Effect of a telephone-delivered coronary heart disease secondary prevention program (ProActive Heart) on quality of life and health behaviours: primary outcomes of a randomised controlled trial

<b>Background b>Participation in coronary heart disease secondary prevention programs is low. Innovative programs to meet this treatment gap are required.<br /><br /><b>Purpose b>To aim of this study is to describe the effectiveness of a telephone-delivered secondary prevention program for myocardial infarction patients.<br /><br /><b>Methods b>Four hundred and thirty adult myocardial infarction patients in Brisbane, Australia were randomised to a 6-month secondary prevention program or usual care. Primary outcomes were health-related quality of life (Short Form-36) and physical activity (Active Australia Survey).<br /><br /><b>Results b>Significant intervention effects were observed for health-related quality of life on the mental component summary score (p = 0.02), and the social functioning (p = 0.04) and role-emotional (p = 0.03) subscales, compared with usual care. Intervention participants were also more likely to meet recommended levels of physical activity (p = 0.02), body mass index (p = 0.05), vegetable intake (p = 0.04) and alcohol consumption (p = 0.05).<br /><br /><b>Conclusions b>Telephone-delivered secondary prevention programs can significantly improve health outcomes and could meet the treatment gap for myocardial infarction patients.

Method for determining reaction rate of mild steel containers during melting of magnesium-aluminium alloys and effect of aluminium content on directionally solidified microstructures

A magnesium alloy of eutectic composition (33 wt-'%Al) was directionally solidified in mild steel tubes at two growth rates, 32 and 580 mum s(-1,) in a temperature gradient between 10 and 20 K mm(-1). After directional solidification, the composition of each specimen varied dramatically, from 32'%Al in the region that had remained solid to 18%Al (32 mum s(-1) specimen) and 13%Al (580 mum s(-1) specimen) at the plane that had been quenched from the eutectic temperature. As the aluminium content decreased, the microstructure contained an increasing volume fraction of primary magnesium dendrites and the eutectic morphology gradually changed from lamellar to partially divorced. The reduction in aluminium content was caused by the growth of an Al-Fe phase ahead of the Mg-Al growth front. Most of the growth of the Al-Fe phase occurred during the remelting period before directional solidification. The thickness of the Al-Fe phase increased with increased temperature and time of contact with the molten Mg-Al alloy. (C) 2003 Maney Publishing.<br />

Spatial prediction of rufous bristlebird habitat in a coastal heathland: a GIS-based approach

<b>1b>. To develop a conservation management plan for a species, knowledge of its distribution and spatial arrangement of preferred habitat is essential. This is a difficult task, especially when the species of concern is in low&nbsp;&nbsp; abundance. In south-western Victoria, Australia, populations of the rare rufous bristlebird Dasyornis broadbenti are threatened by fragmentation of suitable habitat. In order to improve the conservation status of this species, critical habitat requirements must be identified and a system of corridors must be established to link known populations. A predictive spatial model of rufous bristlebird habitat was developed in order to identify critical areas requiring preservation, such as corridors for dispersal. <b><br />2b>. Habitat models generated using generalized linear modelling techniques can assist in delineating the specific habitat requirements of a species. Coupled with geographic information system (GIS) technology, these models can be extrapolated to produce maps displaying the spatial configuration of suitable habitat. <b><br />3b>. Models were generated using logistic regression, with bristlebird presence or absence as the dependent variable and landscape variables, extracted from both GIS data layers and multispectral digital imagery, as the predictors. A multimodel inference approach based on Akaike’s information criterion was used and the resulting model was applied in a GIS to extrapolate predicted likelihood of occurrence across the entire area of concern. The predictive performance of the selected model was evaluated using the receiver operating characteristic (ROC) technique. A hierarchical partitioning protocol was used to identify the predictor variables most likely to influence variation in the dependent variable. Probability of species presence was used as an index of habitat suitability. <b><br />4b>. Negative associations between rufous bristlebird presence and&nbsp; increasing elevation, 'distance to cree', 'distance to coast' and sun index were evident, suggesting a preference for areas relatively low in altitude, in close proximity to the coastal fringe and drainage lines, and receiving less direct sunlight. A positive association with increasing habitat complexity also suggested that this species prefers areas containing high vertical density of vegetation.<br /><b>5b>. The predictive performance of the selected model was shown to be high (area under the curve 0·97), indicating a good fit of the model to the data. Hierarchical partitioning analysis showed that all the variables considered had significant&nbsp; independent contributions towards explaining the variation in the dependent variable. The proportion of the total study area that was predicted as suitable habitat for the rufous bristlebird (using probability of occurrence at a ≥0·5 level ) was 16%. <b><br />6b>. Synthesis and applications. The spatial model clearly delineated areas predicted as highly suitable rufous bristlebird habitat, with evidence of potential corridors linking coastal and inland populations via gullies. Conservation of this species will depend on management actions that protect the critical habitats identified in the model. A multi-scale&nbsp; approach to the modelling process is recommended whereby a spatially explicit model is first generated using landscape variables extracted from a GIS, and a second model at site level is developed using fine-scale habitat variables measured on the ground. Where there are constraints on the time and cost involved in measuring finer scale variables, the first step alone can be used for conservation planning.<br />

