A systematic review of the impact of weight loss on cancer incidence and mortality

Obesity is well recognized as a significant risk factor for certain cancers; however, a corresponding risk reduction with weight loss is not yet clearly defined. This review aims to examine the literature investigating the effect of all types of weight loss on cancer incidence and mortality, and to more clearly describe the relationship between these two factors. A literature search identified 34 publications reporting weight loss data in relation to cancer incidence or mortality. All except one were observational studies and the majority used self-reported weights and did not define intentionality of weight loss. 16/34 studies found a significant inverse association between weight loss and cancer incidence or mortality. The remainder returned null findings. The observed association was more consistently seen in studies that investigated the effect of intentional weight loss (5/6 studies) and the risk reduction was greatest for obesity-related cancers and in women. In conclusion, intentional weight loss does result in a decreased incidence of cancer, particularly female obesity-related cancers. However, there is a need for further evaluation of sustained intentional weight loss in the obese with less reliance on self-reported weight data and more focus on male populations.

A unified mixed-integer programming model for simultaneous fluence weight and aperture optimization in VMAT, tomotherapy, and cyberknife

All rights reserved. In this paper, we propose and study a unified mixed-integer programming model that simultaneously optimizes fluence weights and multi-leaf collimator (MLC) apertures in the treatment planning optimization of VMAT, Tomotherapy, and CyberKnife. The contribution of our model is threefold: (i) Our model optimizes the fluence and MLC apertures simultaneously for a given set of control points. (ii) Our model can incorporate all volume limits or dose upper bounds for organs at risk (OAR) and dose lower bound limits for planning target volumes (PTV) as hard constraints, but it can also relax either of these constraint sets in a Lagrangian fashion and keep the other set as hard constraints. (iii) For faster solutions, we propose several heuristic methods based on the MIP model, as well as a meta-heuristic approach. The meta-heuristic is very efficient in practice, being able to generate dose- and machinery-feasible solutions for problem instances of clinical scale, e.g., obtaining feasible treatment plans to cases with 180 control points, 6750 sample voxels and 18,000 beamlets in 470 seconds, or cases with 72 control points, 8000 sample voxels and 28,800 beamlets in 352 seconds. With discretization and down-sampling of voxels, our method is capable of tackling a treatment field of 8000-64,000cm3, depending on the ratio of critical structure versus unspecified tissues.

Fitting aggregation functions to data: part I-linearization and regularization

The use of supervised learning techniques for fitting weights and/or generator functions of weighted quasi-arithmetic means – a special class of idempotent and nondecreasing aggregation functions – to empirical data has already been considered in a number of papers. Nevertheless, there are still some important issues that have not been discussed in the literature yet. In the first part of this two-part contribution we deal with the concept of regularization, a quite standard technique from machine learning applied so as to increase the fit quality on test and validation data samples. Due to the constraints on the weighting vector, it turns out that quite different methods can be used in the current framework, as compared to regression models. Moreover, it is worth noting that so far fitting weighted quasi-arithmetic means to empirical data has only been performed approximately, via the so-called linearization technique. In this paper we consider exact solutions to such special optimization tasks and indicate cases where linearization leads to much worse solutions.

Dietary sodium intake and overweight and obesity in children and adults: a protocol for a systematic review and meta-analysis.

BACKGROUND: Overweight and obesity in children and adults is a major public health concern. Emerging evidence suggests dietary sodium intake may be associated with obesity. This systematic review and meta-analysis will aim to (i) assess the relation between dietary sodium intake and measures of adiposity in children and adults and (ii) examine the relation between sodium intake and sugar-sweetened beverage (SSB) consumption, which is a known risk factor for obesity. METHODS/DESIGN: An electronic search will be conducted using Medline Complete, CINAHL, Scopus, Embase and Cochrane central register of controlled trials (CENTRAL). The search strategy will identify published peer-reviewed articles that report on dietary sodium and either a marker of adiposity or SSB consumption. Only human studies (ages >1 year) in English will be included, and no limits will be placed on publication date. No restrictions will be placed on the method of sodium intake assessment. Cross-sectional, prospective studies, and randomised controlled trials with a duration of ≥ 3 months will be included. Studies with participants with renal disease, cancer, type 1 diabetes or heart failure or who are pregnant will be excluded. To assess the quality of studies, the Cochrane's Collaboration tool for assessing risk of bias in randomised trials will be used for randomised controlled trials (RCTs), and the modified Newcastle-Ottawa Scale will be used for cross-sectional and prospective studies. Meta-analysis will be used to assess the relation of sodium intake with two primary outcomes: (i) BMI and body weight in adults and BMI z-score in children and (ii) weight category (i.e. healthy weight vs. overweight/obese). For any outcomes in which meta-analysis is not possible, we will present data as a systematic review. Findings will be grouped and reported separately for children and adolescents (ages 1-17 years) and adults (ages >18 years). DISCUSSION: This review and meta-analysis will provide insight into the relation between dietary sodium intake and overweight and obesity. This information can be used to inform public health policies which target population sodium consumption.

