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Aims It has been proposed that the Chronic Kidney Disease Epidemiology Collaboration formula estimates glomerular filtration rate more accurately than the Modification of Diet in Renal Disease formula. With the very high incidence of diabetes and end-stage kidney disease in Indigenous Australians, accurate estimation of glomerular filtration rate is vital in early detection of kidney disease. We aimed to assess the performance of the Chronic Kidney Disease Epidemiology Collaboration, Modification of Diet in Renal Disease and Cockcroft-Gault formulas in Indigenous Australians with and without diabetes. Methods Indigenous Australians with ( n = 224) or without ( n = 340) Type 2 diabetes had a reference glomerular filtration rate measure using plasma disappearance of iohexol (measured glomerular filtration rate) over 4 h. Serum creatinine was measured by an enzymatic method. Performance was assessed by bias (measured glomerular filtration rate - estimated glomerular filtration rate) and accuracy (percentage of estimated glomerular filtration rate within 30% of measured glomerular filtration rate). Results The median measured glomerular filtration rate (interquartile range) in participants with or without diabetes was 97 (68-119) and 108 (90-122) ml min−1 1.73 m−2, respectively. The Chronic Kidney Disease Epidemiology Collaboration formula had smaller bias and greater accuracy than the Modification of Diet in Renal Disease and Cockcroft-Gault formulas overall, for participants both with and without diabetes. However, for estimated glomerular filtration rate > 90 ml min−1 1.73 m−2, the Chronic Kidney Disease Epidemiology Collaboration formula had greater bias in participants with diabetes, underestimating measured glomerular filtration rate by 7.4 vs. 1.0 ml min−1 1.73 m−2 in those without diabetes. The Chronic Kidney Disease Epidemiology Collaboration formula was less accurate across the whole range of estimated glomerular filtration rates in participants with vs. those without diabetes (87.1% vs. 93.3%). Conclusions The Chronic Kidney Disease Epidemiology Collaboration formula outperforms the Modification of Diet in Renal Disease and Cockcroft-Gault formulas overall in Indigenous Australians with and without diabetes. However, the Chronic Kidney Disease Epidemiology Collaboration formula has greater bias in people with diabetes compared with those without diabetes, especially in those with normal renal function. [ABSTRACT FROM AUTHOR]

Summary: Sunlight deprivation results in vitamin D deficiency but serum vitamin D levels can be maintained above 50nmol/L when supplemented with 50,000IU at least every alternate month. Introduction: Antarctic expeditioners are exposed to prolonged sunlight deprivation resulting in vitamin D deficiency. We hypothesised that monthly dosing of 50,000 IU vitamin D (~1,600 IU daily) will increase serum 25-hydroxyvitamin D (25(OH)D), suppress parathyroid hormone (PTH) and improve bone mineral density (BMD), 50,000 IU alternate months (~800 IU daily) will maintain these measures, while a single 50,000 IU dose pre-departure (~1,00 IU daily) will not be protective. Methods: This was a randomised double-blind study involving 110 healthy adults: 91 males, mean age 41 years (range 24-65 years) working in Antarctica for up to 12 months, who we administered 50,000 IU vitamin D3 monthly, alternate months or a single dose pre-departure. Serum 25(OH)D, PTH, osteocalcin, CTx and calcium were assessed at baseline, mid- and end of expedition. Proximal femur and lumbar spine BMD were assessed pre- and post-expedition. Results: Baseline 25(OH)D was 59 ± 14 nmol/L. By mid-expedition, 25(OH)D increased by 7 nmol/L in those supplemented monthly ( p < 0.05) and remained unchanged in those supplemented in alternate months. In those given a single dose pre-departure, 25(OH)D decreased by 8 nmol/L ( p < 0.05) and PTH increased by 27% ( p < 0.09). Serum osteocalcin increased by ~22% in all groups but BMD remained unchanged. If serum 25(OH)D was >50 nmol/L at baseline, 25(OH)D was maintained above this level with all regimens. If 25(OH)D was <50 nmol/L at baseline, monthly or alternate month regimens were needed to achieve levels >50 nmol/L, the single pre-departure dose was ineffective. Conclusion: During sunlight deprivation of up to 12 months, serum 25(OH)D levels can be maintained above 50 nmol/L when expeditioners are provided with 50,000 I U at least every alternate month. [ABSTRACT FROM AUTHOR]

Summary: In this large population-based study, walking was assessed twice yearly for a week, each time by pedometer, had consistent clinically important associations with hip areal bone mineral density (aBMD) in both sexes which appears most important in those over 65 years of age suggesting that walking becomes more important with increasing age. Introduction: Walking is advocated as a preventative strategy for osteoporosis but the evidence is conflicting in females and lacking in males. The aim of this population-based longitudinal study in community dwelling older people ( n = 875) was to determine the association between pedometer determined ambulatory activity (PAA) and bone mass. Methods: Bone mass was assessed as aBMD at the hip and spine using dual X-ray absorptiometry. Steps per day were measured using pedometers for 1 week on four occasions at least 6 months apart. Data were analysed using linear mixed models. Results: At baseline, PAA was positively associated with hip aBMD. An age interaction was present with steps having a stronger association for those aged over 65 years. Longitudinally, the effect of steps on hip aBMD was constant, but not additive over time. For those over 65 years, the difference in hip aBMD between the lowest and highest steps quartiles ranged from 3.1% to 9.4%. With regard to the spine, the relationship between daily steps and spine aBMD was modified by sex. For males; there was no significant relationship between steps and spine aBMD. However, for females, higher steps were associated with higher spine aBMD with the effect being constant over time but not additive. There was no evidence of a threshold effect. Conclusion: In conclusion, pedometer-determined ambulatory activity has consistent clinically important associations with hip aBMD in both sexes which appears most important in those over 65 years of age. The associations for spine aBMD were both weaker and inconsistent suggesting site specificity. [ABSTRACT FROM AUTHOR]

Abstract: Thoroughbred jumps racing jockeys have a fall rate greater than their flat racing counterparts. Previous studies have focused on factors that contribute to falls by horses but, to date, there has not been a study of risk factors for falls to jockeys in jumps races. Data on race-day falls were extracted from stipendiary stewards reports lodged with Principal Racing Authorities following each race meeting. Denominator data were provided by Racing Information Services Australia on races conducted from August 2002 until July 2009. Univariable and multivariable analyses, estimating incidence rate ratios, were conducted using Poisson regression. In multivariable analysis in hurdle racing, important predictors of falls were higher club level, larger field size, greater prize money, provisionally licenced jockeys and older jockeys. There were significant interactions between jockey licence and prize money; jockey age and previous rides this meeting; race grade and race distance; horse age and field size; and club level and field size. In steeplechase racing, important predictors were type of jump with lowest fall rates in races over Mark III jumps compared to standard fences, provisionally licenced jockeys, jockeys having had previous rides at a meeting, and larger field size. There were significant interactions between the number of previous starts by the horse and field size; race distance and prize money; and race distance and previous rides this meeting. This study has identified factors for falls in jumps racing that could form the basis for targeted strategies to improve occupational health and safety standards. [Copyright &y& Elsevier]