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Poster presentation at the European Association for the Study of Diabetes in Berlin, Germany from Oct 1-5, 2018.

FORGE AHEAD Community Profile Survey. (PDF 257 kb)

Poster presented at the European Diabetes Epidemiology Group Meeting in Elsinore, Denmark from April 21-24, 2018.

Poster for the 77th Scientific Sessions of the American Diabetes Association (2017) in San Diego, USA. Abstract below:While triglycerides (TG) are a part of the MetS, the impact of the specific TG fatty acid (TGFA) composition on metabolic functioning is not well known, especially over time. Our aim was to examine the longitudinal association of serum TGFA composition with MetS components.Adults at risk for diabetes had 3 visits over 6 yrs (n=477). TGFA (mol%) was measured at baseline. Outcomes were MetS components waist, HDL, clinical TG, fasting glucose (FG), and mean arterial pressure (MAP). We used partial least squares (PLS) to extract TGFA clusters. We evaluated longitudinal associations using generalized estimating equations (GEE) adjusted for time, sex, age, and ethnicity.Four TGFA loaded positively on PLS cluster 1 (C1): 14:0, 16:0, 14:1n-7, and 16:1n-7 (Fig. A). TGFA were distributed evenly on cluster 2 (C2). In GEE models (Fig. B), higher C1 associated with lower HDL and higher FG, MAP, TG, and waist consistently over the 6 years. While higher C2 similarly associated with higher FG, MAP, and waist, it associated with higher HDL and lower TG. We found that a higher proportion of 4 TGFA strongly predicted worsening of MetS components. These 4 TGFA are products of DNL from refined carbohydrates. Our results provide further evidence to support the harmful impact of refined carbohydrates on metabolic health.

FORGE AHEAD: Community Profile Survey. (DOCX 144 kb)

Presented at the American Diabetes Association's 76th Scientific Sessions in New Orleans, US in June 2016.Full citation:Johnston LW, Retnakaran R, Harris S, Zinman B, Liu Z, Bazinet RP, Hanley AJ. Triglyceride Fatty Acid (TGFA) Composition Longitudinally Associates with Changes in Insulin Sensitivity (IS) and Beta-Cell Function Over 6-yrs in the Prospective Metabolism and Islet Cell Evaluation (PROMISE) Cohort. Diabetes. 2016;65(Supplemental 1):A406.

Presented in a guided poster session at the American Diabetes Association's 75th Scientific Session, on June 7th, 2015 at 1:00pm in Boston, US. Part of a PhD project. Full citation from conference: Johnston, L.W., Lee, C., Harris, S.B., Retnakaran, R., Zinman, B., Bazinet, R.P., Hanley, A.J. Serum Non-Esterified Fatty Acid (NEFA) Concentration is Associated with Longitudinal Progression of β-Cell Dysfunction: Prospective Metabolism and Islet Cell Evaluation (PROMISE) Cohort Diabetes 64 (Suppl. 1): A421, 1621-P, 2015.

Objectives were to gather information from Talking Circles of Aboriginal women who participated in a maternal Nutrition and Exercise Lifestyle Intervention Program (NELIP) to identify strategies to bring NELIP into the community. Twelve First Nations women participated. Several main themes were identified regarding health: balance, knowledge/education and time management. Benefits of the NELIP were improvement in health, stamina, stress, and a healthy baby, no gestational diabetes and a successful home birth, with social support as an important contributing factor for success. Suggestions for improvement for the NELIP included group walking, and incorporating more traditional foods into the meal plan. The information gathered is the first step in determining strategies using participatory research and capacity-building to develop a community-based NELIP for pregnant Aboriginal women.

BACKGROUND: Expanding evidence indicates that apolipoprotein B (apo B) is superior to LDL cholesterol as a marker of vascular disease. Although traditional lipid measures are known to predict type 2 diabetes, limited data are available regarding apo B. We assessed the association of apo B with incident type 2 diabetes and compared it with traditional lipid variables as a risk predictor in aboriginal Canadians. METHODS: Of an initial cohort of 606 individuals without diabetes in 1993-1995, 540 were contacted for the 10-year follow-up evaluation in 2003-2005. Fasting and 2-h postload glucose concentrations were obtained at baseline and follow-up to determine incident type 2 diabetes. Baseline fasting serum lipids were measured with standard laboratory procedures. RESULTS: The cumulative 10-year incidence of type 2 diabetes was 17.5%. High concentrations of apo B, triglycerides, and LDL cholesterol, and low concentrations of HDL cholesterol were individually associated with incident type 2 diabetes in univariate analyses. Comparing C statistics of univariate models showed apo B to be a superior determinant of incident diabetes compared with LDL (P = 0.026) or HDL (P = 0.004) cholesterol. With multivariate adjustment including waist circumference, apo B (odds ratio, 1.50; 95% CI, 1.11-2.02) and triglycerides (odds ratio, 1.49; 95% CI, 1.12-1.98) remained associated with incident diabetes, whereas LDL and HDL cholesterol became nonsignificant. CONCLUSIONS: The association of plasma apo B with incident type 2 diabetes and its better prediction of risk compared with LDL or HDL cholesterol suggest the potential for the use of apo B in type 2 diabetes risk communication and prevention.

