Chronic disease and impairment among Alaska native elders : the Alaska Education and Research Towards Health (EARTH) study

Background: Chronic diseases and impairments are prevalent among older Americans. However, prevalence data for Alaska Native (AN) elders are limited, with estimates usually extrapolated from national studies in which AN elders may not be well-represented. The aim of this study was to describe the prevalence of selected chronic diseases, impairments, and measured medical risk factors among a large community sample of AN elders.

Methods: Design, setting, and participants. A community-based cross-sectional study of baseline information from 656 AN elders aged 55 years or over who participated in the Alaska Education and Research Towards Health (EARTH) Study, March 2004 to August 2006. Measurements. Self-reported lifetime prevalence of 17 doctor-diagnosed chronic diseases, and point prevalence of vision, hearing, oral, and general health impairment were estimated from data collected using audio computer-assisted self-administered questionnaires. In addition, height, weight, blood pressure, fasting blood lipids, and fasting blood glucose levels were measured.

Results: The four most prevalent chronic diseases among AN elders were high blood pressure (55%), arthritis (49%), high cholesterol (42%), and adult bone fracture/break (35%). The median number of chronic diseases reported was three (inter-quartile range, 2 to 5). The prevalence of self-reported vision impairment was 15%, hearing impairment 18%, and having had all natural teeth removed 25%. Almost 50% were obese. High blood pressure (systolic ≥ 140 mm Hg and/or diastolic ≥ 90 mm Hg) was measured in 23%, high low density lipoprotein (LDL) cholesterol (≥ 130 mg/dL) in 39%, and high fasting plasma glucose (> 125 mg/dL) in 9%. Obesity was more prevalent among women than men. There were also significant regional differences in rates of obesity and high LDL cholesterol.

Conclusion: These data may be useful in public health programs and health services planning.

Animals as disregarded pawns in family violence : exclusionary practices of feminist based refuge policies

Commonly agreed upon is the relationship between family violenceand violence toward nonhuman animals. Workers in the field of family violence also acknowledge that women may delay leaving a violent home due to loyalty to their nonhuman counterparts, and because refuge policies often do not allow them to accompany humans into safe shelter. The recent work of Clifton Flynn has indicated the relationship between nonhuman animals and human animals to be one of responsive interaction, with theoretical analyses most often based upon Goffman’s theory of symbolic interaction. Despite literature indicating the level of harm inflicted upon nonhuman family members in violent homes, and requests from women and children that they accompany them to safe shelter, refuge policies often negate the possibility of this occurring. This article critiques the feminist ideals on which refuge policies are based, and in doing so, argues that justice is denied to nonhuman animals. Their existence in the violent home is maintained by lack of choices available to their human counterpart, and is enforced by feminist ideals, which are ironically based upon equity. Unless feminist principles are challenged, nonhuman family members will continue to be denied justice in violent families where escape is the only option to ensure safety.

Psychological maturity of at-risk juveniles, young adults and adults : implications for the justice system

While the justice system assumes adulthood is reached by the age of 18 and given the increase in the number of juveniles being tried within adult court, it is imperative to understand whether young people are as criminally culpable for their actions as adults and where differences may lie in the maturity of young people and their adult counterparts. Psychological maturity was assessed in order to gain a better understanding of culpability and responsibility in at-risk young people, 18-year-olds and 25-year-olds to determine where psychosocial maturity levels and the propensity to make antisocial decisions differ and, if so, how. At-risk young people and 18-year-olds differed from 25-year-olds in psychological maturity levels, instigating implications for future research and the trial of young people as adults.

Young people and the justice system : consideration of maturity in criminal responsibility

The age of majority determines when a young person is considered adult in the eyes of the law, and in many countries this is set at 18 years. This does not take into account the differing ways and time-frames in which young people mature and develop. In justice systems in which individuals can be awarded leniency due to mental impairment, it becomes apparent that a similar justification can be made for issues surrounding maturity. This is of particular importance due to a growing trend in the Western world for young people to be tried as adults based on their crime, rather than their individual culpability. The aim of this review was to consider the interaction between maturity and criminal culpability.

The epidemiology of the first wave of H1N1 influenza pandemic in Australia : a population-based study

Objectives: Following the recent H1N1 influenza pandemic we were able to describe seropositivity in a repre-sentative sample of adults prior to the availability of a specific vaccine.

