Diabetes, hyperinsulinemia, and hyperlipidemia in small aboriginal community in northern Australia

A small rural Aboriginal community in northern Australia was surveyed for diabetes, impaired glucose tolerance (IGT), hyperinsulinemia, and lipid levels. Of the 122 adults >17 yr of age who participated (95% response rate), 11.5% had diabetes, 7.4% had IGT, and the remaining 81.1% had normal glucose tolerance. Both diabetes and IGT were strongly age related. This high frequency of diabetes occurred, despite the population being relatively lean. Although the body mass index (BMI) increased with age in both men and women, only 25% of the population overall had BMI >25 kg/m2. There were wide ranges of insulin responses to glucose, with the upper fertile of 2-h insulin levels being more than seven times higher than the lower fertile (144 ± 13 vs. 19 ± 1 mLI/L). Hyperinsulinemia was associated with IGT, elevated triglycerides, and lower high-density lipoprotein cholesterol levels. Lipid abnormalities were much more frequent among men than women. Cholesterol levels were an average of 0.55 mM higher and triglycerides an average of 1.05 mM higher in men than in women, and both increased with age. In conclusion, this small isolated Aboriginal population from northern Australia had an unexpectedly high frequency of diabetes (in view of their relative leanness) in association with a high frequency of metabolic abnormalities indicative of insulin resistance (hyperinsulinemia, IGT, hypertriglyceridemia).

Rich and purposeful mathematical knowledge of mothers and children in a Torres Strait Islander community

This paper focuses on a pilot study that explored the situated mathematical knowledge of mothers and children in one Torres Strait Islander community in Australia. The community encouraged parental involvement in their children’s learning and schooling. The study explored parents’ understandings of mathematics and how their children came to learn about it on the island. A funds of knowledge approach was used in the study. This approach is based on the premise that people are competent and have knowledge that has been historically and culturally accumulated into a body of knowledge and skills essential for their functioning and well-being (Moll, 1992). The participants, three adults and one child are featured in this paper. Three separate events are described with epiphanic or illuminative moments analysed to ascertain the features that enabled an understanding of the nature of the mathematical events. The study found that Indigenous ways of knowing of mathematics were deeply embedded in rich cultural practices that were tied to the community. This finding has implications for teachers of children in the early years. Where school mathematics is often presented as disembodied and isolated facts with children seeing little relevance, learning a different perspective of mathematics that is tied to the resources and practices of children’s lives and facilitated through social relationships, may go a long way to improving the engagement of children and their parents in learning and schooling.

A theory of literacies for considering the role of adult and community education in postcolonial change

In this paper, I use a case study drawn from education in the Grenada revolution and afterwards to discuss lessons that postcolonial societies can learn from comparing two approaches to adult basic and popular education. I argue that some approaches to adult education provide subordinate literacies and catch-up schooling on the cheap, while others contribute to sociopolitical change by helping participants develop powerful literacies that challenge the structures of injustice, inefficiency, and dysfunctionality that are still entrenched in most societies. The paper puts forward the concept of epistemic, humanist and public ‘literacies’ as a tool for considering the role of adult education in national development.

Sex and the virtual suburbs : the pornosphere and community standards

This chapter looks at the management and zoning of online sexual culture–the web sites which make up the pornosphere (McNair 2013). It explores the concept of ‘community standards’, which has been a central part of the management of sexually explicit materials in the offline world, and asks what it might mean to talk about ‘community standards’ on the Internet. And finally, it uses the concept of virtual-community standards to revisit the question of managing access to sexually explicit materials on the Internet.

The invisible elderly : lesbian, gay, bisexual, and transgender older adults

More than 2 million older adults identify as lesbian, gay, bisexual, or transgender (LGBT). The purpose of this article is to present an overview of the physical and mental health needs of LGBT older adults to sensitize nurses to the specific needs of this group. Nurses are in a prominent position to create health care environments that will meet the needs of this invisible, and often misunderstood, group of people.

