Health and mortality consequences of abdominal obesity : evidence from the AusDiab study

Objective: To provide an estimate of the morbidity and mortality resulting from abdominal overweight and obesity in the Australian population.

Design and setting: Prospective, national, population-based study (the Australian Diabetes, Obesity and Lifestyle [AusDiab] study).

Participants: 6072 men and women aged ≥ 25 years at study entry between May 1999 and December 2000, and aged ≤ 75 years, not pregnant and for whom there were waist circumference data at the follow-up survey between June 2004 and December 2005.

Main outcome measures: Incident health outcomes (type 2 diabetes, hypertension, dyslipidaemia, the metabolic syndrome and cardiovascular diseases) at 5 years and mortality at 8 years. Comparison of outcome measures between those classified as abdominally overweight or obese and those with a normal waist circumference at baseline, and across quintiles of waist circumference, and (for mortality only) waist-to-hip ratio.

Results: Abdominal obesity was associated with odds ratios of between 2 and 5 for incident type 2 diabetes, dyslipidaemia, hypertension and the metabolic syndrome. The risk of myocardial infarction among obese participants was similarly increased in men (hazard ratio [HR], 2.75; 95% CI, 1.08–7.03), but not women (HR, 1.43; 95% CI, 0.37–5.50). Abdominal obesity-related population attributable fractions for these outcomes ranged from 13% to 47%, and were highest for type 2 diabetes. No significant associations were observed between all-cause mortality and increasing quintiles of abdominal obesity.

Conclusions: Our findings confirm that abdominal obesity confers a considerably heightened risk for type 2 diabetes, the metabolic syndrome (as well as its components) and cardiovascular disease, and they provide important information that enables a more precise estimate of the burden of disease attributable to obesity in Australia.

Use of high resolution digital multi-spectral imagery to assess the distribution of disease caused by Phytophthora cinnamomi on heathland at Anglesea, Victoria

Disease caused by the soilborne plant pathogen Phytophthora cinnamomi causes long-term floristic and structural changes in native vegetation communities in Australia. Key components of the management of this disease are to know where it occurs and the rate at which it spreads. The distribution of P. cinnamomi has generally been assessed as locality points of infestation and mapping the extent of diseased vegetation in any area is difficult and costly. This study was undertaken in P. cinnamomi-infested heathland communities in southern Victoria, Australia, where the symptoms of P. cinnamomi arise as a mosaic within healthy vegetation. We investigated the potential to improve the efficiency and effectiveness of mapping and monitoring vegetation affected by P. cinnamomi using digital multi-spectral imaging. This technique was developed for the purposes of monitoring vegetation and provides a single, seamless ortho-rectified digital image over the total area of interest. It is used to spatially quantify small differences in the characteristics of vegetation. In this study, the symptoms of disease caused by P. cinnamomi infestation were related to differences in the imagery and were used to map areas of infestation. Comparison of the digital multi-spectral imaging indications with on-ground observations gave moderate accuracy between the datasets (κ = 0.49) for disease and healthy indications. This study demonstrates the ability of the technique to determine disease extent over broad areas in native vegetation and provides a non-invasive, cost effective tool for management.

Is there global inclusion of authors in the five leading advertising journals? A regional comparison 1998-2007

A question that has been raised in academia has to do with whether there is global inclusion of authors in publishing. While this issue has been explored in some areas in business and marketing it has generally not been investigated across 30 years of advertising research activity. This paper seeks to examine the global inclusion of authors in five advertising-focused journals. We found that, while there appears to be an increase in international publishing activity in advertising compared to data extrapolated from past studies, published advertising research still reveals a North American bias/domination. A failure to be globally inclusive may lead to an under-exploration of academic issues and perspectives, as important 'non-US' issues could possibly be ignored.

Management of lipids in rural Australia : are the guidelines being followed?

Background: Hypercholesterolaemia is ranked seventh among the major factors contributing to the overall burden of disease in Australia. Guidelines for evidence-based lipid management were released in 2001 and updated in 2005, however little population level data has been published on the current gap between recommended management and actual practice in Australia.

