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AimsTo determine serum zinc level and other relevant biological markers in normal, prediabetic and diabetic individuals and their association with Homeostasis Model Assessment (HOMA) parameters.MethodsThis cross-sectional study was conducted between March and December 2009. Any patient aged ≥ 30 years attending the medicine outpatient department of a medical university hospital in Dhaka, Bangladesh and who had a blood glucose level ordered by a physician was eligible to participate.ResultsA total of 280 participants were analysed. On fasting blood sugar results, 51% were normal, 13% had prediabetes and 36% had diabetes. Mean serum zinc level was lowest in prediabetic compared to normal and diabetic participants (mean differences were approximately 65 ppb/L and 33 ppb/L, respectively). In multiple linear regression, serum zinc level was found to be significantly lower in prediabetes than in those with normoglycemia. Beta cell function was significantly lower in prediabetes than normal participants. Adjusted linear regression for HOMA parameters did not show a statistically significant association between serum zinc level, beta cell function (P = 0.07) and insulin resistance (P = 0.08). Low serum zinc accentuated the increase in insulin resistance seen with increasing BMI.ConclusionParticipants with prediabetes have lower zinc levels than controls and zinc is significantly associated with beta cell function and insulin resistance. Further longitudinal population based studies are warranted and controlled trials would be valuable for establishing whether zinc supplementation in prediabetes could be a useful strategy in preventing progression to Type 2 diabetes.

Genetic factors explain a majority of risk variance for age-related macular degeneration (AMD). While genome-wide association studies (GWAS) for late AMD implicate genes in complement, inflammatory and lipid pathways, the genetic architecture of early AMD has been relatively under studied. We conducted a GWAS meta-analysis of early AMD, including 4,089 individuals with prevalent signs of early AMD (soft drusen and/or retinal pigment epithelial changes) and 20,453 individuals without these signs. For various published late AMD risk loci, we also compared effect sizes between early and late AMD using an additional 484 individuals with prevalent late AMD. GWAS meta-analysis confirmed previously reported association of variants at the complement factor H (CFH) (peak P = 1.5×10(-31)) and age-related maculopathy susceptibility 2 (ARMS2) (P = 4.3×10(-24)) loci, and suggested Apolipoprotein E (ApoE) polymorphisms (rs2075650; P = 1.1×10(-6)) associated with early AMD. Other possible loci that did not reach GWAS significance included variants in the zinc finger protein gene GLI3 (rs2049622; P = 8.9×10(-6)) and upstream of GLI2 (rs6721654; P = 6.5×10(-6)), encoding retinal Sonic hedgehog signalling regulators, and in the tyrosinase (TYR) gene (rs621313; P = 3.5×10(-6)), involved in melanin biosynthesis. For a range of published, late AMD risk loci, estimated effect sizes were significantly lower for early than late AMD. This study confirms the involvement of multiple established AMD risk variants in early AMD, but suggests weaker genetic effects on the risk of early AMD relative to late AMD. Several biological processes were suggested to be potentially specific for early AMD, including pathways regulating RPE cell melanin content and signalling pathways potentially involved in retinal regeneration, generating hypotheses for further investigation.

Iodine deficiency, the leading preventable cause of intellectual impairment in the world (World Health Organization, 1999), has reappeared in Australia. Recently, we identified the re-emergence of iodine deficiency in Sydney (Gunton, Hams, Fiegert & McElduff, 1999). This has been confirmed locally (Li, Ma, Boyages & Eastman, 2001) and interstate (Guttikonda et al., 2002), most recently in a study of Melbourne schoolchildren (McDonnell, Harris & Zacharin, 2003). We also provided evidence that iodine deficiency influences neonatal thyroid function (McElduff, McElduff, Gunton, Hams & Wiley, 2002). Evidence has been presented from other developed countries that iodine deficiency is re-emerging as a major potential health problem (Hollowell et al., 1998). The reasons for this are not clear, but a loss of awareness of the potential of iodine deficiency in the developed world and a decreased use of iodised salt appear to be major contributors (Gunton et al., 1999). Iodine deficiency impairs brain development through foetal hypothyroidism and in particular hypothyroidism in the early stages of pregnancy (Glinoer et al., 1992; Hetzel, 2000). Endemic cretinism, which is characterised by intellectual impairment, spastic diplegia and deafness, is due to severe iodine deficiency during pregnancy (Hetzel, Chavadej & Potter, 1988). It has been suggested that severe brain impairment easily identified as cretinism is merely one end of a continuous spectrum of neuro-psychological impairment induced by iodine deficiency (Boyages, 1994). Maternal iodine supplementation in populations with high levels of endemic cretinism results in a reduced incidence of cretinism without significant adverse effects (Mahomed & Gulmezoglu, 2000). In populations with less severe iodine deficiency and without cretinism the benefit of iodine supplementation is not as rigorously established, although a meta-analysis suggests an improvement in neuro-psychological functioning with iodine supplementation (Bleichrodf & Born, 1994). The average scores of cognitive capacity (a term used by the authors to amalgamate a variety of different intelligence tests) are improved by about 10% with iodine supplementation (Bleichrodf & Born, 1994).

Once considered a scientific, technocratic activity, marine governance has shifted from a top down, state directed process toward participatory and deliberative approaches. In parallel, there has been increasing acknowledgment of the need to consider the human dimensions of marine and coastal issues, and the role of citizens in delivering the sustainable management and protection of the marine environment. By doing so, a more complete understanding of the complex relationship between society and the sea may be achieved. Research has shown that marine practitioners recognise that higher levels of civic involvement and citizenship in the management of the marine environment would be beneficial. Despite this, questions are raised as to whether existing governing institutions, legal structures, and planning instruments enable this to readily happen in practice. This paper explores the extent to which existing marine governance instruments are positioned to engender a society of marine citizens to meaningfully engage with marine stewardship behaviours in the UK and Ireland. A multi-phased research approach critically analyses existing relevant legislation, legal and policy frameworks, focusing on themes associated with the human dimensions of marine governance, including marine stewardship. This evaluation highlights a limited inclusion of terms relating to marine stewardship nationally, but recognises the foundations are there a more strategic and cognisant recognition of human-ocean relationships within marine governance across a range of scales and contexts. • Marine governance has shifted from a top-down to a more participatory process. • Practitioners recognise a need for higher civic involvement and citizenship. • Research critically analyses existing instruments for human dimensions. • Recommendations call for explicit inclusion of people in marine governance. [ABSTRACT FROM AUTHOR]