The health and cost implications of high body mass index in Australian Defence Force personnel.

BACKGROUND: Frequent illness and injury among workers with high body mass index (BMI) can raise the costs of employee healthcare and reduce workforce maintenance and productivity. These issues are particularly important in vocational settings such as the military, which require good physical health, regular attendance and teamwork to operate efficiently. The purpose of this study was to compare the incidence of injury and illness, absenteeism, productivity, healthcare usage and administrative outcomes among Australian Defence Force personnel with varying BMI. METHODS: Personnel were grouped into cohorts according to the following ranges for (BMI): normal (18.5-24.9 kg/m²; n = 197), overweight (25-29.9 kg/m²; n = 154) and obese (≥30 kg/m²) with restricted body fat (≤28 % for females, ≤24 % for males) (n = 148) and with no restriction on body fat (n = 180). Medical records for each individual were audited retrospectively to record the incidence of injury and illness, absenteeism, productivity, healthcare usage (i.e., consultation with medical specialists, hospital stays, medical investigations, prescriptions) and administrative outcomes (e.g., discharge from service) over one year. These data were then grouped and compared between the cohorts. RESULTS: The prevalence of injury and illness, cost of medical specialist consultations and cost of medical scans were all higher (p <0.05) in both obese cohorts compared with the normal cohort. The estimated productivity losses from restricted work days were also higher (p <0.05) in the obese cohort with no restriction on body fat compared with the normal cohort. Within the obese cohort, the prevalence of injury and illness, healthcare usage and productivity were not significantly greater in the obese cohort with no restriction on body fat compared with the cohort with restricted body fat. The number of restricted work days, the rate of re-classification of Medical Employment Classification and the rate of discharge from service were similar between all four cohorts. CONCLUSIONS: High BMI in the military increases healthcare usage, but does not disrupt workforce maintenance. The greater prevalence of injury and illness, greater healthcare usage and lower productivity in obese Australian Defence Force personnel is not related to higher levels of body fat.

Editorial photographs and patterns of practice

This paper proposes a new theoretical method to analyse patterns of photographic practice of editorial photography– using an ‘action genre’ approach (Lemke, 1995: 32). That is, rather than taking final photographic forms as being definitive of genre, this new method identifies patterns of ‘activity types’ involved in the production of editorial photography to be identified (1995: 32). While there has been much written on editorial photography, there is no organised body of scholarship that distinguishes between different modes of presenting patterns of photographic practice. Claims about the degree of influence of visual images and their ability to drive public opinion have not sufficiently considered the full impact of photographic production processes. Although patterns of activity in the image-making process are not directly evident in the published photograph, the process does impact upon the resulting meanings made.

Large body size in an island-dwelling bird : a microevolutionary analysis

Island races of passerine birds display repeated evolution towards larger body size compared with their continental ancestors. The Capricorn silvereye (Zosterops lateralis chlorocephalus) has become up to six phenotypic standard deviations bigger in several morphological measures since colonization of an island approximately 4000 years ago. We estimated the genetic variance-covariance (G) matrix using full-sib and 'animal model' analyses, and selection gradients, for six morphological traits under field conditions in three consecutive cohorts of nestlings. Significant levels of genetic variance were found for all traits. Significant directional selection was detected for wing and tail lengths in one year and quadratic selection on culmen depth in another year. Although selection gradients on many traits were negative, the predicted evolutionary response to selection of these traits for all cohorts was uniformly positive. These results indicate that the G matrix and predicted evolutionary responses are consistent with those of a population evolving in the manner observed in the island passerine trend, that is, towards larger body size.

