Carotid artery intimal medial thickness, brachial artery flow-mediated vasodilation and cardiovascular risk factors in diabetic and non-diabetic indigenous Australians

Background: Indigenous Australians are at high risk for cardiovascular disease and type 2 diabetes. Carotid artery intimal medial thickness (CIMT) and brachial artery flow-mediated vasodilation (FMD) are ultrasound imaging based surrogate markers of cardiovascular risk. This study examines the relative contributions of traditional cardiovascular risk factors on CIMT and FMD in adult Indigenous Australians with and without type 2 diabetes mellitus. Method: One hundred and nineteen Indigenous Australians were recruited. Physical and biochemical markers of cardiovascular risk, together with CIMT and FMD were meausred for all subjects. Results: Fifty-three Indigenous Australians subjects (45%) had type 2 diabetes mellitus. There was a significantly greater mean CIMT in diabetic versus non-diabetic subjects (p = 0.049). In the non-diabetic group with non-parametric analyses, there were significant correlations between CIMT and: age (r = 0.64, p < 0.001), systolic blood pressure (r = 0.47, p < 0.001) and non-smokers (r = -0.30, p = 0.018). In the diabetic group, non-parametric analysis showed correlations between CIMT, age (r = 0.36, p = 0.009) and duration of diabetes (r = 0.30, p = 0.035) only. Adjusting forage, sex, smoking and history of cardiovascular disease, Hb(A1c) became the sole significant correlate of CIMT (r = 0.35,p = 0.01) in the diabetic group. In non-parametric analysis, age was the sole significant correlate of FMD (r = -0.31,p = 0.013), and only in non-diabetic subjects. Linear regression analysis showed significant associations between CIMT and age (t = 4.6,p < 0.001), systolic blood pressure (t = 2.6, p = 0.010) and Hb(A1c) (t = 2.6, p = 0.012), smoking (t = 2.1, p = 0.04) and fasting LDL-cholesterol (t = 2.1, p = 0.04). There were no significant associations between FMD and examined cardiovascular risk factors with linear regression analysis Conclusions: CIMT appears to be a useful surrogate marker of cardiovascular risk in this sample of Indigenous Australian subjects, correlating better than FMD with established cardiovascular risk factors. A lifestyle intervention programme may alleviate the burden of cardiovascular disease in Indigenous Australians by reducing central obesity, lowering blood pressure, correcting dyslipidaemia and improving glycaemic control. CIMT may prove to be a useful tool to assess efficacy of such an intervention programme. (c) 2004 Elsevier Ireland Ltd. All rights reserved.

Changes in the initiation of heroin use after a reduction in heroin supply

Increasing heroin use in Australia over the past 30 years has been associated with a decline in the age of initiation to heroin use. The 2001 Australian heroin shortage was used to assess the effects of a reduction in heroin supply on age of initiation into heroin injecting. Data collected from regular injecting drug users (IDU) over the period 1996-2004 as part of the Australian Illicit Drug Reporting System were examined for changes in self- reported age of first heroin use after the onset of the heroin shortage. Estimates were also made of the number of young people who may not have commenced injecting heroin during the heroin shortage. The proportion of IDU interviewed in the IDRS who were aged

Influence of gender on mental health literacy in young Australians

Objectives: To determine the effects of gender on mental health literacy in young people between 12 and 25 years of age. Design: Computer-Assisted Telephone Interviewing was employed to conduct a cross-sectional structured interview focusing on young people's awareness of depression and psychosis. Participants: The sample comprised 1207 young Australians (539 males and 668 females) between the ages of 12-25 recruited from two metropolitan and two regional areas within Victoria. Six hundred and six respondents were presented a depression vignette and 601 were presented a psychosis vignette. Results: Female respondents (60.7%) were significantly more likely to correctly identify depression in the vignette as compared to male respondents (34.5%). No significant gender differences were noted for the psychosis vignette. Males were less significantly likely to endorse seeing a doctor or psychologist/counsellor for the treatment of psychosis. Males were also significantly more likely than females to endorse alcohol as a way of dealing with depression and antibiotics as useful for dealing with psychosis. Conclusion: Gender differences in mental health literacy are striking. Males showed significantly lower recognition of symptoms associated with mental illness and were more likely endorse the use alcohol to deal with mental health problems. Such factors may contribute to the delays in help seeking seen in young males. Further research is needed to delineate how these gender differences in young people may obstruct help seeking, early intervention and other aspects of mental health service delivery.

What are the policy implications of the evidence on cannabis and psychosis?

