The role of inflammation in the pathogenesis of non-small cell lung cancer

The link between chronic immune activation and tumorigenesis is well established. Compelling evidence has accumulated that histologic assessment of infiltration patterns of different host immune response components in non-small cell lung cancer specimens helps identify different prognostic patient subgroups. This review provides an overview of recent insights gained in the understanding of the role played by chronic inflammation in lung carcinogenesis. The usefulness of quantification of different populations of lymphocytes, natural killer cells, macrophages, and mast cells within the tumor microenvironment in non-small cell lung cancer is also discussed. In particular, the importance of assessment of inflammatory cell microlocalization within both the tumor islet and surrounding stromal components is emphasized. Copyright © 2010 by the International Association for the Study of Lung Cancer.

The increasing cost of the basic foods required to promote health in Queensland

Objective: To assess changes in the cost and availability of a standard basket of healthy food items (the Healthy Food Access Basket [HFAB]) in Queensland over time. Design and participants: A series of four cross-sectional surveys (in 1998, 2000, 2001 and 2004) describing the cost and availability of foods in the HFAB over time. In the latest survey, 97 Queensland food stores across the five Australian Bureau of Statistics remoteness categories were compared. Main outcome measures: Cost comparisons for HFAB items by remoteness category for the 97 stores surveyed in 2004; changes in cost and availability of foods in the 81 stores surveyed since 2000; comparisons of food prices in the 56 stores surveyed in 1998, 2000, 2001 and 2004. Results: In 2004, the Queensland mean cost of the HFAB was $395.28 a fortnight. The cost of the HFAB was 29.6%($113.89) higher in “very remote” areas than in “major cities” (P<0.001). Between 2001 and 2004, the Queensland mean cost of the HFAB increased by 14.0% ($48.45), while in very remote areas the cost increased by 18.0% ($76.93) (P<0.001). Since 2000, the annualised per cent increase in cost of the HFAB has been higher than the increase in Consumer Price Index for food in Brisbane. The cost of healthy foods has risen more than the cost of some less nutritious foods, so that the latter are now relatively more affordable. Conclusions: Consumers, particularly those in very remote locations, need to pay substantially more for basic healthy foods than they did a few years ago. Higher prices are likely to be a barrier to good health among people of low socioeconomic status and other vulnerable groups. Interventions to make basic healthy food affordable and accessible to all would help reduce the high burden of chronic disease.

High risk feet in subacute rehabilitation facilities : how many are there?

Background Australian subacute rehabilitation facilities face significant challenges from the ageing population with increased burden of chronic disease. High risk foot complications are a negative consequence of many chronic diseases. With the rapid expansion of subacute services, it seems imperative to investigate the prevalence of foot complications in this population. The primary aim of this study was to quantify the high risk foot complication prevalence in a subacute rehabilitation population. Methods Eligible participants were all adults admitted overnight, over two 4 week periods, into a large Australian subacute rehabilitation facility. Consenting participants underwent a short non-invasive foot examination by a podiatrist. The standard Queensland Health High Risk Foot Form collected data on age, sex, co-morbidities and foot complications. Descriptive statistics, logistic regression and odds ratios were used to determine the prevalence of foot complications and associations with explanatory variables. Results Overall, 85 of 97 eligible participants consented; mean age 80(9) and 71% were female. At least one foot complication was present in 56.5% participants; including 21.2% defined as high risk and 11.8% current foot ulcer. A previous diagnosis of neuropathy increased the risk of presenting with a high risk foot by 13-fold (OR 13.504, p = 0.001). Conclusion This study highlights the significance of foot complications in the subacute population. It appears that one in every two patients present with a foot complication and one in eight with a foot ulcer. It is suggested all patients admitted to subacute rehabilitation services should be screened for foot complications.

Current dementia research in Australia : a report from the Alzheimer's Australia 15th National Conference

The Alzheimer’s Australia 15th National Conference held on 14–17 May 2013 in Hobart (Tasmania, Australia) attracted a wide range of attendees, including people living with dementia, family caregivers, health professionals and researchers. The conference theme, The Tiles of Life Coloring the Future, invoking a vision of a better future for those affected by dementia, had seven subthemes: liberation, rehabilitation, leisure,service, creativity, wellbeing and research.

