Mild cognitive impairment in Aboriginal Australians.

Introduction: Aboriginal Australians have among the highest rates of dementia worldwide, yet no study has investigated the subtypes, risk factors, or longer term outcomes of mild cognitive impairment (MCI) in this population.

Methods: A total of 336 community-dwelling Aboriginal Australians aged ≥60 years participated in a longitudinal study, completing a structured interview at baseline. MCI (amnestic subtype, aMCI; non-amnestic subtype, naMCI) and dementia were diagnosed via cognitive screening, medical assessment, and clinical consensus.

Factors Associated with the High Prevalence of Dementia in Older Aboriginal Australians.

Dementia prevalence in Aboriginal and Torres Strait Islander Australians is three to five times higher than the general Australian population. A better understanding of the underlying biomedical and social risk factors is needed to guide dementia prevention in Aboriginal Australians. The current study is the first to examine potential risk factors for dementia in the majority urban and regional population, with a representative sample of 336 Aboriginal Australians aged 60 years and older.

Childhood Stress and Adversity is Associated with Late-Life Dementia in Aboriginal Australians.

Objectives: High rates of dementia have been observed in Aboriginal Australians. This study aimed to describe childhood stress in older Aboriginal Australians and to examine associations with late-life health and dementia.

Design: A cross-sectional study with a representative sample of community-dwelling older Aboriginal Australians.

A three-point time series study of antibiotic usage on an intensive care unit, following an antibiotic stewardship programme, after an outbreak of multi-resistant Acinetobacter baumannii.

Antibiotic use in intensive care units (ICUs) can promote antimicrobial resistance. Outbreaks of multi-resistant bacteria significantly affect patient outcomes and delivery of care. Antibiotic stewardship programmes (ASPs), combining root-cause analyses and multi-faceted prevention strategies, are necessary, often at significant cost and time.

A retrospective observational analysis to identify patient and treatment-related predictors of outcomes in a community mental health programme.

Objectives: This study aims to identify patient and treatment factors that affect clinical outcomes of community psychological therapy through the development of a predictive model using historic data from 2 services in London. In addition, the study aims to assess the completeness of data collection, explore how treatment outcomes are discriminated using current criteria for classifying recovery, and assess the feasibility and need for undertaking a future larger population analysis.

Design: Observational, retrospective discriminant analysis.

Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians.

Background: Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking.

Methods: In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus.

Prevalence of dementia in urban and regional Aboriginal Australians.

Background: This study aimed to determine the prevalence of dementia in collaboration with urban/regional Aboriginal communities.

Methods: A census of Aboriginal and Torres Strait Islander men and women aged 60 years and above in the target communities identified 546 potential participants, with 336 (61.5%) participating in this cross-sectional study.

The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians.

Background: Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians.

Improvement in out-of-hours outcomes following the implementation of Hospital at Night.

Background: Hospital at Night (H@N) is a Department of Health (England) driven programme being widely implemented across UK. It aims to redefine how medical cover is provided in hospitals during the out-of-hours period.

Aim: To investigate whether the implementation of H@N is associated with significant change in system or clinical outcomes.

Assessment of clinical risk in the out of hours hospital prior to the introduction of Hospital at Night.

Overnight medical cover in hospital is less than during daylight hours. We aimed to quantify the numbers of patients deteriorating overnight and their clinical outcome. Data was collected in real time on use of the Standardised Early Warning Score (SEWS), 'time to doctor', seniority of medical review and clinical outcome.

Correction for the adverse influence of sodium-potassium cotransport on apparent sodium-lithium countertransport activity in human erythrocytes.

Introduction: Erythrocyte sodium-lithium countertransporter (SLC) has traditionally been characterised as the sodium-stimulated lithium efflux from lithium-loaded erythrocytes. Concurrent activity of the sodium-potassium cotransporter (NKCC) can be expected to lead to imprecise estimates of the activity of the SLC. In the present study, we have characterised this methodological problem and have shown that it can be corrected with the inclusion of bumetanide in the physiological salt solution.

Long-term high-fat feeding leads to severe insulin resistance but not diabetes in Wistar rats.

