Physical activity behaviours of adults in the Greater Green Triangle region of rural Australia

Objective: To assess physical activity (PA) behaviours of adults in rural Australia.

Design and setting: Three cross-sectional surveys in the Greater Green Triangle area covering the south-east of South Australia (Limestone Coast), and south-west (Corangamite Shire) and north-west (Wimmera) of Victoria during 2004–2006.

Participants: A total of 1546 persons, aged 25– 74 years, randomly selected from the electoral roll.

Main outcome measures: Overall PA, leisure-time PA, occupational PA, active commuting and moderate-to-vigorous PA.

Results: Approximately 80% of participants, more women than men, engaged in 30 minutes or more of daily PA. Only 30% (95% CI 26.3, 33.0) of men and 21% (95% CI 18.3, 23.9) of women did moderate-to-vigorous PA for at least 20–30 minutes four or more times a week. In leisure time, most participants were moderately active; almost one-fifth were inactive and another fifth highly active. Two-thirds of men engaged in high-level occupational PA, compared with one-sixth of women. Only 30% of participants actively commuted to work. There was a tendency for a positive association between income level and leisure-time PA.

Conclusions: One-fifth of adults in rural Australia were inactive. While there was a high prevalence of participants who engaged in daily PA, few did so at moderate-to-vigorous intensity to achieve health benefits. As occupational PA is difficult to change, improvements in levels of PA are more likely during leisure-time and for some people by engaging in commuting PA.

Prevalence, detection and drug treatment of hypertension in a rural Australian population : the Greater Green Triangle Risk Factor Study 2004

Background: Hypertension is an important risk factor for cardiovascular disease; however, limited findings are available on its detection and management in rural Australia.

Aim: To assess the prevalence, awareness and treatment of hypertension in a rural South-East Australian population.

Methods: Three cross-sectional surveys in Limestone Coast, Corangamite Shire and Wimmera regions during 2004–2006 using a random population sample (n = 3320, participation rate 49%) aged 25–74 years. Blood pressure was measured by trained nurses. Information on history of hypertension and medication was obtained by questionnaires. Hypertension was defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and/or on antihypertensive drug treatment.

Results: Overall, one-third of participants had hypertension; of these, two-thirds, 54% (95% confidence interval (CI) 47–60) of men and 71% (95% CI 65–77) of women, were aware of their condition. Half of the participants with hypertension were treated and nearly half of these were controlled. Both treatment and control were more common in women (60%, 95% CI 54–67 and 55%, 95% CI 47–64) compared with men (42%, 95% CI 36–49 and 35%, 95% CI 26–44). Monotherapy was used by 55% (95% CI 48–61) of treated hypertensives. Angiotensin-converting enzyme inhibitors were the most frequently used class of antihypertensive drugs in men, whereas angiotensin-converting enzyme inhibitors, angiotensin receptor antagonists and diuretics were all widely used among women.

Conclusion: This study emphasizes suboptimal detection and treatment of hypertension, especially in men, in rural Australia.

Dyslipidaemia in rural Australia : prevalence, awareness, and adherence to treatment guidelines in the Greater Green Triangle risk factor study

Objectives: To determine population lipid profiles, awareness of hyperlipidaemia and adherence to Australian lipid management guidelines.
Design and setting: Population survey in rural south-eastern Australia, 2004–2006.
Participants: Stratified random sample from the electoral roll. Data from 1274 participants (40%) aged 25–74 years were analysed.
Main outcome measures: Population mean total, low-density lipoprotein and high-density lipoprotein cholesterol (TC, LDL-C and HDL-C) and triglyceride (TG) concentrations, prevalence of dyslipidaemia, and treatment according to 2001 and 2005 Australian guideline target levels.
Results: Population-adjusted mean TC, TG, LDL-C and HDL-C concentrations were 5.38 mmol/L (95% CI, 5.30–5.45), 1.50 mmol/L (95% CI, 1.43–1.56), 3.23 mmol/L (95% CI, 3.16–3.30) and 1.46 mmol/L (95% CI, 1.44–1.49), respectively. Prevalence of hypercholesterolaemia (TC > 5.5 mmol/L or on treatment) was 48%. Lipid-lowering medication use was reported by 12%. Seventy-seven of 183 participants with established cardiovascular disease (CVD) or diabetes were untreated, and of the 106 treated, 59% reached the target LDL-C. Of those without CVD or diabetes already treated, 38% reached target LDL-C, and 397 participants at high absolute risk did not receive primary prevention. Ninety-five per cent of treated individuals with CVD or diabetes and 86% of others treated had cholesterol measured in the previous year. Sixty-nine per cent of individuals at low risk aged over 45 years had their cholesterol measured within the previous 5 years.
Conclusions: A comprehensive national strategy for lowering mean population cholesterol is required, as is better implementation of absolute risk management guidelines — particularly in rural populations.

