), biotin (n = 1/2), carnitine (n = 1/2), green tea (n = 1/2), coenzyme Q10 (n = 1/1), probiotics (n = 1/1), curcumin (n = 1/1), Andrographis paniculata (n = 1/1), ginseng (n = 1/1), and lemon verbena (n = 1/1) were reported to improve biological (e.g. MRI brain volume change, antioxidant capacity) and/or clinical (e.g. fatigue, depression, Expanded Disability Status Scale) outcomes in multiple sclerosis compared to control. However, most trials were relatively small (average study sample size across included studies, n = 55) and there were few replicate studies per nutraceutical to validate the reported results. Furthermore, some nutraceuticals (e.g. green tea and inosine) should be used with caution due to reported adverse events. Risk of bias across most studies was low, with 31 studies receiving a score between 4 and 5 (out of 5) on the Jadad Scale. The existing literature provides preliminary support for the use of a number of nutraceutical interventions in MS. However, sufficiently powered long-term trials are required to expand the currently limited literature and to investigate unexplored nutraceuticals that may target relevant pathways involved in MS such as the gut microbiome and mitochondrial dysfunction. Prospero ID: CRD42018111736.

ACS Style

Wolfgang Marx; Meghan Hockey; Amelia McGuinness; Melissa Lane; John Christodoulou; Ingrid Van Der Mei; Michael Berk; Olivia M. Dean; Bruce Taylor; Simon Broadley; Jeannette Lechner-Scott; Felice N Jacka; Robyn M. Lucas; Anne-Louise Ponsonby; Relief Trial Team. The effect of emerging nutraceutical interventions for clinical and biological outcomes in multiple sclerosis: A systematic review. Multiple Sclerosis and Related Disorders 2019, 37, 101486 .

AMA Style

Wolfgang Marx, Meghan Hockey, Amelia McGuinness, Melissa Lane, John Christodoulou, Ingrid Van Der Mei, Michael Berk, Olivia M. Dean, Bruce Taylor, Simon Broadley, Jeannette Lechner-Scott, Felice N Jacka, Robyn M. Lucas, Anne-Louise Ponsonby, Relief Trial Team. The effect of emerging nutraceutical interventions for clinical and biological outcomes in multiple sclerosis: A systematic review. Multiple Sclerosis and Related Disorders. 2019; 37 ():101486.

Chicago/Turabian Style

Wolfgang Marx; Meghan Hockey; Amelia McGuinness; Melissa Lane; John Christodoulou; Ingrid Van Der Mei; Michael Berk; Olivia M. Dean; Bruce Taylor; Simon Broadley; Jeannette Lechner-Scott; Felice N Jacka; Robyn M. Lucas; Anne-Louise Ponsonby; Relief Trial Team. 2019. "The effect of emerging nutraceutical interventions for clinical and biological outcomes in multiple sclerosis: A systematic review." Multiple Sclerosis and Related Disorders 37, no. : 101486.

Journal article
Published: 10 August 2019 in International Journal of Environmental Research and Public Health
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Vitamin D deficiency (serum 25-hydroxyvitamin D (25(OH)D) concentrations

ACS Style

Kahlea Horton-French; Eleanor Dunlop; Robyn M. Lucas; Gavin Pereira; Lucinda J. Black. Prevalence and Predictors of Vitamin D Deficiency among African Immigrants Living in Australia. International Journal of Environmental Research and Public Health 2019, 16, 2855 .

AMA Style

Kahlea Horton-French, Eleanor Dunlop, Robyn M. Lucas, Gavin Pereira, Lucinda J. Black. Prevalence and Predictors of Vitamin D Deficiency among African Immigrants Living in Australia. International Journal of Environmental Research and Public Health. 2019; 16 (16):2855.

Chicago/Turabian Style

Kahlea Horton-French; Eleanor Dunlop; Robyn M. Lucas; Gavin Pereira; Lucinda J. Black. 2019. "Prevalence and Predictors of Vitamin D Deficiency among African Immigrants Living in Australia." International Journal of Environmental Research and Public Health 16, no. 16: 2855.

