Gains in life expectancy in the Australian population due to reductions in smoking : comparisons between interventions targeting the population versus interventions in a specific high risk group

Background: Four decades of population-based tobacco control strategies have contributed to substantial reduction in smoking prevalence in Australia. However, smoking prevalence is still double in socially disadvantaged groups compared to those that are not. But not all tobacco control strategies successfully used in the general population is effective in specific high-risk population groups. Hence, an effective way to reduce smoking in high risk population groups may include targeting them specifically to identify and support smokers to quit. In this backdrop, we examined whether tobacco control interventions at the population-level are more effective in increasing life expectancy among Australians compared to interventions targeting a high risk group or a combination of the two when smoking prevalence is reduced to 10 and 0% respectively. Methods: Using the risk percentiles approach, analyses were performed separately for men and women using data from various sources such as the 2014–15 National Health Survey linked to death registry, simulated data for high risk groups, and the Australian population and deaths data from the census. Indigenous status was simulated by preferentially assigning those who are indigenous to lower SES quintiles. The age-sex distribution of mental disorder status was simulated using its distribution from 2016 National Drug Strategy Household Survey with 25.9% of mentally ill being assigned to current smoking category and the rest to non-smoking category. The age-sex distribution of prisoners was simulated based on 2014 ABS Prisoners Australia survey with 74% of prisoners being assigned to current smoker category and the rest to non-smoker category. Homelessness status was simulated according to age, sex and indigenous status for 2011 census with all homeless being allocated to the lowest SES category. The age-sex distribution of total cholesterol level was simulated based on 2011–13 Australian Health Survey. Results: The results showed that the combined approach for reducing smoking is most effective for improving life expectancy of Australians particularly for the socially disadvantaged and mentally ill groups both of which have high fraction of smokers in the population. For those who were mentally ill the gain in ALE due to reduction of smoking to 10% was 0.53 years for males and 0.36 years for females which were around 51 and 42% respectively of the maximal gains in ALE that could be achieved through complete cessation. Conclusions: Targeting high-risk population groups having substantial fraction of smokers in the population can strongly complement the existing population-based smoking reduction strategies. As population and high risk approaches are both important, the national prevention policies should make judicious use of both to maximize health gain

CALL BROADCASTING AND AUTOMATED RECORDERS AS TOOLS FOR ANURAN SURVEYS IN A SUBARCTIC TUNDRA LANDSCAPE

Relatively little is known about population ecology of anurans in arctic and subarctic tundra regions, in part because it is difficult to survey anurans in these landscapes. Anuran survey protocols developed for temperate regions have limited applicability in arctic and subarctic tundra landscapes, which may lack roads and vehicle access, and experience variable and inclement weather during short anuran breeding seasons. To evaluate approaches to address some of the limitations of surveying anurans in tundra landscapes, we assessed the effectiveness of using breeding call broadcasts to increase detection of Boreal Chorus Frogs (Pseudacris maculata) and Wood Frogs (Lithobates sylvaticus) near Cape Churchill, Manitoba, Canada. We also evaluated how counts of anurans derived from automated audio recorders compared with those obtained simultaneously by observers. We detected on average 0.4 additional Wood Frogs per survey when we broadcasted calls (x = 0.82, SD = 1.38), an increase of > 40% compared to surveys without broadcasts (x = 1.24, SD = 1.51; Wilcoxon test; Z = 2.73, P = 0.006). In contrast, broadcasting Boreal Chorus Frog calls did not increase the number of chorus frog detections (Wilcoxon test; Z < 0.001, P > 0.90). Detections of Wood Frogs in a 100-m radius were lower via automated recorders (x = 0.60, SD = 0.87 SD) than by observers during simultaneous surveys (x = 0.96, SD = 1.27 Z = 2.07, P = 0.038), but those of Boreal Chorus Frogs were not different (x = 1.72, SD = 1.31;x = 1.44, SD = 1.5; Z = 1.55, P > 0.121). Our results suggest that broadcasting calls can increase detection of Wood Frogs, and that automated recorders are useful in detecting both Wood Frogs and Boreal Chorus Fogs in arctic and subarctic tundra landscapes

Self modulated dynamics of a relativistic charged particle beam in plasma wake field excitation

Self modulated dynamics of a relativistic charged particle beam is reviewed within the context of the theory of plasma wake field excitation. The self-consistent description of the beam dynamics is provided by coupling the Vlasov equation with a Poisson-type equation relating the plasma wake potential to the beam density. An analysis of the beam envelope self-modulation is then carried out and the criteria for the occurrence of the instability are discussed thereby.Comment: This is a 10 pages manuscript which contain 4 figures. This manuscript is recently submitted in 'Nuclear Instruments and Methods in Physics Research Section A' as a proceeding of the conference 'EAAC 2015