Land use, water quality and ecological responses in Lake Colac – trends from Australia

<b>Purposeb> - Recently, Colac Otway Shire in Australia released its management plan for Lake Colac, claiming over-enrichment of the lake with nutrients and degraded water quality. This paper aims to investigate these claims by establishing a correlation between key water and ecological indicators and land uses. <br /><br /><b>Design/methodology/approachb> - Examines the correlation between impairment and stressors in Lake Colac. This was achieved by identifying the likely sources of pollutants into Lake Colac; identifying any existing monitoring program; and characterizing the water and sediment inputs. The likely impacts of increased nutrients and sediment levels on indigenous flora and fauna were also examined. The use of meiofauna (very small benthic metazoan animals) was investigated as an indicator of degraded sites. Plankton diversity as a measure of water health was also assessed. <br /><br /><b>Findings b>- Water quality in Lake Colac was found to vary both temporally and spatially, and exhibited low attainment against acceptable trigger values/objectives. At current levels the lake can be classified as poorly degraded. Likely sources of pollution were identified to be related to land uses in the catchments. The biota of the lake, investigated at four study sites, yielded a sparse, benthic macrofaunal assemblage that was dominated by oligochaetes. In contrast, an abundant and taxonomically diverse meiofaunal assemblage was noted. Future meiofaunal analyses are likely to resolve suitable biotic indicator species of free-living nematodes in response to land use and waterway threats specified in the study. Originality value - This work will provide a better understanding of integrated environmental systems to enable development of best management practices, thus transforming the way the land and water are used in the future. Following the present work, other key water and ecological indicators (increased dispersion and dominance of biological species) at five additional sites were studied. Alternative management options for the effluent generated at Colac Sewage Treatment Plant and possible ecological effects of each option were also evaluated. More recently, a sediment characterization study was also carried out at sensitive sites representative of locations where build up of sediments and algae outbreaks are reported. This will enable classification of sediment and evaluation of dredging options. <br /><br /><br />

Home range, habitat selection and diet of foxes (vulpes vulpes) in a semi-urban riparian environment

Between 2000 and 2002 the home range, habitat selection and diet of foxes were examined in the Dandenong Creek Valley, Melbourne, Australia. The mean home range was 44.6 ha (range 19.2–152.6 ha). A significant selection towards blackberry and gorse used as diurnal shelter was found during the day with an active avoidance of less structurally complex vegetation types. Although there was obvious selection of certain habitats, the diet of the foxes was highly general and opportunistic and thus offers little potential as a factor to manipulate in order to reduce fox abundance. Given the strong preference for blackberry and gorse as a shelter resource, a habitat-manipulation strategy is suggested whereby patches of blackberry and gorse are removed and replaced with less structurally complex vegetation. Such a strategy has the potential to influence the density of foxes in semi-urban riparian environments such as those discussed in this study.<br /><br /><br />

Training general practitioners in flexible sigmoidoscopy to screen for colorectal cancer

