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1.
Nature ; 597(7875): 209-213, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34497396

RESUMO

Universal control of multiple qubits-the ability to entangle qubits and to perform arbitrary individual qubit operations1-is a fundamental resource for quantum computing2, simulation3 and networking4. Qubits realized in trapped atomic ions have shown the highest-fidelity two-qubit entangling operations5-7 and single-qubit rotations8 so far. Universal control of trapped ion qubits has been separately demonstrated using tightly focused laser beams9-12 or by moving ions with respect to laser beams13-15, but at lower fidelities. Laser-free entangling methods16-20 may offer improved scalability by harnessing microwave technology developed for wireless communications, but so far their performance has lagged the best reported laser-based approaches. Here we demonstrate high-fidelity laser-free universal control of two trapped-ion qubits by creating both symmetric and antisymmetric maximally entangled states with fidelities of [Formula: see text] and [Formula: see text], respectively (68 per cent confidence level), corrected for initialization error. We use a scheme based on radiofrequency magnetic field gradients combined with microwave magnetic fields that is robust against multiple sources of decoherence and usable with essentially any trapped ion species. The scheme has the potential to perform simultaneous entangling operations on multiple pairs of ions in a large-scale trapped-ion quantum processor without increasing control signal power or complexity. Combining this technology with low-power laser light delivered via trap-integrated photonics21,22 and trap-integrated photon detectors for qubit readout23,24 provides an opportunity for scalable, high-fidelity, fully chip-integrated trapped-ion quantum computing.

2.
Occup Med (Lond) ; 74(1): 120-127, 2024 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-38029429

RESUMO

BACKGROUND: Healthcare workers were a priority group for coronavirus disease 2019 (COVID-19) vaccination during the pandemic. Occupational exposure may account for some of the increased risk faced. AIMS: Describe COVID-19 vaccine uptake and infection rates in staff across a large NHS board in Scotland to better understand occupational risk during the pandemic. METHODS: Descriptive cross-sectional study. Demographic data were extracted on 5 August 2021 from 26 058 members of staff. COVID-19 vaccination status and positive polymerase chain reaction (PCR) results were extracted on two separate dates to describe the timeline of staff infections between March 2020 and January 2022. RESULTS: There was high uptake of all three vaccine doses across all demographic groups in hospital staff. PCR positivity decreased with increasing age and Scottish Index of Multiple Deprivation score. Staff and nosocomial COVID-19 infections followed peaks in community infection rates. CONCLUSIONS: NHS Lothian is a typical NHS workforce with good vaccine uptake. Beyond very early cases, there seems to be minimal evidence of occupational acquisition of COVID-19. The large number of nosocomial infections at the start of the pandemic may, in fact, reflect lack of community testing at this time. Despite protection from high vaccine coverage, job type and good Infection Prevention and Control practices, it seems that staff remain at high risk of catching the highly transmissible omicron variant from the community rather than work.


Assuntos
COVID-19 , Infecção Hospitalar , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Estudos Transversais , Medicina Estatal , SARS-CoV-2 , Vacinação , Recursos Humanos em Hospital , Recursos Humanos
3.
Clin Gastroenterol Hepatol ; 20(6): 1229-1240.e5, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-33524598

