Prevalence and trends of the diabetes epidemic in South Asia : a systematic review and meta-analysis

Background Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported. Methods Prevalence data were obtained by searching the Medline® database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic) and ‘Epidemology/EP’ (MeSH subheading). Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years). The conjunction of the above results was narrowed down with country names. Results The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural), India–4.6%:12.5% (2007;Rural); Maldives–3.0%:3.7% (2004;National), Nepal–19.5%:9.5% (2007;Urban), Pakistan–3.0%:7.2% (2002;Rural), Sri Lanka–11.5%:10.3% (2005–2006;National). Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%), while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%). Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes. Conclusion A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies .

Plant-made therapeutics: An emerging platform in South Africa

The field of plant-made therapeutics in South Africa is well established in the form of exploitation of the country's considerable natural plant diversity, both in the use of native plants in traditional herbal medicines over many centuries, and in the more modern extraction of pharmacologically-active compounds from plants, including those known to traditional healers. In recent years, this has been added to by the use of plants for the stable or transient expression of pharmaceutically-important compounds, largely protein-based biologics and vaccines. South Africa has a well-developed plant biotechnology community, as well as a comprehensive legislative framework for the regulation of the exploitation of local botanic resources, and of genetically-modified organisms. The review explores the investigation of both conventional and recombinant plants for pharmaceutical use in South Africa, as well as describing the relevant legislative and regulatory frameworks. Potential opportunities for national projects, as well as factors limiting biopharming in South Africa are discussed. © 2011.

Maize streak virus: An old and complex 'emerging' pathogen

Maize streak virus (MSV; Genus Mastrevirus, Family Geminiviridae) occurs throughout Africa, where it causes what is probably the most serious viral crop disease on the continent. It is obligately transmitted by as many as six leafhopper species in the Genus Cicadulina, but mainly by C. mbila Naudé and C. storeyi. In addition to maize, it can infect over 80 other species in the Family Poaceae. Whereas 11 strains of MSV are currently known, only the MSV-A strain is known to cause economically significant streak disease in maize. Severe maize streak disease (MSD) manifests as pronounced, continuous parallel chlorotic streaks on leaves, with severe stunting of the affected plant and, usuallly, a failure to produce complete cobs or seed. Natural resistance to MSV in maize, and/or maize infections caused by non-maize-adapted MSV strains, can result in narrow, interrupted streaks and no obvious yield losses. MSV epidemiology is primarily governed by environmental influences on its vector species, resulting in erratic epidemics every 3-10 years. Even in epidemic years, disease incidences can vary from a few infected plants per field, with little associated yield loss, to 100% infection rates and complete yield loss. Taxonomy: The only virus species known to cause MSD is MSV, the type member of the Genus Mastrevirus in the Family Geminiviridae. In addition to the MSV-A strain, which causes the most severe form of streak disease in maize, 10 other MSV strains (MSV-B to MSV-K) are known to infect barley, wheat, oats, rye, sugarcane, millet and many wild, mostly annual, grass species. Seven other mastrevirus species, many with host and geographical ranges partially overlapping those of MSV, appear to infect primarily perennial grasses. Physical properties: MSV and all related grass mastreviruses have single-component, circular, single-stranded DNA genomes of approximately 2700 bases, encapsidated in 22 × 38-nm geminate particles comprising two incomplete T = 1 icosahedra, with 22 pentameric capsomers composed of a single 32-kDa capsid protein. Particles are generally stable in buffers of pH 4-8. Disease symptoms: In infected maize plants, streak disease initially manifests as minute, pale, circular spots on the lowest exposed portion of the youngest leaves. The only leaves that develop symptoms are those formed after infection, with older leaves remaining healthy. As the disease progresses, newer leaves emerge containing streaks up to several millimetres in length along the leaf veins, with primary veins being less affected than secondary or tertiary veins. The streaks are often fused laterally, appearing as narrow, broken, chlorotic stripes, which may extend over the entire length of severely affected leaves. Lesion colour generally varies from white to yellow, with some virus strains causing red pigmentation on maize leaves and abnormal shoot and flower bunching in grasses. Reduced photosynthesis and increased respiration usually lead to a reduction in leaf length and plant height; thus, maize plants infected at an early stage become severely stunted, producing undersized, misshapen cobs or giving no yield at all. Yield loss in susceptible maize is directly related to the time of infection: Infected seedlings produce no yield or are killed, whereas plants infected at later times are proportionately less affected. Disease control: Disease avoidance can be practised by only planting maize during the early season when viral inoculum loads are lowest. Leafhopper vectors can also be controlled with insecticides such as carbofuran. However, the development and use of streak-resistant cultivars is probably the most effective and economically viable means of preventing streak epidemics. Naturally occurring tolerance to MSV (meaning that, although plants become systemically infected, they do not suffer serious yield losses) has been found, which has primarily been attributed to a single gene, msv-1. However, other MSV resistance genes also exist and improved resistance has been achieved by concentrating these within individual maiz genotypes. Whereas true MSV immunity (meaning that plants cannot be symptomatically infected by the virus) has been achieved in lines that include multiple small-effect resistance genes together with msv-1, it has proven difficult to transfer this immunity into commercial maize genotypes. An alternative resistance strategy using genetic engineering is currently being investigated in South Africa. Useful websites: 〈http://www.mcb.uct.ac.za/MSV/mastrevirus.htm〉; 〈http://www. danforthcenter.org/iltab/geminiviridae/geminiaccess/mastrevirus/Mastrevirus. htm〉. © 2009 Blackwell Publishing Ltd.

