Survival of relatives of patients with hepatocellular carcinoma

Background:Families of patients with hepatocellular carcinoma (HCC) carry a high risk of developing HCC. We determine the number of fatalities in relatives of HCC patients during an 8-year period to understand the risk and cause of HCC in relatives of patients with HCC.
Methods:From 1992 to 1997, 15 410 relatives of HCC patients in three generations were screened prospectively for HCC by ultrasonography, α-fetoprotein, liver biochemistry and viral markers. By using national citizen identification numbers, we searched the total fatalities in relatives of HCC patients between 1992 and 1999 from the national mortality data bank. The results were compared among different viral infection groups.
Results:Of the relatives studied, 37.8% were hepatitis B s antigen (HBsAg) positive (+), 4.3% were anti-hepatitis C virus (HCV) (+) and 1.7% were both HBsAg (+) and anti-HCV (+). A total of 399 fatalities, including 139 because of HCC (34.8%), 37 because of liver diseases (9.3%), 88 because of other cancers (22.1%) and 135 because of other diseases (33.8%), were found. Relatives who were HBsAg (+) or anti-HCV (+)showed a lower cumulative survival than did relatives who were negative for both HBsAg and anti-HCV. Relatives with dual infection of hepatitis B and C virus showed the highest mortality due to HCC or terminal liver diseases.
Conclusions:Chronic viral infection rather than a hereditary factor is the main cause of a familial tendency for HCC. Dual infection of hepatitis B and C virus increases the risk of HCC or decompensated liver diseases.
Background:Families of patients with hepatocellular carcinoma (HCC) carry a high risk of developing HCC. We determine the number of fatalities in relatives of HCC patients during an 8-year period to understand the risk and cause of HCC in relatives of patients with HCC.
Methods:From 1992 to 1997, 15 410 relatives of HCC patients in three generations were screened prospectively for HCC by ultrasonography, α-fetoprotein, liver biochemistry and viral markers. By using national citizen identification numbers, we searched the total fatalities in relatives of HCC patients between 1992 and 1999 from the national mortality data bank. The results were compared among different viral infection groups.
Results:Of the relatives studied, 37.8% were hepatitis B s antigen (HBsAg) positive (+), 4.3% were anti-hepatitis C virus (HCV) (+) and 1.7% were both HBsAg (+) and anti-HCV (+). A total of 399 fatalities, including 139 because of HCC (34.8%), 37 because of liver diseases (9.3%), 88 because of other cancers (22.1%) and 135 because of other diseases (33.8%), were found. Relatives who were HBsAg (+) or anti-HCV (+)showed a lower cumulative survival than did relatives who were negative for both HBsAg and anti-HCV. Relatives with dual infection of hepatitis B and C virus showed the highest mortality due to HCC or terminal liver diseases.
Conclusions:Chronic viral infection rather than a hereditary factor is the main cause of a familial tendency for HCC. Dual infection of hepatitis B and C virus increases the risk of HCC or decompensated liver diseases.

Replication of hepatitis B in HBsAg-positive siblings

Persistent hepatitis B virus (HBV) replication is important for progression of chronic liver diseases. To understand whether there is a trend of HBV replication in siblings or not, 1850 relatives of patients with hepatocellular carcinoma (HCC) were examined prospectively for liver function test, viral markers and HBV DNA. The prevalence of HBsAg in the parents', siblings', children's and grandchildren's generations were 43.4%, 57.2%, 35.5% and 32.1%, respectively. The prevalence of hepatitis B e antigen (HBeAg) in sibling's generation (mean age 44.4 years) was 19%, which is higher than that of asymptomatic HBsAg carriers. For siblings in the children's generation, the prevalence of HBeAg in hepatitis B surface antigen (HBsAg) carriers declined from 40% in the eldest siblings to 19% in the youngest siblings. In 75 families clustered with three or more HBsAg carrier siblings, the mean age for seven families of which all siblings remained HBeAg + was younger, whereas the mean age for 35 families of which all siblings had cleared HBeAg was older. For the remaining 33 families, in only 10 families had the older siblings cleared the HBeAg earlier than the younger siblings. Twenty families showed that younger siblings cleared the HBeAg earlier than the older or middle siblings. We concluded that HBV replication in HCC relatives cannot be explained by familial tendency alone. A significant number of younger siblings appeared to have a shorter HBV replication phase than their older siblings. The possible role of this in maternal–fetal transmission is discussed.

