Is hyperinsulinemia a possible clinical explanation underlying the myth of Erysichthon?

BACKGROUND

An insulinoma is an endocrine tumor of the pancreas, originating from the beta cells, and has a prevalence of 4 cases per 1 million patients. Insulinomas often follow a "90% rule": 90% are benign [1, 2], 90% originate in the pancreas, 90% are approximately 2 cm wide, and 90% are isolated. Individuals with an insulinoma may have episodic bouts of hyperinsulinemic hypoglycemia. Typically, an insulinoma is indicated by hypoglycemic symptoms which are a result of catecholamine reaction and neuroglycopenia. There is increased secretion of insulin in patients with an insulinoma despite having lower glucose levels.

PURPOSE

This paper examines the myth of Erysichthon and speculates whether the symptoms experienced by him are possibly related to those found in patients with an hyperinsulinoma.

METHODS

The myth of Erysichthon was taken from various sources (i.e. Hesiod, Callimachus, Ovid) and examined. Symptoms of Erysichthon were then examined.

RESULTS

The myth of Erysichthon depicts various sympathoadrenal and neuroglycopenic symptoms including anxiety and abnormal behaviour which can be found in insulinomas. Insulinomas may often present a diagnostic challenge due to their deceptive nature and overlapping symptoms with other disorders such as neurologic disease. Insulinomas inducing weight loss resemble Calamachus's account of Erysichthon whose body is finally emaciated, even though having polyphagia.

CONCLUSION

The myth of Erysichthon provides an interesting range of clinical symptoms which I have argued relate to symptoms found in patients with an insulinoma. Although, insulinomas were unknown in ancient medical lore, this paper has speculated that based on Erysichthon's symptoms, the possibility of an insulinoma cannot be ruled out.

Association study of Bif-1 gene expression with histopathological characteristics and hormone receptors in breast cancer

BACKGROUND

Breast cancer is a heterogeneous disease that has various clinical outcomes. Bax-interacting factor-1 (Bif-1) is a member of the endophilin B family that generates the pro-apoptotic BCL2-Associated X (BAX) protein in response to apoptotic signals. Lack of Bif-1 inhibits the intrinsic pathway of apoptosis and enhancements the risk of tumor genesis. The present study aimed to investigate the relationship between hormone receptors (ER, PR, and HER2) status and different levels of Bif-1 gene expression in breast cancer patients.

METHODS

Bif-1 gene expression was evaluated in 50 breast cancer tumors and 50 normal breast mammary tissues using the SYBR Green real-time RT-PCR technique. Multivariate and univariate analyses were used to appraise the relationship between the prognostic significance of the Bif-1 gene using SPSS software. In this study, the Bif-1 was selected as a candidate for a molecular biomarker and its expression status in breast cancer patients with hormone receptors (ER, RR, and HER2) compared to patients without these hormone receptors.

RESULTS

The study showed that the relative expression of the Bif-1 gene in tissues of patients with hormone receptors in breast cancer compared to those without hormone receptors was not statistically significant. The expression levels of the Bif-1 gene in different groups were evaluated for hormone receptor status. No significant relationship was found between the Bif-1 gene expression and hormone receptors (ER, PR, and HER2) (p > 0.05).

CONCLUSION

Bif-1 gene expression may be a useful prognostic marker in breast cancer.

Evaluation of plasma viral-load monitoring and the prevention of mother-to-child transmission of HIV-1 in three health facilities of the Littoral region of Cameroon

Background

Prevention of mother-to-child transmission (PMTCT) has reduced HIV incidence among new-borns. However, PMTCT remains concerning in sub-Saharan Africa due to bottlenecks including viral load (VL) monitoring during pregnancy. We assessed VL coverage and materno-foetal outcomes of pregnancy among HIV-infected women within the Cameroonian context.