Psychological determinants and outcomes of sedentary and physical activity behaviours

There is now a large body of literature that supports the protective role of physical activity for both physical and psychological health. Sedentary behaviour was previously considered the functional opposite of physical activity, but 10 years ago, Owen and colleagues highlighted the need to study physical activity and sedentary behaviour as two distinct modes of behaviour that can independently influence health [1]. Since then, there has been growing evidence that participation in sedentary behaviours such as television viewing, computer use and sitting at work are associated with higher risk of chronic disease outcomes (type 2 diabetes, obesity), and leisure-time sitting has recently been associated with increased mortality [2]. Growing research points to the possible synergistic effects of physical activity and sedentary behaviours in contributing to health outcomes

Physical activity promotion as a school priority : what do parents think?

The demands and responsibilities placed on schools in contemporary education systems are vast. However, with growing obesity levels and physical inactivity, the prevention of chronic disease has focused on youth populations, with schools playing the focal educative asset in this strategy. Parents play a decisive role in their child’s educational setting, and as fee and tax payers, are ultimately a consumer. Parents (82 males and 208 females) of secondary school children were recruited from three private (n=151) and two government schools (n=150) in Brisbane, Australia. The mean (standard deviation) age was 44.57 (6.21) years. Participants responded to a series of questions about physical activity at their child’s school, in addition to completing the International Physical Activity Questionnaire. Data were analysed using descriptive statistics, frequency distributions and logistic regressions. Parents were deemed sufficiently physically active if they participated in at least 150 minutes of moderate-to-vigorous physical activity per week. Overall, 83 (59.7%) parents from private and 60 (50.8%) parents from government schools were deemed sufficiently physically active. Concerning whether physical activity promotion should be a priority at their child’s school, 111 (73.5%) parents from private schools either agreed or strongly agreed, as opposed to 97 (64.7%) parents from government schools. Logistic regressions indicated that the concept of physical activity promotion being prioritised at schools was dependent on whether the child attended a private school (OR =1.34, z = 2.30, p = 0.02), and whether the participant was sufficiently active (OR =.71, z = -2.48, p = 0.01). Physical activity promotion within schools may provide substantial future benefits on a population scale. The demands on schools may need to be addressed to meet the needs of students and the desires of their parents.

The effect of a supervised exercise training programme on sleep quality in recently discharged heart failure patients

Background Sleep disturbances, including insomnia and sleep-disordered breathing, are a common complaint in people with heart failure and impair well-being. Exercise training (ET) improves quality of life in stable heart failure patients. ET also improves sleep quality in healthy older patients, but there are no previous intervention studies in heart failure patients. Aim The aim of this study was to examine the impact of ET on sleep quality in patients recently discharged from hospital with heart failure. Methods This was a sub-study of a multisite randomised controlled trial. Participants with a heart failure hospitalisation were randomised within six weeks of discharge to a 12-week disease management programme including exercise advice (n=52) or to the same programme with twice weekly structured ET (n=54). ET consisted of two one-hour supervised aerobic and resistance training sessions, prescribed and advanced by an exercise specialist. The primary outcome was change in Pittsburgh Sleep Quality Index (PSQI) between randomisation and week 12. Results At randomisation, 45% of participants reported poor sleep (PSQI≥5). PSQI global score improved significantly more in the ET group than the control group (–1.5±3.7 vs 0.4±3.8, p=0.03). Improved sleep quality correlated with improved exercise capacity and reduced depressive symptoms, but not with changes in body mass index or resting heart rate. Conclusion Twelve weeks of twice-weekly supervised ET improved sleep quality in patients recently discharged from hospital with heart failure.