Lean meat and heart health

The general health message to the public about meat consumption is both confusing and misleading. It is stated that meat is not good for health because meat is rich in fat and cholesterol and high intakes are associated with increased blood cholesterol levels and coronary heart disease (CHD). This paper reviewed 54 studies from the literature in relation to red meat consumption and CHD risk factors. Substantial evidence from recent studies shows that lean red meat trimmed of visible fat does not raise total blood cholesterol and LDL-cholesterol levels. Dietary intake of total and saturated fat mainly comes from fast foods, snack foods, oils, spreads, other processed foods and the visible fat of meat, rather than lean meat. In fact, lean red meat is low in saturated fat, and if consumed in a diet low in SFA is associated with reductions in LDL-cholesterol in both healthy and hypercholesterolemia subjects. Lean red meat consumption has no effect on in vivo and ex vivo production of thromboxane and prostacyclin or the activity of haemostatic factors. Lean red meat is also a good source of protein, omega-3 fatty acids, vitamin B12, niacin, zinc and iron. In conclusion, lean red meat, trimmed of visible fat, which is consumed in a diet low in saturated fat does not increase cardiovascular risk factors (plasma cholesterol levels or thrombotic risk factors).

Social, cultural and environmental influences on child activity and eating in Australian migrant communities

Aim: This study set out to examine the socio-cultural, familial and environmental factors influencing health, eating habits and patterns of physical activity contributing to child and adolescent overweight and obesity. Methods: Semi-structured, community-based interviews were conducted with contrasting key informant three-generation families; and generation by generation focus groups of grandparents, parents and children from four cultural communities in the state of Victoria, Australia. Purposive sampling occurred from Turkish, Greek, Indian and Chinese communities that have migrated to Australia within the last three generations (n = 160, eight families, 47 children aged 5–15 years, 29 parents, 42 grandparents). Results: Evidence of two-way influences on eating and physical activity across three generations was evident, with children reporting the greatest cross-cultural diversity. A range of dietary restrictions was reported across all cultural groups. Efforts to foster healthy eating and lifestyle patterns within communities were evident. Parents, as a generation in particular, felt the need for more access to education and support regarding healthy limits for pre-puberty and puberty stages. Conclusion: There is a dynamic influence of culture on many aspects of family lifestyle across three generations. To achieve successful intervention design, childhood obesity researchers need to collaborate with diverse groups and communities. Considering the role and influence of extended family, a multigenerational, whole-of-community approach beyond that of parent and child populations ought to be considered.

Resilience: a protector from depression

Personality type and resilient behaviors provide protection from the experience of depression, and resilience can increase the risk of not being depressed. Psychiatric–mental health nurses are well positioned to facilitate the development of resilience qualities in people who are depressed. Clinical strategies, which could be undertaken by the psychiatric–mental health nurse, include early intervention, promoting a positive social and familial climate, promoting self-esteem and support building, social and life skills/vocational education, and linking and brokering clients into extracurricular activities.

Profile of dyslipodemia in psammomys obesus, an animal model of the metabolic syndrome

Objective. To investigate lipid profiles in Psammomys obesus and relationships between lipid profile and other components of the Metabolic Syndrome.

Methods. A total number of 49 adults with a wide range of body weight and glucose tolerance were studied in a cross-sectional analysis. Plasma cholesterol distribution profiles were measured by size exclusion lipid chromatography. Blood glucose was measured using an enzymatic glucose analyser, and plasma insulin was determined by radioimmunossay.

Results. Obese diabetic Psammomys obesus had elevated plasma cholesterol (P=0.003) and triglyceride levels (p>0.001) compared to their lean littermates. The hypercholesterolemia was mainly due to increased circulating levels of VLDL-cholesterol (P=0.003) and LDL-cholesterol (P=0.003) in these animals. Multiple linear regression analyses revealed that body weight was independently associated with plasma cholesterol (P=0.011) and LDL concentration (P=0.009), while plasma insulin was associated with VLDL-cholesterol concentration (P=0.005). All of the variables measured exhibited continuous distributions across a wide range of phenotypes, from a normal rodent lipid profile to profound dyslipidemia.

