Determinants of permanent first incisor eruption in grazing Australian Angora goats

Objective: To investigate the effects of live weight, sex and other factors on deciduous (first incisor) loss and permanent first incisor development in Angora goats. Design: Goats were part of a pen study on the effects of energy intake in Angora does during pregnancy and lactation on kid growth and development. The design was three levels of nutrition in mid-pregnancy × two levels of postnatal nutrition in 17 randomised blocks. Methods: Conception times were calculated by using artificial insemination, with ultrasound examination 43 days after insemination. Does were fed different amounts of a formulated diet in their pens. After weaning, goats were grazed in sex groups. Deciduous first incisor loss and permanent first incisor development were recorded at 11 time points from 14 to 20 months of age. Results: For each sex, the time for visible eruption and full development of permanent first incisor declined linearly with increased live weight by 5.9 and 5.4 days/kg live weight, respectively. The time to reach similar development stages for first permanent incisors eruption was 3 months longer for the lightest animals compared with the heaviest animals. Date of birth, birth weight, doe age, growth rates, mid-pregnancy and postnatal nutrition, parity, day of weaning and weaning weight had no detectable effect. Conclusions: The results explain much of the substantial range in reported first permanent incisor eruption dates for small ruminants and have application in ageing of goats, marketing of kids for meat, in the selection of animals for breeding flocks and in educational material.

The cost-effectiveness of universal newborn screening for bilateral permanent congenital hearing impairment : systematic review

Objective - Universal newborn hearing screening for bilateral permanent congenital hearing impairment is standard practice in many developed economies, but until there is clear evidence of cost-effectiveness, it remains a controversial use of limited health care resources. We conducted a formal systematic review of studies of newborn hearing screening that considered both costs and outcomes to produce a summary of the available evidence and to determine whether there was a need for further research.

Methods - A search was conducted of medical and nursing databases and gray literature websites by the use of multiple keywords. The titles and abstracts of studies were examined for preliminary inclusion if reference was made to newborn hearing screening, and to both costs and outcomes. Studies of potential relevance were independently assessed by 2 health economists for final inclusion in the review. Studies that met inclusion criteria were appraised by the use of existing guidelines for observational studies, economic evaluations and decision analytic models, and reported in a narrative literature review.

Results - There were 22 distinct observational or modeled evaluations of which only 2 clearly compared universal newborn hearing screening to risk factor screening for bilateral permanent congenital hearing impairment. Of these, the single evaluation that examined long-term costs and outcomes found that universal newborn hearing screening could be cost-saving if early intervention led to a substantial reduction in future treatment costs and productivity losses.

Conclusions - There are only a small number of economic evaluations that have examined the long-term cost-effectiveness of universal newborn hearing screening. This is partly attributable to ongoing uncertainty about the benefits gained from the early detection and treatment of bilateral permanent congenital hearing impairment. There is a clear need for further research on long-term costs and outcomes to establish the cost-effectiveness of universal newborn hearing screening in relation to other approaches to screening, and to establish whether it is a good long term investment.

Physical activity promotion for male factory workers : a realistic option?

Issue addressed: Worksites are a promising setting for health promotion initiatives. While there is an accumulated body of evidence indicating favourable health and cost outcomes, there have been difficulties identified in recruiting and influencing blue- collar workers. This descriptive study aimed to identify specific opportunities and barriers which may impact upon physical activity options at work for male blue-collar factory workers.

Methods: Fifteen manager interviews and worksite observations, and eight employee group discussions were conducted in manufacturing industry worksites.

Results: Several key barriers emerged which limit opportunities for blue-collar employees to participate in physical activity at work: time constraints; limited facilities; and lack of interest from management to facilitate physical activity due to limited resources and concerns about safety issues. Potential opportunities included the presence of change rooms, showers, outdoor areas suitable for physical activity, nearby parks and local fitness facilities, and occupational health and safety committees.

Conclusions: Increasing opportunities for workers to be active at work did not emerge as a priority of managers who may need to be convinced that allocating time and resources to physical activity is a wise investment and that workers need an environment that both supports and encourages participation in physical activity. The role of physical activity in relation to injury prevention and potential reductions in Workcover premiums is worthy of further investigation.

So what? While worksite physical activity promotion is a national health objective, there are numerous actual and perceived barriers to initiatives directed at factory workers. Rather than offering specific programs, it may be more productive to address work practices and environmental and regulatory barriers through established occupational health and safety channels. Information and education strategies to change the attitudes and beliefs of management and workers about these issues, as well as about the health benefits of physical activity, may also be helpful.

Health promotion practice in the context of climate change

Climate change and environmental degradation caused by human activities are having an irrefutable impact on human health. This thesis by publication demonstrates that health promotion practitioners are well placed to use their professional competencies, strategies and principles to facilitate action on climate change and environmental sustainability.