Environmental exposures : an underrecognized contribution to noncommunicable diseases

Previous attempts to determine the degree to which exposure to environmental factors contribute to noncommunicable diseases (NCDs) have been very conservative and have significantly underestimated the actual contribution of the environment for at least two reasons. Firstly, most previous reports have excluded the contribution of lifestyle behavioral risk factors, but these usually involve significant exposure to environmental chemicals that increase risk of disease. Secondly, early life exposure to chemical contaminants is now clearly associated with an elevated risk of several diseases later in life, but these connections are often difficult to discern. This is especially true for asthma and neurodevelopmental conditions, but there is also a major contribution to the development of obesity and chronic diseases. Most cancers are caused by environmental exposures in genetically susceptible individuals. In addition, new information shows significant associations between cardiovascular diseases and diabetes and exposure to environmental chemicals present in air, food, and water. These relationships likely reflect the combination of epigenetic effects and gene induction. Environmental factors contribute significantly more to NCDs than previous reports have suggested. Prevention needs to shift focus from individual responsibility to societal responsibility and an understanding that effective prevention of NCDs ultimately relies on improved environmental management to reduce exposure to modifiable risks.

The use of prescribed drugs for common chronic conditions in South Africa in 1998

Purpose To determine the prescribed drug-utilisation pattern for six common chronic conditions in adult South Africans in a cross-sectional survey. Methods 13 826 randomly selected participants, 15 years and older, were surveyed by trained fieldworkers at their homes in 1998. Questionnaires included socio-demographic, chronic-disease and drug-use data. The prescribed drugs were recorded from participants' medication containers. The Anatomical Therapeutic Classification (ATC) code of the drugs for tuberculosis (TB), diabetes, hypertension, hyperlipidaemia, other atherosclerosis-related conditions, such as heart conditions or cerebrovascular accidents (CVA), and asthma or chronic obstructive pulmonary disease (COPD), was recorded. The use of logistic regression analyses identified the determinants of those patients who used prescription medication for these six conditions. Results 18.4% of the women and 12.5% of the men used drugs for the six chronic conditions. Men used drugs most frequently for hypertension (50.9%) and asthma or chronic bronchitis (24.3%), while in women it was for hypertension (59.9%) and diabetes (17.5%). The logistic regression analyses showed that women, wealthier and older people, and those with medical insurance used these chronic-disease drugs more frequently compared to men, younger or poor people, or those without medical insurance. The African population group used these drugs less frequently than any other ethnic group. The inappropriate use of methyldopa was found for 14.8% of all antihypertensive drugs, while very few people used aspirin. Conclusions The methodology of this study provides a means of ascertaining the chronic-disease drug-utilisation pattern in national health surveys. The pattern described, suggests an inequitable use of chronic-disease drugs and inadequate use of some effective drugs to control the burden of chronic diseases in South Africa. Copyright © 2004 John Wiley & Sons, Ltd.

Profiling the nature and context of the Australian prefabricated housing industry

The current state of the prefabricated housing market in Australia is systematically profiled, guided by a theoretical systems model. Particular focus is given to two original data collections. The first identifies manufacturers and builders using prefabrication innovations, and the second compares the context for prefabricated housing in Australia with that of key international jurisdictions. The results indicate a small but growing market for prefabricated housing in Australia, often building upon expertise developed through non-residential building applications. The international comparison highlighted the complexity of the interactions between macro policy decisions and historical influences and the uptake of prefabricated housing. The data suggest factors such as the small scale of the Australian market, and a lack of investment in research, development and training have not encouraged prefabrication. A lack of clear regulatory policy surrounding prefabricated housing is common both in Australia and internationally, with local effects in regards to home warranties and housing finance highlighted. Future research should target the continuing lack of consideration of prefabrication from within the housing construction industry, and build upon the research reported in this paper to further quantify the potential end user market and the continuing development of the industry.