RESUMO

BACKGROUND & AIMS: Despite the widespread increase in the incidence of early-onset colorectal cancer (EoCRC), the reasons for this increase remain unclear. The objective of this study was to determine risk factors for the development of EoCRC. METHODS: We conducted a systematic literature review and meta-analysis of studies examining non-genetic risk factors for EoCRC, including demographic factors, comorbidities, and lifestyle factors. Random effects meta-analyses were conducted for risk factors that were examined in at least three studies. Heterogeneity was investigated using the Q-test and I2 statistic. RESULTS: From 3304 initial citations, 20 studies were included in this review. Significant risk factors for EoCRC included CRC history in a first-degree relative (RR 4.21, 95% CI 2.61-6.79), hyperlipidemia (RR 1.62, 95% CI 1.22-2.13), obesity (RR 1.54, 95% CI 1.01-2.35), and alcohol consumption (high vs. non-drinkers) (RR 1.71, 95% CI 1.62-1.80). While smoking was suggestive as a risk factor, the association was not statistically significant (RR 1.35, 95% CI 0.81-2.25). With the exception of alcohol consumption, there was considerable heterogeneity among studies (I2 > 60%). Other potential risk factors included hypertension, metabolic syndrome, ulcerative colitis, chronic kidney disease, dietary factors, sedentary behaviour, and occupational exposure to organic dusts, but these were only examined in one or two studies. CONCLUSIONS: The results of this study advance the understanding of the etiology of EoCRC. High-quality studies conducted on generalizable populations and that comprehensively examine risk factors for EoCRC are required to inform primary and secondary prevention strategies.


Assuntos
Neoplasias Colorretais , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia , Neoplasias Colorretais/prevenção & controle , Comorbidade , Humanos , Incidência , Obesidade/epidemiologia , Fatores de Risco
4.
Phys Rev Lett ; 127(8): 083201, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34477447

RESUMO

Transport, separation, and merging of trapped ion crystals are essential operations for most large-scale quantum computing architectures. In this Letter, we develop a theoretical framework that describes the dynamics of ions in time-varying potentials with a motional squeeze operator, followed by a motional displacement operator. Using this framework, we develop a new, general protocol for trapped ion transport, separation, and merging. We show that motional squeezing can prepare an ion wave packet to enable transfer from the ground state of one trapping potential to another. The framework and protocol are applicable if the potential is harmonic over the extent of the ion wave packets at all times. As illustrations, we discuss two specific operations: changing the strength of the confining potential for a single ion and separating same-species ions with their mutual Coulomb force. Both of these operations are, ideally, free of residual motional excitation.

5.
Phys Rev Lett ; 127(24): 243602, 2021 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-34951804

RESUMO

We report the experimental observation of a superradiant emission emanating from an elongated dense ensemble of laser cooled two-level atoms, with a radial extent smaller than the transition wavelength. In the presence of a strong driving laser, we observe that the system is superradiant along its symmmetry axis. This occurs even though the driving laser is orthogonal to the superradiance direction. This superradiance modifies the spontaneous emission, and, resultantly, the Rabi oscillations. We also investigate Dicke superradiance in the emission of an almost fully inverted system as a function of the atom number. The experimental results are in qualitative agreement with ab-initio, beyond-mean-field calculations.

6.
Prev Med ; 148: 106563, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33878349

RESUMO

The aim of this study was to develop a risk prediction model for high risk adenomas (HRAs) detected at screening colonoscopy based on readily available participant information. The cohort consisted of 3035 participants aged 50 to 74 years with no history of cancer who underwent a primary screening colonoscopy at a centralized colon cancer screening centre between 2008 and 2016. A multivariable logistic regression model was created using CRC risk factors identified from prior research. Model covariates were collected from a baseline questionnaire and included participant demographics (age and sex), lifestyle parameters (body mass index, alcohol, smoking, and vitamin D supplement use) and medical history (family history of CRC and diabetes). Mean participant age was 58.8 years, and 54.7% were male. 249 participants with HRAs were identified (8.2%). An adjusted c-statistic of 0.67 was calculated, and a specificity and negative predictive value of 97.2% (95% CI: 96.5-97.8) and 92.5% (95% CI: 92.2-92.8) for the detection of HRAs, respectively, were achieved using 20% predicted probability as a high-risk threshold. However, only a sensitivity of 12.1% (95% CI: 8.3-16.8) was achieved. Our model has moderate predictive ability, with strengths in being able to rule out those with an absence of HRAs on screening colonoscopy. Maximizing screening efficiency through improved risk prediction can enhance resource allocation. Ultimately, this model has the potential to improve patient care by reducing unnecessary colonoscopies, limiting this invasive procedure to those most likely to have significant findings.


