Making Evaluation Matter: Writings from South Asia | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

2016-04-27

Apr 27, 2016 ... ... South Asia's Community of Evaluators to advance evaluation practices in the region. ... a space and platform to stimulate dynamic exchange and interaction ... health, nutrition, and rights and social justice-oriented programs.

Prevalence of Gestational Diabetes Mellitus in Eastern and Southeastern Asia: A Systematic Review and Meta-Analysis

Science.gov (United States)

Binns, Colin W.; Duong, Dat Van; Lee, Andy H.

2018-01-01

Aim To review the prevalence of gestational diabetes mellitus (GDM) in Eastern and Southeastern Asia. Methods We systematically searched for observational studies on GDM prevalence from January 2000 to December 2016. Inclusion criteria were original English papers, with full texts published in peer-reviewed journals. The quality of included studies was evaluated using the guidelines of the National Health and Medical Research Council, Australia. Fixed effects and random effects models were used to estimate the summary prevalence of GDM and the corresponding 95% confidence intervals (CI). Results A total of 4415 papers were screened, and 48 studies with 63 GDM prevalence observations were included in the final review. The pooled prevalence of GDM was 10.1% (95% CI: 6.5%–15.7%), despite substantial variations across nations. The prevalence of GDM in lower- or upper-middle income countries was about 64% higher than in their high-income counterparts. Moreover, the one-step screening method was twice more likely to be used in diagnosing GDM when compared to the two-step screening procedure. Conclusions The prevalence of GDM in Eastern and Southeastern Asia was high and varied among and within countries. There is a need for international uniformity in screening strategies and diagnostic criteria for GDM. PMID:29675432

A Multiethnic Study of Pre-Diabetes and Diabetes in LMIC.

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Shen, Jia; Kondal, Dimple; Rubinstein, Adolfo; Irazola, Vilma; Gutierrez, Laura; Miranda, J Jaime; Bernabé-Ortiz, Antonio; Lazo-Porras, María; Levitt, Naomi; Steyn, Krisela; Bobrow, Kirsten; Ali, Mohammed K; Prabhakaran, Dorairaj; Tandon, Nikhil

2016-03-01

Diabetes mellitus is one of the leading causes of death and disability worldwide. Approximately three-quarters of people with diabetes live in low- and middle-income countries, and these countries are projected to experience the greatest increase in diabetes burden. We sought to compare the prevalence, awareness, treatment, and control of diabetes in 3 urban and periurban regions: the Southern Cone of Latin America and Peru, South Asia, and South Africa. In addition, we examined the relationship between diabetes and pre-diabetes with known cardiovascular and metabolic risk factors. A total of 26,680 participants (mean age, 47.7 ± 14.0 years; 45.9% male) were enrolled in 4 sites (Southern Cone of Latin America = 7,524; Peru = 3,601; South Asia = 11,907; South Africa = 1,099). Detailed demographic, anthropometric, and biochemical data were collected. Diabetes and pre-diabetes were defined as a fasting plasma glucose ≥126 mg/dl and 100 to 125 mg/dl, respectively. Diabetes control was defined as fasting plasma glucose diabetes and pre-diabetes was 14.0% (95% confidence interval [CI]: 13.2% to 14.8%) and 17.8% (95% CI: 17.0% to 18.7%) in the Southern Cone of Latin America, 9.8% (95% CI: 8.8% to 10.9%) and 17.1% (95% CI: 15.9% to 18.5%) in Peru, 19.0% (95% CI: 18.4% to 19.8%) and 24.0% (95% CI: 23.2% to 24.7%) in South Asia, and 13.8% (95% CI: 11.9% to 16.0%) and 9.9% (95% CI: 8.3% to 11.8%) in South Africa. The age- and sex-specific prevalence of diabetes and pre-diabetes for all countries increased with age (p Peru, and South Africa the prevalence of pre-diabetes rose sharply at 35 to 44 years. In South Asia, the sharpest rise in pre-diabetes prevalence occurred younger at 25 to 34 years. The prevalence of diabetes rose sharply at 45 to 54 years in the Southern Cone of Latin America, Peru, and South Africa, and at 35 to 44 years in South Asia. Diabetes and pre-diabetes prevalence increased with body mass index. South Asians had the highest prevalence of diabetes and

Place of sulfonylureas in the management of type 2 diabetes mellitus in South Asia: A consensus statement

Directory of Open Access Journals (Sweden)

Sanjay Kalra

2015-01-01

Full Text Available Since their introduction in clinical practice in the 1950′s, Sulfonylureas (SUs have remained the main-stay of pharmacotherapy in the management of type 2 diabetes. Despite their well-established benefits, their place in therapy is inappropriately being overshadowed by newer therapies. Many of the clinical issues associated with the use of SUs are agent-specific, and do not pertain to the class as such. Modern SUs (glimepiride, gliclazide MR are backed by a large body of evidence, experience, and most importantly, outcome data, which supports their role in managing patients with diabetes. Person-centred care, i.e., careful choice of SU, appropriate dosage, timing of administration, and adequate patient counseling, will ensure that deserving patients are not deprived of the advantages of this well-established class of anti-diabetic agents. Considering their efficacy, safety, pleiotropic benefits, and low cost of therapy, SUs should be considered as recommended therapy for the treatment of diabetes in South Asia. This initiative by SAFES aims to encourage rational, safe and smart prescription of SUs, and includes appropriate medication counseling.

Hepatocellular carcinoma in Asia: Prevention strategy and planning.

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Ashtari, Sara; Pourhoseingholi, Mohamad Amin; Sharifian, Afsaneh; Zali, Mohamad Reza

2015-06-28

To review all of epidemiological and etiological aspects of hepatocellular carcinoma (HCC) and examined the prevention of this disease in Asia. We conducted a systematic review according to the PRISMA guidelines. We were chosen articles that published previously, from PubMed (MEDLINE), the Cochrane database and Scopus. The key words used in this research were as follows: HCC in Asia and the way of prevention of this disease, with no language limitations. We selected those papers published before 2014 that we considered to be most important and appropriate. All relevant articles were accessed in full text and all relevant materials was evaluated and reviewed. More than 70% of all new cases of liver cancer were diagnosed in Asia, a region that 75% of all those chronically infected with hepatitis B virus (HBV) in the world. Chronic HBV infection is the main cause of HCC in Asia, where the virus is endemic and vertical transmission is common. Japan, Saudi Arabia, Egypt and Pakistan are exception because of high prevalence of HCV infection in these regions. The prevalence of this cancer is high in Eastern and South-Eastern Asia, But Middle Eastern countries are characterized as moderate prevalence rate of HCC region and Central Asia and some part of Middle Eastern countries are known as low prevalence rate of HCC. In addition of HBV and HCV the other factors such as aflatoxin, alcohol, obesity, diabetes and non-alcoholic fatty liver disease (NAFLD) might be responsible for a low prevalence of HCC in Asian countries. Currently available HCC therapies, chemotherapy, surgical are inefficient, mainly due to usually late diagnosis and high recurrence rates after surgical resection, and usually end with treatment failure. Liver transplantation also remains as a difficult strategy in patients with HCC. Thus prevention of HCC by treating and prevention HBV and HCV infection, the major causative agents of HCC, and the other risk factors such as aflatoxin, alcohol, obesity

Prevalence and trends of the diabetes epidemic in South Asia: a systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Jayawardena Ranil

2012-05-01

Full Text Available Abstract Background Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported. Methods Prevalence data were obtained by searching the Medline® database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic and ‘Epidemology/EP’ (MeSH subheading. Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years. The conjunction of the above results was narrowed down with country names. Results The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural, India–4.6%:12.5% (2007;Rural; Maldives–3.0%:3.7% (2004;National, Nepal–19.5%:9.5% (2007;Urban, Pakistan–3.0%:7.2% (2002;Rural, Sri Lanka–11.5%:10.3% (2005–2006;National. Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%, while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%. Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes. Conclusion A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies .

Institutionalizing Evaluation Training in Universities in South Asia ...

International Development Research Centre (IDRC) Digital Library (Canada)

The long-term objectives are to strengthen evaluation skills in the context of the development challenges in South Asia, and to support a culture of innovation, experimentation and research in academic institutions. The overall goal is to contribute to more accountable and effective development research, policy and ...

Resource use associated with type 2 diabetes in Africa, the Middle East, South Asia, Eurasia and Turkey: results from the International Diabetes Management Practice Study (IDMPS).

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Gagliardino, Juan J; Atanasov, Petar K; Chan, Juliana C N; Mbanya, Jean C; Shestakova, Marina V; Leguet-Dinville, Prisca; Annemans, Lieven

2017-01-01

Type 2 diabetes (T2D) and its complications form a global healthcare burden but the exact impact in some geographical regions is still not well documented. We describe the healthcare resource usage (HRU) associated with T2D in Africa, the Middle East, South Asia, Eurasia and Turkey. In the fifth wave of the International Diabetes Management Practices Study (IDMPS; 2011-2012), we collected self-reported and physician-reported cross-sectional data from 8156 patients from 18 countries across 5 regions, including different types of HRU in the previous 3-6 months. Negative binomial regression was used to identify parameters associated with HRU, using incidence rate ratios (IRRs) to express associations. Patients in Africa (n=2220), the Middle East (n=2065), Eurasia (n=1843), South Asia (n=1195) and Turkey (n=842) experienced an annual hospitalization rate (mean±SD) of 0.6±1.9, 0.3±1.2, 1.7±4.1, 0.4±1.5 and 1.3±2.7, respectively. The annual number of diabetes-related inpatient days (mean±SD) was 4.7±22.7, 1.1±6.1, 16.0±30.0, 1.5±6.8 and 10.8±34.3, respectively. Despite some inter-regional heterogeneity, macrovascular complications (IRRs varying between 1.4 and 8.9), microvascular complications (IRRs varying between 3.4 and 4.3) and, to a large extent, inadequate glycemic control (IRRs varying between 1.89 and 10.1), were independent parameters associated with hospitalization in these respective regions. In non-Western countries, macrovascular/microvascular complications and inadequate glycemic control were common and important parameters associated with increased HRU.

Radiographic evaluation of the diabetic foot

International Nuclear Information System (INIS)

Jacobs, A.M.

1989-01-01

Radiographic evaluation of the foot in the patient with diabetes mellitus is discussed in this paper. According to the author, it can only be of value when the soft tissue and bony and joint pathologic conditions, which occur more frequently in the diabetic patient are also considered and understood. Although not pathognomic for diabetes mellitus, neuroarthopathy, osteomyelitis, soft tissue infection, and some rheumatic disorders are present with greater frequency in diabetic populations than in non-diabetic populations. Frequently, edema, erythema, hyperthermia, and tenderness are present as nonspecific clinical findings, in which case radiographic evaluation is called upon to define the specific etiology of a particular patient's pathology. Unfortunately, many radiographic, computerized tomographic, and radionuclide studies demonstrate less than optimal positive and negative predictive values unless interpreted in view of clinical history and examination and integrated with the results of other laboratory data. Radiographic evaluation of the diabetic foot may be utilized to establish the presence of disease, the extent of pedal involvement, and the response to therapy. The establishment of the nature of disease processes from radiographic findings alone, however, may be problematic. The diagnosis of osteomyelitis, for example, rests on the recovery of the offending microorganisms from bone aspiration or culture

Diabetic Mario: Designing and Evaluating Mobile Games for Diabetes Education.

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Baghaei, Nilufar; Nandigam, David; Casey, John; Direito, Artur; Maddison, Ralph

2016-08-01

Traditionally, diabetes education has relied on written materials, with limited resources available for children with diabetes. Mobile games can be effective and motivating tools for the promotion of children's health. In our earlier work, we proposed a novel approach for designing computer games aimed at educating children with diabetes. In this article, we apply our game design to a mobile Android game (Mario Brothers). We also introduce four heuristics that are specifically designed for evaluating the mobile game, by adapting traditional usability heuristics. Results of a pilot study (n = 12) to evaluate gameplay over 1-week showed that the children found the game engaging and improved their knowledge of healthy diet and lifestyle.

Autochthonous blastomycosis of the adrenal: first case report from Asia.

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Kumar, Anil; Sreehari, Sreekala; Velayudhan, Kandan; Biswas, Lalitha; Babu, Rachana; Ahmed, Shabeer; Sharma, Neelakanta; Kurupath, Vasanth P; Jojo, Annie; Dinesh, Kavitha R; Karim, Shamsul; Biswas, Raja

2014-04-01

Systemic endemic mycoses, such as blastomycosis, are rare in Asia and have been reported as health risks among travelers who visit or reside in an endemic area. Adrenal involvement is rarely seen in blastomycosis and has never been reported from Asia. We report the first case of blastomycosis with bilateral involvement of the adrenals in a diabetic patient residing in the state of Arunachal Pradesh, India.

Evaluation of aerosol optical properties of GEOS-Chem over East Asia during the DRAGON-Asia 2012 campaign

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Jo, D. S.; Park, R.; Kim, J.

2015-12-01

A nested version of 3-D chemical transport model (GEOS-Chem v9-01-02) is evaluated over East Asia during the Distributed Regional Aerosol Gridded Observation Networks (DRAGON)-Asia 2012 campaign period, focusing on fine-mode aerosol optical depth (fAOD) and single scattering albedo (SSA). Both are important to assess the effect of anthropogenic aerosols on climate. We compare the daily mean simulated optical properties of aerosols with the observations from DRAGON-Asia campaign for March-May, 2012 (provided in level 2.0: cloud screened and quality assured). We find that the model reproduces the observed daily variability of fAOD (R=0.67), but overestimates the magnitude by 30%, which is in general consistent with other global model comparisons from ACCMIP. However, a significant high bias in the model is found compared to the observed SSA at 440 nm, which is important for determining the sign of aerosol radiative forcing. In order to understand causes for this gap we conduct several sensitivity tests by changing source magnitudes and input parameters of aerosols, affecting the aerosol optical properties under various atmospheric conditions, which allows us to reduce the gap and to find the optimal values in the model.

Patients' Evaluation of the Quality of Diabetes Care (PEQD)

DEFF Research Database (Denmark)

Pouwer, F; Snoek, Frank J

2002-01-01

aspects of the quality of diabetes care as delivered by the specialist in internal medicine (internist) and the diabetes nurse specialist (DNS). Two principal components analyses (internist/DNS) both yielded one 14 item factor with a high internal consistency. Satisfaction with diabetes care, fewer......OBJECTIVES: To develop a brief measure of patients' evaluation of the quality of diabetes care and to study predictors of consumers' rating of the quality of diabetes care. DESIGN: A prospective design. SUBJECTS: 176 adults with type 1 (39%) or type 2 (61%) diabetes. MAIN MEASURES: Demographic...... variables, HbA1c, number of diabetes complications, satisfaction with diabetes care, diabetes related distress, and fear of hypoglycaemia were assessed by self-report. In addition, satisfaction with diabetes care and evaluations about quality of the care were measured at 16 month follow up. Statistical...

Evaluation of the diabetes health plan to improve diabetes care and prevention.

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Duru, O Kenrik; Mangione, Carol M; Chan, Charles; Keckhafer, Abigail; Kimbro, Lindsay; Kirvan, K Anya; Turk, Norman; Luchs, Robert; Li, Jinnan; Ettner, Susan

2013-01-01

Investigators from the University of California, Los Angeles (UCLA), and members of the leadership and data analysis teams at UnitedHealthcare (UHC) are partnering to evaluate the Diabetes Health Plan (DHP), an innovative disease-specific insurance product designed by UHC specifically for patients with prediabetes or diabetes. The DHP provides improved access to care management, telephone coaching, and enhanced Internet-based communication with enrollees. The evaluation will use a quasi-experimental design, comparing patients from employer groups that offer the DHP with patients from groups that do not, to determine the effect of the DHP on incidence of diabetes, adherence to metformin, and costs of care among patients with prediabetes. Other factors studied will be cardiovascular risk factor control, adherence to preventive services, health care use, and costs of care among patients with existing diabetes.

Diabetes-Related distress, depression and Distress-Depression among adults with type 2 diabetes mellitus in Malaysia

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Chew, Boon How; Vos, Rimke; Mohd-Sidik, Sherina; Rutten, Guy E H M

2016-01-01

Type 2 diabetes mellitus (T2DM) brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD) and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their

Review of gastroesophageal reflux disease (GERD) in the diabetic patient.