An Asian perspective of occupational stress coping model : a case study of Sri Lankan employees

Sri Lanka has one of the highest rates of natural disasters and violent conflicts in the world. Yet there is a lack of research on its unique socio-cultural characteristics that determine an individual's cognitive and behavioural responses to distressing encounters. This study extends Goh, Sawang and Oei's (2010) revised transactional model to examine the cognitive and behavioural processes of occupational stress experience in the collectivistic society of Sri Lanka. A time series survey was used to measure the participant's stress-coping process. Using the revised transactional model and path analysis, a unique Sri Lankan model is identified that provides theoretical insights on the revised transactional model, and sheds light on socio-cultural dimensions of occupational stress and coping, thus equipping practitioners with a sound theoretical basis for the development of stress management programs in the workplace.

Predictors of mental health in midlife and older women : results from the Australian Healthy Aging of Women Study

Purpose: To examine the extent to which socio-demographic characteristics, modifiable lifestyle factors and health status influence the mental health of midlife and older Australian women from the Australian Healthy Aging of Women (HOW) study. Methods: Data on health status, chronic disease and modifiable lifestyle factors were collected from a random sample of 340 women aged 40-65 years, residing in Queensland, Australia in 2011. Structural equation modelling (SEM) was used to measure the effect of a range of socio-demographic characteristics (marital status, age, income), modifiable lifestyle factors (caffeine intake, alcohol consumption, exercise, physical activity, sleep), and health markers (self-reported physical health, history of chronic illness) on the latent construct, mental health. Mental health was evaluated using the Medical Outcomes Study Short Form 12 (SF-12®) and the Center for Epidemiologic Studies Depression Scale (CES-D). Results: The model was a good fit for the data (χ2 = 40.166, df =312, p 0.125, CFI = 0.976, TLI = 0.950, RMSEA = 0.030, 90% CI = 0.000-0.053); the model suggested mental health was negatively influenced by sleep disturbance (β = -0.628), sedentary lifestyle (β = -0.137), having been diagnosed with one or more chronic illnesses (β = -0.203), and poor self-reported physical health (β = - 0.161). While mental health was associated with sleep, it was not correlated with many other lifestyle factors (BMI (β = -0.050), alcohol consumption (β = 0.079), or cigarette smoking (β = 0.008)) or background socio-demographic characteristics (age (β = 0.078), or income (β = -0.039)). Conclusion: While research suggests that it is important to engage in a range health promoting behaviours to preserve good health, we found that only sleep disturbance, physical health, chronic illness and level of physical activity predicted current mental health. However, while socio-demographic characteristics and modifiable lifestyle factors seemed to have little direct impact on mental health, they probably had an indirect effect.

What predicts mental health in midlife and older women? Results from the Australian Healthy Aging of Women Study

Objectives: Previous research has linked unhealthy lifestyle with a range of negative health outcomes in women. As women age however, they may have fewer performance expectations, but may view their health more positively. Clearly, the experiences of midlife and older women in relation to health and wellbeing need further exploration. The purpose of this study is to examine the factors associated with poor health-related quality of life in midlife (HRQoL) and older Australian women. Methods: The Australian longitudinal Healthy Aging of Women (HOW) study prospectively examines HRQoL, chronic disease and modifiable lifestyle factors midlife and older women as they age. Random sampling was used to select rural and urban based women from South-East Queensland, Australia. Data were collected from 386 women at three time points over the last decade (2001, 2004 and 2011). Results: The average age of women in this study was 65 years (SD = 2.82). Almost three-quarters (73%, n = 248) of the sample were married or living as though married, nine per cent (n = 30) were separated or divorced and a small proportion were had never married (n = 13). Most (86%, n = 291) of the women sample reported being Australian born, around one quarter (34%, n = 114) had completed additional study since leaving school (university degree or diploma). Over half (55%, n = 186) of participants were retired, one quarter (25%, n = 85) were in paid employment and the remained were unemployed (1%, n = 4), unable to work because of illness (2%, n = 6) or worked within the home (17%, n = 56). Using data collected over time we examined the relationship between a range of modifiable lifestyle factors and mental health using structural equation modelling. The overall model exhibited a good fit with the data. Poor sleep quality was associated with reduced mental health while better mental health was reported in women who exercised regularly and satisfied with their currently weight. As hypothesized, past mental health was a significant mediator of current mental health. Conclusions: These findings demonstrate that the mental health of women is complex and needs to be understood not only in terms of current lifestyle but also in relation to previously reported health status.

