What is a healthy weight for middle aged women?

OBJECTIVE: To explore associations between body mass index (BMI) and selected indicators of health and well-being and to suggest a healthy weight range (based on BMI) for middle aged Australian women. DESIGN: population based longitudinal study (cross-sectional baseline data). SUBJECTS: 13431 women aged 45-49 y who participated in the baseline survey for the Australian Longitudinal Study on Women's Health. RESULTS: Forty-eight percent of women had a BMI>25kg/m(2). Prevalence of medical problems (for example, hypertension, diabetes), surgical procedures (cholescystectomy, hysterectomy) and symptoms (for example, back pain) increased monotonically with BMI, while indicators of health care use (for example, visits to doctors) showed a 'J' shaped relationship with BMI. Scores for several sub-scales of the MOS short form health survey (SF36) (for example, general health, role limitations due to emotional difficulties, social function, mental health and vitality) were optimal when BMI was around 19-24 kg/m(2). After adjustment for area of residence, education, smoking, exercise and menopausal status, low BMI was associated with fewer physical health problems than mid-level or higher BMI, and the nationally recommended BMI range of 20-25 was associated with optimum mental health, lower prevalence of tiredness and lowest use of health services. CONCLUSIONS: Acknowledging the limitations of the cross-sectional nature of these data, the results firmly support the benefits of leanness in terms of reducing the risk of cardiovascular disease, diabetes and gall bladder disease. The findings are moderated, however, by the observation that both low and high BMI are associated with decreased vitality and poorer mental health. The optimal range for BMI appears to be about 19-24 kg/m(2). From a public health perspective this study provides strong support for the recommended BMI range of 20-25 as an appropriate target for the promotion of healthy weight in middle aged Australian women.

Increased risk of psychosis in rural-born individuals: An Australian catchment-area study

The aim of the Brisbane Psychosis Study was to examine a range of candidate genetic and nongenetic risk factors in a large, representative sample of patients with psychosis and well controls. The patients (n=310) were drawn from a census conducted as part of the National Survey of Mental Health and Wellbeing. An age and sex-matched well control group (n = 303) was drawn from the same catchment area. Candidate risk factors assessed included migrant status of proband and proband's parents, occupation of father at time of proband's birth, place of birth and place of residence during the first 5 years of life (urbanicity), self-reported pregnancy and birth complications, season of birth and family history. The main analyses were group (cases versus controls) comparisons, with planned subgroup analyses (1) group comparisons for Australian-born subjects only, (2) within-patient comparisons of affective versus nonaffective psychoses. Of the individuals with psychosis, 68% had DSMIII-R schizophrenia. In the main analyses, there were no significant group differences on season of birth, place of birth, place of residency in the first 5 years, occupation of fathers at time of birth or pregnancy and birth complications. Patients had significantly more family members with schizophrenia. Significantly fewer of the patients were migrants or offspring of migrants compared to the controls. When only Australianborn subjects were assessed (n=457), the findings were essentially unchanged apart from a significant excess of cases born in rural sites (chi-square=9.54, df3, p=0.02). There were no significant differences in the risk factors for the comparison involving affective versus nonaffective psychoses. Potential explanations for the inverse urban-rural risk gradient are reviewed. The Stanley Foundation supported this project

Death and readmission in the year after hospital admission with cardiovascular disease: the Hunter Area Heart and Stroke Register

Objectives: To compare outcomes one year after hospital admission for patients initially discharged with a diagnosis of acute myocardial infarction (AMI), other ischaemic heart disease (other IHD), congestive heart failure (CHF) or stroke. Design: Cohort study. Setting: Hunter Area Heart and Stroke Register, which registers all patients admitted with heart disease or stroke to any of the 22 hospitals in the Hunter Area Health Service in New South Wales. Patients: 4981 patients with AMI, other IHD, CHF or stroke admitted to hospital as an emergency between 1 July 1995 and 30 June 1997 and followed for at least one year. Main outcome measures: Death from any cause or emergency hospital readmission for cardiovascular disease. Results: In-hospital mortality varied from 1% of those with other IHD to 22% of those with stroke. Almost a third of all patients discharged alive (and 38% of those aged 70 or more) had died or been readmitted within one year. This varied from 22% of those with stroke to 49% of those with CHF. The causes of death and readmission were from a spectrum of cardiovascular disease, regardless of the cause of the original hospital admission. Conclusions: Data from this population register show the poor outcome, especially with increasing age, among patients admitted to hospital with cardiovascular disease. This should alert us to determine whether optimal secondary prevention strategies are being adopted among such patients.

