The influence of family history of hypertension on disease prevalence and associated metabolic risk factors among Sri Lankan adults

Background Hypertension is a major contributor to the global non-communicable disease burden. Family history is an important non-modifiable risk factor for hypertension. The present study aims to describe the influence of family history (FH) on hypertension prevalence and associated metabolic risk factors in a large cohort of South Asian adults, from a nationally representative sample from Sri Lanka. Methods A cross-sectional survey among 5,000 Sri Lankan adults, evaluating FH at the levels of parents, grandparents, siblings and children. A binary logistic regression analysis was performed in all patients with ‘presence of hypertension’ as dichotomous dependent variable and using family history in parents, grandparents, siblings and children as binary independent variables. The adjusted odds ratio controlling for confounders (age, gender, body mass index, diabetes, hyperlipidemia and physical activity) are presented below. Results In all adults the prevalence of hypertension was significantly higher in patients with a FH (29.3 %, n = 572/1951) than those without (24.4 %, n = 616/2530) (p < 0.001). Presence of a FH significantly increased the risk of hypertension (OR:1.29; 95 % CI:1.13-1.47), obesity (OR:1.36; 95 % CI: 1.27–1.45), central obesity (OR:1.30; 95 % CI 1.22–1.40) and metabolic syndrome (OR:1.19; 95 % CI: 1.08–1.30). In all adults presence of family history in parents (OR:1.28; 95 % CI: 1.12–1.48), grandparents (OR:1.34; 95 % CI: 1.20–1.50) and siblings (OR:1.27; 95 % CI: 1.21–1.33) all were associated with significantly increased risk of developing hypertension. Conclusions Our results show that the prevalence of hypertension was significantly higher in those with a FH of hypertension. FH of hypertension was also associated with the prevalence of obesity, central obesity and metabolic syndrome. Individuals with a FH of hypertension form an easily identifiable group who may benefit from targeted interventions.

‘We are here to make history’: The United Nations climate summit 2014

In the wake of the 400,000 strong Climate March in New York and the Flood Wall Street protest, the United Nations hosted a Climate Summit in New York on the 23 September 2014. The event was intended to be a catalyst for the development of a binding, fair, and ambitious international agreement upon climate change.

