Intestinal macrophages - specialised adaptation to a unique environment.

Interest in intestinal mononuclear phagocytes (MPs), both DCs and macrophages (Mφs), has exploded in the recent years. In this Viewpoint we will detail how resident intestinal lamina propria (LP) Mφs possess distinctive properties that reflect adaptation to a unique microenvironment. They play quite different roles in the normal and inflamed mucosa and, as we will show, the existing paradigms of differentiated Mφ subsets and of 'resident' versus 'inflammatory' monocytes based on other tissues may not apply to the gut.

A poxvirus vaccine is safe, induces T-cell responses, and decreases viral load in patients with chronic hepatitis C.

Background & Aims: Therapy for chronic hepatitis C (CHC) has limited efficacy, adverse effects, and high costs. Cohort and vaccine-based preclinical studies have indicated the importance of T-cell-based immunity in controlling viral infection. TG4040 is a recombinant poxvirus vaccine that expresses the hepatitis C virus (HCV) proteins NS3, NS4, and NS5B.

Folate and related micronutrients, folate-metabolising genes and risk of ovarian cancer.

Background/objective: Folates are essential for DNA synthesis and methylation, and thus may have a role in carcinogenesis. Limited evidence suggests folate-containing foods might protect against some cancers and may partially mitigate the increased risk of breast cancer associated with alcohol intake, but there is little information regarding ovarian cancer. Our aim was to evaluate the role of folate and related micronutrients, polymorphisms in key folate-metabolising genes and environmental factors in ovarian carcinogenesis.

A randomised controlled trial evaluating the use of polyglactin (Vicryl) mesh, polydioxanone (PDS) or polyglactin (Vicryl) sutures for pelvic organ prolapse surgery: outcomes at 2 years.

The effects at 2 years of polyglactin (Vicryl) mesh inlay and polydioxanone (PDS) or polyglactin (Vicryl) suture material on prolapse symptoms, urinary, bowel, sexual function and prolapse related Quality-of-Life (QoL) in women undergoing pelvic organ prolapse surgery were evaluated in a randomised controlled trial with a 2 × 2 factorial design of Vicryl mesh (n = 32) or not (n = 34) and PDS (n = 33) or Vicryl suture (n = 33). The response rate at 2 years was 82%. There were no differences in the prolapse symptom scores between the randomised groups.

Effects of weight loss on serum vitamin D in postmenopausal women.

Background: Low concentrations of circulating vitamin D are common with obesity and may represent a potential mechanism explaining the elevated risk of certain cancers and cardiovascular outcomes observed in individuals who are overweight or obese.

Objective: The objective of this study was to investigate the effects of 12 mo of weight loss through caloric restriction, exercise intervention, or both on serum 25-hydroxyvitamin D [25(OH)D] concentrations.

Design: Overweight and obese postmenopausal women (n = 439) were randomly assigned to 1 of 4 groups: 1) diet modification (n = 118), 2) exercise (n = 117), 3) diet + exercise (n = 117), or 4) control (n = 87).

Surfactant adsorption kinetics by total internal reflection Raman spectroscopy. 1. Pure surfactants on silica.

Total internal reflection Raman spectroscopy provides a sensitive probe of surfactants adsorbed at an interface. A visible laser passes through a silica hemisphere and reflects off the flat silica-water interface. An evanescent wave probes ∼100 nm of solution below the surface, and the Raman scattering from this region provides chemically specific information on the molecules present.

Surfactant adsorption kinetics by total internal reflection Raman spectroscopy. 2. CTAB and Triton X-100 mixtures on silica.

Total internal reflection (TIR) Raman spectroscopy has been used to study the kinetics of adsorption, desorption, and displacement of mixed surfactant systems at the silica-water interface. The limited penetration depth of the evanescent wave provides surface sensitivity while the chemical sensitivity of Raman scattering permits the determination of the time-dependent composition of the adsorbed film. Principal component analysis is used to deconvolute the Raman spectra with a time resolution of 2 s and a precision of 5% of a monolayer.

On the predictions and limitations of the Becker-Döring model for reaction kinetics in micellar surfactant solutions.

We investigate the breakdown of a system of micellar aggregates in a surfactant solution following an order-one dilution. We derive a mathematical model based on the Becker-Döring system of equations, using realistic expressions for the reaction constants fit to results from Molecular Dynamics simulations. We exploit the largeness of typical aggregation numbers to derive a continuum model, substituting a large system of ordinary differential equations for a partial differential equation in two independent variables: time and aggregate size.

Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese postmenopausal women.

Lifestyle interventions for weight loss are the cornerstone of obesity therapy, yet their optimal design is debated. This is particularly true for postmenopausal women; a population with a high prevalence of obesity yet toward whom fewer studies are targeted. We conducted a year-long, 4-arm randomized trial among 439 overweight-to-obese postmenopausal sedentary women to determine the effects of a calorie-reduced, low-fat diet (D), a moderate-intensity, facility-based aerobic exercise program (E), or the combination of both interventions (D+E), vs.

Distribution of transport injury and related risk behaviours in a large national cohort of Thai adults.

Background: A major barrier to addressing the problem of transport injury in low to middle-income countries is the lack of information regarding the incidence of traffic crashes and the demographic, behavioural and socio-economic determinants of crash-related injury. This study aimed to determine the baseline frequency and distribution of transport injury and the prevalence of various road safety behaviours in a newly recruited cohort of Thai adults.

Methods: The Thai Health-Risk Transition Study includes an ongoing population-based cohort study of 87,134 adult students residing across Thailand.

Effects of health screening for adults with intellectual disability: a pooled analysis.

Health screening has been shown to have beneficial effects on health outcomes in adults with intellectual disability. However, the nature of the population, which makes it difficult to recruit, has meant past studies have been relatively small and effect estimates unstable. This study conducted a pooled analysis of two randomised trials and one cohort study, containing a total of 795 participants.