Exploring the likely effect of the introduction of drug eluting stents on requirements for coronary artery revascularisation procedures in Western Australia: a use of the CHD/CARP Markov Simulation Model

Background: Coronary artery revascularisation procedures (CARPs) include coronary artery bypass graft procedures (CABGs) and the less invasive percutaneous coronary interventions (PCIs) and they are common surgical interventions for coronary heart disease (CHD). The effectiveness of PCIs increased when stents were introduced and there was also a shift towards doing more PCIs and less CABGs, especially in older patients. More recently, PCIs have been further improved by the use of drug-eluting-stents (DES). In this study we used a recently developed CHD/CARP Markov model to explore the likely effect on CARP requirements due to the introduction of DES. Methods: This is achieved by considering the population of Western Australia aged 35 to 79 years at the beginning of 2001 (grouped according to history of CHD and CARPs) as the cohort, calculating the mean population risks for CHD/CARP events over three years 1998 to 2000, and using these population risks and certain modifications of them that incorporate the likely effect of the introduction of DES (in 2002) in the CHD/CARP Markov model to explore difference in total requirements for CABGs and PCIs over the period 2001 to 2010. The anticipated likely effect of DES on probabilities of CARP procedures was based on results of meta-analysis of randomized controlled trials comparing DES stents to ordinary stents and an anticipated further reduction in CABGs and increase in PCIs as was observed when (ordinary) stents were introduced. Results: The simulation results suggest that, over the period 2001 to 2010, the total number of CABGs will decline by up to 19% and the total number of PCIs will increase by up to 6%. Conclusion: The introduction of DES will have greater effect on the requirement of CABGs as compared to that on PCIs

Age at quitting smoking as a predictor of risk of cardiovascular disease incidence independent of smoking status, time since quitting and pack-years

BACKGROUND Risk prediction for CVD events has been shown to vary according to current smoking status, pack-years smoked over a lifetime, time since quitting and age at quitting. The latter two are closely and inversely related. It is not known whether the age at which one quits smoking is an additional important predictor of CVD events. The aim of this study was to determine whether the risk of CVD events varied according to age at quitting after taking into account current smoking status, lifetime pack-years smoked and time since quitting. FINDINGS We used the Cox proportional hazards model to evaluate the risk of developing a first CVD event for a cohort of participants in the Framingham Offspring Heart Study who attended the fourth examination between ages 30 and 74 years and were free of CVD. Those who quit before the median age of 37 years had a risk of CVD incidence similar to those who were never smokers. The incorporation of age at quitting in the smoking variable resulted in better prediction than the model which had a simple current smoker/non-smoker measure and the one that incorporated both time since quitting and pack-years. These models demonstrated good discrimination, calibration and global fit. The risk among those quitting more than 5 years prior to the baseline exam and those whose age at quitting was prior to 44 years was similar to the risk among never smokers. However, the risk among those quitting less than 5 years prior to the baseline exam and those who continued to smoke until 44 years of age (or beyond) was two and a half times higher than that of never smokers. CONCLUSIONS Age at quitting improves the prediction of risk of CVD incidence even after other smoking measures are taken into account. The clinical benefit of adding age at quitting to the model with other smoking measures may be greater than the associated costs. Thus, age at quitting should be considered in addition to smoking status, time since quitting and pack-years when counselling individuals about their cardiovascular risk.This research was supported by an NHMRC health services research grant (no. 465130), an NHMRC/NHF PhD scholarship and a Vichealth Fellowship

Password Generators:Old Ideas and New

This paper considers password generators, i.e. systems designed to generate site-specific passwords on demand. Such systems are an alternative to password managers. Over the last 15 years a range of password generator systems have been described. This paper proposes the first general model for such systems, and critically examines options for instantiating this model; options considered include all those previously proposed as part of existing schemes as well as certain novel possibilities. The model enables a more objective and high-level assessment of the design of such systems; it has also been used to sketch a possible new scheme, AutoPass, intended to incorporate the best features of the prior art whilst also addressing many of the most serious shortcomings of existing systems through the inclusion of novel features.Comment: This is the full version of a paper with the same title due to be published in the proceedings of WISTP 2016 in September 201

Sex adjusted standardized prevalence ratios for celiac disease and other autoimmune diseases in patients with postural orthostatic tachycardia syndrome (POTS) : a systematic review and meta-analysis

