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This chapter reviews the importance of diabetes as a major complication of obesity, starting with examining the epidemiological relationship between diabetes and obesity. It is clear from the epidemiological data reported that obesity is strongly associated with onset and, in particular, the premature onset, of type 2 diabetes. However, in established heart disease and heart failure, obesity is associated with lower mortality. The chapter considers the epidemiological evidence linking adiposity with the development of cancer, and describes the proposed mechanisms by which excess body fat may impact on cancer risk. The global prevalence of osteoarthritis continues to rise, both because of an ageing population as well as because of the current obesity epidemic, with obesity in the elderly becoming an increasing problem. The chapter explains individual psychosocial factors and views them as part of a vicious circle, including personal beliefs. The combination of binge eating and obesity is particularly problematic with regard to comorbidity and risk.

In 2006 the avian influenza A (H5N1) virus received considerable media coverage in Australia, as it did in many other countries. It is often argued that the media sensationalizes health crises, and experts cautioned about the risk of panic as a result of fear of avian influenza. The purpose of the present study was to systematically analyze Australian print media coverage of avian influenza in 2006 and to examine whether this coverage served the purpose of informing, rather than alarming, the general public. For the period January 1, 2006 to December 31, 2006, 20 Australian newspaper titles were monitored for coverage of avian influenza. The identified articles were analyzed using aspects of protection motivation theory for theoretical direction to determine whether there were any consistent themes or perspectives in the coverage. A total of 850 articles were identified for analysis. Concerning vulnerability, 46% of articles reported the incidence of human cases, with 24% noting that avian influenza was a potential threat to Australia. The most common severity theme was “deadly” with over 50% of mentions, followed by “pandemic” with 35%. Only 11% of articles referred to any form of self-protection. We found that a considerable proportion of the articles reporting on avian influenza were framed in a way that had the potential to incite fear and panic amongst the public; the intensity of media coverage reduced over time; and, of particular concern, that there was little media coverage that focused on protective or preventative issues. Whether an influenza pandemic eventuates or not, it is prudent for governments and health authorities to continually develop appropriate resources and strategies to prepare the health system and the general public to respond to current, and future, infectious disease risks.

Leading medical experts have cautioned about the risk of inappropriate behavioural responses as a result of fear of avian influenza (bird flu) even before a pandemic emerges, and have emphasised the need for appropriate risk communication strategies. There is a paucity of in-depth qualitative research into the general public's understanding of, and reactions to, such potential health crises. Four focus groups were conducted in April 2006 and a further eight focus groups in July 2006, to examine people's knowledge, beliefs and behaviours in relation to avian influenza, with the primary aim being to inform the development of future communication strategies. It was clear from the focus groups that avian influenza is not a disease the participants perceive they are likely to acquire; it was not simply that Australia was far from mind when thinking of avian influenza, but that they also saw Australia as a haven protected from avian influenza. We found that, in general, participants see avian influenza as yet another example of media sensationalism—not as a disease that poses any real risk to Australia—and are clearly unprepared for a potential outbreak. Governments and health authorities should conduct further research to understand consumer perceptions of avian (or other pandemic) influenza, and attitudes towards the recommended protective behaviours, in order to pro-actively develop communication strategies to rapidly inform the public and encourage appropriate behavioural responses in the event that the potential risk is realised. Copyright © 2009 John Wiley & Sons, Ltd.

Issue addressed: To evaluate the effectiveness of a brief intervention using a pedometer and step-recording diary on promoting physical activity in people with type 2 diabetes or impaired glucose tolerance (IGT). Methods: People with type 2 diabetes or IGT who attended the Illawarra Diabetes Service were invited to participate. Participants in the intervention group received a pedometer and a diary to record their daily steps for a two-week period. Both the intervention and comparison group received advice on physical activity. Physical activity levels were measured using the Active Australia Survey at baseline, and at two and 20 weeks. Results: A total of 226 participants were recruited. At two-week follow-up the mean self-reported minutes of walking was significantly higher in the intervention group than the comparison group (223 minutes versus 164 minutes; p=0.01), as was the percentage of intervention participants achieving recommended levels of moderate-intensity physical activity (63.5% versus 41.8%, p=0.02) and the percentage of intervention participants achieving adequate levels of total physical activity (68.9% versus 48.0%, p=0.04). There were no differences between study groups for any physical activity measure at 20-week follow-up. Conclusions: A pedometer and a step-recording diary were useful tools to promote short-term increase in physical activity in people diagnosed with type 2 diabetes or IGT. Future studies need to examine whether a longer intervention, individualised physical activity counselling and support for achieving step goals could result in increasing physical activity over the long term.

Introduction Pancreatic cancer (PC) is the sixth leading cause of cancer death in Australia and the fourth in the United States, yet research in PC is lagging behind that in other cancers associated with a high disease burden. In the absence of agreed processes to reliably identify research areas which can deliver significant advances in PC research, the Cancer Council NSW established a strategic partnership with the NSW Pancreatic Cancer Network to define critical research issues and opportunities that could accelerate progress in this field in Australia. Materials and methods The process consisted of five distinct stages: a literature review on recent progress in PC research, semi-structured expert interviews, a Delphi process, consumer focus groups, and a nominal group process. Information collected at each step informed the development of subsequent stages. Results The results from these steps were refined by the nominal group into a set of seven specific pancreatic cancer research goals. The goals were disseminated and led to a new funding scheme for key PC research priorities. Discussion This prioritisation exercise provided a much needed “road map” for research prioritisation in PC and served as a checklist to researchers applying for PC research grants to confirm how their research can contribute towards accelerating progress in PC research in Australia.