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Sir Gustav Nossal, universally known as Gus Nossal, is Australia's best known medical research scientist and advocate, who over the past five decades has influenced the course of immunology. His research interests in this field commenced during PhD studies, and his accomplishments centre around the cellular events of antibody production. His scientific achievements are matched by the energy he has devoted over his entire career to public health; science in society; political, philanthropic and community support for science; global access to existing vaccines and development of new vaccines; and the personal and scientific development of colleagues and young scientists. His contribution and philosophy of science, together with political influence, capacity to inspire and an extraordinarily engaging personality, place Gus Nossal in the top bracket of biomedical scientists of the second half of the 20th century.
Although substance abuse professionals are generally open to new and better therapeutic methods, most evidence-based treatments do not easily find their way into practice. Natural diffusion processes for innovations in substance abuse treatments are relatively informal and have yielded a widely acknowledged gap between science and community practice. This review focuses on methods for effectively disseminating new treatment methods into practice. Therapist manuals and one-time workshops are in themselves relatively ineffective in helping practitioners gain proficiency in new clinical approaches. Individual performance feedback and coaching improve the acquisition of clinical skills. Specific incentives for implementation may also be needed to encourage treatment providers, programs, and systems to adopt new approaches.
Adolescence is a time of rapid growth and development with biologic, psychological, and emotional changes occurring simultaneously. We conducted a critical review of the literature to analyze key topics in the study of adolescents' eating behaviors and to identify barriers to healthy eating experienced by adolescents. The literature documents that nutritional deficits and poor eating established during adolescence have long-term health, growth, and developmental consequences. Gaps in the literature are identified and recommendations for future studies are proposed.
The basic science immunology community is quite accepting of the phenomenon of oral tolerance induction in animals; however, in contradistinction, the clinical community is somewhat agnostic regarding oral tolerance. Progress in multiple sclerosis has not been definitive and outcomes in RA have been modest at best. Recent reports in animal models have suggested that oral ingestion of autoantigen can have deleterious effects on the host. Although those experiments have had a highly artificial framework, they are consistent with the possibility that oral antigen therapy in human disease may be: (1) beneficial; (2) of no consequence; or (3) detrimental. An extremely open mind will hopefully be applied to future research efforts.
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DATA SOURCES: Medline, PubMed, Embase, Cochrane Central Register of Controlled Trials, Dissertation Abstracts, SIGLE, the World Wide Web (Google) and the Community of Science Database were searched for relevant trials and references. Reference lists from relevant articles were scanned and the authors contacted to identify trials and obtain additional information. There were no language restrictions. Trials pre-1966 were not searched. STUDY SELECTION: Studies were selected if they met the following criteria: randomised controlled trials of conscious sedation comparing two or more drugs/techniques/placebo undertaken by the dentist or one of the dental team in anxious children up to 16 years of age. DATA EXTRACTION AND SYNTHESIS: Information regarding methods, participants, interventions and outcome measures and results was independently extracted, in duplicate, by two authors. Specialist advice was sought to categorise interventions. Authors of trials were contacted for details of randomisation and withdrawals and a quality assessment was carried out not using any formal scoring system. The Cochrane Oral Health Group statistical guidelines were followed. RESULTS: Fifty-three studies were included with 2345 subjects in total. Overall quality of studies was found to be disappointing with poor reporting, often the main problem. Data reported could not easily be aggregated into groups to facilitate description of results. Meta-analysis of the available data was also not possible for the same reason. The variety of differing drug regimens compared made it difficult to isolate groups of studies that were sufficiently similar in design to allow sensible comparison. Where groups of studies could be isolated, the differing outcome measures used made their meta-analysis impossible. CONCLUSIONS: Authors were not able to reach any definitive conclusion on which was the most effective drug or method of sedation used for anxious children. A list of proposed areas of study was described.
Evidence-based nutrition is essential to move forward in the science of community nutrition. The present study is a review of the epidemiological evidence of dairy products and health. There is an inverse association between the intake of dairy products and hypertension, stroke and colorectal cancer. There is no evidence of an association between the consumption of dairy products and breast cancer. There is some evidence linking high-fat dairy products and an incremental risk of prostate cancer and weak evidence of the protective capacity of dairy products on bone health. More prospective studies should be developed in order to establish better evidence of the relationship between dairy products and health. Due to the importance of dairy products in public health nutrition, quantitative recommendations should be established in the light of the scientific evidence.