Optimal image sample size for corneal nerve morphometry

Purpose Arbitrary numbers of corneal confocal microscopy images have been used for analysis of corneal subbasal nerve parameters under the implicit assumption that these are a representative sample of the central corneal nerve plexus. The purpose of this study is to present a technique for quantifying the number of random central corneal images required to achieve an acceptable level of accuracy in the measurement of corneal nerve fiber length and branch density. Methods Every possible combination of 2 to 16 images (where 16 was deemed the true mean) of the central corneal subbasal nerve plexus, not overlapping by more than 20%, were assessed for nerve fiber length and branch density in 20 subjects with type 2 diabetes and varying degrees of functional nerve deficit. Mean ratios were calculated to allow comparisons between and within subjects. Results In assessing nerve branch density, eight randomly chosen images not overlapping by more than 20% produced an average that was within 30% of the true mean 95% of the time. A similar sampling strategy of five images was 13% within the true mean 80% of the time for corneal nerve fiber length. Conclusions The “sample combination analysis” presented here can be used to determine the sample size required for a desired level of accuracy of quantification of corneal subbasal nerve parameters. This technique may have applications in other biological sampling studies.

Whole-body substrate metabolism is associated with disease severity in patients with non-alcoholic fatty liver disease

Objectives In non-alcoholic fatty liver disease (NAFLD), hepatic steatosis is intricately linked with a number of metabolic alterations. We studied substrate utilisation in NAFLD during basal, insulin-stimulated and exercise conditions, and correlated these outcomes with disease severity. Methods 20 patients with NAFLD (mean±SD body mass index (BMI) 34.1±6.7 kg/m2) and 15 healthy controls (BMI 23.4±2.7 kg/m2) were assessed. Respiratory quotient (RQ), whole-body fat (Fatox) and carbohydrate (CHOox) oxidation rates were determined by indirect calorimetry in three conditions: basal (resting and fasted), insulin-stimulated (hyperinsulinaemic–euglycaemic clamp) and exercise (cycling at an intensity to elicit maximal Fatox). Severity of disease and steatosis were determined by liver histology, hepatic Fatox from plasma β-hydroxybutyrate concentrations, aerobic fitness expressed as , and visceral adipose tissue (VAT) measured by computed tomography. Results Within the overweight/obese NAFLD cohort, basal RQ correlated positively with steatosis (r=0.57, p=0.01) and was higher (indicating smaller contribution of Fatox to energy expenditure) in patients with NAFLD activity score (NAS) ≥5 vs <5 (p=0.008). Both results were independent of VAT, % body fat and BMI. Compared with the lean control group, patients with NAFLD had lower basal whole-body Fatox (1.2±0.3 vs 1.5±0.4 mg/kgFFM/min, p=0.024) and lower basal hepatic Fatox (ie, β-hydroxybutyrate, p=0.004). During exercise, they achieved lower maximal Fatox (2.5±1.4 vs. 5.8±3.7 mg/kgFFM/min, p=0.002) and lower (p<0.001) than controls. Fatox during exercise was not associated with disease severity (p=0.79). Conclusions Overweight/obese patients with NAFLD had reduced hepatic Fatox and reduced whole-body Fatox under basal and exercise conditions. There was an inverse relationship between ability to oxidise fat in basal conditions and histological features of NAFLD including severity of steatosis and NAS

User participation in the categorisation of the State Library of Queensland digital image collections: characteristics, motivations and experiences

In 2010, the State Library of Queensland (SLQ) donated their out-of-copyright Queensland images to Wikimedia Commons. One direct effect of publishing the collections at Wikimedia Commons is the ability of general audiences to participate and help the library in processing the images in the collection. This paper will discuss a project that explored user participation in the categorisation of the State Library of Queensland digital image collections. The outcomes of this project can be used to gain a better understanding of user participation that lead to improving access to library digital collections. Two techniques for data collection were used: documents analysis and interview. Document analysis was performed on the Wikimedia Commons monthly reports. Meanwhile, interview was used as the main data collection technique in this research. The data collected from document analysis was used to help the researchers to devise appropriate questions for interviews. The interviews were undertaken with participants who were divided into two groups: SLQ staff members and Wikimedians (users who participate in Wikimedia). The two sets of data collected from participants were analysed independently and compared. This method was useful for the researchers to understand the differences between the experiences of categorisation from both the librarians’ and the users’ perspectives. This paper will provide a discussion on the preliminary findings that have emerged from each group participant. This research provides preliminary information about the extent of user participation in the categorisation of SLQ collections in Wikimedia Commons that can be used by SLQ and other interested libraries in describing their digital content by their categorisations to improve user access to the collection in the future.