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Punjabi, Paawan; Hira, Angela; Prasad, Shanti; Wang, Xiangbing; Chokhavatia, Sita

2015-09-01

This article reviews the known pathophysiological mechanisms of comorbid gastroesophageal reflux disease (GERD) in the diabetic patient, discusses therapeutic options in care, and provides an approach to its evaluation and management. We searched for review articles published in the past 10 years through a PubMed search using the filters diabetes mellitus, GERD, pathophysiology, and management. The search only yielded a handful of articles, so we independently included relevant studies from these review articles along with related citations as suggested by PubMed. We found diabetic patients are more prone to developing GERD and may present with atypical manifestations. A number of mechanisms have been proposed to elucidate the connection between these two diseases. Studies involving treatment options for comorbid disease suggest conflicting drug-drug interactions. Currently, there are no published guidelines specifically for the evaluation and management of GERD in the diabetic patient. Although there are several proposed mechanisms for the higher prevalence of GERD in the diabetic patient, this complex interrelationship requires further research. Understanding the pathophysiology will help direct diagnostic evaluation. In our review, we propose a management algorithm for GERD in the diabetic patient. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Evaluation of diabetes care management in primary clinics based on the guidelines of American Diabetes Association.

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Albarrak, Ahmed Ismail; Mohammed, Rafiuddin; Assery, Bushra; Allam, Dalya; Morit, Sarah Al; Saleh, Reem Al; Zare'a, Reem

2018-01-01

There is a rapid increase in the incidence of diabetes mellitus in Saudi Arabia. Diabetes management is an essential constituent to prevent prognosis of diabetes complications. The main objective of this study was to assess diabetes care in primary clinics based on the guidelines of American Diabetes Association (ADA). A retrospective study at King Khaled University Hospitals, Riyadh, Saudi Arabia. A total of 200 patients were randomly selected from the databases of primary care clinics. An evaluation checklist was created based on the ADA treatment guidelines such as medical history, physical examination, laboratory evaluation, and referrals. The result showed that elements achieving the ADA targets for overall care were medical history (44.9%), physical examination (59.6%), laboratory evaluation (36.3%), and referrals (19.3%). The other subelement indicators such as referral to diabetes self-management education clinics (10%), dental examination (2%), HbA1c regular monitoring (33.5%), and blood pressure determination (100%) were documented with adherence to ADA standards. Diabetes management standards are an essential element in the success of the management plan. Most of the elements examined are not in full compliance with the ADA standard. Continues monitoring and self-review are recommended.

A Self-adaptive Dynamic Evaluation Model for Diabetes Mellitus, Based on Evolutionary Strategies

Directory of Open Access Journals (Sweden)

An-Jiang Lu

2016-03-01

Full Text Available In order to evaluate diabetes mellitus objectively and accurately, this paper builds a self-adaptive dynamic evaluation model for diabetes mellitus, based on evolutionary strategies. First of all, on the basis of a formalized description of the evolutionary process of diabetes syndromes, using a state transition function, it judges whether a disease is evolutionary, through an excitation parameter. It then, provides evidence for the rebuilding of the evaluation index system. After that, by abstracting and rebuilding the composition of evaluation indexes, it makes use of a heuristic algorithm to determine the composition of the evolved evaluation index set of diabetes mellitus, It then, calculates the weight of each index in the evolved evaluation index set of diabetes mellitus by building a dependency matrix and realizes the self-adaptive dynamic evaluation of diabetes mellitus under an evolutionary environment. Using this evaluation model, it is possible to, quantify all kinds of diagnoses and treatment experiences of diabetes and finally to adopt ideal diagnoses and treatment measures for different patients with diabetics.

The looming epidemic of diabetes-associated tuberculosis

DEFF Research Database (Denmark)

Harries, A D; Lin, Y; Satyanarayana, S

2011-01-01

The prevalence of diabetes mellitus is increasing at a dramatic rate, and countries in Asia, particularly India and China, will bear the brunt of this epidemic. Persons with diabetes have a significantly increased risk of active tuberculosis (TB), which is two to three times higher than in persons...

Diabetes mellitus is strongly associated with tuberculosis in Indonesia.

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Alisjahbana, B.; Crevel, R. van; Sahiratmadja, E.; Heijer, M. den; Maya, A.; Istriana, E.; Danusantoso, H.; Ottenhoff, T.H.; Nelwan, R.H.; Meer, J.W.M. van der

2006-01-01

SETTING: Diabetes mellitus is a known risk factor for tuberculosis (TB), but no studies have been reported from South-East Asia, which has a high burden of TB and a rapidly growing prevalence of diabetes. OBJECTIVE: To examine if and to what extent diabetes is associated with an increased risk of TB

Evaluating energy security in the Asia-Pacific region: A novel methodological approach

International Nuclear Information System (INIS)

Vivoda, Vlado

2010-01-01

This paper establishes an 'energy security assessment instrument' based on a new and expanded conceptualisation of energy security. The instrument is a systematic interrogative tool for evaluating energy security of individual states or regions. It consists of eleven broad energy security dimensions associated with the current global energy system. These energy security dimensions take into account numerous quantitative and qualitative attributes of each country's energy security and policy, and include both traditional energy security concerns and many new factors, such as environmental, socio-cultural and technological. Another dimension, largely absent from previous analyses, is the existence of, and the issues addressed in, energy security policy in each country. This instrument serves as an assessment system with which to evaluate energy security in the Asia-Pacific region. The existing studies on energy security in the Asia-Pacific region suffer from serious limitations. No study to date examines regional energy security policies by adopting a more comprehensive energy security definition as a starting point. Most studies also focus on a single country or issue. Even if they examine energy security in major regional economies, they lack critical comparative analysis. The instrument is valuable as it may be utilised to draw a comprehensive map of regional energy security situation, which can also include comparative analysis of energy security characteristics across the Asia-Pacific region. Ultimately, it may be utilised to set up a framework for improved regional energy cooperation with the aim of providing regional leaders with a blueprint for improving regional energy security and policy.

Accuracy Evaluation of 19 Blood Glucose Monitoring Systems Manufactured in the Asia-Pacific Region: A Multicenter Study.

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Yu-Fei, Wang; Wei-Ping, Jia; Ming-Hsun, Wu; Miao-O, Chien; Ming-Chang, Hsieh; Chi-Pin, Wang; Ming-Shih, Lee

2017-09-01

System accuracy of current blood glucose monitors (BGMs) in the market has already been evaluated extensively, yet mostly focused on European and North American manufacturers. Data on BGMs manufactured in the Asia-Pacific region remain to be established. In this study, we sought to assess the accuracy performance of 19 BGMs manufactured in the Asia-pacific region. A total of 19 BGMs were obtained from local pharmacies in China. The study was conducted at three hospitals located in the Asia-Pacific region. Measurement results of each system were compared with results of the reference instrument (YSI 2300 PLUS Glucose Analyzer), and accuracy evaluation was performed in accordance to the ISO 15197:2003 and updated 2015 guidelines. Radar plots, which is a new method, are described herein to visualize the analytical performance of the 19 BGMs evaluated. Consensus error grid is a tool for evaluating the clinical significance of the results. The 19 BGMs resulted in a satisfaction rate between 83.5% and 100.0% within ISO 15197:2003 error limits, and between 71.3% and 100.0% within EN ISO 15197:2015 (ISO 15197:2013) error limits. Of the 19 BGMs evaluated, 12 met the minimal accuracy requirement of the ISO 15197:2003 standard, whereas only 4 met the tighter EN ISO 15197:2015 (ISO 15197:2013) requirements. Accuracy evaluation of BGMs should be performed regularly to maximize patient safety.

Peritoneal Dialysis in Asia.

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Kwong, Vickie Wai-Ki; Li, Philip Kam-Tao

2015-12-01

There is a growing demand of dialysis in Asia for end-stage renal failure patients. Diabetes mellitus is the leading cause of end-stage renal failure in many countries in Asia. The growth of peritoneal dialysis (PD) in Asia is significant and seeing a good trend. With the enhanced practices of PD, the quality of care in PD in Asia is also improved. Overall, PD and hemodialysis (HD) are comparable in clinical outcome. There is a global trend in the reduction of peritonitis rates and Asian countries also witness such improvement. The socio-economic benefits of PD for end-stage renal failure patients in both urban and rural areas in the developed and developing regions of Asia are an important consideration. This can help to reduce the financial burden of renal failure in addressing the growing demand of patients on dialysis. Initiatives should be considered to further drive down the cost of PD in Asia. Growing demand for dialysis by an increasing number of end-stage renal failure patients requires the use of a cost-effective quality dialysis modality. PD is found to be comparable to HD in outcome and quality. In most countries in Asia, PD should be more cost-effective than HD. A 'PD-first' or a 'PD as first considered therapy' policy can be an overall strategy in many countries in Asia in managing renal failure patients, taking the examples of Hong Kong and Thailand. (1) PD is cheaper than HD and provides a better quality of life worldwide, but its prevalence is significantly lower than that of HD in all countries, with the exception of Hong Kong. Allowing reimbursement of PD but not HD has permitted to increase the use of PD over HD in many Asian countries like Hong Kong, Vietnam, Taiwan, Thailand, as well as in New Zealand and Australia over the last years. In the Western world, however, HD is still promoted, and the proportion of patients treated with PD decreases. Japan remains an exception in Asia where PD penetration is very low. Lack of adequate education of

Evaluating the influences of biomass burning during 2006 BASE-ASIA: a regional chemical transport modeling

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Fu, J. S.; Hsu, N. C.; Gao, Y.; Huang, K.; Li, C.; Lin, N.-H.; Tsay, S.-C.

2012-05-01

To evaluate the impact of biomass burning from Southeast Asia to East Asia, this study conducted numerical simulations during NASA's 2006 Biomass-burning Aerosols in South-East Asia: Smoke Impact Assessment (BASE-ASIA). Two typical episode periods (27-28 March and 13-14 April) were examined. Two emission inventories, FLAMBE and GFED, were used in the simulations. The influences during two episodes in the source region (Southeast Asia) contributed to the surface CO, O3 and PM2.5 concentrations as high as 400 ppbv, 20 ppbv and 80 μg m-3, respectively. The perturbations with and without biomass burning of the above three species during the intense episodes were in the range of 10 to 60%, 10 to 20% and 30 to 70%, respectively. The impact due to long-range transport could spread over the southeastern parts of East Asia and could reach about 160 to 360 ppbv, 8 to 18 ppbv and 8 to 64 μg m-3 on CO, O3 and PM2.5, respectively; the percentage impact could reach 20 to 50% on CO, 10 to 30% on O3, and as high as 70% on PM2.5. In March, the impact of biomass burning mainly concentrated in Southeast Asia and southern China, while in April the impact becomes slightly broader and even could go up to the Yangtze River Delta region. Two cross-sections at 15° N and 20° N were used to compare the vertical flux of biomass burning. In the source region (Southeast Asia), CO, O3 and PM2.5 concentrations had a strong upward transport from surface to high altitudes. The eastward transport becomes strong from 2 to 8 km in the free troposphere. The subsidence process during the long-range transport contributed 60 to 70%, 20 to 50%, and 80% on CO, O3 and PM2.5, respectively to surface in the downwind area. The study reveals the significant impact of Southeastern Asia biomass burning on the air quality in both local and downwind areas, particularly during biomass burning episodes. This modeling study might provide constraints of lower limit. An additional study is underway for an active

Diagnostic accuracy of HbA1c in diabetes between Eastern and Western.

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Yan, Shuang; Liu, Siying; Zhao, Yashuang; Zhang, Wencui; Sun, Xiaohui; Li, Jianing; Jiang, Fuli; Ju, Jiaming; Lang, Ning; Zhang, Yingqi; Zhou, Weiyu; Li, Qiang

2013-07-01

In 2010, the American Diabetes Association recommended the use of HbA1c as a diagnostic criterion for diabetes. However, HbA1c is not an accepted diagnostic tool for diabetes in Eastern Asia, because genetic differences compromise the standardization of the diagnostic cut-off point. This study evaluated differences in the use of HbA1c for diagnosing diabetes in Eastern and Western populations and investigated whether HbA1c cut-off point of ≥ 6.5% is diagnostic of diabetes in patients from Eastern Asia. Literature was obtained from MEDLINE, EMBASE and Cochrane databases. The pooled sensitivity and specificity of each HbA1c cut-off point were extracted and compared between Western and Eastern populations. Differences in the cut-off point for diagnosing diabetes in each region were compared by examining differences in the area under summary receiver operating characteristic (SROC) curves. Twelve publications from Eastern countries (n = 59,735) and 13 from Western countries (n = 22,954) were included in the analysis. Areas under SROC curves in the Eastern and Western groups were 0.9331 and 0.9120, respectively (P = 0.98). The cut-off point of the highest Youden index was 6.0%. At the HbA1c cut-off point of 6.5%, the pooled sensitivity and specificity were 58.7% and 98.4% for Eastern countries and 65.5% and 98.1% for Western countries, respectively. HbA1c exhibits the same diagnostic value for diabetes in Eastern and Western populations. In both populations, HbA1c levels > 6.0% identify the population at high risk of diabetes, and HbA1c > 6.5% is diagnostic of clinically established diabetes. © 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd.

Diabetes control and complications in public hospitals in Malaysia.

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Mafauzy, M

2006-10-01

The Diabcare-Asia project was initiated to study the status of diabetes care and prevalence of diabetic complications in Asia and this study was done to evaluate the above in public hospitals in Malaysia and compare to a similar study done in 1998. A total of 19 public hospitals participated in this study from which a total of 1099 patients were included and analysed. The majority of patients (94.8%) had type 2 diabetes mellitus and 66.5% were overweight or obese. As for glycaemic control only 41.0% of the patients had HbA1c 1.1 mmol/L and 51.1% had triglycerides diet regularly and 38.9% exercised regularly. As for glucose monitoring, only 26.8% of the patients did home blood glucose monitoring and 1.8% did home urine glucose testing. There was also a high complication rate with the commonest being neuropathy (19.0%) followed by albuminuria (15.7%), background retinopathy (11.1%) and microalbuminuria (6.6%). Compared to the 1998 study, there was some improvement in the percentage of patients achieving target levels and a reduction in the prevalence of complications. In conclusion, the majority of diabetic patients treated at the public hospitals were still not satisfactorily controlled and this was still associated with a high prevalence of complications. There is still an urgent need to educate both patients and health care personnel on the importance of achieving the clinical targets and greater effort must be made to achieve these targets.

CREED study: Hypoglycaemia during Ramadan in individuals with Type 2 diabetes mellitus from three continents.

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Jabbar, Abdul; Hassanein, Mohamed; Beshyah, Salem A; Boye, Kristina S; Yu, Maria; Babineaux, Steven M

2017-10-01

To describe diabetes treatment and hypoglycaemia in individuals with Type 2 diabetes mellitus during Ramadan. A multi-country, retrospective, observational study with data captured before, during, and after Ramadan. We report on a cohort of people (N=3250) with Type 2 diabetes mellitus in four culturally distinct regions: Asia, North Africa, Europe, and the Middle East. During Ramadan, the proportion of participants on oral anti-diabetic medication alone ranged from 68.4% (Middle East) to 80.5% (Asia); the proportion on insulin alone ranged from 3.7% (Middle East) to 8.6% (Europe). The average number of days fasted for individuals with an American Diabetes Association (ADA) risk status of very high was 27 (Middle East), 25.7 (Asia), 25.4 (North Africa), and 21 (Europe). The incidence of hypoglycaemia according to an ADA risk status of very high was 5.6% (n=1/18, Europe), 6.1% (n=2/33, Middle East), 8.7% (n=4/46, Asia), and 38% (n=10/26, North Africa). The incidence of hypoglycaemia, during Ramadan, for the entire cohort was 16.8% with insulin treatment and 5.3% with oral anti-diabetic medication. Having an episode of hypoglycaemia before Ramadan was associated with hypoglycaemia during Ramadan (odds ratio 7.80; 95% confidence interval 5.31-11.45). Approaches to the management of Type 2 diabetes mellitus during Ramadan varied across regions. Episodes of hypoglycaemia and insulin therapy predicted risk of hypoglycaemia during Ramadan and identified individuals who required Ramadan-specific education. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

Diabetic Nephropathy : Evaluation with Doppler Ultrasonography

International Nuclear Information System (INIS)

Sim, Jung Suk; Kim, Seung Hyup; Kang, Heung Sik; Park, Jae Hyung; Han, Man Chung

1996-01-01

To compare Doppler ultrasonography with laboratory tests in evaluation of diabetic nephropathy. Fifty-five patients (mean age = 60, M : F = 26 : 29) with diabetes mellitus underwent renal Doppler ultrasonography. Resistive indices were compared with degree of proteinuria, serum creatinine level, and creatinine clearance rate. Eighteen patients who showed no proteinuria or microscopic proteinuria had a mean resistive index (RI) of 0.72 (SD, 0.05), 16 patients with macroscopic proteinuria without nephrotic syndrome had a mean RI of 0.82 (SD, 0.13), and 21 patients with nephrotic syndrome had a mean RI of 0.90 (SD, 0.12). Renal RI correlated highly with serum creatinine level (r = 0.62) and creatinine clearance rate (r = -0.43). Renal Doppler ultrasonography provides a useful indication of renal function in diabetic nephropathy but cannot offer an advantage over conventional laboratory test

Case study of evaluations that go beyond clinical outcomes to assess quality improvement diabetes programmes using the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE).

