Sixteen years of change in the global terrestrial human footprint and implications for biodiversity conservation.

Human pressures on the environment are changing spatially and temporally, with profound implications for the planet's biodiversity and human economies. Here we use recently available data on infrastructure, land cover and human access into natural areas to construct a globally standardized measure of the cumulative human footprint on the terrestrial environment at 1 km(2) resolution from 1993 to 2009. We note that while the human population has increased by 23% and the world economy has grown 153%, the human footprint has increased by just 9%. Still, 75% the planet's land surface is experiencing measurable human pressures. Moreover, pressures are perversely intense, widespread and rapidly intensifying in places with high biodiversity. Encouragingly, we discover decreases in environmental pressures in the wealthiest countries and those with strong control of corruption. Clearly the human footprint on Earth is changing, yet there are still opportunities for conservation gains.

Pediatric Treadmill Burns: Assessing the effectiveness of prevention strategies.

PURPOSE: Legislative changes in 2008 in Australia mandated that all new treadmills display a warning sticker about the risk of friction burns in children. This was accompanied by a health promotion campaign advising of the risks of treadmills to children. METHODS: Analyses of pediatric burns data identified all cases of treadmill burns occurring between 2005 and 2014. The incidence of treadmill burns, associations with age and gender, characteristics of the burns and the adequacy of first aid provided immediately after the burn was examined. RESULTS: There were 298 cases of treadmill burns over the 10-year period (3.5% of all pediatric burns). The incidence rose until the introduction of legislation and health promotion in 2008, and then declined over the remaining study period. The majority of treadmill burns in children were inflicted on the upper limbs (91%), and 93% involved the hands. Most burns were full thickness (62%, n=182) and 49% (n=148) required skin grafts. Approximately one-third of treadmill burns (35%, n=105) occurred while someone else was using the treadmill. In the vast majority of treadmill burn injuries (74%, n=223), there was either no first aid or inadequate first aid provided immediately after the injury. CONCLUSION: A significant number of treadmill burns occur in children, and these often result in serious injuries that are not treated with appropriate first aid. A reduction in the incidence of these burns was associated with the introduction of legislation and health promotion targeted at child safety around treadmills.

Improving attendance for cardiovascular risk assessment in Australian general practice: an RCT of a monetary incentive for patients.

BACKGROUND: Preventive health care is an important part of general practice however uptake of activities by patients is variable. Monetary incentives for doctors have been used in the UK and Australia to improve rates of screening and immunisation. Few studies have focussed on incentives for patients to attend preventive health care examinations. Our objective was to investigate the use of a monetary incentive to increase patient attendance with their general practitioner for a cardiovascular risk assessment (CVRA). METHODS: A pragmatic RCT was conducted in two Australian general practices. Participating GPs underwent academic detailing for cardiovascular risk assessment. 301 patients aged 40-74, who did not have cardiovascular disease, were independently randomised to receive a letter inviting them to a no cost cardiovascular risk assessment with their GP, or the same letter plus an offer of a $25 shopping voucher if they attended. An audit of patient medical records was also undertaken and a patient questionnaire administered to a sub sample of participants. Our main outcome measure was attendance for cardiovascular risk assessment. RESULTS: In the RCT, 56/301(18.6%) patients attended for cardiovascular risk assessment, 29/182 (15.9%) in the control group and 27/119 (22.7%) in the intervention group. The estimated difference of 6.8% (95% CI: -2.5% to 16.0%) was not statistically significant, P = 0.15. The audit showed that GPs may underestimate patients' absolute cardiovascular risk and the questionnaire that mailed invitations from GPs for a CVRA may encourage patients to attend. CONCLUSIONS: A small monetary incentive does not improve attendance for cardiovascular risk assessment. Further research should be undertaken to determine if there are other incentives that may increase attendance for preventive activities in the general practice setting. CLINICAL TRIALS REGISTRATION: ACTRN12608000183381.

Gender, socioeconomic status, need or access? Differences in statin prescribing across urban, rural and remote Australia.