Air pollution trends in four Australian cities

This study examined the long-term trends in four air pollutants in Australia’s four largest cities between 1996 and 2011. There were long-term improvements in carbon monoxide and sulfur dioxide. Particulate matter levels (PM10) remained relatively constant. Ozone levels increased in all four cities when including the influence of temperature, and levels are predicted to increase further because of climate change.

The cancer stem-cell hypothesis : its emerging role in lung cancer biology and its relevance for future therapy

The cancer stem-cell (CSC) hypothesis suggests that there is a small subset of cancer cells that are responsible for tumor initiation and growth, possessing properties such as indefinite self-renewal, slow replication, intrinsic resistance to chemotherapy and radiotherapy, and an ability to give rise to differentiated progeny. Through the use of xenotransplantation assays, putative CSCs have been identified in many cancers, often identified by markers usually expressed in normal stem cells. This is also the case in lung cancer, and the accumulated data on side population cells, CD133, CD166, CD44 and ALDH1 are beginning to clarify the true phenotype of the lung cancer stem cell. Furthermore, it is now clear that many of the pathways of normal stem cells, which guide cellular proliferation, differentiation, and apoptosis are also prominent in CSCs; the Hedgehog (Hh), Notch, and Wnt signaling pathways being notable examples. The CSC hypothesis suggests that there is a small reservoir of cells within the tumor, which are resistant to many standard therapies, and can give rise to new tumors in the form of metastases or relapses after apparent tumor regression. Therapeutic interventions that target CSC pathways are still in their infancy and clinical data of their efficacy remain limited. However Smoothened inhibitors, gamma-secretase inhibitors, anti-DLL4 antagonists, Wnt antagonists, and CBP/β-catenin inhibitors have all shown promising anticancer effects in early studies. The evidence to support the emerging picture of a lung cancer CSC phenotype and the development of novel therapeutic strategies to target CSCs are described in this review.

Emerging work practice with a telehealth stethoscope

We investigated the collaboration of ten doctor-nurse pairs with a prototype digital telehealth stethoscope. Doctors could see and hear the patient but could not touch them or the stethoscope. The nurse in each pair controlled the stethoscope. For ethical reasons, an experimenter stood in for a patient. Each of the ten interactions was video recorded and analysed to understand the interaction and collaboration between the doctor and nurse. The video recordings were coded and transformed into maps of interaction that were analysed for patterns of activity. The analysis showed that as doctors and nurses became more experienced at using the telehealth stethoscope their collaboration was more effective. The main measure of effectiveness was the number of corrections in stethoscope placement required by the doctor. In early collaborations, the doctors gave many corrections. After several trials, each doctor and nurse had reduced corrections and all pairs reduced their corrections. The significance of this research is the identification of the qualities of effective collaboration in the use of the telehealth stethoscope and telehealth systems more generally.

Creating fashion professionals for the 21st century : a tale of pedagogical tensions and emerging challenges

The ‘Fashion Tales’ Conference identifies three fashion discourses: that of making, that of media, and that of scholarship. We propose a fourth, which provides a foundational base for the others: the discourse of fashion pedagogy. We begin with the argument that to thrive in any of these discourses, all fashion graduates require the ability to navigate the complexities of the 21st century fashion industry. Fashion graduates emerge into a professional world which demands a range of high level capabilities above and beyond those traditionally acknowledged by the discipline. Professional education in fashion must transform itself to accommodate these imperatives. In this paper, we document a tale of fashion learning, teaching and scholarship – the tale of a highly successful future-orientated boutique university-based undergraduate fashion course in Queensland, Australia. The Discipline consistently maintains the highest student satisfaction and lowest attrition of any course in the university, achieves extremely competitive student satisfaction scores when compared with other courses nationally and internationally, and reports outstanding graduate employment outcomes. The core of the article addresses how the course effectively balances five key pedagogical tensions identified from the findings of in-depth focus groups with graduating students, and interviews with teaching staff. The pedagogical tensions are: high concept/ authenticity; high disciplinarity/ interdisciplinarity; high rigour/ play; high autonomy/ scaffolding; and high individuality/ community, where community can be further divided into high challenge and high support. We discuss each of these tensions and how they are characterised within the course, using rich descriptions given by the students. We also draw upon the wider andragogical and learning futures literatures to link the tensions with what is already known about excellence in 21st century higher and further education curriculum and pedagogic practice. We ask: as the fashion industry becomes truly globalised, virtualised, and diversified, and as initial professional training for the industry becomes increasingly massified and performatised, what are the best teaching approaches to produce autonomous, professionally capable, enterprising and responsible graduates into the future? Can the pedagogical balances described in this case study be maintained in the light of these powerful external forces, and if so, how?

