The sustainability of health promotion interventions for different levels of social organization

In health promotion, enthusiasm for sustainability has frequently overshadowed critical reflection with regard to whether this aim is warranted, let alone feasible. Consequently, the not insubstantial body of literature on sustainability in health promotion is not particularly helpful to decision makers. In this paper we seek to provide some guidance for the development of sustainability for health promotion interventions, arguing that it is necessary to be able to differentiate between (i) levels of social organization which are the focus of change, (ii) the programmes and agencies which are the means employed to achieve change, and (iii) the outcomes or effects that are achieved. Furthermore, funding allocations need to be congruent with programme characteristics if one is serious about achieving sustainability.

Trends in BMI of urban Australian adults, 1980-2000

OBJECTIVE: To analyse changes in the distribution of BMI in Australia between 1980 and 2000. DESIGN: Data were from the 1980, 1983 and 1989 National Heart Foundation Risk Factor Prevalence Study, the 1995 National Nutrition Survey and the 1999/2000 Australian Diabetes, Obesity and Lifestyle Study. Survey participants were aged 25-64 years and resident in Australian capital cities. BMI was calculated as weight divided by height squared (kg/m2), where weight and height were measured using standard procedures. RESULTS: Mean BMI was higher in 2000 than 1980 in all sex and age groups. The age-adjusted increase was 1.4 kg/m2 in men and 2.1 kg/m2 in women. The BMI distribution shifted rightwards for all sex and age groups and became increasingly right-skewed. The change between 1980 and 2000 ranged from a decrease of 0.04 kg/m2 at the lower end of the distribution for men aged 25-34 years to an increase of 7.4 kg/m2 at the higher end for women aged 55-64 years. While the prevalence of obesity (BMI >or= 30 kg/m2) doubled, the prevalence of obesity class III (BMI >or= 40 kg/m2) increased fourfold. CONCLUSIONS: BMI in urban Australian adults has increased and its distribution has become increasingly right-skewed. This has resulted in a large increase in the prevalence of obesity, particularly the more severe levels of obesity. It will be important to monitor changes in the different classes of obesity and the extent to which obesity interventions both shift the BMI distribution leftwards and decrease the skew of the distribution.

Systematic approach to the quantitative voltammetric analysis of the Fe III /Fe II component of the [α 2 -Fe(OH 2 )P 2 W 17 O 61 ] 7-/8- reduction process in buffered and unbuffered aqueous media

The one-electron reduction of [α2-FeIII(OH2)P2W17O61]7- at a glassy carbon electrode was investigated using cyclic and rotating-disk-electrode voltammetry in buffered and unbuffered aqueous solutions over the pH range 3.45−7.50 with an ionic strength of approximately 0.6 M maintained. The behavior is well-described by a square-scheme mechanism P + e- ↔ Q (E10/ = −0.275 V, k10/ = 0.008 cm s-1, and α1 = 1/2), PH+ + e- ↔ QH+ (E20/ = −0.036 V, k20/ = 0.014 cm s-1, and α2 = 1/2), PH+ ↔ P + H+ (KP = 3.02 × 10-6 M), and QH+ ↔ Q + H+ (KQ = 2.35 × 10-10 M), where P, Q, PH+, and QH+ correspond to [α2-FeIII(OH)P2W17O61]8-, [α2-FeII(OH)P2W17O61]9-, [α2-FeIII(OH2)P2W17O61]7-, and [α2-FeII(OH2)P2W17O61]8-, respectively; E10‘ and E20‘ are the formal potentials, k10‘ and k20‘ are the formal (standard) rate constants, and KP and KQ are the acid dissociation constants for the relevant reactions. The analysis for the buffered media is based on the approach of Laviron who demonstrated that a square scheme with fully reversible protonations, reversible or quasi reversible electron transfers with the assumption that α1 = α2, can be well-described by the behavior of a simple redox couple, ox + e- ↔ red, whose formal potential, Eapp0‘, and standard rate constant, kapp0‘, are straightforwardly derived functions of pH, as are the values of E10‘, k10‘, E20‘, k20‘, and KP (only three of the four thermodynamic parameters in a square scheme can be specified). It was assumed that αapp = 1/2, and the simulation program DigiSim was used to determine the values of Eapp0‘ and kapp0‘, which are required to describe the cyclic voltammograms obtained in buffered media in the pH range from 3.45 to 7.52 (buffer-related reactions which effect general acid−base catalysis are included in the simulations). DigiSim simulations of cyclic voltammograms obtained in unbuffered media yielded the values of E10‘ and k10‘; KQ was then directly computed from thermodynamic constraints. These simulations included additional reactions between the redox species and H2O. The value of the diffusion coefficient of the [α2-FeIII(OH2)P2W17O61]7-, 2.92 × 10-6 cm2 s-1, was determined using DigiSim simulations of voltammograms at a rotating disk electrode in buffered and unbuffered media at pH 3.45. The diffusion coefficients of all redox species were assumed to be identical. When the pH is greater than 6, instability of P (i.e., [α2-FeIII(OH)P2W17O61]8-) led to the loss of the reactant and precluded lengthy experimentation.

