Substitution Program in Indonesia and Australia as Health Promotion Model at Schools

Obesity has been increasing as much as twice on age 6-12 years. The increase is happening both in Indonesia and Australia. The objective of this research is to construct a program model in Australia that can be substituted to be a health promotion model at School in effort to suppress child obesity. Research was conducted in 2014 with qualitative approach. Instruments used are as follow 1) Secondary data filling form 2) In depth interview guidence instrument 3) FGD (Focus Group Discussion) and BST (Brain Storming Technique). The informations were obtained by purposive and snowball technique. Data analysis by Miles and Huberman model. Substitution model is based on consideration that applied model has potential to be developed and other models whether internal or external ones in Indonesia. The model will be substituted by considering school condition and situation. School Health Unit (SKU) is a potential platform to promote health by these activities 1) Formal health education as taken place curricullum 2) Informal health education in forms of (1) health education information (2) Self health behaviour monitoring and control (3) Health promotion by doing healthy life (4) distribution of health education booklet to teachers and parents

Gold remobilisation and formation of high grade ore shoots driven by dissolution-reprecipitation replacement and Ni substitution into auriferous arsenopyrite

Both gold-rich sulphides and ultra-high grade native gold oreshoots are common but poorly understood phenomenon in orogenic-type mineral systems, partly because fluids in these systems are considered to have relatively low gold solubilities and are unlikely to generate high gold concentrations. The world-class Obuasi gold deposit, Ghana, has gold-rich arsenopyrite spatially associated with quartz veins, which have extremely high, localised concentrations of native gold, contained in microcrack networks within the quartz veins where they are folded. Here, we examine selected samples from Obuasi using a novel combination of quantitative electron backscatter diffraction analysis, ion microprobe imaging, synchrotron XFM mapping and geochemical modelling to investigate the origin of the unusually high gold concentrations. The auriferous arsenopyrites are shown to have undergone partial replacement (~15%) by Au-poor, nickeliferous arsenopyrite, during localised crystal-plastic deformation, intragranular microfracture and metamorphism (340-460 °C, 2 kbars). Our results show the dominant replacement mechanism was pseudomorphic dissolution-reprecipitation, driven by small volumes of an infiltrating fluid that had relatively low fS2 and carried aqueous NiCl2. We find that arsenopyrite replacement produced strong chemical gradients at crystal-fluid interfaces due to an increase in fS2 during reaction, which enabled efficient removal of gold to the fluid phase and development of anomalously gold-rich fluid (potentially 10 ppm or more depending on sulphur concentration). This process was facilitated by precipitation of ankerite, which removed CO2 from the fluid, increasing the relative proportion of sulphur for gold complexation and inhibited additional quartz precipitation. Gold re-precipitation occurred over distances of 10 µm to several tens of metres and was likely a result of sulphur activity reduction through precipitation of pyrite and other sulphides. We suggest this late remobilisation process may be relatively common in orogenic belts containing abundant mafic/ultramafic rocks, which act as a source of Ni and Co scavenged by chloride-bearing fluids. Both the preference of the arsenopyrite crystal structure for Ni and Co, rather than gold, and the release of sulphur during reaction, can drive gold remobilisation in many deposits across broad regions

International approaches to health-oriented physical education: Local health debates and differing conceptions of health

Physical education's place in school curricula has been justified in different ways over the last 150 years. Health in a general sense has always been part of this rationalisation, and within current cultural contexts, health has gained increasing significance. However, a global look at health reveals that it has been approached in different ways - both as justification and in practice. The broad aims of this paper are to map out some of the ways that health is conceptualized and practiced and to identify underlying assumptions that frame these approaches. We begin by briefly examining the existing literature that links health with physical education. We then introduce the voices of four advocates of health from three different countries. These scholars respond to a set of questions concerning public health debates; current theories of health; research and evidence; practical approaches in physical education; problems, and 'best practice'. These commentaries are treated as empirical material and are considered in the final section of the paper. The specific aim here is to consider and locate the commentaries within their cultural environments. We conclude with some reflective questions for thinking about approaches to health in physical education

Breastfeeding and the risk of epithelial ovarian cancer among women with a BRCA1 or BRCA2 mutation

