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Introduction: We conducted a double-blind randomised controlled trial in a remote-living Australian Aboriginal group at high risk for chronic disease to assess whether pharmacological treatment with angiotensin converting enzyme inhibitor (ACEi) could delay the onset of albuminuria, hypertension or diabetes in people currently free of those conditions. Methods: Eligibility criteria in 2008 were age =18yr, blood pressure =140/90 mm/Hg, urinary albumin creatinine ratio (ACR) < 3.4 mg/mmol, normal levels of glycosylated haemoglobin, and, in females, infertility. A 2011 amendment allowed enrolment of fertile females using long-term contraception. “Treatment” was the ACEi perindopril arginine, or placebo, and participant events were ACR =3.4 mg/mmol and/or blood pressure >140/90 mm Hg and/or haemoglobin A1c >6.5%, and/or cardiovascular events. Results were analysed in 125 randomised participants who commenced treatment. Results: Recruitment was low, especially of women, and dropout rates high: there were finally 60 and 65 people in the ACEi and placebo groups respectively. In females, there were no events among 10 in the ACEi group, versus 5 events among 17 in the placebo group, and longitudinal ACR, HbA1c and blood pressure levels supported probable benefit of ACEi. There was no benefit of ACEi in males, but a probable benefit on diabetes/hypertension events. With the genders combined, there was probable reduction of diabetes (zero vs 4 events, p = 0.068), and of diabetes or hypertension (zero vs 5 events, p = 0.037). Discussion: In this high-risk population, ACEi probably delays development of albuminuria, diabetes and hypertension in females, and of non-ACR events overall. Repeat investigation with a larger sample size is warranted.

Reports of relationships between lower birthweight and later chronic diseases are mainly from populations with low rates of low birthweight (LBW) and growth-restricted births. A prospective study of an Australian Aboriginal birth cohort with a mean birthweight of 3050 g (SD 630), 16% LBW and 28% fetal growth restriction was used to examine the relationships between birthweight and selected biomarkers of chronic adult disease. At a mean age of 11.4 years (range 8.9–14), the mean weight was 35.7 kg (SD 11.8) and the mean height was 143.8 cm (SD 10.6). Using the Centers for Disease Control and Prevention (CDC) 2000 growth references, weight and height-for-age z-scores were −0.8 (SD 1.4) and −0.5 (SD 1.07) respectively and using World Health Organisation criteria, 19% of children were classified as underweight (weight for age Z-score <2.0). The relationships between birthweight and blood pressure (n = 475), total cholesterol (n = 461), Apolipoprotein A-1 (n = 343), Apolipoprotein B (n = 390), respiratory function tests (n = 427), kidney size determined by ultrasound (n = 446), urinary albumin/creatinine ratio (n = 420) and fasting triglycerides (n = 281), insulin (n = 272) and glucose (n = 279) were examined using regression models adjusted for sex, gestational age, current age and puberty status. In this population with high rates of fetal growth restriction at birth and an excess of under-nutrition at age 11 years we found that birthweight had a negative relationship with child blood pressure only, while current child weight was positively related to blood pressure, total cholesterol, Apolipoprotein B, respiratory function tests, kidney size, and fasting triglycerides, insulin and glucose.

Agitation is a major problem for older people and is present in over half of the hospitalizations for people > 65 years of age. In a previous study by the authors, results indicated that nursing actions often did not meet best-practice standards in the care of older, agitated patients. This paper builds on these results by reviewing the literature pertaining to the use of restraints and contributes to the body of knowledge surrounding the impact of the acute-care experience on rehabilitation outcomes. Successful rehabilitation relies on the improvement of functional health outcomes and, for this to happen, physical and emotional well-being are important. The sequelae of restraint use in acute care have the potential to alter peoples' ability to participate fully in a rehabilitation programme, thereby placing their future placement at risk. This paper explores the outcomes of restraint use in the acute-care setting and presents the argument that their effects are likely to be detrimental to rehabilitation outcomes.

