Association between apolipoprotein E epsilon 4 and neuropsychiatric symptoms during interferon alpha treatment for chronic hepatitis C

Neuropsychiatric complications are common in patients with chronic hepatitis C undergoing treatment with interferon alpha. These side effects include alterations of mood, cognition, and neuroendocrine function and are unpredictable. In a number of neurological disorders characterized by neuropsychiatric symptoms and cognitive dysfunction, inheritance of an apolipoprotein E (APOE) epsilon4 allele is associated with adverse neuropsychiatric outcomes. The authors present evidence that the APOE genotype may influence a patient's neuropsychiatric response to interferon alpha treatment. The inheritance of APOE genotypes was examined in 110 patients with chronic hepatitis C treated with interferon alpha. A retrospective investigation was conducted by assessing the rates of psychiatric referral and neuropsychiatric symptoms experienced during treatment along with other complaints indicating psychological distress. A highly statistically significant association was seen between APOE genotypes and interferon-induced neuropsychiatric symptoms. Patients with an epsilon4 allele were more likely to be referred to a psychiatrist and had more neuropsychiatric symptoms during antiviral treatment than those without an epsilon4 allele. Additionally, patients with an epsilon4 allele were more likely to experience irritability or anger and anxiety or other mood symptoms. These data demonstrate that an individual's APOE genotype may influence the neuropsychiatric response to antiviral therapy with interferon alpha. Prospective studies evaluating the importance of APOE in susceptibility to interferon alpha-induced neuropsychiatric complications are needed. Moreover, pathways involving APOE should be considered in understanding the pathophysiology of interferon alpha-induced neuropsychiatric complications.

Periodontitis and rheumatoid arthritis: A review

Periodontitis and rheumatoid arthritis (RA) appear to share many pathologic features. In this review, the common pathologic mechanisms of these two common chronic conditions are explored. Emerging evidence now suggests a strong relationship between the extent and severity of periodontal disease and RA. While this relationship is unlikely to be causal, it is clear that individuals with advanced RA are more likely to experience more significant periodontal problems compared to their non-RA counterparts, and vice versa. A case is made that these two diseases could be very closely related through common underlying dysfunction of fundamental inflammatory mechanisms. The nature of such dysfunction is still unknown. Nonetheless, there is accruing evidence to support the notion that both conditions manifest as a result of an imbalance between proinflammatory and anti-inflammatory cytokines. As a result, new treatment strategies are expected to emerge for both diseases that may target the inhibition of proinflammatory cytokines and destructive proteases. The clinical implications of the current data dictate that patients with RA should be carefully screened for their periodontal status.

Physical activity of young children

Occupational therapists concerned with the long-term health and welfare of children need to be aware of the decline. in physical activity of children in most Western societies. The current study examined the extent of physical activity in the lives of 50 Australian children with a mean age of 7.74 years through questionnaires completed by the children's parents and pedometer (step) data collected from the children during 4 days. The current data show that higher self-perception of physical competence, child's levels of physical skill, and low parental perception of peer teasing were the best predictors of physical activity. Higher family socioeconomic status was found to be a significant predictor of more steps being taken on weekends, and partner's (usually a father's) level of exercise was an important predictor of the number of weekend steps. Children who were perceived to experience more peer teasing completed fewer steps on the weekend. The findings from this study indicate that children's physical activity levels may depend on the availability of family resources, and that children in their early school years may already experience negative effects from teasing that, combined with reduced self-confidence, may lay the foundation for their with drawing from physical activity as they get older.

Ethical perspectives of the Australian live export trade

Objective To examine the ethical perspectives of the Australian live export trade. Design and method The perspectives of farmers and other industry personnel, overseas consumers, the Australian public, veterinarians and the assumed interests of transported animals are compared in relation to the ethical consequences. Animal welfare, societal, personal and professional ethics are identified and the ratification of different perspectives considered. Results and conclusions There are positive and negative aspects of the trade for each stakeholder group, and the overall position adopted by any individual reflects their perspective of the balance of these components. The debate as to whether Australia should continue with the trade will be best served by consideration of the interests of all parties in the trade, including the consumers and animals, which are among the most affected by the trade. There is a need for further research to address the major welfare problems for the animals, an openness to inspection on the part of the trade and balance in media reporting.

