Home medication review. A personal experience in rural Tasmania.
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The Home Medical Review (HMR) was introduced into the Medical Benefits Scheme in October 2001, presuming teamwork and a holistic approach to treatment to be paramount in patient management at the primary health care level. (+info)
Origins of the southeastern Australian vegetation.
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Australia is an ancient continent with an interesting geological history that includes a recent major shift in its position, both globally and compared with neighbouring land masses. This has led to a great deal of confusion over many years about the origins of the Australian biomes. The plant fossil record is now clarifying this, and it is clear that the ancient Gondwanan rainforests that covered Australia while it was still part of that supercontinent contained many of the elements of the modern vegetation. However, major climatic sifting, along with responses to other factors, including soil nutrient levels, disturbance regimes, atmospheric CO2 levels, fire frequency and intensity, glaciations and the arrival of humans, have had profound impacts on the Australian vegetation, which today reflects the sum of all these factors and more. The origins of Australian vegetation and its present-day management cannot be properly understood without an appreciation of this vast history, and the fossil record has a vital role to play in maintaining the health of this continent's vegetation into the future. (+info)
Maternal calcium supplementation and cardiovascular risk factors in twin offspring.
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BACKGROUND: There is evidence that maternal calcium supplementation may result in lower offspring blood pressure. We hypothesized that maternal calcium supplementation also influences other cardiovascular risk factors. METHODS: In the Tasmanian Infant Health Study, supplements reportedly taken in pregnancy were recorded. Twin children of 147 participating mothers were seen at mean age 9 years. Blood pressure was measured in all 294 children and fasting blood samples taken from 230 (78%) for glucose and insulin, triacylglycerol, total cholesterol (T-C) and HDL cholesterol (HDL-C). LDL cholesterol (LDL-C) was calculated. RESULTS: Children of supplemented mothers (n = 110, 77 had venipuncture) had lower geometric mean triacylglycerol, T-C, and LDL-C than other children. After adjustment for potential confounding factors, geometric mean ratios were 0.86 (95% CI: 0.75, 0.98), 0.94, (95% CI: 0.90, 0.99) and 0.90, (95% CI: 0.83, 0.98) respectively. The association with T-C and LDL-C was seen principally among children with BMI > 17.5: estimated ratios 0.85 (95% CI: 0.79, 0.92) for total cholesterol and 0.79 (95% CI: 0.70, 0.90) for LDL cholesterol (P for interaction 0.001 and 0.009 respectively). There was no significant association between maternal calcium supplementation and child size at birth and follow up, blood pressure, fasting glucose or insulin or HDL-C. CONCLUSIONS: Maternal calcium supplementation may confer health benefits on twin offspring, especially if they are relatively fat. Calcium availability could permanently programme lipid metabolism during fetal life, directly or by influencing maternal lipid profile. Our findings need to be replicated in other studies and in singletons. If confirmed, our findings could have important implications for population health. (+info)
Dietary preference and digestive enzyme activities as indicators of trophic resource utilization by six species of crab.
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The digestive physiology and stomach contents of six crab species from a variety of habitats were investigated to provide an indication of their digestive capability and dietary preferences. Stomach contents varied between species, but the key enzymes present were generally consistent with the types of dietary material being ingested. Nectocarcinus integrifons (red rock crab) consumed large quantities of seagrass and had high cellulase activity (0.02+/-0.004 units mg-1) to digest the constituent cellulose. Petrolisthes elongatus (porcelain crab) ingested brown and green phytoplankton and algae and had considerable laminarinase (0.35+/-0.08 units mg-1) and beta-glucosidase (0.025+/-0.005 units mg-1) activities to digest the laminarin in its diet. Leptograpsus variegatus (omnivorous swift-footed shore crab) had high activities of protease (1.2+/-0.02 units mg-1), alpha-glucosidase, and alpha-amylase and appeared well equipped to utilize both dietary protein and carbohydrate. Stomach contents in Nectocarcinus tuberculosus (velvet crab) and Carcinus maenas (green crab) also suggest that these species are omnivorous. N. tuberculosus had high cellulase and chitinase for digesting the cellulose in plants and the chitin in invertebrate shells respectively. C. maenas had intermediate digestive enzyme levels and may employ more of a generalist feeding strategy than other species. Plagusia chabrus (speedy crab) is carnivorous, consuming encrusting bryozoans, hydroids, crustaceans, and fish. It has high protease activity, particularly trypsin (0.73+/-0.12 units mg-1), to digest the protein in its animal prey. Each species of crab studied had a complex suite of digestive enzymes, the relative activities of which reflected individual and very different species-specific dietary niches. (+info)
Sudden infant death syndrome: seasonality and a biphasic model of pathogenesis.