<b>Backgroundb>: A screening programme to detect polyps or early carcinoma would significantly reduce the mortality and morbidity of colorectal cancer (CRC). The aims of the present study were to evaluate: (i) the feasibility of training general practitioners in flexible sigmoidoscopy (FS) for CRC screening; (ii) the acceptability of screening by faecal occult blood testing (FOBT) and FS in asymptomatic standard risk Australians aged over 50 years; and (iii) the yield of such screening. <b>Methodsb>: Subjects were recruited by general practitioner (GP) referral, newspaper advertisement or by a direct approach to retirement villages. Participants were mailed a FOBT kit and a prescreening questionnaire. Flexible sigmoidoscopy was performed by a GP supervised by an experienced endoscopist. Subjects then completed a second questionnaire. General practitioners were assessed after 50 unassisted procedures. <b>Resultsb>: A total of 264 individuals contacted the study coordinator; 169 were screened. Screening was accepted well by the participants. Fifteen per cent of subjects had polyps and 4% had a positive FOBT. Training in FS was adversely affected by the availability of resources. Three GPs completed 50 unassisted procedures over a 15-month period, but none were able to reliably assess the distal bowel. <b>Conclusionsb>: Although the three trainees and their supervisors did not consider that the GPs were adequately trained after 50 unassisted procedures, training was adversely affected by limited resources within the Victorian public hospital system. Screening by FOBT and FS was considered to be acceptable by the patients undergoing these procedures. Existing facilities are not adequate if GPs are to be trained in FS as part of a national CRC screening program.<br />

Family, school, peer and individual influences on early adolescent alcohol use: first-year impact of the Resilient Families programme

<b>Introduction and Aimsb>:&nbsp; This study aimed to examine: (a) the influence of family factors relative to school, peer and individual influences on the development of adolescent alcohol use during the first year of secondary school; and (b) the feasibility of preventing adolescent alcohol use by modifying family factors. <b>Design and Methodsb>:&nbsp; Twenty-four schools in Melbourne, Australia were randomly assigned to either the 'Resilient Families' intervention or a control condition. A baseline cohort of 2315 grade 7 students (mean age 12.3 years) were followed-up one year later (n = 2128 for longitudinal analyses). A sub-set of parents (n = 1166) also returned baseline surveys. <b>Resultsb>: The prevalence of lifetime alcohol use in year 7 was 33% and rose to 47% by year 8. Student-reported predictors of year 8 alcohol use included baseline alcohol [Odds Ratio (OR) 3.64] and tobacco use (2.68), and school friend's alcohol (1.41) and tobacco use (1.64). After adjusting for other influences, student-reported family factors were not maintained as significant predictors of year 8 alcohol use. Parent-report predictors of student-reported alcohol use included allowing alcohol use in the home (2.55), parental alcohol use (1.88) and child hyperactivity (1.85). Protective factors included attendance at brief parent education (0.60) and parent involvement in school education (0.65). <b>Discussion and Conclusionsb>: The intervention appeared to benefit education-related outcomes, but no overall effect in reducing student alcohol use was found in year 8. Intervention effects on alcohol misuse may become significant in later secondary school once the entire program has been implemented. Considerable alcohol use was detected in early secondary school,&nbsp;&nbsp; suggesting that interventions to reduce alcohol use may be usefully implemented prior to this period.<br />

Effects of gamma-tocopherol supplementation on thrombotic risk factors

<b>Objectiveb>: The antioxidant activity of vitamin E is derived primarily from alpha-tocopherol (α-T) and gammatocopherol (γ-T). Results of epidemiological studies have demonstrated an inverse relationship between vitamin E intake and coronary disease. However, the results of clinical trials using α-T are equivocal. We determined the effect of 5 weeks of 100 mg/d or 200 mg/d γ-T supplementation on thrombotic markers such as platelet reactivity, lipid profile and the inflammation marker C-reactive protein (CRP). <b>Methods and results:b> Fourteen healthy subjects consumed 100 mg/day while 13 consumed 200 mg/d of γ-T and 12 received placebo (soybean capsules with less than 5 mg/d γ-T) in a double-blinded parallel study design. Fasting pre and post dose blood samples were analysed. Blood γ-T concentrations increased significantly (p<0.05) relative to dose during the intervention period. Both groups receiving active ingredients showed significantly lower platelet activation after supplementation (p<0.05). Subjects consuming 100 mg/d γ-T had significantly decreased LDL cholesterol, platelet aggregation and mean platelet volume (MPV) (p<0.05). Little effect of γ-T was observed on other parameters. <b>Conclusionsb>: These data suggest that γ-T&nbsp; supplementation may have a permissive role in decreasing the risk of<br />thrombotic events by improving lipid profile and reducing platelet activity.<br />