This paper deals with a serious question that is largely unaddressed by the U.S. or international legal systems: how should society deal with inherently, catastrophically dangerous information—information that, in the wrong hands, could lead to the destruction of a city, a continent, or, conceivably, the entire planet? Such information includes, but is not limited to, blueprints for nuclear weapons, as well as specific formulae for chemical and biological weapons of mass destruction. The paper is not a critique of the existing statutes and regulations that various governments use to keep their secrets secret. Rather, it is a discussion of what to do when some such secrets are inevitably disclosed, or, more generally, how to deal with catastrophically dangerous information that is generated outside of governmental control. Addressing these issues is primarily a matter of policy, but policy with significant constitutional dimensions. Perhaps the most fundamental of thosedimensions is the question of whether a governmental restriction on receipt, dissemination, and even mere possession of information can be reconciled with the speech and press clauses of the First Amendment. Although existing authorities do not directly address the subject, what little authority there is suggests that reasonable restrictions upon the possession and dissemination of catastrophically dangerous information—even when that information is already within the public domain—can be implemented in a way that is consistent with the First Amendment. Given the growing urgency of the subject and the need for a comprehensive approach, I advocate a statutory solution in the United States that defines and limits access to catastrophically dangerous information, but which also limits governmental seizures and restrictions to only the most dangerous types of information, and which provides for a pre-seizure warrant requirement and expedited post-seizure judicial review. Given the global dimensions of the problem, I also advocate a corresponding international regime patterned upon the Nuclear Nonproliferation Treaty of 1968.

Three major lithogenetic sequences of regional extent are recognized in the Upper Triassic Series of the Colorado Plateau region. The sequences, which correspond only partly with named formations, are useful in describing the gross lithologic character and the origin of the Upper Triassic Series. The lowest of the three, the bentonitic sequence, consists of variegated bentonitic claystone and clayey sandstone and thin widespread sandstone and conglomerate units. The sediment in the sequence was derived predominantly from a volcanic source area south of the Colorado Plateau, the Mogollon highland, and was deposited in streams, on floodplains, and in lakes. The overlying redbed sequence consists of reddish-brown or reddish-orange, horizontally stratified siltstone and minor amounts of limestone and sandstone. The sediments were predominantly quiet-water deposits, probably lacustrine, derived from several source areas, the most important of which may have been the Uncompahgre and Front Range highlands of Colorado. The next overlying sequence consists of light-brown, fine- to medium-grained, conspicuously cross-stratified sandstone. It is considered to be of eolian origin; the sediment probably was derived from reworking of upwind arenaceous sedimentary units on the northwest.

Recent work on strata of Permian and Triassic age on the Colorado Plateau indicates that the unit originally defined as the Hoskinnini tongue of the Cutler formation extends into parts of southeastern Utah where it had not been previously reported. In addition, the Hoskinnini is correlated with part or all of the unit defined as the Tenderfoot member of the Moenkopi formation in the salt anticline region of east-central Utah and west-central Colorado. As a result of this work, the Hoskinnini is redefined as the Hoskinnini member of the Moenkopi formation. The Hoskinnini and laterally continuous strata in the Tenderfoot member are exposed within a north-northeast oriented area about 180 miles long and 50 miles wide extending from the Monument Valley area, in northeastern A izona and southeastern Utah, to west-central Colorado. Previously the Hoskinnini had been recognized only in the Monument Valley area. The Hoskinnini member and laterally continuous strata in the Tenderfoot member are pale reddish brown sandy siltstone grading to silty very fine-grained sandstone and contains disseminated fine, medium, and coarse quartz grains. The Hoskinnini is composed of horizontal beds, which generally range from 1 to 2 feet in thickness. Individual beds are marked by indistinct discontinuous wavy laminae bounded by grayish red claystone or siltstone films. The Hoskinnini is 50-120 feet thick in most areas. The combination of fine to coarse sand grains in a silt or very fine-grained asnd matrix and of discontinuous wavy laminae serves to differentiate the Hoskinnini member from the underlying and overlying strata. These features also make possible the correlation of the member with rocks not previously correlated with the Hoskinnini in southeastern Utah and adjoining parts of Colorado.

