Quality of life related to oral versus subcutaneous iron chelation: a time trade-off study

Objective: To investigate the utility associated with subcutaneous infusion (deferoxamine) compared with once-daily oral administration (deferasirox) of iron chelation therapy.

Methods: Interviews using the time trade-off technique were used to estimate preferences (utility) for health states by finding the point at which respondents were indifferent between a longer but lower quality of life (QoL) and a shorter time in full health. Participants (n = 110) were community-based, 51% women, median age 35 years, from four regions in Sydney, Australia. Respondents rated three health states involving equal outcomes for people with thalassemia but with different treatment modalities for iron chelation; an "anchor state" describing a patient receiving iron chelation without administration mode specified, anchor state plus iron chelation via subcutaneous infusion, and anchor state plus iron chelation through once-daily oral medication.

Results: On an interval scale between 0 (death) and 1 (full health), median (interquartile range) utility of 0.80 (0.65–0.95) for the anchor state, 0.66 (0.45–0.87) for subcutaneous infusion, and 0.93 (0.80–0.97) for once-daily oral administration was obtained. The mean (median) difference of 0.23 (0.27) between the two treatments was statistically significant (Wilcoxon-signed rank test, P < 0.001). Subcutaneous infusion was associated with a mean (median) utility 0.13 (0.14) lower than the anchor state (P < 0.001), and once-daily oral treatment had a utility 0.10 (0.13) higher (P < 0.001).

Conclusion: Community respondents associate oral administration of an iron chelator such as deferasirox with enhanced QoL compared with subcutaneous treatment. Assuming equal safety and efficacy, QoL gains from once-daily oral treatment compared with subcutaneous infusion are significant.

Family influences on children's physical activity and fruit and vegetable consumption

Background : There is evidence of a clustering of healthy dietary patterns and physical activity among young people and also of unhealthy behaviours. The identification of influences on children's health behaviors, particularly clustered health behaviors, at the time at which they develop is imperative for the design of interventions. This study examines associations between parental modelling and support and children's physical activity (PA) and consumption of fruit and vegetables (FV), and combinations of these behaviours.

Methods : In 2002/3 parents of 775 Australian children aged 10–12 years reported how frequently their child ate a variety of fruits and vegetables in the last week. Children wore accelerometers for eight days during waking hours. Parental modelling and parental support (financial and transport) were self-reported. Binary logistic and multinomial logistic regression analyses examined the likelihood of achieving ≥ 2 hours of PA per day (high PA) and of consuming ≥ 5 portions of FV per day (high FV) and combinations of these behaviors (e.g. high PA/low FV), according to parental modelling and support.

Results : Items of parental modelling and support were differentially associated with child behaviours. For example, girls whose parents reported high PA modelling had higher odds of consuming ≥ 5 portions of FV/day (OR = 1.95, 95% CI = 1.32–2.87, p < 0.001). Boys whose parents reported high financial support for snacks/fast foods had higher odds of having 'high PA/low FV' (OR = 2.0, 95% CI = 1.1–3.7).

Conclusion : Parental modelling of and support for physical activity and fruit and vegetable consumption were differentially associated with these behaviours in children across behavioural domains and with combinations of these behaviours. Promoting parents' own healthy eating and physical activity behaviours as well encouraging parental modelling and support of these behaviours in their children may be important strategies to test in future research.

Effects of alternate phases of fish oil and vegetable oil-based diets in Murray cod

Fish oil (FO)- and canola oil (CO)-based diets were regularly alternated in a daily cycle (amCO: alternation of CO in the morning and FO in the afternoon, and pmCO: alternation of FO in the morning and CO in the afternoon) or in a series of weekly cycles (2W: alternation of 2 weeks on CO and 2 weeks on FO, 4W: alternation of 4 weeks on CO and 4 weeks on FO), over a 16-week period in juvenile Murray cod (Maccullochella peelii peelii). No significant differences were observed between any of the treatments in relation to the final weight. However, fish subjected to the 2W schedule were larger (P>0.05) than all other treatments (37.2 ± 0.30 vs. 34.3 ± 0.58 in the control treatment). Fish receiving the 2W treatment had a significantly lower total net disappearance of eicosapentaenoic acid 20:5n-3 (EPA) and docosahexaenoic acid 22:6n-3 (62.1% and 24.0% respectively) compared with the control treatment (fish continuously fed a blend of 50% FO and 50% CO). Likewise, Murray cod receiving the amCO daily schedule had a significantly lower total net disappearance of EPA in comparison with the CD and pmCO treatments. These data point towards the existence of cyclical mechanisms relative to fatty acid utilization/retention.

'Waltzing Matilda' - registrable as a trade mark or not? (first instance decision)

In brief: The Federal Court has ruled against an application to register the trade mark 'WALTZING MATILDA' for a variety of foods and associated services. It found that the Winton Shire Council and the Waltzing Matilda Centre Limited (also in Winton, Queensland) had the better rights to ownership of the Australian icon – despite them not having coined the term 'Waltzing Matilda'.

Progress report : 'Waltzing Matilda' trade mark case (appeal decision)

In brief: In our August 2002 Bulletin, we reported on the decision of a single judge in the Federal Court that the Winton Shire Council in Queensland and the Waltzing Matilda Centre Limited (also in Winton) had better rights to ownership of the Australian icon 'WALTZING MATILDA', based on prior trade mark use, than the original applicant for the trade mark, Brenda Lomas. Ms Lomas has now won an appeal against this decision in the Full Court of the Federal Court.

Trade commitments in education services : the need to move out of the current impasse

Education services is included as part of the General Agreement on Trade in Services (GATS). This inclusion, however, has not gone without its critics, and discussions about the liberalization of education remain distinctly polarized. This article seeks to bring a more balanced debate to the mix by presenting the case of New Zealand, one of the most liberalized World Trade Organization (WTO) Members in trade in education services. Through this case study, it is discussed how New Zealand has chosen to shape the growth of the education market and steer its developments by including controlled mechanisms as part of its regulatory framework.