Maternal alcohol use disorder and offspring ADHD: disentangling genetic and environmental effects using a children-of-twins design

Background. Children of alcoholics are significantly more likely to experience high-risk environmental exposures, including prenatal substance exposure, and are more likely to exhibit externalizing problems [e.g. attention deficit hyperactivity disorder (ADHD)]. While there is evidence that genetic influences and prenatal nicotine and/or alcohol exposure play separate roles in determining risk of ADHD, little has been done on determining the joint roles that genetic risk associated with maternal alcohol use disorder (AUD) and prenatal risk factors play in determining risk of ADHD. Method. Using a children-of-twins design, diagnostic telephone interview data from high-risk families (female monozygotic and dizygotic twins concordant or discordant for AUD as parents) and control families targeted from a large Australian twin cohort were analyzed using logistic regression models. Results. Offspring of twins with a history of AUD, as well as offspring of non-AUD monozygotic twins whose co-twin had AUD, were significantly more likely to exhibit ADHD than offspring of controls. This pattern is consistent with a genetic explanation for the association between maternal AUD and increased offspring risk of ADHD. Adjustment for prenatal smoking, which remained significantly predictive, did not remove the significant genetic association between maternal AUD and offspring ADHD. Conclusions. While maternal smoking during pregnancy probably contributes to the association between maternal AUD and offspring ADHD risk, the evidence for a significant genetic correlation suggests: (i) pleiotropic genetic effects, with some genes that influence risk of AUD also influencing vulnerability to ADHD; or (ii) ADHD is a direct risk-factor for AUD.

A community-based wildlife survey: the knowledge and attitudes of residents of suburban Brisbane, with a focus on bandicoots

Within the expanding city of Brisbane in south-east Queensland, numerous fragments of native and regrowth vegetation are scattered across the largely urbanised landscape. These fragments provide refuge to a great diversity of native wildlife, and, provide residents with the opportunity to experience nature on their doorstep. To assess the diversity and abundance of this wildlife, recent changes in these parameters, and the value of wildlife and bushland fragments to residents of Brisbane, a questionnaire survey was distributed to 300 households each located adjacent to one of 38 urban bushland fragments. A total of 172 surveys (57%) were returned, producing 768 records of 83 fauna species, dominated by birds and mammals; bandicoots were widely reported from the 38 fragments. Several historical records provided evidence of recent local extinctions within fragments, highlighting the continuing declines in various species of native wildlife within Brisbane. Several human-wildlife conflicts were identified, but overall residents were tolerant of such conflicts. Bandicoots were disliked by a small minority (3%) of residents owing to the holes they dig in lawns and gardens in search of food. and their potential as vectors of ticks. Most respondents expressed ail appreciation for the presence of native wildlife (96%) and bushland fragments (97%) in their local area, emphasising the importance of incorporating human dimension values into the management of this urban biodiversity.

Pharmacological treatment and perceived health status during 1-year follow up in patients diagnosed with coronary artery disease, but ineligible for revascularization. Results from the Euro Heart Survey on Coronary Revascularization

Background It has been recognized that a clinically significant portion of patients with coronary artery disease (CAD) continue to experience anginal and other related symptoms that are refractory to the combination of medical therapy and revascularization. The Euro Heart Survey on Revascularization (EHSCR) provided an opportunity to assess pharmacological treatment and outcome in patients with proven CAD who were ineligible for revascularization. Methods We performed a secondary analysis of EHS-CR data. After excluding patients with ST-elevation myocardial infarction and those in whom revascularization was not indicated, 4409 patients remained in the analyses. We selected two groups: (1) patients in whom revascularization was the preferred treatment option (n = 3777, 86%), and (2) patients who were considered ineligible for revascularization (n = 632, 14%). Results Patient ineligible for revascularization had a worse risk profile, more often had a total occlusion (59% vs. 37%, p < 0.001), were treated more often with ACE-inhibitors (65% vs. 55%, p < 0.001) but less likely with aspirin (83% vs. 88%, p < 0.001). Overall, they had higher case-fatality at 1-year (7.0% vs. 3.7%, p < 0.001). Regarding self-perceived health status, measured via the EuroQol 5D (EQ-5D) questionnaire, these same patients reported more problems on all dimensions of the EQ-5D. Furthermore, in the revascularization group we observed an increase between discharge and 1-year follow up (utility score from 0.85 to 1.00) whereas patients ineligible for revascularization did not improve over time (utility score remained 0.80) Conclusion In this large cohort of European patients with CAD, those considered ineligible for revascularization had more co-morbidities and risk factors, and scored worse on self-perceived health status as compared to revascularized patients in the revascularization group. With the exception of ACE-inhibitors and aspirin, there were no major differences regarding drug treatment between the two groups. Given these clinically significant observations, there appears to be a role for nurse-led, multidisciplinary, rehabilitation teams that target clinically vulnerable patients whose symptoms remain refractory to standard medical care.