Neo-liberalism and new configurations of global space: possibilities, tensions and problematics for gender justice

While the global neo-liberal agenda has increased the impoverishment and marginalisation of many women, it has also created possibilities for pursuing gender justice. Deepened and broadened understandings and measures of equity brought about by the processes of globalisation and insights from feminism have disturbed neo-liberal regimes and produced action around the pursuit of gender equity goals. Moreover, new configurations of ‘the global’ have strengthened transnational feminist networks and coalitions and generated multiple and varied spaces for feminist engagement. Against this backdrop, this article draws attention to the ways in which these shifts have brought to light previously unrecognised complexities and tensions that continue to hinder the pursuit of global gender justice. Focusing on the feminist work of NGOs and CSOs and, specifically, issues of social capital and cultural context, the article examines the problematics and possibilities regarding these organisations' promotion of gender change at local, national and transnational levels. Such examination foregrounds the significance of a coherent feminist politics and activism that responds to the social conditions and cultural nuances that impact on gender relations in particular contexts and is supported by broader facilitative structures and social networks.

The oral language skills of young offenders: a pilot invesitgation

Although there is a large body of evidence attesting to the poor social skills of juvenile offenders, few workers have examined the underlying language skills of this population. This pilot study investigated the language skills of a group of young offenders in comparison to non-offending school students. Data were gathered from 15 community-based young offender males, aged between 13 and 21 years (M = 16.5 years, SD = 2.1) from the Victorian southern region Juvenile Justice Units. The comparison group comprised 15 male students, aged between 15 and 17 years (M = I 6.4 years; SD = 0.5 I) from government high schools in south-eastern metropolitan Melbourne. Each participant completed a narrative discourse task and measures of speed of processing, and abstract language. It was hypothesised that the young offender group would perform more poorly on each of the language tasks than the comparison group. Independent t tests (with a modified alpha level to control for family-wise error rates) showed that there were significant differences in the expected direction, on all language measures. Notwithstanding the pilot nature of the investigation, implications of these findings for both further research and intervention/early intervention are described.

Safety of low-carbohydrate diets

Low-carbohydrate diets have re-emerged into the public spotlight and are enjoying a high degree of popularity as people search for a solution to the population's ever-expanding waistline. The current evidence though indicates that low-carbohydrate diets present no significant advantage over more traditional energy-restricted diets on long-term weight loss and maintenance. Furthermore, a higher rate of adverse side-effects can be attributed to low-carbohydrate dieting approaches. Short-term efficacy of low-carbohydrate diets has been demonstrated for some lipid parameters of cardiovascular risk and measures of glucose control and insulin sensitivity, but no studies have ascertained if these effects represent a change in primary outcome measures. Low-carbohydrate diets are likely effective and not harmful in the short term and may have therapeutic benefits for weight-related chronic diseases although weight loss on such a program should be undertaken under medical supervision. While new commercial incarnations of the low-carbohydrate diet are now addressing overall dietary adequacy by encouraging plenty of high-fibre vegetables, fruit, low-glycaemic-index carbohydrates and healthier fat sources, this is not the message that reaches the entire public nor is it the type of diet adopted by many people outside of the world of a well-designed clinical trial. Health effects of long-term ad hoc restriction of inherently beneficial food groups without a concomitant reduction in body weight remains unanswered.

