Prevention of hypertension in patients with pre-hypertension: protocol for the PREVER-prevention trial

Background: Blood pressure (BP) within pre-hypertensive levels confers higher cardiovascular risk and is an intermediate stage for full hypertension, which develops in an annual rate of 7 out of 100 individuals with 40 to 50 years of age. Non-drug interventions to prevent hypertension have had low effectiveness. In individuals with previous cardiovascular disease or diabetes, the use of BP-lowering agents reduces the incidence of major cardiovascular events. In the absence of higher baseline risk, the use of BP agents reduces the incidence of hypertension. The PREVER-prevention trial aims to investigate the efficacy, safety and feasibility of a population-based intervention to prevent the incidence of hypertension and the development of target-organ damage. Methods: This is a randomized, double-blind, placebo-controlled clinical trial, with participants aged 30 to 70 years, with pre-hypertension. The trial arms will be chlorthalidone 12.5 mg plus amiloride 2.5 mg or identical placebo. The primary outcomes will be the incidence of hypertension, adverse events and development or worsening of microalbuminuria and of left ventricular hypertrophy in the EKG. The secondary outcomes will be fatal or non-fatal cardiovascular events: myocardial infarction, stroke, heart failure, evidence of new sub-clinical atherosclerosis, and sudden death. The study will last 18 months. The sample size was calculated on the basis of an incidence of hypertension of 14% in the control group, a size effect of 40%, power of 85% and P alpha of 5%, resulting in 625 participants per group. The project was approved by the Ethics committee of each participating institution. Discussion: The early use of blood pressure-lowering drugs, particularly diuretics, which act on the main mechanism of blood pressure rising with age, may prevent cardiovascular events and the incidence of hypertension in individuals with hypertension. If this intervention shows to be effective and safe in a population-based perspective, it could be the basis for an innovative public health program to prevent hypertension in Brazil.

Aussie don't be led by the nose - withdraw troops from Vietnam

Two men on back of Vanguard utility during Labour Day procession 1966, Brisbane, Australia. One is dressed as Uncle Sam. He is leading the other by the nose. The second man is dressed as an Australian soldier. Placards on utility read "Don't be led by the nose - withdraw troops from Vietnam".

Communism and Public Opinion in Queensland, 1939-1951 : An Explanation of Queensland's Vote in the 1951 Anti-Communist Referendum

The starting point of this thesis was a desire to explain the rapid demise in the popularity which the Communist Party enjoyed in Queensland during the second world war. Wartime Queensland gave the Australian Communist Party its highest state vote and six years later Queensland again gave the Communist Party its highest state vote - this time however, to ban the Party. From this I was led into exploring the changing policies, beliefs and strategies of the Party, as well as the many sub-groups on its periphery, and the shifts in public response to these. In 1939 Townsville elected Australia's first Communist alderman. Five years later, Bowen elected not only Australia's first but also the British Empire's first, Communist state government member. Of the five electorates the Australian Communist Party contested in the 1944 Queensland State elections, in none did the Party's candidate receive less than twenty per-cent of the formal vote. Not only was the Party seemingly enjoying considerable popular support but this was occurring in a State which, but for the Depression years (May 1929 - June 1932) had elected a Labor State Government at every state election since 1915. In the September 1951 Constitution Alteration Referendum, 'Powers To Deal With Communists and Communism', Queensland regist¬ered the nation's highest "Yes" majority - 55.76% of the valid vote. Only two other states registered a majority in favour of the referendum's proposals, Western Australia and Tasmania. As this research was undertaken it became evident that while various trends exhibited at the time, anti-Communism, the work of the Industrial Groups, Labor opportunism, local area feelings, ideological shifts of the Party, tactics of Communist-led unions, etc., were present throughout the entire period, they were best seen when divided into three chronological phases of the Party's history and popularity. The first period covers the consolidation of the Party's post-Depression popularity during the war years as it benefited from the Soviet Union's colossal contribution to the Allied war efforts, and this support continued for some six months or so after the war. Throughout the period Communist strength within the trade union movement greatly increased as did total Party membership. The second period was marked by a rapid series of events starting in March 1946, with Winston Churchill's "Official Opening" of the Cold War by his sweeping attack on Communism and Russia, at Fulton. Several days later the first of a series of long and bitter strikes in Communist-led unions occurred, as the Party mobil¬ized for what it believed would be a series of attacks on the working class from a ruling class, defending a capitalist system on the verge of an economic collapse. It was a period when the Party believed this ruling class was using Labor reformism as a last desperate 'carrot' to get workers to accept their lot within a capitalist economic framework. Out of the Meat Strike emerged the Industrial Groups, who waged not only a determined war against Communist trade union leadership but also encouraged the A.W.U.-influenced State Labor apparatus to even greater anti-Communist antagonisms. The Communist Party's increasing militancy and Labor's resistance to it, ended finally in the collapse of the Chifley Labor government. Characteristically the third period opens with the Communist Party making an another about-face, desperately trying to form an alliance with the Labor Party and curbing its former adventurist industrial policy, as it prepared for Menzies' direct assault. The Communist Party's activities were greatly reduced, a function of both a declining member-ship and, furthermore, a membership reluctant to confront an increasingly hostile society. In examining the changing policies, beliefs and strategies of the Party and the shifts in public response to these, I have tried to distinguish between general trends occurring within Australia and the national party, and trends peculiar to Queensland and the Queensland branch of the Party, The Communist Party suffered a decline in support and membership right across Australia throughout this period as a result of the national policies of the Party, and the changing nature of world politics. There were particular features of this decline that were peculiar to Queensland. I have, however, singled out three features of particular importance throughout the period for a short but more specifically detailed analysis, than would be possible in a purely chronological study: i.e. the Party's structure, the Party's ideological subservience to Moscow, and the general effect upon it of the Cold War.

