Longitudinal changes in dietary patterns during adult life

Despite the growing interest in dietary patterns, there have been few longitudinal investigations. The objective of the present study was to extend an earlier method of dietary pattern assessment to longitudinal binary data and to assess changes in patterns over time and in relation to socio-demographic covariates. A prospective national cohort of 1265 participants completed a 5 d food diary at three time-points during their adult life (at age 36 years in 1982, 43 years in 1989 and 53 years in 1999). Factor analysis identified three dietary patterns for women (fruit, vegetables and dairy; ethnic foods and alcohol; meat, potatoes and sweet foods) and two patterns in men (ethnic foods and alcohol; mixed). Trends in dietary pattern scores were calculated using random effects models. Marked changes were found in scores for all patterns between 1989 and 1999, with only the meat, potatoes and sweet foods pattern in women recording a decline. In a multiple variable model that included the three time-points, socio-demographic variables and BMI time-dependent covariates, both non-manual social class and higher education level were also strongly associated with the consumption of more items from the ethnic foods and alcohol pattern and the mixed pattern for men (P<0[middle dot]0001) and the fruit, vegetables and dairy pattern and the ethnic foods and alcohol pattern for women (P<0[middle dot]01). In conclusion, longitudinal changes in dietary patterns and across socio-economic groups can assist with targeting public health initiatives by identifying stages during adult life when interventions to improve diet would be most beneficial to health.

Preliminary validation of the Chinese version of the pediatric quality of life inventory

The Pediatric Quality of Life Inventory (PedsQL) is a scale for assessing health-related quality of life of children and adolescents aged 2-18 years. Three reports of PedsQL for the age ranges 2-4 years and 5-7 years were translated into Chinese and their validities were examined. A total of 186 children and parents were involved in the study. Content validity, test-retest reliability, internal consistency reliability and construct validity were assessed. The correlation of parents' and children's reports was also examined. The results showed that the internal consistency is generally good, test-retest reliability ranged from moderate to good, differences between disabled and non-disabled individuals are significant in total scores and in all subscales except for the physical functioning subscale for the children's self-report for the age ranges of 2-4 years and 5-7 years and the correlation between the reports of the parents and children for the age range of 5-7 years is moderate to high. This suggests that the newly translated Chinese PedsQL for children aged 2-4 years and 5-7 years seems to be reliable and valid to be used as a measure of health-related quality of life in Chinese pediatric research and clinical applications.

Virtual non-profit organisations : literary virtual communities in Russia

This paper is a study of one of the "unknown" segments of the Internet - non-profit ventures in the Russian language. Based on the understanding of the concept of virtual community we consider the family of free publishing literary websites. We discuss their experience to demonstrate their contribution not only to the national culture, but also to the creation of open and democratic society in the former communist world, and to new forms of literary life. Some of the innovative concepts, principles and practices, adopted on those sites may be of interest to the Internet developers and communities worldwide.

The nature and development of the general insurance industry in Australia to 1973

The development of the insurance industry in Australia in the twentieth century was fundamentally shaped by a collusive code of conduct called the tariff. This arrangement, established to overcome problems of uncertainty, initially benefited both tariff and non-tariff firms by enhancing market stability. It also reduced competition. The collusive agreements gradually broke down, however, as new entrants and products entered the market in the 1950s. Self-regulation gradually gave way as the 'rules of the game' changed. The result was a period of instability before new competitive practices, and more direct and specific regulatory requirements emerged in the 1970s.

The moral status of wrongful life claims

A wrongful life action is a claim brought by a disabled child who asserts that but for a physician's negligence he or she would not have been born, thereby being spared the suffering of life. The action is inherently controversial because the alternative to an impaired life is non-existence. Lord Griffiths has described such claims as 'utterly offensive; there should be rejoicing that the hospital's mistake bestowed the gift of life upon the child'.' This paper cuts through the rhetoric that the debate has generated and analyses whether there is a sound doctrinal basis for recognizing wrongful life actions.