Methods

A hospital-based study was conducted among HIV-infected mothers and their babies in three facilities of the Littoral region of Cameroon from January 2019 to May 2021. Maternal VL-coverage was monitored during pregnancy (VL>1000 copies/ml or unknown were classified as MTCT high-risk group); HIV early infant diagnosis (EID) was evaluated by PCR at six-weeks after birth, and EID results were analysed according to maternal VL; p<0.05 was considered statistically significant.

Results

Of 135 HIV-infected pregnant women enrolled (median [IQR] age 39 [27–37] years), VL-coverage during antenatal care (ANC) was 50.4% (68/135), with a lower VL-coverage in 2019 (37.5% vs. 61.9%, p = 0.0069). Married women vs. single (61.8% vs. 42.5%, p = 0.0275) and those on treatment before vs. during pregnancy (56.7% vs. 5.8%, p = 0.0043) had a higher VL-coverage, respectively. Among those with known VL, 10.3% (7/68) had high (VL>1000 copies/mL), 22.1% (15/68) had low (50–1000 copies/mL), and 67.6% (46/68) had undetectable (<50 copies/mL) VL, suggesting an overall viral suppression (<1000copies/mL) of 89.7% (61/68). Vaginal delivery was 80.75% (109/135) regardless of VL, including 81.1% (59/74) women in the high-risk group. EID coverage was 88.1% (119/135) and the rate of HIV-1 MTCT was 1.68% (2/119). Both HIV-positive infants were from the high-risk group, had prolonged labour, had vaginal delivery and were breastfed.

Conclusion

In these Cameroonian settings, VL-coverage remains suboptimal (below 90%) among ANC attendees, and women at high-risk of MTCT mainly have vaginal delivery. Viral suppression rate remains below the target (below 90%) for accelerating the elimination of MTCT. HIV-MTCT persists, and might be driven essentially by poor VL monitoring. Thus, achieving an optimal PMTCT performance requires a thorough compliance to virologic assessment during ANC.

The role of microglia in neuropsychiatric disorders and suicide

This narrative review examines the possible role of microglial cells, first, in neuroinflammation and, second, in schizophrenia, depression, and suicide. Recent research on the interactions between microglia, astrocytes and neurons and their involvement in pathophysiological processes of neuropsychiatric disorders is presented. This review focuses on results from postmortem, positron emission tomography (PET) imaging studies, and animal models of schizophrenia and depression. Third, the effects of antipsychotic and antidepressant drug therapy, and of electroconvulsive therapy on microglial cells are explored and the upcoming development of therapeutic drugs targeting microglia is described. Finally, there is a discussion on the role of microglia in the evolutionary progression of human lineage. This view may contribute to a new understanding of neuropsychiatric disorders.

Incidence and geographical distribution of tuberculosis disease in Erbil city, Iraq

OBJECTIVES

This study aimed to identify the geographical distribution of TB in Erbil city, Kurdistan Region, Iraq, determine potential risk factors associated with TB distribution, and provide recommendations to improve TB control programs in the region.

METHODS

The records of TB patients registered at the Chest and Respiratory Disease Center in Erbil, Iraqi Kurdistan Region, from January 2012 to December 2016 were reviewed and analyzed. The number of cases by the quarter of residence within Erbil city were analyzed spatially and presented in an appropriate map.

RESULTS

The estimated annual incidence of TB in Erbil city constantly increased from 16 per 100,000 inhabitants in the year 2012 to 21.7 per 100,000 inhabitants in the year 2016. Most of the TB cases were from the middle zone of Erbil city (44%), followed by the outer zone (43.8%) and the central zone (12.2%). The largest number of the cases were from Brayaty quarter (40), followed by Badawa (35) Nawroz (35) and Kurdistan (31) quarters. Clusters with a large number of cases were mainly located in the southern part of the city.

CONCLUSION

The estimated TB incidence constantly increased in Erbil city from 2012 to 2016. Mapping the distribution of TB cases in Erbil city provided useful information about the epidemiological situation of TB that can be used to direct future TB control strategies.

