Body mass index, waist circumference, and chronic disease risk factors in australian adolescents

Objective: To determine the association between measures of adiposity (body mass index and waist circumference) and risk factors for heart disease, type 2 diabetes, fatty liver disease, and the clustering of risk factors in middle adolescence. Design: Cross-sectional study. Setting: Secondary schools in Sydney. Participants: Grade 10 students (N = 496; 58.4% boys; mean [SD] age, 15.4 [0.4] years). Main Exposures: Height, weight, waist circumference, blood pressure, and fasting blood samples. Outcome Measures: Participants were categorized as overweight or obese using the International Obesity Task Force cut points and the UK waist circumference cut points. Blood was analyzed for high- and low-density lipoprotein cholesterol, triglycerides, insulin, glucose, alanine aminotransferase, γ-glutamyltransferase, and high-sensitivity C-reactive protein levels, and the results were categorized as normal or abnormal according to published guidelines where possible. Associations between overweight and obesity and risk factors were explored using logistic regression. Clustering of risk factors within individuals was also explored. Results: Insulin (P < .001), alanine aminotransferase (P < .001), γ-glutamyltransferase (P = .005), high-density lipoprotein cholesterol (P < .001), highsensitivity C-reactive protein (P < .001), and blood pressure (P < .001) were significantly associated with overweight and obesity in adolescent boys. In adolescent girls, insulin, high-density lipoprotein cholesterol (P < .001), and high-sensitivity C-reactive protein (P < .001) were significantly associated with overweight and obesity. Obese adolescent boys and girls were significantly more likely to have 2 or more risk factors (boys: 73.5% vs 7.6%; girls: 44.4% vs 5.4%; P < .001 for both) than nonoverweight adolescents. Conclusions: Overweight and obese adolescents, especially boys, are at substantial risk for chronic conditions. Waist circumference is not a better predictor of metabolic risk factors than is body mass index. ©2008 American Medical Association. All rights reserved

A multi targeting conditionally replicating adenovirus displays enhanced oncolysis while maintaining expression of immunotherapeutic agents

Studies have demonstrated that oncolytic adenoviruses based on a 24 base pair deletion in the viral E1A gene (D24) may be promising therapeutics for treating a number of cancer types. In order to increase the therapeutic potential of these oncolytic viruses, a novel conditionally replicating adenovirus targeting multiple receptors upregulated on tumors was generated by incorporating an Ad5/3 fiber with a carboxyl terminus RGD ligand. The virus displayed full cytopathic effect in all tumor lines assayed at low titers with improved cytotoxicity over Ad5-RGD D24, Ad5/3 D24 and an HSV oncolytic virus. The virus was then engineered to deliver immunotherapeutic agents such as GM-CSF while maintaining enhanced heterogenic oncolysis

Customer Focus in European Higher Education Systems

This article looks at the idea and practice of “customer focus” in higher education. As a global trend with origins in the business and corporate world, customer focus has come to increasingly shape public services worldwide. Influenced by business thinking, terminology, and practices, governmental organizations across policy areas have used customer focus to reform public services in order to bring them closer to the demands and expectations of their users. The paper particularly analyzes changes in customer focus understanding and its implications for the European higher education policies. The aim of the article is to contribute to a better conceptualization and policy understanding of this growing approach to higher education reform.fi=vertaisarvioitu|en=peerReviewed

Automated lung segmentation in digital chest tomosynthesis: Lung segmentation in tomosynthesis

Purpose: The purpose of this study was to develop an automated lung segmentation method for computerized detection of lung nodules in digital chest tomosynthesis

Associations between insulin and glucose concentrations and anthropometric measures of fat mass in Australian adolescents