Burden of disease and injury in Aboriginal and non-Aboriginal populations in the Northern Territory

Objective:
To quantify the burden of disease and injury for the Aboriginal and non-Aboriginal populations in the Northern Territory.

Design and setting:
Analysis of Northern Territory data for 1 January 1994 to 30 December 1998 from multiple sources.

Main outcome measures:
Disability-adjusted life-years (DALYs), by age, sex, cause and Aboriginality.

Results:
Cardiovascular disease was the leading contributor (14.9%) to the total burden of disease and injury in the NT, followed by mental disorders (14.5%) and malignant neoplasms (11.2%). There was also a substantial contribution from unintentional injury (10.4%) and intentional injury (4.9%). Overall, the NT Aboriginal population had a rate of burden of disease 2.5 times higher than the non-Aboriginal population; in the 35-54-year age group their DALY rate was 4.1 times higher. The leading causes of disease burden were cardiovascular disease for both Aboriginal men (19.1%) and women (15.7%) and mental disorders for both non-Aboriginal men (16.7%) and women (22.3%).

Conclusions:
A comprehensive assessment of fatal and non-fatal conditions is important in describing differentials in health status of the NT population. Our study provides comparative data to identify health priorities and facilitate a more equitable distribution of health funding.

Validity of the assessment of quality of life (AQoL) utility instrument in patients with operable and inoperable lung cancer

There have been few longitudinal studies of quality of life in patients with all stages of lung cancer, particularly those that have included measures of utility. The purpose of this study was to examine the psychometric properties of the Assessment of Quality of Life instrument (AQoL) in patients with lung cancer. The AQoL is a health-related quality of life questionnaire and provides a descriptive system for a multi-attribute utility instrument (MAU), so that scores can be used in cost-utility evaluations. In the present study the reliability (internal consistency) of the AQoL was examined and the concurrent validity was assessed using the Medical Outcomes 36-item Short Form Health Survey (SF-36) as the comparator instrument. The sensitivity to different health states of the AQoL and the responsiveness to change over time was also examined. A prospective, non-experimental cohort study was undertaken. Ninety-two participants with all stages of lung cancer were recruited from a tertiary multi-disciplinary lung cancer clinic. Ninety participants had non-small cell lung cancer (NSCLC) and two had limited stage small cell lung cancer. The AQOL and SF-36 surveys were administered concurrently at baseline. In patients with NSCLC the surveys were then repeated 3 and 6 months later. Correlations between the baseline AQoL summary scales and SF-36 summary scales support the divergent and convergent validity of the AQoL. Reliability was also found to be sufficient (Cronbach's Alpha = 0.76). In addition, in patients with inoperable NSCLC, baseline AQoL scores were found to be predictive of survival at 6 months in Cox proportional hazards multivariate analysis. However, the physical components summary score of the SF-36 was more sensitive to differences in health states between patients with different stages of NSCLC at 6 months of follow-up and more responsive to change over time in both operable and inoperable patients with NSCLC than the AQoL. The findings support the construct validity and reliability of the AQoL in this population. However, there remains some uncertainty about whether the AQoL has sufficient sensitivity to different health states in this population. Further studies using other MAU instruments may determine whether alternative instruments are more sensitive to different health states in individuals with lung cancer.

Virtual non-profit organisations: literary virtual communities in Russia

This paper is a study of one of the “unknown” segments of the Internet - non-profit ventures in the Russian language.Based on the understanding of the concept of virtual community we consider the family of free publishing literary websites. We discuss their experience to demonstrate their contribution not only to the national culture, but also to the creation of open and democratic society in the former communist world, and to new forms of literary life. Some of the innovative concepts, principles and practices, adopted on those sites may be of interest to the Internet developers and
communities worldwide.