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Paquette-Warren, Jann; Harris, Stewart B; Naqshbandi Hayward, Mariam; Tompkins, Jordan W

2016-10-01

Investments in efforts to reduce the burden of diabetes on patients and health care are critical; however, more evaluation is needed to provide evidence that informs and supports future policies and programmes. The newly developed Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE) incorporates the theoretical concepts needed to facilitate the capture of critical information to guide investments, policy and programmatic decision making. The aim of the study is to assess the applicability and value of DEFINE in comprehensive real-world evaluation. Using a critical and positivist approach, this intrinsic and collective case study retrospectively examines two naturalistic evaluations to demonstrate how DEFINE could be used when conducting real-world comprehensive evaluations in health care settings. The variability between the cases and the evaluation designs are described and aligned to the DEFINE goals, steps and sub-steps. The majority of the theoretical steps of DEFINE were exemplified in both cases, although limited for knowledge translation efforts. Application of DEFINE to evaluate diverse programmes that target various chronic diseases is needed to further test the inclusivity and built-in flexibility of DEFINE and its role in encouraging more comprehensive knowledge translation. This case study shows how DEFINE could be used to structure or guide comprehensive evaluations of programmes and initiatives implemented in health care settings and support scale-up of successful innovations. Future use of the framework will continue to strengthen its value in guiding programme evaluation and informing health policy to reduce the burden of diabetes and other chronic diseases. © 2016 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Evaluation of Plasma Lipoprotein (A Levels in Diabetic and Non Diabetic Indiviuals

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BA Jalai

2005-01-01

Full Text Available Introduction: Lipoprotein (a is a particle rich in cholesterol in human plasma and it is known as an independent risk factor for coronary artery disease. In addition to genetic background, other factors such as diabetes affect the plasma concentration of this lipoprotein as a risk factor. The aim of this study was evaluation and comparison of plasma concentration of Lp(a in type II diabetics and non diabetic individuals. Material and Methods: The study population included 180 diabetic patients who had referred to the Diabetic Research center of Yazd and 180 non diabetic individuals who were matched according to age and sex with the patient group. Blood samples were collected from the study groups in fasting condition. Glycated hemoglobin, glucose, lipids and lipoproteins were measured by routine laboratory methods and Lp(a assay was carried out by electro immunodiffusion. Results were analyzed with the use of SPSS program. Statistical tests included variance analysis, t-test for comparing lipids and lipoproteins, U-test for comparing Lp(a in the two groups and Pearson Correlation for determining of the variables with Lp(a. Results: Mean plasma concentratin of Lp(a in diabetic patients (Mean + SD 41.98+ 34.63 mg/dl was significantly higher than that of the control group (26.6 + 20.2 mg/dl (P<0.001. Mean concentration of cholesterol, triglyceride and LDL cholesterol in the patient group was higher but mean HDL cholesterol in control group was higher than patient group. However, no significant correlation was found between Lp(a and other variables in the patient and control groups. Conclusion: Plasma concentration of Lp(a in Diabetes Mellitus is increased independently. In diabetic patients, the risk of coronary artery disease may increase with increase in Lp(a.

Evaluating the Effect of a Diabetes Health Coach in Individuals with Type 2 Diabetes.

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Sherifali, Diana; Viscardi, Virginia; Bai, Johnny-Wei; Ali, R Muhammad Usman

2016-02-01

Diabetes health coaching has not been adequately assessed in individuals with type 2 diabetes. The objective of this review was to synthesize the evidence of health coaching for individuals with diabetes to determine the effects of coaching on diabetes control, specifically on glycated hemoglobin (A1C) levels. The EMBASE, MEDLINE, CINAHL, PsychINFO and Cochrane Central Register of Controlled Trials databases were searched from inception to January 2015. Reference lists from important publications were also reviewed. At least 2 evaluators independently screened and extracted data from eligible studies. A total of 8 trials met the selection criteria, which included 724 adult participants; 353 participants were randomized to a diabetes health coaching intervention, and 371 were randomized to usual care. The pooled effect of diabetes health coaching overall was a statistically significant reduction of A1C levels by 0.32 (95% CI, -0.50 to -0.15). Longer diabetes health coaching exposure (>6 months) resulted in a 0.57% reduction in A1C levels (95% CI, -0.76 to -0.38), compared to shorter diabetes health coaching exposure (≤6 months) (-0.23%; 95% CI, -0.37 to -0.09). Across all studies, diabetes health coaching consisted of goal setting, knowledge acquisition, individualized care and frequent follow up. Diabetes health coaching has an emerging role in healthcare that facilitates self-care, behaviour change and offers frequent follow up and support. This review finds that health coaching for those with diabetes is an effective intervention for improving glycemic control, which may be of greater benefit when offered in addition to existing diabetes care. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Type 2 diabetes affects sleep quality by disrupting the respiratory function.

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Colbay, Gulcan; Cetin, Mustafa; Colbay, Mehmet; Berker, Dilek; Guler, Serdar

2015-09-01

The effects of diabetes on the respiratory system were investigated with arterial blood gas, sleep quality index and respiratory functions tests. Fifty-three patients with type II diabetes and 41 healthy cases were included. Their biochemical data, demographic characteristics, anthropometric measurements and echocardiographic findings were collected from polyclinic records. Respiratory function tests were performed for all subjects and Pittsburgh Sleep Quality Index questionnaire was conducted. Aforementioned data were compared between these two groups. The age, body weight and body mass index were similar but oxygen pressure, oxygen saturation, forced vital capacity (FVC; %), and sleep quality were decreased in patients with diabetes. Sleep quality was correlated with the presence of diabetes and hypertension, duration of diabetes, fasting and postprandial blood glucose levels, homeostasis model of assessment-insulin resistance, Glycosylated hemoglobin levels, and FVC. Half of the diabetic patients exhibited respiratory failure during sleep. Especially diabetic patients with autonomic neuropathy, experienced a more severe and prolonged decrease in oxygen saturation. Blood gas, respiratory functions and sleep quality, which need to be evaluated as a whole, were affected in patients with diabetes. Assessment of sleep and its quality requires special attention in patients with diabetes. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

Diabetes among migrants in Denmark

DEFF Research Database (Denmark)

Andersen, Gregers Stig; Kamper-Jørgensen, Zaza; Carstensen, Bendix

2016-01-01

Objective Studies of diabetes in migrant populations have shown a higher prevalence compared to their respective countries of origin and to people natively born in the host country, but there is little population-based data on diabetes incidence and mortality in migrant populations. The aim...... of the current study was (1) to describe the incidence rates and prevalence of diabetes among first generation migrants in Denmark compared to the Danish background population, and (2) to compare standardised mortality rates (SMRs) for individuals with and without diabetes according to country of origin...... to the part of the population without diabetes were calculated based on follow up of the entire Danish population. Results Compared with native born Danes, the incidence of diabetes was about 2.5 times higher among migrants from Africa, Asia, and the Middle East, and these migrant groups also showed...

Consumer evaluation of imported organic food products in emerging economies in Asia

OpenAIRE

Pedersen, Susanne; Aschemann-Witzel, Jessica; Thøgersen, John

2017-01-01

Consumer evaluation of imported organic food products in emerging economies in Asia Introduction Consumers in emerging economies such as Thailand and China have started to demand organic food products – mainly due to food safety reasons (Ortega, Wang, Wu, & Hong, 2015; Roitner-Schobesberger, Darnhofer, Somsook, & Vogl, 2008; C. L. Wang, Li, Barnes, & Ahn, 2012; O. Wang, De Steur, Gellynck, & Verbeke, 2015). However, since the domestic organic markets are still not well-establi...

Evaluation of the Treatment of Diabetic Retinopathy A Research Project

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Kupfer, Carl

1973-01-01

Evaluated is the treatment of diabetic retinopathy (blindness due to ruptured vessels of the retina as a side effect of diabetes), and described is a research project comparing two types of photocoagulation treatment. (DB)

Evaluation of a diabetes nurse specialist prescribing project.

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Wilkinson, Jill; Carryer, Jenny; Adams, Jeffery

2014-08-01

To evaluate the diabetes nurse specialist prescribing project with the aim of determining whether diabetes nurse specialist prescribing is safe and effective and to inform the implementation and extension of registered nurse prescribing. Registered nurses in many countries are able to prescribe medicines, but in New Zealand, prior to the diabetes nurse specialist project, nurse practitioners were the only nurses who could prescribe medicines. New regulations allowed the nurses to prescribe a limited number of prescription medicines. The study was a process and outcome clinical programme evaluation. The project took place between April-September 2011 and involved 12 diabetes nurse specialist in four localities. Quantitative data were collected from clinical records maintained by the diabetes nurse specialist for the project (1274 patients and 3402 prescribing events), from surveys with stakeholders (general practitioners, n = 30; team members, n = 19; and patients, n = 89) and audits from patient notes (n = 117) and prescriptions (n = 227), and qualitative data from interviews with project participants (n = 18) and patients (n = 19). All data were analysed descriptively. Diabetes nurse specialist prescribing was determined to be safe, of high quality and appropriate. It brought important benefits to the effectiveness of specialist diabetes services, was acceptable to patients and was supported by the wider healthcare team. These findings are consistent with the findings reported in the international literature about nurse prescribing in a range of different practice areas. Clarification of the education and competence requirements and resourcing for the ongoing supervision of nurses is recommended if the prescribing model is to be extended. Diabetes nurse specialist prescribing improved access to medicines by providing a more timely service. Nurses felt more satisfied with their work because they could independently provide a complete episode of care

EVALUATION OF DRY EYES IN DIABETES MELLITUS

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Anshu Sharma

2017-12-01

Full Text Available BACKGROUND According to the National Eye Institute, dry eye is a condition in which the eye does not produce tears properly. It can also involve tears not having the right consistency or evaporating too quickly. Tears are necessary to help maintain moisture on the surface of the eye and for clear vision. Diabetes is often associated with several significant ocular conditions such as retinopathy, refractive changes, cataracts, glaucoma and macular oedema. However, one of the most common ocular complications associated with diabetes is dry eye. The aim of the study is to study the prevalence of dry eyes in diabetes mellitus and to evaluate ocular and other risk factors relevant to diabetic dry eyes. MATERIALS AND METHODS A hospital-based cross-sectional clinical study of 100 diabetic patients who presented to the Department of Ophthalmology, Santosh Medical College and Hospital, Ghaziabad, between January 2016 to June 2017 was conducted. Detailed diabetic history was recorded. Assessment of anterior segment via slit-lamp biomicroscopy was done. The examinations for dry eyes included Schirmer's test, tear breakup time, fluorescein and rose Bengal staining. RESULTS Sixty two (62% diabetic patients had dry eye. The prevalence in type I was 3% and prevalence in type II was 59%. Dry eye prevalence was maximum in those above 40 years of age. Symptoms like reduced corneal sensation (44% and meibomitis (20% were major attributable risk factors. Ocular surface damage was predominantly superficial punctate keratitis. Retinopathy was not statistically associated with the prevalence of dry eyes. CONCLUSION Diabetes and dry eye appears to be a common association. Reduction in the modifiable risk factors of dry eye is essential to reduce its prevalence. No significant statistical correlation was found between retinopathy and dry eyes. However, examination for dry eyes should be an integral part of the assessment of diabetic eye disease.

Stroke in Asia: a global disaster.

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Kim, Jong S

2014-10-01

Although stroke is a world-wide problem, the burden of stroke is particularly serious in Asia; its mortality is higher than in Europe or North America. The situation in Asia is dichotomized. Stroke mortality and case fatality has been declining in northern-eastern countries such as Korea, Japan, Taiwan, and urbanized areas of China. This is attributed to both the risk factor control and stroke care improvement. However, declining stroke incidence is rarely observed, which is in part due to rapidly aging population. As a result, there is an increase in the number of stroke survivors who require long-term, costly care. The extremely low birth rate and relatively insecure social health system markedly increases the caregiver burden. The problem in southern Asian countries, such as India, Pakistan, Bangladesh, and Indonesia is more fundamental. With the improving control of infectious diseases, life expectancy is prolonged. However, risk factors such as hypertension, diabetes, obesity and cigarette smoking become prevalent, and are poorly controlled. Stroke neurologists, organized stroke centers, and diagnostic tools are insufficient, which has resulted in high stroke fatality and mortality. Throughout Asia, the most urgent priority should be the primary stroke prevention through promoting a healthy lifestyle, e.g. low salt intake, regular physical exercise, stopping smoking, government sectors should take a stronger initiative to accomplish this. The rapidly aging populations and stroke burden will shrink the economy and destabilize the society, not only in Asia but also globally unless appropriate efforts are promptly initiated, this may result in a global disaster. © 2014 World Stroke Organization.

Review of insulin-associated hypoglycemia and its impact on the management of diabetes in Southeast Asian countries.

Science.gov (United States)

Goh, Su-Yen; Hussein, Zanariah; Rudijanto, Achmad

2017-09-01

Although the incidence of diabetes is rising in Southeast Asia, there is limited information regarding the incidence and manifestation of insulin-associated hypoglycemia. The aim of the present review was to discuss what is currently known regarding insulin-associated hypoglycemia in Southeast Asia, including its known incidence and impact in the region, and how the Southeast Asian population with diabetes differs from other populations. We found a paucity of data regarding the incidence of hypoglycemia in Southeast Asia, which has contributed to the adoption of Western guidelines. This might not be appropriate, as Southeast Asians have a range of etiological, educational and cultural differences from Western populations with diabetes that might place them at greater risk of hypoglycemia if not managed optimally. For example, Southeast Asians with type 2 diabetes tend to be younger, with lower body mass indexes than their Western counterparts, and the management of type 2 diabetes with premixed insulin preparations is more common in Southeast Asia. Both of these factors might result in higher rates of hypoglycemia. In addition, Southeast Asians are often poorly educated about hypoglycemia and its management, including during Ramadan fasting. We conclude there is a need for more information about Southeast Asian populations with diabetes to assist with the construction of more appropriate national and regional guidelines for the management of hypoglycemia, more closely aligned to patient demographics, behaviors and treatment practices. Such bespoke guidelines might result in a greater degree of implementation and adherence within clinical practice in Southeast Asian nations. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

Comparative Anti-Diabetic Evaluation of Different Parts of Himalrandia tetrasperma in Alloxan Induced Diabetic in Mice

International Nuclear Information System (INIS)

Ajaib, M.

2016-01-01

The present experiments were designed to investigate the acute effects of methanolic extracts of various parts of H. tetrasperma in diabetic mice. The basic phyto-chemical study showed the occurrence of alkaloids, saponins, flavonoids and tannins as main phyto-constituents in the methanolic extract. Diabetes was induced experimentally in mice by intra peritoneally injecting alloxan (150 mg/kg i.p.). In acute study, methanolic H. tetrasperma extracts of various parts of plant were evaluated for anti-diabetic potential in alloxan induced diabetic mice. Extracts of leaves, bark and seeds (250 mg/kg, i.p) and metformin (250 mg/kg i.p) were given intra peritoneal in alloxan treated diabetic mice and blood glucose levels were measured at 0, 360 and 24 h. There was significant lowering of blood glucose level at 1 h after treatment, in diabetic mice treated with methanolic extracts of bark (182.3 ± 3.6 mg/dL), leaves (178.5 ± 1.2 mg/dL) and seeds (156.3 ± 11.3 mg/dL) when compared with control diabetic group (280 ± 7.92 mg/dL). Highly significant results were also obtained at 24 h after treatment with methanolic extracts of bark (187.67 ±1.2 mg/dL), leaves (170.66 ± 2.3 mg/dL) and seeds (142 ± 8.7 mg/dL) when compared with control diabetic group (257.7 ± 6.7 mg/dL). It is concluded that methanolic extract of all parts possess significant anti-diabetic activity which is due to the presence of phytochemicals, i.e. alkaloids, flavonoids, phenols, saponins, tannins and it can be further evaluated for the mechanism involved. (author)

Evaluating the influences of biomass burning during 2006 BASE-ASIA: a regional chemical transport modeling

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N. C. Hsu

2012-05-01

Full Text Available To evaluate the impact of biomass burning from Southeast Asia to East Asia, this study conducted numerical simulations during NASA's 2006 Biomass-burning Aerosols in South-East Asia: Smoke Impact Assessment (BASE-ASIA. Two typical episode periods (27–28 March and 13–14 April were examined. Two emission inventories, FLAMBE and GFED, were used in the simulations. The influences during two episodes in the source region (Southeast Asia contributed to the surface CO, O₃ and PM_2.5 concentrations as high as 400 ppbv, 20 ppbv and 80 μg m⁻³, respectively. The perturbations with and without biomass burning of the above three species during the intense episodes were in the range of 10 to 60%, 10 to 20% and 30 to 70%, respectively. The impact due to long-range transport could spread over the southeastern parts of East Asia and could reach about 160 to 360 ppbv, 8 to 18 ppbv and 8 to 64 μg m⁻³ on CO, O₃ and PM_2.5, respectively; the percentage impact could reach 20 to 50% on CO, 10 to 30% on O₃, and as high as 70% on PM_2.5. In March, the impact of biomass burning mainly concentrated in Southeast Asia and southern China, while in April the impact becomes slightly broader and even could go up to the Yangtze River Delta region.