Objective: To explore the implications for mental health services, for health education about the risks of cannabis use, and for public policy toward cannabis use of observational evidence that cannabis use is a contributory cause of psychosis. Method: Using comparative analyses of similar evidence for the harmful effects of alcohol, tobacco, and amphetamine use, we considered the relation between observational evidence and action on cannabis. We examined arguments on the grounds of public health prudence for discouraging cannabis use by young individuals. With the assumption that the relation may be causal, we considered recommendations for policy in mental health services, health education, and public policy toward cannabis. Results: The observational evidence and biological plausibility of the hypothesis that cannabis is a contributory cause of psychosis is at least as strong as evidence for causal relations between heavy alcohol and amphetamine use and psychosis. On public health grounds, there is a good case for discouraging cannabis use among adolescents and young adults. It remains uncertain how best to discourage use and at whom campaigns to reduce cannabis use should be targeted. Conclusions: We should discourage young adults seeking treatment in mental health services from using cannabis and inform them of the probable mental health risks of cannabis use, especially of early and frequent use. We must exercise caution in liberalizing cannabis laws in ways that may increase young individuals' access to cannabis, decrease their age of first use, or increase their frequency of cannabis use. We should consider the feasibility of reducing the availability of high-potency cannabis products.

Belief in dealing with depression alone: Results from community surveys of adolescents and adults

Background: Community surveys have found that some people believe that it is better to deal with depression alone rather than seek help. However, there has been little research into the characteristics of this group. Methods: Data were drawn from three Australian surveys: (1) a national survey of 1001 adults aged 18+ years; (2) a school survey of 552 students aged 14-16 years from two regions; (3) a survey of 577 young people aged 12-17 years from the Melbourne region. In all three surveys, participants who believed it would be helpful to deal with depression alone were contrasted with those who believed it would be harmful in terms of sociodemographic characteristics, recognition of depression in a vignette, contact with people who experienced depression, beliefs about treatments, beliefs about using substances, beliefs about long-term outcomes, and beliefs about causes. Results: In both adolescents and adults, belief in dealing with depression alone was associated with male gender, less favourable views about mental health professionals, more favourable views about using substances to deal with depression, and a more positive expectation about the outcome if treatment is not sought. Adolescents believing in dealing with depression alone had more favourable views about some potential helpers, such as church workers and pharmacists. In adults, but not adolescents, there was an association with the belief that depression is caused by personal weakness. Limitations: The surveys did not directly ask about reasons for believing that dealing with depression alone would be helpful and did not assess actual help-seeking. Conclusions: Factors encouraging dealing with depression alone are a belief that it is a self-limiting disorder, that substances are an effective way to deal with it and, in adults, that depression is due to personal weakness. Consistent with previous research, males are an important target group for encouraging seeking help to deal with depression. (c) 2006 Elsevier B.V. All rights reserved.

The mental health risks of adolescent cannabis use

Since the early 1970s, when cannabis first began to be widely used [1], the proportion of young people who have used cannabis has steeply increased and the age of first use has declined [2, 3]. Most cannabis users now start in the mid-to-late teens [1], an important period of psychosocial transition when misadventures can have large adverse effects on a young person's life chances.

Introducing evidence-based family assessment and therapy in child and youth mental health services: Applying systemic principles to maintain, sustain and build capacity

The purpose of this article is to overview the context of the mental health service in which we work, and family therapy's status prior to and after the impact of changes wrought by the introduction of the National Mental Health Policy. We then explore some key issues that we think contribute to the persistence of the occlusion of family therapy in child psychiatric services; and the strategies that we developed and are continuing to develop to support change, finally, we describe the use of a family assessment instrument that we believe is central to our change strategy.