Person-organization congruence of high performance values in Australian universities

This study explores the applicability of the personal and organizational value clusters identified by Abbott, White & Charles, (2005) employing the McDonald & Gandz (1991) list of values to university settings. It examines the personal values of business students in two universities, their perception ofthe organizational values important to their university, and measures the extent to which the personal and organizational values are consistent with 'High Performance Work Systems '. Results provide support for individual and organizational values factors similar to those found by Finegan, (2000) and Abbott et al. (2005) and consistent with Schwartz s (1992) an-cultural values hierarchy. While usiness/commerce students rated their personal values as consistent with HPWS and the major pan-cultural values, this did not match their perception of the organizations' values. The implications of personal-organizational value incongruence on motivation, satisfaction, organizational commitment and effectiveness are discussed.

Extent of heart failure self-care as an endpoint to patient education: a literature review

Background: In western countries the number of chronic heart failure (CHF) management programs has escalated in recent times. One key component of them is to teach self-care behaviours that enable affected individuals to monitor themselves and engage in lifestyles that improve their health status.
Aim: The aim of this article is to describe CHF self-care management and to review the literature which examines the effectiveness of patient education on patients’ performance of self-care behaviours.
Design/method: bibliographical databases were searched for papers published in English between 1982 to 2006. The search used the key words: heart failure, education, self-care and measures. Only randomized controlled trials (RCTs) were selected.
Results: Ten randomized controlled trials were selected that used education as an intervention and, in total, 1064 patients with CHF participated in these studies. The studies were heterogenous as to the sample population, the health outcomes measured, the education interventions, the expertise of the educator, and the length of time that was spent on teaching patients. No consistent patterns of implementation and specific evaluation of its impact were found, although three respective groups of investigators reported signifi cant differences in recurrent hospitalisation rates and mortality rates which were relative to usual care.
Conclusions: Teaching patients appropriate CHF self-care behaviours can significantly improve their health outcomes. Improvements in self-care were demonstrated in seven studies but only three had used validated instruments to measure such changes. This suggests that no firm conclusions can be drawn about changes in self-care practices.

Sense of community in science fiction random, part 1: Understanding sense of community in an international community of interest

Within the discipline of community psychology there is debate as to the dimensions underlying the construct psychological sense of community (PSOC). One of the few theoretical discussions is that of McMillan and Chavis (1986), who hypothesized four dimensions: Belonging; Fulfillment of Needs; Influence; and Shared Connections. Discussion has also emerged in the literature regarding the role of identification within PSOC. It has been suggested that differences in PSOC may be understood in terms of the degree to which members identify with their community (Fisher & Sonn, 1999). However, few studies have explored the place of identification in PSOC. In addition, while PSOC has been applied to both communities of interest and geographical communities, little research has looked in depth at PSOC within communities of interest. The current study therefore explored PSOC in science fiction fandom, a community of interest with membership from all over the world, by means of a questionnaire distributed at an international science fiction convention (N = 359). In an endeavor to clarify the underlying dimensions of PSOC, the questionnaire included several measures of PSOC, and measures of identification with the community. Results showed that science fiction fandom reported high levels of PSOC. Support emerged for McMillan and Chavis' (1986) four dimensions of PSOC, with the addition of a fifth dimension, that of Conscious Identification. These results, and implications for PSOC research, are discussed.

An algorithm for logit network loading problem by topological sorting

This paper presents a topological sorting based algorithm for logit network loading problem to exclude all cycles by removing certain links from loops. The new algorithm calculates the link weights and flows according to topological order. It produces the theoretical results for networks without loops. Numerical examples show that the new algorithm can reduce errors introduced by the strict definition of 'reasonable route' in Dial's algorithm.