Two cross-sections at 15° N and 20° N were used to compare the vertical flux of biomass burning. In the source region (Southeast Asia, CO, O₃ and PM_2.5 concentrations had a strong upward transport from surface to high altitudes. The eastward transport becomes strong from 2 to 8 km in the free troposphere. The subsidence process during the long-range transport contributed 60 to 70%, 20 to 50%, and 80% on CO, O₃ and PM_2.5, respectively to surface in the downwind area. The study reveals the significant impact of Southeastern Asia biomass burning on the air quality in both local and downwind

South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

OpenAIRE

Sarita Bajaj; Fatema Jawad; Najmul Islam; Hajera Mahtab; Jyoti Bhattarai; Dina Shrestha; Chandrika Wijeyaratne; Dimuthu T Muthukuda; Niranjala Weegoda Widanage; Than Than Aye; Moe Wint Aung; Bharti Kalra; R M Anjana; Aswathy Sreedevi; Komal Verma

2013-01-01

Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultur...

Diabetes in Kyrgyzstan: changes between 2002 and 2009.

Science.gov (United States)

Beran, David; Abdraimova, Aida; Akkazieva, Baktygul; McKee, Martin; Balabanova, Dina; Yudkin, John S

2013-01-01

Health system reform in Kyrgyzstan is seen as a relative success story in central Asia. Initially, most attention focused on structural changes, and it is only since 2006 that the delivery of care and the experience of health service users have risen on the agenda. One exception from the earlier period was a rapid appraisal of the management of diabetes, undertaken in 2002. Using that study as a baseline, we describe the findings of a new evaluation of diabetes management, undertaken in 2009, using the Rapid Assessment Protocol for Insulin Access, now implemented in seven countries. Access to care has improved through the creation of the Family Medical Centres and the deployment of endocrinologists to them. Another improvement is the access to insulin and related medicines, although assessment of the procurement system reveals that the government is getting very poor value for money. Looking ahead, there are grounds for optimism that the passage of the law on diabetes may progressively have a greater impact. Although the law is not yet fully implemented, it has enabled the diabetes associations to defend the rights of their members. This increased capacity is credited with some improvements in diabetes care. Copyright © 2012 John Wiley & Sons, Ltd.

Sensitivity Evaluation of Spectral Nudging Schemes in Historical Dynamical Downscaling for South Asia

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Mehwish Ramzan

2017-01-01

Full Text Available Sensitivity experiments testing two scale-selective bias correction (SSBC methods have been carried out to identify an optimal spectral nudging scheme for historical dynamically downscaled simulations of South Asia, using the coordinated regional climate downscaling experiment (CORDEX protocol and the regional spectral model (RSM. Two time periods were selected under the category of short-term extreme summer and long-term decadal analysis. The new SSBC version applied nudging to full wind components, with an increased relaxation time in the lower model layers, incorporating a vertical weighted damping coefficient. An evaluation of the extraordinary weather conditions experienced in South Asia in the summer of 2005 confirmed the advantages of the new SSBC when modeling monsoon precipitation. Furthermore, the new SSBC scheme was found to predict precipitation and wind patterns more accurately than the older version in decadal analysis, which applies nudging only to the rotational wind field, with a constant strength at all heights.

Evaluation of the difference in caries experience in diabetic and non-diabetic children-A case control study.

Science.gov (United States)

Lai, Stefano; Cagetti, Maria Grazia; Cocco, Fabio; Cossellu, Dina; Meloni, Gianfranco; Campus, Guglielmo; Lingström, Peter

2017-01-01

To evaluate the caries prevalence and related variables in Type 1 diabetic and non-diabetic children and among the diabetic children according to their metabolic status. Sixty-eight diabetic and 136 non-diabetic children, matching by gender and age (4-14 years) were enrolled. The diabetic children were divided: a) 20 children in good metabolic control (Hb1ac≤7.5) and b) 48 children in bad metabolic control (Hb1ac>7.5). Dietary and oral hygiene habits were investigated. Caries status was registered using the International Caries Detection and Assessment System. Oral microflora was analysed using the checkerboard DNA-DNA hybridisation method. Plaque acidogenicity was recorded after a sucrose rinse. Sugared beverage and snack intake was higher in diabetic group compared to non-diabetic group (p = 0.03 and p = 0.04, respectively) and in subjects in bad metabolic control (p = 0.03 and pgood metabolic control (pgood and bad metabolic control (pgood metabolic control might even be considered at low caries risk, while those in bad metabolic control showed an oral environment prone to a high caries risk.

Evaluation of New-Onset Diabetes in Patients Presenting Emergency Service with a Diabetic Ketoacidosis Attack

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Yavuz Yiğit

2013-12-01

Full Text Available Aim: The aim of this study was to investigate the rate of new-onset diabetes mellitus (DM in patients presenting to our emergency department with diabetic ketoacidosis. Methods: We retrospectively evaluated hospital records of patients who presented to the Emergency Department at Istanbul Goztepe Research and Training Hospital between 01 April 2009 and 01 April 2011 and were diagnosed with diabetic ketoacidosis. 57 patients having complete clinical data were included in the study. Results: 45.6%of patients had type 1 DM, 33.3%- type 2 DM, and 21%of them were with new-onset DM. No statistically significant difference was found between type 1 DM, type 2 DM and new-onset DM patients with respect to arterial blood pH and HCO3 levels and serum sodium, potassium and plasma glucose levels at presentation as well as time of presentation (p>0.05, while HbA1c levels showed statistically significant difference in new-onset DM patients. Conclusion: No statistically significant difference was found between types of DM in patients diagnosed with diabetic ketoacidosis except for precipitating factors, age and HbA1c. Detecting high blood glucose levels in patients presenting to emergency room for reasons other than DM is not a rare condition. Cautious evaluation and recognition of these patients in emergency room for the possibility of undiagnosed DM is important for prevention of future diabetic ketoacidosis episodes. (The Medical Bulletin of Haseki 2013; 51: 168-72

Bariatric surgery for diabetes: the International Diabetes Federation takes a position.

Science.gov (United States)

Dixon, John B; Zimmet, Paul; Alberti, K George; Mbanya, Jean Claude; Rubino, Francesco

2011-12-01

Type 2 diabetes (T2D) and obesity are both complex and chronic medical disorders, each with an escalating worldwide prevalence. When obesity is severe, and/or available medical therapies fail to control the diabetes, bariatric surgery becomes a cost-effective therapy for T2D. When there are other major comorbidities and cardiovascular risk, the option of bariatric surgery becomes even more worthy of consideration. National guidelines for bariatric surgery need to be developed and implemented for people with T2D. With this in mind, the International Diabetes Federation convened a multidisciplinary working group to develop a position statement. The key recommendations cover describing those eligible for surgery and who should be prioritized, incorporating bariatric surgery into T2D treatment algorithms, performing surgery in centers with multidisciplinary teams that are experienced in the management of both obesity and diabetes, and developing bariatric surgery registries and reporting standards. © 2011 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.

Computer vision algorithm for diabetic foot injury identification and evaluation

Energy Technology Data Exchange (ETDEWEB)

Castaneda M, C. L.; Solis S, L. O.; Martinez B, M. R.; Ortiz R, J. M.; Garza V, I.; Martinez F, M.; Castaneda M, R.; Vega C, H. R., E-mail: lsolis@uaz.edu.mx [Universidad Autonoma de Zacatecas, 98000 Zacatecas, Zac. (Mexico)

2016-10-15

Diabetic foot is one of the most devastating consequences related to diabetes. It is relevant because of its incidence and the elevated percentage of amputations and deaths that the disease implies. Given the fact that the existing tests and laboratories designed to diagnose it are limited and expensive, the most common evaluation is still based on signs and symptoms. This means that the specialist completes a questionnaire based solely on observation and an invasive wound measurement. Using the questionnaire, the physician issues a diagnosis. In the sense, the diagnosis relies only on the criteria and the specialists experience. For some variables such as the lesions area or their location, this dependency is not acceptable. Currently bio-engineering has played a key role on the diagnose of different chronic degenerative diseases. A timely diagnose has proven to be the best tool against diabetic foot. The diabetics foot clinical evaluation, increases the possibility to identify risks and further complications. The main goal of this paper is to present the development of an algorithm based on digital image processing techniques, which enables to optimize the results on the diabetics foot lesion evaluation. Using advanced techniques for object segmentation and adjusting the sensibility parameter, allows the correlation between the algorithms identified wounds and those observed by the physician. Using the developed algorithm it is possible to identify and assess the wounds, their size, and location, in a non-invasive way. (Author)

Computer vision algorithm for diabetic foot injury identification and evaluation

International Nuclear Information System (INIS)

Castaneda M, C. L.; Solis S, L. O.; Martinez B, M. R.; Ortiz R, J. M.; Garza V, I.; Martinez F, M.; Castaneda M, R.; Vega C, H. R.

2016-10-01

Diabetic foot is one of the most devastating consequences related to diabetes. It is relevant because of its incidence and the elevated percentage of amputations and deaths that the disease implies. Given the fact that the existing tests and laboratories designed to diagnose it are limited and expensive, the most common evaluation is still based on signs and symptoms. This means that the specialist completes a questionnaire based solely on observation and an invasive wound measurement. Using the questionnaire, the physician issues a diagnosis. In the sense, the diagnosis relies only on the criteria and the specialists experience. For some variables such as the lesions area or their location, this dependency is not acceptable. Currently bio-engineering has played a key role on the diagnose of different chronic degenerative diseases. A timely diagnose has proven to be the best tool against diabetic foot. The diabetics foot clinical evaluation, increases the possibility to identify risks and further complications. The main goal of this paper is to present the development of an algorithm based on digital image processing techniques, which enables to optimize the results on the diabetics foot lesion evaluation. Using advanced techniques for object segmentation and adjusting the sensibility parameter, allows the correlation between the algorithms identified wounds and those observed by the physician. Using the developed algorithm it is possible to identify and assess the wounds, their size, and location, in a non-invasive way. (Author)

Evaluation of the difference in caries experience in diabetic and non-diabetic children-A case control study.

Directory of Open Access Journals (Sweden)

Stefano Lai

Full Text Available To evaluate the caries prevalence and related variables in Type 1 diabetic and non-diabetic children and among the diabetic children according to their metabolic status.Sixty-eight diabetic and 136 non-diabetic children, matching by gender and age (4-14 years were enrolled. The diabetic children were divided: a 20 children in good metabolic control (Hb1ac≤7.5 and b 48 children in bad metabolic control (Hb1ac>7.5. Dietary and oral hygiene habits were investigated. Caries status was registered using the International Caries Detection and Assessment System. Oral microflora was analysed using the checkerboard DNA-DNA hybridisation method. Plaque acidogenicity was recorded after a sucrose rinse.Sugared beverage and snack intake was higher in diabetic group compared to non-diabetic group (p = 0.03 and p = 0.04, respectively and in subjects in bad metabolic control (p = 0.03 and p<0.01, respectively. Oral hygiene habits were similar, except for the use of fluoridated adjuvants, higher in non-diabetic children (p = 0.04. No statistically significant differences were observed regarding caries figures, but a higher number of caries free subjects was found in diabetic subjects in good metabolic control (p<0.01. Significant difference for the main cariogenic bacteria was found between diabetic and non-diabetic subjects (p<0.05. The pH values showed statistically significant differences between diabetic and non-diabetic subjects and between diabetic subjects in good and bad metabolic control (p<0.01.Diabetic children in good metabolic control might even be considered at low caries risk, while those in bad metabolic control showed an oral environment prone to a high caries risk.

Predictors of cardiac morbidity in diabetic, new-onset diabetic and non-diabetic high-risk hypertensive patients: The Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial.

Science.gov (United States)

Aksnes, Tonje A; Kjeldsen, Sverre E; Rostrup, Morten; Holzhauer, Björn; Hua, Tsushung A; Julius, Stevo

2016-08-01

Diabetic and new-onset diabetic patients with hypertension have higher cardiac morbidity than patients without diabetes. We aimed to investigate whether baseline predictors of cardiac morbidity, the major constituent of the primary endpoint in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) trial, were different in patients with diabetes and new-onset diabetes compared to patients without diabetes. In total, 15,245 high-risk hypertensive patients in the VALUE trial were followed for an average of 4.2 years. At baseline, 5250 patients were diabetic by the 1999 World Health Organization criteria, 1298 patients developed new-onset diabetes and 8697 patients stayed non-diabetic during follow-up. Cardiac morbidity was defined as a composite of myocardial infarction and heart failure requiring hospitalization, and baseline predictors were identified by univariate and multivariate stepwise Cox regression analyses. History of coronary heart disease (CHD) and age were the most important predictors of cardiac morbidity in both diabetic and non-diabetic patients. History of CHD, history of stroke and age were the only significant predictors of cardiac morbidity in patients with new-onset diabetes. Predictors of cardiac morbidity, in particular history of CHD and age, were essentially the same in high-risk hypertensive patients with diabetes, new-onset diabetes and without diabetes who participated in the VALUE trial.

Security in the Asia Pacific region

International Nuclear Information System (INIS)

1999-01-01

The Working Group began by discussing the meaning of security in terms of its comprehensive, cooperative and human dimensions. In doing so, the members of the Group focused on major issues which could endanger regional stability and non-proliferation. In order to identify the major problems and sources of tension, it was agreed that the Group would concentrate on two sub-regions, namely, East Asia and South East Asia and then to compare these briefly with South Asia and Latin America, the aim being to identify common security concerns. The discussion was framed in terms of: (i) evaluating the adequacy of the existing institutional framework for security cooperation; (ii) evaluating linkages between economic development and security; and (iii) seeking ways to reduce tension and to increase security in the region. Discussion was focused on the broad subject of security risks and challenges as well as opportunities for effective cooperative security in the Asia Pacific region. Attention was devoted to ways of changing Cold War mentalities, which still hinder the normalization process and the achievement of comprehensive security cooperation among the countries in the region

THE EVALUATION OF PHYSICAL ACTIVITY IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Directory of Open Access Journals (Sweden)

Vladan Jovanović

2003-10-01

Full Text Available It is already known that physical activity is very important measure in treatment of type 2 diabetes mellitus, but in spite of that, in our country, there is neither its adequate use in therapy, nor the evaluation of its level in type 2 diabetics.The aim of this study is to evaluate the level of physical activity in patients with type 2 diabetes, by using the questionnaire for evaluation of physical activity, based on the International Physical Activity Questionnaire used in the Framingham Heart Study.The level of physical activity is evaluated by the Physical Activity Index (PAI, which is calculated by summing the number of hours spent in each activity intensity level (vigorous, moderate, light physical activity, sedentary behavior and sleep and multiplying by a respective weight factor, derived from the estimated oxygen consumption requirement for each intensity level (Metabolic Equivalent, MET. The results were compared to the results of healthy control subjects.The estimated value of PAI in patients with type 2 diabetes was 34.1 ± 6.4 and in controls 37.6 ± 6.4. The energy expenditure in the subgroup of patients with type 2 diabetes with predominantly sedentary behavior was 852 kcal minor than in the control group.The results of this investigation show very low level of physical activity in patients with type 2 diabetes and its correlation with coronary risk factors

Simulating the impact of climate change on rice production in Asia and evaluating options for adaptation.

NARCIS (Netherlands)

Matthews, R.B.; Kropff, M.J.; Horie, T.; Bachelet, D.

1997-01-01

The likely effects of climate change caused by increasing atmospheric carbon dioxide levels on rice production in Asia were evaluated using two rice crop simulation models, ORYZA1 and SIMRIW, running under fixed-change' climate scenarios and scenarios predicted for a doubled-CO2 (2xCO2) atmosphere

Retinal micropseudocysts in diabetic retinopathy: prospective functional and anatomic evaluation.