OBJECTIVES: To determine whether EMS educational programs in North Carolina adequately prepare paramedics, and whether there is additional value to an associate of applied science (AAS) degree education in EMS when compared with traditional certificate training programs. METHODS: Surveys were developed and distributed to EMS administrators, AAS paramedics, and certificate paramedics. The administrators were asked to rate the performance of both AAS and certificate paramedics in the areas of preemployment evaluation, patient-care skills, and non-patient-care duties. The paramedics were asked to rate their preparation for specific responsibilities within those three categories. All of the participants were asked to describe the requirements for employment within their EMS systems, and any preferences given to AAS paramedics. RESULTS: The administrators rated both AAS and certificate paramedics as good or excellent in all three categories. The paramedics also rated their preparation for patient care as good or excellent. The certificate paramedics rated their preparation for eight non-patient-care duties significantly lower than did the AAS paramedics. The eight areas were: 1) verbal communication, 2) reading ability, 3) leadership, 4) conflict resolution, 5) computer skills, 6) teaching skills, 7) personal health/hygiene, and 8) Occupational Safety and Health Administration (OSHA) compliance. Fewer than half of the EMS administrators reported preferences in hiring (46.2%) or promotion (39.6%) for AAS paramedics, but at least half (50.0% and 54.2%) of the AAS paramedics worked in systems offering such preferences. CONCLUSIONS: While administrators and paramedics believe the current EMS educational programs in North Carolina adequately prepare students to function as paramedics, there are identifiable areas that require additional emphasis. There appears to be additional value to an AAS education when compared with traditional certificate EMS educational programs.
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BACKGROUND AND AIMS: Leaf thickness plays an important role in leaf and plant functioning, and relates to a species' strategy of resource acquisition and use. As such, it has been widely used for screening purposes in crop science and community ecology. However, since its measurement is not straightforward, a number of estimates have been proposed. Here, the validity of the (SLA x LDMC)(-1) product is tested to estimate leaf thickness, where SLA is the specific leaf area (leaf area/dry mass) and LDMC is the leaf dry matter content (leaf dry mass/fresh mass). SLA and LDMC are two leaf traits that are both more easily measurable and often reported in the literature. METHODS: The relationship between leaf thickness (LT) and (SLA x LDMC)(-1) was tested in two analyses of covariance using 11 datasets (three original and eight published) for a total number of 1039 data points, corresponding to a wide range of growth forms growing in contrasted environments in four continents. KEY RESULTS AND CONCLUSIONS: The overall slope and intercept of the relationship were not significantly different from one and zero, respectively, and the residual standard error was 0.11. Only two of the eight datasets displayed a significant difference in the intercepts, and the only significant difference among the most represented growth forms was for trees. LT can therefore be estimated by (SLA x LDMC)(-1), allowing leaf thickness to be derived from easily and widely measured leaf traits.
Social-ecological (SE) models are becoming more widely used in health behavior research. Applying SE models to the design of interventions is challenging because models must be tailor-made for each behavior and population, other theories need to be integrated into multi-level frameworks, and empirical research to guide model development is limited. The purpose of the present paper is to describe a SE framework that guided the intervention and measurement plans for a specific study. The trial of activity for adolescent girls (TAAG) is a multi-center study of interventions to reduce the decline of physical activity in adolescent girls. The TAAG framework incorporates operant learning theory, social cognitive theory, organizational change theory and the diffusion of innovation model in a multi-level model. The explicit and practical model developed for TAAG has already benefited the study and may have elements that can generalize to other health promotion studies.
A partnership in Genesee County, Michigan, has been working to reduce African American infant mortality. A plan was developed utilizing "bench" science and community residents' "trench" knowledge. Its theoretical foundation is ecological, grounded in a philosophy of public health as social justice, and based on the understanding that cultural beliefs and practices can be both protective and harmful. Partners agree that no single intervention will eliminate racial disparities and that interventions must precede, include, and follow the period of pregnancy. Core themes for the work include: reducing racism, enhancing the medical care and social services systems, and fostering community mobilization. Strategies include community dialogue and raising awareness, education and training, outreach and advocacy, and mentoring and support. The evaluation has several components: scrutinizing the effect of partnership activities on direct measures of infant health; analyzing changes in knowledge, attitudes, behaviors and other mediating variables thought to influence maternal and infant health; and effecting changes in personal and organizational policy and practice.
