Quality of diabetes care and coronary heart disease absolute risk in patients with type 2 diabetes mellitus in Australian general practice

Objective: To examine the quality of diabetes care and prevention of cardiovascular disease (CVD) in Australian general practice patients with type 2 diabetes and to investigate its relationship with coronary heart disease absolute risk (CHDAR). Methods: A total of 3286 patient records were extracted from registers of patients with type 2 diabetes held by 16 divisions of general practice (250 practices) across Australia for the year 2002. CHDAR was estimated using the United Kingdom Prospective Diabetes Study algorithm with higher CHDAR set at a 10 year risk of >15%. Multivariate multilevel logistic regression investigated the association between CHDAR and diabetes care. Results: 47.9% of diabetic patient records had glycosylated haemoglobin (HbA1c) >7%, 87.6% had total cholesterol >= 4.0 mmol/l, and 73.8% had blood pressure (BP) >= 130/85 mm Hg. 57.6% of patients were at a higher CHDAR, 76.8% of whom were not on lipid modifying medication and 66.2% were not on antihypertensive medication. After adjusting for clustering at the general practice level and age, lipid modifying medication was negatively related to CHDAR (odds ratio (OR) 0.84) and total cholesterol. Antihypertensive medication was positively related to systolic BP but negatively related to CHDAR (OR 0.88). Referral to ophthalmologists/optometrists and attendance at other health professionals were not related to CHDAR. Conclusions: At the time of the study the diabetes and CVD preventive care in Australian general practice was suboptimal, even after a number of national initiatives. The Australian Pharmaceutical Benefits Scheme (PBS) guidelines need to be modified to improve CVD preventive care in patients with type 2 diabetes.

Dating the dreaming? Creation of myths and rituals for mounds along the northern Australian coastline

Shell mounds ceased to be built in many parts of coastal northern Australia about 800-600 years ago. They are the subject of stories told by Aboriginal people and some have been incorporated in ritual and political activities during the last 150 ears. These understandings emerged only after termination of the economic and environmental system that created them, 800-600 years ago, in a number of widely separated coastal regions, Modern stories and treatments of these mounds by Aboriginal people concern modern or near-modern practices. Modern views of the mounds, their mythological and ritual associations, may be explained by reference to the socioeconomic transitions seen in the archaeological record; but the recent cultural, social and symbolic statements about these places cannot inform us of the process or ideology concerned with the formation of the mounds. Many Aboriginal communities over the last half a millennium actively,formed understandings of new landscapes and systems of land use. Attempts to impose historic ideologies and cosmologies on earlier times fail to acknowledge the magnitude and rate of economic and ideological change on the tropical coastline of Australia.

The effects of air pollution on hospitalizations for cardiovascular disease in elderly people in Australian and New Zealand cities

OBJECTIVE: The goal of this study was to estimate the associations between outdoor air pollution and cardiovascular hospital admissions for the elderly. DESIGN: Associations were assessed using the case-crossover method for seven cities: Auckland and Christchurch, New Zealand; and Brisbane, Canberra, Melbourne, Perth, and Sydney Australia. Results were combined across cities using a random-effects meta-analysis and stratified for two adult age groups: 15-64 years and >= 65 years of age (elderly). Pollutants considered were nitrogen dioxide, carbon monoxide, daily measures of particulate matter (PM) and ozone. Where multiple pollutant associations were found, a matched case-control analysis was used to identify the most consistent association. RESULTS: In the elderly, all pollutants except 03 were significantly associated with five categories or cardiovascular disease admissions. No associations were found for arrhythmia and stroke. For a 0.9-ppm increase in CO, there were significant increases in elderly hospital admissions for total cardiovascular disease (2.2%), all cardiac disease (2.8%), cardiac failure (6.0%), ischemic heart disease (2.3%), and myocardial infarction (2.9%). There was some heterogeneity between cities, possibly due to differences in humidity and the percentage of elderly people. In matched analyses, CO had the most consistent association. CONCLUSIONS. The results suggest that air pollution arising from common emission sources for CO, NO2, and PM (e.g., motor vehicle exhausts) has significant associations with adult cardiovascular hospital admissions, especially in the elderly, at air pollution concentrations below normal health guidelines. RELEVANCE TO CLINICAL AND PROFESSIONAL PRACTICE: Elderly populations in Australia need to be protected from air pollution arising from outdoor sources to reduce cardiovascular disease.

The response of native Australian rodents to predator odours varies seasonally: a by-product of life history variation?