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Forte, Raimondo; Cennamo, Gilda; Finelli, Maria Luisa; Bonavolontà, Paola; Greco, Giovanni Maria; de Crecchio, Giuseppe

2012-01-01

To evaluate the prevalence, progression and functional predictive value of retinal micropseudocysts (MPCs) in diabetic patients. Prospective controlled observational study. From among all the type 2 diabetic patients evaluated during a period of 5 months between September 2009 and January 2010, we enrolled all patients with retinal MPCs at spectral-domain scanning laser ophthalmoscope/optical coherence tomography (SD-SLO/OCT) not previously treated for diabetic retinopathy. Forty diabetic patients without MPCs served as the control group. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), macular sensitivity and stability of fixation at SD-SLO/OCT microperimetry were measured monthly for 12 months. 22/156 patients with type 2 diabetes (14.1%, 32 eyes) met the inclusion criteria. The 95% confidence interval for the prevalence estimate of MPCs was 12.3-16.6%. Mean BCVA, CRT and central retinal sensitivity at baseline were 77.53 ± 2.2 Early Treatment Diabetic Retinopathy Study letters, 242.31 ± 31.0 µm and 15.95 ± 0.61 dB, respectively. Fixation was stable in all cases. Compared to the control group, eyes with MPCs had similar BCVA but greater CRT (p = 0.01) and reduced macular sensitivity (p = 0.001) at baseline and at each follow-up visit. Over time, CRT remained stable in eyes with MPCs, whereas macular sensitivity progressively decreased. MPCs in diabetic retinopathy are associated, temporally or causally, with a progressive reduction of macular sensitivity despite a stable BCVA, CRT and fixation. Copyright © 2011 S. Karger AG, Basel.

Air quality and climate change, Topic 3 of the Model Inter-Comparison Study for Asia Phase III (MICS-Asia III) - Part 1: Overview and model evaluation

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Gao, Meng; Han, Zhiwei; Liu, Zirui; Li, Meng; Xin, Jinyuan; Tao, Zhining; Li, Jiawei; Kang, Jeong-Eon; Huang, Kan; Dong, Xinyi; Zhuang, Bingliang; Li, Shu; Ge, Baozhu; Wu, Qizhong; Cheng, Yafang; Wang, Yuesi; Lee, Hyo-Jung; Kim, Cheol-Hee; Fu, Joshua S.; Wang, Tijian; Chin, Mian; Woo, Jung-Hun; Zhang, Qiang; Wang, Zifa; Carmichael, Gregory R.

2018-04-01

Topic 3 of the Model Inter-Comparison Study for Asia (MICS-Asia) Phase III examines how online coupled air quality models perform in simulating high aerosol pollution in the North China Plain region during wintertime haze events and evaluates the importance of aerosol radiative and microphysical feedbacks. A comprehensive overview of the MICS-Asia III Topic 3 study design, including descriptions of participating models and model inputs, the experimental designs, and results of model evaluation, are presented. Six modeling groups from China, Korea and the United States submitted results from seven applications of online coupled chemistry-meteorology models. Results are compared to meteorology and air quality measurements, including data from the Campaign on Atmospheric Aerosol Research Network of China (CARE-China) and the Acid Deposition Monitoring Network in East Asia (EANET). The correlation coefficients between the multi-model ensemble mean and the CARE-China observed near-surface air pollutants range from 0.51 to 0.94 (0.51 for ozone and 0.94 for PM2.5) for January 2010. However, large discrepancies exist between simulated aerosol chemical compositions from different models. The coefficient of variation (SD divided by the mean) can reach above 1.3 for sulfate in Beijing and above 1.6 for nitrate and organic aerosols in coastal regions, indicating that these compositions are less consistent from different models. During clean periods, simulated aerosol optical depths (AODs) from different models are similar, but peak values differ during severe haze events, which can be explained by the differences in simulated inorganic aerosol concentrations and the hygroscopic growth efficiency (affected by varied relative humidity). These differences in composition and AOD suggest that future models can be improved by including new heterogeneous or aqueous pathways for sulfate and nitrate formation under hazy conditions, a secondary organic aerosol (SOA) formation chemical

The political and scientific challenges in evaluating compulsory drug treatment centers in Southeast Asia

OpenAIRE

Vuong, Thu; Nguyen, Nhu; Le, Giang; Shanahan, Marian; Ali, Robert; Ritter, Alison

2017-01-01

Background In Vietnam, like many countries in Southeast Asia, the commonly used approach of center-based compulsory drug treatment (CCT) has been criticized on human rights ground. Meanwhile, community-based voluntary methadone maintenance treatment (MMT) has been implemented for nearly a decade with promising results. Reform-minded leaders have been seeking empirical evidence of the costs and effectiveness associated with these two main treatment modalities. Conducting evaluations of these t...

Assessment of self-reported self-esteem in healthy and diabetic children and adolescents in Greece.

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Vlachioti, Efrosini; Petsios, Konstantinos; Boutopoulou, Barbara; Chrisostomou, Anthi; Galanis, Petros; Matziou, Vasiliki

2010-06-01

The aim of the present study was to evaluate any possible negative effect of diabetes on the self-esteem of children and adolescents with diabetes. Self-esteem was evaluated using the Culture-Free Self-Esteem Inventory (CFSEI-2) in 144 patients with Type 1 diabetes mellitus (T1DM; 7-18 years of age) treated in a diabetes center and compared against that of 136 healthy children and adolescents. Self-esteem was correlated with age (P = 0.017), but not with diabetes (P = 0.886). The median CFSEI-2 score for both healthy and diabetic children was 22. There was no significant correlation between self-esteem and sex, body mass index (BMI), physical exercise, HbA1c or parental educational level. According to Spearman's rank correlation coefficient (r(s)), there was a significant association between age and self-esteem (r(s) = -0.15). Conversely, although BMI (r(s) = -0.09) and treatment duration (r(s) = -0.107) had a slight negative effect on self-esteem and the duration of physical exercise (r(s) = 0.11) and parental education (r(s) = 0.07) seemed to have a positive effect, the associations did not reach statistical significance. Self-esteem in diabetic children is mainly affected by their age, level of physical activity and level of family support. These findings emphasize the need to discriminate between glycemic control and diabetic adjustment. © 2010 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Blackwell Publishing Asia Pty Ltd.

The Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE): Construct and Content Validation Using a Modified Delphi Method.

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Paquette-Warren, Jann; Tyler, Marie; Fournie, Meghan; Harris, Stewart B

2017-06-01

In order to scale-up successful innovations, more evidence is needed to evaluate programs that attempt to address the rising prevalence of diabetes and the associated burdens on patients and the healthcare system. This study aimed to assess the construct and content validity of the Diabetes Evaluation Framework for Innovative National Evaluations (DEFINE), a tool developed to guide the evaluation, design and implementation with built-in knowledge translation principles. A modified Delphi method, including 3 individual rounds (questionnaire with 7-point agreement/importance Likert scales and/or open-ended questions) and 1 group round (open discussion) were conducted. Twelve experts in diabetes, research, knowledge translation, evaluation and policy from Canada (Ontario, Quebec and British Columbia) and Australia participated. Quantitative consensus criteria were an interquartile range of ≤1. Qualitative data were analyzed thematically and confirmed by participants. An importance scale was used to determine a priority multi-level indicator set. Items rated very or extremely important by 80% or more of the experts were reviewed in the final group round to build the final set. Participants reached consensus on the content and construct validity of DEFINE, including its title, overall goal, 5-step evaluation approach, medical and nonmedical determinants of health schematics, full list of indicators and associated measurement tools, priority multi-level indicator set and next steps in DEFINE's development. Validated by experts, DEFINE has the right theoretic components to evaluate comprehensively diabetes prevention and management programs and to support acquisition of evidence that could influence the knowledge translation of innovations to reduce the burden of diabetes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Detection, Evaluation and Treatment of Diabetes Mellitus in Chronic Pancreatitis: Recommendations from PancreasFest 2012

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Rickels, Michael R.; Bellin, Melena; Toledo, Frederico G.S.; Robertson, R. Paul; Andersen, Dana K.; Chari, Suresh T.; Brand, Randall; Frulloni, Luca; Anderson, Michelle A.; Whitcomb, David C.

2013-01-01

Description Diabetes and glucose intolerance are common complications of chronic pancreatitis, yet clinical guidance on their detection, classification, and management is lacking. Methods A working group reviewed the medical problems, diagnostic methods, and treatment options for chronic pancreatitis-associated diabetes for a consensus meeting at PancreasFest 2012. Results Guidance Statement 1.1 Diabetes mellitus is common in chronic pancreatitis. While any patient with chronic pancreatitis should be monitored for development of diabetes, those with long-standing duration of disease, prior partial pancreatectomy, and early onset of calcific disease may be at higher risk. Those patients developing diabetes mellitus are likely to have co-existing pancreatic exocrine insufficiency. Guidance Statement 1.2 Diabetes occurring secondary to chronic pancreatitis should be recognized as pancreatogenic diabetes (type 3c diabetes). Guidance Statement 2.1 The initial evaluation should include fasting glucose and HbA1c. These tests should be repeated annually. Impairment in either fasting glucose or HbA1c requires further evaluation. Guidance Statement 2.2 Impairment in either fasting glucose or HbA1c should be further evaluated by a standard 75 gram oral glucose tolerance test. Guidance Statement 2.3 An absent pancreatic polypeptide response to mixed-nutrient ingestion is a specific indicator of type 3c diabetes. Guidance Statement 2.4 Assessment of pancreatic endocrine reserve, and importantly that of functional beta-cell mass, should be performed as part of the evaluation and follow-up for total pancreatectomy with islet autotransplantation (TPIAT). Guidance Statement 3 Patients with pancreatic diabetes shall be treated with specifically tailored medical nutrition and pharmacologic therapies. Conclusions Physicians should evaluate and treat glucose intolerance in patients with pancreatitis. PMID:23890130

Evaluation of anti-diabetic effects of hydroalcoholic extract of green tea and cinnamon on streptozotocin-induced diabetic rats

OpenAIRE

Ghasem Shokri; Hamed Fathi; Majid Jafari Sabet; Nafiseh Nasri Nasrabadi; Ramin Ataee

2015-01-01

Today diabetes is one of the most common diseases in the world that affects half of the world population. The use of medicinal herbs especially green tea and cinnamon has been taken into consideration for relieving the symptoms of diabetes, but there were some different ideas about their effectiveness. So, this study was conducted to evaluate the effect of cinnamon and green tea extract, individually and in combination, on blood glucose and weight loss in diabetic mice with Streptozotocin (ST...

Evaluation and Prevention of Diabetic Neuropathy

Directory of Open Access Journals (Sweden)

Pajouhi M

2007-07-01

Full Text Available Background: Diabetic neuropathy is an incapacitating disease that afflicts almost 50 percent of patients with diabetes. A late finding in type 1 diabetes, diabetic neuropathy can be an early finding in non insulin-dependent diabetes. Diabetic neuropathies are divided primarily into two groups, sensorimotor and autonomic. Patients may acquire only one type of diabetic neuropathy or may present with combinations of neuropathies, such as autonomic neuropathy or distal symmetric polyneuropathy, the latter of which the most common form. Motor deficits, orthostatic hypotension, silent cardiac ischemia, hyperhidrosis, vasomotor instability, gastroparesis, bladder dysfunction, and sexual dysfunction can also result from diabetic neuropathy. Strict control of blood sugar, combined with proper daily foot care, is essential to avoid the complications of this disorder. With the potential to afflict any part of the nervous system, diabetic neuropathy should be suspected in all patients with type 2 diabetes as well as patients who have had type 1 diabetes for over five years. Although some patients with diabetic neuropathy notice few symptoms, upon physical examination mild to moderately severe sensory loss may be noted by the physician. Idiopathic neuropathy has been known to precede the onset of type 2 diabetes.

Drug addiction and diabetes: South Asian action.

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Singh Balhara, Yatan Pal; Kalra, Sanjay

2017-06-01

Both diabetes and drug addiction are common phenomena across the world. Drug abuse impacts glycaemic control in multiple ways. It becomes imperative, therefore, to share guidance on drug deaddiction in persons with diabetes. The South Asian subcontinent is home to specific forms and patterns of drug abuse. Detailed study is needed to ensure good clinical practice regarding the same. This communication provides a simple and pragmatic framework to address this issue, while calling for concerted action on drug deaddiction in South Asia.

Gender equity and health: evaluating the impact of Millennium Development Goal Three on women's health in South Asia.

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Shannon, Geordan D; Im, Dana D; Katzelnick, Leah; Franco, Oscar H

2013-01-01

Researchers evaluated the progress of Millennium Development Goal Three, which promotes gender equity and empowering women, by assessing the targets for education, employment, and government, and their relation to women's health in South Asia. Researchers obtained data from the United Nations, Inter-Parliamentary Union, International Labor Organization, World Bank, and World Health Organization. First, they performed a literature review including manuscripts that quantified a Millenium Development Goal Three outcome in South Asia and were published after 1991. They derived women's health outcomes from World Health Organization databases. Spearman's rank test was used to evaluate the relationship between change in gender parity and change in women's health outcomes. South Asia's average primary education Gender Parity Index (defined as the ratio of girls to boys enrolled in primary, secondary, and tertiary education and expressed as a value between 0 and 1.0) improved from 0.73 (SD 0.34) to 0.92 (SD 0.13) between 2000 and 2008. Secondary and tertiary education had a lower Gender Parity Index (average 2008 Gender Parity Index 0.87 (SD 0.21) and 0.59 (SD 0.23), respectively), but had also improved from 2000 (average Gender Parity Index = 0.77, SD 0.38) to 2008 (average Gender Parity Index = 0.52, SD 0.11). An average proportion of 22.1% (SD 12.58) of women participated in waged, non-agricultural employment and 16.6% (SD 10.3) in national parliaments. No clear association was found between change in gender equity and women's health in South Asia between 2000 and 2008. Some progress has been made toward gender equity in South Asia, although the results have been mixed and inequities persist, especially in employment and government. While gender equity does not appear to have been related to female health outcomes, both must be addressed simultaneously as priority development targets and remain prerequisites to achieving the overall Millennium Development Goals

History of Diabetes Insipidus.

Science.gov (United States)

Valenti, Giovanna; Tamma, Grazia

2016-02-01

Under physiological conditions, fluid and electrolyte homoeostasis is maintained by the kidney adjusting urine volume and composition according to body needs. Diabetes Insipidus is a complex and heterogeneous clinical syndrome affecting water balance and characterized by constant diuresis, resulting in large volumes of dilute urine. With respect to the similarly named Diabetes Mellitus, a disease already known in ancient Egypt, Greece and Asia, Diabetes Insipidus has been described several thousand years later. In 1670s Thomas Willis, noted the difference in taste of urine from polyuric subjects compared with healthy individuals and started the differentiation of Diabetes Mellitus from the more rare entity of Diabetes Insipidus. In 1794, Johann Peter Frank described polyuric patients excreting nonsaccharine urine and introduced the term of Diabetes Insipidus. An hystorical milestone was the in 1913, when Farini successfully used posterior pituitary extracts to treat Diabetes Insipidus. Until 1920s the available evidence indicated Diabetes Insipidus as a disorder of the pituitary gland. In the early 1928, De Lange first observed that some patients with Diabetes Insipidus did not respond to posterior pituitary extracts and subsequently Forssman and Waring in 1945 established that the kidney had a critical role for these forms of Diabetes Insipidus resistant to this treatment. In 1947 Williams and Henry introduced the term Nephrogenic Diabetes Insipidus for the congenital syndrome characterized by polyuria and renal concentrating defect resistant to vasopressin. In 1955, du Vigneaud received the 1955 Nobel Prize in chemistry for the first synthesis of the hormone vasopressin representing a milestone for the treatment of Central Diabetes Insipidus.

Evaluation of US Veterans Nutrition Education for Diabetes Prevention.

Science.gov (United States)

Erickson, Megan; Braun, Katie; List, Riesa; Utech, Anne; Moore, Carolyn; White, Donna L; Garcia, Jose M

2016-09-01

Evaluate the effectiveness of nutrition education interventions for diabetes prevention. Retrospective cohort design. Tertiary-care US Veterans' Hospital, July 2007 to July 2012, using pre-existing database. Prediabetic, adult veterans (n = 372), mostly men (94.4%, n = 351). Visits with existing nutrition education classes were collected. diabetes status; predictors: visits/encounters, age, body mass index, weight change, and hemoglobin A1c. Cox proportional hazards method, χ(2) test, and logistic regression. In this sample, prediabetic veterans who received nutrition education were less likely to develop diabetes when compared with prediabetic veterans who did not receive nutrition education (hazard ratio, 0.71; 95% confidence interval, 0.55-0.92; P Nutrition education was significantly associated with preventing the progression from prediabetes to diabetes in US Veterans participating in a nutrition education intervention at the Michael E. DeBakey Veterans Affairs Medical Center. Copyright © 2016 Society for Nutrition Education and Behavior. All rights reserved.

