Breastfeeding duration and residential isolation amid Aboriginal children in Western Australia

Objectives: To examine factors that impact on breastfeeding duration among Western Australian Aboriginal children. We hypothesised that Aboriginal children living in remote locations in Western Australia were breastfed for longer than those living in metropolitan locations. Methods: A population-based cross-sectional survey was conducted from 2000 to 2002 in urban, rural and remote settings across Western Australia. Cross-tabulations and multivariate logistic regression analyses were performed, using survey weights to produce unbiased estimates for the population of Aboriginal children. Data on demographic, maternal and infant characteristics were collected from 3932 Aboriginal birth mothers about their children aged 0–17 years (representing 22,100 Aboriginal children in Western Australia). Results: 71% of Aboriginal children were breastfed for three months or more. Accounting for other factors, there was a strong gradient for breastfeeding duration by remoteness, with Aboriginal children living in areas of moderate isolation being 3.2 times more likely to be breastfed for three months or more (p <0.001) compared to children in metropolitan Perth. Those in areas of extreme isolation were 8.6 times more likely to be breastfed for three months or longer (p <0.001). Conclusions: Greater residential isolation a protective factor linked to longer breastfeeding duration for Aboriginal children in our West Australian cohort

Indiana Uplands Park, Recreation, and Protected Land Inventory and Opportunity Mapping

This study was undertaken to better understand the resources in the Indiana Uplands region and the opportunities that exist. Specifically, the purpose was to: • Develop an inventory of the region’s resources, which include public, non-profit, and private conservation and recreation areas, recreation and tourism facilities, and recreation and tourism programming in 11 counties; • Map the public, non-profit, and private conservation and recreation areas and facilities in the 11 Indiana counties; and • Provide recommendations to improve park, recreation, and protected land resources to assist communities with economic sustainability, health, and quality of life. The Indiana Uplands park, recreation, and protected lands inventory and opportunity mapping project included research and civic engagement. The research component comprised the identification of public, non-profit, and private conservation and recreation areas, recreation and tourism facilities, and recreation and tourism programming, their accessibility, and the benchmark analysis. The civic engagement piece of the study included focus groups with stakeholders in the 11 counties of the Indiana Uplands region to understand perceptions of resource use and opportunities for the region.Indiana University Center for Rural Engagemen

Socioeconomic disparities in physical health among Aboriginal and Torres Strait Islander children in Western Australia

Objective. Few empirical studies have specifically examined the relationship between socio-economic status (SES) and health in Indigenous populations of Australia. We sought to provide insights into the nature of this relationship by examining socio-economic disparities in physical health outcomes among Aboriginal and Torres Strait Islander children in Western Australia. Design. We used a diverse set of health and SES indicators from a representative survey conducted in 20002002 on the health and development of 5289 Indigenous children aged 017 years in Western Australia. Analysis was conducted using multivariate logistic regression within a multilevel framework. Results. After controlling for age and sex, we found statistically significant socio- economic disparities in health in almost half of the associations that were investigated, although the direction, shape and magnitude of associations differed. For ear infections, recurring chest infections and sensory function problems, the patterns were generally consistent with a positive socio-economic gradient where better health was associated with higher SES. The reverse pattern was found for asthma, accidents and injuries, and oral health problems, although this was primarily observed for area-level SES indicators. Conclusion. Conventional notions of social position and class have some influence on the physical health of Indigenous children, although the diversity of results implies that there are other ways of conceptualising and measuring SES that are important for Indigenous populations. We need to consider factors that relate specifically to Indigenous circumstances and culture in the past and present day, and give more thought to how we measure social position in the Indigenous community, to gain a better understanding of the pathways from SES to Indigenous child health

Selumetinib in combination with dacarbazine in patients with metastatic uveal melanoma: a phase III, multicentre, randomised trial (SUMIT)