Expertise and the perception of kinematic and situational probability information

Two experiments were conducted on the nature of expert perception in the sport of squash. In the first experiment, ten expert and fifteen novice players attempted to predict the direction and force of squash strokes from either a film display (occluded at variable time periods before and after the opposing player had struck the ball) or a matched point-light display (containing only the basic kinematic features of the opponent's movement pattern). Experts outperformed the novices under both display conditions, and the same basic time windows that characterised expert and novice pick-up of information in the film task also persisted in the point-light task. This suggests that the experts' perceptual advantage is directly related to their superior pick-up of essential kinematic information. In the second experiment, the vision of six expert and six less skilled players was occluded by remotely triggered liquid-crystal spectacles at quasi-random intervals during simulated match play. Players were required to complete their current stroke even when the display was occluded and their prediction performance was assessed with respect to whether they moved to the correct half of the court to match the direction and depth of the opponent's stroke. Consistent with experiment 1, experts were found to be superior in their advance pick-up of both directional and depth information when the display was occluded during the opponent's hitting action. However, experts also remained better than chance, and clearly superior to less skilled players, in their prediction performance under conditions where occlusion occurred before any significant pre-contact preparatory movement by the opposing player was visible. This additional source of expert superiority is attributable to their superior attunement to the information contained in the situational probabilities and sequential dependences within their opponent's pattern of play.

The interaction between technologies and society: Lessons learnt from 160 evolutionary years of online news services

In mapping the evolutionary process of online news and the socio-cultural factors determining this development, this paper has a dual purpose. First, in reworking the definition of “online communication”, it argues that despite its seemingly sudden emergence in the 1990s, the history of online news started right in the early days of the telegraphs and spread throughout the development of the telephone and the fax machine before becoming computer-based in the 1980s and Web-based in the 1990s. Second, merging macro-perspectives on the dynamic of media evolution by DeFleur and Ball-Rokeach (1989) and Winston (1998), the paper consolidates a critical point for thinking about new media development: that something technically feasible does not always mean that it will be socially accepted and/or demanded. From a producer-centric perspective, the birth and development of pre-Web online news forms have been more or less generated by the traditional media’s sometimes excessive hype about the power of new technologies. However, placing such an emphasis on technological potentials at the expense of their social conditions not only can be misleading but also can be detrimental to the development of new media, including the potential of today’s online news.