How does Nepal Television (NTV) frame natural disasters? A qualitative content analysis of news scripts using news frames and PPRR cycle

Introduction- This study investigates the prevailing status of Nepalese media portrayal of natural disasters. It is contributing to the development of a disaster management model to improve the effectiveness and efficiency of news production throughout the continuum of prevention, preparedness, response and recovery (PPRR) phases of disaster management. Theoretical framework- Studies of media content often rely on framing as the theoretical underpinning of the study, as it describes how the press crafts the message. However there are additional theoretical perspectives that underline an understanding of the role of the media. This article outlines a conceptual understanding of the role of the media in modern society, the way that this conceptual understanding is used in the crafting of media messages and how those theoretical considerations are applied to the concepts that underpin effective disaster management. (R.M. Entman, 2003; Liu, 2007; Meng & Berger, 2008). Methodology- A qualitative descriptive design is used to analyse the disaster news of Nepal Television (NTV). However, this paper presents the preliminary findings of Nepal Television (a government owned Television station) using qualitative content analysis of 105 natural disaster related news scripts (June 2012-March 2013) based on the framing theory and PPRR cycle. Results- The preliminary results indicate that the media focus while framing natural disasters is dominated by human interest frame followed by responsibility frame. News about response phase was found to be most prominent in terms of PPRR cycle. Limited disaster reporting by NTV has impacted the national disaster management programs and strategies. The findings describe natural disasters are being reported within the limited understanding of the important principles of disaster management and PPRR cycle. Conclusion- This paper describes the current status of the coverage of natural disasters by Nepal Television to identify the frames used in the news content. It contributes to determining the characteristics of effective media reporting of natural disasters in the government owned media outlets, and also leads to including communities and agencies involved in disasters. It suggests the frames which are best suited for news making and how media responds to the different phases of the disaster cycle.

Relevance of the deletion polymorphisms of the glutathione S-transferases GSTT1 and GSTM1 in pharmacology and toxicology

Although cytosolic glutathione S-transferase (GST) enzymes occupy a key position in biological detoxification processes, two of the most relevant human isoenzymes, GSTT1-1 and GSTM1-1, are genetically deleted (non-functional alleles GSTT1*0 and GSTM1*0) in a high percentage of the human population, with major ethnic differences. The structures of the GSTT and GSTM gene areas explain the underlying genetic processes. GSTT1-1 is highly conserved during evolution and plays a major role in phase-II biotransformation of a number of drugs and industrial chemicals, e.g. cytostatic drugs, hydrocarbons and halogenated hydrocarbons. GSTM1-1 is particularly relevant in the deactivation of carcinogenic intermediates of polycyclic aromatic hydrocarbons. Several lines of evidence suggest that hGSTT1-1 and/or hGSTM1-1 play a role in the deactivation of reactive oxygen species that are likely to be involved in cellular processes of inflammation, ageing and degenerative diseases. There is cumulating evidence that combinations of the GSTM1*0 state with other genetic traits affecting the metabolism of carcinogens (CYP1A1, GSTP1) may predispose the aero-digestive tract and lung, especially in smokers, to a higher risk of cancer. The GSTM1*0 status appears also associated with a modest increase in the risk of bladder cancer, consistent with a GSTM1 interaction with carcinogenic tobacco smoke constituents. Both human GST deletions, although largely counterbalanced by overlapping substrate affinities within the GST superfamily, have consequences when the organism comes into contact with distinct man-made chemicals. This appears relevant in industrial toxicology and in drug metabolism.