The empire of cancer: Gene patents and cancer voices

In his book, The Emperor of All Maladies, Siddhartha Mukherjee writes a history of cancer — "It is a chronicle of an ancient disease — once a clandestine, 'whispered-about' illness — that has metamorphosed into a lethal shape-shifting entity imbued with such penetrating metaphorical, medical, scientific, and political potency that cancer is often described as the defining plague of our generation." Increasingly, an important theme in the history of cancer is the role of law, particularly in the field of intellectual property law. It is striking that a number of contemporary policy debates over intellectual property and public health have concerned cancer research, diagnosis, and treatment. In the area of access to essential medicines, there has been much debate over Novartis’ patent application in respect of Glivec, a treatment for leukaemia. India’s Supreme Court held that the Swiss company’s patent application violated a safeguard provision in India’s patent law designed to stop evergreening. In the field of tobacco control, the Australian Government introduced plain packaging for tobacco products in order to address the health burdens associated with the tobacco epidemic. This regime was successfully defended in the High Court of Australia. In the area of intellectual property and biotechnology, there have been significant disputes over the Utah biotechnology company Myriad Genetics and its patents in respect of genetic testing for BRCA1 and BRCA2, which are related to breast cancer and ovarian cancer. The Federal Court of Australia handed down a decision on the validity of Myriad Genetics’ patent in respect of genetic testing for BRCA1 in February 2013. The Supreme Court of the United States heard a challenge to the validity of Myriad Genetics’ patents in this area in April 2013, and handed down a judgment in July 2013. Such disputes have involved tensions between intellectual property rights, and public health. This article focuses upon one of these important test cases involving intellectual property, public health, and cancer research. In June 2010, Cancer Voices Australia and Yvonne D’Arcy brought an action in the Federal Court of Australia against the validity of a BRCA1 patent — held by Myriad Genetics Inc, the Centre de Recherche du Chul, the Cancer Institute of Japan and Genetic Technologies Limited. Yvonne D’Arcy — a Brisbane woman who has had treatment for breast cancer — maintained: "I believe that what they are doing is morally and ethically corrupt and that big companies should not control any parts of the human body." She observed: "For my daughter, I've had her have [sic] mammograms, etc, because of me but I would still like her to be able to have the test to see if the mutation gene is in there from me." The applicants made the following arguments: "Genes and the information represented by human gene sequences are products of nature universally present in each individual, and the information content of a human gene sequence is fixed. Genetic variations or mutations are products of nature. The isolation of the BRCA1 gene mutation from the human body constitutes no more than a medical or scientific discovery of a naturally occurring phenomenon and does not give rise to a patentable invention." The applicants also argued that "the alleged invention is not a patentable invention in that, so far as claimed in claims 1–3, it is not a manner of manufacture within the meaning of s 6 of the Statute of Monopolies". The applicants suggested that "the alleged invention is a mere discovery". Moreover, the applicants contended that "the alleged invention of each of claims 1-3 is not a patentable invention because they are claims for biological processes for the generation of human beings". The applicants, though, later dropped the argument that the patent claims related to biological processes for the generation of human beings. In February 2013, Nicholas J of the Federal Court of Australia considered the case brought by Cancer Voices Australia and Yvonne D’Arcy against Myriad Genetics. The judge presented the issues in the case, as follows: "The issue that arises in this case is of considerable importance. It relates to the patentability of genes, or gene sequences, and the practice of 'gene patenting'. Briefly stated, the issue to be decided is whether under the Patents Act 1990 (Cth) a valid patent may be granted for a claim that covers naturally occurring nucleic acid — either deoxyribonucleic acid (DNA) or ribonucleic acid (RNA) — that has been 'isolated'". In this context, the word "isolated" implies that naturally occurring nucleic acid found in the cells of the human body, whether it be DNA or RNA, has been removed from the cellular environment in which it naturally exists and separated from other cellular components also found there. The genes found in the human body are made of nucleic acid. The particular gene with which the patent in suit is concerned (BRCA1) is a human breast and ovarian cancer disposing gene. Various mutations that may be present in this gene have been linked to various forms of cancer including breast cancer and ovarian cancer.' The judge held in this particular case that Myriad Genetics’ patent claims were a "manner of manufacture" under s 6 of the Statute of Monopolies and s 18(1)(a) of the Patents Act 1990 (Cth). The matter is currently under appeal in the Full Court of the Federal Court of Australia. This article interprets the dispute over Myriad Genetics in light of the scholarly work of Nobel Laureate Professor Joseph Stiglitz on inequality. Such work has significant explanatory power in the context of intellectual property and biotechnology. First, Stiglitz has contended that "societal inequality was a result not just of the laws of economics, but also of how we shape the economy — through politics, including through almost every aspect of our legal system". Stiglitz is concerned that "our intellectual property regime … contributes needlessly to the gravest form of inequality." He maintains: "The right to life should not be contingent on the ability to pay." Second, Stiglitz worries that "some of the most iniquitous aspects of inequality creation within our economic system are a result of 'rent-seeking': profits, and inequality, generated by manipulating social or political conditions to get a larger share of the economic pie, rather than increasing the size of that pie". He observes that "the most iniquitous aspect of this wealth appropriation arises when the wealth that goes to the top comes at the expense of the bottom." Third, Stiglitz comments: "When the legal regime governing intellectual property rights is designed poorly, it facilitates rent-seeking" and "the result is that there is actually less innovation and more inequality." He is concerned that intellectual property regimes "create monopoly rents that impede access to health both create inequality and hamper growth more generally." Finally, Stiglitz has recommended: "Government-financed research, foundations, and the prize system … are alternatives, with major advantages, and without the inequality-increasing disadvantages of the current intellectual property rights system.’" This article provides a critical analysis of the Australian litigation and debate surrounding Myriad Genetics’ patents in respect of genetic testing for BRCA1. First, it considers the ruling of Nicholas J in the Federal Court of Australia that Myriad Genetics’ patent was a manner of manufacture as it related to an artificially created state of affairs, and not mere products of nature. Second, it examines the policy debate over gene patents in Australia, and its relevance to the litigation involving Myriad Genetics. Third, it examines comparative law, and contrasts the ruling by Nicholas J in the Federal Court of Australia with developments in the United States, Canada, and the European Union. Fourth, this piece considers the reaction to the decision of Nicholas at first instance in Australia. Fifth, the article assesses the prospects of an appeal to the Full Federal Court of Australia over the Myriad Genetics’ patents. Finally, this article observes that, whatever happens in respect of litigation against Myriad Genetics, there remains controversy over Genetic Technologies Limited. The Melbourne firm has been aggressively licensing and enforcing its related patents on non-coding DNA and genomic mapping.