The Triassic rocks in southeastern Utah have been divided into the Moenkopi formation of Early and Middle (?) Triassic age, and the Shinarump conglomerate, Chinle formation, and Wingate sandstone of Late Triassic age. Recent work has shown that the strata formerly called Shinarump conglomerate in southeastern Utah consist, in places, of a lower sandstone and conglomerate unit, a middle claystone and clayey sandstone unit, and an upper sandstone and conglomerate unit. The lower and upper units are Shinarump-type deposits whereas the middle unit is a Chinle-type deposit. Deposits of Shinarump-type and Chinle-type are interstratified and intertonguing. The writer proposes that the two types be grouped together in the Chinle formation and that the Shinarump conglomerate be re efined as the Shinarump member of the Chinle formation. The lower unit is correlative with strata in southwestern Utah, that are designated as type Shinarump conglomerate, and the writer proposes that the term Shinarump member be restricted in southeastern Utah to this lower unit. The middle and upper units, although formerly included in the Shinarump conglomerate, are considered as separate members of the Chinle formation. The middle unit has been defined as the Monitor Butte member of the Chinle formation, and the name Moss Back member is here proposed for the upper unit. In southeastern Utah, the Shinarump conglomerate included, in places, all of the Shinarump, Monitor Butte, and Moss Back members of the Chinle formation. In other places, the Shinarump conglomerate consisted only of the Moss Back member, and in still other parts of southeastern Utah the Shinarump conglomerate consisted of only the Shinarump member. Locally in the San Rafael Swell area, Emery County, a thin unit now called Temple Mountain member was included by previous workers in the Shinarump conglomerate. In addition to subdividing the strata previously included in the Shinarump conglomerate, the overlying part of the Chinle formation has been subdivided into members. As now recognized, the Chinle formation consists of seven members in southeastern Utah. They are, in ascending order, the Temple Mountain, Shinarump, Monitor Butte, Moss Back, Petrified Forest, Owl Rock, and Church Rock members.

The Triassic rocks in southeastern Utah have been divided into the Moenkopi formation of Early and Middle (?) Triassic age, and the Shinarump conglomerate, Chinle formation, and Wingate sandstone of Late Triassic age. Recent work has shown that the strata formerly called Shinarump conglomerate in southeastern Utah consist, in places, of a lower sandstone and conglomerate unit, a middle claystone and clayey sandstone unit, and an upper sandstone and conglomerate unit. The lower and upper units are Shinarump-type deposits whereas the middle unit is a Chinle-type deposit. Deposits of Shinarump-type and Chinle-type are interstratified and intertonguing. The writer proposes that the two types be grouped together in the Chinle formation and that the Shinarump conglomerate be re efined as the Shinarump member of the Chinle formation. The lower unit is correlative with strata in southwestern Utah, that are designated as type Shinarump conglomerate, and the writer proposes that the term Shinarump member be restricted in southeastern Utah to this lower unit. The middle and upper units, although formerly included in the Shinarump conglomerate, are considered as separate members of the Chinle formation. The middle unit has been defined as the Monitor Butte member of the Chinle formation, and the name Moss Back member is here proposed for the upper unit. In southeastern Utah, the Shinarump conglomerate included, in places, all of the Shinarump, Monitor Butte, and Moss Back members of the Chinle formation. In other places, the Shinarump conglomerate consisted only of the Moss Back member, and in still other parts of southeastern Utah the Shinarump conglomerate consisted of only the Shinarump member. Locally in the San Rafael Swell area, Emery County, a thin unit now called Temple Mountain member was included by previous workers in the Shinarump conglomerate. In addition to subdividing the strata previously included in the Shinarump conglomerate, the overlying part of the Chinle formation has been subdivided into members. As now recognized, the Chinle formation consists of seven members in southeastern Utah. They are, in ascending order, the Temple Mountain, Shinarump, Monitor Butte, Moss Back, Petrified Forest, Owl Rock, and Church Rock members.

Report discussing stratigraphic studies of the Triassic and associated formations in northern Arizona and southern Utah. The programs of study included are "(1) regional stratigraphic descriptions and correlation of units, (2) sedimentary structure studies, (3) pebble studies, and (4) sedimentary petrology."