The grow-shrink-and-turncoat

This reversible garment, the grow-shrink-and-turncoat, is constructed in modules which allow it to be extended or tightened depending on the wearer. Later, it can be disassembled and then reassembled to form a new garment. The laser-cut holes allow for layers of cloth to be added or removed. The design was developed in part from a brainstorming activity with first and second year QUT students – their ideas included a garment which can be taken apart, a garment to fit many people, and most intriguingly, a garment that can open and ‘grow’ like a flower, swelling up in cold weather to warm the body. Taking these ideas, I developed a garment which can be disassembled, with layers added or subtracted by the wearer according to aesthetics and / or comfort. The shell is constructed from six squares of laser cut cloth, draped together with six smaller laser-cut rectangles, held in place with removable stitching. Additional squares and rectangles of cloth can be added / subtracted with ties knotted through the laser-cut holes. The laser cutting becomes a patterning device as well as integral to the construction of the garment. Conceptually, the garment is grounded in the notion of fabric as a precious resource – the pieces are designed to be disassembled at end-of-life, and then reconfigured into a fresh design.

Rotorcraft collision avoidance using spherical image-based visual servoing and single point features

This paper presents a reactive collision avoidance method for small unmanned rotorcraft using spherical image-based visual servoing. Only a single point feature is used to guide the aircraft in a safe spiral like trajectory around the target, whilst a spherical camera model ensures the target always remains visible. A decision strategy to stop the avoidance control is derived based on the properties of spiral like motion, and the effect of accurate range measurements on the control scheme is discussed. We show that using a poor range estimate does not significantly degrade the collision avoidance performance, thus relaxing the need for accurate range measurements. We present simulated and experimental results using a small quad rotor to validate the approach.

Diet, physical activity and substrate oxidation : implications for appetite control, weight loss and body composition

In many countries, governments and health agencies are strongly promoting physical activity as a means to prevent the accumulation of fatness that leads to weight gain and obesity. However, there is often a resistance to respond to health promotion initiatives. For example, in the UK, the Chief Medical Officer has recently reported that 71% of women and 61% of men fail to carry out even the minimal amount of physical activity recommended in the government’s guidelines. Similarly, the Food safety Agency has promoted reductions in the intake of fat, sugar and salt but with very little impact on the pattern of consumption. Why is it that recommendations to improve health are so difficult to implement, and produce the desired outcome?

Negligible heat strain in armored vehicle officers wearing personal body armor

Objectives This study evaluated the heat strain experienced by armored vehicle officers (AVOs) wearing personal body armor (PBA) in a sub-tropical climate. Methods Twelve male AVOs, aged 35-58 years, undertook an eight hour shift while wearing PBA. Heart rate and core temperature were monitored continuously. Urine specific gravity (USG) was measured before and after, and with any urination during the shift. Results Heart rate indicated an intermittent and low-intensity nature of the work. USG revealed six AVOs were dehydrated from pre through post shift, and two others became dehydrated. Core temperature averaged 37.4 ± 0.3°C, with maximum's of 37.7 ± 0.2°C. Conclusions Despite increased age, body mass, and poor hydration practices, and Wet-Bulb Globe Temperatures in excess of 30°C; the intermittent nature and low intensity of the work prevented excessive heat strain from developing.