The role of social support in promoting recovery from chronic illness has been the focus of a debate within the nursing and social science research communities. This paper reviews the literature on this important issue and discusses the implications for patient management. In providing holistic patient care, health care professionals need to reflect on the impact of this research for their clinical practice.
Previous studies have consistently shown that autopsy examination after surgery can identify a significant rate of discrepant and/or erroneous diagnoses. Findings gleaned from autopsies can be invaluable for the medical community and science as a whole, ultimately leading to improvements in quality surgical care. Despite the proven benefits of this underused tool, the number of autopsies carried out in Australian hospitals is declining dramatically, with autopsy rates plummeting from 21% in 1992-1993 to 12% in 2002-2003. This notable decline ought to be a genuine source of concern and deserves further examination. This review seeks to address the reasons for decline, while reasserting the value and relevance of autopsies within modern surgical practice Down Under.
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BACKGROUND: High-throughput systems are powerful tools for the life science research community. The complexity and volume of data from these systems, however, demand special treatment. Graphical tools are needed to evaluate many aspects of the data throughout the analysis process because plots can provide quality assessments for thousands of values simultaneously. The utility of a plot, in turn, is contingent on both its interpretability and its efficiency. RESULTS: The shivplot, a graphical technique motivated by microarrays but applicable to any replicated high-throughput data set, is described. The plot capitalizes on the strengths of three well-established plotting graphics--a boxplot, a distribution density plot, and a variability vs intensity plot--by effectively combining them into a single representation. CONCLUSION: The utility of the new display is illustrated with microarray data sets. The proposed graph, retaining all the information of its precursors, conserves space and minimizes redundancy, but also highlights features of the data that would be difficult to appreciate from the individual display components. We recommend the use of the shivplot both for exploratory data analysis and for the communication of experimental data in publications.
During the past 20 years there have been great developments in the scientific understanding of the role of nutrition in health and physical performance. Epidemiological and physiological studies have provided evidence that certain forms of dietary behaviour may be linked with an increased risk of developing disorders such as high blood pressure, coronary artery disease and some cancers. This has resulted in dietary recommendations that are intended to reduce the incidence of these disorders in the community. The science of nutrition in relation to sports performance has progressed from empirical studies investigating the effects of dietary manipulations, such as restriction and supplementation, to the direct investigation of the physiological basis of the specific nutritional demands of hard physical exercise. This review is based on the premise that it is "what comes out' rather than "what goes in', which provides the clues to ideal nutrition for athletic performance. Various aspects of the physical demands of athletic exercise are viewed as stresses that induce specific biochemical, and hence nutritional, strains in the athlete. Training is the predominant demand in the athletic lifestyle. This is characterised by acute bouts of high power output. During one hour of hard training an athlete may expend 30% of his or her total 24-hour energy output. These high power outputs have important implications for energy substrate and water requirements. Carbohydrate, specifically muscle glycogen, is an obligatory fuel for the high power outputs demanded by athletic sports. Muscle glycogen is a limiting factor in hard exercise because it is held in limited amounts, utilised rapidly by intense exercise, and fatigue occurs when it is depleted to low levels in the active muscles. Liver glycogen may also be exhausted by hard exercise and low blood glucose contributes to fatigue. High sweat rates are demanded during severe exercise and large water deficits commensurate with energy expenditure are incurred during extended periods of hard training and competition. Salt, potassium, and magnesium are lost in nutritionally significant amounts in the sweat, but vitamins and trace elements are not. Adaptive mechanisms protect athletes against electrolyte depletion. Iron loss in sweat may contribute to the iron deficiency seen in some endurance runners. Protein is degraded and amino acids are oxidised during physical exercise. Protein is also retained during muscle building training. Recent investigations indicate that the minimal protein requirements of athletes may be substantially higher than those for sedentary persons.(ABSTRACT TRUNCATED AT 400 WORDS)