Total Meat Intake is Associated with Life Expectancy: A Cross-Sectional Data Analysis of 175 Contemporary Populations

Background

The association between a plant-based diet (vegetarianism) and extended life span is increasingly criticised since it may be based on the lack of representative data and insufficient removal of confounders such as lifestyles.

Aim

We examined the association between meat intake and life expectancy at a population level based on ecological data published by the United Nations agencies.

Methods

Population-specific data were obtained from 175 countries/territories. Scatter plots, bivariate, partial correlation and linear regression models were used with SPSS 25 to explore and compare the correlations between newborn life expectancy (e₍₀₎), life expectancy at 5 years of life (e₍₅₎) and intakes of meat, and carbohydrate crops, respectively. The established risk factors to life expectancy – caloric intake, urbanization, obesity and education levels – were included as the potential confounders.

Results

Worldwide, bivariate correlation analyses revealed that meat intake is positively correlated with life expectancies. This relationship remained significant when influences of caloric intake, urbanization, obesity, education and carbohydrate crops were statistically controlled. Stepwise linear regression selected meat intake, not carbohydrate crops, as one of the significant predictors of life expectancy. In contrast, carbohydrate crops showed weak and negative correlation with life expectancy.

Conclusion

If meat intake is not incorporated into nutrition science for predicting human life expectancy, results could prove inaccurate.

Anatomical variations and evolution: re-evaluating their importance for surgeons

For several decades, anatomists and biological anthropologists have made an intensive study in anatomical variations in ancestral and living humans. While many anatomical variants do not require clinical attention, some may present diagnostic problems or augur adverse symptoms. It is only in the last few decades that a plausible argument has been made that anatomical changes in human individuals and lineages demonstrate ongoing microevolution. Since the mid-19th century, there has been a reduction in differential mortality. Increased variation of heritable traits is a consequential outcome of relaxation of natural selection. Consequently, this has contributed to various anatomical variations in musculo-skeletal anatomy, vascular anatomy as well as congenital disorders such as spina bifida occulta. The authors argue that surgeons and anatomists should improve their knowledge of evolution and its continuing influence on human morphology. Simply repeating the old mantra that anatomical variations are important because knowledge of them minimizes surgical complications, albeit important, is inadequate.

After more than sixty years we are still unclear whether LSD has a place in clinical psychiatry

Dear Editor, The use of the psychedelic Lysergic Acid Diethylamide (LSD) has again provoked scientific debate over its efficacy and safety. In the 1950s-1960s LSD was used in psychotherapy for treating depression, anxiety related to terminal cancer, addiction, and pain. (...)

A Multi-Stakeholder Perspective on the Integration of Safety in University Nursing, Education, and Engineering Curricula

Improvement in workplace safety is dependent upon the active engagement of workforce leaders and designers. The university sector plays a key role in the education of these future leaders, and there is an expectation that safety education in universities will encompass more than just a safe learning environment—that is the nurturing of broader safety attitudes and awareness. However, with the exception of dedicated safety training programs, safety education is often delivered and assessed on an ad-hoc basis and at academic discretion. This is partly due to the absence of a simple tool with which curricula can be evaluated from a safety perspective. In a qualitative approach, semi-structured interviews were undertaken with multiple stakeholders (academics, professional organizations, and students) to determine their views on existing safety content in university curricula and on the level of preparedness, from a safety perspective, for workforce entry. University participants came from nursing, mechanical engineering, and education schools at three universities. A simple curriculum evaluative tool was also validated. Results indicated there were divergent views on the level of preparedness for workforce entry both between schools and stakeholder groups. However, the limitations of university curricula were acknowledged. The evaluation tool was shown to provide positive feedback on existing, but previously unacknowledged, safety content and also highlighted areas for future improvement and integration. However, voluntary utilization of the tool was a challenge for busy academics.

Understanding Mind/Body Medicine from Muslim Religious Practices of Salat and Dhikr

There has been an increasing medical interest in Muslim religious practices in promoting well-being. Central to Muslim religious practices are salat (prayer) and dhikr (chanting). These two religious forms may be argued as comprising elements of mind/body medicine due to their positive effect on the psychoneuroimmunological response. The aim of this article was to further understand the mind/body aspects of Muslim salat and dhikr.

