The Heartbeat Award Scheme: an evaluation of catering practices

The Heartbeat Award Scheme was launched in England in 1990 by the Health Education Authority as part of the national strategy to reduce the incidence of coronary heart disease. To date there has been no formal evaluation of the impact the award has had on catering practices. This study aimed to compare the differences between those premises with and without the award with regard to their catering practices. All Heartbeat premises (497) within the former Wessex region, along with 495 control premises without the award, were sent postal questionnaires. A total of 380 premises with the award and 306 premises without responded, representing a response rate of 77% and 62%, respectively. Respondents were grouped into one of three categories: public eating places, workplaces or educational establishments. Differences were found between award and non-award holders, particularly with regard to the provision of healthy food, including brown rice and semi/skimmed milk, healthy options available to the consumer and commitment to healthy eating. While this research suggests that the award scheme may be increasing consumer choice, it is not possible to draw conclusions about the impact of the scheme on eating habits.     

Time course of hypo-osmotic swellings of human spermatozoa: evidence of ordered transition between swelling subtypes

The hypo-osmotic swelling test (HOST or HOS test) usually takes into consideration the total HOS response value with no emphasis either on the value of the response subtypes or the response evaluation time. This study investigated the time course of HOS responses and analysed their physiological relevance. Raw semen spermatozoa and Percoll washed spermatozoa were used in the experiment. The morphological changes in the sperm tail were monitored by incubating the spermatozoa in the hypo- osmotic solution for 16 different time periods. The HOS reactive spermatozoa and the type of HOS reaction (swelling subtypes) of the samples subjected to different duration of treatment were identified under a phase contrast microscope. Also the fate of individual spermatozoa in a hypo-osmotic environment were monitored for 30 min. In spermatozoa exposed to a hypo-osmotic solution, the motility lasted usually less than 2 min and motility characteristics were uniquely different from that of the spermatozoa under iso-osmotic conditions. The HOS response development was permanent but the motility loss due to hypo-osmotic shock was reversible up to 1 min of incubation. There was an indication of ordered transition among the HOS swelling subtypes apparently initiating with subtype b destined to c, d, e, f and g. Further, the subtypes a and g showed gradual decrease and increase, respectively, while subtype b showed abrupt initial increase and then gradual decrease. Transition from b to g could be direct or via one or more than one subtypes. Ultrastructure based analysis indicated that HOS response subtypes are the apparent reflection of the differences in the cytoskeletal assembly of the sperm tail and thus may be identifying different physiological variants in the sperm population. These results indicate that shorter incubation is essential to document the kinetics of various HOS responses but the conventional HOS test misses these important HOS features because of lengthy incubation. Since the time course of ordered transition of HOS responses will vary more than the total HOS response in semen of different aetiologies, the importance of HOS response subtypes and response evaluation time should be taken into consideration when applying HOS test.      

Identifying the nature and extent of public and donor concern about the commercialisation of biobanks for genomic research

Various forms of private investment are considered necessary for the sustainability of biobanks, yet pose significant challenges to public trust. To manage this tension, it is vital to identify the concerns of relevant stakeholders to ensure effective and acceptable policy and practice. This research examines the aspects of commercialisation that are of most concern to the Australian public (n = 800) and patients who had donated their tissue to two large disease specific (cancer) public biobanks (n = 564). Overall, we found a commercialisation effect (higher support for public relative to private) in relation to funding, research location and access to stored biospecimens. The effect was strongest for research locations and access compared to funding. A latent class analysis revealed the pattern of concern differed, with the majority (34.1%) opposing all aspects of commercialisation, a minority supporting all (15.7%), one quarter (26.8%) opposing some (sharing and selling tissue) but not others (research locations and funding), and a group who were unsure about most aspects but opposed selling tissue (23.5%). Patient donors were found to be more accepting of and unsure about most aspects of commercialisation. Members of the (general) public who were motivated to participate in biobanking were more likely to oppose some aspects while supporting others, while those who indicated they would not donate to a biobank were more likely to oppose all aspects of commercialisation. The results suggest that approaches to policy, engagement and awareness raising need to be tailored for different publics and patient groups to increase participation.Subject terms: Genetics research, Ethics     

Transvaginal mesh,gender and the ethics of clinical innovation

On 10 October 2018, Australian Health Minister Greg Hunt issued a national apology to the Australian women who experienced ‘horrific outcomes’ following surgery using transvaginal mesh—acknowledging the ‘historic agony and pain that has come from mesh implantation’. This apology followed many decades of ‘innovative’ use of transvaginal mesh for the treatment of pelvic organ prolapse. We use the case of transvaginal mesh to explore how clinical innovation may not only harm patients, but also entrench vulnerability and exacerbate existing inequities—in this case, those relating to gender.     

A major new alliance in Australian healthcare: the Australian consensus framework for ethical collaboration in the healthcare sector

The 'Australian Consensus Framework for Ethical Collaboration in the Healthcare Sector' (ACF) is an Australian initiative aimed at countering dysfunction and growing mistrust in the health sector through the development of a cross‐sectoral consensus framework. The development of this framework arose from Australia's involvement in the Asia Pacific Economic Cooperative (APEC) and has since become the largest of its kind internationally, with over 70 signatories representing professional bodies, industry organisations, hospital and health services associations, regulators and patient and advocacy groups. In this article, we describe and critique the framework and outline its implementation.