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Experiencing traumatic life events is associated with an increased risk of common mental disorders (CMDs), but studies investigating this association within Indigenous populations are limited.
The aim of this study was to investigate associations between trauma and CMDs after controlling for other exposures.
Trauma exposures and CMD diagnoses were determined in a broadly representative sample of 544 Indigenous Australians, using a diagnostic clinical interview. Associations were determined by multivariate logistic regression.
Trauma exposure independently predicted CMDs. After adjustment for potential confounders, trauma exposure was associated with a 4.01-fold increased risk of a diagnosis of a CMD in the past 12 months. The increased risks were 4.38-, 2.65- and 2.78-fold of having an anxiety disorder, mood disorder or a substance use disorder, respectively. Trauma exposure and comorbid post-traumatic stress disorder was associated with a 4.53-fold increased risk of a diagnosis of a mood disorder, 2.47-fold increased risk of a diagnosis of a substance use disorder, and 3.58-fold increased risk of any diagnosis of a CMD, in the past 12 months. Experiencing both sexual and physical violence was associated with a 4.98-fold increased risk of a diagnosis of an anxiety disorder in the past 12 months.
Indigenous Australians experience significantly increased exposure to potentially harmful trauma compared with non-Indigenous Australians. Preventing and healing trauma exposure is paramount to reduce the high burden of CMDs in this population.
We have previously argued that the 2008 global financial and economic crisis was a clear manifestation of an unstable and contradictory world characterized by a disjunction between (1) massive economic growth and unprecedented advances in science, technology, and medical care and (2) the widening of disparities in wealth and health within and between nations. We also argued that the global financial crisis was much more than a crisis of capitalist accumulation or a necessary self-correction aided by macroeconomic intervention and bailouts.
In Chapter 18, we outlined a reading of the present global conjuncture that we characterized as one of organic crisis. The term was meant to invoke a paradoxical situation, one pregnant with possibilities for alternative ways in which global health might be improved, yet nevertheless a situation in which new alternatives have yet to emerge or indeed to be born.
Spectacular progress, both intellectual and material, has been achieved through the Enlightenment notion of the centrality of the individual and the supremacy of science and technology in advancing health and healthcare practices. The modern Western belief system and its frames for global thinking that have now become powerful worldwide are succinctly characterized by an individualistic, self-determining, and rights-bearing concept of being; an epistemological framework that centers on abstract thinking, objectivity in observation, logical reasoning processes, verifiable knowledge, and a positivist version of the scientific method; and moral and political values of autonomy supportive of individual rights. Scientific and technological progress and diverse socioeconomic systems contributed to fostering great “accelerations” in the scale of production, consumption, communication, and transportation that in particular since 1945 have improved the duration and quality of life for many people.
OBJECTIVES/SPECIFIC AIMS: Evaluate the effect of multijoint functional electrical stimulation (FES) on energy consumption during post-stroke walking. METHODS/STUDY POPULATION: A 67-year-old male with chronic stroke was implanted with an 8-channel implanted pulse generator to stimulate flexor and extensor muscles of the hip, knee, and ankle. Oxygen consumption was measured with a k2b4 portable pulmonary gas analyzer during walking with and without FES assistance. Data were analyzed during steady state oxygen consumption within the last 2 minutes of a 5 minute walk. Distance and walking speed were also measured. RESULTS/ANTICIPATED RESULTS: Electrical stimulation increased walking speed from 0.29 to 0.64 minute/second. Faster walking corresponded with increased oxygen consumption from 10.1 to 14.4 mL O2/kg per minute. Energy cost, consumption as a function of distance, decreased from 3.7 to 2.9 mL O2/kg per minute walking with stimulation compared with without. DISCUSSION/SIGNIFICANCE OF IMPACT: These preliminary data suggest improvements in walking speed with FES are accompanied by increased energy consumption and decreased energy cost. Oxygen consumption during FES assisted walking was <50% of the peak for able bodied individuals of similar age; patients may successfully use the system for community ambulation.
Remains of a coelacanth specimen are described from Rhaetian deposits of the Var Department, southeastern France. They comprise the lower part of a branchial apparatus associated with a left lower jaw and a basisphenoid. Osteological features of the angular and basisphenoid and the teeth ornamentation allow the inclusion of the specimen in the mawsoniid family, genus and species indeterminate. Mawsoniids are known in freshwater environments from the Triassic of North America and from the Cretaceous of Western Gondwana and Europe, as well as from Late Jurassic marine environments from Europe. The new discovery here reported represents the first coelacanth from the marine Triassic of France and improves the understanding of the palaeobiogeography of the Mawsoniidae.