Journal article
Published: 08 August 2019 in European Journal of Clinical Nutrition
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Lucinda J. Black; the Ausimmune Investigator Group; Yun Zhao; Yee Cheng Peng; Jill L. Sherriff; Robyn M. Lucas; Ingrid Van Der Mei; Gavin Pereira. Higher fish consumption and lower risk of central nervous system demyelination. European Journal of Clinical Nutrition 2019, 74, 818 -824.

AMA Style

Lucinda J. Black, the Ausimmune Investigator Group, Yun Zhao, Yee Cheng Peng, Jill L. Sherriff, Robyn M. Lucas, Ingrid Van Der Mei, Gavin Pereira. Higher fish consumption and lower risk of central nervous system demyelination. European Journal of Clinical Nutrition. 2019; 74 (5):818-824.

Chicago/Turabian Style

Lucinda J. Black; the Ausimmune Investigator Group; Yun Zhao; Yee Cheng Peng; Jill L. Sherriff; Robyn M. Lucas; Ingrid Van Der Mei; Gavin Pereira. 2019. "Higher fish consumption and lower risk of central nervous system demyelination." European Journal of Clinical Nutrition 74, no. 5: 818-824.

Original articles
Published: 01 August 2019 in Journal of Pediatric Gastroenterology & Nutrition
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Objectives: The incidence of pediatric inflammatory bowel disease (IBD) is increasing worldwide. Ecological studies show higher incidence in regions at higher latitude or lower ambient ultraviolet radiation; individual-level associations with sun exposure have not been assessed. Methods: We recruited children (0–17 years) with IBD from 2 large hospitals in Melbourne, Australia. Control participants were recruited from the day surgery unit of one of the same hospitals. Questionnaires provided data on demographics, past sun exposure, the likelihood of sunburn (skin sensitivity) or tanning following sun exposure, use of sun protection, physical activity, and parental smoking and education. Grandparent ancestry was used to determine participant ethnicity. Cases and controls were matched on age and sex. We used conditional logistic regression to test the association between being an IBD case and past sun exposure at different ages, adjusted for a range of other factors. Results: After matching, n = 99 cases and n = 396 controls were included in the analysis. In multivariable analysis, for each 10 min increment in leisure-time sun exposure in summer or winter there was a linear 6% reduction in the odds of having IBD (P = 0.002). Results were similar in sensitivity analyses including only the most recently diagnosed cases, only Caucasian cases and controls, only those with symptom onset within the year before study entry, or additionally adjusted for age or physical activity. Conclusions: Higher sun exposure in the previous summer or winter was associated with a reduced risk of having IBD. There are plausible pathways that could mediate this effect.

ACS Style

Elizabeth Ann Holmes; Anne-Louise Ponsonby; Angela Pezic; Justine A. Ellis; Carl D. Kirkwood; Robyn M. Lucas. Higher Sun Exposure is Associated With Lower Risk of Pediatric Inflammatory Bowel Disease: A Matched Case-control Study. Journal of Pediatric Gastroenterology & Nutrition 2019, 69, 182 -188.

AMA Style

Elizabeth Ann Holmes, Anne-Louise Ponsonby, Angela Pezic, Justine A. Ellis, Carl D. Kirkwood, Robyn M. Lucas. Higher Sun Exposure is Associated With Lower Risk of Pediatric Inflammatory Bowel Disease: A Matched Case-control Study. Journal of Pediatric Gastroenterology & Nutrition. 2019; 69 (2):182-188.

Chicago/Turabian Style

Elizabeth Ann Holmes; Anne-Louise Ponsonby; Angela Pezic; Justine A. Ellis; Carl D. Kirkwood; Robyn M. Lucas. 2019. "Higher Sun Exposure is Associated With Lower Risk of Pediatric Inflammatory Bowel Disease: A Matched Case-control Study." Journal of Pediatric Gastroenterology & Nutrition 69, no. 2: 182-188.