Integration of Nanobots Into Neural Circuits As a Future Therapy for Treating Neurodegenerative Disorders

Recent neuroscientific research demonstrates that the human brain is becoming altered by technological devices. Improvements in biotechnologies and computer based technologies are now increasing the likelihood for the development of brain augmentation devices in the next 20 years. We have developed the idea of an “Endomyccorhizae like interface” (ELI) nanocognitive device as a new kind of future neuroprosthetic which aims to facilitate neuronal network properties in individuals with neurodegenerative disorders. The design of our ELI may overcome the problems of invasive neuroprosthetics, post-operative inflammation, and infection and neuroprosthetic degradation. The method in which our ELI is connected and integrated to neuronal networks is based on a mechanism similar to endomyccorhizae which is the oldest and most widespread form of plant symbiosis. We propose that the principle of Endomyccorhizae could be relevant for developing a crossing point between the ELI and neuronal networks. Similar to endomyccorhizae the ELI will be designed to form webs, each of which connects multiple neurons together. The ELI will function to sense action potentials and deliver it to the neurons it connects to. This is expected to compensate for neuronal loss in some neurodegenerative disorders, such as Alzheimer's disease and Parkinson's disease.

Calretinin and parvalbumin in schizophrenia and affective disorders: a mini-review, a perspective on the evolutionary role of calretinin in schizophrenia, and a preliminary post-mortem study of calretinin in the septal nuclei

OBJECTIVE

The septal nuclei are important limbic regions that are involved in emotional behavior and connect to various brain regions such as the habenular complex. Both the septal nuclei and the habenular complex are involved in the pathology of schizophrenia and affective disorders.

METHODS

We characterized the number and density of calretinin-immunoreactive neurons in the lateral, medial, and dorsal subregions of the septal nuclei in three groups of subjects: healthy control subjects (N = 6), patients with schizophrenia (N = 10), and patients with affective disorders (N = 6).

RESULTS

Our mini-review of the combined role of calretinin and parvalbumin in schizophrenia and affective disorders summarizes 23 studies. We did not observe significant differences in the numbers of calretinin-immunoreactive neurons or neuronal densities in the lateral, medial, and dorsal septal nuclei of patients with schizophrenia or patients with affective disorders compared to healthy control subjects.

CONCLUSIONS

Most post-mortem investigations of patients with schizophrenia have indicated significant abnormalities of parvalbumin-immunoreactive neurons in various brain regions including the hippocampus, the anterior cingulate cortex, and the prefrontal cortex in schizophrenia. This study also provides an explanation from an evolutionary perspective for why calretinin is affected in schizophrenia.

"Messing with the mind": evolutionary challenges to human brain augmentation

The issue of brain augmentation has received considerable scientific attention over the last two decades. A key factor to brain augmentation that has been widely overlooked are the complex evolutionary processes which have taken place in evolving the human brain to its current state of functioning. Like other bodily organs, the human brain has been subject to the forces of biological adaptation. The structure and function of the brain, is very complex and only now we are beginning to understand some of the basic concepts of cognition. Therefore, this article proposes that brain-machine interfacing and nootropics are not going to produce “augmented” brains because we do not understand enough about how evolutionary pressures have informed the neural networks which support human cognitive faculties.

Extreme heat and cultural and linguistic minorities in Australia: perceptions of stakeholders

Background

Despite acclimatisation to hot weather, many individuals in Australia are adversely affected by extreme heat each summer, placing added pressure on the health sector. In terms of public health, it is therefore important to identify vulnerable groups, particularly in the face of a warming climate. International evidence points to a disparity in heat-susceptibility in certain minority groups, although it is unknown if this occurs in Australia. With cultural diversity increasing, the aim of this study was to explore how migrants from different cultural backgrounds and climate experiences manage periods of extreme heat in Australia.

