Objective: To assess the sustainability and effectiveness of a community-directed program for primary and secondary prevention of obesity, diabetes and cardiovascular disease in an Aboriginal community in north-west Western Australia. Method: Evaluation of health outcomes (body mass index, glucose tolerance, and plasma insulin and triglyceride concentrations) in a cohort of high-risk individuals (n=49, followed over two years) and cross-sectional community samples (n=200 at baseline, 185 at two-year and 132 at four-year follow-ups), process (interventions and their implementation) and impact (diet and exercise behaviour).

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Objective. Rheumatoid arthritis (RA) is associated with increased rates of cardiovascular disease. Reduced small artery elasticity (SAE) and large artery elasticity (LAE) and increased systemic vascular resistance (SVR) have been found in other high-risk groups. In the present study, we sought to determine whether arterial elasticity was reduced and SVR was increased in RA patients compared with controls matched for coronary artery disease (CAD) status, and to relate the results to vascular disease risk factors, including measures of inflammation.Methods. Arterial elasticity was assessed by pulse wave analysis in RA patients with (n ‫؍‬ 15) and without (n ‫؍‬ 38) CAD, and in controls matched 1:1 for age, sex, and CAD status. Vascular risk factors, including highsensitivity C-reactive protein (hsCRP), soluble vascular cell adhesion molecule 1 (sVCAM-1), and serum amyloid A (SAA) levels, were assessed.Results. SAE and LAE were significantly lower and SVR was significantly higher in RA patients than in controls. RA patients also had higher levels of hsCRP, SAA, and sVCAM-1. SAE and LAE values were inversely correlated with markers of inflammation. Associations of SAE and LAE with RA were independent of conventional risk factors, but were dependent on markers of inflammation.Conclusion. Vascular function is abnormal in RA, with reduced SAE and LAE and increased SVR relative to controls. Arterial elasticity is inversely associated with measures of inflammation. These measures may be clinically useful in the detection and monitoring of vascular disease in RA.

This community-directed dietary intervention program reduced the prevalence of coronary heart disease risk factors related to diet.

BMI-specific diabetes incidence rates in Australian aboriginal people are among the highest in the world. Diabetes incidence in the lowest BMI category (10.7 cases/1,000 person-years) is two to five times greater than corresponding rates for non-aboriginal populations. An urgent need exists to prevent weight gain associated with diabetes. Further study is required to determine for aboriginal people an optimal range of BMI, likely lower than that suggested for non-aboriginal populations.

Objective: To document change in prevalence of obesity, diabetes and other cardiovascular diease (CVD) risk factors, and trends in dietary macronutrient intake, over an eight-year period in a rural Aboriginal community in central Australia.Design: Sequential cross-sectional community surveys in 1987, 1991 and 1995. Subjects: All adults (15 years and over) in the community were invited to participate. In 1987In , 1991 (87% of eligible adults), 331 (76%) and 304 (68%), respectively, were surveyed.Main outcome measures: Body mass index and waist: hip ratio; blood glucose level and glucose tolerance; fasting total and high density lipoprotein (HDL) cholesterol and triglyceride levels; and apparent dietary intake (estimated by the store turnover method).Intervention: A community-based nutrition awareness and healthy lifestyle program, 1988-1990.Results: At the eight-year follow-up, the odds ratios (95% Cis) for CVD risk factors relative to baseline were obesity, 1.84 (1.28-2.66); diabetes, 1.83 (1.11-3.03); hypercholesterolaemia, 0.29 (0.2CH>.42); and dyslipidaemia (high triglyceride plus low HDL cholesterol level), 4.54 (2.84-7.29). In younger women (15-24 years), there was a trebling in obesity prevalence and a four-to fivefold increase in diabetes prevalence. Store turnover data suggested a relative reduction in the consumption of refined carbohydrates and saturated fats. Conclusion:Interventions targeting nutritional factors alone are unlikely to greatly alter trends towards increasing prevalences of obesity and diabetes. In communities where healthy food choices are limited, the role of regular physical activity in improving metabolic fitness may also need to be emphasised.

SummaryThe present study examined the degree to which specific probabilistic biases (misperception of chance and conjunction fallacy) were associated with belief in the paranormal and proneness to reality testing (RT) deficits. Participants completed measures assessing probabilistic reasoning, belief in the paranormal and RT. Perception of randomness predicted the level of paranormal belief and proneness to RT deficits. These results provide support for the notion that paranormal believers demonstrate greater misrepresentation of chance. With regard to conjunction, a framing effect occurred. Problems presented in a paranormal context correlated negatively with the level of paranormal belief and proneness to RT deficits. Copyright © 2014 John Wiley & Sons, Ltd.

In Type 1 diabetes, serum PEDF levels are associated with microvascular complications, poor vascular health, hyperglycaemia, adiposity and inflammation.