ECOSYSTEM MANAGEMENT AND RESTORATION RESEARCH PROGRAM TECHNICAL REPORT EL-97-16 YAUPON (Ilex vomitoria) 4 Section 7.5.10, U.S. ARMY CORPS OF ENGINEERS WILDLIFE RESOURCES MANAGEMENT MANUAL by Chester O. Martin DEPARTMENT OF THE ARMY Waterways Experiment Station, Corps of Engineers 3909 Halls Ferry Road, Vicksburg, Mississippi 39180-6199 and Sarah P. Mott Conservation Communications Vicksburg, Mississippi 39180 .W34t EL-97-16 1997 August 1997 Final Report Approved For Public Release; Distribution Is Unlimited Prepared for DEPARTMENT OF THE ARMY U.S. Army Corps of Engineers Washington, DC 20314-1000 Under EIRP Work Unit 32420 LIBRARY DEC I 2 2000 The contents of this report are not to be used for advertising, publication, or promotional purposes. Citation of trade names does not constitute an official endorsement or approval of the use of such commercial products. The findings of this report are not to be construed as an official Department of the Army position, unless so designated by other authorized documents. 0PRINTED ON RECYCLED PAPER BUREAU OF RECLAMATION IBRARY T¿V ò + ^ * 0 1. ^ 7 * PREFACE 4bfl73 This work was sponsored by the Headquarters, U.S. Army Corps of Engineers (HQUSACE), as part of the Ecosystem Management and Restoration Research Program (EMRRP), Work Unit 32420, entitled Development of U.S. Army Corps of Engineers Wildlife Resources Management Manual. Mr. Dave Mathis, CERD-C, was the EIRP Coordinator at the Directorate of Research and Development, HQUSACE. The Program Monitors for the study were Ms. Cheryl Smith, Mr. F. B. Juhle, and Mr. Forrester Einarsen, HQUSACE. The report serves as a section of the U.S. Army Corps of Engineers Wildlife Resources Management Manual. This report was prepared by Mr. Chester O. Martin, Stewardship Branch (SB), Environmental Laboratory (EL), U.S. Army Engineer Waterways Experiment Station (WES), and Ms. Sarah Pearson Mott, Conservation Communications, Vicksburg, MS. Review and comments were provided by Dr. Wilma A. M

ECOSYSTEM MANAGEMENT AND RESTORATION RESEARCH PROGRAM TECHNICAL REPORT EL-97-14 AMERICAN ELDER (Sambucus canadensis) Section 7.5.7, U.S. ARMY CORPS OF ENGINEERS WILDLIFE RESOURCES MANAGEMENT MANUAL by Chester O. Martin DEPARTMENT OF THE ARMY Waterways Experiment Station, Corps of Engineers 3909 Halls Ferry Road, Vicksburg, Mississippi 39180-6199 and Sarah P. Mott Conservation Communications Vicksburg, Mississippi 39180 August 1997 Final Report Approved For Public Release; Distribution Is Unlimited Prepared for DEPARTMENT OF THE ARMY U.S. Army Corps of Engineers Washington, DC 20314-1000 Under ElRP Work Unit 32420 L DEC ! 2 2000 Bureau of Reclamation Reclamation Service Center The contents of this report are not to be used for advertising, publication, or promotional purposes. Citation of trade names does not constitute an official endorsement or approval of the use of such commercial products. The findings of this report are not to be construed as an official Department of the Army position, unless so designated by other authorized documents. PRINTED ON RECYCLED PAPER PREFACE BUREAU OF RECLAMATIONDEhJjER LIBRARY niP This work was sponsored by the Headquarters, U.S. Army Corps of Engineers (HQUSACE), as part of the Ecosystem Management and Restoration Research Program (EMRRP), Work Unit 32420, entitled Development of U.S. Army Corps of Engineers Wildlife Resources Management Manual. Mr. Dave Mathis, CERD-C, was the EIRP Coordinator at the Directorate o f Research and Development, HQUSACE. The Program M onitors for the study were Ms. Cheryl Smith, Mr. F. B. Juhle, and Mr. Forrester Einarsen, HQUSACE. The report serves as a section o f the U.S. Army Corps of Engineers Wildlife Resources Management Manual. This report was prepared by Mr. Chester O. Martin, Stewardship Branch (SB), Environmental Laboratory (EL), U.S. Army Engineer Waterways Experiment Station (WES), and Ms. Sarah Pearson Mott, Conservation Communications, Vicksburg, MS. Review and comments were provided