Predictive regression equations and clinical uses of peripheral pulse timing characteristics in children

Studies have shown that increased arterial stiffening can be an indication of cardiovascular diseases like hypertension. In clinical practice, this can be detected by measuring the blood pressure (BP) using a sphygmomanometer but it cannot be used for prolonged monitoring. It has been established that pulse wave velocity (PWV) is a direct measure of arterial stiffening but its usefulness is hampered by the absence of non-invasive techniques to estimate it. Pulse transit time (PTT) is a simple and non-invasive method derived from PWV. However, limited knowledge of PTT in children is found in the present literature. The aims of this study are to identify independent variables that confound PTT measure and describe PTT regression equations for healthy children. Therefore, PTT reference values are formulated for future pathological studies. Fifty-five Caucasian children (39 male) aged 8.4 +/- 2.3 yr (range 5-12 yr) were recruited. Predictive equations for PTT were obtained by multiple regressions with age, vascular path length, BP indexes and heart rate. These derived equations were compared in their PWV equivalent against two previously reported equations and significant agreement was obtained (p < 0.05). Findings herein also suggested that PTT can be useful as a continuous surrogate BP monitor in children.

Indefinite determiner introducing definite referent: a special use of 'yi 'one' + classifier' in Chinese

The indefinite determiner yi 'one'+ classifier' is the most approximate to an indefinite article, like the English a, in Chinese. It serves all the functions characteristic of representative stages of grammaticalization from a numeral to a generalized indefinite determiner as elaborated in the literature. It is established in this paper that the Chinese indefinite determiner has developed a special use with definite expressions, serving as a backgrounding device marking entities as of low thematic importance and unlikely to receive subsequent mentions in ensuing discourse. 'yi+ classifier' in the special use with definite expressions displays striking similarities in terms of semantic bleaching and phonological reduction with the same determiner at the advanced stage of grammaticalization characterized by uses with generics, nonspecifics and nonreferentials. An explanation is offered in terms of an implicational relation between nonreferentiality and low thematic importance which characterize the two uses of the indefinite determiner. While providing another piece of evidence in support of the claim that semantically nonreferentials and entities of low thematic importance tend to be encoded in terms of same linguistic devices in language, findings in this paper have shown how an indefinite determiner can undergo a higher degree of grammaticalization than has been reported in the literature-it expands its scope to mark not only indefinite but also definite expressions as semantically nonreferential and/or thematically unimportant. (C) 2003 Elsevier B.V. All rights reserved.

Injury and frequency of use of playground equipment in public schools and parks in Brisbane, Australia

Objective: The purpose of this study was to determine the frequency of use of play equipment in public schools and parks in Brisbane, Australia, and to estimate an annual rate of injury per use of equipment, overall and for particular types of equipment. Methods: Injury data on all children injured from playground equipment and seeking medical attention at the emergency department of either of the two children's hospitals in the City of Brisbane were obtained for the years 1996 and 1997. Children were observed at play on five different pieces of play equipment in a random sample of 16 parks and 16 schools in the City of Brisbane. Children injured in the 16 parks and schools were counted, and rates of injury and use were calculated. Results: The ranked order for equipment use in the 16 schools was climbing equipment (3762 uses), horizontal ladders (2309 uses), and slides (856 uses). Each horizontal ladder was used 2.6 times more often than each piece of climbing equipment. Each horizontal ladder was used 7.8 times more than each piece of climbing equipment in the sample of public parks. Slides were used 4.6 times more than climbing equipment in parks and 1.2 times more in public schools. The annual injury rate for the 16 schools and 16 parks under observation was 0.59/100000 and 0.26/100000 uses of equipment, respectively. Conclusions: This study shows that annual number of injuries per standardized number of uses could be used to determine the relative risk of particular pieces of playground equipment. The low overall rate of injuries/100000 uses of equipment in this study suggests that the benefit of further reduction of injury in this community may be marginal and outweigh the economic costs in addition to reducing challenging play opportunities.

A review of two journals found that articles using multivariable logistic regression frequently did not report commonly recommended assumptions

Background and Objective: To examine if commonly recommended assumptions for multivariable logistic regression are addressed in two major epidemiological journals. Methods: Ninety-nine articles from the Journal of Clinical Epidemiology and the American Journal of Epidemiology were surveyed for 10 criteria: six dealing with computation and four with reporting multivariable logistic regression results. Results: Three of the 10 criteria were addressed in 50% or more of the articles. Statistical significance testing or confidence intervals were reported in all articles. Methods for selecting independent variables were described in 82%, and specific procedures used to generate the models were discussed in 65%. Fewer than 50% of the articles indicated if interactions were tested or met the recommended events per independent variable ratio of 10: 1. Fewer than 20% of the articles described conformity to a linear gradient, examined collinearity, reported information on validation procedures, goodness-of-fit, discrimination statistics, or provided complete information on variable coding. There was no significant difference (P >.05) in the proportion of articles meeting the criteria across the two journals. Conclusion: Articles reviewed frequently did not report commonly recommended assumptions for using multivariable logistic regression. (C) 2004 Elsevier Inc. All rights reserved.

