Is there scope for community health nurses to address lifestyle risk factors? The community nursing SNAP trial

Background: This paper examines the opportunity and need for lifestyle interventions for patients attending generalist community nursing services in Australia. This will help determine the scope for risk factor management within community health care by generalist community nurses (GCNs). Methods: This was a quasi-experimental study conducted in four generalist community nursing services in NSW, Australia. Prior to service contacts, clients were offered a computer-assisted telephone interview to collect baseline data on socio-demographics, health conditions, smoking status, physical activity levels, alcohol consumption, height and weight, fruit and vegetable intake and \u27readiness-to-change\u27 for lifestyle risk factors. Results: 804 clients participated (a response rate of 34.1%). Participants had higher rates of obesity (40.5% vs 32.1%) and higher prevalence of multiple risk factors (40.4% vs 29.5%) than in the general population. Few with a SNAPW (S moking-N utrition-A lcohol-P hysical-Activity-Weight) risk factor had received advice or referral in the previous 3 months. The proportion of clients identified as at risk and who were open to change (i.e. contemplative, in preparation or in action phase) were 65.0% for obese/overweight; 73.8% for smokers; 48.2% for individuals with high alcohol intake; 83.5% for the physically inactive and 59.0% for those with poor nutrition. Conclusions: There was high prevalence of lifestyle risk factors. Although most were ready to change, few clients recalled having received any recent lifestyle advice. This suggests that there is considerable scope for intervention by GCNs. The results of this trial will shed light on how best to implement the lifestyle risk factor management in routine practice

Designing pseudocubic perovskites with enhanced nanoscale polarization

A crystal-chemical framework has been proposed for the design of pseudocubic perovskites with nanoscale ferroelectric order, and its applicability has been demonstrated using a series of represen- tative solid solutions that combined ferroelectric (K 0.5 Bi 0.5 TiO 3 , BaTiO 3 , and PbTiO 3 ) and antifer- roelectric (Nd-substituted BiFeO 3 ) end members. The pseudocubic structures obtained in these systems exhibited distortions that were coherent on a scale ranging from sub-nanometer to tens of nanometers, but, in all cases, the macroscopic distortion remained unresolvable even if using high- resolution X-ray powder diffraction. Different coherence lengths for the local atomic displacements account for the distinctly different dielectric, ferroelectric, and electromechanical properties exhib- ited by the samples. The guidelines identified provide a rationale for chemically tuning the coher- ence length to obtain the desired functional response

Challenges to physician–patient communication about medication use: a window into the skeptical patient’s world

Patients frequently do not take medicines as prescribed and often do not communicate with their physicians about their medication-taking behavior. The movement for “patient-centered” care has led to relabeling of this problem from “noncompliance” to “nonadherence” and later to a rhetoric of “concordance” and “shared decision making” in which physicians and patients are viewed as partners who ideally come to agreement about appropriate treatment. We conducted a qualitative content analysis of online comments to a New York Times article on low rates of medication adherence. The online discussion provides data about how a highly selected, educated sample of patients thinks about medication use and the doctor–patient relationship. Our analysis revealed patient empowerment and self-reliance, considerable mistrust of medications and medical practice, and frequent noncommunication about medication adherence issues. We discuss how these observations can potentially be understood with reference to Habermas’s theory of communicative action, and conclude that physicians can benefit from better understanding the negative ways in which some patients perceive physicians’ prescribing practices

Integrity in democratic politics

The complaint that many professional politicians lack integrity is common. However, it is unclear what such a judgement amounts to. Taking various codes of political ethics in the United Kingdom as my starting point, I examine the extent to which we can understand political integrity as a matter of politicians adhering to the obligations that official codes of ethics prescribe and, in a more general sense, the public-service ethos that underpins these codes. I argue that although this way of approaching the issue usefully draws our attention to an important class of positional duties that apply to politicians, commitment to principled political causes plays a further, indispensable role in coherent assessments of political integrity. In consequence, I claim that politicians of integrity succeed in furthering their deepest political commitments while avoiding malfeasance or misconduct. As such, the ascription of political integrity can often only be made when assessing a long train of action

Discovery of a missense mutation (Q222K) of the APOE gene from the Australian imaging, biomarker and lifestyle study

After age, polymorphisms of the Apolipoprotein E (APOE) gene are the biggest risk factor for the development of Alzheimer\u27s disease (AD). During our investigation to discovery biomarkers in plasma, using 2D gel electrophoresis, we found an individual with and unusual apoE isoelectric point compared to APOE ϵ2, ϵ3, and ϵ4 carriers. Whole exome sequencing of APOE from the donor confirmed a single nucleotide polymorphism (SNP) in exon 4, translating to a rare Q222K missense mutation. The apoE ϵ4 (Q222K) mutation did not form dimers or complexes observed for apoE ϵ2 ϵ3 proteins

Late Miocene to early Pliocene biofacies of Wanganui and Taranaki Basins, New Zealand: Applications to paleoenvironmental and sequence stratigraphic analysis