Nuclear safety cooperation in Southeast Asia. Lessons from Asia's regional networks

International Nuclear Information System (INIS)

Trajano, Julius Cesar I.

2017-01-01

Debate has been ongoing among key stakeholders on whether South-east Asia should use or reject nuclear power. However, there are still significant regional concerns over nuclear safety and security in South-east Asia. As some ASEAN countries plan to pursue nuclear power, they need to create and maintain a pool of local nuclear professionals with actual relevant experience in the nuclear industry. While the IAEA does not influence a country's decision on introducing nuclear power, it supports Member States' efforts to evaluate all options towards making a knowledgeable decision. Nuclear safety is the responsibility of every nation that utilizes nuclear technology. National governments are responsible for regulations that govern how safety at nuclear facilities is maintained, as well as to reduce radiation risks, including emergency response and recovery actions. But nuclear energy has transboundary/ regional implications if nuclear safety in each member state is not strengthened. ASEAN countries share a common goal in achieving high level of public safety and confidence in nuclear and radiation related issues. Can regional cooperation help ASEAN Member-States strengthen nuclear safety? The paper examines the importance of regional cooperation on nuclear energy governance and the role of regional organisations in Asia in strengthening nuclear safety cooperation and emergency preparedness and response in Southeast Asia. (author)

Within-trial economic evaluation of diabetes-specific cognitive behaviour therapy in patients with type 2 diabetes and subthreshold depression

Directory of Open Access Journals (Sweden)

Ohmann Christian

2010-10-01

Full Text Available Abstract Background Despite the high prevalence of subthreshold depression in patients with type 2 diabetes, evidence on cost-effectiveness of different therapy options for these patients is currently lacking. Methods/Design Within-trial economic evaluation of the diabetes-specific cognitive behaviour therapy for subthreshold depression. Patients with diabetes and subthreshold depression are randomly assigned to either 2 weeks of diabetes-specific cognitive behaviour group therapy (n = 104 or to standard diabetes education programme only (n = 104. Patients are followed for 12 months. During this period data on total health sector costs, patient costs and societal productivity costs are collected in addition to clinical data. Health related quality of life (the SF-36 and the EQ-5D is measured at baseline, immediately after the intervention, at 6 and at 12 months after the intervention. Quality adjusted life years (QALYs, and cumulative costs will be estimated for each arm of the trial. Cost-effectiveness of the diabetes-specific cognitive behaviour group therapy will be analysed from the perspective of the German statutory health insurance and from the societal perspective. To this end, incremental cost-effectiveness ratio (ICER in terms of cost per QALY gained will be calculated. Discussion Some methodological issues of the described economic evaluation are discussed. Trial registration The trial has been registered at the Clinical Trials Register (NCT01009138.

Evaluation of the impact of a diabetes education eLearning program for school personnel on diabetes knowledge, knowledge retention and confidence in caring for students with diabetes.

Science.gov (United States)

Taha, Nehad A; Rahme, Zahra; Mesbah, Naglaa; Mahmoud, Fatma; AlKandari, Sarah; Othman, Nashwa; Sharaikha, Hanan; Lari, Bashayer S; AlBeloushi, Shaima; Saad, Eglal; Arefanian, Hossein; Sukkar, Faten F

2018-05-01

To study the impact of a novel comprehensive eLearning approach in delivering diabetes related education program that includes knowledge and sets of practices to the school personnel in Kuwait to enable them to provide a supportive environment for students with diabetes. The program was designed with three components namely; knowledge, skills and recommendations. The diabetes knowledge was delivered through an interactive eLearning program, the effectiveness of which was assessed using diabetes knowledge questionnaires which were deployed pre- and post-course delivery. Additionally, the participants' knowledge retention and confidence in caring for a student with diabetes were evaluated at 6 or 12 months post-intervention. A total of 124 public schools' personnel participated in the program. Post e-Learning delivery, diabetes knowledge increased significantly from baseline (p eLearning diabetes education for school personnel increases their knowledge which can be retained for up to 12 months and imparts confidence in caring for students with diabetes. This novel approach of delivering diabetes education will help school personnel in managing students with diabetes. Copyright © 2018 Elsevier B.V. All rights reserved.

Psychosocial problems and barriers to improved diabetes management: results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study

NARCIS (Netherlands)

Peyrot, M.; Rubin, R.R.; Lauritzen, T.; Snoek, F.J.; Matthews, D.R.; Skovlund, S.E.

2005-01-01

Aims: To examine patient- and provider-reported psychosocial problems and barriers to effective self-care and resources for dealing with those barriers. Methods: Cross-sectional study using face-to-face or telephone interviews with diabetic patients and health-care providers in 13 countries in Asia,

Psychometric evaluation of dietary habits questionnaire for type 2 diabetes mellitus

Science.gov (United States)

Sami, W.; Ansari, T.; Butt, N. S.; Hamid, M. R. Ab

2017-09-01

This research evaluated the psychometric properties of English version of dietary habits questionnaires developed for type 2 diabetic patients. There is scarcity of literature about availability of standardized questionnaires for assessing dietary habits of type 2 diabetics in Saudi Arabia. As dietary habits vary from country to country, therefore, this was an attempt to develop questionnaires that can serve as a baseline. Through intensive literature review, four questionnaires were developed / modified and subsequently tested for psychometric properties. Prior to pilot study, a pre-test was conducted to evaluate the face validity and content validity. The pilot study was conducted from 23 October - 22 November, 2016 to evaluate the questionnaires’ reliability and validity. Systematic random sampling technique was used to collect the data from 132 patients by direct investigation method. Questionnaires assessing diabetes mellitus knowledge (0.891), dietary knowledge (0.869), dietary attitude (0.841) and dietary practices (0.874) had good internal consistency reliability. Factor analysis conducted on dietary attitude questionnaire showed a valid 5 factor solution. Directions of loadings were positive and free from factorial complexity. Relying on the data obtained from type 2 diabetics, these questionnaires can be considered as reliable and valid for the assessment of dietary habits in Saudi Arabia and neighbouring Gulf countries population.

Gastroesophageal reflux disease in patients with diabetes: preliminary study.

Science.gov (United States)

Fujiwara, Mariko; Miwa, Takashi; Kawai, Takashi; Odawara, Masato

2015-03-01

Some studies report that complications of gastroesophageal reflux disease (GERD) occur more frequently in patients with diabetes mellitus (DM) than in non-diabetic patients. This study used transnasal endoscopy to elucidate the current status of concurrent GERD in patients with type 2 diabetes mellitus, and to examine the associations between intraesophageal pressure and GERD, as well as other neuropathic conditions. The study included 57 outpatients with type 2 diabetes mellitus. The mean age was 67 years and the duration of DM was 13 years. The mean hemoglobin A1c was 6.8%. Transnasal endoscopic evaluation items were (i) the presence or absence of esophagitis and its severity; (ii) intraesophageal pressure; and (iii) Helicobacter pylori status, which was evaluated by endoscopic findings, such as the presence or absence of gastritis and peptic ulcer, and by urea breath test. Of 57 patients, 24 (42.1%) were given a diagnosis of GERD based on endoscopy. Patients with concurrent GERD were younger, had shorter duration of DM, and were taller and heavier. Interestingly, no difference in body mass index was observed. There was no significant association between the presence of concurrent GERD and diabetic complications, including peripheral neuropathy, and infection or non-infection with H. pylori. Although there was no significant association between the presence of concurrent GERD and intraesophageal pressure values, we found aging, reduced estimated glomerular filtration rate, and the presence of autonomic nerve symptoms to correlate with reduced intraesophageal pressure. The results of this study could be used to answer the question of whether or not endoscopic GERD is a diabetic complication; however, further study is required. © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

The diabetic foot: Magnetic resonance imaging evaluation

International Nuclear Information System (INIS)

Beltran, J.; Campanini, D.S.; Knight, C.; McCalla, M.

1990-01-01

Fourteen diabetic patients with suspected foot infection and/or neuropathic joint (Charcot Joint) were evaluated with magnetic resonance imaging (MRI) in an attempt to assess the extent of the infection and also to distinguish infection from the changes seen with neuroarthropathy. The majority of patients with infection had more than one site of involvement and the following diagnoses were made by MRI evaluation: Osteomyelitis (n=8), abscess (n=7), neuropathic joint (n=5), septic arthritis (n=4), and tenosynovitis (n=4). Clinical or surgical/pathological confirmation of the MRI diagnoses was obtained in all but nine sites of infection or cases of neuropathic joint. If the two diagnostic categories of septic arthritis and tenosynovitis are excluded, all but four of the MRI diagnoses were confirmed. A distinctive pattern for neuroarthropathy was identified in five cases, consisting of low signal intensity on T1- and T2-weighted images within the bone marrow space adjacent to the involved joint. We conclude that MRI is a valuable adjunct in the evaluation of the diabetic foot, and that it provides accurate information regarding the presence and extent of infection in this subset of patients. MRI has proven particularly helpful in differentiating neuroarthropathy from osteomyelitis. (orig.)

Field evaluation of reflective insulation in south east Asia

Science.gov (United States)

Teh, Khar San; Yarbrough, David W.; Lim, Chin Haw; Salleh, Elias

2017-12-01

The objective of this research was to obtain thermal performance data for reflective insulations in a South East Asia environment. Thermal resistance data (RSI, m2 ṡ K/W) for reflective insulations are well established from 1-D steady-state tests, but thermal data for reflective insulation in structures like those found in South East Asia are scarce. Data for reflective insulations in South East Asia will add to the worldwide database for this type of energy-conserving material. RSI were obtained from heat flux and temperature data of three identical structures in the same location. One unit did not have insulation above the ceiling, while the second and third units were insulated with reflective insulation with emittance less than 0.05. RSI for the uninsulated test unit varied from 0.37 to 0.40 m2 ṡ K/W. RSI for a single-sheet reflective insulation (woven foil) varied from 2.15 to 2.26 m2 ṡ K/W, while bubble-foil insulation varied from 2.69 to 3.09 m2 ṡ K/W. The range of RSI values resulted from differences in the spacing between the reflective insulation and the roof. In addition, the reflective insulation below the roof lowered attic temperatures by as much as 9.7° C. Reductions in ceiling heat flux of 80 to 90% relative to the uninsulated structure, due to the reflective insulation, were observed.

Non-communicable diseases in the Asia-Pacific region: Prevalence, risk factors and community-based prevention

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Wah-Yun Low

2015-02-01

Full Text Available Non-communicable diseases (NCDs lead to substantial mortality and morbidity worldwide. The most common NCDs are cardiovascular diseases (CVD, diabetes, cancer and chronic respiratory diseases. With the rapid increase in NCD-related deaths in Asia Pacific countries, NCDs are now the major cause of deaths and disease burden in the region. NCDs hamper achievement of the Millennium Development Goals (MDG. People in the low socio-economic group are most affected by NCDs as they have poor access to policies, legislations, regulations and healthcare services meant to combat NCDs. This results in loss of productivity by a decreasing labor force with implications at the macroeconomic level. The 3 major NCDs in the Asia Pacific region are CVDs, cancer and diabetes due to the increasing loss of disability adjusted life years (DALYs. The 4 major behavioral risk factors for NCDs are: tobacco use, alcohol consumption, inadequate physical activity and unhealthy diet. The underlying risk factors are urbanization, globalization, sedentary lifestyle, obesity and hypertension. Strategies to combat NCDs in the Asia Pacific region are as follows: population-based dietary salt reduction, health education, psychological interventions, i.e., cognitive behavioral therapy and motivational-interviewing, taxation and bans on tobacco-related advertisements, implementing smoke-free zones and surveillance by the World Health Organization. Control measures must focus on prevention and strengthening inter-sectorial collaboration.

Air quality and climate change, Topic 3 of the Model Inter-Comparison Study for Asia Phase III (MICS-Asia III – Part 1: Overview and model evaluation

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M. Gao

2018-04-01

Full Text Available Topic 3 of the Model Inter-Comparison Study for Asia (MICS-Asia Phase III examines how online coupled air quality models perform in simulating high aerosol pollution in the North China Plain region during wintertime haze events and evaluates the importance of aerosol radiative and microphysical feedbacks. A comprehensive overview of the MICS-Asia III Topic 3 study design, including descriptions of participating models and model inputs, the experimental designs, and results of model evaluation, are presented. Six modeling groups from China, Korea and the United States submitted results from seven applications of online coupled chemistry–meteorology models. Results are compared to meteorology and air quality measurements, including data from the Campaign on Atmospheric Aerosol Research Network of China (CARE-China and the Acid Deposition Monitoring Network in East Asia (EANET. The correlation coefficients between the multi-model ensemble mean and the CARE-China observed near-surface air pollutants range from 0.51 to 0.94 (0.51 for ozone and 0.94 for PM2.5 for January 2010. However, large discrepancies exist between simulated aerosol chemical compositions from different models. The coefficient of variation (SD divided by the mean can reach above 1.3 for sulfate in Beijing and above 1.6 for nitrate and organic aerosols in coastal regions, indicating that these compositions are less consistent from different models. During clean periods, simulated aerosol optical depths (AODs from different models are similar, but peak values differ during severe haze events, which can be explained by the differences in simulated inorganic aerosol concentrations and the hygroscopic growth efficiency (affected by varied relative humidity. These differences in composition and AOD suggest that future models can be improved by including new heterogeneous or aqueous pathways for sulfate and nitrate formation under hazy conditions, a secondary organic aerosol (SOA

Evaluating the implementation of a national clinical programme for diabetes to standardise and improve services: a realist evaluation protocol.

Science.gov (United States)

McHugh, S; Tracey, M L; Riordan, F; O'Neill, K; Mays, N; Kearney, P M

2016-07-28

Over the last three decades in response to the growing burden of diabetes, countries worldwide have developed national and regional multifaceted programmes to improve the monitoring and management of diabetes and to enhance the coordination of care within and across settings. In Ireland in 2010, against a backdrop of limited dedicated strategic planning and engrained variation in the type and level of diabetes care, a national programme was established to standardise and improve care for people with diabetes in Ireland, known as the National Diabetes Programme (NDP). The NDP comprises a range of organisational and service delivery changes to support evidence-based practices and policies. This realist evaluation protocol sets out the approach that will be used to identify and explain which aspects of the programme are working, for whom and in what circumstances to produce the outcomes intended. This mixed method realist evaluation will develop theories about the relationship between the context, mechanisms and outcomes of the diabetes programme. In stage 1, to identify the official programme theories, documentary analysis and qualitative interviews were conducted with national stakeholders involved in the design, development and management of the programme. In stage 2, as part of a multiple case study design with one case per administrative region in the health system, qualitative interviews are being conducted with frontline staff and service users to explore their responses to, and reasoning about, the programme's resources (mechanisms). Finally, administrative data will be used to examine intermediate implementation outcomes such as service uptake, acceptability, and fidelity to models of care. This evaluation is using the principles of realist evaluation to examine the implementation of a national programme to standardise and improve services for people with diabetes in Ireland. The concurrence of implementation and evaluation has enabled us to produce formative

Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) study: Methodology and baseline characteristics of a randomized controlled trial evaluating an occupation-based diabetes management intervention for young adults.

Science.gov (United States)

Pyatak, Elizabeth A; Carandang, Kristine; Vigen, Cheryl; Blanchard, Jeanine; Sequeira, Paola A; Wood, Jamie R; Spruijt-Metz, Donna; Whittemore, Robin; Peters, Anne L

2017-03-01

This paper describes the study protocol used to evaluate the Resilient, Empowered, Active Living with Diabetes (REAL Diabetes) intervention and reports on baseline characteristics of recruited participants. REAL Diabetes is an activity-based intervention designed to address the needs of young adults diagnosed with type 1 (T1D) or type 2 diabetes (T2D) from low socioeconomic status or racial/ethnic minority backgrounds. The REAL intervention incorporates tailored delivery of seven content modules addressing various dimensions of health and well-being as they relate to diabetes, delivered by a licensed occupational therapist. In this pilot randomized controlled trial, participants are assigned to the REAL Diabetes intervention or an attention control condition. The study's primary recruitment strategies included in-person recruitment at diabetes clinics, mass mailings to clinic patients, and social media advertising. Data collection includes baseline and 6-month assessments of primary outcomes, secondary outcomes, and hypothesized mediators of intervention effects, as well as ongoing process evaluation assessment to ensure study protocol adherence and intervention fidelity. At baseline, participants (n=81) were 51% female, 78% Latino, and on average 22.6years old with an average HbA1c of 10.8%. A majority of participants (61.7%) demonstrated clinically significant diabetes distress and 27.2% reported symptoms consistent with major depressive disorder. Compared to participants with T1D, participants with T2D had lower diabetes-related self-efficacy and problem-solving skills. Compared to participants recruited at clinics, participants recruited through other strategies had greater diabetes knowledge but weaker medication adherence. Participants in the REAL study demonstrate clinically significant medical and psychosocial needs. Copyright © 2017 Elsevier Inc. All rights reserved.