Background One of the most serious, yet common co-morbidities of obesity is insulin resistance, which if untreated may progress to type 2 diabetes. This paper describes the insulin and glucose concentration distributions, the prevalence of elevated insulin, the associations between insulin and body mass index (BMI), waist circumference, waist-to-height ratio (WHtR) and fat mass index in a representative sample of Australian adolescents. Methods Cross-sectional population-based study of adolescent boys and girls (N = 496, mean age 15.3 years) attending schools in metropolitan Sydney, Australia. Fasting venous blood collected and analysed for insulin and glucose concentrations. Height, weight, waist circumference measured, BMI and waist-to-height ratio calculated. Pubertal status self-reported. Results Glucose concentrations were normally distributed and were not associated with adiposity. Insulin concentrations were distributed logarithmically, were higher among girls than boys overall and within the same ranges of BMI and waist circumference, but were lower among girls than boys within the same ranges of fat mass adjusted for height. The prevalence of elevated insulin concentration (defined as \u3e 100 pmol/L) was 15.9% and 17.1% among boys and girls, respectively. Correlations between insulin concentration and BMI, waist circumference, WHtR and fat mass adjusted for height were 0.53, 0.49, 0.51 and 0.55, among boys, respectively, and 0.35, 0.40, 0.42 and 0.34, among girls, respectively. Conclusions Elevated insulin is highly correlated with adiposity in adolescents. BMI and WHtR are simple measures that can be used to identify young people who should be screened for insulin resistance and other co-morbidities

Estimating the number of regular and dependent methamphetamine users in Australia, 2002-2014.

Objective: To estimate the number of regular and dependent methamphetamine users in Australia. Design: Indirect prevalence estimates were made for each year from 2002–03 to 2013–14. We applied multiplier methods to data on treatment episodes for amphetamines (eg, counselling, rehabilitation, detoxification) and amphetamine-related hospitalisations to estimate the numbers of regular (at least monthly) and dependent methamphetamine users for each year. Dependent users comprised a subgroup of those who used the drug regularly, so that estimates of the sizes of these two populations were not additive. Results: We estimated that during 2013–14 there were 268 000 regular methamphetamine users (95% CI, 187 000–385 000) and 160 000 dependent users (95% CI, 110 000–232 000) aged 15–54 years in Australia. This equated to population rates of 2.09% (95% CI, 1.45–3.00%) for regular and 1.24% (95% CI, 0.85–1.81%) for dependent use. The rate of dependent use had increased since 2009–10 (when the rate was estimated to be 0.74%), and was higher than the previous peak (1.22% in 2006–07). The highest rates were consistently among those aged 25–34 years, in whom the rate of dependent use during 2012–2013 was estimated to be 1.50% (95% CI, 1.05–2.22%). There had also been an increase in the rate of dependent use among those aged 15–24 years (in 2012–13 reaching 1.14%; 95% CI, 0.80–1.69%). Conclusions: There have been increases over the past 12 years in the numbers of regular and dependent methamphetamine users in Australia. Our estimates suggest that the most recent numbers are the highest for this period, and that the increase has been most marked among young adults (those aged 15–34 years)

Understanding evidence: a statewide survey to explore evidence-informed public health decision-making in a local government setting

&nbsp;Background: The value placed on types of evidence within decision-making contexts is highly dependent on individuals, the organizations in which the work and the systems and sectors they operate in. Decision-making processes too are highly contextual. Understanding the values placed on evidence and processes guiding decision-making is crucial to designing strategies to support evidence-informed decision-making (EIDM). This paper describes how evidence is used to inform local government (LG) public health decisions.Methods: The study used mixed methods including a cross-sectional survey and interviews. The Evidence-Informed Decision-Making Tool (EvIDenT) survey was designed to assess three key domains likely to impact on EIDM: access, confidence, and organizational culture. Other elements included the usefulness and influence of sources of evidence (people/groups and resources), skills and barriers, and facilitators to EIDM. Forty-five LGs from Victoria, Australia agreed to participate in the survey and up to four people from each organization were invited to complete the survey (n = 175). To further explore definitions of evidence and generate experiential data on EIDM practice, key informant interviews were conducted with a range of LG employees working in areas relevant to public health.Results: In total, 135 responses were received (75% response rate) and 13 interviews were conducted. Analysis revealed varying levels of access, confidence and organizational culture to support EIDM. Significant relationships were found between domains: confidence, culture and access to research evidence. Some forms of evidence (e.g. community views) appeared to be used more commonly and at the expense of others (e.g. research evidence). Overall, a mixture of evidence (but more internal than external evidence) was influential in public health decision-making in councils. By comparison, a mixture of evidence (but more external than internal evidence) was deemed to be useful in public health decision-making.Conclusions: This study makes an important contribution to understanding how evidence is used within the public health LG context