Method: Three population stratified surveys were undertaken in the Greater Green Triangle. Three thousand three hundred and twenty adults aged 25–74 years were randomly selected, stratified by gender and 10-year age groups. Anthropometric, clinical and self-administered questionnaire data relating to cardiovascular disease risk were collected in accordance with the WHO MONICA protocol. Blood samples were collected for lipid profile analysis. Participants were divided into four groups—Group 1: treated, high CVD risk; Group 2: treated, primary prevention; Group 3: untreated, high CVD risk; Group 4: untreated, low CVD risk. For each of these groups we compared cholesterol, HDL cholesterol, triglyceride and LDL cholesterol with targets recommended by the National Heart Foundation's 2005 guidelines.

Results: All lipids were at target in 39.4% of the study population with marked differences between groups: Group 1, 11.2%; Group 2, 38.5%; Group 3, 1.8%; Group 4, 47.6%.

Only 50.8% of the untreated high CVD risk group reported having blood cholesterol measured within the last 12 months.

Conclusion: Current rates of detection and treatment practices in rural Australia are suboptimal. Although one-third of the study population age 25–74 years are at sufficiently high risk to warrant consideration of lipid lowering medication only just over half of these were on treatment at the time of the study. These results suggest that an intensive implementation plan is required for the management of hyperlipidaemia in rural Australia.

Improving the communication between care providers of individuals who may require joint replacement surgery (JRS) a framework for referral

Aims & rationale/Objectives : The objective of the project was to specify the information required in referrals to public hospital orthopaedic outpatient departments in order to streamline the care and prioritisation of individuals who may require JRS. It was envisaged that an evidence-based GP-Orthopaedic derived referral system would assist in ensuring that the right person accessed the right care at the right time.

Methods : In collaboration with the RACGP and the Commonwealth Department of Health and Ageing, a national stakeholder working group was convened. A scoping document was prepared with input from key stakeholders. A review of primary research was undertaken as well as a review of relevant guidelines. Information on the implementation and evaluation of similar programs in Australia and overseas also informed the referral specification.

Principal findings : The initial scoping processes with key stakeholders provided clear information on core components of the referral. These were the use of standardised and respected assessment tools to determine the severity of arthritis, fitness for surgery and willingness of affected individuals to undergo surgery.

Discussion : About 20,000 JRS occur each year in public hospitals which emanate from 5 to 10 fold number of referrals. Arthritis and musculoskeletal diseases are a national health priority area reflecting the high burden of disease associated with these conditions. Various initiatives are being undertaken to address the quality of life of affected individuals. This project has revealed areas of potential improvement in the communication between care providers of individuals who may need JRS.

Implications : The project will result in the development of a standard referral form and guidelines to assist referring practitioners to communicate more effectively with the multidisciplinary care team, in particular orthopaedic care providers. The guidelines will be piloted in a large rural setting.

Roadian – Wordian (Guadalupian, Middle Permian) global palaeobiogeography of brachiopods

A database of 4471 Roadian–Wordian (Guadalupian, Middle Permian) occurrences of 381 brachiopod genera in 44 different operational geographical units (stations) was analyzed by both Q-mode and R-mode quantitative methods. Four distinct brachiopod biogeographical realms and nine provinces, and 11 brachiopod associations are recognized. The Boreal Realm in the Northern Hemisphere includes the Verkolyman Province in the northern and northeastern Siberian Platform and the eastern European Province in the Ural seaway between the European and Siberian platforms. Both provinces are characterized by containing typical Boreal cold-water brachiopod associations. The Gondwanan Realm in the south also includes two provinces. The Austrazean Province in eastern Australia and New Zealand is probably the most stable province throughout the Permian and characterized by typical Gondwanan brachiopod associations. The Westralian Province centered in Western Australia is also characterized by typical Gondwanan brachiopods, but also demonstrates biogeographical links with the Tethyan stations. The Palaeoequatorial Realm located mainly in the palaeotropical zone contains highly diverse and abundant brachiopod faunas. Two regions/subrealms and four provinces are recognized within this realm. The North America Subrealm contains a distinct Grandian Province characterized by many endemic brachiopod genera and a few coldwater genera. East-central Alaska and Yukon Territory may constitute another brachiopod province. All the stations in the Tethyan Ocean (both Palaeotethys and Neotethys) constitute a distinct Asian–Tethyan Region/ Subrealm and incorporate three different provinces. The Cathaysian Province is comprised of the stations in South China and its surrounding terranes/blocks and a few stations in the northern and western margin of the Palaeotethys. Two transitional provinces (Sino–Mongolian–Japanese Province and Cimmerian Province) in the northern and southern temperate zones are also recognizable. The brachiopod fauna from the Mino Belt in Japan is well distinguished from those from other regions, and is hence assigned to the palaeoceanic Panthalassan Realm. Principal coordinates analysis and minimum spanning tree analysis suggest that a latitude-related thermal gradient was the major control for the palaeobiogeography of Roadian–Wordian global brachiopod faunas and for the latitudinal of pattern of decreasing brachiopod generic diversities from the equator to the poles. In addition, geographic separation and oceanic currents may also have played some role in the spatial distribution of brachiopods during Roadian–Wordian times.

