Histological composition and progression of carotid plaque

Abstract Background To analyse histological composition and progression of carotid plaque. Methods Thirty-one patients (22 males, mean age 68.03 ± 7.3 years) admitted for carotid endarterectomy for extracranial high-grade internal carotid artery stenosis (≥ 70% luminal narrowing) were enrolled. The patients were divided into 2 groups according to symptomatology (group I, 17 symptomatic patients; and group II, 14 asymptomatic patients). A histological analysis and inflammatory cell quantification of each excised carotid plaque was made. Nine carotid arteries were removed from human cadavers that were not preselected for carotid artery disease. These specimens were used as a control tissue without any macroscopic signs of atherosclerotic plaques. Results Fifty eight percent of all carotid plaques were classified as complex plaque with possible surface defect, hemorrhage or thrombus. The inflammatory cells concentration did not differ between the two groups. All specimens from human cadavers were classified as preatheroma with extracellular lipid pools. Conclusion Asymptomatic and symptomatic patients could have the same histological components on their carotid plaques. Fibrotic and calcific plaques could become vulnerable as complex plaques with surface defect, hemorrhage and thrombus could remain silent. Asymptomatic carotid stenosis should be followed close with no invasive diagnostic methods and clinical evaluation.

Protecting the most vulnerable in consumer credit transactions

There are two key ways in which the Australian Uniform Consumer Credit Code seeks to protect consumers in relation to consumer credit transactions. The first is by means of disclosure regulation where information is required to be disclosed to the consumer before the credit contract is entered into and the second is by way of “safety net” provisions, where contracts can be varied or set aside in the event of hardship, a finding that the transaction was unjust, or a finding of unconscionable fees or charges. This article explores the limitations of both of these means of protection, particularly in the case of vulnerable, low-income consumers. In order to highlight the inadequacies of these forms of consumer protection and the need for regulatory reform, we draw on interviews conducted with 30 low-income consumers who had recently signed a credit contract, focusing on their understanding of information disclosed in the contract, as well as their responses to hypothetical unfair terms and their understanding of their rights, for example in the event of an unjust transaction. These interviews were conducted as part of a joint research project between Brotherhood of St Laurence and Griffith University’s Centre for Credit and Consumer Law, funded by Consumer Affairs Victoria.

Predicting loss and fragmentation of habitat of the vulnerable subtropical rainforest tree Macadamia integrifolia with models developed from compiled ecological data

Habitat models are widely used in ecology, however there are relatively few studies of rare species, primarily because of a paucity of survey records and lack of robust means of assessing accuracy of modelled spatial predictions. We investigated the potential of compiled ecological data in developing habitat models for Macadamia integrifolia, a vulnerable mid-stratum tree endemic to lowland subtropical rainforests of southeast Queensland, Australia. We compared performance of two binomial models—Classification and Regression Trees (CART) and Generalised Additive Models (GAM)—with Maximum Entropy (MAXENT) models developed from (i) presence records and available absence data and (ii) developed using presence records and background data. The GAM model was the best performer across the range of evaluation measures employed, however all models were assessed as potentially useful for informing in situ conservation of M. integrifolia, A significant loss in the amount of M. integrifolia habitat has occurred (p < 0.05), with only 37% of former habitat (pre-clearing) remaining in 2003. Remnant patches are significantly smaller, have larger edge-to-area ratios and are more isolated from each other compared to pre-clearing configurations (p < 0.05). Whilst the network of suitable habitat patches is still largely intact, there are numerous smaller patches that are more isolated in the contemporary landscape compared with their connectedness before clearing. These results suggest that in situ conservation of M. integrifolia may be best achieved through a landscape approach that considers the relative contribution of small remnant habitat fragments to the species as a whole, as facilitating connectivity among the entire network of habitat patches.

The Chronic Heart-Failure Assistance by Telephone (CHAT) Study: Assessment of Telephone Support for Vulnerable Patients with Chronic Disease

Aim: To determine whether telephone support using an evidence-based protocol for chronic heart failure (CHF) management will improve patient outcomes and will reduce hospital readmission rates in patients without access to hospital-based management programs. Methods: The rationale and protocol for a cluster-design randomised controlled trial (RCT) of a semi-automated telephone intervention for the management of CHF, the Chronic Heart-failure Assistance by Telephone (CHAT) Study is described. Care is coordinated by trained cardiac nurses located in Heartline, the national call center of the National Heart Foundation of Australia in partnership with patients’ general practitioners (GPs). Conclusions: The CHAT Study model represents a potentially cost-effective and accessible model for the Australian health system in caring for CHF patients in rural and remote areas. The system of care could also be readily adapted for a range of chronic diseases and health systems. Key words: chronic disease management; chronic heart failure; integrated health care systems; nursing care, rural health services; telemedicine; telenursing

Vulnerable and invisible : depictions of trafficking victims in public awareness campaigns

Public concern about the crime of human trafficking has dramatically risen over the last two decades. . This concern and panic has both spawned and been fuelled by an array of public awareness campaigns that aim to educate the public about this crime. Campaigns such as the Blue Blindfold Campaign in the UK, the UN-driven Blue Heart Campaign, and the worldwide Body Shop campaign have contributed to the public’s awareness and, to an extent, understanding of the phenomenon of human trafficking. This research explores these and other government and non-government campaigns aimed at raising public awareness of human trafficking. It questions the rationale, call to action and impact of these efforts, and analyses the depiction of trafficking victims in these campaigns. In particular, this research argues that some of these campaigns perpetuate an understanding of a hierarchy of victimisation of trafficking. A public focus on sex trafficking often results in the conflation of prostitution and trafficking, and renders invisible the male and female victims of trafficking for other forms of labour.