Unhealthy substance-use behaviors as symptom-related self-care in persons with HIV/AIDS.

Unhealthy substance-use behaviors, including a heavy alcohol intake, illicit drug use, and cigarette smoking, are engaged in by many HIV-positive individuals, often as a way to manage their disease-related symptoms. This study, based on data from a larger randomized controlled trial of an HIV/AIDS symptom management manual, examines the prevalence and characteristics of unhealthy behaviors in relation to HIV/AIDS symptoms. The mean age of the sample (n = 775) was 42.

Work/life balance and health: the Nurses and Midwives e-cohort Study.

Background: Nursing and midwifery are demanding professions. Efforts to understand the health consequences and workforce needs of these professions are urgently needed. Using a novel electronic approach, the Nurses and Midwives e-cohort Study (NMeS) aims to investigate longitudinally Australian and New Zealand nurses' and midwives' work/life balance and health.

Mortality from diabetic renal disease: a hidden epidemic.

Background: Population-level mortality indicators can be useful outcome measures of diabetes care. Death registration systems serve as the main source of data for such measures. However, standard mortality indicators based on underlying causes do not adequately reflect the burden from diabetic renal disease.

Hormone replacement therapy: the risks and benefits of treatment.

Several recent large studies have provoked concern among both health professionals and the general public regarding the safety of hormone replacement therapy (HRT). This article provides a review of the current literature surrounding the risks and benefits of HRT in postmenopausal women, and how the data can be applied safely in everyday clinical practice.

Review of injuries over a one year period among 87,134 adults studying at an open university in Thailand.

Countries need epidemiological information about population injury statistics to devise preventive strategies. To generate such information we estimated the one-year incidence and distribution of injury in a group of 87,134 adult Sukhothai Thammathirat Open University distance-learning students residing throughout Thailand. Those who participated joined the study by filling out a baseline questionnaire in 2005 which included a one-year recall of injuries serious enough to interfere with daily activities and/or require medical treatment.

Head and neck loading in everyday and vigorous activities.

The purpose of this study was to document head and neck loading in a group of ordinary people engaged in non-injurious everyday and more vigorous physical activities. Twenty (20) volunteers that were representative of the general population were subjected to seven test scenarios: a soccer ball impact to the forehead, a self-imposed hand strike to the forehead, vigorous head shaking, plopping down in a chair, jumping off a step, a seated drop onto the buttocks, and a vertical drop while seated supine in a chair. Some scenarios involved prescribed and well-controlled stimuli, while others allowed the volunteers to perform common activities at a self-selected level of intensity.

A study of new referrals to a menopause clinic and their initial outcomes: how can we improve the service we provide?

This retrospective case-note study was performed to examine the ways in which an already established menopause clinic could improve service to its patients. The management of 151 patients was examined. Most were referred by their general practitioner and the most common reason for referral was to seek an alternative to hormone replacement therapy (HRT).

Oestrogens for treatment or prevention of pelvic organ prolapse in postmenopausal women.

Background: Pelvic organ prolapse is common and can be detected in up to 50% of parous women although many are asymptomatic. Oestrogen preparations are used to improve vaginal thinning (atrophy). It is possible that oestrogens, alone or in conjunction with other interventions, might prevent or assist in the management of pelvic organ prolapse, for example by improving the strength of weakened supporting structures.

Secular changes and predictors of adult height for 86 105 male and female members of the Thai Cohort Study born between 1940 and 1990.

Background: Height trends can be useful indicators of population health but, despite Thailand's rapid socioeconomic development since the 1950s, few studies have examined accompanying secular changes in adult height or the effects of the transition on the heights of rural versus urban populations. This study therefore sought to document average heights in different age groups of rural and urban Thais and to investigate factors associated with attained height.

Methods: Data from 86,105 Thai Cohort Study participants was used to estimate mean heights for men and women in different birth year groups.

Evaluation of the impact of implementation of a Medical Assessment and Planning Unit on length of stay.

Objective: The Medical Assessment and Planning Unit (MAPU) model provides a multidisciplinary and 'front end loading' approach to acute medical care. The objective of this study was to evaluate the impact of a 10-bed MAPU in Royal Melbourne Hospital (RMH) on hospital length of stay.

Methods: A pre-post study design was used.

Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence.

Objectives: To assess the clinical effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence (SUI) through systematic review and economic modelling.

Data Sources: The Cochrane Incontinence Group Specialised Register, electronic databases and the websites of relevant professional organisations and manufacturers, and the following databases: CINAHL, EMBASE, BIOSIS, Science Citation Index and Social Science Citation Index, Current Controlled Trials, ClinicalTrials.gov and the UKCRN Portfolio Database.

Validity of self-reported abdominal obesity in Thai adults: a comparison of waist circumference, waist-to-hip ratio and waist-to-stature ratio.

Background And Aims: Waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-stature ratio (WSR), being common proxy measures of abdominal obesity, are useful tools in epidemiologic studies, but little is known about their validity when the indices are derived from self-reported measurements. We determine and compare the validity of self-reported WC, WHR and WSR in order to identify the optimal index for use in epidemiologic surveys.

Methods And Results: Technician- and self-reported measurements of height, waist and hip circumference were obtained from 613 Thai adults (mean age 35 years).

The role of patient activation in frequent attendance at primary care: a population-based study of people with chronic disease.

Objective: This study explores a range of relevant socio-demographic, physical and psychological factors in a unique examination of the risk factors for frequent attendance at primary care. The impact of patient activation for self-management on health service utilisation is of particular interest.

Methods: A population-based sample of people with chronic disease from Queensland, Australia, was interviewed using computer assisted telephone surveying.