Mechanisms that contribute to differences in motor performance between young and old adults

This paper examines the physiological mechanisms responsible for differences in the amplitude of force fluctuations between young and old adults. Because muscle force is a consequence of motor unit activity, the potential mechanisms include both motor unit properties and the behavior of motor unit populations. The force fluctuations, however, depend not only on the age of the individual but also on the muscle group performing the task, the type and intensity of the muscle contraction, and the physical activity status of the individual. Computer simulations and experimental findings performed on tasks that involved single agonist and antagonist muscles suggest that differences in force fluctuations are not attributable to motor unit twitch force, motor unit number, or nonuniform activation of the agonist muscle, but that they are influenced by the variability and common modulation of motor unit discharge in both the agonist and antagonist muscles. Because the amplitude of the force fluctuations does not vary linearly with muscle activation, these results suggest that multiple mechanisms contribute to the differences in force fluctuations between young and old adults, although the boundary conditions for each mechanism remain to be determined.<br />

Futures in education

Futures education (FE) in a rapidly changing world is critical if young people are to be empowered to be proactive rather than reactive about the future. Research into young people's images and ideas of the future lead to the disturbing conclusion that, for many, the future is a depressing and fearful place where they feel hopeless and disempowered. On the other hand, as Richard Slaughter writes, 'young people are passionately interested in their own futures, and that of the society in which they live. They universally 'jump at the chance to study something with such intrinsic interest that also intersects with their own life interests in so many ways'. FE explicitly attempts to build on this interest and counter these fears by offering a profound and empowering set of learning strategies and ideas that can help people think and act critically and creatively about the future, without necessarily trying to predict it. Futures educators have, over the past decades, developed useful tools, ideas and a language for use with students of all ages to enable them to develop foresight literacy. Most of us tend to view the future as somehow beyond the present and rarely consider how decisions and choices made today profoundly affect not just one fixed future but any number of futures. The underlying goal of FE is to move from the idea of a single, pre-determined future to that of many possible futures, so that students begin to see that they can determine the future, that they need not be reactive and that they are not powerless. How does one do that? Ideas include, but are not limited to: timelines and Y-diagrams, futures wheels and mind maps, and 'Preferable, possible and probable' futures - a.k.a. the 3Ps. Current Australian curricula present education about the future in various implicit or explicit guises. A plethora of statements and curriculum outcomes mention the future, but essentially take 'it' for granted, and are uninformed by FE literature, language, ideas or tools. Science, the humanities and technology tend to be the main areas where such an implicit futures focus can be found. It also appears in documents about vocational education, civics and lifelong learning. Explicit FE is, as Beare and Slaughter put it, still the missing dimension in education. Explicit FE attempts to develop futures literacy, and draws widely upon futures studies literature for processes and content. FE provides such a wide range of ideas and tools that it can be incorporated into education in any number of ways. Programs in two very different schools, one primary and one secondary, are described in this article to provide examples of some of these ways. The first school, Kimberley Park State Primary School in Brisbane, operates with multi-age classrooms based on a 'thinking curriculum' developed around four organisers: change, perspectives, interconnectedness and sustainability. The second school, St John's Grammar School in Adelaide, is an independent school where FE operates as an integrated approach in Year Seven, as a separate one-semester subject in Year Nine and in separate subjects at other levels. Teachers both at Kimberley Park and St John's are very positive about FE. They say it promotes valuable and authentic learning, assists students to realise they have choices that matter and helps them see that the future need not be all doom and gloom. Because students are interested in the Big Questions, as one teacher put it, FE provides a perfect opportunity to address them, and to consider values that are fundamental for them and the future of the planet. Like any innovation, the long-term success of FE in schools depends on an embedding process so that the innovation does not depend on the enthusiasm and energy of a few individuals, only to disappear when they move on. It requires strong leadership, teacher knowledge, support and enthusiasm, and the support and understanding of the wider school community.<br />