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Background Rural patients with atherosclerotic cardiovascular disease (ASCVD) experience greater cardiovascular morbidity and mortality than their urban counterparts. Statin therapy is a key component of ASCVD treatment. The extent to which there may be regional differences in long-term adherence to statins is unknown. Objective To assess long-term rates of adherence to statins in a high-risk ASCVD cohort, and whether regional differences exist between rural and urban patients. Methods Follow-up was conducted in patients who underwent coronary angiography at a single tertiary center between 2009 and 2013. Adherence was defined as consumption of prescribed statin ≥6 days per week. Patients were divided into remoteness areas (RAs), classified as RA1 (major city), RA2 (inner regional), and RA3 (outer regional) based on the Australian Standard Geographical Classification. Results Five hundred twenty-five patients (69% male, mean age 64 ± 11 years) were followed-up after a median of 5.3 years. Baseline characteristics were similar between RAs. Overall adherence was 83%; however, rural patients were significantly more adherent to their statin therapy (80% in RA1, 83% in RA2, and 93% in RA3, P =.04). Living in RA3 independently predicted greater statin adherence than living in RA1 (odds ratio: 2.75, 95% CI: 1.1–7.8, P =.03). All-cause mortality was significantly higher in RA3 than other regional areas (6% RA1, 12% RA2, and 18% RA3, P =.01). Conclusions Despite higher all-cause mortality, rural patients with ASCVD demonstrate significantly greater long-term adherence to statins than urban patients. Other factors, such as reduced access to health care and delayed diagnosis may explain the gap in outcomes between rural and urban patients. Highlights • Long-term statin adherence is suboptimal in patients at high atherosclerotic risk. • Rural patients are significantly more adherent than urban patients. • Despite greater adherence, all-cause mortality is greater in rural populations. • Poorer access to health services and delayed diagnosis are likely contributory. [ABSTRACT FROM AUTHOR]

Subgrades of expansive nature are one of the main causes of damage to road network in Australia. Consequently, lime stabilization has been widely used to reduce the swell- shrink potential of these types of soils and thus reduce the associated damage. After stabilization and compaction, the subgrade will naturally be exposed to cycles of full swell and or partial shrinkage due to climatic cycles. This paper investigates this behaviour for lime stabilized compacted expansive soil from weathered Quaternary Volcanic geological deposits located in Western Victoria; Australia. These soils were stabilized with varying percentages of hydrated lime (2, 3, 4, 6 and 8 percent) and the swell-shrink paths of both untreated and treated soils were studied. Test specimens were compacted at optimum moisture content and maximum dry density. The samples were subjected to full swell-shrink cycles under a surcharge of 25 kPa to reach structural stabilization and to simulate the impact of climatic wetting and drying cycles. Vertical deformation and swell-shrink cycle relationships for untreated and treated samples were obtained and analyzed. The results of lime stabilization indicate that equilibrium is reached after three cycles for both untreated and treated samples. In addition, results suggest that maximum deformation occurs in the second swelling cycle. Vertical deformation of untreated sample was reduced to a third after adding 2 percent lime and reduced to a sixth after adding 3 percent lime. The gradient of swelling and shrinkage path reduced to about a sixth and third when it is treated with 2 and 3 percent, respectively. The treated samples reached maximum swelling at a higher degree of saturation than the untreated sample. [ABSTRACT FROM AUTHOR]

Objective: To examine the association between long-term health conditions and being out of the labour force among older Australians.Design, Setting and Participants: Retrospective analysis of cross-sectional data from the Australian Bureau of Statistics 2003 Survey of Disability, Ageing and Carers for people aged 45-64 years.Main Outcome Measures: Rates of premature retirement associated with ill health; odds ratios of being out of the labour force associated with each long-term health condition and number of conditions; weighted population estimates; estimates of gross domestic product lost as a result.Results: 9198 people surveyed were aged 45-64 years, 3010 of whom were not in the labour force. Of these, 1373 (45.6%) had retired because of a chronic health condition, most commonly a back problem (10.4%), or arthritis and related disorders (8.6%). When adjusted for age and sex, all conditions studied except diseases of the ear and mastoid process, other endocrine/nutritional and metabolic disorders, noise-induced deafness or hearing loss, and high cholesterol were significantly associated with being out of the labour force. Extrapolating from these results, an estimated 663 235 older Australians were not working because of ill health, reducing Australia's gross domestic product by around $14.7 billion per annum.Conclusion: Prevention of long-term health conditions may help older Australians remain in the labour force longer, thereby increasing revenue to fund health care for the ageing population. [ABSTRACT FROM AUTHOR]