Effect of body position on measurements of diffusion capacity after exercise

Background--Pulmonary diffusing capacity for carbon monoxide (Dlco), alveolar capillary membrane diffusing capacity (Dm), and pulmonary capillary blood volume (Vc) are all significantly reduced after exercise. Objective--To investigate whether measurement position affects this impaired gas transfer. Methods--Before and one, two, and four hours after incremental cycle ergometer exercise to fatigue, single breath Dlco, Dm, and Vc measurements were obtained in 10 healthy men in a randomly assigned supine and upright seated position. Results--After exercise, Dlco, Dm, and Vc were significantly depressed compared with baseline in both positions. The supine position produced significantly higher values over time for Dlco (5.22 (0.13) v 4.66 (0.15) ml/min/mm Hg/l, p = 0.022) and Dm (6.78 (0.19) v 6.03 (0.19) ml/min/mm Hg/l, p = 0.016), but there was no significant position effect for Vc. There was a similar pattern of change over time for Dlco, Dm, and Vc in the two positions. Conclusions--The change in Dlco after exercise appears to be primarily due to a decrease in Vc. Although the mechanism for the reduction in Vc cannot be determined from these data, passive relocation of blood to the periphery as the result of gravity can be discounted, suggesting that active vasoconstriction of the pulmonary vasculature and/or peripheral vasodilatation is occurring after exercise.

Image based flow visualisation of experimental flow fields inside a gross pollutant trap

Typical flow fields in a stormwater gross pollutant trap (GPT) with blocked retaining screens were experimentally captured and visualised. Particle image velocimetry (PIV) software was used to capture the flow field data by tracking neutrally buoyant particles with a high speed camera. A technique was developed to apply the Image Based Flow Visualization (IBFV) algorithm to the experimental raw dataset generated by the PIV software. The dataset consisted of scattered 2D point velocity vectors and the IBFV visualisation facilitates flow feature characterisation within the GPT. The flow features played a pivotal role in understanding gross pollutant capture and retention within the GPT. It was found that the IBFV animations revealed otherwise unnoticed flow features and experimental artefacts. For example, a circular tracer marker in the IBFV program visually highlighted streamlines to investigate specific areas and identify the flow features within the GPT.

Finitude (V03)

WHAT: An interactive installation with full body interface, digital projection, multi-touch sensitive screen surfaces, interactive 3D gaming software, motorised dioramas, 4.1 spatial sound & new furniture forms - investigating the cultural dimensions of sustainability through the lens of 'time'. “Time is change, time is finitude. Humans are a finite species. Every decision we make today brings that end closer, or alternatively pushes it further away. Nothing can be neutral”. Tony Fry DETAILS: Each participant/viewer lies comfortably on their back. Directly above them is a semi-transparent Perspex screen that displays projected 3D imagery and is simultaneously sensitive to the lightest of finger touches. Depending upon the ever changing qualities of the projected image on this screen the participant can see through its surface to a series of physical dioramas suspended above, lit by subtle LED spotlighting. This diorama consists of a slowly rotating series of physical environments, which also include several animatronic components, allowing the realtime composition of whimsical ‘landscapes’ of both 'real' and 'virtual' media. Through subtle, non-didactic touch-sensitive interactivity the participant then has influence over both the 3D graphic imagery, the physical movements of the diorama and the 4 channel immersive soundscape, creating an uncanny blend of physical and virtual media. Five speakers positioned around the room deliver a rich interactive soundscape that responds both audibly and physically to interactions.

Upper-body morbidity after breast cancer : incidence and evidence for evaluation, prevention, and management within a prospective surveillance model of care

The purpose of this paper is to review the incidence of upper-body morbidity (arm and breast symptoms, impairments, and lymphedema), methods for diagnosis, and prevention and treatment strategies. It was also the purpose to highlight the evidence base for integration of prospective surveillance for upper-body morbidity within standard clinical care of women with breast cancer. Between 10% and 64% of women report upper-body symptoms between 6 months and 3 years after breast cancer, and approximately 20% develop lymphedema. Symptoms remain common into longer-term survivorship, and although lymphedema may be transient for some, those who present with mild lymphedema are at increased risk of developing moderate to severe lymphedema. The etiology of morbidity seems to be multifactorial, with the most consistent risk factors being those associated with extent of treatment. However, known risk factors cannot reliably distinguish between those who will and will not develop upper-body morbidity. Upper-body morbidity may be treatable with physical therapy. There is also evidence in support of integrating regular surveillance for upper-body morbidity into the routine care provided to women with breast cancer, with early diagnosis potentially contributing to more effective management and prevention of progression of these conditions.