Coronary angiography observations: evidence-based or ritualistic practice?

Objective: The purposes of this study were to describe the incidence and occurrence of femoral artery bleeding during the first 6 hours after coronary angiography and to determine whether there is a relationship between  current postangiogram observation protocols and the detection of  complications.

Design: This was a prospective descriptive study.

Setting: The study was conducted in 3 university hospitals in Melbourne, Australia.

Patients: Subjects included 55 patients representing the complication rate of 1075 patients, mean age 61 years (SD, 12), 69% male.

Results: About 5.1% of patients had 1 or more incidents of bleeding  requiring manual compression. In 4.2% of patients, bleeding occurred within 6 hours of angiography. Bleeding occurred a median of 2.02 hours (Q1 = 45 minutes, Q3 = 4.31 hours) after angiography. Patients without pressure bandaging bled a median of 1.32 hours (Q1 = 36.50 minutes, Q3 = 2.59 hours) after angiography. Patients with pressure bandaging bled a median of 4.75 hours (Q1 = 2.25 hours, Q3 = 7.28 hours) after angiography. In 40.6% of cases, bleeding was detected through the patient’s call for assistance, and in 59.4% of cases nurses noted bleeding while checking the puncture site. Postcatheter observations were recorded 23.70 (SD, 14.60) minutes before the bleeding incident. There were no significant changes in vital signs, systolic blood pressure (P > .05), diastolic blood pressure (P > .05), or pulse (P > .05) before or during a bleeding episode. All were within normal parameters. No neurovascular assessment anomalies were detected.

Conclusion: The use of pressure bandaging has a significant effect on the incidence and pattern of bleeding. Routine vital sign measurement has no relevance in detecting local complications after angiography. The most significant complication is bleeding that requires manual compression. Detection is through frequent puncture site observation and patient recognition and communication.

On the problem of algebraic completeness for the invariants of the Riemann tensor. III.

We study the set CZ of invariants [Zakhary and Carminati, J. Math. Phys. 42, 1474 (2001)] for the class of space-times whose Ricci tensors possess a null eigenvector. We show that all cases are maximally backsolvable, in terms of sets of invariants from CZ, but that some cases are not completely backsolvable and these all possess an alignment between an eigenvector of the Ricci tensor with a repeated principal null vector of the Weyl tensor. We provide algebraically complete sets for each canonically different space-time and hence conclude with these results and those of a previous article [Carminati, Zakhary, and McLenaghan, J. Math. Phys. 43, 492 (2002)] that the CZ set is determining or maximal.

Mechanical behavior of irregular fibers part III : the flexural buckling behavior

Fiber buckling behavior is associated with fabric-evoked prickle, which affects clothing comfort and aesthetics. In this paper, the flexural buckling behavior of irregular or nonuniform fibers is studied using the finite element method (FEM). Fiber dimensional irregularities are simulated with sine waves of different magnitude, frequency, and initial phase. The critical buckling loads of the simulated fibers are then calculated from the FE model. The results indicate that increasing the level of irregularity will decrease the critical buckling load of fibers, but the effect of the frequency and initial phase of irregularity on fiber buckling behavior is complicated and is affected by fiber diameter and effective length.