Assuntos
Adenoma , Neoplasias Colorretais , Adenoma/diagnóstico , Adenoma/prevenção & controle , Canadá , Colonoscopia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Detecção Precoce de Câncer , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Fatores de Risco
7.
Nature ; 518(7537): 85-8, 2015 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-25653000

RESUMO

Plate tectonics successfully describes the surface of Earth as a mosaic of moving lithospheric plates. But it is not clear what happens at the base of the plates, the lithosphere-asthenosphere boundary (LAB). The LAB has been well imaged with converted teleseismic waves, whose 10-40-kilometre wavelength controls the structural resolution. Here we use explosion-generated seismic waves (of about 0.5-kilometre wavelength) to form a high-resolution image for the base of an oceanic plate that is subducting beneath North Island, New Zealand. Our 80-kilometre-wide image is based on P-wave reflections and shows an approximately 15° dipping, abrupt, seismic wave-speed transition (less than 1 kilometre thick) at a depth of about 100 kilometres. The boundary is parallel to the top of the plate and seismic attributes indicate a P-wave speed decrease of at least 8 ± 3 per cent across it. A parallel reflection event approximately 10 kilometres deeper shows that the decrease in P-wave speed is confined to a channel at the base of the plate, which we interpret as a sheared zone of ponded partial melts or volatiles. This is independent, high-resolution evidence for a low-viscosity channel at the LAB that decouples plates from mantle flow beneath, and allows plate tectonics to work.

8.
Clin Gastroenterol Hepatol ; 18(10): 2192-2208.e12, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32240836

RESUMO

BACKGROUND & AIMS: In addition to monitoring adverse events (AEs) and post-colonoscopy colorectal cancers (PCCRC), indicators for assessing colonoscopy quality include adenoma detection rate (ADR) and cecal intubation rate (CIR). It is unclear whether there is an association between annual colonoscopy volume and ADR, CIR, AEs, or PCCRC. METHODS: We searched publication databases through March 2019 for studies assessing the relationship between annual colonoscopy volume and outcomes, including ADR, CIR, AEs, or PCCRC. Pooled odds ratios (ORs) were calculated using DerSimonian and Laird random effects models. Sensitivity analyses were performed to assess for potential methodological or clinical factors associated with outcomes. RESULTS: We performed a systematic review of 9235 initial citations, generating 27 retained studies comprising 11,276,244 colonoscopies. There was no association between procedural volume and ADR (OR, 1.00; 95% CI, 0.98-1.02 per additional 100 annual procedures). CIR improved with each additional 100 annual procedures (OR, 1.17; 95% CI, 1.08-1.28). There was a non-significant trend toward decreased overall AEs per additional 100 annual procedures (OR, 0.95; 95% CI, 0.90-1.00). There was considerable heterogeneity among most analyses. CONCLUSIONS: In a systematic review and meta-analysis, we found higher annual colonoscopy volumes to correlate with higher CIR, but not with ADR or PCCRC. Trends toward fewer AEs were associated with higher annual colonoscopy volumes. There are few data available from endoscopists who perform fewer than 100 annual colonoscopies. Studies are needed on extremes in performance volumes to more clearly elucidate associations between colonoscopy volumes and outcomes.


