A global approach to dissecting lipid-induced impairment of liver gluconeogenesis

This thesis identified: 1) novel aspects of cholesterol metabolism, 2) a novel signalling lipid in the phosphatidylinositol class, and 3) a gene involved in regulating lipid breakdown, as being regulated in the reversal of a fatty acid induced diabetic liver. The identification of these targets may allow for future development of targeted therapies against type 2 diabetes with a specific focus on the liver.

Spinoza/space/speed/sublime: Problems of philosophy and politics in the post-colonial fiction of Gerald Murnane

This article takes account of the ‘spontaneity’ of the post-colonial fiction of Gerald Murnane within the ‘dominating space’ of the philosophy of Spinoza. My use of Paul Carter’s terms here is strategic. The compact of fiction and philosophy in Murnane corresponds with the relationship of spontaneity to the dominating organization of desire in Carter’s rendering of an Aboriginal hunter. Carter’s phrase “‘a figure at once spontaneous and wholly dominated by the space of his desire’” worries Ken Gelder and Jane M. Jacobs, who suggest that it subjugates the formation of Aboriginal desire (incorporating spontaneity) to impulses of imperialism. The captivating immanence of Spinoza’s philosophy in Murnane’s fiction, which I will demonstrate with various examples, puts pressure on the fiction to occupy the same space as the space of the philosophy. Here is a clue to why Murnane’s post-colonial thematics have been little explored by critics with an interest in post-colonial politics. The desire of Spinoza’s philosophy creates a spatial textuality within which the spontaneity of Murnane’s fiction, to the degree that it maximizes or fills the philosophy, is minimized in its political effects. That is to say, the fiction shifts politics into an external space of what Roland Barthes calls “resistance or condemnation”. However, the different speeds (or timings) of Murnane and Spinoza, within the one space, mitigate this resistance of the outside, at least in respect of certain circumstances of post-coloniality. It is especially productive, I suggest, to engage Carter’s representation of an Aboriginal hunter through the compact of coincidental spaces and differential speeds created by Murnane’s fiction in Spinoza’s philosophy. This produces a ceaseless activation of desire and domination, evidenced in Murnane’s short story ‘Land Deal’, and indexed by a post-Romantic sublime. What limits the value of Murnane’s fiction in most contexts of post-colonial politics, is precisely what makes it useful in the matter of Carter’s Aboriginal hunter.

Serum 25-hydroxyvitamin D deficiency and the 5-year incidence of CKD

Low serum 25-hydroxyvitamin D (25[OH]D) levels have been associated with chronic kidney disease in cross-sectional studies. However, this association has not been studied prospectively in a large general population–based cohort.

This prospective cohort study shows that vitamin D deficiency is associated with a higher annual incidence of albuminuria and reduced eGFR and independently predicts the 5-year incidence of albuminuria. These associations warrant further exploration in long-term prospective clinical trials.

Integrating the human factor into the holistic understanding of sustainability

Using a number of literary sources with sustainable design and architectural phenomenology as their foundation, this paper uses Integral theory, drawing on the writings of Ken Wilber and Mark DeKay to justify the importance of human architectural experience in the holistic view of sustainable design. The literature critiques modern practices and ideas of sustainability and identifies factors that contribute towards the success of sustainable building. It explores the implications for an Integral approach to sustainable design and then uses it to analyse the relationships that exist between the objective and the subjective value spheres of Integral theory.

The timing of Rapid-Response Team activations: a multicentre international study

Background:
Most studies of Rapid-Response Teams (RRTs) assess their effect on outcomes of all hospitalised patients. Little information exists on RRT activation patterns or why RRT calls are needed. Triage error may necessitate RRT review of ward patients shortly after hospital admission. RRT diurnal activation rates may reflect the likely frequency of caregiver visits.

Objectives:
To study the timing of RRT calls in relation to time of day and day of week, and their frequency and outcomes in relation to days after hospital admission.

Methods:
We prospectively studied RRT calls over 1 month in seven hospitals during 2009, collecting data on patient age, sex, admitting unit, admission source, limitations of medical therapy (LOMTs), and admission and discharge dates. We assessed the timing of RRT calls in relation to hospital admission and circadian variation; and differences in characteristics and outcomes of calls occurring early (Days 0 and 1) versus late (after Day 7) after hospital admission.

Results:
There were 652 RRT calls for 518 patients. Calls were more likely on Mondays (P=0.018) and during work hours (P<0.0001) but less likely on weekends (P=0.003) or overnight (P<0.001). There were 177 early calls (27.1%) and 198 late calls (30.4%). Early calls involved younger patients (median ages, 67.5 years [early calls] v 73 years [late calls]; P= 0.01), fewer LOMTs (P=0.029), and lower in hospital mortality (12.8% [early calls] v 32.3% [late calls]; P<0.0001). The mortality difference remained in patients without LOMTs (5.6% [early calls] v 19.6% [late calls]; P=0.003).

