Food patterns associated with blood lipids are predictive of coronary heart disease : the Whitehall II study

Analysis of the epidemiological effects of overall dietary patterns offers an alternative approach to the investigation of the role of diet in CHD. We analysed the role of blood lipid-related dietary patterns using a two-step method to confirm the prospective association of dietary pattern with incident CHD. Analysis is based on 7314 participants of the Whitehall II study. Dietary intake was measured using a 127-item FFQ. Reduced rank regression (RRR) was used to derive dietary pattern scores using baseline serum total and HDL-cholesterol, and TAG levels as dependent variables. Cox proportional hazard regression was used to confirm the association between dietary patterns and incident CHD (n 243) over 15 years of follow-up. Increased CHD risk (hazard ratio (HR) for top quartile: 2·01 (95 % CI 1·41, 2·85) adjusted for age, sex, ethnicity and energy misreporting) was observed with a diet characterised by high consumption of white bread, fried potatoes, sugar in tea and coffee, burgers and sausages, soft drinks, and low consumption of French dressing and vegetables. The diet-CHD relationship was attenuated after adjustment for employment grade and health behaviours (HR for top quartile: 1·81; 95 % CI 1·26, 2·62), and further adjustment for blood pressure and BMI (HR for top quartile: 1·57; 95 % CI 1·08, 2·27). Dietary patterns are associated with serum lipids and predict CHD risk after adjustment for confounders. RRR identifies dietary patterns using prior knowledge and focuses on the pathways through which diet may influence disease. The present study adds to the evidence that diet is an important risk factor for CHD.

Stroke statistics

This publication is the latest edition of a series of statistical compendia and supplements that document the burden of cardiovascular disease in the United Kingdom. This series of publications, published by the British Heart Foundation, usually focuses on coronary heart disease, but Stroke Statistics is jointly published by the British Heart Foundation and The Stroke Association and focuses on the important and substantial burden of stroke in the United Kingdom.

Stroke Statistics is designed for policy makers, health professionals, medical researchers and anyone else with an interest in stroke or cardiovascular disease. It aims to provide the most recent statistics related to the burden of stroke and to document the geographic, social and ethnic inequalities in the experience of stroke.

Stroke Statistics is divided into five chapters. Chapter 1 documents trends and patterns in stroke mortality and premature mortality. Chapter 2 reports on the morbidity burden of stroke, both in terms of prevalence (the rate of people who have had a stroke in the past) and incidence (the rate of first ever strokes). Chapter 3 describes the burden of stroke on the National Health Service, in terms of drug therapy, hospitalisations and surgical procedures. Chapter 4 provides estimates of the prevalence of risk factors for stroke, broken down by age, sex, socioeconomic status and ethnicity. Details about Government targets to tackle the risk factor status of the population are also provided where available. Chapter 5 provides new estimates, calculated specifically for Stroke Statistics, of the economic cost of stroke to the National Health Service and to the United Kingdom economy.

Statphylococcus aureus bacteraemia : a major cause of mortaility in Australia and New Zealand

Objective : To document the types of, and mortality from, Staphylococcus aureus bacteraemia in Australia and New Zealand, and determine factors associated with mortality.

Design and setting : Prospective observational study in 27 independent or hospital pathology laboratories in Australia (24) and New Zealand (3), employing a web-based database to prospectively record demographic features, selected risk factors, principal antibiotic treatment and mortality data on all patients with positive blood cultures for S. aureus from June 2007 to May 2008.

Main outcome measure : 30-day all-cause mortality.

