Diabetes as a tracer condition in international benchmarking of health systems

OBJECTIVE - To assess the performance of health systems using diabetes as a tracer condition. RESEARCH DESIGN AND METHODS - We generated a measure of case-fatality among young people with diabetes Using the mortalily-to-incidence ratio (M/I ratio) for 29 industrialized countries using published data on diabetes incidence and mortality. Standardized incidence rates for ages 0-14 years were extracted from the World Health Organization DiaMond Study for the period 1990-1994; data on death from diabetes for ages 0-39 years were obtained from the World Health Organization Mortality database and converted into age-standardized death rates for the period 1994-1998, using the European standard population. RESULTS - The MA ratio varied > 10-fold. These relative differences appear similar to those observed in cohort studies of mortality among young people with type I diabetes in five countries. A sensitivity analysis showed that using plausible assumptions about potential overestimation of diabetes as a cause of death and underestimation of incidence rates in the U.S. yields an M/I ratio that would still be twice as high as in the U.K. or Canada. CONCLUSIONS - The M/I ratio for diabetes provides a means of differentiating countries on quality of care for people with diabetes. It is solely an indicator of potential problems, a basis for Stimulating more detailed assessments of whether such problems exist, and what can be done to address them.

Reversible active switching of the mechanical properties of a peptide film at a fluid-fluid interface

Designer peptides have recently been developed as building blocks for novel self-assembled materials with stimuli-responsive properties. To date, such materials have been based on self-assembly in bulk aqueous solution or at solid-fluid interfaces. We have designed a 21-residue peptide, AM1, as a stimuli-responsive surfactant that switches molecular architectures at a fluid-fluid interface in response to changes in bulk aqueous solution composition. In the presence of divalent zinc at neutral pH, the peptide forms a mechanically strong 'film state'. In the absence of metal ions or at acid pH, the peptide adsorbs to form a mobile 'detergent state'. The two interfacial states can be actively and reversibly switched. Switching between the two states by a change in pH or the addition of a chelating agent leads to rapid emulsion coalescence or foam collapse. This work introduces a new class of surfactants that offer an environmentally friendly approach to control the stability of interfaces in foams, emulsions and fluid-fluid interfaces more generally.

Being fit and looking healthy: Young women's and men's constructions of health and fitness

We drew on Foucault's notion of 'practices of the self' to examine how young people take up, negotiate, and resist the imperatives of a public health discourse concerned with the relationships between health, fitness, and the body. We did this through a discussion of the ways young women and men talk about their own and others' bodies, in the context of a number of in-depth interviews conducted for the Life Activity Project, a study of the place and meaning of physical activity in young people's lives, funded by an Australian Research Council Grant. We found that the young women and men in the study engaged the health/fitness discourse very differently: for the young men, health conflated with fitness as an embodied capacity to do physical work; and for the young women, health was a much more difficult and complex project associated with managing and monitoring practices associated with eating and exercise to maintain an 'appropriate' body shape.

The provision of health information to stroke patients within an acute hospital setting: What actually happens and how do patients feel about it?

This preliminary study describes how health information is provided to stroke patients in an acute hospital and describes their perceptions of health information provision. A further aim was to determine if patients with aphasia were disadvantaged in their receipt of information. Seven stroke patients were observed in hospital for an average of 102 minutes each and then interviewed using a semi-structured interview. When communication occurred, only 17.5% of communication time was spent providing information. Patients with aphasia received information for less time and on fewer topics. Implications regarding approaches to information provision for patients with and without aphasia are discussed.

The handbook of physical education

What is the current condition of the field of physical education? How has it adapted to the rise of kinesiology, sport and exercise science and human movement studies over the last thirty years? This Handbook provides an authoritative critical overview of the field and identifies future challenges and directions. The Handbook is divided in to six parts: - Perspectives and Paradigms in Physical Education Pedagogy Research; - Cross-disciplinary Contributions to Research on Physical Education; - Learners and Learning in Physical Education; - Teachers, Teaching and Teacher Education in Physical Education; - Physical Education Curriculum; - Difference and Diversity in Physical Education. This benchmark work is essential reading for educators and students in the field of physical education.