Purpose: Uveal melanoma is the most common primary intraocular malignancy in adults with no effective systemic treatment option in the metastatic setting. Selumetinib (AZD6244, ARRY-142886) is an oral, potent, and selective MEK1/2 inhibitor with a short half-life, which demonstrated single-agent activity in patients with metastatic uveal melanoma in a randomized phase II trial. Methods: The Selumetinib (AZD6244: ARRY-142886) (Hyd-Sulfate) in Metastatic Uveal Melanoma (SUMIT) study was a phase III, double-blind trial (ClinicalTrial.gov identifier: NCT01974752) in which patients with metastatic uveal melanoma and no prior systemic therapy were randomly assigned (3:1) to selumetinib (75 mg twice daily) plus dacarbazine (1,000 mg/m2 intravenously on day 1 of every 21- day cycle) or placebo plus dacarbazine. The primary end point was progression-free survival (PFS) by blinded independent central radiologic review. Secondary end points included overall survival and objective response rate. Results: A total of 129 patients were randomly assigned to receive selumetinib plus dacarbazine (n = 97) or placebo plus dacarbazine (n = 32). In the selumetinib plus dacarbazine group, 82 patients (85%) experienced a PFS event, compared with 24 (75%) in the placebo plus dacarbazine group (median, 2.8 v 1.8 months); the hazard ratio for PFS was 0.78 (95% CI, 0.48 to 1.27; two-sided P = .32). The objective response rate was 3% with selumetinib plus dacarbazine and 0% with placebo plus dacarbazine (two-sided P = .36). At 37% maturity (n = 48 deaths), analysis of overall survival gave a hazard ratio of 0.75 (95% CI, 0.39 to 1.46; two-sided P = .40). The most frequently reported adverse events (selumetinib plus dacarbazine v placebo plus dacarbazine) were nausea (62% v 19%), rash (57% v 6%), fatigue (44% v 47%), diarrhea (44% v 22%), and peripheral edema (43% v 6%). Conclusion: In patients with metastatic uveal melanoma, the combination of selumetinib plus dacarbazine had a tolerable safety profile but did not significantly improve PFS compared with placebo plus dacarbazine

Using atmospheric trace gas vertical profiles to evaluate model fluxes: a case study of Arctic-CAP observations and GEOS simulations for the ABoVE domain

Accurate estimates of carbon&ndash;climate feedbacks require an independent means for evaluating surface flux models at regional scales. The altitude-integrated enhancement (AIE) derived from the Arctic Carbon Atmospheric Profiles (Arctic-CAP) project demonstrates the utility of this bulk quantity for surface flux model evaluation. This bulk quantity leverages background mole fraction values from the middle free troposphere, is agnostic to uncertainties in boundary layer height, and can be derived from model estimates of mole fractions and vertical gradients. To demonstrate the utility of the bulk quantity, six airborne profiling surveys of atmospheric carbon dioxide (CO2), methane (CH4), and carbon monoxide (CO) throughout Alaska and northwestern Canada between April and November&nbsp;2017 were completed as part of NASA's Arctic&ndash;Boreal Vulnerability Experiment (ABoVE). The Arctic-CAP sampling strategy involved acquiring vertical profiles of CO2, CH4, and CO from the surface to 5&thinsp;km altitude at 25 sites around the ABoVE domain on a 4- to 6-week time interval. All Arctic-CAP measurements were compared to a global simulation using the Goddard Earth Observing System (GEOS) modeling system. Comparisons of the AIE bulk quantity from aircraft observations and GEOS simulations of atmospheric CO2, CH4, and CO highlight the fidelity of the modeled surface fluxes. The model&ndash;data comparison over the ABoVE domain reveals that while current state-of-the-art models and flux estimates are able to capture broad-scale spatial and temporal patterns in near-surface CO2 and CH4 concentrations, more work is needed to resolve fine-scale flux features that are captured in CO observations. &nbsp;</p

Research Needs and Challenges in the FEW System: Coupling Economic Models with Agronomic, Hydrologic, and Bioenergy Models for Sustainable Food, Energy, and Water Systems