Evolving governance arrangements in multi-tenure reserve networks

Multi-tenure reserve networks (MTRNs) aim to connect areas managed for biodiversity conservation across public and private land (for example biosphere reserves (BRs) and conservation management networks (CMNs)). A key function of MTRNs is facilitating communication, information exchange and management activities between land managers of differing tenures not usually in contact with each other; governance arrangements are therefore crucial. Australian MTRNs vary greatly in their goals and measures of success, criteria for entry, ecosystems targeted, geographic extent and financial arrangements. The successful operation of a MTRN is likely to be influenced by a manager's confidence in the governance model/coordination arrangements (Belcher & Wellman 1991). We analysed the organizational structure of three Australian MTRNs (Fig. 1) including the objectives and role of the coordinating body, entry requirements, goals and measures of success, restrictions placed on the geographic or ecological extent of the network and financial arrangements. We highlight how substantial changes in governance arrangements have occurred for two of three networks studied, suggesting a fluid evolution of MTRN structures is likely.

Patient outcomes in the acute revovery phase following robotic-assisted prostate surgery : a prospective study

Background: Robotic-assisted minimally invasive urologic surgery was developed to minimise surgical trauma resulting in quicker recovery. It has many potential benefits for patients with localised prostate cancer over traditional surgical techniques without taking a risk with the oncological result.

Objectives: To report the specific surgical outcomes for the first Australian cohort of patients with localised prostate cancer that had undergone robotic-assisted radical prostatectomy (RARP) surgery. The outcomes represent the acute (in-hospital) recovery phase and include pain, length of stay (LOS), urinary catheter management and wound management.

Methods: Prospective descriptive survey of 214 consecutive patients admitted to a large metropolitan private hospital in Melbourne, Australia between December 2003 and June 2005. Patients had undergone RARP surgery for localised prostate cancer. Data were collected from the medical records and through interview at the time of discharge. Descriptive statistics were used to describe the frequency and proportion of outcomes. Patient characteristics were tabulated using cross tabulation frequency distribution and measures of central tendency.

Results: The findings from this study are highly encouraging when compared to outcomes associated with traditional surgical techniques. Transurethral catheter duration (median 7 days (IQ range 2)) and LOS (median 3 days (IQ range 2)) were considerably reduced. While operation time (median 3.30 h (IQ range 1.07)) was marginally reduced we would expect a further reduction as the surgical team becomes more skilled.

Conclusion: The findings from this study contribute to building a comprehensive picture of patient outcomes in the acute (in-hospital) recovery phase for a cohort of Australian patients who have undergone RARP surgery for localised prostate cancer. As such, these findings will provide valuable information with which to plan care for patients’ who undergo robotic-assisted surgery.

On the communal analysis suspicion scoring for identity crime in streaming credit applications

This paper describes a rapid technique: communal analysis suspicion scoring (CASS), for generating numeric suspicion scores on streaming credit applications based on implicit links to each other, over both time and space. CASS includes pair-wise communal scoring of identifier attributes for applications, definition of categories of suspiciousness for application-pairs, the incorporation of temporal and spatial weights, and smoothed k-wise scoring of multiple linked application-pairs. Results on mining several hundred thousand real credit applications demonstrate that CASS reduces false alarm rates while maintaining reasonable hit rates. CASS is scalable for this large data sample, and can rapidly detect early symptoms of identity crime. In addition, new insights have been observed from the relationships between applications.

Egg colour matching in an African cuckoo, as revealed by ultraviolet-visible reflectance spectrophotometry

Despite major differences between human and avian colour vision, previous studies of cuckoo egg mimicry have used human colour vision (or standards based thereon) to assess colour matching. Using ultraviolet-visible reflectance spectrophotometry (300-700 nm), we measured museum collections of eggs of the red-chested cuckoo and its hosts. The first three principal components explained more than 99% of the variance in spectra, and measures of cuckoo-host egg similarity derived from these transformations were compared with measures of cuckoo-host egg similarity estimated by human observers unaware of the hypotheses we were testing. Monte Carlo methods were used to simulate laying of cuckoo eggs at random in nests. Results showed that host and cuckoo eggs were very highly matched for an ultraviolet versus greenness component, which was not detected by humans. Furthermore, whereas cuckoo and host were dissimilar in achromatic brightness, humans did not detect this difference. Our study thus reveals aspects of cuckoo-host egg colour matching which have hitherto not been described. These results suggest subtleties and complexities in the evolution of host-cuckoo egg mimicry that were not previously suspected. Our results also have the potential to explain the longstanding paradox that some host species accept cuckoo eggs that are non-mimetic to the human eye.