A semiotic view of Dewey's times and Habermas's lifeworlds

John Dewey (1859-1952) explained how life was ‘corporatised’ at the time of rampant, laissez faire capitalism in early 20th century America. This paper refers Dewey’s observations to Habermas’s notions of the colonisation of the lifeworld. The semiotic and pragmatist approaches of Charles Saunders Peirce are then enlisted to look further into these lifeworld changes. The
paper suggests modifications to Habermas’s schema to bring it more in line with Dewey’s empirical account. It puts together a theoretically and empirically informed picture of the contemporary disruption to ways of living and the accompanying social and political instability. The paper then goes on to suggest how that instability appears to have been quelled by communicative means. These stages of: (1) stability; (2) disruption/instability; and (3) the regaining of stability are compared to Habermas’s notions of: (1) an original lifeworld; (2) colonisation of that lifeworld by the consequences of purposive rational activity; then (3) communicative action which ‘rebuilds’— that is which replaces or modifies or reforms or repairs—the disrupted lifeworld in order to create a new lifeworld. ‘Colonisation’ could be said to have provoked social instability. Notions of building a new ‘lifeworld’—a new cultural and psychic reference—could be said to correspond with attempts to resume social and political stability. The implication is that whatever the degree of purposive rationalism there is always a need for a return to some level of shared values and
understandings which imply communicative rationality. This ‘return’ or ‘counter-colonisation’ can be thought of as operating via a ‘lifeworld negotiation’ which might best be understood with reference to a Peircean based pragmatism-semiotic theory of human subjectivity. This paper
has been criticised for discussing “arguments” which: “would justify those who accommodated themselves to Nazism.” What this paper in fact tries to do is to use the concepts of the above three philosophers to try to account for the ways people think. This paper is not about justifying what philosophies people should hold. It is presumed that most readers are sensible and ethical and can make their own minds up in that respect. Rather it attempts to draw from Dewey, Habermas and Peirce to offer a characterisation of what philosophies might be argued to be held and to offer an explanation about how these modes of thinking might be said to have come into existence.
This paper rejects the notion that ones ‘will’ and thus the way one is able to think, is totally free and beyond the formative influences of the social-cultural context—including the influences of public relations and other persuasive discourse industries.

Chronic disease risk factors in rural Australia : results from the Greater Green Triangle risk factor surveys

The aim of this article was to assess the level and prevalence of major chronic disease risk factors among rural adults. Two cross-sectional surveys were carried out in 2004 and 2005 in the southeast of South Australia and the southwest of Victoria. Altogether 891 randomly selected persons aged 25 to 74 years participated in the studies. Surveys included a self-administered questionnaire, physical measurements, and a venous blood specimen for lipid analyses. Two thirds of participants had cholesterol levels ≥5.0 mmol/L. The prevalence of high diastolic blood pressure (≥90 mm Hg) was 22% for men and 10% for women in southeast of South Australia, and less than 10% for both sexes in southwest of Victoria. Two thirds of participants were overweight or obese (body mass index ≥25 kg/m2). About 15% of men and slightly less women were daily smokers. The abnormal risk factor levels underline the need for targeted prevention activities in the Greater Green Triangle region. Continuing surveillance of levels and patterns of risk factors is fundamentally important for planning and evaluating preventive activities.