Traumatic injury and dementia in New Zealand : a Palmerston North Hospital case-control study : a thesis presented in partial fulfilment of the requirements for the degree of Masters of Health Science in Psychology at Massey University, Palmerston North, New Zealand

Little is known about the relationship between traumatic injury (TI) and dementia. The increasing prevalence of both conditions in the world and in New Zealand (NZ) drove the Author to want to investigate whether the pathophysiological consequences of major trauma of any kind - mostly due to falls in the dementia population - and not just traumatic brain injury (TBI), may result in dementia. Both TI and dementia constitute major health and socio-economic problems contributing to long-term disability worldwide and have important implications for health service delivery and for medico-legal compensation issues. The first specific objective was to determine whether dementia was associated with an increased risk and incidence of trauma in the past and whether such an association might be explained by the injuries or by medical comorbidities. The second specific objective was to identify whether there were any differences in the mechanisms of injury and type of discharge from hospital between cases and controls. The research was a non-experimental, retrospective, hospital-based, case-control study. Cases and controls were selected from the Palmerston North Hospital (PNH) acute admissions database and were matched in terms of exposure to traumatic injury, sex, age, ethnicity, and recorded comordibites. Statistical and epidemiological analyses were done using RaosoftR and MedCalcR softwares. All medical conditions were operationally defined using the current World Health Organization’s International Classification of Diseases (ICD-10). The results showed that a history of TI was more frequently found in cases with dementia than in the controls. Patients with dementia and TI were more likely to have preexisting comorbidities and were more unlikely to be discharged to their previous habitual residence. The findings strongly indicate that the brain is affected by the way the body responds to TI both locally and systemically. The conclusion was that the direct and indirect consequences of TI, mostly due to falls, could constitute a plausible risk factor for the development or progression of dementia but that further research is needed to assess what type of trauma and what type of dementia could be involved in the association, one that is likely to be multifactorial in the elderly population

Academic Domains As Political Battlegrounds: A Global Enquiry By 99 Academics in The Fields of Education and Technology

This article theorizes the functional relationship between the human components (i.e., scholars) and non-human components (i.e., structural configurations) of academic domains. It is organized around the following question: in what ways have scholars formed and been formed by the structural configurations of their academic domain? The article uses as a case study the academic domain of education and technology to examine this question. Its authorship approach is innovative, with a worldwide collection of academics (99 authors) collaborating to address the proposed question based on their reflections on daily social and academic practices. This collaboration followed a three-round process of contributions via email. Analysis of these scholars' reflective accounts was carried out, and a theoretical proposition was established from this analysis. The proposition is of a mutual (yet not necessarily balanced) power (and therefore political) relationship between the human and non-human constituents of an academic realm, with the two shaping one another. One implication of this proposition is that these non-human elements exist as political actors', just like their human counterparts, having agency' - which they exercise over humans. This turns academic domains into political (functional or dysfunctional) battlefields' wherein both humans and non-humans engage in political activities and actions that form the identity of the academic domain. For more information about the authorship approach, please see Al Lily AEA (2015) A crowd-authoring project on the scholarship of educational technology. Information Development. doi: 10.1177/0266666915622044.Wo

Rationale, design, and baseline characteristics in Evaluation of LIXisenatide in Acute Coronary Syndrome, a long-term cardiovascular end point trial of lixisenatide versus placebo

BACKGROUND: Cardiovascular (CV) disease is the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Furthermore, patients with T2DM and acute coronary syndrome (ACS) have a particularly high risk of CV events. The glucagon-like peptide 1 receptor agonist, lixisenatide, improves glycemia, but its effects on CV events have not been thoroughly evaluated. METHODS: ELIXA (www.clinicaltrials.gov no. NCT01147250) is a randomized, double-blind, placebo-controlled, parallel-group, multicenter study of lixisenatide in patients with T2DM and a recent ACS event. The primary aim is to evaluate the effects of lixisenatide on CV morbidity and mortality in a population at high CV risk. The primary efficacy end point is a composite of time to CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for unstable angina. Data are systematically collected for safety outcomes, including hypoglycemia, pancreatitis, and malignancy. RESULTS: Enrollment began in July 2010 and ended in August 2013; 6,068 patients from 49 countries were randomized. Of these, 69% are men and 75% are white; at baseline, the mean ± SD age was 60.3 ± 9.7 years, body mass index was 30.2 ± 5.7 kg/m(2), and duration of T2DM was 9.3 ± 8.2 years. The qualifying ACS was a myocardial infarction in 83% and unstable angina in 17%. The study will continue until the positive adjudication of the protocol-specified number of primary CV events. CONCLUSION: ELIXA will be the first trial to report the safety and efficacy of a glucagon-like peptide 1 receptor agonist in people with T2DM and high CV event risk