The obesity epidemic in Sri Lanka revisited

Obesity has reached epidemic levels in most affluent countries. In contrast, South Asia is presently considered a minimally affected region as malnutrition and infectious diseases are still their main health concerns.1 South Asians have poor attitudes toward obesity and being obese is considered as a sign of prosperity...

‘Supersize me’ : on equine obesity

There’s nothing like travel to broaden the mind. As a young man living in Britain during the 1980s I thought I knew about human obesity, but it took a visit to the US to show me what an epidemic looks like. Nowadays I live in Australia, where human obesity is rife. We have plenty of fat horses too (Sillence et al., 2006), but they are noticeable. In fact, it was only recently during a return visit to Britain, that I was finally sold on the concept of an equine obesity epidemic. It seems that in the UK, the fat horse or pony is now so commonplace that it has come to represent the norm in the eyes of many owners. I met clinicians who claim to have forgotten what a fit horse looks like, and heard anecdotes of a responsible owner who kept their animals in a healthy body condition, only to be reported to the RSPCA for ‘cruelty’. Round and shiny have become the order of the day and, as we have learned from the tsunami of human obesity, once a problem reaches a certain scale it can seem unstoppable, despite the attendant risks, costs and consequences.

Near work-induced contrast adaptation in emmetropic and myopic children

Purpose. Contrast adaptation may induce an error signal for emmetropization. This research aims to determine whether reading causes contrast adaptation in children and, if so, to determine whether myopes exhibit greater contrast adaptation than emmetropes. Methods. Baseline contrast sensitivity was determined in 34 emmetropic and 34 spectacle-corrected myopic children for 0.5, 1.2, 2.7, 4.4, and 6.2 cycles per degree (cpd) horizontal sine-wave gratings. Effects of near tasks on contrast sensitivity were determined during periods spent looking at a 6.2 cpd horizontal grating and during periods spent reading lines of English text, with 1.2 cpd row frequency and 6 cpd stroke frequency. Results. Both emmetropic and myopic groups (mean ± SD; age, 10.3 ± 1.4 years) showed reduced contrast sensitivity during both near tasks, with greatest overall adaptation at 6.2 cpd. Adaptation induced by viewing the grating (0.15 ± 0.17 log unit [40%]; range, 0.07-0.27 log unit) was significantly greater than adaptation induced by reading text (0.11 ± 0.18 log unit [29%], 0.08-0.16 log unit) (F(1,594) = 10.7; P = 0.001). Myopic children showed significantly greater adaptation across the tasks (0.15 ± 0.18 log unit [42%]) than emmetropic children (0.10 ± 0.16 log unit [26%]) (F(1,66) = 7.30; P = 0.009), with the greatest difference occurring at 4.4 cpd (mean, 0.11 log unit [30%]). Conclusions. Grating and reading tasks induced contrast adaptation; viewing horizontal gratings induced greater adaptation than reading, and myopes exhibited greater adaptation than emmetropes. Contrast adaptation effects may underlie findings of prolonged near work being associated with myopia. However, our research does not show whether this is consequential or causal.

Change-induced stressors and effective coping strategies in nursing

This study seeks to examine the causality of non-nursing and nursing stressors on the job satisfaction of nurses and how coping strategies have a mediating influence on this relationship in the context of sector-wide reform. To conceptualize the relationships, a mediation path model was developed. Data were collected at two time points using a self-completed online survey over a six monthly interval. During time 1, 306 Australian nurses completed the online survey. In the first wave (time 1), 306 Australian nurses completed the survey. In the second wave (time 2), matched survey data were collected from 119 nurses. The analysis showed a significant causal relationship between time 1 administrative and role stressors and an increase in nursing stress in time 2. A significant relationship was also identified between job specific context stressors and the adoption of effective coping strategies to deal with increased level of change-induced stress and strain and the likelihood of reporting higher level of job satisfaction in time 2. This study contributes by providing an integrated theoretical perspective on how stress affects retention that has so far been elusive. This is useful to researchers wanting to examine this phenomenon further and practitioners responsible for implementing change programs.

Variation in risk seeking behavior in a natural experiment following a large negative wealth shock induced by a natural disaster

An ongoing challenge in behavioral economics is to understand the variations observed in risk attitudes as a function of their environmental context. Of particular interest is the effect of wealth on risk attitudes. The research in this area has however faced two constraints: the difficulty to study the causal effects of large changes in wealth, and the causal effects of losses on risk behavior. The present paper address this double limitation by providing evidence of the variation of risk attitude after large losses using a natural disaster (Brisbane floods) as the setting for a natural experiment.

