Assessing the relationship between global warming and mortality : lag effects of temperature fluctuations by age and mortality categories

Although interests in assessing the relationship between temperature and mortality have arisen due to climate change, relatively few data are available on lag structure of temperature-mortality relationship, particularly in the Southern Hemisphere. This study identified the lag effects of mean temperature on mortality among age groups and death categories using polynomial distributed lag models in Brisbane, Australia, a subtropical city, 1996-2004. For a 1 °C increase above the threshold, the highest percent increase in mortality on the current day occurred among people over 85 years (7.2% (95% CI: 4.3%, 10.2%)). The effect estimates among cardiovascular deaths were higher than those among all-cause mortality. For a 1 °C decrease below the threshold, the percent increases in mortality at 21 lag days were 3.9% (95% CI: 1.9%, 6.0%) and 3.4% (95% CI: 0.9%, 6.0%) for people aged over 85 years and with cardiovascular diseases, respectively. These findings may have implications for developing intervention strategies to reduce and prevent temperature-related mortality.

Children’s food and activity patterns following a six-month child weight management program

Objective To describe the impact of a parent-led, family focused child weight management program on the food intake and activity patterns of pre-pubertal children. Methods n assessor-blinded, randomized controlled trial involving 111 (64% female) overweight, pre-pubertal children 6 to 9 years of age randomly assigned to parenting-skills training plus intensive lifestyle education, parenting-skills training alone, or a 12-month wait-listed control. Study outcomes were assessed at baseline, 6 months, and 12 months. This paper presents data on food intake assessed via a validated 54-item parent completed dietary questionnaire and activity behaviours assessed via a parent-report 20-item activity questionnaire. Results Intake of energy-dense nutrient poor foods was lower in both intervention groups at 6 months (mean difference, P+DA -1.5 serves [CI -2.0;-1.0]; P -1.0 serves [-2.0;-0.5]) and 12 months (mean difference P+DA -1.0 serves [CI -2.0;-0.5]; P -1.0 serves [-1.5; 0.0]) compared to baseline. Intake of vegetables, fruit, breads and cereals, meat and alternatives and dairy foods remained unchanged. Regardless of study group there were significant reductions over time in the reported time spent engaged in small screen activities and an increase in the time reported spent in active play. Conclusion Child weight management intervention that promotes food intake in line with national dietary guidelines achieves a reduction in children’s intake of energy dense, nutrient poor foods. This was achieved without compromising intake of nutrient-rich food and changes in were maintained even once the intervention ceased.

How consistent are drivers in their driving? A driver training perspective

The value and effectiveness of driver training as a means of improving driver behaviour and road safety continues to fuel research and societal debates. Knowledge about what are the characteristics of safe driving that need to be learnt is extensive. Research has shown that young drivers are over represented in crash statistics. The encouraging fact is that novice drivers have shown improvement in road scanning pattern after training. This paper presents a driver behaviour study conducted on a closed circuit track. A group of experienced and novice drivers performed repeated multiple manoeuvres (i.e. turn, overtake and lane change) under identical conditions Variables related to the driver, vehicle and environment were recorded in a research vehicle equipped with multiple in-vehicle sensors such as GPS accelerometers, vision processing, eye tracker and laser scanner. Each group exhibited consistently a set of driving pattern characterising a particular group. Behaviour such as the indicator usage before lane change, following distance while performing a manoeuvre were among the consistent observed behaviour differentiating novice from experienced drivers. This paper will highlight the results of our study and emphasize the need for effective driver training programs focusing on young and novice drivers.

Living well with diabetes: a randomized controlled trial of a telephone-delivered intervention for maintenance of weight loss, physical activity and glycaemic control in adults with type 2 diabetes

Background By 2025, it is estimated that approximately 1.8 million Australian adults (approximately 8.4% of the adult population) will have diabetes, with the majority having type 2 diabetes. Weight management via improved physical activity and diet is the cornerstone of type 2 diabetes management. However, the majority of weight loss trials in diabetes have evaluated short-term, intensive clinic-based interventions that, while producing short-term outcomes, have failed to address issues of maintenance and broad population reach. Telephone-delivered interventions have the potential to address these gaps. Methods/Design Using a two-arm randomised controlled design, this study will evaluate an 18-month, telephone-delivered, behavioural weight loss intervention focussing on physical activity, diet and behavioural therapy, versus usual care, with follow-up at 24 months. Three-hundred adult participants, aged 20-75 years, with type 2 diabetes, will be recruited from 10 general practices via electronic medical records search. The Social-Cognitive Theory driven intervention involves a six-month intensive phase (4 weekly calls and 11 fortnightly calls) and a 12-month maintenance phase (one call per month). Primary outcomes, assessed at 6, 18 and 24 months, are: weight loss, physical activity, and glycaemic control (HbA1c), with weight loss and physical activity also measured at 12 months. Incremental cost-effectiveness will also be examined. Study recruitment began in February 2009, with final data collection expected by February 2013. Discussion This is the first study to evaluate the telephone as the primary method of delivering a behavioural weight loss intervention in type 2 diabetes. The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice.

Cyclists' experiences of harassment from motorists : findings from a survey of cyclists in Queensland, Australia

Objective Harassment from motorists is a major constraint on cycling that has been under-researched. We examined incidence and correlates of harassment of cyclists. Methods Cyclists in Queensland, Australia were surveyed in 2009 about their experiences of harassment while cycling, from motor vehicle occupants. Respondents also indicated the forms of harassment they experienced. Logistic regression modeling was used to examine gender and other correlates of harassment. Results Of 1830 respondents, 76% of men and 72% of women reported harassment in the previous 12 months. The most reported forms of harassment were driving too close (66%), shouting abuse (63%), and making obscene gestures/sexual harassment (45%). Older age, overweight/obesity, less cycling experience (< 2 years) and less frequent cycling (< 3 days/week) were associated with less likelihood of harassment, while living in highly advantaged areas (SEIFA deciles 8 or 9), cycling for recreation, and cycling for competition were associated with increased likelihood of harassment. Gender was not associated with reports of harassment. Conclusions Efforts to decrease harassment should include a closer examination of the circumstances that give rise to harassment, as well as fostering road environments and driver attitudes and behaviors that recognize that cyclists are legitimate road users.