Festival focus : Brisbane International Film Festival

In 2012, the Brisbane International Film Festival officially came of age, celebrating its twenty-first birthday. The festival has emerged from a tumultuous adolescence and redefined its position on the Australian festival circuit as an advocate of locally made films and documentary filmmaking in particular. Brisbane’s International Film Festival opened in 1992 and has since been attended by more than 400,000 filmgoers. The festival is held annually and showcases a diverse range of feature films, documentaries, short films, animation and experimental work, children’s films and retrospectives.

ICT in teacher education in the age of AITSL

This paper is drawn from a 2012-2013 OLT National Teaching Fellowship investigating the agencies impacting on whole-of course curriculum design in initial teacher education. The chief of these is AITSL (Australian Institute for Teaching and School Leadership) through the Australian Professional Standards for Teachers at Graduate level and the Program Accreditation Standards. This paper will begin with a discussion of the requirements on both beginning teachers and initial teacher education programs in regard to ICT (both content and pedagogy). It will then present case studies from four universities whose degree programs have been approved for implementation in 2014. It will focus on how each institution has responded to the APST as well as accreditation requirements. This will be based on responses to surveys to selected institutions and with one on one interviews to capture rich data. From this, it will draw a contemporary profile of how institutions are rising to the real requirements of ICT pedagogy within the regulatory constraints now in place. The methodology employed is qualitative and is based on document analysis enriched by interview data. It is important to know, as a profession, how future teachers are being introduced to and immersed in digital learning environments.

A framework for qualitative analysis of focus group data in information systems

Focus groups are a popular qualitative research method for information systems researchers. However, compared with the abundance of research articles and handbooks on planning and conducting focus groups, surprisingly, there is little research on how to analyse focus group data. Moreover, those few articles that specifically address focus group analysis are all in fields other than information systems, and offer little specific guidance for information systems researchers. Further, even the studies that exist in other fields do not provide a systematic and integrated procedure to analyse both focus group ‘content’ and ‘interaction’ data. As the focus group is a valuable method to answer the research questions of many IS studies (in the business, government and society contexts), we believe that more attention should be paid to this method in the IS research. This paper offers a systematic and integrated procedure for qualitative focus group data analysis in information systems research.

Cytokine expression and secretion by skeletal muscle cells : regulatory mechanisms and exercise effects

Cytokines are important mediators of various aspects of health and disease, including appetite, glucose and lipid metabolism, insulin sensitivity, skeletal muscle hypertrophy and atrophy. Over the past decade or so, considerable attention has focused on the potential for regular exercise to counteract a range of disease states by modulating cytokine production. Exercise stimulates moderate to large increases in the circulating concentrations of interleukin (IL)-6, IL-8, IL-10, IL-1 receptor antagonist, granulocyte-colony stimulating factor, and smaller increases in tumor necrosis factor-α, monocyte chemotactic protein-1, IL-1β, brain-derived neurotrophic factor, IL-12p35/p40 and IL-15. Although many of these cytokines are also expressed in skeletal muscle, not all are released from skeletal muscle into the circulation during exercise. Conversely, some cytokines that are present in the circulation are not expressed in skeletal muscle after exercise. The reasons for these discrepant cytokine responses to exercise are unclear. In this review, we address these uncertainties by summarizing the capacity of skeletal muscle cells to produce cytokines, analyzing other potential cellular sources of circulating cytokines during exercise, and discussing the soluble factors and intracellular signaling pathways that regulate cytokine synthesis (e.g., RNA-binding proteins, microRNAs, suppressor of cytokine signaling proteins, soluble receptors).

The Threshold Learning Outcome on self-management for the Bachelor of Laws degree : a proposed focus for teaching strategies in the first year law curriculum

The Australian Learning and Teaching Council (ALTC) Discipline Scholars for Law, Professors Sally Kift and Mark Israel, articulated six Threshold Learning Outcomes (TLOs) for the Bachelor of Laws degree as part of the ALTC’s 2010 project on Learning and Teaching Academic Standards. One of these TLOs promotes the learning, teaching and assessment of self-management skills in Australian law schools. This paper explores the concept of self-management and how it can be relevantly applied in the first year of legal education. Recent literature from the United States (US) and Australia provides insights into the types of issues facing law students, as well as potential antidotes to these problems. Based on these findings, I argue that designing a pedagogical framework for the first year law curriculum that promotes students’ connection with their intrinsic interests, values, motivations and purposes will facilitate student success in terms of their personal well-being, ethical dispositions and academic engagement.