Sediments deposited from the Permian–Triassic boundary (~252 Ma) until the end-Smithian (Early Triassic; c. 250.7 Ma) in the Sonoma Foreland Basin show marked thickness variations between its southern (up to c. 250 m thick) and northern (up to c. 550 m thick) parts. This basin formed as a flexural response to the emplacement of the Golconda Allochthon during the Sonoma orogeny. Using a high-resolution backstripping approach, a numerical model and sediment thickness to obtain a quantitative subsidence analysis, we discuss the controlling factor(s) responsible for spatial variations in thickness. We show that sedimentary overload is not sufficient to explain the significant discrepancy observed in the sedimentary record of the basin. We argue that the inherited rheological properties of the basement terranes and spatial heterogeneity of the allochthon are of paramount importance in controlling the subsidence and thickness spatial distribution across the Sonoma Foreland Basin.
In this paper, a unique dataset of improvised explosive device attacks during “The Troubles” in Northern Ireland (NI) is analysed via a Hawkes process model. It is found that this past dependent model is a good fit to improvised explosive device attacks yielding key insights about the nature of terrorism in NI. We also present a novel approach to quantitatively investigate some of the sociological theory surrounding the Provisional Irish Republican Army which challenges previously held assumptions concerning changes seen in the organisation. Finally, we extend our use of the Hawkes process model by considering a multidimensional version which permits both self and mutual-excitations. This allows us to test how the Provisional Irish Republican Army responded to past improvised explosive device attacks on different geographical scales from which we find evidence for the autonomy of the organisation over the six counties of NI and Belfast. By incorporating a second dataset concerning British Security Force (BSF) interventions, the multidimensional model allows us to test counter-terrorism (CT) operations in NI where we find subsequent increases in violence.
To determine if total lifetime physical activity (PA) is associated with better cognitive functioning with aging and if cerebrovascular function mediates this association. A sample of 226 (52.2% female) community dwelling middle-aged and older adults (66.5±6.4 years) in the Brain in Motion Study, completed the Lifetime Total Physical Activity Questionnaire and underwent neuropsychological and cerebrovascular blood flow testing. Multiple robust linear regressions were used to model the associations between lifetime PA and global cognition after adjusting for age, sex, North American Adult Reading Test results (i.e., an estimate of premorbid intellectual ability), maximal aerobic capacity, body mass index and interactions between age, sex, and lifetime PA. Mediation analysis assessed the effect of cerebrovascular measures on the association between lifetime PA and global cognition. Post hoc analyses assessed past year PA and current fitness levels relation to global cognition and cerebrovascular measures. Better global cognitive performance was associated with higher lifetime PA (p=.045), recreational PA (p=.021), and vigorous intensity PA (p=.004), PA between the ages of 0 and 20 years (p=.036), and between the ages of 21 and 35 years (p<.0001). Cerebrovascular measures did not mediate the association between PA and global cognition scores (p>.5), but partially mediated the relation between current fitness and global cognition. This study revealed significant associations between higher levels of PA (i.e., total lifetime, recreational, vigorous PA, and past year) and better cognitive function in later life. Current fitness levels relation to cognitive function may be partially mediated through current cerebrovascular function. (JINS, 2015, 21, 816–830)
Background: “Stress Control” (SC) has been adopted as a core intervention in step 2 of Improving Access to Psychological Therapies (IAPT) services, but contemporary evidence of effectiveness has lagged behind service uptake. Aims: To investigate the acceptability and effectiveness of SC and to explore moderators of outcome. Method: Analysis of acceptability (via attendance rates) and effectiveness (via IAPT minimum dataset). Results: SC was well tolerated with 73.3% of all patients and 75.4% of “clinical cases” attending three or more sessions. Of the 546 “clinical cases” attending SC and not in receipt of other interventions, 37% moved to recovery. Attendance improved outcome; for those patients attending all SC sessions the recovery rate rose to 59.2%. Conclusion: SC appears a well-tolerated and effective intervention that enables large numbers to gain access to treatment in an organizationally efficient manner. Attendance is important in facilitating SC outcomes and research evaluating attendance interventions are needed.