Methods: This cross-sectional serological study is set in the Barwon Statistical Division, Australia. Blood samples were collected from September 2009 through to May 2010, from 1184 individuals (569 men, 615 women; median age 61.7 years), randomly selected from electoral rolls. Serum was analysed for specific H1N1 immunity using a haemagglutina-tion inhibition test. A self-report provided information about symptoms, demographics and healthcare. Associations be-tween H1N1 infection, gender, households and occupation were determined using logistic regression, adjusting for age.

Results: Of 1184 individuals, 129 (58 men, 71 women) were seropositive. Gender-adjusted age-specific prevalence was: 8.3% 20-29 years, 13.5% 30-39, 10.4% 40-49, 6.5% 50-59, 9.7% 60-69, 10.3% 70-79, 18.8% 80+. Standardised preva-lence was 10.3% (95%CI 9.6-11.0). No associations were detected between seropositivity and gender (OR=0.82, 95%CI 0.57-1.19) or being a healthcare worker (OR=1.43, 95%CI 0.62-3.29). Smokers (OR=1.86, 95%CI 1.09-3.15) and those socioeconomically disadvantaged (OR=2.52, 95%CI 1.24-5.13) were at increased risk. Among 129 seropositive individu-als, 31 reported symptoms that were either mild (n = 13) or moderate (time off work, doctor visit, n = 18). For age <60, 39.6% of seropositive individuals reported symptoms, whereas the proportion was 13.2% for age 60+.

Conclusions: Following the pandemic, the proportion of seropositive adults was low, but significant subclinical infection was found. Social disadvantage increased the likelihood of infection. The low symptom rate for older ages may relate to pre-existing immunity.

Reversal of vascular macrophage accumulation and hypertension by a CCR2 antagonist in deoxycorticosterone/salt-treated mice

Infiltration of macrophages into the artery wall plays detrimental roles during hypertension by promoting vascular inflammation and endothelial dysfunction, and it occurs via a chemo-attractant action of chemokines on macrophage cytokine receptors. We sought to identify the key chemokine receptors associated with macrophage infiltration into the vascular wall during deoxycorticosterone acetate (DOCA)/salt-induced hypertension in mice and to evaluate the impact of pharmacological inhibition of these receptors on blood pressure and leukocyte accumulation. Mice treated with DOCA/salt for 21 days displayed markedly elevated systolic blood pressure (158±2 versus 114±5 mm Hg in sham group; P<0.0001). Polymerase chain reaction screening via a gene array of 20 chemokine receptors indicated an increased expression of CCR2 in aortas of DOCA/salt-treated mice. Real-time polymerase chain reaction confirmed mRNA upregulation of CCR2 in aortas from DOCA/salt-treated animals and of the CCR2 ligands CCL2, CCL7, CCL8, and CCL12 (all >2-fold versus sham; P<0.05). Flow cytometry revealed 2.9-fold higher macrophage numbers (ie, CD45+ CD11b+ F4/80+ cells) in the aortic wall of DOCA/salt versus sham-treated mice. Intervention with a CCR2 antagonist, INCB3344 (30 mg/kg per day, IP), 10 days after the induction of hypertension with DOCA/salt treatment, reduced the aortic expression of CCR2 mRNA and completely reversed the DOCA/salt-induced influx of macrophages. Importantly, INCB3344 substantially reduced the elevated blood pressure in DOCA/salt-treated mice. Hence, our findings highlight CCR2 as a promising therapeutic target to reduce both macrophage accumulation in the vascular wall and blood pressure in hypertension.

Seasons of the Upper Yarra Valley : a report to the Museum Victoria

This report has been prepared on commission for the Museum Victoria to provide cultural and ethno-ecological advice in proposing theoretical principles to enable the design of a section of the Climate-Seasons zone of the Gallery of Life in the new Melbourne Museum complex

Modelling skill acquisition in acquired brain injury

Acquired brain injury (ABI) is a debilitating condition often requiring extensive rehabilitation. Although cognitive rehabilitation is concerned with overcoming a skills deficit, the application of skill acquisition research in this context has been non-existent. Examining post-injury learning in terms of the qualitative variables associated with different phases of skill acquisition is likely to be beneficial in assessing patient status and monitoring progress, as well as identifying changing needs over the course of learning. However, current models of skill acquisition overlook the potential impact of variables such as emotion, implicit learning, metacognition, motivation, and strategies that can be leveraged to improve skill acquisition. The current paper attempts to lay the groundwork for modelling and improving skill acquisition in ABI.