Guideline for the non-surgical management of hip and knee osteoarthritis

Introduction: Chronic disease is a major public health burden on Australian society. An increasing proportion of the population has risk factors for, or at least one, chronic disease, leading to increasing public health costs. Health service policy and delivery must not only address acute conditions, it must also effectively respond to the wide range of health and public service requirements of people with chronic illness.^1,2 Strong primary health care policy is an important foundation for a successful national health delivery system and long term management of public health, and is linked to practical outcomes including lower mortality, decreased hospitalisation and improved health outcomes.¹ National strategic health policy has recently given increased recognition to the importance of chronic disease management, with the Australian Federal Government endorsement of a number of initiatives for the prevention (or delay in onset), early detection and evidence based management of chronic disease, including osteoarthritis.^1,3
Chronic musculoskeletal conditions, including arthritis, account for over 4% of the national disease burden in terms of disability adjusted life years. Over 6 million Australians (almost one-third of the population) are estimated to have a chronic musculoskeletal disease; chronic musculoskeletal disease represents the main cause of long term pain and physical disability. In Australia, osteoarthritis is self reported by more than 1.4 million people (7.3% of the population4) and is the tenth most commonly managed problem in general practice.5 This number is set to rise as the elderly population grows. Osteoarthritis exerts a significant burden on the individual and the community through reduction in quality of life, diminished employment capacity and an increase in health care costs. For further details, refer to the Evidence to support the National Action Plan for Osteoarthritis, Rheumatoid Arthritis and Osteoporosis: Opportunities to improve health-related quality of life and reduce the burden of disease and disability (2004).⁶
As such, federal government health policy has identified arthritis as a National Health Priority Area and adopted a number of initiatives aimed at decreasing the burden of chronic disease and disability; raising awareness of preventive disease factors; providing access to evidence based knowledge; and improving the overall management of arthritis within the community.4 In 2002, all Australian health ministers designated arthritis and musculoskeletal conditions as Australia’s seventh National Health Priority Area. In response, a National Action Plan was developed in 2004 by the National Arthritis and Musculoskeletal Conditions Advisory Group (NAMSCAG).6 The aim of this document was to provide a blueprint for national initiatives to improve the health related quality of life of people living with osteoarthritis, rheumatoid arthritis and osteoporosis; reduce the cost and prevalence of these conditions; and reduce the impact on individuals, their carers and their communities within Australia. The National Action Plan was developed to complement both the National Chronic Disease Strategy – which is broader – and the National Service Improvement Framework for Osteoarthritis, Rheumatoid Arthritis and Osteoporosis, in addition to other national and state/ territory structures.

Occupational and non-occupational physical activity and the social determinants of physical activity : results from the Health Survey for England

Background: This article aims to examine the relative contribution of occupational activity to English adults’ meeting of government recommendations for physical activity (PA).

Methods: Data were extracted from a cross-sectional survey of householders in the UK via the Health Survey for England.¹ In total, 14,018 adult participants were included in the analysis. Multivariate logistic regression was used to examine the odds of achieving PA recommendations with and without including occupational activity and to examine the contribution of gender and social and demographic characteristics.

Results: When occupational PA was included, 36% of men and 25% of women were active at the recommended level. Once occupational PA was removed, these proportions were 23% and 19%, respectively. These results were socially patterned, most notably by age and gender.

Conclusions: Occupational PA provides a substantial contribution to those meeting the government target for PA.

FEA simulation of contact and wear between non-metallic materials for accelerated new product development

The conventional approach ie laboratory life testing to examine the reliability of products takes long time and involves tremendous cost as samples are tested till failures. The accelerated life test (ALT) has recently been used as an alternative method. Although ALT reduces the cost of reliability testing through applying more severe environmental conditions than the normal ones, it is no longer sufficient as it does not describe the process of products’ failure explicitly and it is still highly dependent on physical testing. Consequently, novel practices need to be developed for better understanding of the products’ reliability. A novel Finite Element Analysis (FEA) model incorporating mathematical wear equations is developed in the current work and applied to polymer materials. Wear rate, a key parameter, is calculated by using a combinatorial formula that combines a conventional linear equation with a recently published exponential equation. The local wear is firstly calculated and then integrated over the sliding distance. The FEA simulation works in a loop and performs a series of simulation with updated surface geometries. The simulation is in good agreement with the physical testing result.

