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Review of Spatiality and Symbolic Expression: On the Links between Place and Culture edited by Bill Richardson
No full textReview of Spatiality and Symbolic Expression: On the Links between Place and Culture edited by Bill Richardso
Health-related quality of life measured using the EQ-5D-5L: South Australian population norms.
No full textOpen AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
Although a five level version of the widely-used EuroQol 5 dimensions (EQ-5D) instrument has been developed, population norms are not yet available for Australia to inform the future valuation of health in economic evaluations. The aim of this study was to estimate HrQOL normative values for the EQ-5D-5L preference-based measure in a large, randomly selected, community sample in South Australia.
Methods
The EQ-5D-5L instrument was included in the 2013 South Australian Health Omnibus Survey, an interviewer-administered, face-to-face, cross-sectional survey. Respondents rated their level of impairment across dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) and global health rating on a visual analogue scale (EQ-VAS). Utility scores were derived using the newly-developed UK general population-based algorithm and relationships between utility and EQ-VAS scores and socio-demographic factors were also explored using multivariate regression analyses.
Results
Ultimately, 2,908 adults participated in the survey (63.4 % participation rate). The mean utility and EQ-VAS scores were 0.91 (95 CI 0.90, 0.91) and 78.55 (95 % CI 77.95, 79.15), respectively. Almost half of respondents reported no problems across all dimensions (42.8 %), whereas only 7.2 % rated their health >90 on the EQ-VAS (100 = the best health you can imagine). Younger age, male gender, longer duration of education, higher annual household income, employment and marriage/de facto relationships were all independent, statistically significant predictors of better health status (p < 0.01) measured with the EQ-VAS. Only age and employment status were associated with higher utility scores, indicating fundamental differences between these measures of health status.
Conclusions
This is the first Australian study to apply the EQ-5D-5L in a large, community sample. Overall, findings are consistent with EQ-5D-5L utility and VAS scores reported for other countries and indicate that the majority of South Australian adults report themselves in full health. When valuing health in Australian economic evaluations, the utility population norms can be used to estimate HrQOL. More generally, the EQ-VAS score may be a better measure of population health given the smaller ceiling effect and broader coverage of HrQOL dimensions. Further research is recommended to update EQ-5D-5L population norms using the Australian general population specific scoring algorithm once this becomes publically available
Communities for Children Final Report: KidStuff and the use of Communities for Children programs
No full textThe evaluation of the KidStuff for Young Parents programs provided by the Communities for Children initiative (CfC) is presented here. This report is divided into three sections. The first section presents the background information on the CfC initiative including an outline of the demographic and epidemiological outcomes for children in the area of focus for this evaluation. Additionally, the introduction outlines some of the theoretical basis for the models of care and the therapeutic models of care that are common in all the programs provided. The second section describes the implementation of the programs and the evaluation of the programs based on the therapeutic models of care specific to the KidStuff for young parent’s program provided by Metropolitan Youth Health through Anglicare SA, and UnitingCare Wesley, Port Adelaide communities for Children programs. The third section of this report provides the results of the research; discussions; conclusions, and a set of recommendations for future program improvements and research
Mothers after Gestational Diabetes in Australia (MAGDA): A Randomised Controlled Trial of a Postnatal Diabetes Prevention Program
No full textThis is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Background
Gestational diabetes mellitus (GDM) is an increasingly prevalent risk factor for type 2 diabetes. We evaluated the effectiveness of a group-based lifestyle modification program in mothers with prior GDM within their first postnatal year.
Methods and Findings
In this study, 573 women were randomised to either the intervention (n = 284) or usual care (n = 289). At baseline, 10% had impaired glucose tolerance and 2% impaired fasting glucose. The diabetes prevention intervention comprised one individual session, five group sessions, and two telephone sessions. Primary outcomes were changes in diabetes risk factors (weight, waist circumference, and fasting blood glucose), and secondary outcomes included achievement of lifestyle modification goals and changes in depression score and cardiovascular disease risk factors. The mean changes (intention-to-treat [ITT] analysis) over 12 mo were as follows: −0.23 kg body weight in intervention group (95% CI −0.89, 0.43) compared with +0.72 kg in usual care group (95% CI 0.09, 1.35) (change difference −0.95 kg, 95% CI −1.87, −0.04; group by treatment interaction p = 0.04); −2.24 cm waist measurement in intervention group (95% CI −3.01, −1.42) compared with −1.74 cm in usual care group (95% CI −2.52, −0.96) (change difference −0.50 cm, 95% CI −1.63, 0.63; group by treatment interaction p = 0.389); and +0.18 mmol/l fasting blood glucose in intervention group (95% CI 0.11, 0.24) compared with +0.22 mmol/l in usual care group (95% CI 0.16, 0.29) (change difference −0.05 mmol/l, 95% CI −0.14, 0.05; group by treatment interaction p = 0.331). Only 10% of women attended all sessions, 53% attended one individual and at least one group session, and 34% attended no sessions. Loss to follow-up was 27% and 21% for the intervention and control groups, respectively, primarily due to subsequent pregnancies. Study limitations include low exposure to the full intervention and glucose metabolism profiles being near normal at baseline.