Moving and removing: relocation threatens people's wellbeing

The implications of relocation on Indigenous Australians

O PROCESSO EDUCACIONAL DA CULTURA INDÍGENA TICUNA NA REGIÃO DO ALTO SOLIMÕES

Esse trabalho busca analisar o sistema educacional na tribo Ticuna, localizada na região do Alto Solimões, estado do Amazonas, onde estou há 21 anos em contato permanente com os índios Ticuna. Com o passar dos anos tenho observado que a cada dia, e de forma mais intensa, a manutenção de sua cultura vem sofrendo com o processo de influência da cultura não índia. Nesse trabalho realiza-se um levantamento histórico referente à possível existência de duas correntes educacionais entre os professores Ticuna. Uma considera importante um ensino bilíngue, o estudo dos mitos e costumes para preservação da cultura; a outra acredita que é inócuo estudar os mitos e outros aspectos culturais, que podem ser apreendidos no dia a dia, defendem que os índios precisam de uma educação igual a dos não indígenas, para competir no mercado em condições de igualdade. Inicialmente propõe-se uma busca histórica sobre o processo educacional relacionado à cultura Ticuna fora da escola, procurando verificar as relações entre o que é transmitido pela escola e o que se evidencia no cotidiano Ticuna. Em seguida, realiza-se uma análise de como se processa a educação implantada no meio Ticuna sob o título Educação Indígena . Destacam-se os fatores que influenciaram a fundação da escola, sua localização e aspectos relacionados ao meio físico, econômico, social e cultural, bem como, o ambiente humano e de aprendizagem, dados esses que subsidiam o objetivo proposto para este trabalho. Procura-se verificar se a educação desenvolvida na escola indígena cumpre o papel de estar constantemente buscando alternativas para uma educação que seja apropriada à sobrevivência da cultura Ticuna, uma educação adequada à realidade cultural. A pesquisa baseia-se em levantamento de dados através de documentos, como também em entrevistas com lideranças, professores e idosos da Tribo Ticuna; também na observação direta, com anotações feitas em caderno de campo. O processo de assimilação e influência da cultura não índia predomina na região do Alto Solimões e tem esmagado a cultura Ticuna, fazendo com que muitos já não queiram mais pescar, caçar ou viver como produtores ou coletores. É necessário buscar alternativas educacionais para a escola indígena Ticuna, em uma educação que seja apropriada para a sobrevivência de sua cultura e ao mesmo tempo minimize o preconceito enfrentado por esse povo. As lideranças e professores Ticuna esperam que a escola ajude na preservação e valorização de sua cultura. O prejuízo causado à educação cultural dos índios Ticuna é grande, a maioria dos jovens e crianças não são conhecedores dos significados dos rituais religiosos, mitos, lendas e crenças. Muitas vezes sabem até realizar o ritual, mas parece mais uma imitação de gestos, que se desvincula do seu real sentido. Espera-se que ao final dessa pesquisa sejamos capazes de utilizar o material desenvolvido para reflexão e que ela talvez possa servir como ponto de partida para os professores Ticuna na elaboração de diretrizes e desenvolvimento de um novo paradigma educacional que valorize mais a cultura.

The madness that is the world:young activists' emotional reasoning and their participation in a local Occupy movement

The focus of this paper is young people’s participation in the Occupy protest movement that emerged in the early autumn of 2011. Its concern is with the emotional dimensions of this and in particular the significance of emotions to the reasoning of young people who came to commit significant time and energy to the movement. Its starting point is the critique of emotions as narrowly subjective, whereby the passions that events like Occupy arouse are treated as beyond the scope of human reason. The rightful rejection of this reductionist argument has given rise to an interest in under- standings of the emotional content of social and political protest as normatively con- stituted, but this paper seeks a different perspective by arguing that the emotions of Occupy activists can be regarded as a reasonable force. It does so by discussing find- ings from long-term qualitative research with a Local Occupy movement somewhere in England and Wales. Using the arguments of social realists, the paper explores this data to examine why things matter sufficiently for young people to care about them and how the emotional force that this involves constitutes an indispensable source of reason in young activists’ decisions to become involved in Local Occupy.

Sexuality and Christianity:understanding the attitudes and negotiations of young adults in the UK

Christianity has historically incorporated numerous strands of thinking on sexuality; in some cases, problematizing sexuality through the endorsement of celibacy and asceticism while at other historical and contextual moments, marriage and procreation become ideals (Price 2006). Contemporary Christians negotiate many sexual scripts (including ‘secular’ ones), but ‘appropriate’ Christian sexuality is still usually defined in terms of monogamy, the containment of sex within marriage, and heterosexuality. This chapter will explore the attitudes, beliefs and practices toward sexuality of young Christian women and men aged between 18 and 25 and living in the UK, based on a qualitative and quantitative research project entitled Religion, Youth and Sexuality: A Multi-faith Exploration, which utilized questionnaires, in-depth interviews and video diaries. The chapter will consider the variations in attitude between young people from different Christian denominations in relation to three themes: sex outside of marriage, celibacy and monogamy.

Sex talk:discussion and meaning-making among religious young adults

Where does discussion about sex and sexuality take place for religious young adults? How well do religious young people feel they know the perspectives and debates within their religious tradition regarding sexuality? This chapter, based on a project which studied 18-25 year olds from a variety of religious traditions, will examine the context in which sexuality was discussed, giving particular attention to religious spaces, significant individuals (e.g. parents and friends) and popular media. The concluding section will also highlight some points for good practice, based on the perspectives of young people.