Evaluation of cardiac denervation in patients with long-standing diabetes

International Nuclear Information System (INIS)

Khurram, M.; Khar, Hamama-tul-Bushra; Malik, M.F. Fazal-ur-Rehman; Javed, S.; Hassan, Z.; Minhas, Z.; Goraya, M.F.; Shakoor, A.

2002-01-01

Objective: Evaluation of cardiac autonomic dysfunction in long-standing diabetics, comparing patients treated with insulin and oral hypo glycemic agents. Design: Observational and comparative study between two treatment groups. Place and Duration of Study: At department of Medicine, Pakistan Institute of Medical Sciences, Islamabad, for 6 months. Subjects and Methods: Fifty diabetic patients of about 10 years illness were studied. Patients were divided into two groups, Group 1(13 males, 12 females; mean age 33.08 years) included those who received insulin, and Group II patients (12 males, 13 females; mean age 54.68 years) who received oral hypo glycemic agents for their diabetic illness. Evaluation of cardiac denervation in both the groups was done in terms of presence of resting tachycardia, loss of sinus arrhythmia and abnormalities of Valsava response. Results: At least some form of cardiac denervation was present in 62% of total subjects. 48% of Group I and 76 % of Group II patients. A significantly high number of patients treated with oral hypo glycemic agents had evidence of cardiac denervation when compared with patients who were treated with insulin (p < 0.05). Conclusion: Cardiac denervation is common in long-standing diabetics specifically in those treated with oral hypo glycemic agents. (author)

Evaluation of an Ongoing Diabetes Group Medical Visit in a Family Medicine Practice.

Science.gov (United States)

Cunningham, Amy T; Delgado, David J; Jackson, Joseph D; Crawford, Albert G; Jabbour, Serge; Lieberthal, Robert D; Diaz, Victor; LaNoue, Marianna

2018-01-01

Group medical visits (GMVs), which combine 1-on-1 clinical consultations and group self-management education, have emerged as a promising vehicle for supporting type 2 diabetes management in primary care. However, few evaluations exist of ongoing diabetes GMVs embedded in medical practices. This study used a quasi-experimental design to evaluate diabetes GMV at a large family medicine practice. We examined program attendance and attrition, used propensity score matching to create a matched comparison group, and compared participants and the matched group on clinical, process of care, and utilization outcomes. GMV participants (n = 230) attended an average of 1 session. Participants did not differ significantly from the matched comparison group (n = 230) on clinical, process of care or utilization outcomes. The diabetes GMV was not associated with improvements in outcomes. Further studies should examine diabetes GMV implementation challenges to enhance their effectiveness in everyday practice. © Copyright 2018 by the American Board of Family Medicine.

Diabetes and cardiometabolic risk factors in Cambodia: Results from two screening studies.

Science.gov (United States)

Wagner, Julie; Naranjo, Diana; Khun, Touch; Seng, Serey; Horn, Ien S; Suttiratana, Sakinah C; Keuky, Lim

2018-02-01

Despite growing attention to diabetes throughout Asia, data from Southeast Asia are limited. This article reports rates of diabetes, hypertension, and obesity in Cambodia. Two studies were conducted across different regions of Cambodia: (i) a 2012 screening study across urban, semi-urban, and rural areas that used point-of-care capillary glucose for determination of diabetes (n = 13 997); and (ii) a 2005 epidemiological study with random selection from two main urban areas that used oral glucose tolerance tests for determination of diabetes (n = 1863). Blood pressure and anthropometrics were also measured. In the screening study, rates of diabetes were significantly higher in urban than rural sites, with intermediate rates in semi-urban areas. There was a significant dose-response effect for urbanicity on overweight, obesity, and waist:hip ratio, with higher rates for urban versus semi-urban and for semi-urban versus rural locales. Rural sites had the lowest rates of hypertension, followed by urban and semi-urban sites. Among people who screened positive for diabetes, there was a dose-response effect for urbanicity on undiagnosed diabetes; rates of previously undiagnosed diabetes were lowest in urban (51%), followed by semi-urban (55%) and rural (67%) locales. Rural participants reported the highest rates of smoking and alcohol use. In the urban epidemiological study, prevalence rates of diabetes and impaired glucose tolerance were approximately 10%, indicating a prevalence of total glucose intolerance of approximately 20%. In Cambodia, diabetes rates are high among urban residents and undiagnosed diabetes is highest among rural residents. A country-wide public health response is urgently needed; as development continues, rates of diabetes are expected to rise. © 2017 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

TO EVALUATE PREVALENCE OF DIABETES AND HIV IN NEWLY-DIAGNOSED MULTIDRUGRESISTANT TUBERCULOSIS PATIENTS ADMITTED FOR PRETREATMENT EVALUATION IN DOTS PLUS CENTRE, THANJAVUR

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Namasivayam Kuppusamy

2017-07-01

Full Text Available BACKGROUND More than 9 million people fall sick with tuberculosis every year in the world. People with weak immune system as a result of disease like diabetes and HIV are at high risk of developing MDR-TB infection. Proper monitoring and evaluation are needed to control MDR-TB in HIV and diabetes patients. The aim of the study is to find the prevalence of diabetes and HIV among MDR-TB patients admitted for pretreatment evaluation in Dots Plus Centre, Thanjavur Medical College, Tamilnadu. MATERIALS AND METHODS The medical records with datas of 96 patients with MDR-TB who are having diabetes and HIV infection were examined. These cases were diagnosed and registered during January 2015 to December 2015. These patients had drug resistant to first line antituberculosis drugs (isoniazid and rifampicin. Duration of diabetes and HIV infection were noted. Age were categorised in to four groups- 20-29 years, 30-39 years, 40-49 years and above 50 years. The potential risk of association of diabetes, HIV or both with MDR-TB was evaluated by univariate conditional logistic regression model. RESULTS Out of 96 newly-diagnosed MDR-TB patients, prevalence of diabetes is about 34.37%, out of which (84.84% were males and (15.15% were females. Out of 34.37%, 38.54% of patients had controlled diabetes, 61.45% patients had uncontrolled diabetes. Nearly, more than half of diabetes patient falls under uncontrolled diabetes. More number of male patients had diabetes with MDR-TB when compared to females. 10.4% of these persons got oral hypoglycaemic agent and 6.3% got insulin as treatment for diabetes. 1% had irregular treatment with poor compliance. Prevalence of HIV is about 4.16% out of which 75% were males and 25% were females. One patient had both diabetes and HIV with MDR tuberculosis. CONCLUSION In our retrospective study, prevalence of diabetes in MDR-TB patients were more common in males than in females, most of them were in the age groups of 40 years and above

The PRIDE (Partnership to Improve Diabetes Education) Toolkit: Development and Evaluation of Novel Literacy and Culturally Sensitive Diabetes Education Materials.

Science.gov (United States)

Wolff, Kathleen; Chambers, Laura; Bumol, Stefan; White, Richard O; Gregory, Becky Pratt; Davis, Dianne; Rothman, Russell L

2016-02-01

Patients with low literacy, low numeracy, and/or linguistic needs can experience challenges understanding diabetes information and applying concepts to their self-management. The authors designed a toolkit of education materials that are sensitive to patients' literacy and numeracy levels, language preferences, and cultural norms and that encourage shared goal setting to improve diabetes self-management and health outcomes. The Partnership to Improve Diabetes Education (PRIDE) toolkit was developed to facilitate diabetes self-management education and support. The PRIDE toolkit includes a comprehensive set of 30 interactive education modules in English and Spanish to support diabetes self-management activities. The toolkit builds upon the authors' previously validated Diabetes Literacy and Numeracy Education Toolkit (DLNET) by adding a focus on shared goal setting, addressing the needs of Spanish-speaking patients, and including a broader range of diabetes management topics. Each PRIDE module was evaluated using the Suitability Assessment of Materials (SAM) instrument to determine the material's cultural appropriateness and its sensitivity to the needs of patients with low literacy and low numeracy. Reading grade level was also assessed using the Automated Readability Index (ARI), Coleman-Liau, Flesch-Kincaid, Fry, and SMOG formulas. The average reading grade level of the materials was 5.3 (SD 1.0), with a mean SAM of 91.2 (SD 5.4). All of the 30 modules received a "superior" score (SAM >70%) when evaluated by 2 independent raters. The PRIDE toolkit modules can be used by all members of a multidisciplinary team to assist patients with low literacy and low numeracy in managing their diabetes. © 2015 The Author(s).

Association between depression and glycemic control among type 2 diabetes patients in Lima, Peru.

Science.gov (United States)

Crispín-Trebejo, Brenda; Robles-Cuadros, María Cristina; Bernabé-Ortiz, Antonio

2015-12-01

There is limited and controversial information regarding the potential impact of depression on glycemic control. This study aims to evaluate the association between depression and poor glycemic control. In addition, the prevalence of depression and rates of poor glycemic control were determined. Cross-sectional study performed in the endocrinology unit of two hospitals of ESSALUD in Peru. The outcome of interest was poor glycemic control, evaluated by glycated hemoglobin (HbA1c: diabetes patients. Our results suggest that early detection of depression might be important to facilitate appropriate glycemic control and avoid further metabolic complications. © 2015 Wiley Publishing Asia Pty Ltd.

The Guyana Diabetes and Foot Care Project: Improved Diabetic Foot Evaluation Reduces Amputation Rates by Two-Thirds in a Lower Middle Income Country

Science.gov (United States)

Sibbald, R. Gary; Martin, Carlos

2015-01-01

Background. Type 2 diabetes is the fourth leading cause of death in Guyana, South America. A complex, interprofessional, quality improvement intervention to improve foot and diabetes care was rolled out in two phases. Methods & Findings. Phase 1: Establishment of an Interprofessional Diabetic Foot Center (DFC) of Excellence to improve foot care and reduce diabetes-related amputations at the national referral hospital. Phase 2: Regionalization to cover 90% of the Guyanese population and expansion to include improved management of diabetes and hypertension. Fourteen key opinion leaders were educated and 340 health care professionals from 97 facilities trained. Eight centers for the evaluation and treatment of foot ulcers were established and 7567 people with diabetes evaluated. 3452 participants had foot screening and 48% were deemed high risk; 10% of these had undocumented foot ulcers. There was a 68% reduction in rate of major amputations (P diabetes with women (F/M = 2.09) and increased risk of major amputation in men [odds ratio 2.16 (95% CI 1.83, 2.56)] were documented. Conclusions. This intervention improved foot care with reduction in major amputations sustained over 5 years. PMID:26089901

EVALUATION OF PRE AND POST TRAINING PRACTICES REGARDING MANAGEMENT OF DIABETES

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M Mohanty

1995-09-01

Full Text Available The study was conducted on 112 diabetic patients in S.S. Hospital.Varanasi to evaluate the pre- and post- training practices regarding management of Diabetes mellitus. A pre-tested structured respondent schedule urn used to collect information regarding the socio-economic status and some of the managerial aspects of the disease by questionaire cum interview method. Education cum training was imparted to all the respondents in the first three months and in the fourth month evaluation programme was carried out and their level ofpractive regarding different aspects of diabetic management were assessed by using seven point score method. It was found that training was proved effective for the aspect "Physical exer­cise" and "Restricted diet" but slight improvement in the practive score was seen in "Precaution in Special Hygienic Condition" aspects. So. con­tinuous education programme was needed to improve their practice rate.

Non-communicable diseases in South Asia: contemporary perspectives.

Science.gov (United States)

Siegel, Karen R; Patel, Shivani A; Ali, Mohammed K

2014-09-01

Non-communicable diseases (NCDs) such as metabolic, cardiovascular, cancers, injuries and mental health disorders are increasingly contributing to the disease burden in South Asia, in light of demographic and epidemiologic transitions in the region. Home to one-quarter of the world's population, the region is also an important priority area for meeting global health targets. In this review, we describe the current burden of and trends in four common NCDs (cardiovascular disease, diabetes, cancer and chronic obstructive pulmonary disease) in South Asia. The 2010 Global Burden of Disease Study supplemented with the peer-reviewed literature and reports by international agencies and national governments. The burden of NCDs in South Asia is rising at a rate that exceeds global increases in these conditions. Shifts in leading risk factors-particularly dietary habits, tobacco use and high blood pressure-are thought to underlie the mounting burden of death and disability due to NCDs. Improvements in life expectancy, increasing socioeconomic development and urbanization in South Asia are expected to lead to further escalation of NCDs. Although NCD burdens are currently largest among affluent groups in South Asia, many adverse risk factors are concentrated among the poor, portending a future increase in disease burden among lower income individuals. There continues to be a notable lack of national surveillance data to document the distribution and trends in NCDs in the region. Similarly, economic studies and policy initiatives addressing NCD burdens are still in their infancy. Opportunities for innovative structural and behavioral interventions that promote maintenance of healthy lifestyles-such as moderate caloric intake, adequate physical activity and avoidance of tobacco-in the context of socioeconomic development are abundant. Testing of health care infrastructure and systems that best provide low-cost and effective detection and treatment of NCDs is a priority for

Fiscal 1998 report on Japan-Asia international cooperation project; 1998 nendo Nichi Asia kokusai kyodo kenkyu jigyo hokokusho

Energy Technology Data Exchange (ETDEWEB)

NONE

1999-12-01

For the development of talent, industrial infrastructures, and new industries in countries that received Japanese cooperation, Japanese researchers were sent to universities and research organizations in Asian countries, where they were engaged in joint research and development, which involved (1) micro device technology, (2) technology for manufacturing industrial silica material by chaff incineration, (3) technology for forming and machining of alloys difficult to machine, light in weight, and high in strength, (4) technology for rare metal isolation and refining, (5) cascade-wise utilization and practical application of biomass in Asia, (6) exploration and utilization of microbial resources in Tropical Asia, (7) evaluation of biological resources existing in Southeast Asia and construction of information network, (8) development and evaluation of cultured articular cartilage, (9) technology for utilizing wastewater for production of valuable substances, and (10) studies for utilizing biological resources through utilization of diversity of symbiotic microbes and their adaptability to surroundings. Under item (1), it was planned that ultrasonic micro transducers and micro fluid devices be developed for use in the medical field. (NEDO)

Evaluation of Salivary Profile among Adult Type 2 Diabetes Mellitus Patients in South India.

Science.gov (United States)

K M, Prathibha; Johnson, Priscilla; Ganesh, Mathangi; Subhashini, Arcot S

2013-08-01

A lack of consensus on the possible association between diabetes and salivary dysfunction motivated us to conduct this investigation on the salivary parameters in diabetic and non diabetic subjects. This could also make the use of saliva as an alternative to that of blood in the diagnosis/monitoring of diabetes mellitus. To compare the salivary flow rates and the salivary physical and biochemical parameters of diabetic (D) and non diabetic (ND) subjects. The participants in this study included 30 non diabetic subjects and 30 diabetic volunteers who had Type 2 Diabetes mellitus for a minimum of 2 years. Unstimulated whole saliva was collected in the fasting state. Salivary pH, flow rate and organic and inorganic constituents were evaluated. Data which was collected was statistically analysed and interpreted. Salivary pH (ND=7.09±0.29, D=6.69±0.35), flow rate (ND=0.67±0.07, D=0.46±0.02) and salivary amylase (ND=92.51±13.74, D=19.20±1.8) were significantly lower in diabetics. They had significantly higher levels of salivary glucose (ND=4.33 ± 0.29, D=17.31±2.05), total proteins (ND=424.46±237.34, D=877.29±603.84), sodium (ND=4.31±0.65, D=14.42±1.83) and potassium (ND=20.84±0.71, D=25.95±1.56) and lower levels of calcium (ND=6.39±0.5, D=4.22±0.12) in comparison to those in the non-diabetic group. Significant variations were observed in salivary physical and biochemical parameters between diabetics and non diabetics. Evaluation of salivary parameters can be a cost effective and a non invasive alternative for screening, diagnosis and monitoring of diabetes, to blood.

Atmospheric transport of ozone between Southern and Eastern Asia.