Agitation in dementia is common, persistent and distressing and can lead to care breakdown. Medication is often ineffective and harmful.
To systematically review randomised controlled trial evidence regarding non-pharmacological interventions.
We reviewed 33 studies fitting predetermined criteria, assessed their validity and calculated standardised effect sizes (SES).
Person-centred care, communication skills training and adapted dementia care mapping decreased symptomatic and severe agitation in care homes immediately (SES range 0.3–1.8) and for up to 6 months afterwards (SES range 0.2–2.2). Activities and music therapy by protocol (SES range 0.5–0.6) decreased overall agitation and sensory intervention decreased clinically significant agitation immediately. Aromatherapy and light therapy did not demonstrate efficacy.
There are evidence-based strategies for care homes. Future interventions should focus on consistent and long-term implementation through staff training. Further research is needed for people living in their own homes.
Part II of the volume outlines some of the origins, purposes and forms of authority and power associated with liberal constitutions and world orders. The two chapters help illuminate what is ‘old’ and ‘new’ in the emerging new constitutional world order. They illustrate how historical struggles have forged dominant patterns of political authority and are now restructuring the global order. The main themes of Part II involve:
The genealogy of liberal constitutionalism, particularly that of the United States.
How liberal constitutionalism can be understood as a form of insurance on the part of dominant forces against threats to their power, privilege and property, stemming from popular and democratic forces.
The recent global convergence toward constitutional supremacy in light of the rapid spread of democratic politics.
Chapter 5 by Tim Di Muzio suggests that a deeper appreciation of historical struggles over the constitution of liberal political authority helps us to identify the links between what is ‘old’ and what is ‘new’ in the new constitutionalism. In mainstream political science, liberal constitutionalism is often deemed the most desirable framework for promoting material advancement and human freedom while circumscribing arbitrary, unjust and absolute rule. Di Muzio argues, however, that this conventional wisdom disregards how US constitutionalism was developed by a class-based political project that attempted to safeguard and legitimate an empire of liberty for an afl uent minority and forms of domination for the rest. Di Muzio’s genealogical enquiry focuses on key concepts in the political order of the West since at least the seventeenth century, and specifically how US colonial elites understood liberty, property and security during the American Revolutionary War and the subsequent constitutional settlement.
Part IV seeks to explore how the new constitutionalism of disciplinary neo-liberalism has reshaped the global regimes on investment, trade and taxation. It outlines how neo-liberal restructuring of these regimes – despite contradictions and crises – is intensifying in ways that are driven by, and that tend to reinforce, the direct and structural power of capital. The five main themes in Part IV are:
The globalization of capital-exporting legal norms.
The expansion of market-based investment disciplines and agreements.
Challenges for public service provision and environmental regulation in light of these neo-liberal arrangements.
Prospects for the post-global economic crisis political economy of taxation.
Prospects for alternative forms of governance of the investment, trade and tax regimes.
Part V addresses the general question: how far and in what ways has the emergent global extension of neo-liberal market civilization, locked in by new constitutional mechanisms, reconstituted some of our basic socioeconomic and ecological conditions of existence? The contributions explore how restructuring of these conditions amidst ongoing crises has deepened contradictions, inequalities and insecurities, and raised fundamental concerns over social reproduction and ecological sustainability, provoking new patterns of resistance and challenges to disciplinary neo-liberalism. The principal themes of Part V are:
How – in the context of global organic crisis and the intensification of social inequalities – the restructuring of systems of social reproduction is linked to more ‘regressive’ and unjust tax systems in ways that are generating significant constraints on expenditures for health and care, welfare and education (‘fiscal squeeze’), developments that are partly the result of the global extension of new constitutional measures.
How the proliferation of private debt in the United States relates to the erosion of welfare and transformations in social reproduction, and how in response the US legal apparatus has strengthened coercive governance via criminalization and incarceration of debtors.
How, nevertheless, new ‘constitutions’ of the social emerge in complex, variegated and uneven ways through neo-liberalization processes.
How the current global financial crisis impacts on social policy regimes.
How the tension between neo-liberal new constitutionalism and the ethical-normative principles required for sustainable and just ecological governance, especially in light of climate change, is posing urgent threats to humanity.