Drug education with special needs populations : identifying and understanding the challenges

Students with special developmental needs (e.g. learning disabilities, attentional disorders, intellectual disability, conduct disorders, sensory deficits, acquired brain injury) face particular challenges with respect to academic achievement and psychosocial development, whether they are educated in mainstream settings, special settings, or a combination of these. These groups are typically poorly researched with respect to drug and alcohol use and education, however there is some evidence to indicate that they face an elevated risk of experiencing drug-related harms. The aim of the present paper is to highlight the particular challenges facing this heterogeneous population with respect to access to school-based drug education. Special learning challenges facing such students are described, and some suggestions are provided for researchers and practitioners in the drug education field.

Effect of flooding on estuarine bivalve populations near the mouth of the Hopkins River, Victoria, Australia

The densities of two common intertidal/shallow subtidal bivalves, Soletellina alba and Arthritica helmsi, were sampled in vegetated and unvegetated habitats of the Hopkins River estuary on three occasions during the  autumn/winter 1995.Winter flooding coincided with mass mortalities of the infaunal bivalve S. alba, but not A. helmsi. Mortalities were apparent for individuals living deeper in the sediment (≈35 cm) in vegetated and unvegetated habitats, but small S. alba (<1mm) were less susceptible to mortality than larger individuals (>1mm). Mortalities were similar across different habitat types and sediment depths, and at multiple sites within close proximity to the estuary mouth.

Microsatellite DNA analysis of southeast Australian Haliotis laevigata (Donovan) populations - implications for ranching in Port Phillip Bay

The genetic composition of greenlip abalone (Haliotis laevigata) from Point Cook in Port Phillip Bay was examined prior to the aggregation of individuals from this site for ranching. The very thinly distributed natural population at Point Cook was believed to be of low genetic diversity, because the animals all originated from a single spawning event 5 y previously. Animals from Point Cook were compared with other H. laevigata from two sampling sites within Port Phillip Bay, and two sites outside the Bay in Bass Strait, to examine their genetic diversity and origin. Variation was assessed at five microsatellite loci. Deviations from Hardy-Weinberg equilibrium (HWE) were observed at some loci in various populations, but the Point Cook population was in HWE at all five loci. Mean heterozygosity and number of alleles was similar in all populations. Hierarchical analysis of molecular variance indicated significant genetic variation among populations, but did not differentiate Port Phillip Bay from Bass Strait populations. Pairwise comparisons of multilocus F_STand R_ST indicated significant genetic differences between Point Cook and some populations, as well as between other populations, but no consistent spatial pattern of differentiation was observed. There was no significant correlation between genetic and geographic distance. The level of genetic variation observed in the Point Cook individuals was similar to that in individuals from the other four sites, and sufficient to support a ranching program. However, this variation should be monitored to maximize genetic potential, and avoid commercially undesirable effects of inbreeding. Implications of this study in relation to the management of a ranching population in Port Phillip Bay are discussed.

Healthy nature healthy people: 'contact with nature' as an upstream health promotion intervention for populations

Whilst urban-dwelling individuals who seek out parks and gardens appear to intuitively understand the personal health and well-being benefits arising from `contact with nature', public health strategies are yet to maximize the untapped resource nature provides, including the benefits of nature contact as an upstream health promotion intervention for populations. This paper presents a summary of empirical, theoretical and anecdotal evidence drawn from a literature review of the human health benefits of contact with nature. Initial findings indicate that nature plays a vital role in human health and well-being, and that parks and nature reserves play a significant role by providing access to nature for individuals. Implications suggest contact with nature may provide an effective population-wide strategy in prevention of mental ill health, with potential application for sub-populations, communities and individuals at higher risk of ill health. Recommendations include further investigation of `contact with nature' in population health, and examination of the benefits of nature-based interventions. To maximize use of `contact with nature' in the health promotion of populations, collaborative strategies between researchers and primary health, social services, urban planning and environmental management sectors are required. This approach offers not only an augmentation of existing health promotion and prevention activities, but provides the basis for a socio-ecological approach to public health that incorporates environmental sustainability.