Conclusions. These data suggest that the dyslipidemia in obese, diabetic Psammomys obesus is closely associated with other components of the Metabolic Syndrome, including obesity and insulin resistance.

The role of sisters in body image dissatisfaction and disordered eating

The Tripartite Influence Model (TIM) argues sociocultural agents affect body image dissatisfaction (BID) via the mediators of social comparison and internalization. BID subsequently influences disordered eating. Forty-seven Australian sister pairs (18–25 years) provided self-reports of perceived familial modeling and pressure by the sociocultural agents of mother, father and sister, social comparison, internalization, BID, bulimic behaviors, and dietary restriction. Sisters were correlated on internalization, BID, disordered eating, and parental modeling and pressure. Mothers and sisters were equally important modeling agents. Sisters were an equivalent social comparison target to peers. Consistent with the TIM, internalization and social comparison mediated familial pressure on BID. Contrary to the model, sister modeling directly affected bulimic behaviors and dietary restriction.

Rethinking the significance of attitudes in preventing men's violence3 against women

The concept of attitudes has been an important component of campaigns to address men’s violence against women. Attitudes have been examined in relation to men’s perpetration of violence, women’s experience of violence and community and institutional responses. In this article we argue that there has not been sufficient interrogation of the limitations of attitudes in understanding and addressing men’s violence. We propose a social constructionist approach to attitudes and emphasise the need to locate attitudes within the context of familial, organisational, community and social norms which support violence against women. Furthermore, we argue that to prevent violence against women, we must develop interventions beyond cultural and attitudinal change to encompass changes in structural relations and social practices.

Educational organizations and gender in times of uncertainty

In this chapter I identify and elaborate, from a feminist perspective, upon the theoretical shifts and key concepts that inform sociological analyses of gender and educational organizations. Gender inequalities are embedded in the multi-dimensional structure of relationships between women and men, which, as the modern sociology of gender shows, operates at every level of experience, from economic arrangements, culture and the state to interpersonal relationships and individual emotions. (Connell, 2005: 1801) Even naming this a sociology of gender and organizations is problematic. Many sociologists consider gender as a key sociological concept, but not necessarily from a feminist perspective. Feminism is a multidisciplinary, transnational movement that 'focuses on the relationship between social movements, political action and social inequalities' (Arnot, 2002: 3) and on the everyday experiences of women and girls and how they translate into social and structural 'ruling relations' (Smith, 1988). Feminism takes on multiple trajectories and imperatives in different cultural contexts, although with familial resemblances, most particularly the shared objective of equality for women and girls. Education as a primary institution of individual and collective mobility and social change, but also social and economic reproduction, has long been a focus of feminist theory and activism. So a feminist sociology needs to address this complexity of feminist sociological 'encounters' with gender and organizations.

Specific risk assessment based on victim type in children sexual offenders

Actuarial instruments for assessing sex offender recidivism have limited utility for specific risk assessment questions, such as the risk posed to particular types of victim. In order to obtain variables that discriminate between offenders with different classes of victim, data were coded from 324 files of child sexual offenders from a community-based sexual offender treatment program. Offenders with single or multiple victims were compared, as were offenders who did or did not offend against victims of both genders, and offenders with only intra-familial or extra-familial victims versus offenders with victims in both relationship categories. Variables that discriminated single-victim and multiple-victim offenders were similar to those identified in actuarial risk assessment scales, with the exception of history of childhood sexual abuse. With the exception of physical abuse history, the same variables discriminated specific offender groups according to victim gender and victim relationship, although in different combinations. There was limited support for the notion of specific risk variables.