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STUDY OBJECTIVE: This paper examines the relationship between season, age, and the sudden infant death syndrome (SIDS). It provides a theoretical model for the pathogenesis of SIDS and uses it as a framework to consider risk factor mechanism. DESIGN: A case series analysis was used to examine season and age in relation to SIDS and seasonal pattern and age at death distribution of perinatal risk factors. SETTING: The source population for the SIDS cases in this study was all live births in the state of Tasmania, Australia, 1975 to 1987 inclusive. SUBJECTS: Cases were all infants born 1975 to 1987 who died of SIDS on whom birth notification information was available (n = 348). The live birth cohort 1980-87 (n = 55,944) was used as the control population for risk factor identification. MEASUREMENTS AND MAIN RESULTS: The median ages of death for spring, summer, autumn, and winter born infants were 115, 103.5, 91 and 78 days. Spring and summer born infants died at a significantly older median age than winter born infants. The month of birth distribution of SIDS cases did not alter significantly from a uniform, nonseasonal distribution (p greater than 0.25) but month of death was seasonally distributed (p less than 0.01). Premature and low birthweight infants died at an older median age (p less than 0.05) than term and non-low-birthweight infants. An excess of male infant deaths and infant deaths to older mothers occurred during winter (p less than 0.05). CONCLUSIONS: The pathogenesis of SIDS can be represented as a biphasic model with three pathways of risk factor operation. In this study, season influenced the age at death of SIDS infants. We propose that risk factors with a strong seasonal distribution are likely to be operating in the postnatal period. (+info)
Factors associated with hip cartilage volume measured by magnetic resonance imaging: the Tasmanian Older Adult Cohort Study.
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OBJECTIVE: To compare associations between anthropometric and lifestyle factors and femoral head cartilage volume/thickness and radiographic features of osteoarthritis (OA) and to provide evidence of construct validity for magnetic resonance imaging (MRI) assessment of femoral cartilage volume and thickness. METHODS: We studied a cross-sectional sample of 151 randomly selected subjects (79 men, 72 women; mean age 63 years) from the Tasmanian Older Adult Cohort Study. A sagittal T1-weighted fat-suppression MRI scan of the right hip was performed to determine femoral head cartilage volume, cartilage thickness, and size. An anteroposterior radiograph of the pelvis with weight bearing was performed and scored for radiographic evidence of OA in the right hip. Other factors measured were height, weight, leg strength, serum vitamin D levels, and bone mineral density. RESULTS: Hip cartilage volume was significantly associated with female sex, body mass index, and femoral head size, whereas hip cartilage thickness was significantly associated only with the size of the femoral head. Only female sex was significantly associated with the total radiographic OA score and the joint space narrowing (JSN) score, but not the osteophyte score. Radiographic JSN of the hip, especially axial JSN (but not osteophytes), was significantly correlated with hip cartilage volume and thickness. CONCLUSION: Femoral head cartilage volume and thickness have modest but significant construct validity when correlated with radiographic findings. Furthermore, the generally stronger associations with volume compared with radiographic OA suggest that MRI may be superior at identifying risk factors for hip OA. (+info)
Questionnaire-based risk assessment for amoebic gill disease (AGD) and evaluation of freshwater bathing efficacy of reared Atlantic salmon Salmo salar.
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Factors causing amoebic gill disease (AGD), the main disease affecting the salmonid industry in Tasmania, are largely unknown. Managers of 57 sites, from 4 countries, in both the Southern and Northern Hemisphere were questioned regarding the 2000 smolt year-class Atlantic salmon. Questions included site characteristics, fish population characteristics, husbandry and management programs, through to freshwater bathing characteristics. Possible risk factors for AGD outbreaks that were identified in this study using farm managers' opinions were mixed sex stocks (Tasmania), downstream positioning from other salmonid farming sites (pooled), tidal sites (Tasmania), depth of site (pooled), rate of salinity change in halocline and depth of halocline (pooled, Tasmania), phytoplankton blooms (pooled, Tasmania), antifouling paints (Tasmania, overseas) and automated feeding (pooled, overseas). The information from farm managers suggested that freshwater bathing is less effective with smaller bathing cages and lower levels of saturated oxygen in the bathing water. Risk factors could not always be determined due to the complex interactions between the biological and chemical environment, host and pathogenic factors, coupled with low sample numbers. (+info)
Characterisation of an emerging rickettsia-like organism in Tasmanian farmed Atlantic salmon Salmo salar.
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A rickettsia-like organism (RLO) was observed in farmed Atlantic salmon Salmo salar located in south-east Tasmania, Australia. Several assays such as immunoperoxidase, immunoelectron microscopy, polymerase chain reaction and nucleic acid sequencing, as well as phylogenetic analysis of rDNA sequences, were performed on infected fish tissues. Immunohistochemistry results suggested the presence of related antigenic determinants between the Tasmanian RLO and the type strain LF-89 of Piscirickettsia salmonis. However, sequence alignment demonstrated that the Tasmanian RLO contains a 19 bp deletion at the 3'-end of the internal transcribed spacer region of the rDNA operon, indicating a genetic divergence from P. salmonis isolates, which are exotic to Australia. (+info)