Health and well-being naturally: 'contact with nature' in health promotion for targeted individuals, communities and populations

Issue addressed: The increase in mental health disorders worldwide makes it important to recognise health promotion interventions that are effective, accessible and affordable. Although natural spaces are coming to be recognised as health-promoting settings for general populations, little is understood about the use of nature contact in treatment and care for individuals experiencing ill-health.

Methods: This paper provides a summary of key research findings and presents a case study examining the self reported health and well-being benefits of nature contact for a small clinical sample. The 'Spectrum of Interventions for Mental Health Problems and Mental Disorders' provides a conceptual framework for ordering current and future information relating to nature-based interventions.

Results: Evidence demonstrates that separately, physical activity, social connection, and contact with nature enhance human health and well-being. The case example illustrates how 'active', 'social' and 'adventurous' contact with nature may be combined within a treatment intervention to protect and enhance the health of individuals experiencing chronic mental, emotional and physical health difficulties.

Conclusions: 'Contact with nature' constitutes a health promotion strategy with potential application in prevention, early intervention, treatment and care. Recommendations include further research to investigate the benefits of nature contact within existing interventions, and the impacts of 'active' and 'social' nature contact within tailored interventions for targeted individuals and communities.

Unrealistic optimism about becoming infected with HIV: different causes in different populations

People tend to believe that their chance of experiencing undesirable events is lower and their chance of experiencing desirable events is higher than that of the average person like them. Two explanatory models of such 'unrealistic optimism' (UO) have been proposed: While the motivational account holds that UO serves the function of bringing comfort, the cognitive account holds that UO serves no particular function, being simply a by-product of normal cognitive strategies. UO for HIV infection was studied in samples of uninfected students (Study 1, n = 68) and gay men (Study 2, n = 63). In each case, participants rated either their relative likelihood of becoming infected (negative valence condition) or their relative likelihood of remaining uninfected (positive valence condition). As predicted, in Study 1 UO was greater where valence was negative and in Study 2 valence had no effect. The findings suggest that the students' UO is better explained by the motivational account, while the gay men's UO is better explained by the cognitive account. Implications for AIDS education are discussed.

Constitutive activation of zebrafish Stat5 expands hematopoietic cell populations in vivo

Objective
Constitutive activation of Stat5 has been observed in a variety of malignancies, particularly myeloid leukemias. To directly investigate the in vivo consequences of Stat5 perturbation, we expressed constitutively active forms in zebrafish.
Methods
We generated mutants of the zebrafish stat5.1 protein (N646H, H298R/N714F, and N714F) based on previously identified constitutively active mutants of murine Stat5a. The in vitro properties of these mutants were determined using phosphorylation-specific antibodies and luciferase reporter assays, and their in vivo effects were analyzed through microinjection of zebrafish embryos.
Results
Two of these stat5.1 mutants (N646H and H298R/N714F) showed increased tyrosine phosphorylation and transactivation activity compared to the wild-type protein. Expression of either mutant led to a range of hematological perturbations, which were more pronounced for the H298R/N714F mutant. Interestingly, expression of wild-type also produced generally similar phenotypes. Further analysis showed that expression of the H298R/N714F mutant led to increased numbers of early and late myeloid cells, erythrocytes, and B cells. Some nonhematopoietic developmental perturbations were also observed, but these were equally prominent with wild-type or mutant forms.
Conclusion
These data implicate Stat5 activity as a direct critical regulator of hematological cell proliferation, suggesting a causal role for constitutively-active Stat5 in the etiology of hematological malignancies.

Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies

A WHO expert consultation addressed the debate about interpretation of recommended body-mass index (BMI) cut-off points for determining overweight and obesity in Asian populations, and considered whether population-specific cut-off points for BMI are necessary. They reviewed scientific evidence that suggests that Asian populations have different associations between BMI, percentage of body fat, and health risks than do European populations. The consultation concluded that the proportion of Asian people with a high risk of type 2 diabetes and cardiovascular disease is substantial at BMIs lower than the existing WHO cut-off point for overweight (25 kg/m2). However, available data do not necessarily indicate a clear BMI cut-off point for all Asians for overweight or obesity. The cut-off point for observed risk varies from 22kg/m2 to 25kg/m2 in different Asian populations; for high risk it varies from 26kg/m2 to 31kg/m2. No attempt was made, therefore, to redefine cut-off points for each population separately. The consultation also agreed that the WHO BMI cut-off points should be retained as international classifications. The consultation identified further potential public health action points (23·0, 27·5, 32·5, and 37·5 kg/m2) along the continuum of BMI, and proposed methods by which countries could make decisions about the definitions of increased risk for their population.

Intervening early to reduce developmentally harmful substance use among youth populations

Early-onset or frequent substance use during adolescence increases the risk of developing mental health problems, as well as a range of other adverse outcomes (eg, alcohol or drug dependence, educational underachievement, health problems, social difficulties) during late adolescence and early adulthood.

Increases in rates of risky drinking among young people are particularly concerning, suggesting that an effective, evidence-based alcohol policy and preventive framework needs to be developed.

Restricting the supply of licit and illicit substances to adolescents, delaying the age that licit substances can be legally purchased, reducing positive media portrayals of substance use, and banning targeted promotions, should be universal, public prevention priorities.

Mass-media campaigns need to deliver coherent and credible evidence-based messages to young people, utilising a broad array of dissemination strategies.

Clear policy and guidelines for parents regarding appropriate alcohol use for adolescents also need to be developed.

Prevention programs should target children and adolescents in families with parents who use drugs, young people who have been suspended from school, or those with mental health problems.

Preventive screening and targeted brief interventions can be effectively delivered in a variety of settings by a range of health professionals.

Burden of disease and injury in Aboriginal and non-Aboriginal populations in the Northern Territory

Objective:
To quantify the burden of disease and injury for the Aboriginal and non-Aboriginal populations in the Northern Territory.

Design and setting:
Analysis of Northern Territory data for 1 January 1994 to 30 December 1998 from multiple sources.

Main outcome measures:
Disability-adjusted life-years (DALYs), by age, sex, cause and Aboriginality.

Results:
Cardiovascular disease was the leading contributor (14.9%) to the total burden of disease and injury in the NT, followed by mental disorders (14.5%) and malignant neoplasms (11.2%). There was also a substantial contribution from unintentional injury (10.4%) and intentional injury (4.9%). Overall, the NT Aboriginal population had a rate of burden of disease 2.5 times higher than the non-Aboriginal population; in the 35-54-year age group their DALY rate was 4.1 times higher. The leading causes of disease burden were cardiovascular disease for both Aboriginal men (19.1%) and women (15.7%) and mental disorders for both non-Aboriginal men (16.7%) and women (22.3%).

Conclusions:
A comprehensive assessment of fatal and non-fatal conditions is important in describing differentials in health status of the NT population. Our study provides comparative data to identify health priorities and facilitate a more equitable distribution of health funding.

Promotion of exercise prescriptions in general practice for older populations

Regular physical activity in older populations reduces the risks of cardiovascular diseases, diabetes, osteoporosis and falls and also improves mental health. Some programs of written exercise prescriptions by general practitioners have been shown to significantly increase physical activity levels over the medium-term (six to 12 months). Increasing the confidence and skills of general practitioners to prescribe and monitor exercise programs is important. However, the more challenging barriers to the widespread uptake of exercise prescription programs are the structural and economic constraints within general practice, as well as the competing promotion of prescribing pharmaceutical products. Implementation research on overcoming these barriers is urgently needed.