The case of LLACE : challenges, triumphs, and lessons of a community archives

This article uses the Lavender Library, Archives, and Cultural Exchange of Sacramento, Incorporated, a small queer community archives in Northern California, as a case study for expanding our knowledge of community archives and issues of archival practice. It explores why creating a separate community archives was necessary, the role of community members in founding and maintaining the archives, the development of its collections, and the ongoing challenges community archives face. The article also considers the implications community archives have for professional practice, particularly in the areas of collecting, description, and collaboration.

Broadcasting digital stories on Australian community television : the Digistories Anthology

Community-based arts and media movements have been intsrumental in building population-wide creative capacity for cultural development, social participation and social transformation in many parts of the world. Digital storytelling is a form of media practice that was pioneered in the United States at the intersection of these movements. It is described here as a ‘co-creative’ media production method. This description aims to differentiate the approaches to collaborative content creation that are used in community cultural development (CCD) and community media movements from those valued in professional and consumer modes of media production. Yet, the products of co-creative practices, such as digital stories, do not circulate widely through existing media networks or through the newer social media networks that Australian CCD and community media movements anticipated by at least twenty years. The complex politics of story ownership are one of a number of factors that often render ‘publication’ a secondary consideration in the making of digital stories. The possibility of ‘downstream’ use and re-use of stories in other networks is not usually considered in initial planning and development processes. As landmark projects such as Capture Wales indicate, even where stories are made for broadcast outcomes, television can be a problematic window for exhibiting digital stories. Scepticism about the brave new world of reality television and user generated content also circulates in digital storytelling networks, especially when it comes to ethical concerns for managing the risks of harm associated with widespread distribution of digital stories to indiscriminate publics. This publication reports on a collaborative action research project that took a closer look at some of the constraints relating to the problems of re-purposing digital stories for television. It focussed on ‘best practice’ for managing the risks of harm to storytellers in the process of re-purposing digital stories for broadcast on community television.

Academic legal research and academic research capacity enhancement working topic : "purposes and objectives of law schools beyond educating students (research, capacity building,community service and outreach)"

One of the main objectives of law schools beyond educating students is to produce viable legal research. The comments in this paper are basically confined to the Australian context, and to examine this topic effectively, it is necessary to briefly review the current tertiary research agenda in Australia. This paper argues that there is a need for recognition and support for an expanded legal research framework along with additional research training for legal academics. There also needs to be more effective methods of measuring and recognising quality in legal research. This method needs to be one that can engender respect in an interdisciplinary context.

ADCS reaches adulthood : an analysis of the conference and its community over the last eighteen years

How influential is the Australian Document Computing Symposium (ADCS)? What do ADCS articles speak about and who cites them? Who is the ADCS community and how has it evolved? This paper considers eighteen years of ADCS, investigating both the conference and its community. A content analysis of the proceedings uncovers the diversity of topics covered in ADCS and how these have changed over the years. Citation analysis reveals the impact of the papers. The number of authors and where they originate from reveal who has contributed to the conference. Finally, we generate co-author networks which reveal the collaborations within the community. These networks show how clusters of researchers form, the effect geographic location has on collaboration, and how these have evolved over time.

Spatial analysis of community-onset Staphylococcus aureus bacteremia in Queensland, Australia

