The nature and purposes of advocacy for people with disabilities

Although all human beings experience vulnerability, people with disabilities experience heightened vulnerability. For some people, the consequences of this heightened vulnerability may include social devaluation, physical and social rejection, a loss of control over important areas of their lives and brutalisation. Advocacy is one vital response to vulnerability and its consequences. This monograph presents the results of the National Advocacy Research Project which involved an analysis of the status of advocacy for people with disabilities within Australia and provides direction for the future development of advocacy nationally. The monograph explicates the need for and the purposes of advocacy for people with disabilities and provides an account of the fundamental principles which underpin effective advocacy. It analyses the key issues which are facing Australian advocacy efforts and finally presents a list of recommendations which relate to the future development of advocacy within Australia

Trust But Verify, Don't Disregard the Simplex Answer: An Uncommon Presentation of Herpes Simplex Encephalitis

Introduction: Herpes simplex virus type 1 encephalitis is the most common cause of sporadic fatal encephalitis worldwide. Typical presentation includes fever, altered mental status, focal cranial nerve deficits, and seizures. Diagnosis is confirmed by polymerase chain reaction of CSF with very high sensitivity of 98% and specificity of 94% .Atypical symptoms include urinary and fecal incontinence, aseptic meningitis, Guillan-Barre syndrome, amnesia, Kluver-Bucy syndrome, and hypomania. This case demonstrates syncope secondary to sinoatrial dysfunction as an atypical presenting symptom. Case Description: A 50 year old male with a past medical history of childhood traumatic brain injury and hepatitis B on Entecavir presented to the hospital after new onset syncopal episodes. On exam he was afebrile and tachycardic. WBC count was 14,000, , K+ 2.8, and lactate 3.7. Antibiotics were briefly initiated but not continued due to lack of source. Potassium was replaced and patient was preparing for discharge when another syncopal event occurred. Telemetry showed sinus pauses greater than 10 seconds. Electrophysiology was consulted and performed heart catheterization and pacemaker placement. The next day he developed fever of 39.2 C, altered mental status, and seizure. He was transferred to the ICU and started on broad spectrum antibiotics and acyclovir. Electroencephalography showed left frontotemporal epileptogenicity and CTA and CT head were noncontributory. Lumbar puncture had normal cytology, negative PCR for herpes and echoviruses, and negative antibodies for flaviviridae. Acyclovir was discontinued, antiepileptic medication started, and antibiotics were changed to rule out drug fever. Fevers up to 40 degrees continued despite thorough source investigation and advanced cooling efforts. A second lumbar puncture was competed which showed lymphocytic pleocytosis and a CT head with contrast showed a new enhancing focus of the mesial left temporal lobe. Despite negative culture data, our clinical suspicion remained very high for herpes encephalitis so acyclovir was then restarted. Several days later culture data from both spinal fluid samples became positive for herpes simplex 1. His fever broke, he showed clinical improvement on antiretroviral therapy, and he was discharged home several days later in stable condition. Discussion: In this case, the patient presented with syncope and then developed typical findings of HSV1 encephalitis but the misleading negative HSV PCR led to disregarding the correct diagnosis. This resulted in a delay in care until unsurmountable evidence forced a clinical diagnosis which was then later reinforced by corrected objective data. Herpes Simplex Virus 1 has been known to precipitate encephalopathy and seizures but significant viral load causing sinoatrial conduction abnormalities is less described. It is thought that SA node dysfunction is secondary to autonomic dysfunction in the central nervous system rather than myocardial involvement evidenced by autopsy examination. Be aware of atypical presentations of HSV encephalitis as well as the potential for clinical and laboratory disparity in order to not miss this life-threatening illness

The Role of High-Density Lipoproteins in Reducing the Risk of Vascular Diseases, Neurogenerative Disorders, and Cancer