OBJECTIVES: To assess differences in statin prescribing across Australia by geographic area. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional study using Pharmaceutical Benefits Scheme data on statin prescribing by rurality, gender and patient postcode for the period May to December 2002. Participants were the Australian population, stratified by gender, quintile of index of relative socioeconomic disadvantage and rural, remote and metropolitan areas classification. RESULTS: Statin prescribing (scripts per 1000 population per month) was higher in urban areas (women, 51.915; men, 51.892) than in rural (women, 48.311; men, 48.098) or remote (women, 39.679; men, 34.145) areas. In urban areas, weighted least squares regression analysis showed a significant negative linear association between statin prescribing and socioeconomic status for both women (weighted least squares slope, -3.358; standard error (SE) 0.057; P < 0.0001) and men (slope, -0.507; SE 0.056; P < 0.0001). A similar association occurred in rural areas: women (slope, -4.075; SE 0.122; P < 0.0001) and men (slope, -3.455; SE 0.117; P < 0.0001), but not in remote areas where there was a positive linear association (slope, 3.120; SE 0.451; P < 0.0001) and men (slope, 3.098; SE 0.346; P < 0.0001). CONCLUSION: Our results suggest differences in statin prescribing in Australia across geographic location, adjusting for age, gender and socioeconomic status. IMPLICATIONS: These findings suggest that health inequalities due to geography should be addressed.

In silico approaches reveal the potential for DNA sequence-dependent histone octamer affinity to influence chromatin structure in vivo.

Nucleosome positioning signals embedded within the DNA sequence have the potential to influence the detailed structure of the higher-order chromatin fibre. In two previous studies of long stretches of DNA, encompassing the chicken beta-globin and ovine beta-lactoglobulin genes, respectively, we mapped the relative affinity of every site for the core histone octamer. In both cases a periodic arrangement of the in vitro positioning sites suggests that they might influence the folding of a nucleosome chain into higher-order structure; this hypothesis was borne out in the case of the beta-lactoglobulin gene, where the distribution of the in vitro positioning sites is related to the positions nucleosomes actually occupy in sheep liver cells. Here, we have exploited the in vitro nucleosome positioning datasets to simulate nucleosomal organisation using in silico approaches. We use the high-resolution, quantitative positioning maps to define a one-dimensional positioning energy lattice, which can be populated with a defined number of nucleosomes. Monte Carlo techniques are employed to simulate the behaviour of the model at equilibrium to produce a set of configurations, which provide a probability-based occupancy map. Employing a variety of techniques we show that the occupancy maps are a sensitive function of the histone octamer density (nucleosome repeat length) and find that a minimal change in this property can produce dramatic localised changes in structure. Although simulations generally give rise to regular periodic nucleosomal arrangements, they often show octamer density-dependent discontinuities, which tend to co-localise with sequences that adopt distinctive chromatin structure in vivo. Furthermore, the overall organisation of simulated chromatin structures are more closely related to the situation in vivo than is the original in vitro positioning data, particularly at a nucleosome density corresponding to the in vivo state. Although our model is simplified, we argue that it provides a unique insight into the influence that DNA sequence can have in determining chromatin structure and could serve as a useful basis for the incorporation of other parameters.

Desarrollo y evaluación de un programa educativo contra la teniosis en una comunidad rural de México / Evaluation of a didactic program against taenia solium in a mexican rural small town

Se llevó a cabo un estudio en una comunidad rural del estado de Morelos, México para evaluar la educación para la salud como una estrategia de intervención contra la Taenia solium. Se desarrolló una campaña de educación para promover el conocimiento del ciclo de transmisión del parásito y para mejorar los hábitos higiénicos y las condiciones sanitarias que favorecen la transmisión. Los efectos de la campaña de educación fueron evaluados midiendo los cambios en las tasas de prevalencia de teniosis humana y cisticercosis porcina antes y después de la campaña. La estrategia de educación para la salud se aplicó con base de la información obtenida de un estudio sociológico con base en la información obtenida de un estudio sociológico y con la participación activa de la población. Se observaron mejorías estadísticamente significativas (p< 0.05) en el conocimiento sobre el parásito, su ciclo de vida y cómo se adquiere la parasitosis por los humanos; sin embargo, los cambios en el comportamiento relacionado en cerdos al inicio del estudio fueron 2.6 por ciento y 5.2 por ciento por inspección de lengua y detección de anticuerpos (técnica de inmunoblot) respectivamente y aproximadamente un año después de la intervención estas prevalencias fueron 0 por ciento y 1.2 por ciento (p< 0.05) respectivamente. Estos cambios se acompañaron de reducciones significativas en la proporción de cerdos con acceso a las fuentes de infección y en que deambularan libremente. Se concluye que la campaña de educación para la salud, en conjueto con el compromiso de la comunidad, redujo las oportunidades de transmisión de T. soliun en el cilco humano-cerdo