Results : 1994 episodes of S. aureus bacteraemia were identified, and complete 30-day follow-up data were available for 1865. Most episodes had their onset in the community (60.8%; 95% CI, 58.7%–63.0%). Methicillin-resistant S. aureus (MRSA) caused 450 episodes (24.1%; 95% CI, 22.2%–25.9%), and 123 of these (27.3%) had a susceptibility profile consistent with community-associated MRSA. All-cause mortality at 30 days was 20.6% (95% CI, 18.8%–22.5%). On univariate analysis, increased mortality was significantly associated with older age, European ethnicity, MRSA infection, infections not originating from a medical device, sepsis syndrome, pneumonia/empyema, and treatment with a glycopeptide or other non-β-lactam antibiotic. On multivariable analysis, independent predictors of mortality were age, sepsis syndrome, pneumonia/empyema, device-associated infection with a secondary focus, left-sided endocarditis, and treatment with a glycopeptide such as vancomycin, but not MRSA infection.

Conclusions : S. aureus bacteraemia is a common infection in both the community and hospitals in Australia and New Zealand, and is associated with appreciable mortality. Invasive MRSA infection may be more life-threatening, partly because of the inferior efficacy of the standard treatment, vancomycin. National web-based surveillance of S. aureus bacteraemia and its outcomes is not only important but also easily achievable.

Sociodemographic correlates of the increasing trend in prevalence of gestational diabetes mellitus in a large population of women between 1995 and 2005

OBJECTIVE—Gestational diabetes mellitus (GDM) is an increasingly prevalent risk factor for the development of type 2 diabetes in the mother and is  responsible for morbidity in the child. To better identify women at risk of developing GDM we examined sociodemographic correlates and changes in the prevalence of GDM among all births between 1995 and 2005 in Australia's largest state.
RESEARCH DESIGN AND METHODS—A computerized database of all births (n = 956,738) between 1995 and 2005 in New South Wales, Australia, was used in a multivariate logistic regression that examined the association between sociodemographic characteristics and the occurrence of GDM.
RESULTS—Between 1995 and 2005, the prevalence of GDM increased by 45%, from 3.0 to 4.4%. Women born in South Asia had the highest adjusted odds ratio (OR) of any region (4.33 [95% CI 4.12–4.55]) relative to women born in Australia. Women living in the three lowest socioeconomic quartiles had higher adjusted ORs for GDM relative to women in the highest quartile (1.54 [1.50–1.59], 1.74 [1.69–1.8], and 1.65 [1.60–1.70] for decreasing socioeconomic status quartiles). Increasing age was strongly associated with GDM, with women aged >40 years having an adjusted OR of 6.13 (95% CI 5.79–6.49) relative to women in their early 20s. Parity was associated with a small reduced risk. There was no association between smoking and GDM.
CONCLUSIONS—Maternal age, socioeconomic position, and ethnicity are important correlates of GDM. Future culturally specific interventions should target prevention of GDM in these high-risk groups.

Social inclusion in local places

With the decline of official multiculturalism in Australia the focus of the government has turned to promoting programs and services that will provide greater social inclusion.  This paper illustrates that although institutions within society such as the media, federal government agencies, and local governments aim to value cultural diversity, social practices unintentionally regulate inclusion by privileging whiteness and scrutinising ethnic minorities on local places.  An analysis of metropolitan and local newspaper reports and government document provides an insight into these practices that construct 'ethnic' citizens in particular ways.

