To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To assess the extent of error present in self-reported weight data in the Women’s Health Initiative, variables that may be associated with error, and to develop methods to reduce any identified error.
Prospective cohort study.
Forty clinical centres in the USA.
Women (n 75 336) participating in the Women’s Health Initiative Observational Study (WHI-OS) and women (n 6236) participating in the WHI Long Life Study (LLS) with self-reported and measured weight collected about 20 years later (2013–2014).
The correlation between self-reported and measured weights was 0·97. On average, women under-reported their weight by about 2 lb (0·91 kg). The discrepancies varied by age, race/ethnicity, education and BMI. Compared with normal-weight women, underweight women over-reported their weight by 3·86 lb (1·75 kg) and obese women under-reported their weight by 4·18 lb (1·90 kg) on average. The higher the degree of excess weight, the greater the under-reporting of weight. Adjusting self-reported weight for an individual’s age, race/ethnicity and education yielded an identical average weight to that measured.
Correlations between self-reported and measured weights in the WHI are high. Discrepancies varied by different sociodemographic characteristics, especially an individual’s BMI. Correction of self-reported weight for individual characteristics could improve the accuracy of assessment of obesity status in postmenopausal women.
To assess the feasibility and acceptability of a beverage intervention in Hispanic adults.
Eligible individuals identified as Hispanic, were 18–64 years old and had BMI 30·0–50·0 kg/m2. Participants were randomized 2:2:1 to one of three beverages: Mediterranean lemonade (ML), green tea (GT) or flavoured water control (FW). After a 2-week washout period, participants were asked to consume 32 oz (946 ml) of study beverage daily for 6 weeks and avoid other sources of tea, citrus, juice and sweetened beverages; water was permissible. Fasting blood samples were collected at baseline and 8 weeks to assess primary and secondary efficacy outcomes.
Tucson, AZ, USA.
Fifty-two participants were recruited over 6 months; fifty were randomized (twenty-one ML, nineteen GT, ten FW). Study population mean (sd) age 44·6 (sd 10·2) years, BMI 35·9 (4·6) kg/m2; 78 % female.
Forty-four (88 %) completed the 8-week assessment. Self-reported adherence was high. No significant change (95 % CI) in total cholesterol (mg/dl) from baseline was shown −1·7 (−14·2, 10·9), −3·9 (−17·2, 9·4) and −13·2 (−30·2, 3·8) for ML, GT and FW, respectively. Mean change in HDL-cholesterol (mg/dl) −2·3 (−5·3, 0·7; ML), −1·0 (−4·2, 2·2; GT), −3·9 (−8·0, 0·2; FW) and LDL-cholesterol (mg/dl) 0·2 (−11·3, 11·8; ML), 0·5 (−11·4, 12·4; GT), −9·8 (−25·0, 5·4; FW) were also non-significant. Fasting glucose (mg/dl) increased significantly by 5·2 (2·6, 7·9; ML) and 3·3 (0·58, 6·4; GT). No significant change in HbA1c was demonstrated. Due to the small sample size, potential confounders and effect modifiers were not investigated.
Recruitment and retention figures indicate that a larger-scale trial is feasible; however, favourable changes in cardiometabolic biomarkers were not demonstrated.
This study examined the effectiveness of a formal postdoctoral education program designed to teach skills in clinical and translational science, using scholar publication rates as a measure of research productivity.
Participants included 70 clinical fellows who were admitted to a master’s or certificate training program in clinical and translational science from 1999 to 2015 and 70 matched control peers. The primary outcomes were the number of publications 5 years post-fellowship matriculation and time to publishing 15 peer-reviewed manuscripts post-matriculation.
Clinical and translational science program graduates published significantly more peer-reviewed manuscripts at 5 years post-matriculation (median 8 vs 5, p=0.041) and had a faster time to publication of 15 peer-reviewed manuscripts (matched hazard ratio = 2.91, p=0.002). Additionally, program graduates’ publications yielded a significantly higher average H-index (11 vs. 7, p=0.013).
These findings support the effectiveness of formal training programs in clinical and translational science by increasing academic productivity.