Public health implications of new guidelines for lead in drinking water: a case study in an area with historically high water lead levels

Concern about the neurotoxicity of lead, particularly in infants and young children, has led to a revision of blood lead levels which are considered to involve an acceptable level of human exposure. Drinking water guidelines have also been reviewed in order to reduce this source of population exposure to lead. In the last 20 years, guidelines have been reduced from 100 to 50 to 10 mu g/litre. Lead in tap water used to be a major public health problem in Glasgow because of the high prevalence of houses with lead service pipes, the low pH of the public water supply and the resulting high levels of lead in water used for public consumption. Following two separate programmes of water treatment, involving the addition of lime and, a decade later, lime supplemented with orthophosphate, it is considered that maximal measures have been taken to reduce lead exposure by chemical treatment of the water supply. Any residual problem of public exposure would require large scale replacement of lead service pipes. In anticipation of the more stringent limits for lead in drinking water, we set out to measure current lead exposure From tap water in the population of Glasgow served by the Loch Katrine water supply. to compare the current situation with 12 years previously and to assess the public health implications of different limits. The study was based on mothers of young children since maternal blood lead concentrations and the domestic water that mothers use to prepare bottle feeds are the principal sources of foetal and infant lead exposure. An estimated 17% of mothers lived in households with tap water lead concentrations of 10 mu g/litre (the WHO guideline) or above in 1993 compared with 49% in 1981. Mean maternal blood lead concentrations fell by 69% in 12 years. For a given water lead concentration, maternal blood lead concentrations were 67% lower. The mean maternal blood lead concentration was 3.7 mu g/litre in the population at large, compared with 3.3 mu g/litre in households with negligible or absent tap water lead. Nevertheless, between 63% and 76% of cases of mothers with blood lead concentrations of 10 mu g/dl or above were attributable to tap water lead. The study found that maternal blood lead concentrations were well within limits currently considered safe for human health. About 15% of infants may be exposed via bottle feeds to tap water lead concentrations that exceed the WHO guideline of 10 mu g/litre. In the context of the health and social problems which affect the well-being and development of infants and children in Glasgow, however, current levels of lend exposure are considered to present a relatively minor health problem. (C) 2000 Elsevier Science Ltd. All rights reserved.

Target similarity effects: Support for the parallel distributed processing assumptions

Recent research has begun to provide support for the assumptions that memories are stored as a composite and are accessed in parallel (Tehan & Humphreys, 1998). New predictions derived from these assumptions and from the Chappell and Humphreys (1994) implementation of these assumptions were tested. In three experiments, subjects studied relatively short lists of words. Some of the Lists contained two similar targets (thief and theft) or two dissimilar targets (thief and steal) associated with the same cue (ROBBERY). AS predicted, target similarity affected performance in cued recall but not free association. Contrary to predictions, two spaced presentations of a target did not improve performance in free association. Two additional experiments confirmed and extended this finding. Several alternative explanations for the target similarity effect, which incorporate assumptions about separate representations and sequential search, are rejected. The importance of the finding that, in at least one implicit memory paradigm, repetition does not improve performance is also discussed.

Does maintaining green leaf area in sorghum improve yield under drought? I. Leaf growth and senescence

Production of sorghum [Sorghum bicolor (L.) Moench], an important cereal crop in semiarid regions of the world, is often limited by drought. When water is limiting during the grain-filling period, hybrids possessing the stay-green trait maintain more photosynthetically active leaves than hybrids not possessing this trait. To improve yield under drought, knowledge of the extent of genetic variation in green leaf area retention is required. Field studies were undertaken in north-eastern Australia on a cracking and self-mulching gray clay to determine the effects of water regime and hybrid on the components of green leaf area at maturity (GLAM). Nine hybrids varying in stay-green were grown under a fully irrigated control, postflowering water deficit, and terminal (pre- and postflowering) water deficit. Water deficit reduced GLAM by 67% in the terminal drought treatment compared with the fully irrigated control. Under terminal water deficit, hybrids possessing the B35 and KS19 sources of stay-green retained more GLAM (1260 cm(2) plant(-1)) compared with intermediate (780 cm(2) plant(-1)) and senescent (670 cm(2) plant(-1)) hybrids. RQL12 hybrids (KS19 source of stay-green) displayed delayed onset and reduced rate of senescence; A35 hybrids displayed only delayed onset. Visual rating of green leaf retention was highly correlated with measured GLAM, although this procedure is constrained by an inability to distinguish among the functional mechanisms determining the phenotype. Linking functional rather than phenotypic differences to molecular markers may improve the efficiency of selecting for traits such as stay-green.

Does maintaining green leaf area in sorghum improve yield under drought? II. Dry matter production and yield

Retention of green leaf area at maturity (GLAM), known as stay-green, is used as an indicator of postanthesis drought resistance in sorghum [Sorghum bicolor (L.) Moench] breeding programs in the USA and Australia. The critical issue is whether maintaining green leaves under postanthesis drought increases grain yield in stay-green compared with senescent hybrids. Field studies were undertaken in northeastern Australia on a cracking and self-mulching gay clay. Nine closely related hybrids varying in rate of leaf senescence were grown under two water-limiting regimes, post-flowering water deficit and terminal (pre- and postflowering) water deficit, and a fully irrigated control. Under terminal water deficit, grain yield tvas correlated positively with GLAM (r = 0.75**) and negatively with rate of leaf senescence (r = -0.74**). Grain yield also increased by approximate to 0.35 Mg ha(-1) for every day that onset of leaf senescence was delayed beyond 76 DAE in the water-limited treatments. Stay-green hybrids produced 47% more postanthesis biomass than their senescent counterparts (920 vs. 624 g m(-2)) under the terminal water deficit regime. No differences in grain yield were found among eight of the nine hybrids under fully irrigated conditions, suggesting that the stay-green trait did not constrain yield in the well-watered control. The results indicate that sorghum hybrids possessing the stay-green trait have a significant yield advantage under postanthesis drought compared with hybrids not possessing this trait.