Revising history for cost-informed process improvement

Organisations are constantly seeking new ways to improve operational efficiencies. This study investigates a novel way to identify potential efficiency gains in business operations by observing how they were carried out in the past and then exploring better ways of executing them by taking into account trade-offs between time, cost and resource utilisation. This paper demonstrates how these trade-offs can be incorporated in the assessment of alternative process execution scenarios by making use of a cost environment. A number of optimisation techniques are proposed to explore and assess alternative execution scenarios. The objective function is represented by a cost structure that captures different process dimensions. An experimental evaluation is conducted to analyse the performance and scalability of the optimisation techniques: integer linear programming (ILP), hill climbing, tabu search, and our earlier proposed hybrid genetic algorithm approach. The findings demonstrate that the hybrid genetic algorithm is scalable and performs better compared to other techniques. Moreover, we argue that the use of ILP is unrealistic in this setup and cannot handle complex cost functions such as the ones we propose. Finally, we show how cost-related insights can be gained from improved execution scenarios and how these can be utilised to put forward recommendations for reducing process-related cost and overhead within organisations.

The evolutionary history of termites as inferred from 66 mitochondrial genomes

Termites have colonized many habitats and are among the most abundant animals in tropical ecosystems, which they modify considerably through their actions. The timing of their rise in abundance and of the dispersal events that gave rise to modern termite lineages is not well understood. To shed light on termite origins and diversification, we sequenced the mitochondrial genome of 48 termite species and combined them with 18 previously sequenced termite mitochondrial genomes for phylogenetic and molecular clock analyses using multiple fossil calibrations. The 66 genomes represent most major clades of termites. Unlike previous phylogenetic studies based on fewer molecular data, our phylogenetic tree is fully resolved for the lower termites. The phylogenetic positions of Macrotermitinae and Apicotermitinae are also resolved as the basal groups in the higher termites, but in the crown termitid groups, including Termitinae + Syntermitinae + Nasutitermitinae + Cubitermitinae, the position of some nodes remains uncertain. Our molecular clock tree indicates that the lineages leading to termites and Cryptocercus roaches diverged 170 Ma (153-196 Ma 95% confidence interval [CI]), that modern Termitidae arose 54 Ma (46-66 Ma 95% CI), and that the crown termitid group arose 40 Ma (35-49 Ma 95% CI). This indicates that the distribution of basal termite clades was influenced by the final stages of the breakup of Pangaea. Our inference of ancestral geographic ranges shows that the Termitidae, which includes more than 75% of extant termite species, most likely originated in Africa or Asia, and acquired their pantropical distribution after a series of dispersal and subsequent diversification events.

