Postpartum care for Aboriginal and non-Aboriginal women with Gestational Diabetes Mellitus across urban, rural and remote locations : a protocol for a cohort linkage study

Background: Gestational diabetes mellitus (GDM) is increasing, along with obesity and type 2 diabetes (T2DM), with Aboriginal and Torres Strait Islander people* in Australia particularly affected. GDM causes serious complications in pregnancy, birth, and the longer term, for both women and their infants. Women diagnosed with GDM have an eightfold risk of developing T2DM after pregnancy, compared with women who have not had GDM. Indigenous women have an even higher risk, at a younger age, and progress more quickly from GDM to T2DM, compared to non-Indigenous women. If left undetected and untreated, T2DM can lead to heart disease, stroke, renal disease, kidney failure, amputations and blindness. A GDM diagnosis offers a ‘window of opportunity’ for diabetes health interventions and it is vital that acceptable and effective prevention, treatment, and post-pregnancy care are provided. Low rates of post-pregnancy screening for T2DM are reported among non-Aboriginal women in Australia and among Indigenous women in other countries, however data for Aboriginal women are scarce. Breastfeeding, a healthy diet, and exercise can also help to prevent T2DM, and together with T2DM screening are recommended elements of ‘post-pregnancy care’ for women with GDM, This paper describes methods for a data linkage study to investigate rates of post-pregnancy care among women with GDM. Methods/Design: This retrospective cohort includes all women who gave birth at Cairns Base Hospital in Far North Queensland, Australia, from 2004 to 2010, coded as having GDM in the Cairns Base Hospital Clinical Coding system. Data linkage is being conducted with the Queensland Perinatal Data Collection, and three laboratories. Hospital medical records are being reviewed to validate the accuracy of GDM case ascertainment, and gather information on breastfeeding and provision of dietary advice. Multiple logistic regression is being used to compare post-pregnancy care between Aboriginal and non-Aboriginal women, while adjusting for other factors may impact on post-pregnancy care. Survival analysis is being used to estimate the rates of progression from GDM to T2DM. Discussion: There are challenges to collecting post-pregnancy data for women with GDM. However, research is urgently needed to ensure adequate post-pregnancy care is provided for women with GDM in Australia.

Genes and growth performance in crustacean species : a review of relevant genomic studies in crustaceans and other taxa

Global aquaculture has expanded rapidly to address the increasing demand for aquatic protein needs and an uncertain future for wild fisheries. To date, however, most farmed aquatic stocks are essentially wild and little is known about their genomes or the genes that affect important economic traits in culture. Biologists have recognized that recent technological advances including next generation sequencing (NGS) have opened up the possibility of generating genome wide sequence data sets rapidly from non-model organisms at a reasonable cost. In an era when virtually any study organism can 'go genomic', understanding gene function and genetic effects on expressed quantitative trait locus phenotypes will be fundamental to future knowledge development. Many factors can influence the individual growth rate in target species but of particular importance in agriculture and aquaculture will be the identification and characterization of the specific gene loci that contribute important phenotypic variation to growth because the information can be applied to speed up genetic improvement programmes and to increase productivity via marker-assisted selection (MAS). While currently there is only limited genomic information available for any crustacean species, a number of putative candidate genes have been identified or implicated in growth and muscle development in some species. In an effort to stimulate increased research on the identification of growth-related genes in crustacean species, here we review the available information on: (i) associations between genes and growth reported in crustaceans, (ii) growth-related genes involved with moulting, (iii) muscle development and degradation genes involved in moulting, and; (iv) correlations between DNA sequences that have confirmed growth trait effects in farmed animal species used in terrestrial agriculture and related sequences in crustacean species. The information in concert can provide a foundation for increasing the rate at which knowledge about key genes affecting growth traits in crustacean species is gained.

Melanocortin-1 receptor genotype is a risk factor for basal and squamous cell carcinoma

