Dietary patterns across the life course, mammographic density and implications for breast cancer : results from a British prospective cohort

Background : Previous epidemiological studies have investigated the relationship between individual nutrients such as vitamin D and vitamin B12 and mammographic density, a strong marker of breast cancer risk [1], with varied results. There has been limited research on overall dietary patterns and most studies have focused on adult dietary patterns [2]. We examine prospective data to determine whether dietary patterns from childhood to adult life affect mammographic density.

Methods : The Medical Research Council National Survey of Health and Development is a national representative sample of 2,815 men and 2,547 women followed since their birth in March 1946 [3]. A wealth of medical and social data has been collected in over 25 follow-ups by home visits, medical examinations and postal questionnaires. Dietary intakes at age 4 years were determined by 24-hour recalls and in adulthood (ages 36, 43 years) by 5-day food records. Copies of the mammograms (two views for each breast) taken when the women were closest to age 50 years were obtained from the relevant NHS centres. A total of 1,319 women were followed up since birth in 1946 for whom a mammogram at age 50 years was retrieved, and the percentage mammographic density was measured using the computer-assisted threshold method for all 1,161 women. Breast cancer incidence for the whole cohort is being ascertained through the National Health Service Central Register.

Statistical analysis : Reduced rank regression analysis, a relatively new approach to dietary pattern analysis, is being used to identify dietary patterns associated with mammographic density [4]. This approach identifies patterns in food intake that are predictive of an intermediate outcome of the disease process, such as mammographic density, and subsequently examines the relationship between the identified dietary patterns and breast cancer risk.

Results : Preliminary analyses so far suggest that variations in dietary patterns in adulthood might explain more than 10% of the variation in percentage mammographic density at age 50 years (age 36 years: 13%; age 43 years: 14%), with variations in patterns in childhood explaining slightly less. Further work is being carried out on the characteristics of these dietary patterns and their effects on percentage mammographic density and its two components (that is, absolute areas of dense and nondense tissues) and on breast cancer risk, after adjusting for socioeconomic status, anthropometric variables and reproductive factors.

Conclusion : The present study will provide for the first time information on the relationship between dietary patterns across the life course and mammographic density, and will help to clarify the pathways through which diet may affect breast cancer risk.

Navigating human rights across the life course

Issues related to human rights have increasingly moved to the forefront of professional concern in recent years. Despite this, there has been minimal attention paid to exploring how changing human needs across the lifespan impact upon human rights. This paper takes a broad look at human rights issues that occur across the life course, and uses examples of life course transitions to illuminate issues related to moral rights and human rights. The examples include family formation, raising children, adolescent maturation in the context of youth offending and grandparents parenting their grandchildren. Each example explores the contestable rights and responsibilities of children, young people and adults and the ways in which these are negotiated within the context of the family.

ICT to enhance the triangle of life : the soil, the seed, and the life-giver farmer

This paper reports on the outcomes of an ICT enabled social sustainability project “Green Lanka1” trialled in the Wilgamuwa village, which is situated in the Dambulla district of Sri Lanka. The main goals of the project were focused towards the provision of information about market prices, transportation options, agricultural decision support and modern agriculture practices of the farmer communities to improve their livelihood with the effective use of technologies. The project used Web and Mobile (SMS) enabled systems. The Green Lanka project was sponsored by the Information Communication Technology Agency (ICTA) of Sri Lanka under the Institutional Capacity Building Programme (ICBP) grant scheme which was sponsored by the World Bank. Six hundred families in Wilgamuwa village participated in the project activities. The project was designed, executed and studied through an Action Research approach. The lessons learned through the project activities provide an important understanding of the complex interaction between different stakeholders in the process of implementation of ICT enabled solutions within digitally divided societies. The paper analyses the processes used to reduce the resistance to change and improved involvement of farmer communities in ICT enabled projects. It also analyses the interaction between stakeholders involved in design and implementation of the project activities to improve the chances of project success.

Client self-assessment in community aged care: A comparative study involving older Australians and their case managers

Self-assessment of support needs is a relatively new and under-researched phenomenon in domiciliary aged care. This article outlines the results of a comparative study focusing on whether a self-assessment approach assists clients to identify support needs and the degree to which self-assessed needs differ from an assessment conducted by community care professionals. A total of 48 older people and their case managers completed a needs assessment tool. Twenty-two semi-structured interviews were used to ascertain older people’s views and preferences regarding the self-assessment process. The study suggests that while a co-assessment approach as outlined in this article has the potential to assist older people to gain a better understanding of their care needs as well as the assessment process and its ramifications, client self-assessment should be seen as part of a co-assessment process involving care professionals. Such a co-assessment process allows older people to gain a better understanding of their support needs and the wider community aged care context. The article suggests that a co-assessment process involving both clients and care professionals contains features that have the capacity to enhance domiciliary aged care.

‘Cemented in their cells’: a human rights analysis of Blessington, Elliott and the life imprisonment of children in New South Wales

In 2010, two Australians, convicted in childhood of rape and murder, lodged a joint submission with the United Nations Human Rights Committee, claiming that successive changes to sentencing legislation in New South Wales breached their human rights by denying them any meaningful prospect of release. In this article, we examine the political, legislative and procedural moves that have resulted in Australian children being sentenced to life without parole or release. We argue that successive legislative changes in various Australian jurisdictions have resulted in a framework for sentencing decisions that is considerably out of step with international legal standards for criminal justice. These increasingly punitive legislative changes exacerbate Australia’s already declining record of cooperation with UN processes, and reveal Australia’s reluctance to respect the legitimacy and authority of international law. Against this troubling context, the views of the Human Rights Committee serve as a much-needed reminder about the importance of a principled approach to child sentencing that forecloses neither the goal of rehabilitation nor the prospect of release and reintegration.