The effect of botanical diversity on supply of polyunsaturated fatty acids (PUFA) to ruminants in vitro, and the fatty acid (FA) composition of muscle in lambs was investigated. Six plant species, commonly grown as part of UK herbal ley mixtures (Trifolium pratense, Lotus corniculatus, Achillea millefolium, Centaurea nigra, Plantago lanceolata and Prunella vulgaris), were assessed for FA profile, and in vitro biohydrogenation of constituent PUFA, to estimate intestinal supply of PUFA available for absorption by ruminants. Modelling the in vitro data suggested that L. corniculatus and P. vulgaris had the greatest potential to increase 18:3n-3 supply to ruminants, having the highest amounts escaping in vitro biohydrogenation. Biodiverse pastures were established using the six selected species, under-sown in a perennial ryegrass-based sward. Lambs were grazed (~50 days) on biodiverse or control pastures and the effects on the FA composition of musculus longissimus thoracis (lean and subcutaneous fat) and musculus semimembranosus (lean) were determined. Biodiverse pasture increased 18:2n-6 and 18:3n-3 contents of m. semimembranosus (+14.8 and +7.2 mg/100 g tissue, respectively) and the subcutaneous fat of m. longissimus thoracis (+158 and +166 mg/100 g tissue, respectively) relative to feeding a perennial ryegrass pasture. However, there was no effect on total concentrations of saturated FA in the tissues studied. It was concluded that enhancing biodiversity had a positive impact on muscle FA profile reflected by increased levels of total PUFA.
Historical records are valuable for assessing glacier change in the Canadian High Arctic. Ommanney’s (1969) detailed inventory of Axel Heiberg Island glaciers, based on photography from 1958–59, has been revisited, converted into digital format and compared to glacier extents mapped from 1999–2000 satellite imagery. Our results show that the island-wide ice coverage decreased by 15.92 km2 in the 42 year period, a loss of <1%. However, two trends are apparent: one of advance or minor retreat from basins hosting outlet glaciers from Müller and Steacie Ice Caps, and one of significant retreat, on the order of 50–80%, for independent ice masses, which include valley glaciers, mountain glaciers, glacierets, and ice caps smaller than 25 km2. If the contributions to ice advance of only three surging glaciers are removed, then the island-wide ice loss approaches 60 km2. Furthermore, it is notable that 90% of ice masses smaller than 0.2 km2 disappeared entirely during the 42 year study period, an observation confirmed by field studies. Successful predictions from the original inventory are highlighted and the likely mechanisms driving the observed advances and retreats are discussed.
This article presents an analysis of challenges and considerations when developing digital mental health innovations. Recommendations include collaborative working between clinicians, researchers, industry and service users in order to successfully navigate challenges and to ensure e-therapies are engaging, acceptable, evidence based, scalable and sustainable.
The objective was to assess the effects of inclusion rate and chop length of lucerne silage, when fed in a total mixed ration (TMR), on milk yield, dry matter (DM) intake (DMI) and digestion in dairy cows. Diets were formulated to contain a 50 : 50 ratio of forage : concentrate (DM basis) and to be isonitrogenous (170 g/kg CP). The forage portion of the offered diets was comprised of maize and lucerne silage in proportions (DM basis) of either 25 : 75 (high Lucerne (HL)) or 75 : 25 (low lucerne (LL)). Lucerne was harvested and conserved as silage at either a long (L) or short (S) chop length. These variables were combined in a 2×2 factorial arrangement to give four treatments (HLL, HLS, LLL, LLS) which were fed in a Latin square design study to Holstein dairy cows in two separate experiments. In total, 16 and 8 multiparous, mid-lactation cows were used in experiments 1 and 2, respectively. To ensure sufficient silage for both experiments, different cuts of lucerne silage (taken from the same sward) were used for each experiment: first cut for experiment 1 (which was of poorer quality) and second cut for experiment 2. Dry matter intake, milk yield and milk composition where measured in both experiments, and total tract digestibility and nitrogen (N) balance were assessed using four cows in experiment 2. In experiment 1, cows fed LL had increased DMI (+3.2 kg/day), compared with those fed HL. In contrast, there was no difference in DMI due to lucerne silage inclusion rate in experiment 2. A reduction in milk yield was observed with the HL treatment in both experiment 1 and 2 (−3.0 and −2.9 kg/day, respectively). The HL diet had reduced digestibility of DM and organic matter (OM) (−3% and −4%, respectively), and also reduced the efficiency of intake N conversion into milk N (−4%). The S chop length increased total tract digestibility of DM and OM (both +4%), regardless of inclusion rate. Inclusion of lucerne silage at 25% of forage DM increased milk yield relative to 75% inclusion, but a S chop length partially mitigated adverse effects of HL on DMI and milk yield in experiment 1 and on DM digestibility in experiment 2.
