Interactions of ingested food, beverage, and tobacco components involving human cytochrome P4501A2, 2A6, 2E1, and 3A4 enzymes

Human cytochrome P450 (P450) enzymes are involved in the oxidation of natural products found in foods, beverages, and tobacco products and their catalytic activities can also be modulated by components of the materials. The microsomal activation of aflatoxin B1 to the exo-3,9-epoxide is stimulated by flavone and 7,8-benzoflavone, and attenuated by the flavonoid naringenin, a major component of grapefruit. P4502E1 has been demonstrated to play a potentially major role in the activation of a number of very low-molecular weight cancer suspects, including ethyl carbamate (urethan), which is present in alcoholic beverages and particularly stone brandies. The enzyme (P4502E1) is also known to be inducible by ethanol. Tobacco contains a large number of potential carcinogens. In human liver microsomes a significant role for P4501A2 can be demonstrated in the activation of cigarette smoke condensate. Some of the genotoxicity may be due to arylamines. P4501A2 is also inhibited by components of crude cigarette smoke condensate. The tobacco-specific nitrosamines are activated by a number of P450 enzymes. Of those known to be present in human liver, P4501A2, 2A6, and 2E1 can activate these nitrosamines to genotoxic products.

Technicolouring the fridge : reducing food waste through uses of colour-coding and cameras

Domestic food wastage is a growing problem for the environment and food security. Some causes of domestic food wastes are attributed to a consumer’s behaviours during food purchasing, storage and consumption, such as: excessive food purchases and stockpiling in storage. Recent efforts in human-computer interaction research have examined ways of influencing consumer behaviour. The outcomes have led to a number of interventions that assist users with performing everyday tasks. The Internet Fridge is an example of such an intervention. However, new pioneering technologies frequently confront barriers that restrict their future impact in the market place, which has prompted investigations into the effectiveness of behaviour changing interventions used to encourage more sustainable practices. In this paper, we investigate and compare the effectiveness of two interventions that encourage behaviour change: FridgeCam and the Colour Code Project. We use FridgeCam to examine how improving a consumer’s food supply knowledge can reduce food stockpiling. We use the Colour Code Project to examine how improving consumer awareness of food location can encourage consumption of forgotten foods. We explore opportunities to integrate these interventions into commercially available technologies, such as the Internet Fridge, to: (i) increase the technology’s benefit and value to users, and (ii) promote reduced domestic food wastage. We conclude that interventions improving consumer food supply and location knowledge can promote behaviours that reduce domestic food waste over a longer term. The implications of this research present new opportunities for existing and future technologies to play a key role in reducing domestic food waste.

Designing for grassroots food production : an event-based urban agriculture community

As urbanisation of the global population has increased above 50%, growing food in urban spaces increases in importance, as it can contribute to food security, reduce food miles, and improve people’s physical and mental health. Approaching the task of growing food in urban environments is a mixture of residential growers and groups. Permablitz Brisbane is an event-centric grassroots community that organises daylong ‘working bee’ events, drawing on permaculture design principles in the planning and design process. Permablitz Brisbane provides a useful contrast from other location-centric forms of urban agriculture communities (such as city farms or community gardens), as their aim is to help encourage urban residents to grow their own food. We present findings and design implications from a qualitative study with members of this group, using ethnographic methods to engage with and understand how this group operates. Our findings describe four themes that include opportunities, difficulties, and considerations for the creation of interventions by Human-Computer Interaction (HCI) designers.

Theoretical frameworks to support research of health service innovation

Health service managers and policy makers are increasingly concerned about the sustainability of innovations implemented in health care settings. The increasing demand on health services requires that innovations are both effective and sustainable however research in this field is limited with multiple disciplines, approaches and paradigms influencing the field. These variations prevent a cohesive approach and therefore the accumulation of research findings in development of a body of knowledge. A theoretical framework serves to guide research, determine variables, influence data analysis and is central to the quest for ongoing knowledge development. If left unaddressed, health services research will continue in an ad hoc manner preventing full utilisation of outcomes, recommendations and knowledge for effective provision of health services. The purpose of this paper is to provide an integrative review of the literature and introduce a theoretical framework for health services innovation sustainability research based on integration and synthesis of the literature. Finally recommendations for operationalising and testing this theory will be presented.

