Rachel Tham

University of Melbourne | MSD

Traffic-related air pollution (TRAP) is associated with lower cognitive function and diabetes in older adults, but little is known about whether diabetes status moderates the impact of TRAP on older adult cognitive function. We analysed cross-sectional data from 4141 adults who participated in the Australian Diabetes, Obesity and Lifestyle (AusDiab...

Objective: The Australian COVID-19 Frontline Healthcare Workers study examined the prevalence and severity of mental health symptoms during the second wave of the COVID-19 pandemic. This substudy examined the differences in psychological well-being between rural and metropolitan health care workers (HCWs). Design: A nationwide survey conducted b...

Background Evolving evidence suggests that vegetation surrounding schools is beneficial to children's academic performance, however vehicle emissions are adversely related. Little is known about concurrent impacts of vegetation and vehicle emissions on academic performance. This study examined associations of vegetation and vehicle emissions near u...

Background While the relationship between outdoor particulate matter (PM) and lower respiratory tract infections in children and adolescents is accepted, we know little about the impacts of outdoor PM on the risk of developing or aggravating upper respiratory tract infections (URTIs). Methods We aimed to review the literature examining the relatio...

Population ageing and urbanisation are global phenomena that call for an understanding of the impacts of features of the urban environment on older adults’ cognitive function. Because neighbourhood characteristics that can potentially have opposite effects on cognitive function are interdependent, they need to be considered in conjunction. Using da...

Background There is a dearth of studies on the effects of the neighbourhood environment on adults’ cognitive function. We examined how interrelated aspects of the built and natural neighbourhood environment, including air pollution, correlate with adults’ cognitive function, and the roles of physical activity and sedentary behaviours in these assoc...

Background The association between grass pollen exposure and lung function changes and airway inflammation is limited. We investigated these associations in a community-based sample, and whether any such associations were modified by current asthma, current hay fever, pollen sensitization and age. Methods Cross-sectional analyses of data from the...

Parental preconception exposures to built and natural outdoor environments could influence pregnancy and birth outcomes either directly, or via a range of health-related behaviours and conditions. However, there is no existing review summarising the evidence linking natural and built characteristics, such as air and noise pollution, walkability, gr...

Background: Outdoor air pollution and childhood asthma are increasing problems in South Asian countries. However, little is known about the associations between levels of air pollution and severe childhood asthma requiring hospital treatment in these regions. Methods: We undertook a systematic review to assess the evidence between outdoor air pollu...

Background The negative health impacts of traffic-related air pollution (TRAP) have been investigated for many decades, however, less attention has been paid to the effect of TRAP on children’s academic performance. Understanding the TRAP-academic performance relationship will assist in identifying mechanisms for improving students’ learning and ai...

Background There is preliminary evidence that greenery/greenspace around schools may be positively associated with children’s cognitive development and academic outcomes, whereas traffic-related air pollution (TRAP) may have a detrimental effect. Few studies have examined pathways between both exposures and academic outcomes. This study aimed to as...

Environmental correlates, barriers, and facilitators of physical activity, healthy eating, and socializing are understudied in older immigrants to developed countries. This study developed/adapted and validated measures of perceived barriers and neighborhood environmental characteristics related to these health-enhancing behaviors appropriate for o...

Traffic-related air pollution is ubiquitous and almost impossible to avoid. It is important to understand the role that traffic-related air pollution may play in neurodegenerative diseases, such as dementia, Alzheimer’s disease, and Parkinson’s disease, particularly among older populations and at-risk groups. There is a growing interest in this are...

Traffic-related air pollution is ubiquitous and almost impossible to avoid. It is important to understand the role that traffic-related air pollution may play in neurodegenerative diseases, such as dementia, Alzheimer’s disease, and Parkinson’s disease, particularly among older populations and at-risk groups. There is a growing interest in this are...

The unprecedented COVID-19 pandemic has indelibly impacted routine healthcare provision across the globe. Nevertheless, management of traumatic injuries has remained a priority patient care service of oral and maxillofacial (OMF) practice. This study aimed to explore the pattern and mechanisms of OMF injuries presenting at a major public dental hos...

Background The association between grass pollen exposure and early markers of asthma exacerbations such as lung function changes and increase in airway inflammation is limited. We investigated the associations between short‐term grass pollen exposure and lung function and airway inflammation in a community‐based sample, and whether any such associa...