Knowledge regarding association of dietary branched-chain amino acid (BCAA) and type 2 diabetes (T2D), and the contribution of BCAA from meat to the risk of T2D are scarce. We evaluated associations between dietary BCAA intake, meat intake, interaction between BCAA and meat intake and risk of T2D. Data analyses were performed for 74 155 participants aged 50−79 years at baseline from the Women’s Health Initiative for up to 15 years of follow-up. We excluded from analysis participants with treated T2D, and factors potentially associated with T2D or missing covariate data. The BCAA and total meat intake was estimated from FFQ. Using Cox proportional hazards models, we assessed the relationship between BCAA intake, meat intake, and T2D, adjusting for confounders. A 20 % increment in total BCAA intake (g/d and %energy) was associated with a 7 % higher risk for T2D (hazard ratio (HR) 1·07; 95 % CI 1·05, 1·09). For total meat intake, a 20 % increment was associated with a 4 % higher risk of T2D (HR 1·04; 95 % CI 1·03, 1·05). The associations between BCAA intake and T2D were attenuated but remained significant after adjustment for total meat intake. These relations did not materially differ with or without adjustment for BMI. Our results suggest that dietary BCAA and meat intake are positively associated with T2D among postmenopausal women. The association of BCAA and diabetes risk was attenuated but remained positive after adjustment for meat intake suggesting that BCAA intake in part but not in full is contributing to the association of meat with T2D risk.
Assessing time trend in health and health-related factors is important in monitoring population health and its determinants. The social and economic changes have been at a fast pace in recent times. However, the rate of change is not similar for every population subgroup. There were also different changes in policies and practices related to dental service delivery for children between states and territories. All these differences can have an effect on child oral health.
This chapter presents an analysis of trends between the current Survey and several existing surveys of child oral health in Australia. Australia's previous national survey among children, the National Oral Health Survey of Australia (NOHSA) was conducted in 1987–88. Dental caries experience was collected for samples of children across Australia. The National Survey of Adult Oral Health (NSAOH) 2004-06 collected dental fluorosis experience that allows for analysing time trend of fluorosis by year of birth (Slade et al. 2007).
The other available surveys are a series of the National Dental Telephone Interview Surveys (NDTIS) 1994–2013 and the Child Dental Health Surveys (CDHS) series. Dental service use by Australian children has been routinely collected in the NDTIS. The CDHS series collects administrative data on the oral health status of children attending school dental services in Australian states and territories. Therefore, those surveys covered just a proportion of the child population within each state/territory. This difference should be taken into account in interpreting results of this analysis. The CDHS data have been presented for age groups 6 years and 12 years. The presented data had been collected in Australia for the CDHS series from 1989 to 2010.
Two other oral epidemiological studies conducted among children attending school dental services were the Child Fluoride Study (CFS) Mark I 1992–93 and the Child Fluoride Study Mark II 2002–03. The CFS Mark I was conducted in Queensland and South Australia while the CFS Mark II was conducted in four states: Queensland, South Australia, Victoria and Tasmania. Information on child oral health behaviours was collected.
Trends in oral health status
Trend in dental caries experience
Time trend in dental caries experience was assessed using the NOHSA 1987–88, the CDHS series and the NCOHS 2012–14.
The target population for the Survey was Australian children aged 5–14 years. To draw a representative sample of children from this target population a stratified two-stage sample design was implemented within each state/territory. In the first stage, schools were selected from a sampling frame of schools located within each jurisdiction. In the second stage, children were sampled from each selected school.
The sampling strategy was designed to derive accurate population estimates of the oral health of Australian children, and to make valid comparisons between the oral health of children across regions within each state. For New South Wales, Victoria and Queensland, the geographical regions were based on Area Health Services/Health Districts, while in the remaining jurisdictions they were based on Capital City/Rest of State. As a consequence, the sampling methodology differed slightly for each jurisdiction.