Improving national hospice/palliative care service symptom outcomes systematically through point-of-care data collection, structured feedback and benchmarking

PURPOSE Every health care sector including hospice/palliative care needs to systematically improve services using patient-defined outcomes. Data from the national Australian Palliative Care Outcomes Collaboration aims to define whether hospice/palliative care patients' outcomes and the consistency of these outcomes have improved in the last 3 years. METHODS Data were analysed by clinical phase (stable, unstable, deteriorating, terminal). Patient-level data included the Symptom Assessment Scale and the Palliative Care Problem Severity Score. Nationally collected point-of-care data were anchored for the period July-December 2008 and subsequently compared to this baseline in six 6-month reporting cycles for all services that submitted data in every time period (n = 30) using individual longitudinal multi-level random coefficient models. RESULTS Data were analysed for 19,747 patients (46 % female; 85 % cancer; 27,928 episodes of care; 65,463 phases). There were significant improvements across all domains (symptom control, family care, psychological and spiritual care) except pain. Simultaneously, the interquartile ranges decreased, jointly indicating that better and more consistent patient outcomes were being achieved. CONCLUSION These are the first national hospice/palliative care symptom control performance data to demonstrate improvements in clinical outcomes at a service level as a result of routine data collection and systematic feedback.

Profiling emergency nurse practitioner service

The aim of this study was to investigate the practice profile of emergency nurse practitioners across Australia. Nurse practitioners have been providing health service in the emergency setting internationally for more than 30 years, and evidence supports the value of this role in terms of patient satisfaction, effectiveness in improving service indicators, and acceptability of the role. The introduction of this service model has been instrumental in reducing waiting times for low-acuity patients and impacting positively on emergency department service delivery. Recent rapid uptake of this role internationally has outpaced development of the service model to inform education and ongoing service development. This was a national study that used interpretive research methods to identify the practice profile of emergency nurse practitioners. Data were collected from December 2012 to February 2013 through in-depth interviews. An inductive approach was used in data analysis to identify conceptual themes and develop an analysis framework. The study participants worked in a range of service models and managed patient presentations across all levels of acuity and complexity. The findings show that although there is no single definable model of the emergency nurse practitioner role in Australia, there are practice features that are common across all service models; these have been conceptualized as "modes of practice." This study has produced new knowledge about the practice profile of emergency nurse practitioners. The findings will inform development of practice standards for education and continuing professional development for emergency nurse practitioners and facilitate standardized operational definitions for ongoing research into this growing service model.

Food insecurity and physical activity among U.S. populations

Objectives: Examine the association between food insecurity (FI) and physical activity (PA) in the U.S. population. Methods: Accelerometry (PAM) and self-report PA (PAQ) data from NHANES 2003-2006 were used. Those aged less than six years or were older than 65 years, pregnant, with physical limitations, or with family income above 350% of the poverty line were excluded. FI was measured by the USDA Household Food Security Survey Module. Crude and adjusted odd ratios were calculated from logistic regression to identify the association between FI and adherence to the PA recommendation. Crude and adjusted coefficients were calculated from linear regression to identify the association between FI and both sedentary and activity minutes. Results: In children, FI was not associated with adherence to PA recommendation measured via PAM or PAQ (p>0.05) but was significantly associated with sedentary minutes (adjusted coefficient=10.74, one-sided p<0.05). Food-insecure children did less moderate-to-vigorous PA than did food-secure children (adjusted coefficient = -5.31, p = 0.032). In adults, FI was significantly associated with PA (adjusted OR=0.722 for PAM and OR=0.839 for PAQ, one-sided p<0.05) but not associated with sedentary minutes (p>0.05) Conclusions: FI children were more sedentary and FI adults were less likely to adhere to the PA recommendation than those without FI.