Hyphenated Australia : putting intercultural identity on the conceptual map

Interculturality and intercultural identity is a local effect of the global movement and mixing of people, and those of intercultural identities constitute the fastest growing sector of the Australian population. In an age of globalisation and diversification, what does identity mean for those situated in-between governing notions of racial/ethnic formations, and how is intercultural identity experienced? For those informed by (at least) two cultures, what does multiculturalism, ethnicity and 'Australianness' mean, and where are these individuals positioned in relation to these structures? These questions have critical implications for the Australian nation. Within Australian discourses, interculturality and intercultural identity, in particular, has historically been excluded, rendered invisible. This dissertation is, therefore, one of facilitating visibility. Using the hyphens as a conceptual tool, I argue that in this age of accelerating globalisation the hyphens both makes visible and is made visible by interculturality. The hyphens is that grey and fluid site of intersection between structures of identity and is characterised by liminality - contestation, uncertainty, fundamentally ambivalence. Experiences of liminality, however, dissolve in any given time, opening up new terrain for creativity. Some of these emerging and creative forms of identity, as instigated by interculturality, are explored. Based on interviews with 20 daughters (and their mothers) from intercultural unions, this dissertation places intercultural identity on the Australian conceptual map and analyses the unique position occupied by those with an intercultural identity in their relationship with governing discursive formations of race/ethnicity, embodiment, nation and culture. In essence, the dissertation is concerned with examining the ways in which discursive identity structures intersect with subjective experience, and with the ways in which those with an intercultural identity negotiate those structures and their social relations. This examination raises the fundamental question: is the modernist notion of the material realities of individual lives reconcilable with the poststructural notion of identity as always located in discourse. This modernist/postmodernist tension permeates the dissertation.

Clichéd gaze of the migrant on the Australian screen

The thesis takes up the question of the representation of the migrant on the Australian screen in terms of a specific set of concerns around the notions of stereotype and self-reflexivity. The stereotype is read as a self-referential image: hence, as a question of film spectatorship and identity; in short as an unconscious reflex or self image. The text of the thesis is in two parts: part one, comprises the production of the film ‘Italians at home’. It is the major component of research and text which, for this purpose, has been copied and submitted hereto on VHS video cassette. Part two, includes an analysis and discussion of the television documentary ‘The migrant experience’, and an exegesis, of the production, narrative and reception of the film ‘Italians at home’. The migrant experience is read and discussed as an exemplary text of dominant, stereotyped discourse of cultural difference; while ‘Italians at home’ is proposed as a parallel text and a self-reflexive reading and criticism of such a text. Both the television documentary and the film, deal with the representation and problematic of homogenised representations of ethnicity. In the case of ‘The migrant experience’, it is argued, that the figure of the migrant as other and self-image, functions as an object of Australian culture and discourse of national identity within a logic of representation of binary structures; while the film ‘Italians at home’, the question of self-referentiality is seen in terms of the viewing subject and a problematic of film representation; thus, the film attempts to make such signifying structures, visual codes and agreed assumptions of otherness visible, while, at the same time, attempting to displace them or pose them as a problem of representation or reading for the viewer.

Music video and gendered pleasures in the lives of young women and men

The purpose of this thesis is to explore the cultural and social significance of music video in the lives of a group of young women and men. In so doing the thesis pays particular attention to issues of gender and pleasure. This research examines the interaction of a group of young people with music video in relation to four areas of research. Firstly, the importance of music video in terms of social interaction and the pleasure this entails is explored. Secondly the thesis looks at the ways in which gender is seen by the young people in this study to be established by music video performers. Thirdly, how gender becomes inscribed on the body is explored, and fourthly I examine the process of sexualization of the body. Theoretically this thesis draws upon feminist theory, poststructuralist theory, music video scholarship and educational theories. This eclectic approach has been necessary as this research speaks simultaneously to several distinct areas of scholarship: education, cultural studies and feminism. My research with a young audience of music video took place within a secondary school. Over two semesters I conducted research with two separate classes of Media Studies students who were aged fifteen and sixteen. A total of 49 students were interviewed, however I chose mainly to work with a small group of eleven students - five girls and six boys. The school where I conducted this research is located in a working class suburb of a provincial and industrial Australian city . The young people's social positioning in terms of class and ethnicity has been considered in some depth in relation to the construction of the gendered subject. Methodologically the thesis is skewed towards the audience, and also towards dealing with what is normally unspoken in the research process. For example, much academic research does not include the author of the research as an integral part of that research. In this thesis I include myself in a number of ways: historically, personally and as a feminist. This thesis places a high priority on ethics and the effects of research on those who participate in the research process. The thesis uses a number of research methods: structured interviews, informal conversations, memory-work and written responses to music videos. Generally the research methods used in this thesis have been developed reflexively; that is, they have developed directly in relation to the participants’ reactions, responses, suggestions, interests and comments. The research seeks to demonstrate the place of music video in the lives of the young people who participated in the study. I look at how the young people in this study connect music video to other cultural forms and social interactions. In this way the intertextuality of music video is demonstrated. The research looks at how young viewers 'read' the gender of music video performers, and how this affects their own gendering. The social and cultural meanings which are attached to certain parts of the body are also examined. Theorizing the body in terms of its social meanings is a significant part of this thesis. The research argues that young people often experience music video as pleasurable, and that music video can provide young people with access to powerful speaking positions. This is demonstrated through transcripts of our conversations and interviews, and also through the young people's written comments. However, these powerful speaking positions invariably invoke dominant discourses (homophobia and racism, for example). Thus the disruptive potential of music video is called into question. These dominant discourses are gendered in nature. Pleasure in the text (music video) and cultural inscriptions of gender on the body then, are realized differently for the girls and for the boys in this study. My research into music video, gender and young people has implications for research methodology generally, and for music video scholarship specifically. Music video scholarship to date has rarely focussed upon the audience of this cultural form. My research has certain implications for the ways in which research is currently conducted with young people in relation to popular culture generally, and music video specifically, and gendered subjectivity.