Stratigraphic studies of the Triassic and associated formations were made in southeastern Utah and adjoining parts of Colorado and Arizona. Five principal lines of investigation were followed: regional stratigraphy, sedimentary petrology, pebble studies, sedimentary-structure studies, and lithofacies studies. The formations studied are the Cutler formation, Coconino sandstone, and Kaibab limestone of Permian age; the Moenkopi formation, Chinle formation, and Wingate sandstone of Triassic age; the Kayenta formation of Jurassic (?) age; and the Navajo sandstone of Jurassic and Jurassic (?) age. The Cutler formation grades from a conglomeratic facies in southwestern Colorado to a unit containing alternating reddish siltstone and yellowish-gray sandstone members in southeastern Utah. The reddish siltstone members comprise the Halgaito, Organ Rock, and Hoskinnini tongues. These alternate with the yellowish-gray sandstone members the Cedar Mesa, White Rim, and De Chelly sandstone members. The conglomeratic facies of the Cutler is classified as an arkose that was deposited by streams flowing westward from a rising granitic area in southwestern Colorado. The reddish siltstone members were deposited by quiet water in basins of accumulation on a slowly sinking continental margin, and they, also, were derived from a source area in southwestern Colorado. The Organ Rock tongue is part graywacke and part arkose, whereas the Hoskinnini tongue is arkose. The yellowish-gray sandstone members were deposited by winds blowing toward the southeast, and the materials probably were derived from a source area to the northwest. The Cedar Mesa sandstone member is feldspathic orthoquartzite, and the De Chelly sandstone member is tuffaceous feldspathic orthoquartzite. The Coconino sandstone and Kaibab limestone crop out in the western part of southeastern Utah. The Coconino is laterally equivalent to part of the Cutler formation and is an eolian deposit formed by southeastward-blowing winds. The Kaibab is a marine deposit. The Moenkopi formation of Triassic age consists of reddish horizontally and ripple-laminated siltstone that is classified as arkose and some cross-stratified sandstone of moderately well sorted sand that is classified as feldspathic orthoquartzite. The Sinbad limestone member crops out in central and southcentral Utah and to the south overlaps the underlying part of the Moenkopi.

FORGE AHEAD: Clinical Readiness Consultation Tool â Community Feedback Form. The Community Feedback Form was used during the pilot of the CRCT and was includes a qualitative (open-ended) section for suggestions/comments and a five-point Likert scale to gather responses on the following: (1) appropriate language use for First Nations health clinics in Canada, (2) clarity of questions, (3) relevance of questions to health clinics in First Nations communities, (4) appropriate format for the tool, and, (5) helpfulness of examples provided for each question to complete the clinical assessment tool. (DOCX 43 kb)

FORGE AHEAD: Clinical Readiness Consultation Tool. The 27-page tool has 4 main sections: 1) 1-page introduction describing the background, confidentiality, benefits, risks, reimbursement, consent, and contact information; 2) 1-page brief instruction (estimated time to complete, brief description of rating scales and how to submit the completed questionnaire); 3) general information (brief 8-item demographic profile); and 4) 5 main components and sub-components of healthcare systems important in chronic disease care. (DOCX 92 kb)

FORGE AHEAD: Clinical Readiness Consultation Tool. The 27-page tool has 4 main sections: 1) 1-page introduction describing the background, confidentiality, benefits, risks, reimbursement, consent, and contact information; 2) 1-page brief instruction (estimated time to complete, brief description of rating scales and how to submit the completed questionnaire); 3) general information (brief 8-item demographic profile); and 4) 5 main components and sub-components of healthcare systems important in chronic disease care. (DOCX 92 kb)

FORGE AHEAD: Clinical Readiness Consultation Tool â Community Feedback Form. The Community Feedback Form was used during the pilot of the CRCT and was includes a qualitative (open-ended) section for suggestions/comments and a five-point Likert scale to gather responses on the following: (1) appropriate language use for First Nations health clinics in Canada, (2) clarity of questions, (3) relevance of questions to health clinics in First Nations communities, (4) appropriate format for the tool, and, (5) helpfulness of examples provided for each question to complete the clinical assessment tool. (DOCX 43 kb)

Indigenous populations of Australia and Canada experience disproportionately high rates of chronic disease. We hypothesized that despite the common outcome of increased diabetes prevalence, differences in cardiometabolic risk profile may exist between these populations.We compared community-based data on cardiometabolic risks in Aboriginal Australians (n=297 without, 45 with diabetes), and Aboriginal Canadians (n=409 without, 87 with diabetes).Despite strikingly lower weight (62 vs 83 kg, p0.0001) and body mass index (BMI, 22 vs 29 kg/m(2), p0.0001), Aboriginal Australians without diabetes had similar waist-hip ratio (WHR, 0.91 vs 0.91, p=0.732), lower HDL-cholesterol (0.97 vs 1.25 mmol/L, p0.0001) and higher HbA1c (5.4 vs 5.2%, p0.0001) than Aboriginal Canadians without diabetes. Waist was the obesity measure most strongly related to diabetes or cardiometabolic risk in Australians while BMI performed similarly to other obesity measures only in Canadians. Multiple regression of HbA1c revealed age and fasting glucose as independent predictors in each study group, with the addition of WHR in Aboriginal Australians.The notable finding was that waist or WHR are preferred obesity measures to appropriately reflect cardiometabolic risk in Aboriginal Australians, who although leaner by BMI criteria, displayed a similarly adverse risk profile to Aboriginal Canadians. Waist or WHR should be routinely included in clinical assessment in these high-risk populations.