Enhancing experiential learning via virtual environments

Research indicates Virtual Reality (VR) is delivering on it's promised potential to provide enhanced training and education outcomes. A significant research project, at the University of Queensland, has constructed a number of virtual contexts in which the phenomena experienced by patients who have psychosis are reproduced for use in psychiatry education. Symptoms of psychosis reproduced include delusions, hallucinations and thought disorder. The new software enables psychiatry students to experience the inner world of a patient with psychosis. Lecturers in psychiatry report VR has the potential to enhance student's abilities to actually 'feel' the types of emotions and physiological reactions a hallucination precipitates in a patient. The current work of the project and stages of software development will be demonstrated. The virtual environments provide a new method of delivering experiential learning opportunities to higher education classrooms.

EVOCAÇÃO POÉTICA : O velar e o desvelar da obra pictórica Menino morto de Cândido Portinari à luz das concepções de Paul Tillich e de Martin Heidegger sobre as artes

A arte sempre esteve presente entre os humanos como um grande mistério. Sua característica polissêmica nos desafia a pensá-la como algo sempre aberto. Isto é, livre para que os indivíduos a experimentem de formas diversas. Nossa intenção, ao escolher a tela Menino morto do pintor Cândido Portinari, é mostrar que o encontro com uma obra de arte é forçosamente atual, vivo, surpreendente, extraordinário... Não apenas como um mero objeto de prazer, mas, sobretudo, como possibilidades de desvelar experiências originárias, abrindo gamas de sentidos que ajudam os seres humanos a significar a própria existência. Para seguir na investigação, privilegiam-se, nesta dissertação, os estudos sobre as artes do teólogo Paul Tillich e do filósofo Martin Heidegger. Para Tillich, numa obra de arte deve-se buscar o que se esconde no inaparente, pois é aí que reside a sua substância. Assim, na arte, como em qualquer manifestação cultural, por mais secular que aparente ser, se expressa sempre uma preocupação última. Para Heidegger, a arte é fonte de revelação da verdade. Todavia, essa revelação traz em si o ocultamento da mesma verdade, posto que a verdade e a não-verdade acontecem simultaneamente na obra de arte. Portanto, à luz dos estudos feitos por esses dois autores, tentamos captar o desnudar de Menino morto .(AU)

O RITUAL COMO ESPAÇO DE CRIAÇÃO E SUSTENTAÇÃO DO GRUPO RELIGIOSO: UMA APROXIMAÇÃO À SANTERÍA OU REGLA DE OCHA

Neste trabalho busca se estudar o ritual, na Santería ou Regla de Ocha, como espaço de criação e sustentação do grupo religioso. Aqui são demonstrados e interpretados argumentos que evidenciam a pertinência da Santería como sistema religioso que ajuda as pessoas a lidarem com as profundas mudanças sociais que aconteceram e continuam a acontecer na sociedade cubana nos diferentes períodos históricos. Isto, devido a que o ritual na Santería é um espaço dinâmico onde se experimentam as relações individuais e coletivas, sociais e religiosas, e onde se fornece pressupostos indispensáveis para as pessoas enfrentarem com os desafios que o cotidiano lhes reserva. A pesquisa destaca aspectos internos do ritual conhecido como o Wemilere ou Tambor de Santo; bem como a relação entre os sujeitos que participam no ritual, as suas motivações e os espaços litúrgicos onde a celebração acontece. Os aspectos abordados no trabalho não constituem uma apreciação definitiva sobre o ritual, mas uma aproximação a um sistema religioso de grande importância no contexto sócio-cultural cubano. (AU)