High-density lipoprotein (HDL) is one of the major carriers of cholesterol in the blood. It attracts particular attention because, in contrast with other lipoproteins, as many physiological functions of HDL influence the cardiovascular system in favourable ways unless HDL is modified pathologically. The functions of HDL that have recently attracted attention include anti-inflammatory and anti-oxidant activities. High anti-oxidant and anti-inflammatory activities of HDL are associated with protection from cardiovascular disease. Atheroprotective activities, as well as a functional deficiency of HDL, ultimately depend on the protein and lipid composition of HDL. Further, numerous epidemiological studies have shown a protective association between HDL-cholesterol and cognitive impairment. Oxidative stress, including lipid peroxidation, has been shown to be the mediator of the pathologic effects of numerous risk factors of Alzheimer's disease. Lifestyle interventions proven to increase HDL- cholesterol levels including “healthy” diet, regular exercise, weight control, and smoking cessation have also been shown to provide neuro-protective effects. This review will focus on current knowledge of the beneficial effects of HDL-cholesterol as it relates to cardiovascular diseases, breast and lung cancers, non-Hodgkin's lymphoma, as well as its neuroprotective potential in reducing the risk of Alzheimer's disease and dementia

The Maine Annex, vol. 2, no. 19

Following World War II, the federal G.I. Bill enabled approximately 2.3 million, predominantly white male Veterans to receive a post-secondary education. To accommodate increased enrollment in 1946, the University of Maine established the Brunswick Campus at the former Brunswick Naval Air Station. The remote campus operated until spring 1949, when Veteran registrations waned

Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes

<p>Abstract</p> <p>Background</p> <p>Yoga has been shown to be a simple and economical therapeutic modality that may be considered as a beneficial adjuvant for type 2 diabetes mellitus. This study investigated the impact of Hatha yoga and conventional physical training (PT) exercise regimens on biochemical, oxidative stress indicators and oxidant status in patients with type 2 diabetes.</p> <p>Methods</p> <p>This prospective randomized study consisted of 77 type 2 diabetic patients in the Hatha yoga exercise group that were matched with a similar number of type 2 diabetic patients in the conventional PT exercise and control groups. Biochemical parameters such as fasting blood glucose (FBG), serum total cholesterol (TC), triglycerides, low-density lipoprotein (LDL), very low-density lipoproteins (VLDL) and high-density lipoprotein (HDL) were determined at baseline and at two consecutive three monthly intervals. The oxidative stress indicators (malondialdehyde – MDA, protein oxidation – POX, phospholipase A2 – PLA2 activity) and oxidative status [superoxide dismutase (SOD) and catalase activities] were measured.</p> <p>Results</p> <p>The concentrations of FBG in the Hatha yoga and conventional PT exercise groups after six months decreased by 29.48% and 27.43% respectively (P < 0.0001) and there was a significant reduction in serum TC in both groups (P < 0.0001). The concentrations of VLDL in the managed groups after six months differed significantly from baseline values (P = 0.036). Lipid peroxidation as indicated by MDA significantly decreased by 19.9% and 18.1% in the Hatha yoga and conventional PT exercise groups respectively (P < 0.0001); whilst the activity of SOD significantly increased by 24.08% and 20.18% respectively (P = 0.031). There was no significant difference in the baseline and 6 months activities of PLA2 and catalase after six months although the latter increased by 13.68% and 13.19% in the Hatha yoga and conventional PT exercise groups respectively (P = 0.144).</p> <p>Conclusion</p> <p>The study demonstrate the efficacy of Hatha yoga exercise on fasting blood glucose, lipid profile, oxidative stress markers and antioxidant status in patients with type 2 diabetes and suggest that Hatha yoga exercise and conventional PT exercise may have therapeutic preventative and protective effects on diabetes mellitus by decreasing oxidative stress and improving antioxidant status.</p> <p>Trial Registration</p> <p>Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12608000217303</p

Large-Scale Gene-Centric Meta-Analysis across 39 Studies Identifies Type 2 Diabetes Loci

