Addressing evidence treatment gaps for cardiovascular disease through primary care collaboration

Aims & Rationale/Objectives
The aim is to establish the frequency of counselling by general practitioners (GPs) and community pharmacists (CPs) for patients with uncontrolled CVD risk factors. This will identify conditions for which CPs might collaborate with GPs in addressing evidence-treatment gaps.

Methods
A population survey undertaken in the Wimmera region of Victoria in 2006. 1425 adults aged 25-84 yrs were randomly selected using age/sex stratified electoral role samples. A representative 723 participants were recruited.

Principal Findings
Data on GP and CP visits were available for 694 participants. Overall, participants visited GPs 4.6 times and CPs 6.0 times/annum. However, one third of participants never consulted a pharmacist in 12 months compared to just 11.5% for GPs. Among obese patients (BMI ?? 30), the average number of visits/annum was 4.5 to GPs and 6.8 to CPs. The equivalent numbers were 5.6 and 8.6 respectively for those with systolic BP ?? 140 mmHg; 3.7 and 5.5 for total cholesterol > 5.0 mmol/L; and, 6.7 and 14.6 for patients with random blood glucose concentrations ?? 7.0 mmol/L.

Implications
People with suboptimal status for most common CVD risk factor are counselled frequently by CPs. A coordinated approach with GPs to the delivery of cardiovascular health promotion could provide valuable reinforcement of key messages and offers greater opportunity to identify at-risk individuals. Acknowledgements: KM is a pharmacist-academic at Greater Green Triangle UDRH, a position funded by the Department of Health and Ageing through the Rural and Remote Pharmacy Workforce Development Program

Comparing the physiological cost of step-powered video gaming, sedentary video gaming and self paced ambulatory activity in university students

Objectives: Methods for converting inactive video gaming to active video gaming have gained popularity in recent years. This study compared the physiological cost of a new peripheral device that used steps to power video gaming in an interactive manner against sedentary video gaming and self-paced ambulatory activity of university students (aged 19-29 years).
Methods: Nineteen adults (9 male, 10 female) performed six 10-minute activities, namely self-paced leisurely walking, self-paced brisk walking, self-paced jogging, two forms of sedentary video gaming, and step-powered video gaming. Activities were performed in a random order. Physiological cost during the activities was measured using Actiheart.
Results: Energy expenditure during step-powered video gaming (388.8 kcal.h-1) was comparable to the energy expended during brisk walking (373.8 kcal.h-1), and elicited a higher energy cost than sedentary video gaming (124.1 kcal.h-1) but a lower energy cost than jogging (694.5 kcal.h-1).
Conclusion: Overall, step-powered video gaming could be used as an entertaining and appealing tool to increase physical activity, though it should not be used as a complete substitute for traditional exercise, such as jogging.

A new re-ranking method using enhanced pseudo-relevance feedback for content-based medical image retrieval

We propose a novel re-ranking method for content-based medical image retrieval based on the idea of pseudo-relevance feedback (PRF). Since the highest ranked images in original retrieval results are not always relevant, a naive PRF based re-ranking approach is not capable of producing a satisfactory result. We employ a two-step approach to address this issue. In step 1, a Pearson's correlation coefficient based similarity update method is used to re-rank the high ranked images. In step 2, after estimating a relevance probability for each of the highest ranked images, a fuzzy SVM ensemble based approach is adopted to re-rank the images. The experiments demonstrate that the proposed method outperforms two other re-ranking methods.

Establishment and development of a seabird colony : long-term trends in phenology, breeding success, recruitment, breeding density and demography

Few studies document long-term colony-level metrics from colony establishment to maturity (equilibrium) and few test predictions of general models of colony development. We describe long-term trends in a colony of Australasian Gannets (Morus serrator) which has been monitored from an early stage in its development. The colony at Pope’s Eye, within Port Phillip Bay, Victoria, Australia was established in 1984 on an artificial structure and the first nest count (25 nests) was conducted in the same year. The colony was then studied for 15 of 19 years between 1988 and 2006–2007. During the study, 2,516 eggs were recorded, resulting in 1,694 chicks hatching (67 % of eggs), of which 1,310 (77 % of those hatched) fledged. At least 184 (14 %) of fledged offspring returned to Pope’s Eye as breeding adults. Since establishment, the number and density of nests increased (number of nests increased 8.8 % annually), with density increasing at varying rates in different areas of the colony. Early recruitment involved birds from a nearby colony, but within 5 years post establishment the first natal recruits were breeding at Pope’s Eye and thereafter natal recruitment was the main source of new breeding adults (totalling 81.4 % of all recruits). Age of recruitment varied throughout the study, though not systematically, and there was no difference between the sexes. The pattern of rapid initial growth is typical of patterns reported for other seabird colonies. However, as the colony (and birds within it) aged, there was no increase in breeding success and egg laying did not become earlier, as was expected from general models of colony development.

Thermal conductivity of sand and its effect on the temperature of Loggerhead Sea Turtle (Caretta Caretta) nests

The conductivity of sand at a depth of 30–50 cm was measured at 15 sites on the beach at Captiva Island in south-west Florida which is used by nesting loggerhead turtles (Caretta caretta). The mean daily temperature of the sand was correlated with conductivity at the same depth measured the same day (r=0·611). When day to day variation was removed the correlation between nest temperature and conductivity increased to 0·694. The sand was highly variable in its grain structure. The dominant variability (80·6%) was redescribed by the first two principal components of a Principal Components Analysis (PCA). These two components were influenced mostly by percentages of large (> 1 mm) and small (< 500 μm) grains respectively. Conductivity was strongly correlated with the grain structure of the sand. The first three principal components describing sand grain structure, explained 84·1% of the variation in conductivity. Moisture content of the sand (always < 5%) was not an important factor. Sites dominated by larger grains generally had poorer conductivity and were cooler. Comparisons of eight nests to seven adjacent random sites revealed no strong evidence for directional selection in nest placement relative to sand conductivity. The variance in conductivities recorded at nests was also not significantly different from the variance at random sites.

The OPtimising HEalth LIterAcy (Ophelia) process: study protocol for using health literacy profiling and community engagement to create and implement health reform

Health literacy is a multi-dimensional concept comprising a range of cognitive, affective, social, and personal skills and attributes. This paper describes the research and development protocol for a large communities-based collaborative project in Victoria, Australia that aims to identify and respond to health literacy issues for people with chronic conditions. The project, called Ophelia (OPtimising HEalth LIterAcy) Victoria, is a partnership between two universities, eight service organisations and the Victorian Government. Based on the identified issues, it will develop and pilot health literacy interventions across eight disparate health services to inform the creation of a health literacy response framework to improve health outcomes and reduce health inequalities.