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Background: Observational studies have consistently found a link between low serum 25‐hydroxyvitamin D concentration and higher risk of cognitive impairment. Results from randomized controlled trials have been mixed, and few have been conducted in the general population. Methods: We recruited 21,315 community‐dwelling Australians aged between 60 and 84 years to participate in the D‐Health Trial, a randomized, double‐blind, placebo‐controlled trial. The intervention was monthly oral doses of 60,000 international units of vitamin D or placebo for 5 years. We assessed cognitive function in a randomly sampled group of participants aged ≥70 years using the Telephone Interview for Cognitive Status (TICS) at 2 and 5 years after randomization. The primary outcome for this analysis was TICS score; the secondary outcome was the proportion of people who had cognitive impairment (defined as TICS score ≤25). We analyzed data using mixed models (linear and logistic). Results: We interviewed 3887 participants at year 2 and 3614 participants at year 5. The mean TICS score at these time points was 32.3 and 32.2, respectively. Vitamin D supplementation did not affect cognitive function as measured by TICS score (mean difference between vitamin D and placebo groups 0.04; 95% CI −0.14 to 0.23), or alter risk of cognitive impairment (odds ratio 1.00; 95% CI 0.75 to 1.33). Conclusions: Monthly bolus doses of vitamin D supplementation neither enhanced nor hindered cognitive function among older adults. Population‐wide vitamin D supplementation of older adults that are largely vitamin D replete is unlikely to substantially benefit cognition. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether vitamin D supplementation reduces depressive symptoms and incidence of antidepressant use.Methods: We used data from the D-Health Trial (N = 21,315), a randomized double-blind placebo-controlled trial of monthly vitamin D3 for the prevention of all-cause mortality. Participants were Australians aged 60-84 years. Participants completed the Patient Health Questionnaire (PHQ-9) at 1, 2 and 5 years after randomization to measure depressive symptoms; national prescribing records were used to capture antidepressant use. We used mixed models and survival models.Results: Analyses of PHQ-9 scores included 20,487 participants (mean age 69·3 years, 46% women); the mean difference (MD) in PHQ-9 score (vitamin D vs. placebo) was 0·02 (95% CI -0·06, 0·11). There was negligible difference in the prevalence of clinically relevant depression (PHQ-9 score ≥10) (odds ratio 0·99; 95% CI 0·90, 1·08). We included 16,670 participants in the analyses of incident antidepressant use (mean age 69·4 years, 43% women). Incidence of antidepressant use was similar between the groups (hazard ratio [HR] 1·04; 95% CI 0·96, 1·12). In subgroup analyses, vitamin D improved PHQ-9 scores in those taking antidepressants at baseline (MD -0·25; 95% CI -0·49, -0·01; p-interaction = 0·02). It decreased risk of antidepressant use in participants with predicted 25(OH)D concentration <50 nmol/L (HR 0·88; 95% CI 0·75, 1·02; p-interaction = 0·01) and increased risk in those with predicted 25(OH)D ≥ 50 nmol/L (HR 1·10; 95% CI 1·01, 1·20).Conclusion: Monthly supplementation with high-dose vitamin D3 was not of benefit for measures of depression overall, but there was some evidence of benefit in subgroup analyses.Clinical Trial Registration: The trial is registered on the Australian New Zealand Clinical Trials Registry: ACTRN12613000743763. https://www.anzctr.org.au/. [ABSTRACT FROM AUTHOR]

Objective: Smoking has been associated with a reduced risk of thyroid cancer, but whether the association varies between higher‐ and lower‐risk cancers remains unclear. We aimed to assess the association between smoking and risk of thyroid cancer overall as well as by tumour BRAF mutational status as a marker of potentially higher‐risk cancer. Design and Patients: We recruited 1013 people diagnosed with thyroid cancer and 1057 population controls frequency‐matched on age and sex. Methods: Multivariable logistic regression was used to assess the association overall and in analyses stratified by tumour characteristics. We used sensitivity analysis to assess the potential for selection bias. Results: We found little evidence of an association with current smoking (odds ratio [OR] = 0.93; 95% confidence interval [CI]: 0.69–1.26; current vs. never smoking), but a higher number of pack‐years of smoking was associated with a lower risk of thyroid cancer (OR = 0.75; 95% CI: 0.57–0.99; ≥20 pack‐years vs. never). However, after correcting for potential selection bias, we observed a statistically significant inverse association between current smoking and risk of thyroid cancer (bias‐corrected OR = 0.65; 95% CI: 0.51–0.83). Those with BRAF‐positive cancers were less likely to be current smokers than those with BRAF‐negative cancers (prevalence ratio: 0.79; 95% CI: 0.62–0.99). Conclusion: We found smoking was inversely related to thyroid cancer risk and, in particular, current smoking was associated with a reduced risk of potentially more aggressive BRAF‐positive than the likely more indolent BRAF‐negative papillary thyroid cancers. [ABSTRACT FROM AUTHOR]

Fraudulent activities in the international honey market affect 10% of food, and cost the global food market $50 billion per annum. Although many developed countries have created regulations to combat food fraud, illegally imported honey, especially originating from China, still enters through transshipments and relabelling to mask its true origin. This honey laundering poses a health risk to consumers, as Chinese honey potentially contains illegal and unsafe antibiotics and high levels of herbicides and pesticides. We analyse whether information about the negative health impacts of laundered honey increases the proportion of consumers willing to pay a premium for local fraud‐free honey. Using a laboratory experiment, we find when consumers are given honey laundering information, their willingness to pay a premium for local fraud‐free honey increases by as much as 27 percentage points. Our findings suggest that by conveying honey laundering information and guaranteeing their honey is fraud‐free, producers can potentially increase revenues and reduce the prevalence of food fraud. Our results further show that consumers' preference for various honey characteristics and age also influence the probability of paying a premium for local honey. [ABSTRACT FROM AUTHOR]

