Living with osteoarthritis: Patient expenditures, health status, and social impact

Objective. To determine out-of-pocket expenditures related to osteoarthritis (OA) and to explore whether demographic details, health status scores (Medical Outcomes Study 36-item Short Form [SF-36] and Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), or perception of social effect were expenditure determinants. Methods. A prospective cohort study of community-dwelling subjects with OA completed 4 consecutive 3-month cost diaries. In addition, subjects completed the SF-36 and WOMAC at baseline and at 12 months. Social impact at baseline was collected. Four groups categorized by age and sex were compared. Patients undergoing joint replacement were excluded. Results. Differences in health status were defined more by age than by sex, especially for physical function. The costs to the patients were high, particularly for women, who spent more on medications and special equipment. Women also reported receiving more assistance from family and friends. Higher disease-related expenditures were associated with greater pain levels, poorer social function and mental health, and longer duration of disease. Significant independent predictors of total patient expenditures related to OA were being female and having joint stiffness. Conclusion. Despite having heavily subsidized health care and access to the Pharmaceutical Benefits Scheme, out-of-pocket costs for patients with OA in Australia are considerable. Higher expenditures for patients with OA are related to more advanced disease, especially for women.

Social structure in migrating humpback whales (Megaptera novaeangliae)

Although largely solitary, humpback whales exhibit a number of behaviours where individuals co-operate with one another, for example during bubble net feeding. Such cases could be due to reciprocal altruism brought on by exceptional circumstances, for example the presence of abundant shoaling fish. An alternative explanation is that these behaviours have evolved through kin selection. With little restriction to either communication or movement, diffuse groups of relatives could maintain some form of social organization without the need to travel in tight-nit units. To try to distinguish between these hypotheses, we took advantage of the fact that migrating humpback whales often swim together in small groups. If kin selection is important in humpback whale biology, these groups should be enriched for relatives. Consequently, we analysed biopsy samples from 57 groups of humpback whales migrating off Eastern Australia in 1992. A total of 142 whales were screened for eight microsatellite markers. Mitochondrial DNA sequences (371 bp) were also used to verify and assist kinship identification. Our data add support to the notion that mothers travel with their offspring for the first year of the calf's life. However, beyond the presence of mother-calf/yearling pairs, no obvious relatedness pattern was found among whales sampled either in the same pod or on the same day. Levels of relatedness did not vary between migratory phases (towards or away from the breeding ground), nor between the two sexes considered either overall or in the north or south migrations separately. These findings suggest that, if any social organization does exist, it is formed transiently when needed rather than being a constant feature of the population, and hence is more likely based on reciprocal altruism than kin selection.

Perceived social support in a large community sample - Age and sex differences

Background. The positive health and wellbeing effects of social support have been consistently demonstrated in the literature since the late 1970s. However, a better understanding of the effects of age and sex is required. Method. We examined the factor structure and reliability of Kessler's Perceived Social Support (KPSS) measure in a community-based sample that comprised younger and older adult cohorts from the Australian Twin Registry (ATR), totalling 11,389 males and females aged 18-95, of whom 887 were retested 25 months later. Results. Factor analysis consistently identified seven factors: support from spouse, twin, children, parents, relatives, friends and helping support. Internal reliability for the seven dimensions ranged from 0.87 to 0.71 and test-retest reliability ranged from 0.75 to 0.48. Perceived support was only marginally higher in females. Age dependencies were explored. Across the age range, there was a slight decline (more marked in females) in the perceived support from spouse, parent and friend, a slight increase in perceived relative and helping support for males but none for females, a substantial increase in the perceived support from children for males and females and a negligible decline in total KPSS for females against a negligible increase for males. The perceived support from twin remained constant. Females were more likely to have a confidant, although this declined with age whilst increasing with age for males. Conclusions. Total scores for perceived social support conflate heterogeneous patterns on sub-scales that differ markedly by age and sex. Our paper describes these relationships in detail in a very large Australian sample.

Perceptions of the intergroup structure and anti-Asian prejudice among white Australians

Subjective intergroup beliefs and authoritarianism were assessed in a field study (N=255) of White Australians' anti-Asian stereotyping and prejudice. A social identity analysis of intergroup prejudice was adopted, such that perceptions of the intergroup structure (instability, permeability, legitimacy and higher ingroup status) were proposed as predictors of higher prejudice (blatant and covert) and less favorable stereotyping. Consistent with the social identity approach, both independent and interacting roles for sociostructural predictors of Anti-Asian bias were observed, even after demographic and personality variables were controlled. For example, perceived legitimacy was associated with higher prejudice when White Australians' status position relative to Asian Australians was valued. Moreover, when participants evaluated Whites' position as unstable and high status or legitimate, perceptions of permeable intergroup boundaries were associated with anti-Asian bias. The present findings demonstrate status protection responses in advantaged group members in a field setting, lending weight to the contention that perceptions of sociostructural threat interact to predict outgroup derogation. Implications for theories of intergroup relations are discussed.