MC1R gene variants have previously been associated with red hair and fair skin color, moreover skin ultraviolet sensitivity and a strong association with melanoma has been demonstrated for three variant alleles that are active in influencing pigmentation: Arg151Cys, Arg160Trp, and Asp294His. This study has confirmed these pigmentary associations with MC1R genotype in a collection of 220 individuals drawn from the Nambour community in Queensland, Australia, 111 of whom were at high risk and 109 at low risk of basal cell carcinoma and squamous cell carcinoma. Comparative allele frequencies for nine MC1R variants that have been reported in the Caucasian population were determined for these two groups, and an association between prevalence of basal cell carcinoma, squamous cell carcinoma, solar keratosis and the same three active MC1R variant alleles was demonstrated [odds ratio = 3.15 95% CI (1.7, 5.82)]. Three other commonly occurring variant alleles: Val60Leu, Val92Met, and Arg163Gln were identified as having a minimal impact on pigmentation phenotype as well as basal cell carcinoma and squamous cell carcinoma risk. A significant heterozygote effect was demonstrated where individuals carrying a single MC1R variant allele were more likely to have fair and sun sensitive skin as well as carriage of a solar lesion when compared with those individuals with a consensus MC1R genotype. After adjusting for the effects of pigmentation on the association between MC1R variant alleles and basal cell carcinoma and squamous cell carcinoma risk, the association persisted, confirming that presence of at least one variant allele remains informative in terms of predicting risk for developing a solar-induced skin lesion beyond that information wained through observation of pigmentation phenotype.

Social technologies in public libraries : exploring best practice

Purpose This article reports on a research project that explored social media best practice in the public library sector. Design/methodology/approach The primary research approach for the project was case study. Two organisations participated in case studies that involved interviews, document analysis, and social media observation. Findings The two case study organisations use social media effectively to facilitate participatory networks, however, there have been challenges surrounding its implementation in both organisations. Challenges include negotiating requirements of governing bodies and broader organisational environments, and managing staff reluctance around the implementations. As social media use continues to grow and libraries continue to take up new platforms, social media must be considered to be another service point of the virtual branch, and indeed, for the library service as a whole. This acceptance of social media as being core business is critical to the successful implementation of social media based activities. Practical implications The article provides an empirically grounded discussion of best practice and the conditions that support it. The findings are relevant for information organisations across all sectors and could inform the development of policy and practice in other organisations. This paper contributes to the broader dialogue around best practice in participatory service delivery and social media use in library and information organisations.

Rank minimization across appearance and shape for AAM ensemble fitting

Active Appearance Models (AAMs) employ a paradigm of inverting a synthesis model of how an object can vary in terms of shape and appearance. As a result, the ability of AAMs to register an unseen object image is intrinsically linked to two factors. First, how well the synthesis model can reconstruct the object image. Second, the degrees of freedom in the model. Fewer degrees of freedom yield a higher likelihood of good fitting performance. In this paper we look at how these seemingly contrasting factors can complement one another for the problem of AAM fitting of an ensemble of images stemming from a constrained set (e.g. an ensemble of face images of the same person).

The impact of professional development on early childhood educators’ confidence, understanding and knowledge of education for sustainability

In recent times, Australia has recognised and enacted a range of initiatives at service, system and community levels that seek to embed sustainability into the early childhood sector. This paper explores the impact of a professional development (PD) session that provided opportunities for early childhood educators to learn and share ideas about the theory and practice of sustainability generally and early childhood education for sustainability (ECEfS) specifically. The PD was entitled ‘Living and Learning about Sustainability in the Early Years’ and was offered on three occasions across Tasmania. A total of 99 participants attended the three PD sessions (one 5 hour; two 2 hour). The participants had varying levels of experience and included early childhood teachers, centre based educators and preservice teachers. At the start and end of the PD, participants were invited to complete a questionnaire that contained a series of likert scale questions that explored their content knowledge, level of understanding and confidence in regards to ECEfS. Participants were also asked at the start and end of the PD to ‘list five words you think of when you consider the word sustainability.’ A model of teacher professional growth was used to conceptualise the results related to the changes in knowledge, understanding and confidence (personal domain) as a result of the PD related to ECEfS (external domain). The likert-scale questions on the questionnaire revealed significant positive changes in levels of knowledge, understanding and confidence from the start to the end of the PD. Differences as a function of length of PD, level of experience and role are presented and discussed. The ‘5 words’ question showed that participants widened their understandings of ECEfS from a narrow environmental focus to a broader understanding of the social, political and economic dimensions. The early childhood education and care (ECEC) sector has been characterised as having a pedagogical advantage for EfS suggesting that early childhood educators are well placed to engage with EfS more readily than might educators in other education sectors. This article argues that PD is necessary to develop capability in educators in order to meet the imperatives around sustainability outlined in educational policy and curriculum documents in ECEC.