Prevention of a chronic progressive form of experimental autoimmune encephalomyelitis by an antibody against mucosal addressin cell adhesion molecule-1, given early in the course of disease progression.

A role for α4 and β7 integrins in mediating leucocyte entry into the central nervous system in the multiple sclerosis (MS)-like disease experimental autoimmune encephalomyelitis (EAE) has been demonstrated. However, the individual contributions of their respective ligands mucosal addressin cell adhesion molecule-1 (MAdCAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-cadherin expressed on the blood-brain barrier has not been determined. In the present paper, it is shown that an antibody directed against MAdCAM-1, the preferential ligand for α4β7, effectively prevented the development of a progressive, non-remitting, form of EAE, actively induced by injection of myelin oligodendrocyte glycoprotein peptide (MOG(_35-55)) autoantigen. Combinational treatment with both anti-MAdCAM-1, VCAM-1, and intercellular adhesion molecule-1 (ICAM-1) (ligand for integrin lymphocyte function-associated antigen (LFA)-1) mAbs led to more rapid remission than that obtained with anti-MAdCAM-1 antibody alone. However, neither MAdCAM-1 monotherapy, nor combinational antibody blockade was preventative when administered late in the course of disease progression. In conclusion, MAdCAM-1 plays a major contributory role in the progression of chronic EAE and is a potential therapeutic target for the treatment of MS. Critically, antivascular addressin therapy must be given eaA role for alpha4 and beta7 integrins in mediating leucocyte entry into the central nervous system in the multiple sclerosis (MS)-like disease experimental autoimmune encephalomyelitis (EAE) has been demonstrated. However, the individual contributions of their respective ligands mucosal addressin cell adhesion molecule-1 (MAdCAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-cadherin expressed on the blood-brain barrier has not been determined. In the present paper, it is shown that an antibody directed against MAdCAM-1, the preferential ligand for alpha4beta7, effectively prevented the development of a progressive, non-remitting, form of EAE, actively induced by injection of myelin oligodendrocyte glycoprotein peptide (MOG(35-55)) autoantigen. Combinational treatment with both anti-MAdCAM-1, VCAM-1, and intercellular adhesion molecule-1 (ICAM-1) (ligand for integrin lymphocyte function-associated antigen (LFA)-1) mAbs led to more rapid remission than that obtained with anti-MAdCAM-1 antibody alone. However, neither MAdCAM-1 monotherapy, nor combinational antibody blockade was preventative when administered late in the course of disease progression. In conclusion, MAdCAM-1 plays a major contributory role in the progression of chronic EAE and is a potential therapeutic target for the treatment of MS. Critically, antivascular addressin therapy must be given early in the course of disease prior to the establishment of irreversible damage if it is to be effective, as a single treatment modality.

Framework investigations for harmonizing global taxation of internet commerce

Identifies and evaluates contemporary global approaches to taxation in internet commerce. Adapts the principles of evidence-based medicine to develop a working model for evidence-based taxation. A collaborative extranet structure is used to validate the axioms underpinning the critical success factors for a modern knowledge management solution.

Glonacalling doctorates?: The international and global connectedness of Australian PhD graduates

Simon Marginson and Gary Rhoades coined the term ‘glonacal’ the express the interconnectedness of global, national and local social relations, especially in terms educational systems and experiences. This paper presents some selected data from a recent ARC Discovery Project entitled Research capacity-building: the development of the Australian PhD programs in national and emerging global contexts. Some of selected data show the extent Australian PhD theses have addressed topics in South and East Asia as an illustration of how research capacity-building may be created in/for Australia through topics which address problems or ideas located in other (in this case East and South Asia) national and local contexts. Other data relate to the international movements of—particularly astronomy and chemistry—PhD graduates out of Australia, some of whom return to Australia. The paper discusses these movements in terms of PhD culture being ‘glonacal’ in nature from its programs and postdoctoral relations.