OBJECTIVES To investigate and describe the relationship between indigenous Australian populations, residential aged care services, and community-onset Staphylococcus aureus bacteremia (SAB) among patients admitted to public hospitals in Queensland, Australia. DESIGN Ecological study. METHODS We used administrative healthcare data linked to microbiology results from patients with SAB admitted to Queensland public hospitals from 2005 through 2010 to identify community-onset infections. Data about indigenous Australian population and residential aged care services at the local government area level were obtained from the Queensland Office of Economic and Statistical Research. Associations between community-onset SAB and indigenous Australian population and residential aged care services were calculated using Poisson regression models in a Bayesian framework. Choropleth maps were used to describe the spatial patterns of SAB risk. RESULTS We observed a 21% increase in relative risk (RR) of bacteremia with methicillin-susceptible S. aureus (MSSA; RR, 1.21 [95% credible interval, 1.15-1.26]) and a 24% increase in RR with nonmultiresistant methicillin-resistant S. aureus (nmMRSA; RR, 1.24 [95% credible interval, 1.13-1.34]) with a 10% increase in the indigenous Australian population proportion. There was no significant association between RR of SAB and the number of residential aged care services. Areas with the highest RR for nmMRSA and MSSA bacteremia were identified in the northern and western regions of Queensland. CONCLUSIONS The RR of community-onset SAB varied spatially across Queensland. There was increased RR of community-onset SAB with nmMRSA and MSSA in areas of Queensland with increased indigenous population proportions. Additional research should be undertaken to understand other factors that increase the risk of infection due to this organism.

Replacement of healthcare-associated MRSA by community-associated MRSA in Queensland : confirmation by genotyping

Objective To describe the changing prevalence of healthcare- and community-associated MRSA. Methods Susceptibility phenotypes of MRSA were observed from 2000 to 2012 using routine susceptibility data. Phenotypic definitions of major clones were validated by genotyping isolates from a nested period prevalence survey in 2011. Results The predominant healthcare-associated (AUS-2/3 like) MRSA phenotype decreased from 42 to 14 isolates per million occasions of service in outpatients (P < 0.0001) and from 650 to 75 isolates per million accrued patient days in inpatients (P 0.0005), while the respective rates of the healthcare-related EMRSA-15 like phenotype increased from 1 to 19 in outpatients (P < 0.0001) and from 11 to 83 in inpatients (P < 0.0001) and those of the community-associated MRSA phenotype increased from 17 to 296 in outpatients (P < 0.0001) and from 71 to 486 in inpatients (P < 0.0001). When compared with single nucleotide polymorphism genotyping the AUS-2/3 like phenotype had a sensitivity and positive predictive value (PPV) for CC239 of 1 and 0.791 respectively, while the EMRSA-15 like phenotype had a sensitivity and PPV for CC22 of 0.903 and 0.774. PVL-positive CA-MRSA, predominantly ST93 and CC30, accounted for 60.8% of MRSA, while PVL-negative CA-MRSA, mainly CC5 and CC1, accounted for 21.4%. Conclusions The initially dominant healthcare-associated MRSA clone has been progressively replaced, mainly by four community-associated lineages.

Management of over-the-counter insomnia complaints in Australian community pharmacies: A standardized patient study

Objective To evaluate the current management of over-the-counter (OTC) insomnia complaints in Australian community pharmacies using standardized patient methodology. Methods Trained standardized patients visited a sample of 100 randomly selected South East Queensland community pharmacies in June 2011. The standardized patients enacted two OTC insomnia scenarios: a direct product request (DPR) (n = 50) and a symptom-based request (SBR) (n = 50). Results of the interactions were documented immediately after each visit and evaluated using the Pharmaceutical Society of Australia's WHAT STOP GO protocol as a standard comparison. Key findings Of all DPRs, 30% were handled entirely by the pharmacist, 70% of staff enquired about specific symptoms and 28% investigated the cause of insomnia. No staff investigated the frequency of product use. The DPR scenario resulted in a 92% supply of the requested doxylamine product (Restavit). In the SBR scenario, 18% of requests were handled entirely by the pharmacist, 58% of staff enquired about specific symptoms and 44% investigated the cause of insomnia. Staff recommended medicated products (38%), or herbal (78%) or non-drug techniques (18%). Investigation into smoking and alcohol intake was not undertaken in DPR or SBR interactions, while questioning on caffeine intake was undertaken in 2 and 14% of cases respectively. There were no significant differences found in the handling of sleep requests by pharmacists compared to pharmacy assistants. Conclusion The standardized patient methodology was a successful way to assess the community pharmacy counselling provided with OTC sleep requests and suboptimal staff responses were found when compared with recommended practice standards.