Small mammals are subject to predation from mammalian, avian and reptilian predators. There is an obvious advantage for prey species to detect the presence of predators in their environment, enabling them to make decisions about movement and foraging behaviour based on perceived risk of predation. We examined the effect of faecal odours from marsupial and eutherian predators, and a native reptilian predator, on the behaviour of three endemic Australian rodent species (the fawn-footed melomys, Melomys cervinipes, the bush rat, Rattus fuscipes, and the giant white-tailed rat, Uromys caudimaculatus) in rainforest remnants on the Atherton Tableland, North Queensland, Australia. Infrared camera traps were used to assess visit rates of rodents to odour stations containing faecal and control odours. Rodents avoided odour stations containing predator faeces, but did not avoid herbivore or control odours. The responses of the three prey species differed: in the late wet season U. caudimaculatus avoided predator odours, whereas R. fuscipes and M. cervinipes did not. In contrast, in the late dry season all three species avoided odour stations containing predator odours. We speculate that these different responses may result from variation in life history traits between the species. (c) 2006 The Association for the Study of Animal Behaviour Published by Elsevier Ltd. All rights reserved.

The Australian species of Lobatocreadium Madhavi, 1972, Hypocreadium Ozaki, 1936 and Dermadena Manter, 1945 (Digenea: Lepocreadiidae), parasites of marine tetraodontiform fishes

The genera Lobatocreadium, Pseudocreadium, Hypocreadium and Dermadena are redefined and host lists given. Provisional keys to species of Lobatocreadium, Hypocreadium and Dermadena are presented. The following species are described from (1) the Great Barrier Reef: Lobatocreadium exiguum from Balistapus undulatus and Sufflamen bursa; Hypocreadium cavum n. sp. from Abalistes stellatus (type-host) and Cantheschenia grandisquamis; H. grandisquamis n. sp. from Cantheschenia grandisquamis; Dermadena spatiosa n. sp, from Cantheschenia grandisquamis; and (2) southwestern Australia: D. stirlingi n. sp. from Meeschenia hippocrepis. The following new combinations are made: Lobatocreadium vitellosum (Ozaki, 1936) n. comb. (originally Leptocreadium); Hypocrendium balistes (Nagaty, 1942) n. comb. (originally Pseudocreadium); H. biminensis (Sogandares-Bernal, 1959) n. comb. (originally Pseudocreadium); H. indicum (Madhavi, 1972) n. comb. (originally Pseudocreadium); and H. galapagoensis (Manter, 1945) n. comb. (originally Pseudocreadium). Several nominal species of Pseudocreadium and Hypocreadium are considered incertae sedis.

New chromenols from a southern Australian tunicate, Aplidium solidum

Two new chromenols, namely (R)-2-methyl-2-(4-methylpenta-1,3-dienyl)-2H-chromen-6-ol (7) and 1-[(R)-6-hydroxy-2-methyl-2H-chromen-2-yl]-4-methylpentan-2-one (8), have been isolated from a southern Australian tunicate, Aplidium solidum. The structures of (7) and (8) were assigned by spectroscopic analysis, and the absolute stereochemistry of (7) by chemical degradation.

Improved method for counting virus and virus like particles

An improved method for counting virus and virus like particles by electron microscopy (EM) was developed. The procedure involves the determination of the absolute concentration of pure or semi-pure particles once deposited evenly on EM grids using either centrifugation or antibody capture techniques. The counting of particles was done with a Microfiche unit which enlarged approximately 50 x the image of particles on a developed negative film which had been taken at a relatively low magnification (2500 x) by EM. Initially, latex particles of a known concentration were counted using this approach, to prove the accuracy of the technique. The latex particles were deposited evenly on an EM grid using centrifugation (Modified Beckmen EM-90 Airfuge technique). Subsequently, recombinant Bluetongue virus (BTV) core-like particles (CLPs) captured by a Monoclonal antibody using a hovel sample loading method were counted by the Microfiche unit method and by a direct EM method. Comparison of the simplified counting method developed with a conventional method, showed good agreement. The method is simple, accurate, rapid, and reproducible when used with either pure particles or with particles from crude cell culture extracts.

Dictyosphaerin: A novel bicyclic lipid from a southern Australian marine green algae, Dictyosphaeria sericea

The novel bicyclic lipid, dictyosphaerin (1), has been isolated from the southern Australian marine green alga Dictyosphaeria sericea. The molecular structure for 1 was secured by chemical derivatization and detailed spectroscopic analysis.

Sulfated galactans from Australian specimens of the red alga Phacelocarpus peperocarpos (Gigartinales, Rhodophyta)

Polysaccharides from the red alga Phacelocarpos peperocarpos were extracted with hot water, clarified, and precipitated with 2-propanol. The native preparation was highly sulfated (36.2% w/w). Alkali modification decreased the sulfate content by 2.0% w/w. The alkali-modified polysaccharide is composed mostly of galactose (Gal, 51 mol%) and 3,6-anhydrogalactose (AnGal, 41 mol%), with minor amounts of a mono-O-methylgalactose (MeGal, 1 mol%), xylose (Xyl, 6 mol%), and glucose (Glc, 1 mol%). The FTIR spectrum of the alkali-modified polysaccharide resembled K-carrageenan with absorption at 930 cm(-1) (indicative of AnGal) and 850 cm(-1) (Gal ii-sulfate). However, an additional, major band of absorption occurred at 820 cm(-1) indicating the presence of equatorial sulfate ester substitution at O-6 of Gal residues, A combination of linkage and C-13 NMR spectroscopic analyses showed that the polysaccharide was composed predominantly of a novel repeating-unit, O-beta-D-galactopyranosyl 4,6-disulfate)-(1 --> 4)-3,6-anhydro-alpha-D-galactopyranose. Minor structural variations also occurred, including alternative patterns of sulfation and the presence of terminal Xylp, The location of the terminal Xylp residues was not certain but evidence supported their attachment at O-3 of some 4-linked Galp residues. The cell-wall galactans remain unchanged during the life cycle of the alga. (C) 1996 Elsevier Science Ltd.

