Clinical measures of obesity and weight loss in men

OBJECTIVES: (?) To determine the relationship between waist circumference and body weight in overweight men both before and after participation in a weight loss program; and (2) to make recommendations for the appropriate use of these measures at various stages of weight toss. DESIGN: Weight and waist circumference measures were taken in two diverse groups of men both before and 1-2y after commencing a men's 'waist loss' program. Regression analyses were used to assess the relationship between weight and waist measures. SUBJECTS: One group of 42 retired Caucasian men from New South Wales, and one group of 45 indigenous men from the Torres Strait region of Northern Australia. RESULTS: There were differences in the relationships of weight and waist circumference before the program and change in weight and change in waist circumference after weight loss. These differences were similar in both groups of men (indigenous men and retired Caucasian men), with a 1 cm waist loss being on average equivalent to about 3/4 kg, but with wide variability, suggesting inter-individual variation in fat losses from different depots. This variation suggests that neither weight nor waist alone is a sufficient measure of fat loss for men. CONCLUSIONS: Weight and waist circumference should both be used at various stages in the clinical situation to assess change in body fat in men involved in obesity reduction.

Social-cognitive and perceived environment influences associated with physical activity in older Australians

Background, Regular physical activity in older adults can facilitate healthy aging, improve functional capacity, and prevent disease. However, factors associated with physical inactivity in older populations are poorly understood. This study attempts to identify social-cognitive and perceived environmental influences associated with physical activity participation in older populations. Methods. In a randomly selected sample of 449 Australian adults age 60 and older, we assessed self-reported physical activity and a range of social-cognitive and perceived environmental factors. Respondents were classified as sufficiently active and inactive based on energy expenditure estimates (kcal/week) derived from self-reported physical activity. Two logistic regression models, with and without self-efficacy included, were conducted to identify modifiable independent predictors of physical activity. Results. Significantly more males than females were physically active. Physical activity participation was related to age with a greater proportion of those age 65-69 being active than those age 60-64 or 70 or older. High self-efficacy, regular participation of friends and family, finding footpaths safe for walking, and access to local facilities were significantly associated with being active. Conclusion. Identifying predictors of physical activity in older populations, particularly social support, facility access, and neighbourhood safety, can inform the development of policy and intervention strategies to promote the health of older people. (C) 2000 American Health Foundation and Academic Press.

Age-related differences in physical activity levels of young adults

Purpose: To examine age-related differences in the physical activity behaviors of young adults. Methods: We examined rates of participation in vigorous- and moderate-intensity leisure-time activity and walking, as well as an index of physical activity sufficient for health benefits in three Australian cross-sectional samples, for the age ranges of 18-19, 20-24, and 25-29 yr. Data were collected in 1991, 1996, and 1997/8. Results: There was at least a 15% difference in vigorous-intensity leisure-time physical activity from the 18-19 yr to the 25-29 yr age groups, and at least a 10% difference in moderate-intensity leisure-time physical activity. For the index of sufficient activity there was a difference between 9 and 21% across age groups. Differences in rates of walking were less than 8%. For all age groups, males had higher rates of participation for vigorous and moderate-intensity activity than did females, bur females had much higher rates of participation in walking than males. Age-associated differences in activity levels were more apparent for males. Conclusions: Promoting walking and various forms of moderate-intensity physical activities to young adult males, and encouraging young adult females to adopt other forms of moderate-intensity activity to complement walking may help to ameliorate decreases in physical activity over the adult lifespan.

Population-based mammography screening and breast cancer incidence in New South Wales, Australia

To analyse breast cancer incidence trends in New South Wales (NSW), Australia, in relation to population-based mammography screening targeting women aged 50 to 69 years. Trends in age-specific incidence of invasive breast cancers in NSW women aged >= 40 years were examined in relation to mammography screening rates and screening cancer detection rates. Incidence of invasive breast cancer in NSW women increased in all age-groups over 1972 to 2002. The incidence trend for women aged 50 to 69 years showed that the steepest rise was associated with increased participation in population-based mammography screening, which was implemented from 1988 and achieved state-wide coverage in 1995. The elevated incidence of invasive cancer significantly exceeded pre-screening levels, and persisted after rates of initial screens declined. This elevated incidence was sustained by the contribution of cancers diagnosed through subsequent screening, and resulted from increased cancer detection rates in subsequent screens. The recent increase in invasive breast cancer incidence in NSW is associated with mammography screening, and occurred mostly in the target age-group women. Persistence of higher incidence after 1994 was not explicable by inflation of cancer incidence due to detection of prevalent screen cases, but was associated with a trend of increased cancer detection rates in subsequent screening rounds, probably consequent to quality improvements in mammography screening diagnosis.