ObjectiveBRCA mutation carriers face a high lifetime risk of developing ovarian cancer. The strong inverse association between breastfeeding and the risk of ovarian cancer is established in the general population but is less well studied among women with a germline BRCA1 or BRCA2 mutation.MethodThus, we conducted a matched case-control analysis to evaluate the association between breastfeeding history and the risk of developing ovarian cancer. After matching for year of birth, country of residence, BRCA gene and personal history of breast cancer, a total of 1650 cases and 2702 controls were included in the analysis. Conditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (CI) associated with various breastfeeding exposures.ResultsA history of ever-breastfeeding was associated with a 23% reduction in risk (OR = 0.77; 95%CI 0.66-0.90; P = 0.001). The protective effect increased with breastfeeding from one month to seven months after which the association was relatively stable. Compared to women who never breastfed, breastfeeding for seven or more months was associated with a 32% reduction in risk (OR = 0.68; 95%CI 0.57-0.81; P < 0.0001) and did not vary by BRCA gene or age at diagnosis. The combination of breastfeeding and oral contraceptive use was strongly protective (0.47; 95%CI 0.37-0.58; P < 0.0001).ConclusionsThese findings support a protective effect of breastfeeding for at least seven months among women with a BRCA1 or BRCA2 mutation, that is independent of oral contraceptive use

Bilateral Oophorectomy and the Risk of Breast Cancer in BRCA1 Mutation Carriers: A Reappraisal.

BackgroundThe lack of consensus on whether bilateral oophorectomy impacts risk of developing breast cancer among BRCA1 mutation carriers might be attributed to various biases, specifically, cancer-induced testing bias due to inclusion of prevalent cases. We conducted two complementary matched case-control analyses to evaluate the association of oophorectomy and BRCA1 breast cancer.MethodsA research questionnaire was administered every two years to collect information on exposures and disease. In the first analysis, we limited the study to prevalent breast cancer cases (diagnosed prior to study entry; n = 2,962) who were matched to controls on year of birth and country of residence (n = 4,358). In the second approach, we limited to 330 incident cases (diagnosed in the follow-up period) and 1,548 matched controls. Conditional logistic regression was used to estimate the adjusted odds ratios (OR) and 95% confidence intervals (CI) of invasive breast cancer.ResultsIn the first approach, there was a significant inverse association between oophorectomy and the risk of developing breast cancer [OR = 0.43; 95% confidence interval (CI), 0.34-0.55; P < 00001]. In the second approach, there was no association between oophorectomy and risk (OR = 1.21; 95% CI, 0.87-1.70; P = 0.26).ConclusionsThe inclusion of women with a personal history of breast cancer prior to ascertainment likely impacts upon the association of oophorectomy and BRCA1 breast cancer risk.ImpactOophorectomy is unlikely a determinant of breast cancer risk in BRCA1 mutation carriers but should be offered at age 35 to reduce the risk of ovarian and fallopian tube cancer

Physical activity-academic achievement: student and teacher perspectives on the 'new' nexus

Background: The association between physical activity/fitness with cognitive and academic functioning has become a topic of considerable research interest. Increasingly, schooling systems are being expected to respond to these relationships through curricular and extra-curricular interventions.Purpose: This paper reports on the qualitative findings of the impact of the Active Kids Active Minds (AKAM) intervention that included one hour of moderate to vigorous daily physical activity for the promotion of learning in a regional primary school in Australia. It gives student and teacher voice to the corpus of literature on physical activity and academic performance intervention studies that are gaining momentum in the bid to justify and promote forms of school-based physical activity.Participants: Twelve Year 5 students, their classroom teachers, and the school principal's perspectives are shared in this paper. They were key informants from 107 students and 5 teachers who participated in the intervention.Data collection: Students, their classroom teachers, and the school principal were interviewed individually or in groups by a member of the research team. Researcher field observations, along with a diary kept by the dedicated AKAM teacher, were used to interrogate the complexity and pragmatics of both delivering the intervention and succeeding in the intervention.Data analysis: Transcribed interviews were reviewed independently by the authors for recurring themes. Field observations and the AKAM teacher diary were used to triangulate interview data.Findings: Data suggested that the intervention group benefited from and welcomed the additional daily physical activity when it offered high time-on-task, fun, and reflected students' interests. The intervention design with a dedicated physical activity leader and professional development support seemingly promoted teachers' confidence and enthusiasm.Conclusions: While this intervention was designed to complement physical education, we raise questions about how physical activity in schools may be channelled towards a new wave of instrumental outcomes. © 201

MRI Surveillance and Breast Cancer Mortality in Women With BRCA1 and BRCA2 Sequence Variations