Methods

A qualitative study was undertaken across three Australian cities, involving interviews and focus groups with key informants including stakeholders involved in multicultural service provision and community members. Thematic analysis and a framework approach were used to analyse the data.

Results

Whilst migrants and refugees generally adapt well upon resettlement, there are sociocultural barriers encountered by some that hinder environmental adaptation to periods of extreme heat in Australia. These barriers include socioeconomic disadvantage and poor housing, language barriers to the access of information, isolation, health issues, cultural factors and lack of acclimatisation. Most often mentioned as being at risk were new arrivals, people in new and emerging communities, and older migrants.

Conclusions

With increasing diversity within populations, it is important that the health sector is aware that during periods of extreme heat there may be disparities in the adaptive capacity of minority groups, underpinned by sociocultural and language-based vulnerabilities in migrants and refugees. These factors need to be considered by policymakers when formulating and disseminating heat health strategies.

A systematic review of telecounselling and its effectiveness in managing depression amongst minority ethnic communities

Telecounselling--the provision of counselling services by telephone, videoconferencing or Internet media--can assist with disparities in the treatment and management of depression for minority ethnic groups. We therefore reviewed the evidence examining the effectiveness of telecounselling for this population. This involved a search of electronic databases, the grey literature and two peer-reviewed journals. Study quality was examined using the Oxford Centre for Evidence Based Medicine guidelines. Cohen's d effect sizes were additionally calculated for between-study comparisons. The final sample comprised eight independent studies, with a total of 498 adults of Asian, African-American or Spanish origin. None of the studies met the criteria for the highest methodological rating (Level 1) and there were five studies at Level 2. Significant short-term treatment effects were associated with telephone- and Internet-mediated services, including moderate to large improvements across measures of depression, anxiety, quality of life and psychosocial functioning reported. Longer-term treatment effects were also reported, although these results were based on very limited data. The results highlight the need for additional rigorous research to determine the clinical efficacy of telecounselling as a treatment option for depression among minority communities.

A possible cause of Alzheimer's dementia - industrial soy foods

Alzheimer's data indicate that at present, approximately one new case of this form of dementia is identified in the USA every 68 s and that by 2050 the incidence will be about every 33 s, with projections from the Alzheimer Association (USA) indicating that nearly 25% of Americans will be affected by Alzheimer's dementia by 2031. Despite the numerous advances in medical science and neurological research, the causes are still unknown and the incidence is not decreasing or levelling out. Most research on the causes of Alzheimer's dementia indicates the possible roles of viruses, obesity, physical inactivity, diabetes, psychological depression, high blood pressure, frequent inflammation, environmental or domestic chemicals and toxins, or inescapable genetic factors. Alzheimer's, being the degeneration of parts of the neural pathways in the brain, may indeed involve neuro-toxic compounds that can bypass the blood-brain barrier. Therefore, it is necessary to examine what is prolific in the environment and, in particular, the food supply. One of the many suggestions in the literature is the ingestion of food items derived from unfermented soybean products; the anti-thyroid, anti-nutrient, and endocrine disruption properties of soy can have a deleterious effect in many individuals. Among the many theories and different factors that may be involved in dementiae, soy consumption may be a significant contributor to Alzheimer's dementia, and it cannot be excluded as a possible contributing cause. Our hypothesis argues that consumption of soy food products may contribute to the increasing incidence of Alzheimer's dementia and other dementiae.

The role of dopamine in schizophrenia from a neurobiological and evolutionary perspective: old fashioned, but still in vogue

Dopamine is an inhibitory neurotransmitter involved in the pathology of schizophrenia. The revised dopamine hypothesis states that dopamine abnormalities in the mesolimbic and prefrontal brain regions exist in schizophrenia. However, recent research has indicated that glutamate, GABA, acetylcholine, and serotonin alterations are also involved in the pathology of schizophrenia. This review provides an in-depth analysis of dopamine in animal models of schizophrenia and also focuses on dopamine and cognition. Furthermore, this review provides not only an overview of dopamine receptors and the antipsychotic effects of treatments targeting them but also an outline of dopamine and its interaction with other neurochemical models of schizophrenia. The roles of dopamine in the evolution of the human brain and human mental abilities, which are affected in schizophrenia patients, are also discussed.