Household food insecurity is associated with less physical activity among children and adults in the U.S. population

Background Household food insecurity and physical activity are each important public-health concerns in the United States, but the relation between them was not investigated thoroughly. Objective We wanted to examine the association between food insecurity and physical activity in the U.S. population. Methods Physical activity measured by accelerometry (PAM) and physical activity measured by questionnaire (PAQ) data from the NHANES 2003–2006 were used. Individuals aged <6 y or >65 y, pregnant, with physical limitations, or with family income >350% of the poverty line were excluded. Food insecurity was measured by the USDA Household Food Security Survey Module. Adjusted ORs were calculated from logistic regression to identify the association between food insecurity and adherence to the physical-activity guidelines. Adjusted coefficients were obtained from linear regression to identify the association between food insecurity with sedentary/physical-activity minutes. Results In children, food insecurity was not associated with adherence to physical-activity guidelines measured via PAM or PAQ and with sedentary minutes (P > 0.05). Food-insecure children did less moderate to vigorous physical activity than food-secure children (adjusted coefficient = −5.24, P = 0.02). In adults, food insecurity was significantly associated with adherence to physical-activity guidelines (adjusted OR = 0.72, P = 0.03 for PAM; and OR = 0.84, P < 0.01 for PAQ) but was not associated with sedentary minutes (P > 0.05). Conclusion Food-insecure children did less moderate to vigorous physical activity, and food-insecure adults were less likely to adhere to the physical-activity guidelines than those without food insecurity.

Design, manufacturing and maintenance of sugar mill equipment

The ISSCT Engineering Workshop 2008 in Brazil was well attended with 62 participants including 39 overseas visitors from 15 countries. The workshop addressed the theme Design, manufacturing and maintenance of sugar mill equipment. From the technical sessions, the following conclusions were drawn: • Several speakers articulated a shared vision of the future of the Brazilian sugar industry. This shared vision gives considerable confidence that the vision can become a reality. • There is an increased focus on energy products. As a result, the reduction of factory energy consumption in order to maximise the energy available for products is also a focus. • New equipment and products are being developed with reduced power consumption, lower capital and maintenance costs, and better performance. • Methods presented for reducing maintenance costs included the use of a maintenance management system, condition monitoring and material selection. The workshop was held in conjunction with Piracicaba’s annual SIMTEC exhibition for the sugar and alcohol industries that provides a forum for technical presentations and discussion, and showcases products and services from manufacturers and service providers. In return for holding the workshop in conjunction with SIMTEC, SIMTEC provided sponsorship for the workshop, including paying travel and accommodation costs for two invited speakers, and organisation for the workshop. The ISSCT and SIMTEC technical programs were arranged so that their technical sessions did not clash, and the ISSCT program was extended a day to provide an opportunity for ISSCT participants to attend the SIMTEC exhibition. Informal feedback from workshop participants suggested that the arrangement between ISSCT and SIMTEC worked well. Site visits to two manufacturing facilities and two sugar mills were arranged as part of the workshop.

The need for internal social marketing (ISM): extending the people focus to service employees

BreastScreen Queensland (BSQ) is a government-based health service that provides free breast cancer screening services to eligible women using digital mammography technology.' In 2007, BSQ launched its first social marketing campaign' aimed at achieving a 30 per cent increase in women's programme participation by addressing the barriers to regular screening and by dispelling myths about breast cancer (Tornabene 2010). 'The Facts' mass media social marketing campaign used a credible spokesperson, Australian journalist]ana Wendt, to deliver the call to action' Don't make excuses. Make an appointment'.

eHealth-as-a-Service (eHaaS) : the industrialisation of health informatics, a practical approach

With the introduction of the Personally Controlled Health Record (PCEHR), the Australian public is being asked to accept greater responsibility for their healthcare. Although well designed, constructed and intentioned, policy and privacy concerns have resulted in an eHealth model that may impact future health information sharing requirements. Thus an opportunity to transform the beleaguered Australian PCEHR into a sustainable on-demand technology consumption model for patient safety must be explored further. Moreover, the current clerical focus of healthcare practitioners must be renegotiated to establish a shared knowledge creation landscape of action for safer patient interventions. To achieve this potential however requires a platform that will facilitate efficient and trusted unification of all health information available in real-time across the continuum of care. As a conceptual paper, the goal of the authors is to deliver insights into the antecedents of usage influencing superior patient outcomes within an eHealth-as-a-Service framework. To achieve this, the paper attempts to distil key concepts and identify common themes drawn from a preliminary literature review of eHealth and cloud computing concepts, specifically cloud service orchestration to establish a conceptual framework and a research agenda. Initial findings support the authors’ view that an eHealth-as-a-Service (eHaaS) construct will serve as a disruptive paradigm shift in the aggregation and transformation of health information for use as real-world knowledge in patient care scenarios. Moreover, the strategic value of extending the community Health Record Bank (HRB) model lies in the ability to automatically draw on a multitude of relevant data repositories and sources to create a single source of practice based evidence and to engage market forces to create financial sustainability.