Conclusions
Although a 1-kg weight difference has the potential to be significant for reducing diabetes risk, the level of engagement during the first postnatal year was low. Further research is needed to improve engagement, including participant involvement in study design; it is potentially more effective to implement annual diabetes screening until women develop prediabetes before offering an intervention.
Trial Registration
Australian New Zealand Clinical Trials Registry ACTRN1261000033806
Criterion validity of the activPALTM and ActiGraph for assessing children’s sitting and standing time in a school classroom setting
No full textOpen AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
Few studies have investigated the accuracy of the ActiGraph (AG) GTX3 accelerometer for assessing children’s sitting and standing time. The activPAL (aP) has an inclinometer function that enables it to distinguish between sitting/lying and standing; however, its accuracy for assessing sitting and standing in older children is unknown. This study validated the accuracy of these devices for estimating sitting and standing time in a school classroom against a criterion measure of direct observation (DO).
Findings
Forty children in grades 5–7 wore both devices while being video recorded during two school lessons. AG and aP data were simultaneously collected in 15-s epochs. Individual participant DO and aP data were recorded as total time spent sitting/lying, standing and stepping. AG data were converted into time spent sitting and standing using previously established cut-points. Compared with DO, the aP underestimated sitting time (mean bias = -1.9 min, 95 % LoA = -8.9 to 5.2 min) and overestimated standing time (mean bias = 1.8 min, 95 % LoA = -9.6 to 13.3 min). The best-performing AG cut-point across both sitting and standing (<75 counts/15 s) was more accurate than the aP, underestimating sitting time (mean bias = -0.8 min, 95 % LoA = -10.5 to 9.9 min) and standing time (mean bias = -0.4 min, 95 % LoA = -9.8 to 9.1 min), but was less precise as evidenced by wider LoAs and poorer correlations with DO (sitting r = 0.86 aP vs 0.80 AG; standing r = 0.78 aP vs 0.60 AG).
Conclusions
The aP demonstrated good accuracy and precision for assessing free-living sitting and standing time in classroom settings. The AG was most accurate using a cut-point of < 75 counts/15 s. Further studies should validate the monitors in settings with greater inter- and intra-individual variation in movement patterns
Multiple Domain Associations within the Arabidopsis Immune Receptor RPP1 Regulate the Activation of Programmed Cell Death
No full textThis is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Upon recognition of pathogen virulence effectors, plant nucleotide-binding leucine-rich
repeat (NLR) proteins induce defense responses including localized host cell death. In an
effort to understand the molecular mechanisms leading to this response, we examined the
Arabidopsis thaliana NLR protein RECOGNITION OF PERONOSPORA PARASITICA1
(RPP1), which recognizes the Hyaloperonospora arabidopsidis effector ARABIDOPSIS
THALIANA RECOGNIZED1 (ATR1). Expression of the N-terminus of RPP1, including the
Toll/interleukin-1 receptor (TIR) domain (“N-TIR”), elicited an effector-independent cell
death response, and we used allelic variation in TIR domain sequences to define the key
residues that contribute to this phenotype. Further biochemical characterization indicated
that cell death induction was correlated with N-TIR domain self-association. In addition,
we demonstrated that the nucleotide-binding (NB)-ARC1 region of RPP1 self-associates
and plays a critical role in cell death activation, likely by facilitating TIR:TIR interactions.
Structural homology modeling of the NB subdomain allowed us to identify a putative oligomerization
interface that was shown to influence NB-ARC1 self-association. Significantly,
full-length RPP1 exhibited effector-dependent oligomerization and, although mutations at
the NB-ARC1 oligomerization interface eliminated cell death induction, RPP1 self-association
was unaffected, suggesting that additional regions contribute to oligomerization.