Origins of Australian Football: Victoria's Early History. Volume 3: Covert 'Professionalism': The Power of the Wealthy Clubs 1886 to 1890

This volume continues the story of football in Marvellous Melbourne during the 1880s. At this time the VFA continued to expand as Melbourne’s boom continued apace. In 1886 Port Melbourne, Prahran, St Kilda, Footscray and South Williamstown joined the competition, and the Ballarat clubs Ballarat, Ballarat Imperial and South Ballarat were also contending for the VFA premiership. In 1886 matches were divided into four quarters, goal umpires waved two flags to announce a goal, and time clocks and bells were employed to mark the end of quarters. Victoria also played inter-colonial matches against New South Wales, Tasmania and South Australia. VFA secretary T.S. Marshall was at the forefront of fighting the game’s turn towards professionalism, but although it was illegal to pay players, the practice continued. The period 1886 to 1890 also set the stage for the eventual formation of the Victorian Football League, for by the end of the 1880s the Victorian Football Association had become in effect a two-tier competition. The most popular clubs in the VFA, South Melbourne, Geelong, Carlton and Essendon collected the lion’s share of the gate money, which they used to build their wealth and entrench their position as the dominant Victorian teams. The lower tier clubs had to make do with paltry gate money and season fixtures that advantaged the strong clubs. In these fixtures the strong clubs elected to play each other first to increase their gate money, and only deemed to play the poorer clubs at the start of the season. This led to an increasing divide between the VFA’s rich and poor, and by 1890 South Williamstown and Prahran merged with Williamstown and St Kilda respectively, University dropped out of senior ranks, and the Ballarat clubs were excluded from competing for the VFA premiership, which left 12 senior clubs until Collingwood’s emergence in 1892. At this time, no team was as powerful as South Melbourne, which experienced the greatest success in the club’s VFA and VFL history when it collected triple premiership crowns in 1888, 1889, and 1890. South Melbourne was a most ambitious club and spearheaded the move towards professionalism, although this could not be made public. The fine teams it produced at this time contained some of the greatest players of the era, such as Peter Burns, “Sonny” Elms and “Dinny” McKay, and it looked after players with health insurance, jobs, inter-colonial trips, and other incentives. Geelong’s premiership in 1886 was perhaps its greatest triumph, but this success was followed by a premiership drought that would last for 39 years. Carlton remained one of Victorian football’s power clubs, and after securing the premiership in 1887 continued to compete for top honours. As always, the game became ever more popular and world record crowds of over 30,000 attended matches between South Melbourne, Carlton, Geelong and Essendon.

Light history-dependent respiration explains the hysteresis in the daily ecosystem metabolism of seagrass

Oxygen flux between aquatic ecosystems and the water column is a measure of ecosystem metabolism. However, the oxygen flux varies during the day in a “hysteretic” pattern: there is higher net oxygen production at a given irradiance in the morning than in the afternoon. In this study, we investigated the mechanism responsible for the hysteresis in oxygen flux by measuring the daily pattern of oxygen flux, light, and temperature in a seagrass ecosystem (Zostera muelleri in Swansea Shoals, Australia) at three depths. We hypothesised that the oxygen flux pattern could be due to diel variations in either gross primary production or respiration in response to light history or temperature. Hysteresis in oxygen flux was clearly observed at all three depths. We compared this data to mathematical models, and found that the modification of ecosystem respiration by light history is the best explanation for the hysteresis in oxygen flux. Light history-dependent respiration might be due to diel variations in seagrass respiration or the dependence of bacterial production on dissolved organic carbon exudates. Our results indicate that the daily variation in respiration rate may be as important as the daily changes of photosynthetic characteristics in determining the metabolic status of aquatic ecosystems.

Introducing Design History Lectures 2015

This compilation of slides from eleven lectures spans the core content themes about design history including: what, when, how, where, who, why, heritage and future history. Examples are drawn for these design disciplines: architecture, fashion, industrial design, interactive & visual design, interior design, and landscape architecture.