Assuntos
Adenoma , Neoplasias Colorretais , Adenoma/diagnóstico , Ceco , Colonoscopia , Detecção Precoce de Câncer , Humanos
9.
Int J Behav Nutr Phys Act ; 17(1): 111, 2020 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-32883294

RESUMO

BACKGROUND: Prolonged sitting time is a risk factor for chronic disease, yet recent global surveillance is not well described. The aims were to clarify: (i) the countries that have collected country-level data on self-reported sitting time; (ii) the single-item tools used to collect these data; and (iii) the duration of sitting time reported across low- to high-income countries. METHODS: Country-level data collected within the last 10 years using single-item self-report were included. The six-stage methodology: (1) reviewing Global Observatory for Physical Activity! Country Cards; (2-4) country-specific searches of PubMed, the Demographic and Health Survey website and Google; (5) analysing the Eurobarometer 88.4; and (6) country-specific searches for World Health Organization STEPwise reports. RESULTS: A total of 7641 records were identified and screened for eligibility. Sixty-two countries (29%) reported sitting time representing 47% of the global adult population. The majority of data were from high-income (61%) and middle income (29%) countries. The tools used were the International Physical Activity Questionnaire (IPAQ; n = 34), a modified IPAQ (n = 1) or the Global Physical Activity Questionnaire (GPAQ; n = 27). The median of mean daily sitting times was 4.7 (IQR: 3.5-5.1) hours across all countries. Higher-income countries recorded a longer duration of sitting time than lower-income countries (4.9 vs 2.7 h). CONCLUSIONS: This study provides an updated collation of countries collecting self-reported sitting time data. The daily sitting time findings should be interpreted cautiously. Current surveillance of sitting time is limited by a lack of coverage. Measures of population sitting time that are valid, feasible and sensitive to change should be embedded within global surveillance systems, to help guide future policy, research and practice. TRIAL REGISTRATION: Not applicable.


Assuntos
Exercício Físico , Saúde Global , Comportamento Sedentário , Postura Sentada , Feminino , Humanos , Renda , Masculino , Pobreza , Autorrelato , Inquéritos e Questionários , Fatores de Tempo
10.
Prev Med ; 135: 106072, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32247012

RESUMO

There is suggestive evidence for the role of vitamin D in the development of colorectal cancer (CRC). Due to high latitudes in Canada, many Canadians are vitamin D deficient throughout winter. In this analysis, we examined the association between vitamin D supplement use and high-risk adenomatous polyps (HRAPs). The study population was drawn from the biorepository at the Forzani & MacPhail Colon Cancer Screening Centre (CCSC) in Calgary. Individuals enrolled between 2013 and 2016 between the age of 50 and 74 years (n = 1409) were included. When examining the association between any supplemental vitamin D use and HRAPs, a protective effect is observed with an ORadj of 0.57 (95% CI: 0.33-0.96). Similarly, meeting the recommended daily intake (RDI) of vitamin D (600 IU) is protective against HRAPs with an ORadj of 0.78 (95% CI: 0.62-0.99). This study suggests that adequate vitamin D supplementation reduces the occurrence of colorectal polyps in high-latitude locations.


Assuntos
Pólipos Adenomatosos/epidemiologia , Pólipos do Colo/epidemiologia , Suplementos Nutricionais , Vitamina D/uso terapêutico , Pólipos Adenomatosos/prevenção & controle , Canadá/epidemiologia , Neoplasias Colorretais/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Deficiência de Vitamina D/prevenção & controle
11.
Phys Rev Lett ; 122(16): 163201, 2019 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-31075007

RESUMO

We present a new method of spin-motion coupling for trapped ions using microwaves and a magnetic field gradient oscillating close to the ions' motional frequency. We demonstrate and characterize this coupling experimentally using a single ion in a surface-electrode trap that incorporates current-carrying electrodes to generate the microwave field and the oscillating magnetic field gradient. Using this method, we perform resolved-sideband cooling of a single motional mode to its ground state.