Australia’s Lily Brayton: Performer and theatre artist

Recognition is the aim of this account of an artist who is now remembered largely for her beauty, her wide iconic fame achieved by mass distribution of her image via photography and postcards, and her professional association with a internationally prominent producer who was also her husband. It is however a historically situated study, confining itself to readings of the kind of theatrical, social and cultural work performed by Brayton's presence in a rapidly-modernising Australia during the period between Federation in 1901 and the first World War, which event marks a disjuncture in the patterns of entertainment and cultural discourse in the new nation. Pre-war Australian theatre and vaudeville managements competed vigorously to secure the most acclaimed artists, seeing it as a kind of service and duty to boost their country's prestige along with their own coffers. Meanwhile, local playwrights and producers promoted a burgeoning repertoire of Australian dramas and films which played alongside the imported products in a complex network of cultural codes and affects.

Existence of Multiple Solutions for Second Order Boundary Value Problems

We give conditions on f involving pairs of lower and upper solutions which lead to the existence of at least three solutions of the two point boundary value problem y" + f(x, y, y') = 0, x epsilon [0, 1], y(0) = 0 = y(1). In the special case f(x, y, y') = f(y) greater than or equal to 0 we give growth conditions on f and apply our general result to show the existence of three positive solutions. We give an example showing this latter result is sharp. Our results extend those of Avery and of Lakshmikantham et al.

Contextual Deliberation of Cognitive Agents in Defeasible Logic

This article extends Defeasible Logic to deal with the contextual deliberation process of cognitive agents. First, we introduce meta-rules to reason with rules. Meta-rules are rules that have as a consequent rules for motivational components, such as obligations, intentions and desires. In other words, they include nested rules. Second, we introduce explicit preferences among rules. They deal with complex structures where nested rules can be involved.

Vaccine-induced Th1-type responses are dominant over Th2-type responses in the short term whereas pre-existing Th2 responses are dominant in the longer term

The effect of adjuvant on induction of human papillomavirus type 16 E7 protein-specific cytotoxic T lymphocytes (CTL) and immunoglobulin G (IgG)(2a) antibody was studied in C57BL/6 J mice immunized with various adjuvants and E7 protein. Quil-A adjuvant, but not complete Freund's adjuvant (CFA) or Algammulin, induced a T-helper 1 (Th1)-type response to E7, which was characterized by CTL activity against a tumour cell line transfected with E7 protein and by E7-specific IgG(2a). All tested adjuvants elicited comparable levels of E7-specific IgG(1). The longest duration and greatest magnitude of CTL response was seen following two immunizations with the highest dose of E7 and Quil-A. Simultaneous immunization with a Th1 and a T helper 2 (Th2)-promoting adjuvant gave a Th1-type response. However, E7 and Quil-A were unable to induce a Th1-type response (as measured by the inability to generate anti-E7 IgG(2a) antibody) in animals with a pre-existing Th2-type response to E7. These results suggest that saponin adjuvants may be suitable for immunotherapy in humans where a Th1-type response is sought, provided that there is no pre existing Th2-type response to the antigen.

Subcycling first- and second-order generalizations of the trapezoidal rule

Subcycling algorithms which employ multiple timesteps have been previously proposed for explicit direct integration of first- and second-order systems of equations arising in finite element analysis, as well as for integration using explicit/implicit partitions of a model. The author has recently extended this work to implicit/implicit multi-timestep partitions of both first- and second-order systems. In this paper, improved algorithms for multi-timestep implicit integration are introduced, that overcome some weaknesses of those proposed previously. In particular, in the second-order case, improved stability is obtained. Some of the energy conservation properties of the Newmark family of algorithms are shown to be preserved in the new multi-timestep extensions of the Newmark method. In the first-order case, the generalized trapezoidal rule is extended to multiple timesteps, in a simple way that permits an implicit/implicit partition. Explicit special cases of the present algorithms exist. These are compared to algorithms proposed previously. (C) 1998 John Wiley & Sons, Ltd.

Folding, calcium binding, and structural characterization of a concatemer of the first and second ligand-binding modules of the low-density lipoprotein receptor