Antisocial personality disorder and therapeutic justice court programs

It has become commonplace for courts to supervise an offender as part of the sentencing process. Many of them have Anti Social Personality Disorder (ASPD). The focus of this article is how the work of specialist and/or problem solving courts can be informed by the insights of the psychology profession into the best practice in the treatment and management of people with ASPD. It is a legitimate purpose of legal work to consider and improve the well-being of the participants in the legal process. Programs designed specifically to deal with those with ASPD could be incorporated into existing Drug Courts, or implemented separately by courts to aid with reforming offenders with ASPD and in managing the re-entry of offenders into the community as part of their sentence. For the success of this initiative on the part of the court, ASPD will need to be specifically diagnosed and treated. Close co-operation between courts and psychologists is required to improve the effectiveness of court programs to treat people with ASPD and to evaluate their success.

Moderation in higher education: Four discourses

Across the globe, higher education institutions are working in environments of increasing accountability with little sign of this trend abating. This heightened focus on accountability has placed greater demands on institutions to provide evidence of quality and the achievement of standards that assure that quality. Moderation is one quality assurance process that plays a central role in the teaching, learning and assessment cycle in higher education institutions. While there is a growing body of research globally on teaching, learning and , to a lesser degree, assessment in higher education, the process of moderation has received even less attention (Watty, Freeman, Howieson, Hancock, O'Connell, et al. 2013). Until recently, moderation processes in Australian universities have been typically located within individual institutions, with universities given the responsibility for developing their own specific policies and practices. However, in 2009 the Australian Government announced that an independent national quality and regulatory body for higher education institutions would be established. With the introduction of the Tertiary Education Quality Standards Authority (TEQSA), more formalised requirements for moderation of assessment are being mandated. In light of these reforms, the purpose of this qualitative study was to identify and investigate current moderation practices operating within one faculty, the Faculty of Education, in a large urban university in eastern Australia. The findings of this study revealed four discourses of moderation: equity, justification, community building and accountability. These discourses provide a starting point for academics to engage in substantive conversations around assessment and to further critique the processes of moderation.

Past, present and the evolving future of public health and health promotion: Reflections on dismantling in Queensland Australia

Objective For more than ten years the public health and health promotion workforce in the Australian state of Queensland grew dramatically. This growth was most pronounced in the disciplines of Health Promotion and in Public Health Nutrition, both regionally and corporately. In 2012 political change led to an abrupt dismantling of its public and preventive health services across the state. Individual responsibility was declared. Method This presentation provides a qualitative narrative description of past achievements and activities, the current situation and provides a perspective towards the future. Findings Government reports over several years described the growing burden of chronic disease arising from conditions such as obesity, physical inactivity, and poor nutrition in Queensland. By 2008, obesity had overtaken smoking as the single greatest risk factor to the health of Queenslanders. In 2010, the Chief Health Officer called for an increased focus on prevention to address the continuing need for more beds in hospitals. However, with political change in 2012 resulted in the dismantling and dismissal of preventive health services across the state. The following year, despite outcry, sexual health services were also axed. At present, outbreaks of vaccine preventable diseases such as measles are occurring. The epidemics of chronic disease, obesity and physical inactivity continue to grow. Conclusion The evolution of public health is not necessarily progressive, but cyclic. Challenges include political change, health practice and the interplay of health policy. A lack of an embedded emphasis on systematic review translation is one potential contributor. Perhaps the warning of Lang & Rayner should be heeded: “public health proponents have allowed themselves to be corralled into the narrow language of individualism and choice”.