Comparison of bovine RNA polymerase III promoters for short hairpin RNA expression

RNA interference (RNAi) mediated by DNA-based expression of short hairpin RNA (shRNA) is a powerful method of sequence-specific gene knockdown. A number of vectors for expression of shRNA have been developed that feature promoters from RNA polymerase III (pol III)-transcribed genes of mouse or human origin. To advance the use of RNAi as a tool for functional genomic research and for future development of specific therapeutics in the bovine species, we have developed shRNA expression vectors that feature novel bovine RNA pol III promoters. We characterized two bovine U6 small nuclear RNA (snRNA) promoters (bU6-2 and bU6-3) and a bovine 7SK snRNA promoter (b7SK). We compared the efficiency of each of these promoters to express shRNA molecules. Promoter activity was measured in the context of RNAi by targeting and suppressing the reporter gene encoding enhanced green fluorescent protein. Results show that the b7SK promoter induced the greatest level of suppression in a range of cell lines. The comparison of these bovine promoters in shRNA expression is an important component for the future development of bovine-specific RNAi-based research.

Use of calcium or calcuim in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis

Background:  Whether calcium supplementation can reduce osteoporotic fractures is uncertain. We did a meta-analysis to include all the randomised trials in which calcium, or calcium in combination with vitamin D, was used to prevent fracture and osteoporotic bone loss.

Methods:  We identified 29 randomised trials (n=63 897) using electronic databases, supplemented by a hand-search of reference lists, review articles, and conference abstracts. All randomised trials that recruited people aged 50 years or older were eligible. The main outcomes were fractures of all types and percentage change of bone-mineral density from baseline. Data were pooled by use of a random-effect model.

Findings:  In trials that reported fracture as an outcome (17 trials, n=52 625), treatment was associated with a 12% risk reduction in fractures of all types (risk ratio 0·88, 95% CI 0·83–0·95; p=0·0004). In trials that reported bone-mineral density as an outcome (23 trials, n=41 419), the treatment was associated with a reduced rate of bone loss of 0·54% (0·35–0·73; p<0·0001) at the hip and 1·19% (0·76–1·61%; p<0·0001) in the spine. The fracture risk reduction was significantly greater (24%) in trials in which the compliance rate was high (p<0·0001). The treatment effect was better with calcium doses of 1200 mg or more than with doses less than 1200 mg (0·80 vs 0·94; p=0·006), and with vitamin D doses of 800 IU or more than with doses less than 800 IU (0·84 vs 0·87; p=0·03).

Interpretation:  Evidence supports the use of calcium, or calcium in combination with vitamin D supplementation, in the preventive treatment of osteoporosis in people aged 50 years or older. For best therapeutic effect, we recommend minimum doses of 1200 mg of calcium, and 800 IU of vitamin D (for combined calcium plus vitamin D supplementation).

Effect of oxidant type on the chemiluminescence intensity from the reaction of tris(2,2’-biyridyl)ruthenium(III) with various organic acids

An investigation into the chemiluminescence of fourteen organic acids and tris(2,2′-bipyridyl)ruthenium(II) was undertaken. Particular emphasis was placed upon the method of production of the reagent, tris(2,2′-bipyridyl)ruthenium(III), with cerium(IV) sulfate, potassium permanganate, lead dioxide and electrochemical generation. Analytically useful chemiluminescence was observed when Ce(IV) or potassium permanganate were employed as oxidants. The kinetics of analyte oxidation was related to the intensity of the chemiluminescence emission, which increased by three orders of magnitude for tartaric acid after 40 h of oxidation.

The influence of age on reproductive success and diet in Australasian gannets (Morus Serrator) breeding at Pope's Eye, Port Phillip Bay, Victoria

The influence of age on reproductive success and diet was examined in ‘old’ (experienced; 12 years and older) and ‘young’ (5–8 years of age) Australasian gannets (Morus serrator) breeding at Pope’s Eye, Port Phillip Bay, Victoria during the 2002–2003 breeding period. Although food availability, as indicated by commercial fish catches, throughout this breeding period was low, there were no significant differences in breeding success or chick growth between groups. Nevertheless, old birds tended to have higher reproductive success, replacing more lost eggs and fledging chicks of a greater mass. However, old birds also laid more eggs that failed to hatch. Five fish species, including jack mackerel (Trachurus declivis), barracouta (Thyrsites atun), redbait (Emmelichthys nitidus), anchovy (Engraulis australis) and red mullet (Upeneichthys vlamingii), were important in the gannet diet during this breeding period. There were no significant differences in dietary parameters, including range of species and size of prey, between old and young gannets, nor were there any differences between those of the chicks and their parents, suggesting that adults do not forage selectively for their chicks. This study showed that even during a period of presumed low food availability, when experienced (older) birds might be expected to have enhanced success, the differences between these and less experienced (younger) birds may not be apparent.