The ligand-binding domain of the low-density lipoprotein (LDL) receptor is comprised of seven tandemly repeated ligand-binding modules, each being approximately 40 amino acids long and containing six conserved cysteine residues. We have expressed and characterized a concatemer of the first two modules (LB1 and LB2) of the human LDL receptor. Oxidative folding of the recombinant concatemer (rLB(1-2)), in the presence of calcium ions, gave a single dominant isomer with six disulfide bonds. Peptic cleavage of the short Linker region that connects the last cysteine residue of LB1 and the first cysteine residue of LB2 yielded two discrete fragments, thus excluding the presence of intermodule disulfide bonds. The N-terminal module, LB1, reacted with a conformation-specific monoclonal antibody (IgG-C7) made to LB1 in the native LDL receptor. From this, we concluded that the first module was correctly folded, with the same set of disulfide bonds as LB1 of the LDL receptor. The disulfide bond connections of LB2 were identified from mass spectral analysis of fragments formed by digestion of the C-terminal peptic fragment with elastase. These data showed that the disulfide bonds of LB2 connected Cys(I) and Cys(III), Cys(II) and Cys(V), and Cys(IV) and Cys(VI). This pattern is identical to that found for recombinant LB1 and LB2. The concatemer has two high-affinity calcium-binding sites, one per module. An analysis of the secondary chemical shifts of C alpha protons shows that the conformations of LB1 and LB2 in the concatemer are very similar to those of the individual modules, with no evidence for strong interactions between the two modules.

Perceptual quality metrics applied to still image compression

We present a review of perceptual image quality metrics and their application to still image compression. The review describes how image quality metrics can be used to guide an image compression scheme and outlines the advantages, disadvantages and limitations of a number of quality metrics. We examine a broad range of metrics ranging from simple mathematical measures to those which incorporate full perceptual models. We highlight some variation in the models for luminance adaptation and the contrast sensitivity function and discuss what appears to be a lack of a general consensus regarding the models which best describe contrast masking and error summation. We identify how the various perceptual components have been incorporated in quality metrics, and identify a number of psychophysical testing techniques that can be used to validate the metrics. We conclude by illustrating some of the issues discussed throughout the paper with a simple demonstration. (C) 1998 Elsevier Science B.V. All rights reserved.

Inference of phylogeny and taxonomy within the Didymozoidae (Digenea) from the second internal transcribed spacer (ITS2) of ribosomal DNA

DNA sequences of the second internal transcribed spacer (ITS2) of ribosomal DNA (rDNA) were determined for 11 species from four genera of Didymozoinae (Indodidymozoon, Helicodidymozoon, Rhopalotrema and Neometadidymozoon) and a species of the Lecithasteridae, Lecithaster stellatus. Sequences were used to test the validity of species recognised on morphological criteria and to infer phylogenetic relationships. Sequences of the 11 didymozoids differed by 0.5% to 19%. Our phylogenetic analyses: (i) indicate that species in the genera Helicodidymozoon and Rhopalotrema are a monophyletic group; (ii) support separation of the genus Helicodidymozoon from the genera Indodidymozoon and Neometadidymozoon; and (iii) support recognition of Rhopalotrema as a genus distinct from Neometadidymozoon. We found the gonochoristic species, I. pearsoni and I. suttiei, to be genetically similar to the hermaphroditic species in the genus Indodidymozoon and found no evidence to indicate that they belong in a separate genus.

Cannabis use and psychosis

This paper reviews evidence on two hypotheses about the relationship between cannabis use and psychosis. The first hypothesis is that heavy cannabis use may cause a cannabis psychosis-a psychosis that would not occur in the absence of cannabis use, the symptoms of which are preceded by heavy cannabis use and remit after abstinence. The second hypothesis is that cannabis use may precipitate schizophrenia, or exacerbate its symptoms. Evaluation of these hypotheses requires evidence of an association between cannabis use and psychosis, that is unlikely to be due to chance, in which cannabis use precedes psychosis, and in which we can exclude the hypothesis that the relationship is due to other factors, such as other drug use, or a personal vulnerability to psychosis. There is some clinical support for the first hypothesis. If these disorders exist they seem to be rare, because they require very high doses of THC, the prolonged use of highly potent forms of cannabis, or a pre-existing (but as yet unspecified) vulnerability. There is more support for the second hypothesis, in that a large prospective study has shown a linear relationship between the frequency with which cannabis has been used by age 18 and the risks over the subsequent 15 years of a diagnosis of schizophrenia. It is still unclear whether this means that cannabis use precipitates schizophrenia, whether it is a form of self-medication, or whether the association is due to the use of other drugs, such as amphetamines, which heavy cannabis users are more Likely to use. There is stronger evidence that cannabis use can exacerbate the symptoms of schizophrenia. Mental health services should identify patients with schizophrenia who use alcohol, cannabis and other drugs and advise them to abstain or to greatly reduce their drug use.