On October 12–13, a workshop funded by the National Science Foundation was held at Iowa State University in Ames, Iowa with a goal of identifying research needs related to coupled economic and biophysical models within the FEW system. Approximately 80 people attended the workshop with about half representing the social sciences (primarily economics) and the rest from the physical and natural sciences. The focus and attendees were chosen so that findings would be particularly relevant to SBE research needs while taking into account the critical connectivity needed between social sciences and other disciplines. We have identified several major gaps in existing scientific knowledge that present substantial impediments to understanding the FEW system. We especially recommend research in these areas as a priority for future funding: 1. Economic models of decision-making in coupled systems Deliberate human activity has been the dominant factor driving environmental and land-use changes for hundreds of years. While economists have made great strides in modeling and understanding these choices, the coupled systems modeling literature, with some important exceptions, has not reflected these contributions. Several paths forward seem fruitful. First, baseline economic models that assume rationality can be used much more widely than they are currently. Moreover, the current generation of IAMs that include rational agents have emphasized partial equilibrium studies appropriate for smaller systems. To allow this approach to be used to study larger systems, the potential for (and consequences of) general equilibrium effects should be studied as well. Second, it is important to address shortcomings in these models of economic decision-making. Valuable improvements could be gained from developing coupled models that draw insights from behavioral economics. Many decision-makers deviate systematically from actions that would be predicted by strict rationality, but very few IAMs incorporate this behavior, potentially leading to inaccurate predictions about the effects of policies and regulations. Improved models of human adaptation and induced technological change can also be incorporated into coupled models. Particularly for medium to long-run models, decisions about adaptation and technological change will have substantial effects on the conclusions and policy implications, but more compelling methods for incorporating these changes into modeling are sorely needed. In addition, some economic decisions are intrinsically dynamic yet few coupled models explicitly incorporate dynamic models. Economic models that address uncertainty in decision making are also underutilized in coupled models of the FEW system. 2. Coupling models across disciplines Despite much recent progress, established models for one component of the FEW system often cannot currently produce outcomes that can be used as inputs for models of other components. This misalignment makes integrated modeling difficult and is especially apparent in linking models of natural phenomena with models of economic decision-making. Economic agents typically act to maximize a form of utility or welfare that is not directly linked to physical processes, and they typically require probabilistic forecasts as an input to their decision-making that many models in the natural sciences cannot directly produce. We believe that an especially promising approach is the development of “bridge” models that convert outputs from one model into inputs for another. Such models can be viewed as application-specific, reduced-form distillations of a richer and more realistic underlying model. Ideally, these bridge models would be developed in collaborative research projects involving economists, statisticians, and disciplinary specialists, and would contribute to improved understanding in the scientific discipline as well. 3. Model validation and comparison There is little clarity on how models should be evaluated and compared to each other, both within individual disciplines and as components of larger IAMs. This challenge makes larger integrated modeling exercises extremely difficult. Some potential ways to advance are by developing statistical criteria that measure model performance along the dimensions suitable for inclusion in an IAM as well as infrastructure and procedures to facilitate model comparisons. Focusing on the models’ out-of-sample distributional forecasting performance, as well as that of the IAM overall, is especially promising and of particular importance. Moreover, applications of IAMs tend to estimate the effect of hypothetical future policy actions, but there have been very few studies that have used these models to estimate the effect of past policy actions. These exercises should be encouraged. They offer a well-understood test bed for the IAMs, and also contribute to fundamental scientific knowledge through better understanding of the episode in question. The retrospective nature of this form of analysis also presents the opportunity to combine reduced-form estimation strategies with the IAMs as an additional method of validation

Sugar sweetened beverage consumption by Australian children: Implications for public health strategy

<p>Abstract</p> <p>Background</p> <p>High consumption of sugar sweetened beverages (SSBs) has been linked to unhealthy weight gain and nutrition related chronic disease. Intake of SSB among children remains high in spite of public health efforts to reduce consumption, including restrictions on marketing to children and limitations on the sale of these products in many schools. Much extant literature on Australian SSB consumption is out-dated and lacks information on several key issues. We sought to address this using a contemporary Australian dataset to examine purchase source, consumption pattern, dietary factors, and demographic profile of SSB consumption in children.</p> <p>Methods</p> <p>Data were from the 2007 Australian National Children's Nutrition and Physical Activity Survey, a representative random sample of 4,834 Australian children aged 2-16 years. Mean SSB intake by type, location and source was calculated and logistic regression models were fitted to determine factors associated with different levels of consumption.</p> <p>Results</p> <p>SSB consumption was high and age-associated differences in patterns of consumption were evident. Over 77% of SSB consumed was purchased via supermarkets and 60% of all SSB was consumed in the home environment. Less than 17% of SSB was sourced from school canteens and fast food establishments. Children whose parents had lower levels of education consumed more SSB on average, while children whose parents had higher education levels were more likely to favour sweetened juices and flavoured milks.</p> <p>Conclusions</p> <p>SSB intake by Australian children remains high and warrants continued public health attention. Evidence based and age-targeted interventions, which also recognise supermarkets as the primary source of SSB, are recommended to reduce SSB consumption among children. Additionally, education of parents and children regarding the health consequences of high consumption of both carbonated and non-carbonated SSBs is required.</p

Pan-Cancer Analysis of lncRNA Regulation Supports Their Targeting of Cancer Genes in Each Tumor Context

Long noncoding RNAs (lncRNAs) are commonly dys-regulated in tumors, but only a handful are known toplay pathophysiological roles in cancer. We inferredlncRNAs that dysregulate cancer pathways, onco-genes, and tumor suppressors (cancer genes) bymodeling their effects on the activity of transcriptionfactors, RNA-binding proteins, and microRNAs in5,185 TCGA tumors and 1,019 ENCODE assays.Our predictions included hundreds of candidateonco- and tumor-suppressor lncRNAs (cancerlncRNAs) whose somatic alterations account for thedysregulation of dozens of cancer genes and path-ways in each of 14 tumor contexts. To demonstrateproof of concept, we showed that perturbations tar-geting OIP5-AS1 (an inferred tumor suppressor) andTUG1 and WT1-AS (inferred onco-lncRNAs) dysre-gulated cancer genes and altered proliferation ofbreast and gynecologic cancer cells. Our analysis in-dicates that, although most lncRNAs are dysregu-lated in a tumor-specific manner, some, includingOIP5-AS1, TUG1, NEAT1, MEG3, and TSIX, synergis-tically dysregulate cancer pathways in multiple tumorcontexts