Preptetos and Neopreptetos (Digenea: Lepocreadiidae) from Australian marine fishes

The genera Preptetos Pritchard, 1960 and Neopreptetos Machida, 1982 are redefined. The following species are described and/or recorded from marine fishes. From the Great Barrier Reef: Preptetos caballeroi Pritchard, 1960 in Naso annulatus, N. brevirostris and N. vlamingii; P. xesuri (Yamaguti, 1940) in Zebrasoma veliferum and Z.scopas; Preptetos cannoni Barker, Bray et Cribb, 1993 in Siganus doliatus and S. fuscescens; Preptetas luguncula sp. n. in Naso unicoris (type-host); P. impar sp. n. in Lutjanus erythropterus (type-host) and L. malabaricus; Neopreptetos arursettae Machida, 1982 in Pomacanthus semicirculatus; and N. kurochkini (Toman, 1989) in Chaetodontoplus meredithi. From southwestern Australia: Preptetos rotto sp. n. in Nelusetta ayraudi (type-host), Neosebastes pandus, Oplegnathus woodwardi and Pagrus auratus. The new combination Preptetos trulla (Linton, 1907) (originally Distormum then Lepocreadium) is made and the species Lepocreadium areolatum (Linton, 1900) is considered likely to belong in Preptetos.

CD4+T cells from HIV-1-infected patients recognize wild-type and mutant human immunodeficiency virus-1 protease epitopes

P>Human immunodeficiency virus (HIV)-1 protease is a known target of CD8+ T cell responses, but it is the only HIV-1 protein in which no fully characterized HIV-1 protease CD4 epitopes have been identified to date. We investigated the recognition of HIV-1 protease by CD4+ T cells from 75 HIV-1-infected, protease inhibitor (PI)-treated patients, using the 5,6-carboxyfluorescein diacetate succinimidyl ester-based proliferation assay. In order to identify putative promiscuous CD4+ T cell epitopes, we used the TEPITOPE algorithm to scan the sequence of the HXB2 HIV-1 protease. Protease regions 4-23, 45-64 and 73-95 were identified; 32 sequence variants of the mentioned regions, encoding frequent PI-induced mutations and polymorphisms, were also tested. On average, each peptide bound to five of 15 tested common human leucocyte antigen D-related (HLA-DR) molecules. More than 80% of the patients displayed CD4+ as well as CD8+ T cell recognition of at least one of the protease peptides. All 35 peptides were recognized. The response was not associated with particular HLA-DR or -DQ alleles. Our results thus indicate that protease is a frequent target of CD4+ along with CD8+ proliferative T cell responses by the majority of HIV-1-infected patients under PI therapy. The frequent finding of matching CD4+ and CD8+ T cell responses to the same peptides may indicate that CD4+ T cells provide cognate T cell help for the maintenance of long-living protease-specific functional CD8+ T cells.

Human immunodeficiency virus test-seeking blood donors in a large blood bank in Sao Paulo, Brazil

BACKGROUND: Persons with human immunodeficiency virus (HIV) risk behaviors are excluded from donation to reduce the risk of transfusion-transmitted infection. Persons donating to be tested for HIV may therefore deny risk behaviors. STUDY DESIGN AND METHODS: A random sample of donors completed a survey on motivations, knowledge, and attitudes on the screening process. Donors were considered test seekers if they agreed with two statements ""I think that blood donation is a good, fast, and anonymous way to get my blood tested"" and ""I donate to get my test results."" This study was conducted from June to November 2006 at the largest blood bank in Sao Paulo, Brazil. RESULTS: Of 3061 participants, 208 (7%) were test seekers. They tended to be male and had a lower educational level. They were more likely to have incorrect knowledge about blood safety (e.g., not knowing that a unit can test antibody negative and still transmit infection, 60% vs. 42%, p = 0.02), express dissatisfaction with screening questions (e.g., feeling that important questions were not asked, 14% vs. 5%, p < 0.01), and concur that donors do not answer questions truthfully (e.g., donors have more sexual partners than they admit, 29% vs. 18%, p < 0.01). Test seekers were more likely to believe that it is acceptable to donate blood to get tested for HIV (41% vs. 10%, p < 0.01). CONCLUSIONS: Test-seeking motivation, coupled with low knowledge of window period risk, is counter to improving blood safety and to donor prevention needs. Donor education needs to be improved along with availability of appropriate HIV counseling and testing.