1948 and 1968 Czech refugee settlers in Australia : a comparison of the settlement and integration processes among two waves of settlers

Nearly eighteen years ago when I first became interested in the history and sociology of Australian immigration, I was particularly attracted by the fact and opportunity to incorporate immigration settlement, experience and accomplishments in my history teaching in secondary school. In particular it was the area of the settlement of Australia that needed a fuller understanding in the teaching of Australian history. By that I mean it was needed to show that there were many other ethnic groups besides the Anglo-Saxon group which had participated in the development of Australia since 1788. Since the end of World War II, the Australian population has doubled, the population structure and characteristics have changed and knowledge about the diverse groups forming the Australian nation is now sought. Sane ethnic groups, mainly the numerically large, have been studied and numerous reports are available. But many of the smaller groups have attracted little interest among Australian scholars. This was one of the reasons that I decided to research the behaviour of one of the smaller groups - the Czechs - to find out about their immigration history to Australia; their immigration processes such as re-settlement and re-establishment; and their community life since World War II. Because of the scarcity of written materials on Czechs in Australia, I had to rely on interviews, personal reminiscenses, letters and documents translated from the Czech language. I should like to express my gratitude to all people and officials of Czech ethnic organisations and clubs in Australia, who agreed to be interviewed and who provided me with documentary material so important for my work. Respecting the wishes of my interviewees their anonymity had to be preserved. In the course of my research, I have received substantial help and the encouragement from the Editor of the now extinct Czech language paper Newspaper Hlas domova, Mr. F.V., whose co-operation is gratefully recognised. I am also grateful to Associate Professor William D. Rubinstein for his help and encouragement in all stages of my work. The introductory part of the study is covered in Chapter One. She reasons for the need to increase Australia's population after World War II and an analysis of the development of settlement in Australia between 1947 and 1984 are discussed. The emigration of Czechs into Australia and their place in the post-war immigration scheme is introduced. To obtain an overview of how Czechs have emigrated around the world, the literature describing their settlement is compared. Also discussed in the literature on Czech settlement in Australia from an historical point of view. The studies on the concept of ethnicity and settlement in Australia are used to document the theoretical issues for an understanding of Australian society. This chapter also contains aspects of sources and research, shewing the processes of documentary research, interviews and related matters. In Chapter Two the history of Czech emigration is discussed, covering the period from the seventeenth to the twentieth century. The first contacts with Australia are highlighted, continuing into the inter-war period and finally the re-settlement of Czechs after World War II. To understand why Czechs left their ancestral country after World War II, the political situation in Czechoslovakia is analysed. The third chapter concentrates mainly in the 1948 wave of settlers, who left Czechoslovakia after the communist take-over in 1948. Their means of departure from their homeland, selection of Australia as a new homeland and their re-settlement and re-establishment are discussed. Their attitudes after their arrival and their later stages of their settlement are analysed. The formation of numerous Czech ethnic organisations which mushroomed between 1950 and 1954 led to an active community life which began to change about five years after their arrival. These charges led to disorganisation of Czech community's life. The causes of these changes which were influential for the failure of the 1948 group to establish a viable community in Australia are analysed. In Chapter Four the wave of 1968 is viewed, their arrival and settling is covered. The study of their group attitudes and formation of group institutions is the main part of this section. A comparison of my data of the two waves, 1948 and 1968, reveals the information that these two groups did not develop the harmonious relationship expected of them as members of the one ethnic group. Chapter Five discusses immigration typologies and concentrates on the differences between legal and illegal emigrants from the Czechoslovak point of view. The integration processes of Czechs and their incorporation into Australian society are discussed. The sixth chapter sums up the findings of this disertation and states the influences which were responsible for the divisions in Czech ethnic life in Australia in the 1980s.