12.
Public Health ; 177: 19-25, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31494359

RESUMO

OBJECTIVES: Although evidence-based interventions (EBIs) and effective strategies to implement them exist, they cannot be used by policy makers and practitioners if they do not align with end users' needs. As such, adaptations to EBIs and implementation approaches are likely to occur to increase 'fit' with end users' capacity. This article describes an approach undertaken by a population health service delivery unit in one Australian state to develop an adapted implementation strategy to support the implementation of the mandatory healthy canteen policy (EBI) to all schools located in the service delivery region. STUDY DESIGN: This is a case study of adapting an intervention to improve implementation of the healthy canteen policy. METHODS AND RESULTS: This is a six-step pragmatic, empirically driven approach. The steps include (i) adapt, where appropriate, the EBI to facilitate implementation; (ii) identify end users' capacity for implementation; (iii) identify opportunities to adapt the implementation interventions while preserving meaningful intervention impact; (iv) undertake program adaptation; (v) develop training and resources to support delivery of implementation strategies and; (vi) evaluate the adapted intervention. This article describes the application of these steps by the authors to develop an adapted support strategy consistent with end users' needs. CONCLUSIONS: This study provides some guidance on how to adapt implementation support approaches particularly when EBIs cannot be adapted. Future empirical research providing guidance on making practical adaptation decisions are needed.


Assuntos
Serviços de Alimentação/organização & administração , Política de Saúde , Instituições Acadêmicas/organização & administração , Austrália , Humanos
13.
New J Phys ; 212019.
Artigo em Inglês | MEDLINE | ID: mdl-31555055

RESUMO

We present a general theory for laser-free entangling gates with trapped-ion hyperfine qubits, using either static or oscillating magnetic-field gradients combined with a pair of uniform microwave fields symmetrically detuned about the qubit frequency. By transforming into a 'bichromatic' interaction picture, we show that either σ ^ ϕ ⊗ σ ^ ϕ or σ ^ z ⊗ σ ^ z geometric phase gates can be performed. The gate basis is determined by selecting the microwave detuning. The driving parameters can be tuned to provide intrinsic dynamical decoupling from qubit frequency fluctuations. The σ ^ z ⊗ σ ^ z gates can be implemented in a novel manner which eases experimental constraints. We present numerical simulations of gate fidelities assuming realistic parameters.

15.
Health Educ Res ; 32(2): 197-205, 2017 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-28380629

RESUMO

Implementation of vegetable and fruit programs in schools is less than optimal. This study aimed to identify, using a theoretical framework, factors associated with implementation of a school vegetable and fruit program; that provides a time in class for children to consume a piece of vegetable or fruit they have brought from home. Three hundred and three randomly selected school principals across the state of New South Wales, Australia responded to a 25-min telephone survey. Principals were asked if their school had implemented a vegetable and fruit program, and which of 12 factors from Damschroder's consolidated framework for implementation research had facilitated or impeded implementation. Multiple logistic regression models examined the association between such factors and program implementation. Seventy-eight percent of schools had a vegetable and fruit program. Schools were significantly more likely to implement the program if the principal believed that: the program was effective (OR = 2.97; P < 0.02); they had sufficient resources to implement the program (OR = 4.22; P < 0.0001); the program would not be difficult to implement (OR = 10.16; P< 0.0001) and that the program was as important as other school priorities (OR = 2.45; P < 0.02). Realizing the intended benefits of vegetable and fruit programs requires widespread implementation by schools. Consideration of principal beliefs about the program effectiveness, resources, difficultly and relative importance in program implementation strategies appear key to increasing program implementation.


Assuntos
Frutas , Promoção da Saúde/métodos , Recursos em Saúde , Instituições Acadêmicas/estatística & dados numéricos , Verduras , Criança , Pré-Escolar , Feminino , Humanos , Masculino , New South Wales , Avaliação de Programas e Projetos de Saúde
16.
Hippocampus ; 26(10): 1328-44, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27273259