Vulnerability to extreme heat and climate change: is ethnicity a factor?

Background

With a warming climate, it is important to identify sub-populations at risk of harm during extreme heat. Several international studies have reported that individuals from ethnic minorities are at increased risk of heat-related illness, for reasons that are not often discussed.

Objective

The aim of this article is to investigate the underpinning reasons as to why ethnicity may be associated with susceptibility to extreme heat, and how this may be relevant to Australia’s population.

Design

Drawing upon literary sources, the authors provide commentary on this important, yet poorly understood area of heat research.

Results

Social and economic disparities, living conditions, language barriers, and occupational exposure are among the many factors contributing to heat-susceptibility among minority ethnic groups in the United States. However, there is a knowledge gap about socio-cultural influences on vulnerability in other countries.

Conclusion

More research needs to be undertaken to determine the effects of heat on tourists, migrants, and refugees who are confronted with a different climatic environment. Thorough epidemiological investigations of the association between ethnicity and heat-related health outcomes are required, and this could be assisted with better reporting of nationality data in health statistics. Climate change adaptation strategies in Australia and elsewhere need to be ethnically inclusive and cognisant of an upward trend in the proportion of the population who are migrants and refugees.

Islamic medicine and evolutionary medicine: a comparative analysis

The advent of evolutionary medicine in the last two decades has provided new insights into the causes of human disease and possible preventative strategies. One of the strengths of evolutionary medicine is that it follows a multi-disciplinary approach. Such an approach is vital to future biomedicine as it enables for the infiltration of new ideas. Although evolutionary medicine uses Darwinian evolution as a heuristic for understanding human beings' susceptibility to disease, this is not necessarily in conflict with Islamic medicine. It should be noted that current evolutionary theory was first expounded by various Muslim scientists such as al-Jāḥiẓ, al-Ṭūsī, Ibn Khaldūn and Ibn Maskawayh centuries before Darwin and Wallace. In this way, evolution should not be viewed as being totally antithetical to Islam. This article provides a comparative overview of Islamic medicine and Evolutionary medicine as well as drawing points of comparison between the two approaches which enables their possible future integration.

Influence of living arrangements on health services utilisation in Australia

BACKGROUND

The number of people living alone is increasing markedly. Others live as couples only, couples with child(ren) and single adult with child(ren). Health service utilisation could differ for people in different living arrangements as a result of varying levels of risk factors, health status, access to informal care and decision-making for accessing care.

OBJECTIVE

To identify the association between living arrangements and health service use.

METHODS

The Australian Bureau of Statistics' National Health Survey 2001 data for people 18-65 years old were analysed for household composition and service use.

RESULTS

People in various household types differ in terms of their overall use of health services and their use of services by general practitioners. Sex, rurality, socioeconomic status and status of heart condition significantly influenced the use of health services.

CONCLUSION

There are implications for health services provision and planning within the context of rapid changes in living arrangements. Additional research is required to explore the reasons to such differences, level of access to informal care, healthcare decision-making processes and consequences of under- or over-utilisation of services.

Medicine could be constructing human bodies in the future

In the 21st century human life has been profoundly changed by developments in sanitation, medical interventions and public health measures. Practically every person born into a developed nation population has a chance to survive throughout entire reproductive life and well beyond. Human body has evolved in the past adaptations to hunting-gathering, and later, agricultural ways of life. In the new situation of practically non-existent premature mortality and technologically developed complex societies medical practice will devote less attention to "saving lives"--preventing premature deaths--and more to enhancing capacities of our biological organisms and providing for maintenance of the bodies beyond their biological limits established by evolution. The role of advances in nanotechnology, information technology, neuroscience and biotechnology is discussed in the context of mind and body enhancements.