Exome sequencing identifies recurrent somatic RAC1 mutations in melanoma

We characterized the mutational landscape of melanoma, the form of skin cancer with the highest mortality rate, by sequencing the exomes of 147 melanomas. Sun-exposed melanomas had markedly more ultraviolet (UV)-like C>T somatic mutations compared to sun-shielded acral, mucosal and uveal melanomas. Among the newly identified cancer genes was PPP6C, encoding a serine/threonine phosphatase, which harbored mutations that clustered in the active site in 12% of sun-exposed melanomas, exclusively in tumors with mutations in BRAF or NRAS. Notably, we identified a recurrent UV-signature, an activating mutation in RAC1 in 9.2% of sun-exposed melanomas. This activating mutation, the third most frequent in our cohort of sun-exposed melanoma after those of BRAF and NRAS, changes Pro29 to serine (RAC1P29S) in the highly conserved switch I domain. Crystal structures, and biochemical and functional studies of RAC1P29S showed that the alteration releases the conformational restraint conferred by the conserved proline, causes an increased binding of the protein to downstream effectors, and promotes melanocyte proliferation and migration. These findings raise the possibility that pharmacological inhibition of downstream effectors of RAC1 signaling could be of therapeutic benefit.

Fresh ideas : services thinking for social marketing

Purpose The social marketing literature tends to focus on upstream marketing (policy) and downstream (individual behaviour change) and has a limited view on midstream (working with partners and community groups) social marketing. The paper proposes midstream social marketing should also include an understanding of how services and service employees influence and support individual behaviour change goals. The paper presents four key services marketing principles - derived from services theory and thinking - which the paper believes to be essential for implementing effective midstream social marketing. Design/methodology/approach This is a conceptual paper that uses service theory and case-examples to show how service thinking can be used as a midstream social marketing approach. Findings For effective uptake and impact of social marketing services amongst people and populations, social marketers need to design programs that consider the service experience, the service employee, service quality/customer value and the active role of the customer in value creation. Research limitations/implications Services marketing is a well-established sub-discipline of marketing which, until recently, has not interacted with social marketing. The extension and application of services theory for social marketing can enrich and propel the social marketing discipline forward. Further research is recommended to evaluate how service principles can be applied in practice. Social implications Given that social marketing services tend not to be accessed in sufficient numbers by the people who most need them, social marketers need to think beyond the technical, cognitive, and organisational-focused goals when designing social services. Originality/value This paper identifies key service theories that social marketers should understand and use and is thus a source of fresh ideas for theory and practice.

The value of health and wellbeing : an empirical model of value creation in social marketing

Purpose The purpose of this paper is to investigate the role of multiple actors in the value creation process for a preventative health service, and observe the subsequent impact on key service outcomes of satisfaction and customer behaviour intentions to use a preventative health service again in the future. Design/methodology/approach An online self-completion survey of Australian women (n=797) was conducted to test the proposed framework in the context of a free, government-provided breastscreening service. Data were analysed using Structural Equation Modelling (SEM). Findings The findings indicate that functional and emotional value are created from organisational and customer resources. These findings indicate that health service providers and customers are jointly responsible for the successful creation of value, leading to desirable outcomes for all stakeholders. Practical implications The results highlight to health professionals the aspects of service that can be managed in order to create value with target audiences. The findings also indicate the importance of the resources provided by users in the creation of value, signifying the importance of customer education and management. Originality/value This study provides a significant contribution to social marketing through the provision of an empirically validated model of value creation in a preventative health service. The model demonstrates how the creation and provision of value can lead to the achievement of desirable social behaviours - a key aim of social marketing.

Exosomes in prostate cancer: Putting together the pieces of a puzzle

Exosomes have been shown to act as mediators for cell to cell communication and as a potential source of biomarkers for many diseases, including prostate cancer. Exosomes are nanosized vesicles secreted by cells and consist of proteins normally found in multivesicular bodies, RNA, DNA and lipids. As a potential source of biomarkers, exosomes have attracted considerable attention, as their protein content resembles that of their cells of origin, even though it is noted that the proteins, miRNAs and lipids found in the exosomes are not a reflective stoichiometric sampling of the contents from the parent cells. While the biogenesis of exosomes in dendritic cells and platelets has been extensively characterized, much less is known about the biogenesis of exosomes in cancer cells. An understanding of the processes involved in prostate cancer will help to further elucidate the role of exosomes and other extracellular vesicles in prostate cancer progression and metastasis. There are few methodologies available for general isolation of exosomes, however validation of those methodologies is necessary to study the role of exosomal-derived biomarkers in various diseases. In this review, we discuss “exosomes” as a member of the family of extracellular vesicles and their potential to provide candidate biomarkers for prostate cancer.