Is being childless detrimental to a woman's health and well-being across her life course?

BACKGROUND: Childlessness is a growing phenomenon. Previous research examining health and well-being differentials between women with and without children has produced conflicting results. Most of this research has been conducted in the United States or parts of Europe. There has been limited research in Australia that has examined the health and well-being of women with and without children across the life course. The aim of the current study was to examine the association between motherhood status and general physical and mental health and well-being over a 10-year time period. METHODS: Using 10 waves of data from the Household, Income and Labour Dynamics in Australia study, longitudinal linear mixed models with time varying variables (both dependent and independent) were constructed to assess the effect of childlessness on health and well-being based on the Short Form-36 Health Survey Version 1 (n=52,381 observations). FINDINGS: Findings suggest that childless women experience poorer physical and mental health and well-being during the peak reproductive years; however, this trend is reversed for women aged 65 years or more. Although never-married, childless women experienced better health and well-being compared with mothers, this was not the case for childless women who were divorced, separated, or widowed or in a relationship. CONCLUSION: The findings support the notion that whether or not a woman has children does have consequences for her health and well-being; however, this differs across the life course.

Gait termination : a review of experimental methods and the effects of aging and gait pathologies

The study of human gait has expanded and diversified to the extent that it is now possible to identify a substantive literature concerning a variety of gait tasks, such as gait initiation [Halliday SE, Winter DA, Frank JS, Patla AE, Prince F. The initiation of gait in young, elderly, and Parkinson's disease subjects. Gait Posture 1998;8:8–14; Mickelborough J, van der Linden ML, Tallis RC, Ennos AR. Muscle activity during gait initiation in normal elderly people. Gait Posture 2004;19:50–57], stepping over and across obstacles [Patla AE, Prentice SD, Robinson C, Newfold J. Visual control of locomotion: strategies for changing direction and for going over obstacles. J Exp Psych 1991;17:603–34; Chen, HC, Ashton-Miller JA, Alexander NB, Schultz AB. Effect of age and available response time on ability to step over an obstacle. J Gerontol 1994;49:227–33; Sparrow WA, Shinkfield AJ, Chow S, Begg RK. Gait characteristics in stepping over obstacles. Hum Mov Sci 1996;15:605–22; Begg RK, Sparrow WA, Lythgo ND. Time-domain analysis of foot–ground reaction forces in negotiating obstacles. Gait Posture 1998;7:99–109; Patla AE, Rietdyk S. Visual control of limb trajectory over obstacles during locomotion: effect of obstacle height and width. Gait Posture 1993;1:45–60] negotiating raised surfaces such as curbs and stairs [Begg RK, Sparrow WA. Gait characteristics of young and older individuals negotiating a raised surface: implications for the prevention of falls. J Gerontol Med Sci 2000;55A:147–54; Mcfayden BJ, Winter DA. An integrated biomechanical analysis of normal stair ascent and descent. J Biomech 1988;21:733–44]. In addition, increasing research interest in age-related declines in gait that might predispose individuals to falls has engendered a very extensive literature concerning ageing effects on gait. While rapid locomotor adjustments are common in the course of daily activities there has been no previous review of the findings concerning gait adaptations when walking is terminated both rapidly and unexpectedly. The aims of this review were first, to summarise the key research findings and methodological considerations from studies of termination. The second aim was to demonstrate the effects of ageing and gait pathologies on termination with respect to the regulation of step characteristics, lower-limb muscle activation patterns and foot–ground reaction forces.

The challenge of reconciling working time demands and life transitions : a policy proposal

Labour markets, like all market institutions, exhibit structural and dynamic characteristics. Both the structural and dynamic characteristics of labour markets inevitably change and evolve over time in response to a host of exogenous and endogenous factors. In the case of the Australian labour market, structural changes are reflected in significant shifts in the industry and occupational composition of employment, the decline of full-time work and the concomitant rise in part-time and atypical forms of employment, demographic changes in the labour force, as well as changes in social and individual preferences. Dynamic shifts can be found in cyclical pattern of employment and wages growth, the growth in labour mobility, and transitions between various labour market states.
The starting point for this paper is that these structural and dynamic changes have given rise to an increase in the likelihood that individuals will experience a transition between various labour market states, and a greater diversity in the range of transitions they may experience over their working life. This acceleration in the rate of transition generates ‘transition costs’ for both employers and employees, as well the likelihood of mismatch between employer and employee working time preferences. As a consequence, existing labour market policy regimes, based on the traditional model of labour market participation over the life course may not provide adequate protection for most workers today.
Gunther Schmid (1998) and others have proposed institutional reforms which promote ‘transitional labour markets’. Transitional labour market institutions are those that allow individuals (and firms) to successfully adjust to critical events. While transitional labour market institutions may consist of traditional ‘active labour market policy’ mechanisms, Schmid and others have proposed a range of innovative policy responses which allow individuals (and firms) to adjust the intensity of their abour market participation over the life cycle. In this paper we use the general approach of advocated by the transitional labour market concept to do three things. First, we investigate the processes by which the nature of labour market transitions has changed over time. Second, we review the range of policy options available to government to smooth labour market dysfunctions associated with labour market transitions, with the objective of ensuring labour markets operate more efficiently and more equitably. Third, we focus on one possible way in which an existing labour market institution, Long Service Leave (LSL), could be reformed to make way for a more comprehensive transitional labour market institution in the form of a ‘working time bank’.