The emerging framework of cross-border insolvency in and around Australia : Saad Investments, Japan Airlines and Lehman Brothers – part one

Recent decades have witnessed a global acceleration of legislative and private sector initiatives to deal with Cross-Border insolvency. Legislative institutions include the various national implementations of the Model Law on Cross-Border Insolvency (Model Law) published by the United Nations Commission on International Trade (UNCITRAL).3 Private mechanisms include Cross-Border protocols developed and utilised by insolvency professionals and their advisers (often with the imprimatur of the judiciary), on both general and ad hoc bases. The Asia Pacific region has not escaped the effect of those developments, and the economic turmoil of the past few years has provided an early test for some of the emerging initiatives in that region. This two-part article explores the operation of those institutions through the medium of three recent cases.

The emerging framework of cross-border insolvency in and around Australia : Saad Investments, Japan Airlines and Lehman Brothers – Part Two

Recent decades have witnessed a global acceleration of legislative and private sector initiatives to deal with Cross-Border insolvency. Legislative institutions include the various national implementations of the Model Law on Cross-Border Insolvency (Model Law) published by the United Nations Commission on International Trade (UNCITRAL).3 Private mechanisms include Cross-Border protocols developed and utilised by insolvency professionals and their advisers (often with the imprimatur of the judiciary), on both general and ad hoc bases. The Asia Pacific region has not escaped the effect of those developments, and the economic turmoil of the past few years has provided an early test for some of the emerging initiatives in that region. This two-part article explores the operation of those institutions through the medium of three recent cases.

Guerrilla research tactics: alternative research methods

This case-study explores alternative and experimental methods of research data acquisition, through an emerging research methodology, ‘Guerrilla Research Tactics’ [GRT]. The premise is that the researcher develops covert tactics for attracting and engaging with research participants. These methods range between simple analogue interventions to physical bespoke artefacts which contain an embedded digital link to a live, interactive data collecting resource, such as an online poll, survey or similar. These artefacts are purposefully placed in environments where the researcher anticipates an encounter and response from the potential research participant. The choice of design and placement of artefacts is specific and intentional. DESCRIPTION: Additional information may include: the outcomes; key factors or principles that contribute to its effectiveness; anticipated impact/evidence of impact. This case-study assesses the application of ‘Guerrilla Research Tactics’ [GRT] Methodology as an alternative, engaging and interactive method of data acquisition for higher degree research. Extending Gauntlett’s definition of ‘new creative methods… an alternative to language driven qualitative research methods' (2007), this case-study contributes to the existing body of literature addressing creative and interactive approaches to HDR data collection. The case-study was undertaken with Masters of Architecture and Urban Design research students at QUT, in 2012. Typically students within these creative disciplines view research as a taxing and boring process, distracting them from their studio design focus. An obstacle that many students face, is acquiring data from their intended participant groups. In response to these challenges the authors worked with students to develop creative, fun, and engaging research methods for both the students and their research participants. GRT are influenced by and developed from a combination of participatory action research (Kindon, 2008) and unobtrusive research methods (Kellehear, 1993), to enhance social research. GRT takes un-obtrusive research in a new direction, beyond the typical social research methods. The Masters research students developed alternative methods for acquiring data, which relied on a combination of analogue design interventions and online platforms commonly distributed through social networks. They identified critical issues that required action by the community, and the processes they developed focused on engaging with communities, to propose solutions. Key characteristics shared between both GRT and Guerrilla Activism, are notions of political issues, the unexpected, the unconventional, and being interactive, unique and thought provoking. The trend of Guerrilla Activism has been adapted to: marketing, communication, gardening, craftivism, theatre, poetry, and art. Focusing on the action element and examining elements of current trends within Guerrilla marketing, we believe that GRT can be applied to a range of research areas within various academic disciplines.