Standardised sex-adjusted prevalence ratios (SSPRs) have not been published for any autoimmune diseases (ADs) in patients with Postural Orthostatic Tachycardia Syndrome (POTS), who are predominantly young females. We performed a systematic review according to PRISMA guidelines of POTS cohorts reporting the prevalence of at least one AD. Only four studies were found: two providing data on celiac disease; and two with data on ‘any AD’, Hashimoto’s thyroiditis, rheumatoid arthritis, systemic lupus erythematosus (SLE), Sjogren ¨ ’s syndrome and celiac disease and (one study) antiphospholipid syndrome. All studies were assessed as being at high risk of bias for estimating AD prevalence in POTS patients, with under-reporting of ADs likely due to the lack of rigorous prospective screening for ADs. A literature search found a ‘gold standard’ general population (GP) comparator only for celiac disease in the United States, leading to a pooled SSPR in POTS patients of 2.75 with 95% confidence interval (1.06–4.40). The lack of recent high-quality studies on GP prevalence for the other ADs was noteworthy. Exploratory pooled SSPRs were calculated for ‘any AD’ and for the other five ADs using GP comparator data from a comprehensive review. All pooled SSPRs were greater than one and statistically significant, implying a higher prevalence of these ADs, and any AD, in POTS patients. The magnitude of the exploratory SSPRs was very large for SLE, Sjogren ¨ ’s syndrome and antiphospholipid syndrome, perhaps reflecting the use of non-gold standard GP comparators, which may underestimate AD prevalence. Further research in a large POTS cohort with an appropriately age- and sex-matched GP control group is recommended, to confirm the SSPR for celiac disease and to determine whether SLE, Sjogren’s syndrome and antiphospholipid syndrome are indeed many times more prevalent in POTS patients than in the GP. The findings are consistent with POTS itself being an AD

Community women's lifestyle and eating disorders in the era of COVID-19 pandemic : a 15-year follow-up study

Most studies suggest that COVID-19 has adversely affected the quality of life and mental health, including eating disorders. However, studies have yet to examine longitudinally the impact of COVID-19 on eating disorder symptomatic individuals. This study aims to examine longitudinally the impact of the COVID-19 pandemic on the lifestyle and eating disorder symptoms of a symptomatic group of community-dwelling women. These women (n = 171) were enrolled in a longitudinal study, completed a COVID-19 modular self-report (post or Qualtrics, 2020/21), and participated in the current study. This study examined a 15th year follow-up. In 2020, 40% were tested for COVID-19. Of these, 87% had negative results; 5.3% self-isolated at home; 20.5% stopped working/studying in person; 28% continued online work/study; and 28% stopped work/studying in person. The pandemic affected sporting activities, music, and club activities (32.7% discontinued); 38% socialized in person; 16% socialized online; and 10% completely stopped socializing. Preliminary findings showed that the respondents showed no significant changes in levels of psychological distress (K10: 21.4 ± 9.8 vs. 19.0 ± 7.1, p < 0.171), and impaired quality of life (SF12: 50.9 ± 8.0 vs. 48.3 ± 9.5, p < 0.055) at 15-year follow-up. Eating disorder symptoms increased over time (EDE-Q global: 2.1 ± 1.4 vs. 2.9 ± 1.4, p < 0.013). Observed worsening of eating disorder-related symptoms during the COVID-19 pandemic may be due to interrupted eating patterns, exercise restrictions and the absence of social support. Provision and access to interventions to support those affected by eating disorders are a high priority, especially during these times. Further analyses with data imputation may find or further establish direct implications of COVID-19 in eating disorders

Association between the timing of pre-workout macronutrient intake and rated appetite among resistance-trained adults in Jbeil, Lebanon

Macronutrients play an important role in appetite regulation. In addition, adequate nutrient and energy intake, which may be altered by exercise-induced appetite fluctuations, is required to ensure important training outcomes. However, findings regarding appetite responses to macronutrient consumption before training and to different resistance training intensities remain inconclusive. This study investigated the association of three types of macronutrient intake before different intensities of resistance training with appetite. A purposive cross-sectional design was used to collect data from 280 resistance-trained individuals (mean age 26.4 ± 5.8 years) representing five gyms located in Jbeil, Lebanon, and who completed an online questionnaire. Data collected included socio-demographics, nutritional strategies followed by each respondent, training characteristics, and appetite rating before, during and after exercise using a validated visual analogue scale (VAS). A short-term suppression of appetite was reported during resistance-training, with no significant difference in exercise intensities (p > 0.05). In addition, low-fiber carbohydrate and protein food/beverage content consumed 30–60 min before training had an advantage in appetite suppression. In summary, these findings suggest that resistance training combined with pre-workout consumption of a whole meal was associated with appetite suppression, at least during the short period of exercise. From the perspective of appetite control and energy balance, the critical factor is the quantity and quality of macronutrient food sources, in addition to the timing surrounding training of nutrients ingested