Arabic translation, adaptation and modification of the dialysis symptom index for chronic kidney disease stages four and five

Background Symptom burden in chronic kidney disease (CKD) is poorly understood. To date, the majority of research focuses on single symptoms and there is a lack of suitable multidimensional symptom measures. The purpose of this study was to modify, translate, cross-culturally adapt and psychometrically analyse the Dialysis Symptom Index (DSI). Methods The study methods involved four phases: modification, translation, pilot-testing with a bilingual non-CKD sample and then psychometric testing with the target population. Content validity was assessed using an expert panel. Inter-rater agreement, test-retest reliability and Cronbach’s alpha coefficient were calculated to demonstrate reliability of the modified DSI. Discriminative and convergent validity were assessed to demonstrate construct validity. Results Content validity index during translation was 0.98. In the pilot study with 25 bilingual students a moderate to perfect agreement (Kappa statistic = 0.60-1.00) was found between English and Arabic versions of the modified DSI. The main study recruited 433 patients CKD with stages 4 and 5. The modified DSI was able to discriminate between non-dialysis and dialysis groups (p < 0.001) and demonstrated convergent validity with domains of the Kidney Disease Quality of Life short form. Excellent test-retest and internal consistency (Cronbach’s α = 0.91) reliability were also demonstrated. Conclusion The Arabic version of the modified DSI demonstrated good psychometric properties, measures the multidimensional nature of symptoms and can be used to assess symptom burden at different stages of CKD. The modified instrument, renamed the CKD Symptom Burden Index (CKD-SBI), should encourage greater clinical and research attention to symptom burden in CKD.

Heavy vehicle safety in Oman: Police interviews and heavy vehicle driver survey and focus groups. Third Report of the Heavy Vehicle Safety Research in Oman Project for The Research Council of Oman.

Over the past six months the project has undertaken three key, separate, data collection rounds. Each of these rounds focused on essentially different issues within the broader common construct of heavy vehicle road safety. This document will initially report on a series of two key qualitative data collections rounds. Firstly it will detail findings and report on discussions held in focus groups with 43 heavy vehicle drivers. The second qualitative study involved a series of interviews undertaken with 19 police officers from various levels of command and operations within the Royal Oman Police. The final data collection round reported on in this document is a roadside survey questionnaire undertaken with 400 heavy vehicle drivers.

Focus group discussions exploring major social influences on young driver safety in Oman. Report to the Research Council of Oman, Muscat.

This report documents the findings of in-depth focus groups conducted with 17 young drivers. The main aim of these focus groups was to explore key themes related to the risky behaviour of young drivers (17-25 years) in Oman. Specifically the interviews explored the influence of parents and peers, who may serve as a source of imitation, reward and punishment. Additionally, the interviews explored the influence of policing and licensing on young driver behaviour.

Different correlation of Sphingosine-1-Phosphate receptor 1 with receptor activator of nuclear factor kappa B ligand and regulatory T cells in rat periapical lesions

Introduction Sphingosine-1-phosphate receptor 1 (S1P1) is crucial for regulation of immunity and bone metabolism. This study aimed to investigate the expression of S1P1 in rat periapical lesions and its relationship with receptor activator of nuclear factor kappa B ligand (RANKL) and regulatory T (Treg) cells. Methods Periapical lesions were induced by pulp exposure in the first lower molars of 55 Wistar rats. Thirty rats were killed on days 0, 7, 14, 21, 28, and 35, and their mandibles were harvested for x-ray imaging, micro–computed tomography scanning, histologic observation, immunohistochemistry, enzyme histochemistry, and double immunofluorescence analysis. The remaining 25 rats were killed on days 0, 14, 21, 28, and 35, and mandibles were harvested for flow cytometry. Results The volume and area of the periapical lesions increased from day 0 to day 21 and then remained comparably stable after day 28. S1P1-positive cells were observed in the inflammatory periapical regions; the number of S1P1-positive cells peaked at day 14 and then decreased from day 21 to day 35. The distribution of S1P1-positive cells was positively correlated with the dynamics of RANKL-positive cells but was negatively correlated with that of Treg cells. Conclusions S1P1 expression was differentially correlated with RANKL and Treg cell infiltration in the periapical lesions and is therefore a contributing factor to the pathogenesis of such lesions.