Postpartum diet quality in Australian women following a gestational diabetes pregnancy

BACKGROUND/OBJECTIVES: To describe the diet quality of a national sample of Australian women with a recent history of gestational diabetes mellitus (GDM) and determine factors associated with adherence to national dietary recommendations. SUBJECTS/METHODS: A postpartum lifestyle survey with 1499 Australian women diagnosed with GDM p3 years previously. Diet quality was measured using the Australian recommended food score (ARFS) and weighted by demographic and diabetes management characteristics. Multinominal logistic regression analysis was used to determine the association between diet quality and demographic characteristics, health seeking behaviours and diabetes-related risk factors. RESULTS: Mean (±s.d.) ARFS was 30.9±8.1 from a possible maximum score of 74. Subscale component scores demonstrated that the nuts/legumes, grains and fruits were the most poorly scored. Factors associated with being in the highest compared with the lowest ARFS quintile included age (odds ratio (OR) 5-year increase=1.40; 95% (confidence interval) CI:1.16–1.68), tertiary education (OR=2.19; 95% CI:1.52–3.17), speaking only English (OR=1.92; 95% CI:1.19–3.08), being sufficiently physically active (OR=2.11; 95% CI:1.46–3.05), returning for postpartum blood glucose testing (OR=1.75; 95% CI:1.23–2.50) and receiving riskreduction advice from a health professional (OR=1.80; 95% CI:1.24–2.60). CONCLUSIONS: Despite an increased risk of type 2 diabetes, women in this study had an overall poor diet quality as measured by the ARFS. Women with GDM should be targeted for interventions aimed at achieving a postpartum diet consistent with the guidelines for chronic disease prevention. Encouraging women to return for follow-up and providing risk reduction advice may be positive initial steps to improve diet quality, but additional strategies need to be identified.

BRCA1 is an essential mediator of vinorelbine-induced apoptosis in mesothelioma

The rapeutic options for malignant pleural mesothelioma (MPM) are limited despite the increasing incidence globally. The vinca alkaloid vinorelbine exhibits clinical activity; however, to date, treatment optimization has not been achieved using biomarkers. BRCA1 regulates sensitivity to microtubule poisons; however, its role in regulating vinorelbine-induced apoptosis in mesothelioma is unknown. Here we demonstrate that BRCA1 plays an essential role in mediating vinorelbine-induced apoptosis, as evidenced by (1) the strong correlation between vinorelbine sensitivity and BRCA1 expression level; (2) induction of resistance to vinorelbine by BRCA1 using siRNA oligonucleotides; (3) dramatic down-regulation of BRCA1 following selection for vinorelbine resistance; and (4) the re-activation of vinorelbine-induced apoptosis following re-expression of BRCA1 in resistant cells. To determine whether loss of BRCA1 expression in mesothelioma was potentially relevant in vivo, BRCA1 immunohistochemistry was subsequently performed on 144 primary mesothelioma specimens. Loss of BRCA1 protein expression was identified in 38.9% of samples. Together, these data suggest that BRCA1 plays a critical role in mediating apoptosis by vinorelbine in mesothelioma, warranting its clinical evaluation as a predictive biomarker. Copyright © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Differentiating first episode substance induced and primary psychotic disorders with concurrent substance use in young people

Objective: Substance use is common in first-episode psychosis, and complicates the accurate diagnosis and treatment of the disorder. The differentiation of substance-induced psychotic disorders (SIPD) from primary psychotic disorders (PPD) is particularly challenging. This cross-sectional study compares the clinical, substance use and functional characteristics of substance using first episode psychosis patients diagnosed with a SIPD and PPD. Method: Participants were 61 young people (15-24 years) admitted to a psychiatric inpatient service with first episode psychosis, reporting substance use in the past month. Diagnosis was determined using the Psychiatric Research Interview for DSM-IV Substance and Mental disorders (PRISM-IV). Measures of clinical (severity of psychotic symptoms, level of insight, history of trauma), substance use (frequency/quantity, severity) and social and occupational functioning were also administered. Results: The PRISM-IV differentially diagnosed 56% of first episode patients with a SIPD and 44% with a PPD. Those with a SIPD had higher rates of substance use and disorders, higher levels of insight, were more likely to have a forensic and trauma history and had more severe hostility and anxious symptoms than those with a PPD. Logistic regression analysis indicated a family history of psychosis, trauma history and current cannabis dependence were the strongest predictors of a SIPD. Almost 80% of diagnostic predictions of a SIPD were accurate using this model. Conclusions: This clinical profile of SIPD could help to facilitate the accurate diagnosis and treatment of SIPD versus PPD in young people with first episode psychosis admitted to an inpatient psychiatric service.