Markers of genetic susceptibility in human environmental hygiene and toxicology : the role of selected CYP, NAT and GST genes

Inherited genetic traits co-determine the susceptibility of an individual to a toxic chemical. Special emphasis has been put on individual responses to environmental and industrial carcinogens, but other chronic diseases are of increasing interest. Polymorphisms of relevant xenobiotic metabolising enzymes may be used as toxicological susceptibility markers. A growing number of genes encoding enzymes involved in biotransformation of toxicants and in cellular defence against toxicant-induced damage to the cells has been identified and cloned, leading to increased knowledge of allelic variants of genes and genetic defects that may result in a differential susceptibility toward environmental toxicants. "Low penetrating" polymorphisms in metabolism genes tend to be much more common in the population than allelic variants of "high penetrating" cancer genes, and are therefore of considerable importance from a public health point of view. Positive associations between cancer and CYP1A1 alleles, in particular the *2C I462V allele, were found for tissues following the aerodigestive tract. Again, in most cases, the effect of the variant CYP1A1 allele becomes apparent or clearer in connection with the GSTM1 null allele. The CYP1B1 codon 432 polymorphism (CYP1B1*3) has been identified as a susceptibility factor in smoking-related head-and-neck squameous cell cancer. The impact of this polymorphic variant of CYP1B1 on cancer risk was also reflected by an association with the frequency of somatic mutations of the p53 gene. Combined genotype analysis of CYP1B1 and the glutathione transferases GSTM1 or GSTT1 has also pointed to interactive effects. Of particular interest for the industrial and environmental field is the isozyme CYP2E1. Several genotypes of this isozyme have been characterised which seem to be associated with different levels of expression of enzyme activity. The acetylator status for NAT2 can be determined by genotyping or by phenotyping. In the pathogenesis of human bladder cancer due to occupational exposure to "classical" aromatic amines (benzidine, 4-aminodiphenyl, 1-naphthylamine) acetylation by NAT2 is regarded as a detoxication step. Interestingly, the underlying European findings of a higher susceptibility of slow acetylators towards aromatic amines are in contrast to findings in Chinese workers occupationally exposed to aromatic amines which points to different mechanisms of susceptibility between European and Chinese populations. Regarding human bladder cancer, the hypothesis has been put forward that genetic polymorphism of GSTM1 might be linked with the occurrence of this tumour type. This supports the hypothesis that exposure to PAH might causally be involved in urothelial cancers. The human polymorphic GST catalysing conjugation of halomethanes, dihalomethanes, ethylene oxide and a number of other industrial compounds could be characterised as a class theta enzyme (GSTT1) by means of molecular biology. "Conjugator" and "non-conjugator" phenotypes are coincident with the presence and absence of the GSTT1 gene. There are wide variations in the frequencies of GSTT1 deletion (GSTT1 *0/0) among different ethnicities. Human phenotyping is facilitated by the GST activity towards methyl bromide or ethylene oxide in erythrocytes which is representative of the metabolic GSTT1 competence of the entire organism. Inter-individual variations in xenobiotic metabolism capacities may be due to polymorphisms of the genes coding for the enzymes themselves or of the genes coding for the receptors or transcription factors which regulate the expression of the enzymes. Also, polymorphisms in several regions of genes may cause altered ligand affinity, transactivation activity or expression levels of the receptor subsequently influencing the expression of the downstream target genes. Studies of individual susceptibility to toxicants and gene-environment interaction are now emerging as an important component of molecular epidemiology.

The impact of Cool Roof applications on energy performance : results from Australian sub-tropical and tropical field studies

Cool roof coatings are identified by their solar reflectance index. They have been reported to have multiple benefits, the extent of which are strongly dependent on the peculiarities of the local climate, building stock and electricity network. This paper presents measured and simulated data from residential, educational and commercial buildings involved in recent field trials in Australia. The purpose of the field trials was to evaluate the impact of such coatings on electricity demand and load and to assess their potential application to improve comfort whilst avoiding the need for air conditioners. Measured reductions in temperature, power (kW) and energy (kWh) were used to develop a predictive model that correlates ambient temperature distribution profiles, building demand reduction profiles and electricity network peak demand times. Combined with simulated data, the study indicates the types of buildings that could be targeted in Demand Management programs for the mutual benefit of electricity networks and building occupants.