Conclusions:
About one-quarter of RRT calls occurred shortly after hospital admission, and were more common when caregivers were around. Early calls may partially reflect suboptimal triage, though the associated mortality appeared low. Late calls may reflect suboptimal end-of-life care planning, and the associated mortality was high. There is a need to further assess the epidemiology of RRT calls at different phases of the hospital stay.

Reducing stress in the workplace

Exposure to workplace stressors is widespread and is related to a substantial fraction of common chronic diseases. However this is preventable. VicHealth’s Creating Healthy Workplaces program includes pilot projects to develop and test solutions to reduce job stress and prevent illness.

Potential of textile hemp in biomedical and composite applications

The fabrication of hemp fine powder was documented for the first time. The antibacterial properties of hemp powders and hemp plant extracts from textile hemp were investigated for the first time. Fabrication and characteristics of hemp powder blended polypropylene polymer composite filaments were investigated for the first time.

Rapid development of non-alcoholic steatohepatitis in Psammomys obesus (Israeli Sand Rat)

Background and AimsA major impediment to establishing new treatments for non-alcoholic steatohepatitis is the lack of suitable animal models that accurately mimic the biochemical and metabolic characteristics of the disease. The aim of this study was to explore a unique polygenic animal model of metabolic disease as a model of non-alcoholic steatohepatitis by determining the effects of 2% dietary cholesterol supplementation on metabolic and liver endpoints in Psammomys obesus (Israeli sand rat).MethodsP. obesus were provided ad libitum access to either a standard rodent diet (20% kcal/fat) or a standard rodent diet supplemented with 2% cholesterol (w/w) for 4 weeks. Histological sections of liver from animals on both diets were examined for key features of non-alcoholic steatohepatitis. The expression levels of key genes involved in hepatic lipid metabolism were measured by real-time PCR.ResultsP. obesus fed a cholesterol-supplemented diet exhibited profound hepatomegaly and steatosis, and higher plasma transaminase levels. Histological analysis identified extensive steatosis, inflammation, hepatocyte injury and fibrosis. Hepatic gene expression profiling revealed decreased expression of genes involved in delivery and uptake of lipids, and fatty acid and triglyceride synthesis, and increased expression of genes involved in very low density lipoprotein cholesterol synthesis, triglyceride and cholesterol export.ConclusionsP. obesus rapidly develop non-alcoholic steatohepatitis when fed a cholesterol-supplemented diet that appears to be histologically and mechanistically similar to patients.

Diabetes mellitus in the australian indigenous community

This report aims to investigate the higher prevalence of type 2 diabetes (T2D) among Indigenous Australians, with recommendations to Australians Health Professionals in order to increase awareness of Indigenous health peculiarities related to diabetes mellitus (DM). Diabetes has become one of the most common public health problems of the 21st century. The proportion of Aborigines Australians developing T2D is 5 to 10 times greater than non-Aborigines. Although DM in Aboriginal community is multifactorial, this report shows three perceived causes: (i) obesity and the "Thrifty Gene Hypothesis", (ii) geographical position and (iii) smoking. It concluded that the combination of these causes have increased the incidence of DM among Indigenous Australians. Therefore, the following are recommended: improvement of genetic research, improvement of medical facilities, and increased employment of Indigenous Health Professionals and improvement of anti-smoking policies.

Improving transfer of mental health care for rural and remote consumers in South Australia

In Australia, it is commonplace for tertiary mental health care to be provided in large regional centres or metropolitan cities. Rural and remote consumers must be transferred long distances, and this inevitably results in difficulties with the integration of their care between primary and tertiary settings. Because of the need to address these issues, and improve the transfer process, a research project was commissioned by a national government department to be conducted in South Australia. The aim of the project was to document the experiences of mental health consumers travelling from the country to the city for acute care and to make policy recommendations to improve transitions of care. Six purposively sampled case studies were conducted collecting data through semistructured interviews with consumers, country professional and occupational groups and tertiary providers. Data were analysed to produce themes for consumers, and country and tertiary mental healthcare providers. The study found that consumers saw transfer to the city for mental health care as beneficial in spite of the challenges of being transferred over long distances, while being very unwell, and of being separated from family and friends. Country care providers noted that the disjointed nature of the mental health system caused problems with key aspects of transfer of care including transport and information flow, and achieving integration between the primary and tertiary settings. Improving transfer of care involves overcoming the systemic barriers to integration and moving to a primary care-led model of care. The distance consultation and liaison model provided by the Rural and Remote Mental Health Services, the major tertiary provider of services for country consumers, uses a primary care-led approach and was highly regarded by research participants. Extending the use of this model to other primary mental healthcare providers and tertiary facilities will improve transfer of care.