Positive pathways for couples and families : meeting existing and emerging challenges of relationships

There is a growing need to develop an understanding of the positive pathways that strengthen the relationships of Australian couples and families. The couples and families in contemporary society are faced with many challenges and pressures that can mitigate against maintaining satisfying and enduring couple and family relationships. For example, increasing need for dual income families, longer working hours and demographic shifts that see older people living longer and children staying at home longer mean that couples are often required to provide familial care across two generations – frail ageing parents and children. These highlight just some of the pressures faced which can lead to couples not taking the time to cultivate their relationships. The aim of the workshop was to deal with many of these issues by linking research, policy and practice in ways that would help families meet such challenges. The two-day workshop, held 1-2 November 2008 in Melbourne, brought together leading and emerging Australian and international relationship researchers with practitioners, educators, policy makers and service-delivery organisations. Alongside the Academy, the event was sponsored by Deakin University, the University of Queensland, the Department of Families, Housing and Community Services and Indigenous Affairs (FaCHSIA), the Attorney General's Department (AG Department), the Australian Institute of Family Studies (AIFS) and Lifeworks. The workshop comprised seven sessions and two break-out discussions. A total of 28 participants attended the workshop. Of these participants, there were 19 speakers and 7 delegates from the various sponsor organisations that took part in group discussions.

Migrant youth, cultural identity and media representation

The current social climate of heightened intercultural tensions in culturally pluralist societies such as Australia highlights the need to develop a more nuanced understanding of the complex cultural adjustment processes  encountered by migrant youth in developing and articulating a sense of  national belonging, To this end, this chapter examines migrant settlement experiences as a 'process by which individuals and groups ... maintain their cultural identity while actively participating in the larger societal framework' (Karac 2001). Research into these critical aspects of integration and  acculturation examines identity formation as a cultural process of  renegotiating individual and group identity, and focuses on concepts of belonging, recognition and self-respect (Berry '997). While cultural factors are considered critical indicators of successful integration into the host community, insufficient research has been conducted into the particular processes of group and individual identity formation that take place amongst migrant youth. In the case of Australia, this process has been made  particularly difficult for some cultural groups due to the contemporary resurgence of populist and exclusionary discourses of national identity. In such a context, the construction of identity amongst migrant youth is all the more challenging, especially when this process exhibits notions of dual attachment, hybridity and difference. For migrant youth, the engagement with different social institutions such as family, school and wider societal networks often affects the processes of identity 'formation that are inherently  dynamic and 'necessarily multiple and fluid' (Noble & Tabar 2002, pp.I28). Negotiating life in-between cultures, youths from migrant backgrounds experience identity construction as a highly contested territory.

Cultural identity is a central issue for immigrants, regardless of how much time has elapsed since leaving their country of origin. This issue is particularly salient for first- and second-generation1 migrant youth, who negotiate identity space comfortably alongside, in opposition to, or more commonly, somewhere in between, their immigrant parents' conceptions of culture and the receiving culture in which they live. Unlike their native peers,  the children of immigrants arc exposed to intra-ethnic and inter- ethnic   dynamics and experiences in their journey towards cultural identity formation. These experiences are complex and diverse, and are navigated within multi- layered ethnic, racial, familial, gendered, socioeconomic and educational  contexts.

The chapter begins by providing theoretical frameworks for conceptualising  cultural diversity and cultural identity. It then examines how migrant youth  negotiate cultural identity in the public realms of family networks and school  environments and how these translate into key educational and behavioural  outcomes. It will draw on some qualitative snapshots as a way of illustrating  shifting migrant youth attitudes towards society, school and culture.