Indeed, the leucine-rich repeat domain of RPP1 also self-associates, indicating that multiple
interaction interfaces exist within activated RPP1 oligomers. Finally, we observed numerous
intramolecular interactions that likely function to negatively regulate RPP1, and present
a model describing the transition to an active NLR protein
"To the Lighthouse Towards a Global Minimum Wage: Building on the International Poverty Line"
No full text"This article outlines how a global minimum wage might be introduced having regard to the political, institutional, and technical barriers in its way. It reviews the issues surrounding minimum wages in the context of globalisation, and assesses the evolution of labour standards in developing countries with a view to their application to a new minimum wages regime. The proposed global minimum wage rests on four pillars: (i) the World Bank’s international poverty line recalculated as a universal wage floor; (ii) an electronic lighthouse that provides the global minimum wage translated for each developing country, and for the informal sector; (iii) involvement of the widest range of stakeholders; and (iv) commercialisation of its monitoring and remediation. The International Labour Organisation–World Bank ‘Better Work’ program is discussed as an
example of how its governance might proceed.
Prescription of opioids for breathlessness in end-stage COPD: a national population-based study
No full textThis work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/).Background: Low-dose opioids can relieve breathlessness but may be underused in late-stage COPD due to fear of complications, contributing to poor symptom control.
Objectives: We aimed to study the period prevalence and indications of opioids actually prescribed in people with end-stage COPD.
Methods: The study was a longitudinal, population-based study of patients starting long-term oxygen therapy (LTOT) for COPD between October 1, 2005 and June 30, 2009 in Sweden. A random sample (n=2,000) of their dispensed opioid prescriptions was obtained from the national Prescribed Drugs Register from 91 days before starting LTOT until the first of LTOT withdrawal, death, or study end (December 31, 2009). We analyzed medication type, dispensed quantity, date of dispensing, and indications categorized as pain, breathlessness, other, or unknown.
Results: In total, 2,249 COPD patients (59% women) were included. During a median follow-up of 1.1 (interquartile range 0.6–2.0) years, 1,034 patients (46%) were dispensed $1 opioid prescription (N=13,722 prescriptions). The most frequently prescribed opioids were tramadol (23%), oxycodone (23%), morphine (16%), and codeine (16%). Average dispensed quantity was 9.3 (interquartile range 3.7–16.7) defined daily doses per prescription. In the random sample, the most commonly stated indication was pain (97%), with only 2% for breathlessness and 1% for other reasons.
Conclusion: Despite evidence that supported the use of opioids for the relief of breathlessness predating this study, opioids are rarely prescribed to relieve breathlessness in oxygen-dependent COPD, potentially contributing to less-than-optimal symptom control. This study creates a baseline against which to compare future changes in morphine prescribing in this setting
Critical Criminology Guest Editors’ Introduction
No full textThis work is licensed under a Creative Commons Attribution 4.0 License
Chronic hepatitis infection is associated with extrahepatic cancer development: a nationwide population-based study in Taiwan
No full textThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the major causes of chronic hepatitis infection
(CHI). This longitudinal cohort study investigated the association of CHI with hepatic and extrahepatic cancer
development in Taiwan.
Methods: Patients with HBV infection and HCV infection were identified from the Taiwan National Health Insurance
Research Database. A Cox proportional hazard model was used to calculate hazard ratios (HRs) and 95 %
confidence intervals (CIs) for determining the association between CHI and cancer development.
Results: The patients with HBV infection exhibited an increased risk of colorectal cancer (HR: 1.36, 95 % CI: 1.09–1.70), liver cancer (HR: 21.47, 95 % CI: 18.0–25.6), gallbladder and extrahepatic bile duct cancer (HR: 2.05, 95 % CI: 1.07–3.91), pancreatic cancer (HR: 2.61, 95 % CI: 1.47–4.61), kidney cancer (HR: 1.72, 95 % CI: 1.10–2.68), ovarian cancer (HR: 2.31, 95 % CI: 1.21–4.39), and non-Hodgkin’s lymphoma (HR: 2.10, 95 % CI: 1.25–3.52). The patients with HCV infection exhibited an increased risk of liver cancer (HR: 25.10, 95 % CI: 20.9–30.2), gallbladder and extrahepatic bile duct cancer (HR: 2.60, 95 % CI: 1.42–4.73), ovarian cancer (HR: 5.15, 95 % CI: 1.98–13.4), and non-Hodgkin’s lymphoma (HR: 2.30, 95 % CI: 1.34–3.96).
Conclusion: The present population-based study revealed that in addition to its association with primary liver cancer,
CHI is associated with an increased risk of extrahepatic cancer