Family advocacy roles and highly dependent residents in nursing homes

A developing critique has questioned the practical utility of user rights policy initiatives for highly dependent residents of nursing homes. This paper seeks to extend this critique to the advocacy roles that families have been accorded within the policy initiatives, The discussion is based on a qualitative research study of family participation in six aged care units, The paper argues that the capacity of families to act as advocates for highly dependent nursing home residents is is limited by the their weak position within the organisations and the complexity of their relations with staff It questions both the applicability and the appropriateness of rights models which do not take sufficient account of the structure and meaning of care.

A 1-year longitudinal study of severe traumatic brain injury in Australia using the Sickness Impact Profile

Objective: To document outcome and to investigate patterns of physical and psychosocial recovery in the first year following severe traumatic brain injury (TBI) in an Australian patient sample. Design: A longitudinal prospective study of a cohort of patients, with data collection at 3, 6, 9, and 12 months post injury. Setting: A head injury rehabilitation unit in a large metropolitan public hospital. Patients: A sample of 55 patients selected from 120 consecutive admissions with severe TBI. Patients who were more than 3 months post injury on admission, who remained confused, or who had severe communication deficits or a previous neurologic disorder were excluded. Interventions: All subjects participated in a multidisciplinary inpatient rehabilitation program, followed by varied participation in outpatient rehabilitation and community-based sen ices. Main Outcome Measures: The Sickness impact Profile (SIP) provided physical, psychosocial, and total dysfunction scores at each follow-up. Outcome at 1 year was measured by the Disability Rating Scale. Results: Multivariate analysis of variance indicated that the linear trend of recovery over time was less for psychosocial dysfunction than for physical dysfunction (F(1,51) = 5.87, P < .02). One rear post injury, 22% of subjects had returned to their previous level of employability, and 42% were able to live independently. Conclusions: Recovery from TBI in this Australian sample followed a pattern similar to that observed in other countries, with psychosocial dysfunction being more persistent. Self-report measures such as the SIP in TBI research are limited by problems of diminished self-awareness.

Closing the gender gap in Bangladesh: Inequality in education, employment and earnings

Assesses the status of women in Bangladesh by analysing the dynamics of female participation in labour force and education as well as gender earnings differentials at the macro level. The study finds evidence of growing commercialisation of women’s work in Bangladesh. Although the bulk of the female labour force is engaged in self-employment activities in the rural area or in low-skilled textile and readymade garment industries in the urban area, women’s participation in high-skill and entrepreneurial jobs as well as various decision-making bodies is also on the rise. While the gender wage differentials have been considerably reduced in many industries, in general women tend to be paid less than men. There have been remarkable improvements in women’s educational attainments compared to men. Further, female access to education is found to be highly correlated with overall female labour force participation, and relative to male participation. The overall results are suggestive of an improvement in the status of women in Bangladesh.

Does workforce participation empower women? Micro-level evidence from urban Bangladesh

Empirical studies on the impact of women’s paid jobs on their empowerment and welfare in the Bangladesh context are rare. The few studies on the issue to date have all been confined to the garment workers only although studies indicate that women’s workforce participation in Bangladesh has increased across-the-board. Besides, none of these studies has made an attempt to control for the non-working women and/or applied any statistical technique to control for the effects of other pertinent determinants of women’s empowerment and welfare such as education, age, religion and place of living. This study overcomes these drawbacks and presents alternative assessments of the link between women’s workforce participation and empowerment on the basis of survey data from the two largest cities in Bangladesh. While the generic assessment indicates that women’s paid jobs have positive implications for women’s participation in decisions on fertility, children’s education and healthcare as well as their possession and control of resources, the econometric assessment negates most of these observations. Women’s education, on the other hand, appears to be more important than their participation in the labour force. The study underlines the fact that by omitting other relevant explanatory variables from the analysis, the previous studies might have overestimated the impact of women’s paid work on their empowerment. Among other things, the paper also highlights the importance of women’s job category, religion and regional differences for women’s empowerment.

User's Views of an Outreaching Social Work Team in Hong Kong

This article reports the survey findings of a recent study on users’ views of the service provided by an outreaching social work team in Hong Kong. It attempts to explore how youth at risk can be jointly involved in evaluating the quality of the social service. Users appear to have favourable opinions towards the service received and would like to have greater involvement in programme planning, implementation and evaluation. Finally, recommendations on improving the understanding of the needs of users and encouraging greater user participation in future service delivery are suggested.

Tactics at the interface: Australian Aboriginal and Torres Strait Islander health managers

Over the past thirty years in Australia, there has been a recognition of the need for increasing Aboriginal and Torres Strait Islander participation in the management of their health services as part of the strategy to improve the poor health of Australia's indigenous peoples. The proliferation of Aboriginal Community-Controlled Health Services and the vigorous advocacy of groups such as the National Aboriginal Community Controlled Health Organisation have significantly contributed to this recognition. This, combined with additional management opportunities in government service, has drawn attention to difficulties in recruiting and retaining appropriately experienced Aboriginal and Torres Strait Islander managers, particularly in the northern states of Australia. (C) 2001 Elsevier Science Ltd. All rights reserved.