ImportanceMagnetic resonance imaging (MRI) surveillance is offered to women with a pathogenic variant in the BRCA1 or BRCA2 gene who face a high lifetime risk of breast cancer. Surveillance with MRI is effective in downstaging breast cancers, but the association of MRI surveillance with mortality risk has not been well defined.ObjectiveTo compare breast cancer mortality rates in women with a BRCA1 or BRCA2 sequence variation who entered an MRI surveillance program with those who did not.Design, setting, and participantsWomen with a BRCA1 or BRCA2 sequence variation were identified from 59 participating centers in 11 countries. Participants completed a baseline questionnaire between 1995 and 2015 and a follow-up questionnaire every 2 years to document screening histories, incident cancers, and vital status. Women who had breast cancer, a screening MRI examination, or bilateral mastectomy prior to enrollment were excluded. Participants were followed up from age 30 years (or the date of the baseline questionnaire, whichever was later) until age 75 years, the last follow-up, or death from breast cancer. Data were analyzed from January 1 to July 31, 2023.ExposuresEntrance into an MRI surveillance program.Main outcomes and measuresCox proportional hazards modeling was used to estimate the hazard ratios (HRs) and 95% CIs for breast cancer mortality associated with MRI surveillance compared with no MRI surveillance using a time-dependent analysis.ResultsA total of 2488 women (mean [range] age at study entry 41.2 [30-69] years), with a sequence variation in the BRCA1 (n = 2004) or BRCA2 (n = 484) genes were included in the analysis. Of these participants, 1756 (70.6%) had at least 1 screening MRI examination and 732 women (29.4%) did not. After a mean follow-up of 9.2 years, 344 women (13.8%) developed breast cancer and 35 women (1.4%) died of breast cancer. The age-adjusted HRs for breast cancer mortality associated with entering an MRI surveillance program were 0.20 (95% CI, 0.10-0.43; P < .001) for women with BRCA1 sequence variations and 0.87 (95% CI, 0.10-17.25; P = .93) for women with BRCA2 sequence variations.Conclusion and relevanceResults of this cohort study suggest that among women with a BRCA1 sequence variation, MRI surveillance was associated with a significant reduction in breast cancer mortality compared with no MRI surveillance. Further studies of women with BRCA2 sequence variations are needed to ascertain these women obtain the same benefits associated with MRI surveillance

Bilateral Oophorectomy and All-Cause Mortality in Women With BRCA1 and BRCA2 Sequence Variations

ImportancePreventive bilateral salpingo-oophorectomy is offered to women at high risk of ovarian cancer who carry a pathogenic variant in BRCA1 or BRCA2; however, the association of oophorectomy with all-cause mortality has not been clearly defined.ObjectiveTo evaluate the association between bilateral oophorectomy and all-cause mortality among women with a BRCA1 or BRCA2 sequence variation.Design, setting, and participantsIn this international, longitudinal cohort study of women with BRCA sequence variations, information on bilateral oophorectomy was obtained via biennial questionnaire. Participants were women with a BRCA1 or BRCA2 sequence variation, no prior history of cancer, and at least 1 follow-up questionnaire completed. Women were followed up from age 35 to 75 years for incident cancers and deaths. Cox proportional hazards regression was used to estimate the hazard ratios (HRs) and 95% CIs for all-cause mortality associated with a bilateral oophorectomy (time dependent). Data analysis was performed from January 1 to June 1, 2023.ExposuresSelf-reported bilateral oophorectomy (with or without salpingectomy).Main outcomes and measuresAll-cause mortality, breast cancer-specific mortality, and ovarian cancer-specific mortality.ResultsThere were 4332 women (mean age, 42.6 years) enrolled in the cohort, of whom 2932 (67.8%) chose to undergo a preventive oophorectomy at a mean (range) age of 45.4 (23.0-77.0) years. After a mean follow-up of 9.0 years, 851 women had developed cancer and 228 had died; 57 died of ovarian or fallopian tube cancer, 58 died of breast cancer, 16 died of peritoneal cancer, and 97 died of other causes. The age-adjusted HR for all-cause mortality associated with oophorectomy was 0.32 (95% CI, 0.24-0.42; P < .001). The age-adjusted HR was 0.28 (95% CI, 0.20-0.38; P < .001) and 0.43 (95% CI, 0.22-0.90; P = .03) for women with BRCA1 and BRCA2 sequence variations, respectively. For women with BRCA1 sequence variations, the estimated cumulative all-cause mortality to age 75 years for women who had an oophorectomy at age 35 years was 25%, compared to 62% for women who did not have an oophorectomy. For women with BRCA2 sequence variations, the estimated cumulative all-cause mortality to age 75 years was 14% for women who had an oophorectomy at age 35 years compared to 28% for women who did not have an oophorectomy.Conclusions and relevanceIn this cohort study among women with a BRCA1 or BRCA2 sequence variation, oophorectomy was associated with a significant reduction in all-cause mortality