Summary: Published studies on the epidemiology of amyloidosis have relied on death certificate data for case ascertainment. We estimated the incidence and mortality burden of amyloidosis among residents of the Australian state, Queensland, aged ≥20 years for the years 1999–2013 based on case ascertainment from histopathology reports. Information systems for participating laboratories were scrutinised to identify histopathology reports that documented a diagnosis of amyloidosis. Case mortality status was determined via linkage to the National Death Index. A total of 447 cases of amyloidosis were identified, with a median age at diagnosis of 66 years. A plasma cell dyscrasia was identified in 72% of patients who had paraprotein studies performed. The estimated incidence for Queenslanders aged ≥20 years was 12·1 cases per million person years. The median survival was 2·45 years. Age at diagnosis, presence of a paraprotein, earlier year of diagnosis, and inner regional location of residence (compared with residence in a major city) were independently associated with reduced survival. Our data confirms previously reported incidence data for amyloidosis of approximately 10 cases per million patient years and indicates that survival for Queensland patients with amyloidosis is improving, though it remains poor for the elderly and patients with AL amyloidosis. [ABSTRACT FROM AUTHOR]

Summary: Prognosis from differentiated thyroid cancer is worse when the disease becomes refractory to radioiodine. Until recently, treatment options have been limited to local therapies such as surgery and radiotherapy, but the recent availability of systemic therapies now provides some potential for disease control. Multitargeted kinase inhibitors (TKIs) including lenvatinib and sorafenib have been shown to improve progression‐free survival in phase III clinical trials, but are also associated with a spectrum of adverse effects. Other TKIs have been utilized as “redifferentiation” agents, increasing sodium iodide symporter expression in metastases and thus restoring radioiodine avidity. Some patients whose disease progresses on initial TKI therapy will still respond to a different TKI and clinical trials currently in progress will clarify the best options for such patients. As these drugs are not inexpensive, care needs to be taken to minimize not only biological but also financial toxicity. In this review, we examine the basic biology of radioiodine refractory disease and discuss optimal treatment approaches, with specific focus on choice and timing of TKI treatment. This clinical field remains fluid, and directions for future research include exploring biomarkers and considering adjuvant TKI use in certain patient groups. [ABSTRACT FROM AUTHOR]

Background Recombinant factor VIIa ( rFVIIa) is used for many off-label indications without high quality evidence to support its efficacy. The aim of this study was to determine indications for use of off-label rFVIIa, efficacy and safety, and adherence to institutional guidelines. Methods We performed a retrospective review of off-label rFVIIa at two tertiary hospitals from 2007 to 2010. Results One hundred forty-five administrations were identified and analysed. Haemorrhage associated with cardiac surgery made up one-third of all rFVIIa usage, with trauma (20%) and other surgery (11%) the next most frequent indications. Compared with all others, cardiac surgery patients were older (60.0 years versus 47.4 years, P < 0.001) and had lower pre- rFVIIa transfusion requirements, a higher subjective response rate (88% versus 46%, P < 0.001) and lower mortality rates (6.1% versus 33%, P < 0.001), but higher rates of arterial thrombormbolic events (16.7% versus 2.1%, P = 0.002). Most patients received only one or two doses ( n = 137; 95%), with no subject receiving a third or subsequent dose having an appreciable reduction in bleeding. Only a small number of patients ( n = 15; 10.3%) had rFVIIa administered in accordance with our institutions' guidelines. Conclusion Patients administered rFVIIa for haemorrhage not associated with cardiac surgery were severely unwell. Despite lack of evidence, administration of rFVIIa may be justified by the high mortality rate, but more than two doses are unlikely to provide further benefit. The high rate of arterial thromboembolism in cardiac surgical patients raises risk-benefit considerations. Adherence to our institutions' guidelines was poor. [ABSTRACT FROM AUTHOR]

Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Minimal extrathyroid extension does not affect the relapse-free survival of patients with papillary thyroid carcinoma measuring 4 cm or less over the age of 45 years. [Extracted from the article]

This study examines craft brewers as a niche market for the malting industry. Results suggest that catering to craft brewers' needs and preferences offers potential opportunities for malt suppliers. Malt suppliers will have to increase services and provide differentiated malt products to increase demand from craft brewers. This may be a problem for a number of firms that have invested capital to supply large volumes of mass-produced malt inputs. Malt barley producers may also be able to exploit niche markets as input suppliers to malting facilities. [ABSTRACT FROM PUBLISHER]

Agricultural lands provide open space, which is valuable as wildlife habitat, as a visual resource, and as access to public lands. Sublette County, WY, is the basis for a case study relevant to rural land use planning. A mail survey provided responses from landowners and other residents. Agricultural land uses and public involvement in land use planning were approved. Land use controls including zoning were accepted. Differences existed between residents and nonresidents regarding personal income, local employment, the future importance of extractive industries, and the reasons for living in the county. [ABSTRACT FROM PUBLISHER]

A letter to the editor is presented in response to the article "Serum 25-hydroxyvitamin D and glycated haemoglobin levels in women with gestational diabetes mellitus," by S. L. Lau et al in a 2011 issue.

Presents a letter to the editor about a conference related to the occupational psychology.