Emerging from student to practitioner : a cumulative development tool for students

PURPOSE: This pilot project’s aim was to trial a tool and process for developing students’ ability to engage in self-assessment using reflection on their clinical experiences, including feedback from workplace learning, in order to aid them in linking theory to practice and develop strategies to improve performance. BACKGROUND: In nursing education, students can experience a mismatch in performance compared to theoretical learning, this is referred to as the ‘theory practice gap’ (Scully 2011, Chan Chan & Liu 2011). One specific contributing factor seems to be students’ inability to engage in meaningful reflection and self-correcting behaviours. A self-assessment strategy was implemented within a third year clinical unit to ameliorate this mismatch with encouraging results, as students developed self-direction in addressing learning needs. In this pilot project the above strategy was adapted for implementation between different clinical units, to create a whole of course approach to integrating workplace learning. METHOD: The methodology underpinning this project is a scaffolded, supported reflective practice process. Improved self-assessment skills is achieved by students reflecting on and engaging with feedback, then mapping this to learning outcomes to identify where performance can be improved. Evaluation of this project includes: collation of student feedback identifying successful strategies along with barriers encountered in implementation; feedback from students and teachers via above processes and tools; and comparison of the number of learning contracts issued in clinical nursing units with similar cohorts. RESULTS: Results will be complete by May 2012 and include analysis of the data collected via the above evaluation methods. Other outcomes will include the refined process and tool, plus resources that should improve cost effectiveness without reducing student support. CONCLUSION: Implementing these tools and processes over the entire student’s learning package, will assist them to demonstrate progressive development through the course. Students will have learnt to understand feedback and integrate these skills for life-long learning.

Modeling destination brand equity in an emerging long haul market

The destination branding literature emerged as recently as 1998, and there remains a dearth of empirical data that tests the effectiveness of brand campaigns over time. This paper reports the results of an investigation into consumer-based brand equity for Australia as a long haul destination in an emerging South American market. In spite of the high level of academic interest in the measurement of perceptions of destinations since the 1970s, few previous studies have examined perceptions held by South American consumers. Findings suggest that destination brand awareness, brand image, and brand value are positively related to brand loyalty for a long-haul destination. The results also indicate that Australia is a more compelling destination brand for previous visitors compared to non-visitors.

Seriously playful : the uses of networked spoof videos in China

This thesis examines online spoof videos in China. It shows the relationship between user-created content and change and how such videos are impacting on social memory. In the West, we are witnessing two outstanding trends in media. On the one hand, media are turning more "demotic" (Turner, 2006) and "participatory" (Jenkins, 2006), whereby lay audiences use popular media for identity formation, representation and association, reconfiguring the media and cultural landscape, and rendering invalid the old paradigm based on the dichotomy of audience and author, creator and consumer, expert and amateur. On the other hand, in both mainstream media and user-creation online there is a trend towards "silly citizenship", with comedy, send-ups and spoofs that used to reside in the margin propelled to the central stage in both pleasure and politics (Hartley, 2010), as is shown in the rising popularity of the Daily Show, Colbert Report, and spoof videos in elections ,e.g. the 2008 presidential election in US (Gray, Jones, & Thompson, 2009; Tryon, 2008). User generated content—and spoof subcultures—is now much a debated phenomenon in China. However, with different political (one party rule and censorship) and cultural (media regarded mainly as instrument for education and social stabilization instead of a critical fourth estate) configurations, will the social and cultural impacts of the two trends in the West be as the same in China? If not, what will be the specificities in the China context? The project starts with a historical review of popular culture and user-created content in China, before turning to spoof videos and looking at how they are produced and shared, travel and diffused on the Internet, and how the communities and sub-cultures forming and emerging around spoof videos are changing the overall cultural landscape in China. By acting as a participant observer in online video sharing sites and conducting face-to face as well as online interviews, I identify lead users and creators of spoof videos and the social networks emerging around them. I call these lead users "skill hubs" and their networks "liquid communities", foregrounding the fact that their appeal doesn’t come from their amicable personality, but rather from their creative skills; and that the networks surrounding them are in a permanent flux, with members coming and going as they see fit. I argue that the "liquidness" (Bauman, 2000) of these communities is what makes them constantly creative and appealing. Textual analysis of online videos, their comments and derivatives are conducted to tease out the uses that that can be made of spoof videos, namely as phatic communication, as alternative memory and as political engagement. Through these analyses I show that spoof videos constitute not only a space where young generations can engage with each other, communicate their anger and dissatisfaction, fun and hope, and where they participate in socio-cultural and political debates, but also create a space where they can experiment with their new skills, new ideas, and new citizenship. The rise of spoof videos heralds the beginning of a trend in popular culture in contemporary China towards the "canonization of the jester" and the dethroning of the establishment. I also argue that a historical perspective is needed to understand the current surge of use creativity and user activism in China, and that many forms of popular media we experience today have their antecedents in various stages of Chinese history. The entrenched "control-resistance" binary is inadequate in interpreting the rich, flux and multilayered Internet space in China.