Phase separation, porous structure, and cure kinetics in aliphatic epoxy resin containing hyperbranched polyester

Thermosetting blends of an aliphatic epoxy resin and a hydroxyl-functionalized hyperbranched polymer (HBP), aliphatic hyperbranched polyester Boltorn H40, were prepared using 4,4'-diaminodiphenylmethane (DDM) as the curing agent. The phase behavior and morphology of the DDM-cured epoxy/HBP blends with HBP content up to 40 wt% were investigated by differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA), and scanning electron microscopy (SEM). The cured epoxy/HBP blends are immiscible and exhibit two separate glass transitions, as revealed by DMA. The SEM observation showed that there exist two phases in the cured blends, which is an epoxy-rich phase and an HBP-rich phase, which is responsible for the two separate glass transitions. The phase morphology was observed to be dependent on the blend composition. For the blends with HBP content up to 10 wt%, discrete HBP domains are dispersed in the continuous cured epoxy matrix, whereas the cured blend with 40 wt% HBP exhibits a combined morphology of connected globules and bicominuous phase structure. Porous epoxy thermosets with continuous open structures on the order of 100-300 nm were formed after the HBP-rich phase was extracted with solvent from the cured blend with 40 wt% HBP. The DSC study showed that the curing rate is not obviously affected in the epoxy/HBP blends with HBP content up to 40 wt %. The activation energy values obtained are not remarkably changed in the blends; the addition of HBP to epoxy resin thus does not change the mechanism of cure reaction of epoxy resin with DDM. (c) 2006 Wiley Periodicals, Inc.

Social inequalities in male mortality, and in male mortality from smoking: indirect estimation from national death rates in England and Wales, Poland, and North America

Background There are substantial social inequalities in adult male mortality in many countries. Smoking is often more prevalent among men of lower social class, education, or income. The contribution of smoking to these social inequalities in mortality remains uncertain. Methods The contribution of smoking to adult mortality in a population can be estimated indirectly from disease-specific death rates in that population (using absolute lung cancer rates to indicate proportions due to smoking of mortality from certain other diseases). We applied these methods to 1996 death rates at ages 35-69 years in men in three different social strata in four countries, based on a total of 0.6 million deaths. The highest and lowest social strata were based on social class (professional vs unskilled manual) in England and Wales, neighbourhood income (top vs bottom quintile) in urban Canada, and completed years of education (more than vs less than 12 years) in the USA and Poland. Results In each country, there was about a two-fold difference between the highest and the lowest social strata in overall risks of dying among men aged 35-69 years (England and Wales 21% vs 43%, USA 20% vs 37%, Canada 21% vs 34%, Poland 26% vs 50%: four-country mean 22% vs 41%, four-country mean absolute difference 19%). More than half of this difference in mortality between the top and bottom social strata involved differences in risks of being killed at age 35-69 years by smoking (England and Wales 4% vs 19%, USA 4% vs 15%, Canada 6% vs 13%, Poland 5% vs 22%: four-country mean 5% vs 17%, four-country mean absolute difference 12%). Smoking-attributed mortality accounted for nearly half of total male mortality in the lowest social stratum of each country. Conclusion In these populations, most, but not all, of the substantial social inequalities in adult male mortality during the 1990s were due to the effects of smoking. Widespread cessation of smoking could eventually halve the absolute differences between these social strata in the risk of premature death.

Understanding Isolation and Change in Island Human Populations through a study of Indigenous Cultural Patterns in the Gulf of Carpentaria

This paper presents a set of hypotheses to explain the cultural differences between Aboriginal people of the North and South Wellesley Islands, Gulf of Carpentaria and to characterise the relative degree and nature of their isolation and cultural change over a 10,000-year time-scale. This opportunity to study parallelisms and divergences in the cultural and demographic histories of fisher-hunter-gatherers arises from the comparison of three distinct cultural groupings: (a) the Ganggalida of the mainland, (b) the Lardil and Yangkaal of the North Wellesley Islands, and (c) the Kaiadilt of the South Wellesley Islands. Despite occupying similar island environments and despite their languages being as closely related as for example, the West Germanic languages, there are some major differences in cultural, economic and social organization as well as striking genetic differences between the North and South Wellesley populations. This paper synthesizes data from linguistics, anthropology, archaeology, genetics and environmental science to present hypotheses of how these intriguing differences were generated, and what we might learn about early processes of marine colonization and cultural change from the Wellesley situation.

Genetic structure and male-mediated gene flow in the ghost bat (Macroderma gigas)

The Australian ghost bat is a large, opportunistic carnivorous species that has undergone a marked range contraction toward more mesic, tropical sites over the past century. Comparison of mitochondrial DNA (mtDNA) control region sequences and six nuclear microsatellite loci in 217 ghost bats from nine populations across subtropical and tropical Australia revealed strong population subdivision (mtDNA phi(ST) = 0.80; microsatellites URST = 0.337). Low-latitude (tropical) populations had higher heterozygosity and less marked phylogeographic structure and lower subdivision among sites within regions (within Northern Territory [NT] and within North Queensland [NQ]) than did populations at higher latitudes (subtropical sites; central Queensland [CQ]), although sampling of geographically proximal breeding sites is unavoidably restricted for the latter. Gene flow among populations within each of the northern regions appears to be male biased in that the difference in population subdivision for mtDNA and microsatellites (NT phi(ST) = 0.39, URST = 0.02; NQ phi(ST) = 0.60, URST = -0.03) is greater than expected from differences in the effective population size of haploid versus diploid loci. The high level of population subdivision across the range of the ghost bat contrasts with evidence for high gene flow in other chiropteran species and may be due to narrow physiological tolerances and consequent limited availability of roosts for ghost bats, particularly across the subtropical and relatively arid regions. This observation is consistent with the hypothesis that the contraction of the species' range is associated with late Holocene climate change. The extreme isolation among higher-latitude populations may predispose them to additional local extinctions if the processes responsible for the range contraction continue to operate.