Introduction Numerous studies have found associations between characteristics of urban environments and risk factors for dementia and cognitive decline, such as physical inactivity and obesity. However, the contribution of urban environments to brain and cognitive health has been seldom examined directly. This cohort study investigates the extent t...

Background: Studies on air pollution and depression in the elderly are limited and the results are heterogeneous. Objectives: We examined the association of ambient air pollution exposure and diagnosis and symptoms of depression in the elderly; and whether any associations were confounded or modified by cognitive decline. Methods: We enrolled 821...

Background: Asthma-related outcomes are regularly used by studies to investigate the association between human exposure to landscape fire smoke and health. Robust summary effect estimates are required to inform health protection policy for fire smoke exposure. Objective: To conduct a systematic review and meta-analysis to estimate the associatio...

Background: Asthma-related outcomes are among the most reported from human exposure to landscape fire smoke. Robust summary estimates are required to adequately inform health protection policy. Objective: To obtain summary estimates of the association between fine particulate matter (PM2.5) from landscape fire smoke and asthma-related outcomes. M...

Background: Many outdoor fungal spores are ubiquitous, respirable and possibly allergenic. They may contribute to asthma symptoms; however, little is known about their effects on respiratory function. Objective: To investigate if outdoor fungal spore levels were associated with lung function or airway inflammation, and whether fungal sensitizati...

In the last decade, studies investigating greenspace have highlighted several benefits to human health. However, the effect of greenspace on allergies and atopic sensitization in children was not clear. While several studies have investigated this link, the evidence has not been systematically synthesized. We conducted a systematic search of eight...

Background: Pollen is an important aeroallergen that triggers asthma exacerbations in children, but we know little about the impact of different pollen types in cities with varying climatic conditions and pollen seasons. Objectives: We aimed to assess the role of ambient level of different types of pollen on a large time series of child and adol...

Young children are particularly vulnerable to otitis media (OM) which globally affects over 80% of children below the age of 3 years. Although there is convincing evidence for an association between environmental tobacco smoke exposure and OM in children, the relationship with ambient air pollution is not clear. We aimed to systematically review th...

Background: In the context of increased asthma exacerbations associated with climatic changes such as thunderstorm asthma, interest in establishing the link between pollen exposure and asthma hospital admissions has intensified. Here, we systematically reviewed and performed a meta-analysis of studies on pollen and ED attendance. Methods: A sear...

Background: The aetiology of allergic respiratory disease in children is not yet fully understood. Environmental factors are believed to play a major part. The amount of green vegetation surrounding the home (residential greenness) has been recently identified as a potentially important exposure OBJECTIVES: Our goal was to provide a systematic rev...

Background: Elevated cord blood IgE is important on the pathway to allergic disease. The association between season of birth and infant cord blood IgE is not well-established. Study findings differ on which birth season is associated with higher cord blood IgE risk and its magnitude. We conducted a systematic review and meta-analysis of studies on...

Background: Some fungal spores can trigger asthma exacerbation but knowledge of which outdoor fungal spores contribute to asthma hospitalisation is limited. Objectives: To examine the role of outdoor fungal spores in child and adolescent asthma hospitalisations. Methods: We conducted a bi-directional time-stratified case-crossover study of chi...

Background Childhood asthma is a significant public health problem and severe exacerbations can result in diminished quality of life and hospitalization. Objective We sought to examine the contribution of outdoor fungi to childhood and adolescent asthma hospitalizations. Methods The Melbourne Air Pollen Children and Adolescent study is a case-cro...

Background: Childhood asthma is a significant public health problem and severe exacerbations can result in diminished quality of life and hospitalisation. Objective: To examine the contribution of outdoor fungi to childhood and adolescent asthma hospitalisations. Methods: The Melbourne Air Pollen Children and Adolescent (MAPCAH) study is a cas...

To synthesise the evidence on the association between duration and exclusivity of breastfeeding and the risk of acute otitis media (AOM). Systematic review and meta-analyses following searching of PubMed, CINAHL, and EMBASE electronic databases. Twenty four studies, all from the USA or Europe, met the inclusion criteria. In the pooled analyses, any...

To synthesise the current evidence for the associations between breastfeeding and dental caries, with respect to specific windows of early childhood caries risk. Systematic review, meta-analyses and narrative synthesis following searches of PubMed, CINAHL, and EMBASE databases. 63 papers included. Children exposed to longer versus shorter duration...