Postsocial relations:towards a performative view of accounting knowledge

This paper discusses the impact and influences of the growth of postsocial relations on accounting practice. Aspects of the growth of knowledge cultures, which have been argued to impact social and organizational arrangements, are discussed. Extending this view to accounting, we see accountants forming a distinctive knowledge culture with their own unique rules of how knowledge is constituted. These rules are embedded in accounting systems and practices. This paper suggests the need to further develop a research program that seeks to investigate accounting practice in local settings. The discussion in the paper is based on views which posit the growth of intimate links with epistemic objects within organizations and society. This paper argues that such ideas lead to an increasing tendency for us to experience the changes in societal relations and social arrangements as a compression of time and space. The paper relates these ideas to developments in the accounting research literature.

Making sense of violence: a study of narrative meaning

Dramatized violence has been a feature of entertainment in western civilization throughout history. The function of film violence is explored and compared to violence encountered in real life. The role of narrative in individuals' meaning-making processes is also investigated. Six adults were individually interviewed using a semi-structured schedule and narrative analysis was implemented. The findings revealed that real life violence is experientially distinct from film violence but narrative was found to be central to participants' quest for the meaning of violence in both contexts. The narrative framework of violence and whether it is justifiable were fundamental to participants' understanding. The function of violent film was found to be multifaceted: it can teach viewers about the consequences of violence; it allows them to speculate about their own and others' reactions to violence; and it provides an opportunity to experience something which is ordinarily outside of our experience in order to satisfy our human existential needs.

Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson's disease dementia and cognitive impairment in Parkinson's disease