To identify genetic factors contributing to type 2 diabetes (T2D), we performed large-scale meta-analyses by using a custom similar to 50,000 SNP genotyping array (the ITMAT-Broad-CARe array) with similar to 2000 candidate genes in 39 multiethnic population-based studies, case-control studies, and clinical trials totaling 17,418 cases and 70,298 controls. First, meta-analysis of 25 studies comprising 14,073 cases and 57,489 controls of European descent confirmed eight established T2D loci at genome-wide significance. In silico follow-up analysis of putative association signals found in independent genome-wide association studies (including 8,130 cases and 38,987 controls) performed by the DIAGRAM consortium identified a T2D locus at genome-wide significance (GATAD2A/CILP2/PBX4; p = 5.7 x 10(-9)) and two loci exceeding study-wide significance (SREBF1, and TH/INS; p <2.4 x 10(-6)). Second, meta-analyses of 1,986 cases and 7,695 controls from eight African-American studies identified study-wide-significant (p = 2.4 x 10(-7)) variants in HMGA2 and replicated variants in TCF7L2 (p = 5.1 x 10(-15)). Third, conditional analysis revealed multiple known and novel independent signals within five T2D-associated genes in samples of European ancestry and within HMGA2 in African-American samples. Fourth, a multiethnic meta-analysis of all 39 studies identified T2D-associated variants in BCL2 (p = 2.1 x 10(-8)). Finally, a composite genetic score of SNPs from new and established T2D signals was significantly associated with increased risk of diabetes in African-American, Hispanic, and Asian populations. In summary, large-scale meta-analysis involving a dense gene-centric approach has uncovered additional loci and variants that contribute to T2D risk and suggests substantial overlap of T2D association signals across multiple ethnic groups

The violent frontline: space, ethnicity and confronting the state in Edwardian Spitalfields and 1980s Brixton

This article discusses in comparative terms the relationship between space, ethnic identity, subaltern status and anti-state violence in twentieth century London. It does so by comparing two examples in which the control of the state, as represented by the Metropolitan Police, was challenged by minority groups through physical force. It will examine the Spitalfields riots of 1906, which began as strike action by predominantly Jewish bakers and escalated into a general confrontation between the local population and the police, and the Brixton riots of 1981, a response to endemic police harassment of mainly Caribbean youth and long-term economic discrimination in that area of South London. It will begin by dissecting the association of physical metropolitan space with the diasporic ‘other’ in the Edwardian East End and post-consensus South London, and how this ‘othering’ was influenced both by the state and the anti-migrant far right. It will then interrogate the difficult relationship between the Metropolitan Police and Jewish and Caribbean working class communities, and how this deteriorating relationship exploded into in extreme violence in 1906 and 1981. The article will conclude by assessing how the relationships between space, identity and violence influenced long-term national and communal narratives of Jewish and Caribbean interactions with the British state

Shell Egg Processing Plant Design

Excerpt from the report Summary: Materials-handling systems and associated equipment are suggested, for various production rates, for egg grading and packing plants that handle a volume ranging from 1,000 to 5,000 cases per week. Nomograms designed to determine exact storage space requirements for various inventory situations are illustrated, and their use, under a specific situation, is discussed. Equipment layouts for the processing area, involving equipment designed for specified production rates, are illustrated with appropriate flow lines for product and materials. Placement of areas auxiliary to the processing and storage areas to provide for economic operation, space utilization, plant construction, and expandability are explained and illustrated. Construction detail of an example design is illustrated by detailed plan drawings that are explained

Lipid Profile of Type 2 Diabetic and Hypertensive Patients in the Jamaican Population

Aims : Previous studies have shown that diabetes mellitus (DM) increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods : The study included 107 type 2 diabetic patients (41 males and 66 females), and 122 hypertensive type 2 diabetic patients (39 males and 83 females), aged 15 years and older. Total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), very low density lipoprotein-cholesterol (VLDL-C) and high density lipoprotein-cholesterol (HDL-C) concentrations were assayed for each group using standard biochemical methods. Results : The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05). Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L) than hypertensive non-diabetic males (5.76±1.57 mmol/L; P < 0.05). All the other lipid and lipoprotein parameters except HDL-C were non-significantly higher in females with type 2 DM and those with hypertension and type 2 DM, compared with type 2 diabetic and hypertensive type 2 diabetic males, respectively (P > 0.05). Conclusion : This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males