Science.gov (United States)

Chakraborty, T; Beig, G; Dentener, F J; Wild, O

2015-08-01

This study describes the effect of pollution transport between East Asia and South Asia on tropospheric ozone (O3) using model results from the Task Force on Hemispheric Transport of Air Pollution (TF HTAP). Ensemble mean O3 concentrations are evaluated against satellite-data and ground observations of surface O3 at four stations in India. Although modeled surface O3 concentrations are 1020ppb higher than those observed, the relative magnitude of the seasonal cycle of O3 is reproduced well. Using 20% reductions in regional anthropogenic emissions, we quantify the seasonal variations in pollution transport between East Asia and South Asia. While there is only a difference of 0.05 to 0.1ppb in the magnitudes of the regional contributions from one region to the other, O3 from East Asian sources affects the most densely populated parts of South Asia while Southern Asian sources only partly affect the populated parts of East Asia. We show that emission changes over East Asia between 2000 and 2010 had a larger impact on populated parts of South Asia than vice versa. This study will help inform future decisions on emission control policy over these regions. Copyright © 2015 Elsevier B.V. All rights reserved.

Educational Gaming for Pharmacy Students - Design and Evaluation of a Diabetes-themed Escape Room.

Science.gov (United States)

Eukel, Heidi N; Frenzel, Jeanne E; Cernusca, Dan

2017-09-01

Objective. To design an educational game that will increase third-year professional pharmacy students' knowledge of diabetes mellitus disease management and to evaluate their perceived value of the game. Methods. Faculty members created an innovative educational game, the diabetes escape room. An authentic escape room gaming environment was established through the use of a locked room, an escape time limit, and game rules within which student teams completed complex puzzles focused on diabetes disease management. To evaluate the impact, students completed a pre-test and post-test to measure the knowledge they've gained and a perception survey to identify moderating factors that could help instructors improve the game's effectiveness and utility. Results. Students showed statistically significant increases in knowledge after completion of the game. A one-sample t -test indicated that students' mean perception was statistically significantly higher than the mean value of the evaluation scale. This statically significant result proved that this gaming act offers a potential instructional benefit beyond its novelty. Conclusion. The diabetes escape room proved to be a valuable educational game that increased students' knowledge of diabetes mellitus disease management and showed a positive perceived overall value by student participants.

Simplifying the Evaluation of Children With New Onset Diabetes: Utility of Pancreatic Autoantibodies for Diabetes Type Classification and Use of Serum Bicarbonate to Diagnose and Classify Diabetic Ketoacidosis.

OpenAIRE

Von Oettingen, Julia Elisabeth

2015-01-01

Objectives: To assess whether routinely measuring pancreatic autoantibodies (PAA) in pediatric new onset diabetes (NODM) is necessary, and to evaluate serum bicarbonate (HCO3) as a substitute for venous pH (vpH) in the diagnosis of diabetic ketoacidosis (DKA). Methods: Retrospective analysis of all patients with NODM admitted to Boston Children's Hospital from 10/1/07-7/1/13. Logistic regression was used to develop a clinical score to classify diabetes type. Linear and logistic regression...

Evaluation of Anticonvulsive ٍEffect of Magnesium Oxide Nanoparticles in Comparison with Conventional MgO in Diabetic and Non-diabetic Male Mice

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Leila Jahangiri

2014-05-01

Full Text Available Introduction: Some studies show magnesium has anticonvulsive effect in some animal models. Despite of the availability of well-studied anticonvulsant drugs, this evaluation was not carried on new kind of magnesium supplement, magnesium oxide nanoparticles (nMgO. According to the interaction between magnesium and convulsion, this study was designed to evaluate the effect of nMgO on strychnine-induced convulsive model in compared to its conventional in diabetic and normal mice. Methods: Healthy male albino mice were divided to 10 groups. Diabete mellitus was induced by streptozocin in 5 groups. Conventional and nanoparticle MgO (5&10mg/kg in presence and absence diabetes injected to mice, then strychnine injected and onset of convulsions and time of death were measured after strychnine administration. Results: Convulsive parameters did not change in normal and diabetic mice. cMgO pretreatment did not have anticonvulsant effect in strychnine-induced convulsion in normal and diabetic mice. But nMgO significantly changed convulsion onset and death time after strychnine administration in normal and diabetic status. Discussion: According to our results It seems that nMgO may be important in prevention or treatment of epilepsy and has more efficacy than its conventional form to showing anticonvulsive effect that probably is related to the physicochemical properties of nMgO, specially in diabetic subjects, a point that need to further investigation.

Diabetic muscle infarction: radiologic evaluation

International Nuclear Information System (INIS)

Chason, D.P.; Fleckenstein, J.L.; Burns, D.K.; Rojas, G.

1996-01-01

Four patients with severe diabetes mellitus presenting with acute thigh pain, tenderness, and swelling were evaluated by imaging techniques and biopsy. Edema in the affected muscles was seen in two patients with MRI studies. Femoral artery calcification and mild muscle swelling was present in one patient who underwent CT. Decreased echogenicity was seen in the involved muscle in a patient studied with ultrasound. Serum enzymes were normal or mildly elevated in three patients (not reported in one). Biopsy demonstrated necrosis and regenerative change in all cases. MRI, although nonspecific, is the best imaging technique to suggest the diagnosis of DMI in the appropriate clinical setting, thereby obviating biopsy. (orig./MG)

Event rates, hospital utilization, and costs associated with major complications of diabetes: a multicountry comparative analysis.

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Philip M Clarke

2010-02-01

Full Text Available Diabetes imposes a substantial burden globally in terms of premature mortality, morbidity, and health care costs. Estimates of economic outcomes associated with diabetes are essential inputs to policy analyses aimed at prevention and treatment of diabetes. Our objective was to estimate and compare event rates, hospital utilization, and costs associated with major diabetes-related complications in high-, middle-, and low-income countries.Incidence and history of diabetes-related complications, hospital admissions, and length of stay were recorded in 11,140 patients with type 2 diabetes participating in the Action in Diabetes and Vascular Disease (ADVANCE study (mean age at entry 66 y. The probability of hospital utilization and number of days in hospital for major events associated with coronary disease, cerebrovascular disease, congestive heart failure, peripheral vascular disease, and nephropathy were estimated for three regions (Asia, Eastern Europe, and Established Market Economies using multiple regression analysis. The resulting estimates of days spent in hospital were multiplied by regional estimates of the costs per hospital bed-day from the World Health Organization to compute annual acute and long-term costs associated with the different types of complications. To assist, comparability, costs are reported in international dollars (Int$, which represent a hypothetical currency that allows for the same quantities of goods or services to be purchased regardless of country, standardized on purchasing power in the United States. A cost calculator accompanying this paper enables the estimation of costs for individual countries and translation of these costs into local currency units. The probability of attending a hospital following an event was highest for heart failure (93%-96% across regions and lowest for nephropathy (15%-26%. The average numbers of days in hospital given at least one admission were greatest for stroke (17-32 d across

Diabetic foot disease: From the evaluation of the “foot at risk” to the novel diabetic ulcer treatment modalities

Science.gov (United States)

Amin, Noha; Doupis, John

2016-01-01

The burden of diabetic foot disease (DFD) is expected to increase in the future. The incidence of DFD is still rising due to the high prevalence of DFD predisposing factors. DFD is multifactorial in nature; however most of the diabetic foot amputations are preceded by foot ulceration. Diabetic peripheral neuropathy (DPN) is a major risk factor for foot ulceration. DPN leads to loss of protective sensation resulting in continuous unconscious traumas. Patient education and detection of high risk foot are essential for the prevention of foot ulceration and amputation. Proper assessment of the diabetic foot ulceration and appropriate management ensure better prognosis. Management is based on revascularization procedures, wound debridement, treatment of infection and ulcer offloading. Management and type of dressing applied are tailored according to the type of wound and the foot condition. The scope of this review paper is to describe the diabetic foot syndrome starting from the evaluation of the foot at risk for ulceration, up to the new treatment modalities. PMID:27076876

78 FR 47326 - Proposed Collection; 60-Day Comment Request: Community Evaluation of the National Diabetes...

Science.gov (United States)

2013-08-05

... efforts to improve diabetes-related health care and education, as well as systems for delivering care; (6... Comment Request: Community Evaluation of the National Diabetes Education Program's Diabetes HealthSense... information technology. To Submit Comments and For Further Information: To obtain a copy of the data...

Malnutrition-modulated diabetes mellitus (MMDM): a state of review ...

African Journals Online (AJOL)

Diabetes is a worldwide public health problem and is progressively increasing in Third World countries, particularly in African continent and Southern Asia due to low socio-economic standards. Since malnutrition and undernutrition with cassava consumption and cyanide intoxication have been thought to be the major ...

Diabetes and Obesity—An Evolutionary Perspective

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Sylvia Kirchengast

2017-01-01

Full Text Available Obesity and type II diabetes belong to the most serious public health challenges of the 21st century. Initially both diseases were typical of affluent societies. Currently both conditions however are increasingly found in low and middle income countries. In future obesity and diabetes are expected to reach epidemic proportions and affect developing countries to a greater extent than developed ones. A globalization of obesity and diabetes is observable. Recently prevalence rates increased, especially in Asia, the Near and Middle East, the Western Pacific region and even in Sub-Saharan Africa. Evolutionary Anthropology tries to understand the evolutionary mechanisms promoting rising obesity and diabetes type II rates. Homo sapiens evolved in an environment quite different from our recent one. Profound changes in physical activity patterns and nutritional habits during the last 10,000 years and increasingly during the last 200 years increased the risk of obesity and diabetes type II. Consequently our recent environment is called “obesogenic”. This mismatch has been recently observable among societies experiencing rapid cultural changes characterized by Westernization and modernization. This review focuses on obesity and type II diabetes from the viewpoint of evolutionary anthropology.

Evolution of Diabetes Care in Hong Kong: From the Hong Kong Diabetes Register to JADE-PEARL Program to RAMP and PEP Program

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Ivy H.Y. Ng

2018-03-01

Full Text Available The rapid increase in diabetes prevalence globally has contributed to large increases in health care expenditure on diabetic complications, posing a major health burden to countries worldwide. Asians are commonly observed to have poorer β-cell function and greater insulin resistance compared to the Caucasian population, which is attributed by their lower lean body mass and central obesity. This “double phenotype” as well as the rising prevalence of young onset diabetes in Asia has placed Asians with diabetes at high risk of cardiovascular and renal complications, with cancer emerging as an important cause of morbidity and mortality. The experience from Hong Kong had demonstrated that a multifaceted approach, involving team-based integrated care, information technological advances, and patient empowerment programs were able to reduce the incidence of diabetic complications, hospitalizations, and mortality. System change and public policies to enhance implementation of such programs may provide solutions to combat the burgeoning health problem of diabetes at a societal level.

Tuberculosis in South Asia: a tide in the affairs of men.

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Basnyat, Buddha; Caws, Maxine; Udwadia, Zarir

2018-01-01

Tuberculosis (TB) remains the most common cause of infectious disease deaths worldwide. What is perhaps less appreciated is that the caseload of tuberculosis patients in South Asia is staggering.South Asia has almost 40% of the global TB burden with 4,028,165 cases in 2015. This region also has a disproportionate share of TB deaths (681,975 deaths, 38% of the global burden). Worldwide just 12.5% of TB cases are in HIV positive individuals, but much research and investment has focused on HIV-associated TB. Only 3.5% of patients with tuberculosis in South Asia have HIV co-infection. Not surprisingly with such a huge burden of disease, this region has an estimated 184,336 multi drug resistant (MDR) cases among notified TB cases which accounts for a third of global MDR burden. Crucially, at least 70% of the estimated MDR cases remain untreated in this region and MDR treatment success ranged from only 46% for India to 88% for Sri Lanka in the 2012 cohort that received treatment. This region represents many of the drivers of the modern TB epidemic: rapid urbanization and high density populations with dramatically rising incidence of diabetes, a burgeoning and largely unregulated private sector with escalating drug resistance and high air pollution both outdoor and household. From bacterial biochemistry to policy implementation, we suggest ways in which South Asia can seize the opportunity lead global TB elimination by demonstrating feasibility in some of the world's most densely populated cities and remotest reaches of the Himalayas. Clearly political will is essential, but we cannot defeat TB without understanding how to eliminate it in South Asia.

A multi-model evaluation of aerosols over South Asia: common problems and possible causes

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Pan, X.; Chin, M.; Gautam, R.; Bian, H.; Kim, D.; Colarco, P. R.; Diehl, T. L.; Takemura, T.; Pozzoli, L.; Tsigaridis, K.; Bauer, S.; Bellouin, N.

2015-05-01

Atmospheric pollution over South Asia attracts special attention due to its effects on regional climate, water cycle and human health. These effects are potentially growing owing to rising trends of anthropogenic aerosol emissions. In this study, the spatio-temporal aerosol distributions over South Asia from seven global aerosol models are evaluated against aerosol retrievals from NASA satellite sensors and ground-based measurements for the period of 2000-2007. Overall, substantial underestimations of aerosol loading over South Asia are found systematically in most model simulations. Averaged over the entire South Asia, the annual mean aerosol optical depth (AOD) is underestimated by a range 15 to 44% across models compared to MISR (Multi-angle Imaging SpectroRadiometer), which is the lowest bound among various satellite AOD retrievals (from MISR, SeaWiFS (Sea-Viewing Wide Field-of-View Sensor), MODIS (Moderate Resolution Imaging Spectroradiometer) Aqua and Terra). In particular during the post-monsoon and wintertime periods (i.e., October-January), when agricultural waste burning and anthropogenic emissions dominate, models fail to capture AOD and aerosol absorption optical depth (AAOD) over the Indo-Gangetic Plain (IGP) compared to ground-based Aerosol Robotic Network (AERONET) sunphotometer measurements. The underestimations of aerosol loading in models generally occur in the lower troposphere (below 2 km) based on the comparisons of aerosol extinction profiles calculated by the models with those from Cloud-Aerosol Lidar with Orthogonal Polarization (CALIOP) data. Furthermore, surface concentrations of all aerosol components (sulfate, nitrate, organic aerosol (OA) and black carbon (BC)) from the models are found much lower than in situ measurements in winter. Several possible causes for these common problems of underestimating aerosols in models during the post-monsoon and wintertime periods are identified: the aerosol hygroscopic growth and formation of

[Evaluation of adiponectin level in children and adolescents with diabetes type 1].

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Peczyńska, Jadwiga; Urban, Mirosława; Głowińska, Barbara; Florys, Bozena

2008-01-01

Adipose tissue is not only an energy storage place, but it also secretes numerous "adipocytokines" - substances that have systemic influence. Adiponectin has an anti-inflammatory, antiatherogenic properties and increases insulin sensitivity. It is emphasized that adiponectin levels are different in type 1 and type 2 diabetes. was to evaluate adiponectin levels in young patients with diabetes type 1, and to analyse of the correlation between adiponectin and: BMI, lipid parameters, glomerular filtration rate and microalbuminuria. The study group was formed by 95 patients from the Outpatient Diabetology Department 2nd Department of Children's Diseases, 45 girls and 50 boys, aged from 7 to 20 years (mean - 14.97 yrs) suffering from diabetes from 1 to 17 years (mean 6.68 yrs). Control group consisted of healthy children, age matched, without family history of cardiovascular diseases. In all patients anthropometric measurements were performed (BMI was calculated), metabolic control was evaluated on the basis of HbA1c level, microalbuminuria was studied in 24 hour urine sample. We assessed glomerular filtration rate (endogenous creatinine clearance), lipid parameters and adiponectin level. In children and adolescents with diabetes type 1 we found significantly higher levels of adiponectin compared to control group: 32.72+/-13.49 vs. 26.53+/-7.63 ug/ml; p=0.024. Adiponectin level was higher in girls than in boys (33.56 vs. 28.75 ug/ml; p=0.036). Adiponectin level did not depend on metabolic control and on diabetes duration. We found a statistically significant negative correlation between adiponectin and creatinine (r=-0.26; p=0.011). In patients with diabetic complications we found insignificantly lower adiponectin level compared to patients without complications (30.99+/-14.29 vs. 33.67+/-11.68 ug/ml; p=0.35). 1. In patients with diabetes type 1 significantly higher level of adiponectin was found compared to healthy control group. 2. Adiponectin level correlated

Measuring Pre-Service Teachers' Asia Literacy and Their Preparedness to Teach Asia

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Grainger, Peter; Christie, Michael

2016-01-01

Asia literacy is a growing concern of the Federal Government in relation to the development of an Asia literate workforce. Despite 30 years of funded initiatives, the thought of teaching about Asia is a daunting one for pre-service teachers. This is due to the lack of Asia foci in university pre-service courses and complicated by the definition of…

DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol.

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Tobe, Sheldon W; