Environmental survey at the Lucas Heights Research Laboratories, 1983.

Results are presented of the environmental survey conducted in the neighbourhood of the Lucas Heights Research Laboratories during 1983. These results are satisfactory. No radioactivity which could have originated from these laboratories was found in samples collected from possible human food chains. All low-level liquid and gaseous waste discharges were within authorised limits. The maximum possible annual dose to the general public from airborne waste discharges during this period is estimated to be less than 0.01 millisieverts which is 1 per cent of the limit for long-term exposure that is recommended by the National Health and Medical Research Council

Population Health Readiness

Wayne H. Giles, MD, MS joined the Centers for Disease Control and Prevention in July 1992. He is currently the Director of the Division of Population Health within the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention (CDC). This forum provides an overview of the different levels, drivers and opportunities available to improve population health. It describes the CDC’s and other Federal initiatives designed to support population health. Additionally, this forum presentation identifies opportunities for health care providers to work with Government programs to advance population health. Presentation: 48 minute

Is a perceived supportive physical environment important for self-reported leisure time physical activity among socioeconomically disadvantaged women with poor psychosocial characteristics? An observational study

Background Over the past decade, studies and public health interventions that target the physical environment as an avenue for promoting physical activity have increased in number. While it appears that a supportive physical environment has a role to play in promoting physical activity, social-ecological models emphasise the importance of considering other multiple levels of influence on behaviour, including individual (e.g. self-efficacy, intentions, enjoyment) and social (e.g. social support, access to childcare) factors (psychosocial factors). However, not everyone has these physical activity-promoting psychosocial characteristics; it remains unclear what contribution the environment makes to physical activity among these groups. This study aimed to examine the association between the perceived physical environment and self-reported leisure-time physical activity (LTPA) among women living in socioeconomically disadvantaged areas demonstrating different psychosocial characteristics.Methods In 2007&ndash;8, 3765 women (18&ndash;45&thinsp;years) randomly selected from low socioeconomic areas in Victoria, Australia, self-reported LTPA, and individual, social and physical environmental factors hypothesised within a social-ecological framework to influence LTPA. Psychosocial and environment scores were created. Associations between environment scores and categories of LTPA (overall and stratified by thirds of perceived environment scores) were examined using generalised ordered logistic regression.Results Women with medium and high perceived environment scores had 20-38% and 44-70% greater odds respectively of achieving higher levels of LTPA than women with low environment scores. When stratified by thirds of psychosocial factor scores, these associations were largely attenuated and mostly became non-significant. However, women with the lowest psychosocial scores but medium or high environment scores had 76% and 58% higher odds respectively of achieving &ge;120&thinsp;minutes/week (vs. &lt;120&thinsp;minutes/week) LTPA.Conclusions Acknowledging the cross-sectional study design, the findings suggest that a physical environment perceived to be supportive of physical activity might help women with less favourable psychosocial characteristics achieve moderate amounts of LTPA (i.e. &ge;120&thinsp;minutes/week). This study provides further support for research and public health interventions to target perceptions of the physical environment as a key component of strategies to promote physical activity.<br /

Capture the fracture: a best practice framework and global campaign to break the fragility fracture cycle

Summary The International Osteoporosis Foundation (IOF) Capture the Fracture Campaign aims to support implementation of Fracture Liaison Services (FLS) throughout the world. Introduction FLS have been shown to close the ubiquitous secondary fracture prevention care gap, ensuring that fragility fracture sufferers receive appropriate assessment and intervention to reduce future fracture risk. Methods Capture the Fracture has developed internationally endorsed standards for best practice, will facilitate change at the national level to drive adoption of FLS and increase awareness of the challenges and opportunities presented by secondary fracture prevention to key stakeholders. The Best Practice Framework (BPF) sets an international benchmark for FLS, which defines essential and aspirational elements of service delivery. Results The BPF has been reviewed by leading experts from many countries and subject to beta-testing to ensure that it is internationally relevant and fit-for-purpose. The BPF will also serve as a measurement tool for IOF to award ‘Capture the Fracture Best Practice Recognition’ to celebrate successful FLS worldwide and drive service development in areas of unmet need. The Capture the Fracture website will provide a suite of resources related to FLS and secondary fracture prevention, which will be updated as new materials become available. A mentoring programme will enable those in the early stages of development of FLS to learn from colleagues elsewhere that have achieved Best Practice Recognition. A grant programme is in development to aid clinical systems which require financial assistance to establish FLS in their localities. Conclusion Nearly half a billion people will reach retirement age during the next 20 years. IOF has developed Capture the Fracture because this is the single most important thing that can be done to directly improve patient care, of both women and men, and reduce the spiralling fracture-related care costs worldwide.</p

Temozolomide and cisplatin in relapsed/refractory acute leukemia

Cisplatin depletes MGMT and increases the sensitivity of leukemia cells to temozolomide. We performed a phase I study of cisplatin and temozolomide in patients with relapsed and refractory acute leukemia. Fifteen patients had AML, 3 had ALL, and 2 had biphenotypic leukemia. The median number of prior chemotherapy regimens was 3 (1–5). Treatment was well tolerated up to the maximal doses of temozolomide 200 mg/m2/d times 7 days and cisplatin 100 mg/m2 on day 1. There was one complete remission in this heavily pretreated patient population. Five of 20 (25%) patients demonstrated a significant reduction in bone marrow blasts

Alcohol consumption and body composition in a population-based sample of elderly Australian men

Background: Alcohol is calorie dense, and impacts&nbsp;activity, appetite and lipid processing. The aim of this&nbsp;study was to therefore investigate the association between&nbsp;alcohol consumption and components of body composition&nbsp;including bone, fat and lean tissue.Methods: Participants were recruited from a randomly&nbsp;selected, population-based sample of 534 men aged&nbsp;65 years and older enrolled in the Geelong Osteoporosis&nbsp;Study. Alcohol intake was ascertained using a food&nbsp;frequency questionnaire and the sample categorised as nondrinkers or alcohol users who consumed B2, 3&ndash;4 or C5&nbsp;standard drinks on a usual drinking day. Bone mineral&nbsp;density (BMD), lean body mass and body fat mass were&nbsp;measured using dual energy X-ray absorptiometry; overall&nbsp;adiposity (%body fat), central adiposity (%truncal fat) and&nbsp;body mass index (BMI) were calculated. Bone quality was&nbsp;determined by quantitative heel ultrasound (QUS).Results: There were 90 current non-drinkers (16.9 %),&nbsp;266 (49.8 %) consumed 1&ndash;2 drinks/day, 104 (19.5 %) 3&ndash;4&nbsp;drinks/day and 74 (13.8 %) C5 drinks/day. Those consuming C5 drinks/day had greater BMI (?4.8 %), fat mass&nbsp;index (?20.1 %), waist circumference (?5.0 %), %body&nbsp;fat (?15.2 %) and proportion of trunk fat (?5.3 %) and&nbsp;lower lean mass (-5.0 %) than non-drinkers after adjustment for demographic and lifestyle factors. Furthermore,&nbsp;they were more likely to be obese than non-drinkers&nbsp;according to criteria based on BMI (OR = 2.83, 95 %CI&nbsp;1.10&ndash;7.29) or waist circumference (OR = 3.36, 95 %CI&nbsp;1.32&ndash;8.54). There was an inverse relationship between&nbsp;alcohol consumption and QUS parameters and BMD at the&nbsp;mid forearm site; no differences were detected for BMD at&nbsp;other skeletal sites.Conclusion:&nbsp;Higher alcohol intake was associated with&nbsp;greater total and central adiposity and reduced bone&nbsp;quality.<br /

Forearm muscle oxidative capacity index predicts sport rock-climbing performance

Abstract: Rock-climbing performance is largely dependent on the endurance of the forearm flexors. Recently, it was reported that forearm flexor endurance in elite climbers is independent of the ability to regulate conduit artery (brachial) blood flow, suggesting that endurance is not primarily dependent on the ability of the brachial artery to deliver oxygen, but rather the ability of the muscle to perfuse and use oxygen, i.e., skeletal muscle oxidative capacity. Purpose: The aim of the study was to determine whether an index of oxidative capacity in the flexor digitorum profundus (FDP) predicts the best sport climbing red-point grade within the last 6 months. Participants consisted of 46 sport climbers with a range of abilities. Methods: Using near-infrared spectroscopy, the oxidative capacity index of the FDP was assessed by calculating the half-time for tissue oxygen resaturation (O2HTR) following 3–5 min of ischemia. Results: Linear regression, adjusted for age, sex, BMI, and training experience, revealed a 1-s decrease in O2HTR was associated with an increase in red-point grade by 0.65 (95 % CI 0.35–0.94, Adj R2 = 0.53). Conclusions: Considering a grade of 0.4 separated the top four competitors in the 2015 International Federation Sport Climbing World Cup, this finding suggests that forearm flexor oxidative capacity index is an important determinant of rock-climbing performance

Critical Limb Ischemia

Critical limb ischemia (CLI), defined as chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease, is the most advanced form of peripheral arterial disease. Traditionally, open surgical bypass was the only effective treatment strategy for limb revascularization in this patient population. However, during the past decade, the introduction and evolution of endovascular procedures have significantly increased treatment options. In a certain subset of patients for whom either surgical or endovascular revascularization may not be appropriate, primary amputation remains a third treatment option. Definitive high-level evidence on which to base treatment decisions, with an emphasis on clinical and cost effectiveness, is still lacking. Treatment decisions in CLI are individualized, based on life expectancy, functional status, anatomy of the arterial occlusive disease, and surgical risk. For patients with aortoiliac disease, endovascular therapy has become first-line therapy for all but the most severe patterns of occlusion, and aortofemoral bypass surgery is a highly effective and durable treatment for the latter group. For infrainguinal disease, the available data suggest that surgical bypass with vein is the preferred therapy for CLI patients likely to survive 2 years or more, and for those with long segment occlusions or severe infrapopliteal disease who have an acceptable surgical risk. Endovascular therapy may be preferred in patients with reduced life expectancy, those who lack usable vein for bypass or who are at elevated risk for operation, and those with less severe arterial occlusions. Patients with unreconstructable disease, extensive necrosis involving weight-bearing areas, nonambulatory status, or other severe comorbidities may be considered for primary amputation or palliative measures