Clinical, ethical and legal considerations in the treatment of newborns with non-ketotic hyperglycinaemia

Non-ketotic hyperglycinaemia (NKH) is a devastating neurometabolic disorder leading, in its classical form, to early death or severe disability and poor quality of life in survivors. Affected neonates may need ventilatory support during a short period of respiratory depression. The transient dependence on ventilation dictates urgency in decision-making regarding withdrawal of therapy. The occurrence of patients with apparent transient forms of the disease, albeit rare, adds uncertainty to the prediction of clinical outcome and dictates that the current practice of withholding or withdrawing therapy in these neonates be reviewed. Both bioethics and law take the view that treatment decisions should be based on the best interests of the patient. The medical-ethics approach is based on the principles of non-maleficence, beneficence, autonomy and justice. The law relating to withholding or withdrawing life-sustaining treatment is complex and varies between jurisdictions. Physicians treating newborns with NKH need to provide families with accurate and complete information regarding the disease and the relative probability of possible outcomes of the neonatal presentation and to explore the extent to which family members are willing to take part in the decision making process. Cultural and religious attitudes, which may potentially clash with bioethical and juridical principles, need to be considered.

A non-radioactive method for measuring Cu uptake in HepG2 cells

At present, all data on Cu uptake and metabolism have been derived from radioactive uptake experiments. These experiments are limited by the availability of the radioactive isotopes ⁶⁴Cu or ⁶⁷Cu, and their short half-life (12.5 and 62 h, respectively). In this paper, we investigate an alternative method to study the uptake of Cu with natural isotopes in HepG2 cells, a liver cell line used extensively to study Cu metabolism. In nature, Cu occurs as two stable isotopes, ⁶³Cu and ⁶⁵Cu (⁶³Cu/⁶⁵Cu = 2.23). This ratio can be measured accurately using inductively coupled plasma mass spectrometry (ICP-MS). In initial experiments, we attempted to measure the time course of Cu uptake using ⁶⁵Cu. The change in the ⁶³Cu/⁶⁵Cu ratio, however, was too small to allow measurement of Cu uptake by the cells. To overcome this difficulty, the natural ⁶³Cu/⁶⁵Cu ratio in HepG2 cells was altered using long-term incubation with ⁶³Cu. This had a significant effect on Cu concentration in HepG2 cells, changing it from 81.9 ± 9.46 pmol μg DNA⁻¹ (week 1) to 155 ± 8.63 pmol μg DNA⁻¹ (week 2) and stabilising at 171 ± 4.82 pmol μg DNA⁻¹ (week 3). After three weeks of culture with 2 μM ⁶³Cu the ⁶³Cu/⁶⁵Cu changed from 2.18 ± 0.05 to 15.3 ± 1.01. Cu uptake was then investigated as before using ⁶⁵Cu. Uptake was linear over 60 min, temperature dependent and consistent with previous kinetics data. These observations suggest that stable isotope ICP-MS provides an alternative technique for the study of Cu uptake by HepG2 cells.

Be(ing) prepared : girl guides, colonial life, and national strength

This paper seeks to bridge a gap in feminist critique of gender and empire with regard to the founding of the Girl Guide movement in 1909. In contrast with previous studies of the Boy Scouts, which have briefly considered Guides as a mere derivative organisation, it suggests that the formation of the Guides, and printed material such as the first handbook How Girls Can Help Build Up the Empire (1912), were grounded in notions of the part which women, and girls specifically, could play in the imperial project. This paper proposes that, although tempered by an emphasis on raising children in order to prevent the “degeneration” of the British race, the Guide handbook permits increased non-domestic activity for Edwardian girls, which is justified by aims of preparing for home defence in case of foreign attack and for life in the colonies.