Combating escalating harms associated with pharmaceutical opioid use in Australia: The POPPY II study protocol

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Introduction Opioid prescribing has increased 15-fold in Australia in the past two decades, alongside increases in a range of opioid-related harms such as opioid dependence and overdose. However, despite concerns about increasing opioid use, extramedical use and harms, there is a lack of population-level evidence about the drivers of long-term prescribed opioid use, dependence, overdose and other harms. Methods and analysis We will form a cohort of all adult residents in New South Wales (NSW), Australia, who initiated prescribed opioids from 2002 using Pharmaceutical Benefits Scheme dispensing records. This cohort will be linked to a wide range of other datasets containing information on sociodemographic and clinical characteristics, health service use and adverse outcomes (eg, opioid dependence and non-fatal and fatal overdose). Analyses will initially examine patterns and predictors of prescribed opioid use and then apply regression and survival analysis to quantify the risks and risk factors of adverse outcomes associated with prescribed opioid use. Ethics and dissemination This study has received full ethical approval from the Australian Institute of Health and Welfare Ethics Committee, the NSW Population and Health Services Research Committee and the ACT Health Human Research Ethics Committee. This will be the largest postmarketing surveillance study of prescribed opioids undertaken in Australia, linking exposure and outcomes and examining risk factors for adverse outcomes of prescribed opioids. As such, this work has important translational promise, with direct relevance to regulatory authorities and agencies worldwide. Project findings will be disseminated at scientific conferences and in peer-reviewed journals. We will also conduct targeted dissemination with policy makers, professional bodies and peak bodies in the pain, medicine and addiction fields through stakeholder workshops and advisory groups. Results will be reported in accordance with the REporting of studies Conducted using Observational Routinely collected Data (RECORD) Statement

Ripple Effects of a Minority Leadership Training Program: Beyond its target

Chair: Michiko Iwasaki, Ph.D. ([email protected]) – Loyola University Maryland Discussant: Y. Barry Chung, Ph.D. ([email protected]) – Indiana University The APA Commission of Ethnic Minority Recruitment, Retention, and Training in Psychology (2008) pointed out the underrepresentation of minorities in the field of psychology, particularly in leadership positions. In response to the shortage of minority leaders, the Council of National Psychological Associations for the Advancement of Ethnic Minority Interests (CNPAAEMI) initiated a Leadership Development Institute (LDI) in 2012. The major purpose of the LDI was to foster and nurture ongoing leadership development among early career ethnic minority psychologists. This symposium addresses the ripple effects of this leadership development program. Although the LDI aimed to foster leadership development among a cohort of six early-career ethnic minority professionals, the training program had ripple effects that extended well beyond its primary purpose. This symposium draws from a collaborative project – interviewing ethnic minority leaders in psychology – initiated by the LDI fellows that provided unanticipated learning opportunities for both the fellows and students assisting the project. The first presentation, led by a LDI fellow, will delineate the LDI mechanism and discusses the importance of connecting in-group and out-group members in minority leadership. The second presentation, led by racial minority graduate students, will emphasize the significance of empowerment and presence of role models when considering the pipeline of minority leadership development. The final presentation, led by White minority graduate and undergraduate students, will discuss the nature of White privilege at academic institutions as well as their own personal growth. This symposium targets the following sub-themes of the 2014 Counseling Psychology Conference: training context and domestic/international diversity. A past president of the Society of Counseling Psychology will be a discussant. This symposium offers valuable information regarding leadership training mechanisms in order to enhance cultural sensitivity among all individuals in the psychology field regardless of their color, sexual orientation, or professional/academic levels