A qualitative study of the determinants of dieting and non-dieting approaches in overweight/obese Australian adults.

Background Dieting has historically been the main behavioural treatment paradigm for overweight/obesity, although a non-dieting paradigm has more recently emerged based on the criticisms of the original dieting approach. There is a dearth of research contrasting why these approaches are adopted. To address this, we conducted a qualitative investigation into the determinants of dieting and non-dieting approaches based on the perspectives and experiences of overweight/obese Australian adults. Methods Grounded theory was used inductively to generate a model of themes contrasting the determinants of dieting and non-dieting approaches based on the perspectives of 21 overweight/obese adults. Data was collected using semi-structured interviews to elicit in-depth individual experiences and perspectives. Results Several categories emerged which distinguished between the adoption of a dieting or non-dieting approach. These categories included the focus of each approach (weight/image or lifestyle/health behaviours); internal or external attributions about dieting failure; attitudes towards established diets, and personal autonomy. Personal autonomy was also influenced by another category; the perceived knowledge and self-efficacy about each approach, with adults more likely to choose an approach they knew more about and were confident in implementing. The time perspective of change (short or long-term) and the perceived identity of the person (fat/dieter or healthy person) also emerged as determinants of dieting or non-dieting approaches respectively. Conclusions The model of determinants elicited from this study assists in understanding why dieting and non-dieting approaches are adopted, from the perspectives and experiences of overweight/obese adults. Understanding this decision-making process can assist clinicians and public health researchers to design and tailor dieting and non-dieting interventions to population subgroups that have preferences and characteristics suitable for each approach.

Calcite precipitation induced by clay-bleach cation exchange in andesitic reservoir rocks

Experiments were carried out on the sodium hypochlorite bleach sensitivity of a deep subsurface andesitic reservoir in order to predict possible deleterious mineral transformations during a downhole clean-up job. Experiments involved examination of core samples from the reservoir using an Environmental Scanning Electron Microscope (ESEM) with an attached Energy Dispersive Spectrometer (EDS) before and after the samples were immersed in bleach. Bleach immersion of whole-rock samples resulted in rapid (less than 1 min) precipitation of abundant 3.0-10.0-μm-wide calcite rhombs within clay-associated micropores and on clay and feldspar grain surfaces. Abundant microporefilling calcite rhombs also formed in pure separates of constituent chlorite/corrensite, whereas no calcite formed in a pure separate of constituent zeolite. These experiments indicate that corrensite is the likely calcium source in this experimental fluid-rock system. Formation of calcite occurs via a cation exchange reaction in which calcium in the smectitic interlayers of corrensite exchanges for sodium in the bleach. Serious formation damage due to calcite precipitation would have occurred in the andesite reservoir had it been exposed to bleach. This finding gives credence to earlier suggestions that cation exchange reactions have the potential to cause calcite precipitation in some sandstone reservoirs when exposed to drilling, completion or stimulation fluids. © 1993.

Does legal heritage affect obesity? The channel of motor vehicle dependence

We find a robust relationship between motor vehicle ownership, its interaction with legal heritage and obesity in OECD countries. Our estimates indicate that an increase of 100 motor vehicles per thousand residents is associated with about a 6% point increase in obesity in common law countries, whereas it has a much smaller or insignificant impact in civil law countries. These relations hold whether we examine trend data and simple correlations, or conduct cross-section or panel data regression analysis. Our results suggest that obesity rises with motor vehicle ownership in countries following a common law tradition where individual liberty is encouraged, whereas the link is small or statistically non-existent in countries with a civil law background where the rights of the individual tend to be circumscribed by the power of the state.

Paclitaxel resistance and multicellular spheroid formation are induced by kallikrein-related peptidase 4 in serous ovarian cancer cells in an ascites mimicking microenvironment