To systematically review the association between breastfeeding and childhood allergic disease. Pre-determined inclusion/exclusion criteria identified 89 articles from PUBMED, CINAHL and EMBASE databases. Meta-analyses performed for categories of breastfeeding and allergic outcomes. Meta-regression explored heterogeneity. More versus less breastfeed...

This study investigated the frequency, patterns and causes of dental trauma in patients seeking emergency treatment at a dental hospital, and evaluated the impact of an electronic structured injury history form to collect key information. A retrospective audit was undertaken of all emergency presentations at the Royal Dental Hospital of Melbourne f...

Strong primary healthcare (PHC) services are efficient, cost-effective and associated with better population health outcomes. However, little is known about the role and perspectives of PHC staff in creating a sustainable service. Staff from a single-point-of-entry primary health care service in Elmore, a small rural community in north-west Victori...

Background In Australia, rural and regional areas have an increased proportion of older people who are ageing more rapidly than their metropolitan counterparts. This increase in the ageing population and its uneven geographic distribution is likely to pose an oral health challenge in the near future.MethodsA cross-sectional study conducted in a sam...

Background Asthma is a significant global public health issue. Severe asthma exacerbations can be triggered by environmental factors and require medical care from health services. Although it is known that fungal exposure may lead to allergic sensitisation, little is understood about its impact on asthma exacerbations. This review aims to examine w...

Asthma is a significant global public health issue. Severe asthma exacerbations can be triggered by environmental factors and require medical care from health services. Although it is known that fungal exposure may lead to allergic sensitization, little is understood about its impact on asthma exacerbations. This review aims to examine whether outd...

Strong primary healthcare (PHC) services are efficient, cost-effective and associated with better population health outcomes. However, little is known about the role and perspectives of PHC staff in creating a sustainable service. Staff from a single-point-of-entry primary health care service in Elmore, a small rural community in north-west Victori...

Objective: This paper reports the impact of oral health on the quality of life of edentulous older adults, living independently in rural Victoria, Australia. Method: Older adults living in rural Victoria were recruited through social clubs and interviewed about oral health, general health, socio-demographics, and quality of life (QoL) using t...

doi: 10.1111/j.1741-2358.2012.00652.x Oral healthcare issues in rural residential aged care services in Victoria, Australia Objectives: To identify major issues in providing and accessing oral health care in Victorian rural residential aged care services from the perspectives of dentists, aged care staff and residents. Methods: Structured intervi...

Few studies have focused on the role of grass pollen on asthma emergency department (ED) presentations among children. None have examined whether a dose-response effect exists between grass pollen levels and these asthma exacerbations. To examine the association between increasing ambient levels of grass pollen and asthma ED presentations in childr...

The ability to sustain comprehensive primary health care (PHC) services in the face of change is crucial to the health of rural communities. This paper illustrates how one service has proactively managed change to remain sustainable. A 6-year longitudinal evaluation of the Elmore Primary Health Service (EPHS) located in rural Victoria, Australia, i...

Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yi...

To develop a conceptual framework for monitoring the relationship between health services and health outcomes in rural Australia. Development of an evaluation framework for a rural comprehensive primary health service in Victoria. Evidence regarding essential components for successful primary health care, and objective health service and health sta...

The aim of this study was to understand the perceptions of Sudanese women regarding their potential vulnerability to HIV infection and their preferred sources of HIV-related information. The study was designed in consultation with members of the Sudanese community in Victoria, Australia. Semi-structured interviews were undertaken with 11 Sudanese-b...

Traumatic orodental injuries are common dental public health problems that have complex aetiology and significant impact on those affected. It is important to understand the frequency, pattern and causes of traumatic orodental injuries so that appropriate and effective treatment services are made available and injury prevention interventions are de...

3 Despite the espoused success of the many 'innovative pilot' health services that have been trialled in rural and remote areas over recent years, little effort has been made to systematise them over time or transfer them to other jurisdictions. Indeed few have been the subject of comprehensive evaluation to assess their sustainability and impact o...

Uncontrolled bushfires produce copious amounts of smoke that can result in adverse effects on human health and so are important considerations for emergency, public health and environmental protection agencies. During January to March 2003, the north-east and Alpine regions of the state of Victoria experienced major bushfires that created a blanket...