Scope & nature of young sudden cardiac death in Newfoundland & Labrador

Introduction: Sudden cardiac death (SCD) in young people (ages 2-40) is a tragedy for families and communities alike. It has multiple causes, one of which is an underlying genetic arrhythmogenic cardiomyopathy. A study from Ontario (ON) using a 2008 cohort assessed the incidence of SCD in persons aged 2-40 years to be 2.64/100,000 person-years. We hypothesized that Newfoundland & Labrador (NL) may have a higher incidence of early SCD in ages 2-40 due to possible underlying genetic causes given the historical genetic isolation of the population and the founder mutations already identified (ex. PKP2, RYR2, TMEM43). Methods: We ascertained cases of sudden death from the comprehensive Medical Examiners’ provincial database for the years 2008 and 1997; 2008 as a direct comparison to ON, and 1997 as it represented a time when the implantable cardioverter-defibrillator was not available in NL. Each case of sudden death was individually analyzed to determine likelihood of SCD. Results: There were 119 cases in 2008 and 157 cases in 1997. The incidence of SCD for ages 2-40 in 2008 was 7.32/100,000 persons. This was significantly higher than the incidence in Ontario. The incidence of SCD was not significantly higher in 1997 than 2008. Coronary artery disease was a major cause of death in all cohorts, similar to Ontario (non-significant difference). Conclusion: In general, there was a trend of more arrhythmogenic deaths in the young and more structural cardiac deaths as age increased. This reflects the cause of SCD in the young is often genetic in nature, while older deaths are often due to coronary artery disease, a disease heavily influenced by environment. To conclude, SCD in NL occurs at a higher incidence than ON, further research is needed on the topic.

HIP HOP COMO PROCESSO COMUNICACIONAL E SOCIABILIDADE PARA JOVENS INDÍGENAS DE DOURADOS – MS

Estudo sobre o Hip Hop como processo comunicacional e sociabilidade entre jovens indígenas de Dourados, Mato Grosso do Sul, para verificar quais os principais objetivos da prática do movimento Hip Hop, compreender se serve como comunicação, contribui para o fortalecimento da língua guarani ou gera novas tensões sociais na reserva. Para tanto, foi analisado aspectos históricos do movimento, passando pelos Estudos Culturais, e como Movimento Social, dando início à discussão de uma voz alternativa por meio do Hip Hop. Do ponto de vista metodológico, trata-se de um de estudo de caso, com representantes dos grupos de jovens Brô Mc's e Jovens Conscientes, das reservas Jaguapirú e Bororó, das etnias Guarani-Kaiowá de Dourados (MS). Foram realizadas entrevistas semiestruturadas junto a jovens que participaram das oficinas de hip hop, das lideranças indígenas e professores. A investigação é complementada pela pesquisa bibliográfica, documental e análises das letras de rap em confrontação com as visões da imprensa, a partir da análise dos jornais Diário MS e O Progresso. Os resultados apontam que os jovens se apropriam de uma cultura global para transformar o ambiente local com objetivo de preservar a língua guarani, uma alternativa para o conhecimento, logo para não seguirem caminhos como o das drogas. Negociando falas sobre sua realidade, dentro e fora da reserva, já que nos meios de comunicação locais há pouco espaço para a voz dos indígenas e dentro da reserva ainda há contestação do movimento em um contexto político, na tentativa de atingir uma cultura “pura”, devido à preocupação dos mais velhos com a perda de território.

Young students' use of the internet for mental health information and support

It is recognized that young people experience difficulties in accessing mainstream mental health services particularly because of the stigma that remains associated with mental health problems. One potential solution is to use the many websites available offering information and support for mental health problems, such support and information could be offered by Psychiatric Nurses. However, young peoples' usage and views on using the Internet for this purpose has yet to be examined. This quantitative descriptive study aimed to elicit the views of 922 University students, aged between 18 and 24 years, on using the Internet for mental health information and support. Data were collected using a 30-item self-designed questionnaire and analysed using descriptive statistics. The findings indicated that 72.4% of participants used the Internet several times a day. In addition, 30.8% had previously searched for mental health information online, predominantly on depression. While it was found that 68% of participants indicated that they would use the Internet for mental health support if they needed to, 79.4% would still prefer face to face support. It is concluded that young people are willing to use the Internet for mental health information and that it represents a viable source of support for this age group.