High tumor kallikrein-related-peptidase 4 (KLK4) levels are associated with a poor outcome for women with serous epithelial ovarian cancer (EOC), for which peritoneal dissemination and chemoresistance are key events. To determine the role of KLK4 in these events, we examined KLK4-transfected SKOV-3 and endogenous KLK4 expressing OVCA432 cells in 3-dimensional (3D) suspension culture to mimic the ascites microenvironment. KLK4-SKOV-3 cells formed multicellular aggregates (MCAs) as seen in ascites, as did SKOV-3 cells treated with active KLK4. MCA formation was reduced by treatment with a KLK4 blocking antibody or the selective active site KLK4 sunflower trypsin inhibitor (SFTI-FCQR). KLK4-MCAs formed larger cancer cell foci in mesothelial cell monolayers than those formed by vector and native SKOV-3 cells, suggesting KLK4-MCAs are highly invasive in the peritoneal microenvironment. A high level of KLK4 is expressed by ascitic EOC cells compared to matched primary tumor cells, further supporting its role in the ascitic microenvironment. Interestingly, KLK4 transfected SKOV-3 cells expressed high levels of the KLK4 substrate, urokinase plasminogen activator (uPA), particularly in 3D-suspension, and high levels of both KLK4 and uPA were observed in patient cells taken from ascites. Importantly, the KLK4-MCAs were paclitaxel resistant which was reversed by SFTI-FCQR and to a lesser degree by the general serine protease inhibitor, Aprotinin, suggesting that in addition to uPA, other as yet unidentified substrates of KLK4 must be involved. Nonetheless, these data suggest that KLK4 inhibition, in conjunction with paclitaxel, may improve the outcome for women with serous epithelial ovarian cancer and high KLK4 levels in their tumors.

The effects of acute exercise-induced cortisol on CCR2 expression on human monocytes

CC-chemokine receptor 2 (CCR2) and its ligand, monocyte chemotactic protein-1 (MCP-1, also known as CCL2), are crucial for the recruitment of monocytes/macrophages to sites of inflammation. We conducted a series of experiments to investigate the relationship between stress, monocyte CCR2 expression and migration activity. First, we collected peripheral blood mononuclear cells (PBMC) from untrained subjects (n=8) and measured CCR2 expression on CD14(+) monocytes cultured with cortisol, epinephrine and norepinephrine. Second, we collected PBMC from the subjects before and after they cycled for 60 min at 70% peak O(2) uptake (VO2(peak)), and measured alterations in CCR2 expression on monocytes following exercise. Third, we cultured PBMC with serum obtained before and after exercise and the glucocorticoid antagonist RU-486 to determine the effect of cortisol on CCR2 expression in vitro. Last, we measured the ability of PBMC treated with serum or cortisol to migrate through membrane filters in response to CCL2. Cortisol (but not epinephrine or norepinephrine) increased CCR2 expression on monocytes in a dose- and time-dependent manner. Exercise did not influence CCR2 expression on PBMC, whereas incubation of PBMC with post-exercise serum significantly increased CCR2 expression. Both cortisol and post-exercise serum increased the migration of PBMC toward CCL2. The increase in CCR2 expression on PBMC following stimulation with cortisol and serum was blocked by the glucocorticoid receptor antagonist RU-486. In conclusion, cortisol released during exercise increased monocyte CCR2 expression and migration activity in vitro. These alterations may influence inflammation and regeneration of damaged tissue after acute stress.

The effects of deep cracks on the rain-induced instability of slopes : A case study

Rainfall can disrupt the balance of natural soil slope. This imbalance will be accelerated by existence of cracks in soil slope, which lead to decreasing shear strength and increasing hydraulic conductivity of the soil slope. Some research works have been conducted on the effects of surface-cracks on slope stability. However, the influence of deep-cracks is yet to be investigated. Limited availability of deep crack data due to the lack of effective sub-soil investigation methods could be one of the obstacles. To emphasize the effects of deep cracks in soil slope on its rain-induced instability, a natural soil slope in Indonesia that failed in 31st October 2010 due to heavy rainfall was analyzed for stability with and without deep cracks in the slope. The slope stability analysis was conducted using SLOPE/W coupling with the results of transient seepage analysis (SEEP/W) that simulate the pore-water pressure development in the slope during the rainfall. The results of Electrical Resistivity Tomography (ERT) survey, bore-hole tests and geometrical survey conducted on the slope before its failure were used to identify the soil layers’ stratification including deep cracks, the properties of different soil layers, and geometrical parameters of the slope for the analysis. The results showed that it is vital to consider the existence of deep crack in soil slopes in analysing their instability induced by rainfalls.

Effects of slope inclination on the rain-induced instability of embankment slopes

Rainfall has been identified as one of the main causes for embankment failures in areas where high annual rainfall is experienced. The inclination of the embankment slope is important for its stability during rainfall. In this study, instrumented model embankments were subjected to artificial rainfalls to investigate the effects of the slope inclination on their stability. The results of the study suggested that when the slope inclination is greater than the friction angle of the soil, the failure is initiated by the loss of soil suction and when it is smaller than the friction angle of the soil, the failure is initiated by the positive pore water pressure developed at the toe of the slope. Further, slopes become more susceptible to sudden collapse during rainfall as the slope angle increases.