The ‘Good Eater’ : modelling maternal perception of food fussiness in Australian toddlers – the NOURISH and SAIDI cohorts

Purpose Food refusal is part of normal toddler development due to an innate ability to self-regulate energy intake and the onset of neophobia. For parents, this ‘fussy’ stage causes great concern, prompting use of coercive feeding practices which ignore a child’s own hunger and satiety cues, promoting overeating and overweight. This analysis defines characteristics of the ‘good eater’ using latent variable structural equation modelling and the relationship with maternal perception of her child as a fussy eater. Methods Mothers in the control group of the NOURISH and South Australian Infants Dietary Intake studies (n=332) completed a self-administered questionnaire - when child was age 12-16 months - describing refusal of familiar and unfamiliar foods and maternal perception as fussy/not fussy. Weight-for-age z-score (WAZ) was derived from weight measured by study staff. Questionnaire items and WAZ were combined in AMOS to represent the latent variable the ‘good eater’. Results/findings Mean age(sd) of children was 13.8(1.3) months, mean WAZ(sd), .58(.86) and 49% were male. The ‘good eater’ was represented by higher WAZ, a child that hardly ever refuses food, hardly ever refuses familiar food, and willing to eat unfamiliar foods (x2/df=2.80, GFI=.98, RMSEA=.07(.03-.12), CFI=.96). The ‘good eater’ was inversely associated with maternal perception of her child as a fussy eater (β=-.64, p<.05). Conclusions Toddlers displaying characteristics of a ‘good eater’ are not perceived as fussy, but these characteristics, especially higher WAZ, may be undesirable in the context of obesity prevention. Clinicians can promote food refusal as normal and even desirable in healthy young children.

The impact of transformative learning in a critical service-learning program on teacher development: Building a foundation for inclusive teaching

With international and national policies requiring teachers to adopt inclusive practices worldwide, this paper examines the impact of transformational learning in a critical service-learning program on final-year pre-service teachers’ approaches to inclusive teaching. Data from emailed questionnaires and focus group interviews are analysed through a social, critical framework. The results indicate that the critical service-learning program provided the students with an opportunity to consider diversity and inclusion in selecting teaching strategies, and to enact values suitable to inclusive practices and appreciation of diversity in schools. In this paper we argue that transformative learning experiences about inclusivity and diversity are needed if pre-service teachers are to be challenged to adopt inclusive values and practice in schools. A critical service-learning program for pre-service teachers provides a solid foundation on which to develop or build on the ability to think and teach inclusively.

Food price volatility and hunger alleviation-can Cannes work

Recent years have seen global food prices rise and become more volatile. Price surges in 2008 and 2011 held devastating consequences for hundreds of millions of people and negatively impacted many more. Today one billion people are hungry. The issue is a high priority for many international agencies and national governments. At the Cannes Summit in November 2011, the G20 leaders agreed to implement five objectives aiming to mitigate food price volatility and protect vulnerable persons. To succeed, the global community must now translate these high level policy objectives into practical actions. In this paper, we describe challenges and unresolved dilemmas before the global community in implementing these five objectives. The paper describes recent food price volatility trends and an evaluation of possible causes. Special attention is given to climate change and water scarcity, which have the potential to impact food prices to a much greater extent in coming decades. We conclude the world needs an improved knowledge base and new analytical capabilities, developed in parallel with the implementation of practical policy actions, to manage food price volatility and reduce hunger and malnutrition. This requires major innovations and paradigm shifts by the global community.

Statistics critical in securing our food supply

“World food security … is at its lowest in half a century,” wrote Julian Cribb FTSE, a wellknown consultant in science communication and founding editor of www.sciencealert. com.au in the lead article in the 2008 ATSE Focus magazine issue entitled “Food for the world: the nation’s challenge”. Food security continues to be a key national and international concern and it is pleasing to see this issue of Focus again exploring aspects of the topic with the aim of continuing to raise awareness of issues and influencing relevant policy decisions. Statistics (or statistical science, more broadly) has been critical to the information and decision-making value chain needed to optimise agriculture and the food supply chain. The key steps are most often addressed by multidisciplinary research groups including statisticians in collaboration with life and physical scientists, agri-industry personnel and other relevant stakeholders.