Identification and validation of candidate Myb target genes

While a considerable number of candidate Myb target genes have been reported to date, most of these are likely to play little or no role in transformation by myb oncogenes. Here we have used a conditionally myb-transformed myeloid cell line (ERMYB) to further examine Myb regulation of one candidate target gene-c-myc-that has the potential to affect cell proliferation. It was found that the major influence on c-myc expression was the presence of cytokine (GM-CSF) rather than Myb activity. We also describe the application of PCR-based subtractive hybridization and low-density cDNA array screening, in conjunction with the ERMYB line, to the identification of additional Myb target genes. Preliminary identification of a number of candidates is reported; these include myeloperoxidase, which is known to have essential Myb-binding sites in its regulatory region. (C) 2001 Academic Press.

Small area population disease burden

Small area health statistics has assumed increasing importance as the focus of population and public health moves to a more individualised approach of smaller area populations. Small populations and low event occurrence produce difficulties in interpretation and require appropriate statistical methods, including for age adjustment. There are also statistical questions related to multiple comparisons. Privacy and confidentiality issues include the possibility of revealing information on individuals or health care providers by fine cross-tabulations. Interpretation of small area population differences in health status requires consideration of migrant and Indigenous composition, socio-economic status and rural-urban geography before assessment of the effects of physical environmental exposure and services and interventions. Burden of disease studies produce a single measure for morbidity and mortality - disability adjusted life year (DALY) - which is the sum of the years of life lost (YLL) from premature mortality and the years lived with disability (YLD) for particular diseases (or all conditions). Calculation of YLD requires estimates of disease incidence (and complications) and duration, and weighting by severity. These procedures often mean problematic assumptions, as does future discounting and age weighting of both YLL and YLD. Evaluation of the Victorian small area population disease burden study presents important cross-disciplinary challenges as it relies heavily on synthetic approaches of demography and economics rather than on the empirical methods of epidemiology. Both empirical and synthetic methods are used to compute small area mortality and morbidity, disease burden, and then attribution to risk factors. Readers need to examine the methodology and assumptions carefully before accepting the results.

Determining complicated winding patterns for shim coils using stream functions and the target-field method

In a magnetic resonance imaging equipment, gradient and shim coils are needed to produce a spatially varying magnetic field throughout the sample being imaged. Such coils consist of turns of wire wound on the surface of a cylindrical tube. Shim coils in particular, must sometimes be designed to produce complicated magnetic fields to correct for impurities. Streamline patterns for shim coils are much more complicated than those for gradient coils, In this work we present a detailed analysis of streamline methods and their application to shim coil design, A method is presented for determining the winding patterns to generate these complicated fields. (C) 2002 John Wiley & Sons, Inc.

Finger and A-B ridge count, and fluctuating asymmetry in psychosis: A catchment area case-control study

Dermatoglyphic measures are of interest to schizophrenia research because they serve as persistent markers of deviant development in foetal life. Several studies have reported alterations in A–B ridge counts, total finger ridge counts and measures related to asymmetry in schizophrenia. The aim of this study was to assess these measures in an Australian catchment area, case-control study. Individuals with psychosisŽns246.were drawn from a catchment-area prevalence study, and well controlsŽns229. were recruited from the same area. Finger and palm prints were taken usingan inkless technique and all dermatoglyphic measures were assessed by a trained rater blind to case status. The dermatoglyphic measures Žfinger ridge count, A–B ridge count, and their derived asymmetry measures. were divided into quartiles based on the distribution of these variables in controls. The main analysis Žlogistic regression controlled for age and sex.examined all psychotic disorders, with planned subgroup analyses comparing controls with Ž1. nonaffective psychosis Žschizophrenia, delusional disorder, schizophreniform psychosis, atypical psychosis.andŽ2. affective psychosis Ždepression with psychosis, bipolar disorder, schizoaffective psychosis.. There were no statistically significant alterations in the odds of havinga psychotic disorder for any of the dermatoglyphic measures. The results did not change when we examined affective and nonaffective psychosis separately. The dermatoglyphic features that distinguish schizophreniar psychosis in other studies were not identified in this Australian study. Regional variations in these findings may provide clues to differential ethnicrgenetic and environmental factors that are associated with schizophrenia. The Stanley Foundation supported this project.

Retaining rural and remote area nurses - The Queensland, Australia experience

Because higher-than-average turnover rates for nurses who work in remote and rural areas are the norm, the authors conducted a study to identify professional and personal factors that influenced rural nurses' decisions to resign. Using a mail survey, the authors gathered qualitative and quantitative data from nurses who had resigned from rural and remote areas in Queensland, Australia. Their findings, categorized into professional and rural influences, highlight the importance of work force planning strategies that capitalize on the positive aspects of rural and remote area practice, to retain nurses in nonmetropolitan areas.