Vulnerable road user groups : a review of younger drivers, motorcyclists and older drivers

Scientific efforts to understand and reduce the occurrence of road crashes continue to expand, particularly in the areas of vulnerable road user groups. Three groups that are receiving increasing attention within the literature are younger drivers, motorcyclists and older drivers. These three groups are at an elevated risk of being in a crash or seriously injured, and research continues to focus on the origins of this risk as well as the development of appropriate countermeasures to improve driving outcomes for these cohorts. However, it currently remains unclear what factors produce the largest contribution to crash risk or what countermeasures are likely to produce the greatest long term positive effects on road safety. This paper reviews research that has focused on the personal and environmental factors that increase crash risk for these groups as well as considers direction for future research in the respective areas. A major theme to emerge from this review is that while there is a plethora of individual and situational factors that influence the likelihood of crashes, these factors often combine in an additive manner to exacerbate the risk of both injury and fatality. Additionally, there are a number of risk factors that are pertinent for all three road user groups, particularly age and the level of driving experience. As a result, targeted interventions that address these factors are likely to maximise the flow-on benefits to a wider range of road users. Finally, there is a need for further research that aims to bridge the research-to-practice gap, in order to develop appropriate pathways to ensure that evidenced-based research is directly transferred to effective policies that improve safety outcomes.

The relationship between lower intelligence, crime and custodial outcomes : a brief literary review of a vulnerable group

The relationship between intellectual functioning and criminal offending has received considerable focus within the literature. While there remains debate regarding the existence (and strength) of this relationship, there is a wider consensus that individuals with below average functioning (in particular cognitive impairments) are disproportionately represented within the prison population. This paper focuses on research that has implications for the effective management of lower functioning individuals within correctional environments as well as the successful rehabilitation and release of such individuals back into the community. This includes a review of the literature regarding the link between lower intelligence and offending and the identification of possible factors that either facilitate (or confound) this relationship. The main themes to emerge from this review are that individuals with lower intellectual functioning continue to be disproportionately represented in custodial settings and that there is a need to increase the provision of specialised programs to cater for their needs. Further research is also needed into a range of areas including: (1) the reason for this over-representation in custodial settings, (2) the existence and effectiveness of rehabilitation and release programs that cater for lower IQ offenders, (3) the effectiveness of custodial alternatives for this group (e.g. intensive corrections orders) and (4) what post-custodial release services are needed to reduce the risk of recidivism.

Protecting Vulnerable Young People in Cyberspace from Sexual Abuse: Raising Awareness and Responding Globally

This paper explores the danger that young people may be exposed to when using the Internet. The first part sets out the context by considering new developments in UK and international legislation and then explores educational moves to protect children. Focus is upon findings from research undertaken on behalf of the London Metropolitan Police Service in evaluating the Safer Surfing programme designed to enable young people’s safe Internet use. In the final part of this paper it is argued that more must however be done internationally both to protect children online and to curb the growing trade in indecent child images.

Does the protection of vulnerable children require a system of mandatory reporting of abuse and neglect? [An issues paper for the New Zealand Government Green Paper for vulnerable children]

In this Issues Paper, I raise some key points relevant for any government which is considering its child protection and family welfare policy. In particular, I will raise questions about whether a form of legislative reporting duty is required, and if so, what consequences this has for child protection. The context of child maltreatment - and each form of maltreatment: physical abuse, sexual abuse, psychological or emotional abuse, and neglect - is extremely complex, and the overarching question of how to deal with these phenomena involve challenging normative, economic and practical questions. There are no easy or perfect solutions. Nor, often, is there the amount and quality of evidence available on which public policy approaches should be devised. However, from the best evidence about the history of this context, from research conducted in this field, and from the best evidence available about the nature, incidence and effects of different subtypes of maltreatment, some observations can be made which may help to inform deliberations. I outline 10 key issues related to mandatory reporting legislation while being mindful of the New Zealand context. My view, based on both research evidence and a concern to protect and promote children’s interests, and society’s interests, is that reporting laws in some form are necessary and can contribute substantially to child protection and enhancing family and community health and wellbeing. However, they are only one necessary part of a sound child protection system, being a method of tertiary and secondary prevention, and primary prevention efforts must also be prioritised. Moreover, it is essential that if a legislative reporting duty is enacted, it must be designed carefully and implemented soundly, and it must be integrated within a properly resourced child protection and family welfare system.

Corporate social responsibility and the parameters of dialogue with vulnerable others

This article presents a case study of corporate dialogue with vulnerable others. Dialogue with marginalized external groups is increasingly presented in the business literature as the key to making corporate social responsibility possible in particular through corporate learning. Corporate public communications at the same time promote community engagement as a core aspect of corporate social responsibility. This article examines the possibilities for and conditions underpinning corporate dialogue with marginalized stakeholders as occurred around the unexpected and sudden closure in January 2009 of the AU$2.2 billion BHP Billiton Ravensthorpe Nickel mine in rural Western Australia. In doing so we draw on John Roberts’ notion of dialogue with vulnerable others, and apply a discourse analysis approach to data spanning corporate public communications and interviews with residents affected by the decision to close the mine. In presenting this case study we contribute to the as yet limited organizational research concerned directly with marginalized stakeholders and argue that corporate social responsibility discourse and vulnerable other dialogue not only affirms the primacy of business interests but also co-opts vulnerable others in the pursuit of these interests. In conclusion we consider case study implications for critical understandings of corporate dialogue with vulnerable others.