Social control, self-control and psychosocial problems in adolescent males

‘Psychosocial problems’ are psychological problems that are regarded as resulting from the interaction between the adaptive capacities of individuals and the demands of their physical and social environments. Many different factors have been theoretically proposed, and empirically established, as predictors of a range of psychosocial problems in adolescents. However, a problem exists in that this literature appears to lack an integrative framework that has validity across the range of problems that are observed. The purpose of the current research is to propose and test a model that draws together three clusters of factors that are useful in predicting the incidence of adolescent psychosocial problems. These are family structural background factors, family functioning variables and control beliefs. Data were collected from 155 adolescent males aged between 12 and 19 by a single concurrent and retrospective self-report questionnaire. This included data about the respondent (age, involvements with mental health or juvenile justice agencies) and family structural background factors (days per week worked by mother/father, occupational status for mother/father, residential mobility, number of persons in the family home). The questionnaire also incorporated the Parental Bonding Instrument (Parker, Tupling & Brown, 1979) to quantify the levels of perceived parental care and overprotection, and an adaptation of the Parental Discipline Style Scale (Shaw & Scott, 1991), to assess punitive, love withdrawing and inductive discipline practices. In addition, the (Low) Self-control Scale (Grasmick, Tittle, Bursick & Arneklev, 1993) and the Locus of Control of Behaviour Scale (Craig, Franklin, & Andrews, 1984) were used to collect data concerning adolescents’ perceived behavioural self-control and locus of control. Finally, selected sub-scales of the Child Behavior Checklist Youth Self-Report (Achenbach, 1991b) were used to collect data on the incidence of social withdrawal, somatisation, anxiety and depression, aggression and delinquency among the respondents, and in aggregated form, the incidence of ‘total problems’ and internalising and externalising behaviours. Results indicated family structural background factors, family functioning variables and control beliefs possess limited predicted validity and that the usefulness of the proposed model varies between specific psychosocial problems. Family functioning variables were generally stronger predictors than family structural background factors, particularly for internalising behaviours. Of these, levels of parental care and overprotection were generally the strongest predictors. Perceived self-control and locus of control were also generally strong predictors, but were particularly powerful with respect to externalising behaviours. The strength of predictive relationships was observed to vary between specific internalising and externalising behaviours, suggesting that individual difference variables not assessed in the current research were differentially influential. Finally, the parental and individual characteristics that predicted maximal levels of adjustment (defined in terms of minimal levels of internalising and externalising behaviours) were explored and the correlates of various parenting style typologies (Parker et al., 1979) were investigated. These results strongly confirmed the importance of family functioning and control beliefs with respect to the prediction of internalising, externalising and well-adjusted behaviours. In all analyses, substantial proportions of the variance in the incidence of problem behaviours remain unexplained. The findings are examined in relation to previous research focused on (familial) social control and (individual) self-control with respect to psychosocial problems in adolescents. In addition, methodological considerations are discussed and the implications of the findings for clinical and community interventions to address problem behaviours, and for further study, are explored.

Playing the Agnes : Hester Thrale-Piozzi and Frances Burney

Guided by the feminist intention of reasserting the importance of neglected female writers, I have used this work to re-examine the lives and texts of eighteenth-century diarists Hester Thrale-Piozzi and Frances Burney. Adopting an interdisciplinary methodology, I draw on both literary and non-literary material to examine the effect of familial and social patriarchy in eighteenth-century England. Using the diaries, journals and letters of Hester and Frances, I ask why female conformity to masculine domination was expected, and how violence was used to extract subserviant behaviour from women. Beginning with gossip, and encompassing social, editorial and physical abuse, I use the medical profession's manipulation of female vulnerability to exemplify the way society legitimates violence to ensure female ductility. Moving beyond this physical aspect, I then examine the psychical, and question the existence of a ‘self’ which is vulnerable to external manipulation. By diverging from the influence of Freudian psychology, and developing a form of Jungian feminism, I propose the existence of an essential female Self which transcends the constraints of societal expectations and physical violence. In this work, both Hester and Frances emerge as physically and psychically strong entities who were forced to adopt socially conformist personae to survive.

"Our fingers were never idle" : women and domestic craft in the Geelong region, 1900-1960

This thesis is an exploration of women's domestic crafts in the Geelong region, between 1900 and I960, Through analysing oral testimony and the women's handicraft artefacts, the nature of the domestic production of handicrafts and the meanings the makers have constructed around their creations and their lives is illuminated. The thesis is organised around the themes of work, space, the construction of femininity, memory, time and meaning. The thesis argues that until recently, the discipline of history has privileged the experiences of men over those of women. It challenges the trivialising of women’s handicrafts. It also argues that within the restrictive social structures around them and within the confined nature of their situations, the women of my study asserted themselves to transform their environments and to improve their situations through labour in the home. In ‘making do’, recycling materials and creating functional and decorative needlework items for their homes and families, the women were often finding solutions to pressing practical and economic problems. Doing handicrafts was rarely just a passive way of filling in time. Rather, making and creating was for these women a multi-layered activity that similtaneously fulfilled a complex range of needs for themselves and their families. A multiplicity of deeply personal, aesthetic, familial, social, practical and economic needs were met in the making of domestic craft artefacts, whose symbolism reflected the values and meanings of the women's cultures, homes and families.