Peacebuilding in East Timor

This essay analyses some of the political, economic and social challenges of East Timer's transition to independence. It scrutinizes the ethical dimensions of building peace in a territory devastated by the combined effect of Indonesia's colonial occupation and the violent militia attacks of September 1999. The most difficult task ahead does not lie in the physical rebuilding of the territory-gargantuan as it may be-but in the more intricate and long-term rehabilitation of a traumatized society. The latter involves competing Timorese factions as well as a range of international actors, including the United Nations Transitional Authority, foreign governments, business institutions and various multilateral and bilateral donors. each having their own organizational leitmotifs and policy priorities. If not managed carefully, the reconstruction process could further exacerbate existing societal tensions and complicate the starch for peace and reconciliation. The essay identifies a number of crucial components necessary to counter such risks, including the need to promote popular participation in the rebuilding process. Without the legitimacy created by strong community involvement and grassroots participation in decision making, the task of national reconstruction may well become overwhelmed by conflict.

Subcortical brain mechanisms in speech and language

This paper reviews current research and contemporary theories of subcortical participation in the motor control of speech production and language processing. As a necessary precursor to the discussion of the functional roles of the basal ganglia and thalamus, the neuroanatomy of the basal ganglial-thalamocortical circuitry is described. Contemporary models of hypokinetic and hyperkinetic movement disorders based on recent neuroanatomical descriptions of the multi-segmented circuits that characterise basal ganglion anatomy are described. Reported effects of surgically induced lesions in the globus pallidus and thalamus on speech production are reviewed. In addition, contemporary models proposed to explain the possible contribution of various subcortical structures to language processing are described and discussed in the context of evidence gained from observation of the effects of circumscribed surgically induced lesions in the basal ganglia and thalamus on language function. The potential of studies based on examination of the speech/language outcomes of patients undergoing pallidotomy and thalamotomy to further inform the debate relating to the role of subcortical structures in speech motor control and language processing is highlighted. Copyright (C) 2001 S. Karger AG, Basel.

Resolving the puzzle of productive and destructive conflict in culturally heterogeneous workgroups: A communication accommodation theory approach

This study presents an investigation of the communicative behaviors and strategies employed in the stimulation and management of productive and destructive conflict in culturally heterogeneous workgroups. Using communication accommodation theory (CAT), we argue that the type and course of conflict in culturally heterogeneous workgroups is impacted by the communicative behaviors and strategies employed by group members during interactions. Analysis of data from participant observations, non-participant observations, semi-structured interviews, and self-report questionnaires support CA T-based predictions and provide fresh insights into the triggers and management strategies associated with conflict in culturally heterogeneous workgroups. In particular, results indicated that the more groups used discourse management Strategies, the more they experienced productive conflict. In addition, the use of explanation and checking of own and others' understanding was a major feature of productive conflict, while speech interruptions emerged as a strategy leading to potential destructive conflict. Groups where leaders emerged and assisted in reversing communication breakdowns were better able to manage their discourse, and achieved consensus On task processes. Contributions to the understanding of the triggers and the management of productive conflict in culturally heterogeneous workgroups are discussed.

Participation and older people: Meaning, theory and practice

Increasing older people's participation in society is important in ageing policies worldwide. There is a need to understand the challenges for health professionals of transforming policy on participation into liberating social change practices on the ground. This paper explores the meaning, theory and practice of participation. It uses the example of a work in progress project that has attempted to address structural barriers to older people's participation within an Australian aged care facility, to illustrate theoretical and practice principles surrounding participation.

Age and gender differences in objectively measured physical activity in youth

TROST. S. G., R. R. PATE, J. F. SALLIS, P. S. FREEDSON, W. C. TAYLOR, M. DOWDA, and J. SIRARD. Age and gender differences in objectively measured physical activity in youth. Med. Sci. Sports Ererc., Vol. 34, No. 2, pp. 350-355, 2002. Purpose: The purpose of this study was to evaluate age and gender differences in objectively measured physical activity (PA) in a population-based sample of students in grades 1-12. Methods: Participants (185 male, 190 female) wore a CSA 7164 accelerometer for 7 consecutive days. To examine age-related trends. students were grouped as follows: grades 1-3 (N = 90), grades 4-6 (N = 91), grades 7-9 (N = 96). and grades 10-12 (N = 92). Bouts of PA and minutes spent in moderate-to-vigorous PA (MVPA) and vigorous PA (VPA) were examined. Results: Daily MVPA and VPA exhibited a significant inverse relationship with grade level, with the largest differences occurring between grades 1d-3 and 4-6. Boys were more active than girls; however, for overall PA, the magnitudes of the gender differences were modest. Participation in continuous 20-min bouts of PA was low to nonexistent. Conclusion: Our results support the notion that PA declines rapidly during childhood and adolescence and that accelerometers are feasible alternatives to self-report methods in moderately sized population-level surveillance studies.