RESUMO

The mechanisms governing how the hippocampus selects neurons to exhibit place fields are not well understood. A default assumption in some previous studies was the uniform random draw with replacement (URDWR) model, which, theoretically, maximizes spatial "pattern separation", and predicts a Poisson distribution of the numbers of place fields expressed by a given cell per unit area. The actual distribution of mean firing rates exhibited by a population of hippocampal neurons, however, is approximately exponential or log-normal in a given environment and these rates are somewhat correlated across multiple places, at least under some conditions. The advantage of neural activity-dependent immediate-early gene (IEG) analysis, as a proxy for electrophysiological recording, is the ability to obtain much larger samples of cells, even those whose activity is so sparse that they are overlooked in recording studies. Thus, a more accurate representation of the activation statistics can potentially be achieved. Some previous IEG studies that examined behavior-driven IEG expression in CA1 appear to support URDWR. There was, however, in some of the same studies, an under-recruitment of dentate gyrus granule cells, indicating a highly skewed excitability distribution, which is inconsistent with URDWR. Although it was suggested that this skewness might be related to increased excitability of recently generated granule cells, we show here that CA1, CA3, and subiculum also exhibit cumulative under-recruitment of neurons. Thus, a highly skewed excitability distribution is a general principle common to all major hippocampal subfields. Finally, a more detailed analysis of the frequency distributions of IEG intranuclear transcription foci suggests that a large fraction of hippocampal neurons is virtually silent, even during sleep. Whether the skewing of the excitability distribution is cell-intrinsic or a network phenomenon, and the degree to which this excitability is fixed or possibly time-varying are open questions for future studies. © 2016 Wiley Periodicals, Inc.


Assuntos
Hipocampo/citologia , Hipocampo/fisiologia , Neurônios/citologia , Neurônios/fisiologia , Percepção Espacial/fisiologia , Potenciais de Ação , Animais , Eletrodos Implantados , Genes Precoces , Hibridização in Situ Fluorescente , Masculino , Ratos Long-Evans
17.
Int J Obes (Lond) ; 40(10): 1486-1493, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27430652

RESUMO

BACKGROUND/OBJECTIVES: Obesity prevention during adolescence is a health priority. The 'Physical Activity 4 Everyone' (PA4E1) study tested a multi-component physical activity intervention in 10 secondary schools from socio-economically disadvantaged communities. This paper aimed to report the secondary outcomes of the study; to determine whether the intervention impacted on adiposity outcomes (weight, body mass index (BMI), BMI z-score), and whether any effect was moderated by sex, baseline BMI and baseline physical activity level, at 12 and 24 months. SUBJECTS/METHODS: A cluster randomised controlled trial was conducted in New South Wales, Australia. The school-based intervention included seven physical activity strategies targeting the following: curriculum (strategies to maximise physical activity in physical education, student physical activity plans, an enhanced school sport programme); school environment (physical activity during school breaks, modification of school policy); and parents and the community (parent engagement, links with community physical activity providers). Students' weight (kg), BMI and BMI z-score, were collected at baseline (Grade 7), 12 and 24 months. Linear Mixed Models were used to assess between-group mean difference from baseline to 12 and 24 months. Exploratory sub-analyses were undertaken according to three moderators of energy balance. RESULTS: A total of 1150 students (mean age=12 years) provided outcome data at baseline, 1051 (91%) at 12 months and 985 (86%) at 24 months. At 12 months, there were group-by-time effects for weight (mean difference=-0.90 kg (95% confidence interval (CI)=-1.50, -0.30), P<0.01) and BMI (-0.28 kg m-2 (-0.50, -0.06), P=0.01) in favour of the intervention group, but not for BMI z-score (-0.05 (-0.11; 0.01), P=0.13). These findings were consistent for weight (-0.62 kg (-1.21, 0.03), P=0.01) and BMI (-0.28 kg m-2 (-0.49, -0.06), P=0.01) at 24 months, with group-by-time effects also found for BMI z-score (-0.08 (-0.14; -0.02), P=0.02) favouring the intervention group. CONCLUSION: The PA4E1 school-based intervention achieved moderate reductions in adiposity among adolescents from socio-economically disadvantaged communities. Multi-component interventions that increase adolescents' engagement in moderate-to-vigorous physical activity (MVPA) may assist in preventing unhealthy weight gain.