Health characteristics of older Australian dietary supplement users compared to non-supplement users

The aim of this study was to measure the prevalence of dietary and health supplement use among Australians aged 65 years and over, and to contrast the health differences between supplement users and non-supplement users. Data was obtained from 1,263 randomly selected older Australians, who provided general demographic data, in addition to information related to their health, symptoms experienced and uses of medication, including dietary supplements. Supplement use was reported by 43% of the sample (52% of females and 35% of males). This investigation has revealed distinct differences in the health profile of older supplement users compared to non-users. Although there was no difference in the number of visits to medical doctors or self-rated health status between supplement users and non-supplement users, supplement users were more likely to report arthritis and osteoporosis, and experience more symptoms and consume more medication than non-supplement users. In contrast, there was a reduced likelihood of taking a supplement for those with hypertension and by those using blood pressure medication and heart tablets. These results suggest that older dietary supplement users may benefit from education and professional advice to assist them make appropriate and informed choices, particularly if they expect these preparations to attenuate their health concerns.

A methodology for analysis of sugarcane productivity trends - 2. Comparing variety trials with commercial productivity

Previous research has reported both agreements and serious anomalies in relationships between production attributes of sugarcane varieties in variety trials (VTs) and commercial production (CP). This paper examines VT and CP data for tonnes of cane per hectare (TCH) and sugar content (CCS). Data, analysed by REML, included 107 VTs and 54 CP mill years for 9 varieties from the mill districts of Mulgrave, Babinda, and Tully for harvest years 1982-99. Important consistencies included high TCH of Q152, high CCS of Q117 and Q120, and low CCS of H56-752. Significant anomalies existed with respect to TCH for Q113, Q117, Q120, Q122, Q138, and H56-752 and to CCS for Q113 and Q124. Investigation of these anomalies was assisted by access to independent REML analyses of CP data for 65692 individual Tully cane blocks from 1988 to 1999 and by the knowledge of persons familiar with the preferential uses of varieties by farmers. Minor anomalies were due to limited year or mill area data. Q124 TCH was deemed to be decreased and its CCS increased by severe disease in Babinda CP in the extremely wet 1998 and 1999 seasons. Other serious anomalies have credible but unsubstantiated explanations. The most convincing, for Q113, Q117, Q138, and H56-752, are that these varieties were deployed unevenly with regard to late season harvesting, predominant use or avoidance on high fertility soils, or use confined to low fertility sandy soils, respectively. Uneven deployment results in confounding of these effects in the varietal CP statistics at mill area level. It is concluded that VTs cannot be enhanced to anticipate or evaluate most effects of uneven deployment. They give adequate predictions of relative CP performance for varieties deployed evenly across confounding influences. Routine analyses of individual block CP data would be useful and enhanced by addition of relevant information to the block records.

Science-policy in environmental and health risk assessment: if we cannot do without, can we do better?

How can empirical evidence of adverse effects from exposure to noxious agents, which is often incomplete and uncertain, be used most appropriately to protect human health? We examine several important questions on the best uses of empirical evidence in regulatory risk management decision-making raised by the US Environmental Protection Agency (EPA)'s science-policy concerning uncertainty and variability in human health risk assessment. In our view, the US EPA (and other agencies that have adopted similar views of risk management) can often improve decision-making by decreasing reliance on default values and assumptions, particularly when causation is uncertain. This can be achieved by more fully exploiting decision-theoretic methods and criteria that explicitly account for uncertain, possibly conflicting scientific beliefs and that can be fully studied by advocates and adversaries of a policy choice, in administrative decision-making involving risk assessment. The substitution of decision-theoretic frameworks for default assumption-driven policies also allows stakeholder attitudes toward risk to be incorporated into policy debates, so that the public and risk managers can more explicitly identify the roles of risk-aversion or other attitudes toward risk and uncertainty in policy recommendations. Decision theory provides a sound scientific way explicitly to account for new knowledge and its effects on eventual policy choices. Although these improvements can complicate regulatory analyses, simplifying default assumptions can create substantial costs to society and can prematurely cut off consideration of new scientific insights (e.g., possible beneficial health effects from exposure to sufficiently low 'hormetic' doses of some agents). In many cases, the administrative burden of applying decision-analytic methods is likely to be more than offset by improved effectiveness of regulations in achieving desired goals. Because many foreign jurisdictions adopt US EPA reasoning and methods of risk analysis, it may be especially valuable to incorporate decision-theoretic principles that transcend local differences among jurisdictions.

Festival attendance and the development of social capital

Festivals are emerging worldwide as a growing and vibrant sector of the tourism and leisure industries and are seen to have significant economic, socio-cultural, and political impacts on the destination area and host groups. While there are a number of scholars working on developing valid models to determine the economic impact of festivals on host communities, there are few studies published which focus on the social, cultural, and/or political impacts of festivals and events. The purpose of this paper, therefore, is to determine the degree to which festival attendance facilitates the augmentation of social capital by drawing upon the literature from various disciplines in order to conceptualize the synergy between festivals and social capital. To achieve this, the paper will (1) examine the relevant literature on the key characteristics of ‘festivals’ as distinct from other events and (2) investigate the current uses of the notion of ‘social capital’ within the academic debates in a variety of disciplinary contexts