Higher leptin levels in Asian Indians than Creoles and Europids : a potential explanation for increased metabolic risk

Background and purpose: Leptin predicts cardiovascular diseases and type 2 diabetes, diseases to which Asian Indians are highly susceptible. As a risk marker, leptin’s intra-individual and seasonal stability is unstudied and only small studies have compared leptin levels in Asian Indians with other populations. The aim of this study was to explore ethnicity related differences in leptin levels and its intra-individual and seasonal stability.

Methods: Leptin and anthropometric data from the northern Sweden MONICA (3513 Europids) and the Mauritius Non-communicable Disease (2480 Asian Indians and Creoles) studies were used. In both studies men and women, 25- to 74-year old, participated in both an initial population survey and a follow-up after 5–13 years. For the analysis of seasonal leptin variation, a subset of 1780 participants, 30- to 60-year old, in the Vasterbotten Intervention Project was used.

Results: Asian Indian men and women had higher levels of leptin, leptin per body mass index (BMI) unit (leptin/BMI) or per cm in waist circumference (WC; leptin/waist) than Creoles and Europids when adjusted for BMI (all P<0.0005) or WC (all P<0.005). In men, Creoles had higher leptin, leptin/BMI and leptin/waist than Europids when adjusted for BMI or WC (all P<0.0005). In women, Creoles had higher leptin/BMI and leptin/waist than Europids only when adjusted for WC (P<0.0005). Asian Indian ethnicity in both sexes, and Creole ethnicity in men, was independently associated with high leptin levels. The intra-class correlation for leptin was similar (0.6–0.7), independently of sex, ethnicity or follow-up time. No seasonal variation in leptin levels was seen.

Conclusion: Asian Indians have higher levels of leptin, leptin/BMI and leptin/waist than Creoles and Europids. Leptin has a high intra-individual stability and seasonal leptin variation does not appear to explain the ethnic differences observed here.

Kiwi ACE

This study used a RCT to determine the efficacy of a school-based indicated preventive depression programme with adolescents identified as experiencing depressive symptoms. At one-year follow-up students had significantly improved scores effective across gender and ethnicity. Findings were supported by data from teachers and student focus groups.

House for Heraclitus

Notions of Australian identity are still being constructed. In landscape painting, problematic differences of possession, ownership, spirituality and ethnicity are frequently highlighted against perceptions of what landscape looks like and how we might begin to imagine our relationships to where we live. This thesis has explored strategies employed in landscape construction. It has involved establishing connections between landscape painting and alternate disciplines that investigate landscape values, many of which aspire to the successful habitation of our environments into the future.

Overseas Chinese as expatriate managers in China : is their recruitment a solution to cross-cultural management problems for multinationals operating in China?