Although lipid excess can impair beta-cell function in vitro, short-term high-fat feeding in normal rats produces insulin resistance but not hyperglycemia. This study examines the effect of long-term (10-mo) high polyunsaturated fat feeding on glucose tolerance in Wistar rats. The high fat-fed compared with the chow-fed group was 30% heavier and 60% fatter, with approximately doubled fasting hyperinsulinemia (P < 0.

Measurement of vitamin D3 metabolites in smelter workers exposed to lead and cadmium.

Objectives: To investigate the effects of lead and cadmium on the metabolic pathway of vitamin D3.

Methods: Blood and urinary cadmium and urinary total proteins were measured in 59 smelter workers occupationally exposed to lead and cadmium. In 19 of these workers, the plasma vitamin D3 metabolites, (25-hydroxycholecalciferol (25 OHD3), 24R, 25-dihydroxycholecalciferol (24R,25(OH)2D3) and 1 alpha,25-dihydroxycholecalciferol (1 alpha, 25(OH)2D3)) were measured together with blood lead.

Five-hour fatty acid elevation increases muscle lipids and impairs glycogen synthesis in the rat.

Insulin-mediated muscle glycogen synthesis is impaired after several weeks of high-fat feeding in rats, but not by short-term (2-hour) nonesterified fatty acids (NEFA) elevation induced by intravenous triglyceride/heparin infusion (TG/H). We examined whether a longer TG/H infusion induces defective glycogen synthesis. Five-hour hyperinsulinemic (700 pmol/L) euglycemic clamps with either TG/H or saline infusion were performed.

Blood lead in U.K. children--time for a lower action level?

1. Blood lead measurements in samples collected from 660 London schoolchildren during 1991 to 1992 suggest that the blood lead values in children in the U.K.

NEFA elevation during a hyperglycaemic clamp enhances insulin secretion.

Elevated non-esterified fatty acid (NEFA) levels may influence insulin secretion and contribute to the development of Type 2 DM. We investigated the effects of acute NEFA elevation in controls (n = 6) and subjects predisposed to Type 2 DM (n = 6) on basal insulin levels, and following glucose and arginine stimulation. Each subject had one study with a triglyceride (TG) plus heparin infusion (elevated NEFA levels) and another with normal saline.

Rat amylin-(8-37) enhances insulin action and alters lipid metabolism in normal and insulin-resistant rats.

To clarify roles of amylin, we investigated metabolic responses to rat amylin-(8-37), a specific amylin antagonist, in normal and insulin-resistant, human growth hormone (hGH)-infused rats. Fasting conscious rats were infused with saline or hGH, each with and without amylin-(8-37) (0.125 mumol/h), over 5.

Cushing's syndrome from an inhaled glucocorticoid.

Objective: To report a case of significant systemic side effects from an inhaled glucocorticoid at a reported dose in the upper recommended therapeutic range.

Clinical Features: A 25-year-old white man with asthma treated with inhaled glucocorticoid (beclomethasone 1500 micrograms daily), and primary testicular failure with inadequate androgen replacement, was referred with back pain. He was found to have osteoporosis, clinical features of Cushing's syndrome and complete suppression of endogenous adrenocorticotrophic hormone adrenal function.

Dietary intake of Al, Ca, Cu, Fe, Pb, and Zn in infants.

The dietary intake of six elements--Al, Ca, Cu, Fe, Pb, and Zn--was measured in 39 normal healthy children aged 17-61 (mean 35.5) weeks. There was a downward trend with age in daily intake of fluid, Pb and Fe, in contrast to an increase in solid intake, Ca and Zn throughout the study.

The use of microfilters as an alternative to centrifugation in radioimmunoassay.

A microfilter was designed, together with a mechanical filtration apparatus for the separation of "antibody-bound" and "free" antigen in radioimmunoassay. A comparison of the results obtained using both filtration and centrifugation was carried out and the optimum incubation times, reaction conditions and washing volume for use with the microfilter were studied. The use of microfilters in radioimmunoassay gave reproducible results and offered a convenient means of automating the separation procedure.

Hormonal pattern of relapse in hyperthyroidism.

22 patients with Grave's disease were followed up for up to a year after antithyroid drug therapy was discontinued. Clinical assessment and serum T3, T4, and thyroid-stimulating-hormone (T.S.