The Matemateaonga Formation is late Miocene to early Pliocene (upper Tongaporutuan to lower Opoitian New Zealand Stages) in age. The formation comprises chiefly shellbeds, siliciclastic sandstone, and siltstone units and to a lesser extent non-marine and shallow marine conglomerate and rare paralic facies. The Matemateaonga Formation accumulated chiefly in shelf paleoenvironments during basement onlap and progradation of a late Miocene to early Pliocene continental margin wedge in the Wanganui and Taranaki Basins. The formation is strongly cyclothemic, being characterised by recurrent vertically stacked facies successions, bounded by sequence boundaries. These facies accumulated in a range of shoreface to mid-outer shelf paleoenvironments during conditions of successively oscillating sea level. This sequential repetition of facies and the biofacies they enclose are the result of sixth-order glacio-eustatic cyclicity. Macrofaunal associations have been identified from statistical analysis of macrofossil occurrences collected from multiple sequences. Each association is restricted to particular lithofacies and stratal positions and shows a consistent order and/or position within the sequences. This pattern of temporal paleoecologic change appears to be the result of lateral, facies-related shifting of broad biofacies belts, or habitat-tracking, in response to fluctuations of relative sea level, sediment flux, and other associated paleoenvironmental variables. The associations also show strong similarity in terms of their generic composition to biofacies identified in younger sedimentary strata and the modern marine benthic environment in New Zealand

Is there scope for community health nurses to address lifestyle risk factors? the community nursing SNAP trial

<p>Abstract</p> <p>Background</p> <p>This paper examines the opportunity and need for lifestyle interventions for patients attending generalist community nursing services in Australia. This will help determine the scope for risk factor management within community health care by generalist community nurses (GCNs).</p> <p>Methods</p> <p>This was a quasi-experimental study conducted in four generalist community nursing services in NSW, Australia. Prior to service contacts, clients were offered a computer-assisted telephone interview to collect baseline data on socio-demographics, health conditions, smoking status, physical activity levels, alcohol consumption, height and weight, fruit and vegetable intake and 'readiness-to-change' for lifestyle risk factors.</p> <p>Results</p> <p>804 clients participated (a response rate of 34.1%). Participants had higher rates of obesity (40.5% vs 32.1%) and higher prevalence of multiple risk factors (40.4% vs 29.5%) than in the general population. Few with a SNAPW (Smoking-Nutrition-Alcohol-Physical-Activity-Weight) risk factor had received advice or referral in the previous 3 months. The proportion of clients identified as at risk and who were open to change (i.e. contemplative, in preparation or in action phase) were 65.0% for obese/overweight; 73.8% for smokers; 48.2% for individuals with high alcohol intake; 83.5% for the physically inactive and 59.0% for those with poor nutrition.</p> <p>Conclusions</p> <p>There was high prevalence of lifestyle risk factors. Although most were ready to change, few clients recalled having received any recent lifestyle advice. This suggests that there is considerable scope for intervention by GCNs. The results of this trial will shed light on how best to implement the lifestyle risk factor management in routine practice.</p

A Differential Spectroscopic Analysis of 16 Cygni A and B

We utilize high-resolution, high signal-to-noise spectra to perform a differential analysis of Fe abundances in the common proper-motion pair 16 Cyg A and B. We confirm that both stars are slightly metal-rich compared to the Sun, and we show for the first time that the primary is enhanced in Fe relative to the secondary by a significant amount. We find Delta[Fe/H]=+0.025\pm0.009. This tends to support the ``self-pollution'' scenario proposed by Gonzalez (1998), though lack of a complete understanding of small primordial metallicity variations among binaries and open cluster members prevents a definitive conclusion

Are Debris Disks and Massive Planets Correlated?

Using data from the Spitzer Space Telescope Legacy Science Program ``Formation and Evolution of Planetary Systems'' (FEPS), we have searched for debris disks around 9 FGK stars (2-10 Gyr), known from radial velocity (RV) studies to have one or more massive planets. Only one of the sources, HD 38529, has excess emission above the stellar photosphere; at 70 micron the signal-to-noise ratio in the excess is 4.7 while at wavelengths < 30 micron there is no evidence of excess. The remaining sources show no excesses at any Spitzer wavelengths. Applying survival tests to the FEPS sample and the results for the FGK survey published in Bryden et al. (2006), we do not find a significant correlation between the frequency and properties of debris disks and the presence of close-in planets. We discuss possible reasons for the lack of a correlation.Comment: 24 pages, 3 figures. Accepted to Astrophysical Journa

The self-perceived knowledge, skills and attitudes of Australian practice nurses in providing nutrition care to patients with chronic disease

Background. Nutrition is important for the management of chronic diseases. While practice nurses have numerous roles in primary care, the expectations on practice nurses to provide nutrition care for chronic disease management are increasing. The self-perceived knowledge, skills and attitudes of practice nurses in providing nutrition care has not been widely investigated