The rapid economic development has gravitated businesses into the Chinese market. It’s entry into the World Trade Organization in 2001 made her an even more formidable player in the global economy and direct foreign investment surged. Yet it is acknowledged that for the foreign investor in China, cross-cultural issues create difficulty at every level, from the intercultural level relating to communication and negotiation, to the organizational level relating to decision making, human resource management practices, corporate legal institutions and dealing with governments. Western multinationals have considered the advantages of posting overseas Chinese, from Southeast Asian countries, Taiwan Hong Kong and etc. But has this policy been successful? In terms of language expertise and cultural literacy this would seem to be a good strategy, yet organizational case material contradicts this in reality. Overseas Chinese, while sharing some elements of Chinese culture with mainland Chinese, the Confucian heritage and other aspects such as language, diet, etc, nevertheless have different world views and values and behave differently from mainland Chinese in areas critical to business management. As a survival strategy, overseas Chinese often developed dual identities operating simultaneously. For many of them, for political and historical reasons, they have had to adapt to the local culture or even hide their own ethnicity in order to survive. On the other hand, the mainland Chinese are different in the sense that their behaviour has only had to be Chinese, but overlaid with this has been the experience of participating in a communist political environment for decades, which has left its mark on mainland Chinese culture. On the basis of this, in the current business environment in China confusion, difficulties and conflict may occur for the overseas Chinese. This paper aims to provide insights of the cultural differences between the overseas Chinese and mainland Chinese. It provides evidence that overseas Chinese are not often favoured by the local Chinese. This problem has yet to be researched in depth within international business and international management studies. It draws the attention to issues on how to manage the local Chinese.

Computers for secondary mathematics: who uses them and how?

In the first stage of a three year ARC-funded study in which the effects of using computers for the teaching and learning of mathematics are being explored, a questionnaire has been developed and is being administered to a large number of students in grades 7-10 in a representative sample of co-educational post-primary schools in Victoria. Using open and closed response formats, the information sought includes: background and biographical details; data on computer ownership and use =96 frequency and mode/s =96 for mathematics learning at home and in mathematics classes; and beliefs about mathematics and the use of computers for learning mathematics. In this paper, the focus will be on some of the preliminary findings related to ownership and use of computers for learning mathematics at home and at school. In previous research, factors such as gender, socio-economic background, and ethnicity have been identified as contributors to inequitable mathematics learning outcomes. The questionnaire data will be analysed to examine if these and other factors are related to any inequities identified in student's access to computers and in how they use computers in their learning of mathematics. The results will be presented and pertinent implications discussed.

Waist circumference has heterogeneous impact on development of diabetes in different populations : Longitudinal comparative study between Australia and Iran

Aims : Comparing waist circumference (WC) role in diabetes risk prediction and diagnosis of metabolic syndrome (MS) in different populations.

Methods : Population-based samples from Australia (n = 9026) and Iran (n = 8259) were studied in 2000 and followed for 4 years. Follow-up attendance was 58% and mean age was 51 vs. 47. Pearson correlations calculated between WC and other MS components. ROC for the role of WC in the prediction of incident diabetes was used.

Results : Prevalences of MS (48% vs. 28%), an increased WC (58.5% vs. 54.5%), low HDL-C (35% vs. 11.2%), high triglyceride (52.2% vs. 29.6%) were significantly higher in Iran. Fasting glucose ≥5.6 mmol/L was higher in Australia (26% vs. 23%). Hypertension was no different (38%). Pearson correlations between WC and other MS components were stronger in Australians: FPG (0.32 vs. 0.2), HDL (0.47 vs. 0.16), TG (0.38 vs. 0.30) and SBP (0.38 vs. 0.36). Among women, area under ROC curve for WC as a predictor for diabetes was significantly higher for Australians (0.76 vs. 0.68, p < 0.001) with no difference among men (0.69 vs. 0.71, p = 0.4).

Conclusion : WC was more strongly related to other components of MS in Australia. Association between WC and MS or incident diabetes varies between ethnicities.