Plantar pressure in diabetic peripheral neuropathy patients with active foot ulceration, previous ulceration and no history of ulceration: A meta-analysis of observational studies

Aims Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. Methods Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP) and pressure time integral (PTI) were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310). Results Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290–0.811, p<0.001; and 0.762, 95% CI 0.303–1.221, p = 0.001, respectively). Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181– 0.753, p = 0.001). Statistical heterogeneity between studies was moderate. Conclusions Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings.

The iconic and the critical

Theodor Adorno was opposed to the cinema because he felt it was too close to reality, and ipso facto an extension of ideological Capital, as he wrote in 1944 in Dialectic of Enlightenment. What troubled Adorno was the iconic nature of cinema – the semiotic category invented by C. S. Peirce where the signifier (sign) does not merely signify, in the arbitrary capacity attested by Saussure, but mimics the formal-visual qualities of its referent. Iconicity finds its perfect example in the film’s ingenuous surface illusion of an unmediated reality – its genealogy (the iconic), since classical antiquity, lay in the Greek term eikōn which meant “image,” to refer to the ancient portrait statues of victorious athletes which were thought to bear a direct similitude with their parent divinities. For the postwar, Hollywood-film spectator, Adorno said, “the world outside is an extension of the film he has just left,” because realism is a precise instrument for the manipulation of the mass spectator by the culture industry, for which the filmic image is an advertisement for the world unedited. Mimesis, or the reproduction of reality, is a “mere reproduction of the economic base.” It is precisely film’s iconicity, then, its “realist aesthetic . . . [that] makes it inseparable from its commodity character.”...

Australia's disabling income support system: Tracing the history of the disability pension from 1908 to today

This article is based on a historical-comparative policy and discourse analysis of the principles underpinning the Australian disability income support system. It determines that these principles rely on a conception of disability that sustains a system of coercion and paternalism that perpetuates disability and referred to as disablism. The article examines the construction of disability in Australian income support across four major historical epochs spanning the period 1908-2007. Contextualisation of the policy trajectory and discourses of the contemporary disability pension regime for the time period 2008-now is also provided. Two major themes were found to have interacted with the ideology of disablism. This article argues that a non-disabling provision based on social citizenship, rather than responsible or productive citizenship, counters the tendency for authoritarian and paternal approaches. [Abridged]

The function of the RNA-binding protein TEL1 in moss reveals ancient regulatory mechanisms of shoot development

The shoot represents the basic body plan in land plants. It consists of a repeated structure composed of stems and leaves. Whereas vascular plants generate a shoot in their diploid phase, non-vascular plants such as mosses form a shoot (called the gametophore) in their haploid generation. The evolution of regulatory mechanisms or genetic networks used in the development of these two kinds of shoots is unclear. TERMINAL EAR1-like genes have been involved in diploid shoot development in vascular plants. Here, we show that disruption of PpTEL1 from the moss Physcomitrella patens, causes reduced protonema growth and gametophore initiation, as well as defects in gametophore development. Leafy shoots formed on ΔTEL1 mutants exhibit shorter stems with more leaves per shoot, suggesting an accelerated leaf initiation (shortened plastochron), a phenotype shared with the Poaceae vascular plants TE1 and PLA2/LHD2 mutants. Moreover, the positive correlation between plastochron length and leaf size observed in ΔTEL1 mutants suggests a conserved compensatory mechanism correlating leaf growth and leaf initiation rate that would minimize overall changes in plant biomass. The RNA-binding protein encoded by PpTEL1 contains two N-terminus RNA-recognition motifs, and a third C-terminus non-canonical RRM, specific to TEL proteins. Removal of the PpTEL1 C-terminus (including this third RRM) or only 16–18 amino acids within it seriously impairs PpTEL1 function, suggesting a critical role for this third RRM. These results show a conserved function of the RNA-binding PpTEL1 protein in the regulation of shoot development, from early ancestors to vascular plants, that depends on the third TEL-specific RRM.