Use of syndromic management algorithm for sexually transmitted infections and reproductive tract infections management in community settings in Karachi

OBJECTIVE

Syndromic management is promoted as a measure to manage and control STIs in resource poor settings. This research was conducted to assess the diagnosis and prescription patterns using syndromic management algorithms as part of a community-based reproductive health programme.

METHODS

The research was conducted in four squatter settlements of Karachi. Health care providers working for a reproductive health programme in these settlements received similar training on the use of algorithms. The people in these settlements had comparable socioeconomic and cultural backgrounds and access to health services. The medical records of 400 women who attended the centres for RTI/STIs were randomly selected. These records were reviewed for diagnosis and prescription patterns.

RESULTS

The diagnoses by and prescription practices of the health care providers differed greatly across the four clinics. As often there are more than one etiologic agents for most of the STI/RTI syndromes, algorithms allow multiple antibiotics use. However, this research pointed that despite diagnosing many patients as suffering from one particular infection, a large number of patients were prescribed more than one antibiotic.

CONCLUSION

It appeared that the health care providers had difficulties in using the algorithms, pointing to the need for ongoing support and training. The difficulty in correctly diagnosing STIs/RTIs could be the reason for over prescription. There is likelihood that the use of algorithms without sufficient support might contribute to the problems of drug resistance and prescription of drugs when they are contraindicated. Effective use of syndromic management algorithms requires training for effective communication, understanding about the locally prevalent STIs & RTIs, and periodic assessments of the quality of services.

Evolutionary and anthropological approaches towards understanding human need for psychotropic and mood altering substances

Human addiction to psychotropic and mood altering substances is an ongoing international problem. While the phenomenon of psychoactive drug use has received considerable theoretical attention there need to be more comparative approaches into this area. Evolutionary and anthropological approaches for understanding human need for psychotropic and mood altering substances offer the reader various insightful angles for analyzing this phenomenon. While evolutionary approaches investigate the evolutionary behaviors and mechanisms of human ancestral psychotropic use, anthropological approaches emphasize the social and religious meanings of individual drug use. While each approach proffers different ideas, a comparative approach, which is utilized in this study, may provide a novel and invaluable insight for understanding human need for psychotropic and mood-altering substances.

The effects of extreme heat on human mortality and morbidity in Australia: implications for public health

Most regions of Australia are exposed to hot summers and regular extreme heat events; and numerous studies have associated high ambient temperatures with adverse health outcomes in Australian cities. Extreme environmental heat can trigger the onset of acute conditions, including heat stroke and dehydration, as well as exacerbate a range of underlying illnesses. Consequently, in the absence of adaptation, the associated mortality and morbidity are expected to increase in a warming climate, particularly within the vulnerable populations of the elderly, children, those with chronic diseases, and people engaged in physical labour in noncooled environments. There is a need for further research to address the evidence needs of public health agencies in Australia. Building resilience to extreme heat events, especially for the most vulnerable groups, is a priority. Public health professionals and executives need to be aware of the very real and urgent need to act now.

Climate change and the possible health effects on older Australians

Climate change is an important issue for Australia. Climate change research forecasts that Australia will experience accelerated warming due to anthrogenic activities. Australia's aging society will face special challenges that demand current attention. This paper discusses two issues in relation to climate change and older Australians: first, pharmacology and autoregulation; and second, mental health among older Australians.

Global warming and Australian public health: reasons to be concerned

Studies in global warming and climate change indicate that human populations will be deleteriously affected in the future. Studies forecast that Australia will experience increasing heat waves and droughts. Heat stress caused by frequent heat waves will have a marked effect on older Australians due to physiological and pharmacological factors. In this paper we present an overview of some of the foreseeable issues which older Australians will face from a public health perspective.

Changing ethics in medical practice: a Thai perspective

The pace of social change in Thailand has seen the rise of various medical services and a global clientele. Currently, medical tourism and cosmetic surgery have an important role in medical practice here. A growing medical market offers a range of services at competitive rates and high levels of efficiency. This essay provides an overview of medical practices in Thailand and their effect on ordinary people.