Background - Previous Cochrane reviews have considered the use of cholinesterase inhibitors in both Parkinson's disease with dementia (PDD) and dementia with Lewy bodies (DLB). The clinical features of DLB and PDD have much in common and are distinguished primarily on the basis of whether or not parkinsonism precedes dementia by more than a year. Patients with both conditions have particularly severe deficits in cortical levels of the neurotransmitter acetylcholine. Therefore, blocking its breakdown using cholinesterase inhibitors may lead to clinical improvement. Objectives - To assess the efficacy, safety and tolerability of cholinesterase inhibitors in dementia with Lewy bodies (DLB), Parkinson’s disease with dementia (PDD), and cognitive impairment in Parkinson’s disease falling short of dementia (CIND-PD) (considered as separate phenomena and also grouped together as Lewy body disease). Search methods - The trials were identified from a search of ALOIS, the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group (on 30 August 2011) using the search terms Lewy, Parkinson, PDD, DLB, LBD. This register consists of records from major healthcare databases (MEDLINE, EMBASE, PsycINFO, CINAHL) and many ongoing trial databases and is updated regularly. Reference lists of relevant studies were searched for additional trials. Selection criteria - Randomised, double-blind, placebo-controlled trials assessing the efficacy of treatment with cholinesterase inhibitors in DLB, PDD and cognitive impairment in Parkinson’s disease (CIND-PD). Data collection and analysis - Data were extracted from published reports by one review author (MR). The data for each 'condition' (that is DLB, PDD or CIND-PD) were considered separately and, where possible, also pooled together. Statistical analysis was conducted using Review Manager version 5.0. Main results - Six trials met the inclusion criteria for this review, in which a total of 1236 participants were randomised. Four of the trials were of a parallel group design and two cross-over trials were included. Four of the trials included participants with a diagnosis of Parkinson's disease with dementia (Aarsland 2002a; Dubois 2007; Emre 2004; Ravina 2005), of which Dubois 2007 remains unpublished. Leroi 2004 included patients with cognitive impairment and Parkinson's disease (both with and without dementia). Patients with dementia with Lewy bodies (DLB) were included in only one of the trials (McKeith 2000). For global assessment, three trials comparing cholinesterase inhibitor treatment to placebo in PDD (Aarsland 2002a; Emre 2004; Ravina 2005) reported a difference in the Alzheimer's Disease Cooperative Study-Clinical Global Impression of Change (ADCS-CGIC) score of -0.38, favouring the cholinesterase inhibitors (95% CI -0.56 to -0.24, P < 0.0001). For cognitive function, a pooled estimate of the effect of cholinesterase inhibitors on cognitive function measures was consistent with the presence of a therapeutic benefit (standardised mean difference (SMD) -0.34, 95% CI -0.46 to -0.23, P < 0.00001). There was evidence of a positive effect of cholinesterase inhibitors on the Mini-Mental State Examination (MMSE) in patients with PDD (WMD 1.09, 95% CI 0.45 to 1.73, P = 0.0008) and in the single PDD and CIND-PD trial (WMD 1.05, 95% CI 0.42 to 1.68, P = 0.01) but not in the single DLB trial. For behavioural disturbance, analysis of the pooled continuous data relating to behavioural disturbance rating scales favoured treatment with cholinesterase inhibitors (SMD -0.20, 95% CI -0.36 to -0.04, P = 0.01). For activities of daily living, combined data for the ADCS and the Unified Parkinson's Disease Rating Scale (UPDRS) activities of daily living rating scales favoured treatment with cholinesterase inhibitors (SMD -0.20, 95% CI -0.38 to -0.02, P = 0.03). For safety and tolerability, those taking a cholinesterase inhibitor were more likely to experience an adverse event (318/452 versus 668/842; odds ratio (OR) 1.64, 95% CI 1.26 to 2.15, P = 0.0003) and to drop out (128/465 versus 45/279; OR 1.94, 95% CI 1.33 to 2.84, P = 0.0006). Adverse events were more common amongst those taking rivastigmine (357/421 versus 173/240; OR 2.28, 95% CI 1.53 to 3.38, P < 0.0001) but not those taking donepezil (311/421 versus 145/212; OR 1.24, 95% CI 0.86 to 1.80, P = 0.25). Parkinsonian symptoms in particular tremor (64/739 versus 12/352; OR 2.71, 95% CI 1.44 to 5.09, P = 0.002), but not falls (P = 0.39), were reported more commonly in the treatment group but this did not have a significant impact on the UPDRS (total and motor) scores (P = 0.71). Fewer deaths occurred in the treatment group than in the placebo group (4/465 versus 9/279; OR 0.28, 95% CI 0.09 to 0.84, P = 0.03). Authors' conclusions - The currently available evidence supports the use of cholinesterase inhibitors in patients with PDD, with a positive impact on global assessment, cognitive function, behavioural disturbance and activities of daily living rating scales. The effect in DLB remains unclear. There is no current disaggregated evidence to support their use in CIND-PD.

Health of entrepreneurs versus employees in a national representative sample

Prior research has found entrepreneurs to experience significantly higher job control and job demands compared with employees. This suggests that entrepreneurs have so-called active jobs and thus may benefit from positive health consequences. The present research compared entrepreneurs' health with employees' health in a national representative sample with regard to the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10) diagnoses of somatic diseases, the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnoses of mental disorders, blood pressure, well-being (life-satisfaction) as well as behavioural health indicators (sick days, physician visits). Entrepreneurs showed significantly lower overall somatic and mental morbidity, lower blood pressure, lower prevalence rates of hypertension, and somatoform disorders, as well as higher well-being and more favourable behavioural health indicators. The results are discussed with regard to the active job hypothesis and recommendations for future research are provided.

The effects of birth order on personality traits and feelings of academic sibling rivalry

The influence of birth order on personality and sibling rivalry is controversial; little research has been conducted into academic sibling rivalry, and none into the connection with personality traits. This study considers the interaction of all three factors. Firstborns (N=22) and lastborns (N=24) completed online personality tests and an Academic Sibling Rivalry Questionnaire. Lastborns were found to experience more academic sibling rivalry: t=2.33, DF=44; p less than 0.05, whereas firstborns are more likely to be conscientious: F(1,44)=3.58; p less than 0.05, and dutiful: F(1,44)=5.39; p less than 0.05. This raises possible implications in domains including education, health and psychotherapy. Further research could be conducted to expand these findings in terms of variables and geographical location. (Contains 2 figures.)