Assuntos
Exercício Físico/fisiologia , Obesidade Infantil/prevenção & controle , Serviços de Saúde Escolar , Estudantes , Adiposidade , Adolescente , Austrália/epidemiologia , Criança , Análise Custo-Benefício , Exercício Físico/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Obesidade Infantil/epidemiologia , Obesidade Infantil/psicologia , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos , Estudantes/psicologia
19.
Health Educ Res ; 30(2): 262-71, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25516479

RESUMO

Despite significant investment in many countries, the extent of schools' adoption of obesity prevention policies and practices has not been widely reported. The aims of this article are to describe Australian schools' adoption of healthy eating and physical activity policies and practices over an 8-year period and to determine if their adoption varies according to schools' size, geographic or socio-economic location. Between 2006 and 2013, a representative randomly selected cohort of primary schools (n = 476) in New South Wales, Australia, participated in four telephone interviews. Repeated measures logistic regression analyses using a Generalised Estimating Equation (GEE) framework were undertaken to assess change over time. The prevalence of all four of the healthy eating practices and one physical activity practice significantly increased, while the prevalence of one physical activity practice significantly decreased. The adoption of practices did not differ by school characteristics. Government investment can equitably enhance school adoption of some obesity prevention policies and practices on a jurisdiction-wide basis. Additional and/or different implementation strategies may be required to facilitate greater adoption of physical activity practices. Ongoing monitoring of school adoption of school policies and practices is needed to ensure the intended benefits of government investment are achieved.


Assuntos
Promoção da Saúde/estatística & dados numéricos , Obesidade/prevenção & controle , Serviços de Saúde Escolar/estatística & dados numéricos , Dieta , Exercício Físico , Promoção da Saúde/legislação & jurisprudência , Humanos , Estudos Longitudinais , New South Wales , Fatores Socioeconômicos
20.
Br J Cancer ; 110(2): 313-9, 2014 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-24263063

RESUMO

BACKGROUND: Adjuvant chemotherapy improves survival for patients with resected pancreatic cancer. Elderly patients are under-represented in Phase III clinical trials, and as a consequence the efficacy of adjuvant therapy in older patients with pancreatic cancer is not clear. We aimed to assess the use and efficacy of adjuvant chemotherapy in older patients with pancreatic cancer. METHODS: We assessed a community cohort of 439 patients with a diagnosis of pancreatic ductal adenocarcinoma who underwent operative resection in centres associated with the Australian Pancreatic Cancer Genome Initiative. RESULTS: The median age of the cohort was 67 years. Overall only 47% of all patients received adjuvant therapy. Patients who received adjuvant chemotherapy were predominantly younger, had later stage disease, more lymph node involvement and more evidence of perineural invasion than the group that did not receive adjuvant treatment. Overall, adjuvant chemotherapy was associated with prolonged survival (median 22.1 vs 15.8 months; P<0.0001). Older patients (aged ≥70) were less likely to receive adjuvant chemotherapy (51.5% vs 29.8%; P<0.0001). Older patients had a particularly poor outcome when adjuvant therapy was not delivered (median survival=13.1 months; HR 1.89, 95% CI: 1.27-2.78, P=0.002). CONCLUSION: Patients aged ≥70 are less likely to receive adjuvant therapy although it is associated with improved outcome. Increased use of adjuvant therapy in older individuals is encouraged as they constitute a large proportion of patients with pancreatic cancer.


Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Ductal Pancreático/tratamento farmacológico , Neoplasias Pancreáticas/tratamento farmacológico , Fatores Etários , Idoso , Carcinoma Ductal Pancreático/patologia , Carcinoma Ductal Pancreático/cirurgia , Quimioterapia Adjuvante , Estudos de Coortes , Feminino , Humanos , Linfonodos/efeitos dos fármacos , Linfonodos/patologia , Metástase Linfática , Masculino , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Prognóstico
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