To sample children across the age range of 5–14 years both primary and secondary schools were in scope of the Survey. A sampling frame of schools was created from a list provided by each jurisdiction which included all public, catholic and independent primary and secondary schools. Information provided on the sampling frame for each school included school code, school name and address, school type, school enrolment and health district.
Schools were excluded from the sampling frame if they were:
• located in very remote locations that would be difficult to access by the mobile dental clinic van
• special schools
• small school enrolment (usually <50 students).
New South Wales
In New South Wales (NSW), there were 2,995 schools that were considered in scope with 2,087 primary only, 567 secondary only and 341 combined primary/secondary schools. Schools on the sampling frame were stratified into 15 regions based on NSW Local Health Districts (LHD). The number of primary and secondary schools selected from each LHD was determined by the region's percentage share of total school enrolment. For primary schools, enrolment was defined as children enrolled in year levels Kindergarten to Year 6. For secondary schools, enrolment was defined as children enrolled in year levels 7–9.
In this paper, consideration is given to the normative use of expected-utility theory for the purposes of asset allocation by the trustees of retirement funds. A distinction is drawn between “type-1 prudence”, which relates to deliberate conservatism on the part of actuaries in the setting of assumptions and the determination of model parameters, and “type-2 prudence”, which relates to the risk aversion of the trustees. The intention of the research was to quantify type-2 prudence for the purposes of asset allocation, both for defined-contribution (DC) and defined-benefit (DB) funds. The authors propose new definitions of the objective variables used as the argument of the utility function: one for DC funds and another for DB funds. A new class of utility functions, referred to as the “weighted average relative risk aversion” class is proposed. Practicalities of implementation are discussed. Illustrative results of the application of the method are presented, and it is shown that the proposed approach resolves the paradox of counter-intuitive results found in the literature regarding the sensitivity of the optimal asset allocation to the funding level of a DB fund.
Evaluating an intervention’s theoretical basis can inform design modifications to produce more effective interventions. Hence the present study’s purpose was to determine if effects from a multicomponent lifestyle intervention were mediated by changes in the psychosocial constructs decisional balance, self-efficacy and social support.
Delta Body and Soul III, conducted from August 2011 to May 2012, was a 6-month, church-based, lifestyle intervention designed to improve diet quality and increase physical activity. Primary outcomes, diet quality and aerobic and strength/flexibility physical activity, as well as psychosocial constructs, were assessed via self-report, interviewer-administered surveys at baseline and post intervention. Mediation analyses were conducted using ordinary least squares (continuous outcomes) and maximum likelihood logistic (dichotomous outcomes) regression path analysis.
Churches (five intervention and three control) were recruited from four counties in the Lower Mississippi Delta region of the USA.
Based upon results from the multiple mediation models, there was no evidence that treatment (intervention v. control) indirectly influenced changes in diet quality or physical activity through its effects on decisional balance, self-efficacy and social support. However, there was evidence for direct effects of social support for exercise on physical activity and of self-efficacy for sugar-sweetened beverages on diet quality.
Results do not support the hypothesis that the psychosocial constructs decisional balance, self-efficacy and social support were the theoretical mechanisms by which the Delta Body and Soul III intervention influenced changes in diet quality and physical activity.
The prevalence of anti-HEV isotype-specific antibodies and viraemia were investigated in serum samples collected from slaughter-age pigs (aged 22–24 weeks) from 23 farms in Scotland. Of 176 serum samples tested, 29·0% (n = 51) were anti-HEV IgG positive, 36·9% (n = 65) anti-HEV IgA positive and 29·0% (n = 51) anti-HEV IgM positive. Overall seroprevalence (anti-HEV IgG+ and/or IgA+ and/or IgM+) was 61·4% (n = 108). HEV RNA was detected in 72/162 serum samples (44·4%). Partial sequence of ORF2 (98 nt) was obtained from eight HEV RNA-positive samples and phylogenetic analysis confirmed that they were all of genotype 3. This is the first report on the prevalence of HEV in pigs in Scotland. Given the increasing incidence of locally acquired HEV infection in the UK, evidence that HEV is a foodborne zoonosis emphasizes the need for surveillance in pigs.
The homogeneous linear equation of the second order may be solved by means of a, continued fraction whose elements are coefficients in the equation. The two dimensional continued fraction is generalised to m dimensions and yields the solution of the equation of the mth order.