Comparison of chicken 7SK and U6 RNA polymerase III promoters for short hairpin RNA expression

Background: RNA polymerase III (pol III) type 3 promoters such as U6 or 7SK are commonly used to express short-hairpin RNA (shRNA) effectors for RNA interference (RNAi). To extend the use of RNAi for studies of development using the chicken as a model system, we have developed a system for expressing shRNAs using the chicken 7SK (ch7SK) promoter.

Results: We identified and characterised the ch7SK promoter sequence upstream of the full-length 7SK small nuclear RNA (snRNA) sequence in the chicken genome and used this to construct vectors to express shRNAs targeting enhanced green fluorescent protein (EGFP). We transfected chicken DF-1 cells with these constructs and found that anti-EGFP-shRNAs (shEGFP) expressed from the ch7SK promoter could induce efficient knockdown of EGFP expression. We further compared the efficiency of ch7SK-directed knockdown to that of chicken U6 (cU6) promoters and found that the efficiency of the ch7SK promoter was not greater than, but comparable to the efficiency of cU6 promoters.

Conclusion: In this study we have demonstrated that the ch7SK promoter can express shRNAs capable of mediating efficient RNAi in a chicken cell line. However, our finding that RNAi driven by the ch7SK promoter is not more efficient than cU6 promoters contrasts previous comparisons of mammalian U6 and 7SK promoters. Since the ch7SK promoter is the first non-mammalian vertebrate 7SK promoter to be characterised, this finding may be helpful in understanding the divergence of pol III promoter activities between mammalian and non-mammalian vertebrates. This aside, our results clearly indicate that the ch7SK promoter is an efficient alternative to U6-based shRNA expression systems for inducing efficient RNAi activity in chicken cells.

Overweight, obesity and metabolic syndrome in rural southeastern Australia

OBJECTIVE: To measure the prevalence of overweight, obesity and the metabolic syndrome (MetS) in rural Australia.

DESIGN, SETTING AND PARTICIPANTS: Cross-sectional surveys were conducted in two rural areas in Victoria and South Australia in 2004-2005. A stratified random sample of men and women aged 25-74 years was selected from the electoral roll. Data were collected by a self-administered questionnaire, physical measurements and laboratory tests.

MAIN OUTCOME MEASURES: Prevalence of overweight and obesity, as defined by body mass index (BMI) and waist circumference; prevalence of MetS and its components.

RESULTS: Data on 806 participants (383 men and 423 women) were analysed. Based on BMI, the prevalence of overweight and obesity combined was 74.1% (95% CI, 69.7%-78.5%) in men and 64.1% (95% CI, 59.5%-68.7%) in women. Based on waist circumference, the prevalence of overweight and obesity was higher in women (72.4%; 95% CI, 68.1%-76.7%) than men (61.9%; 95% CI, 57.0%-66.8%). The overall prevalence of obesity was 30.0% (95% CI, 26.8%-33.2%) based on BMI (> or = 30.0 kg/m(2)) and 44.7% (95% CI, 41.2%-48.1%) based on waist circumference (> or = 102 cm [men] and > or= 88 cm [women]). The prevalence of MetS as defined by the US National Cholesterol Education Program Adult Treatment Panel III 2005 criteria was 27.1% (95% CI, 22.7%-31.6%) in men and 28.3% (95% CI, 24.0%-32.6%) in women; based on International Diabetes Federation criteria, prevalences for men and women were 33.7% (95% CI, 29.0%-38.5%) and 30.1% (95% CI, 25.7%-34.5%), respectively. Prevalences of MetS, central (abdominal) obesity, hyperglycaemia, hypertension and hypertriglyceridaemia increased with age.

CONCLUSIONS: In rural Australia, prevalences of MetS, overweight and obesity are very high. Urgent population-wide action is required to tackle the problem.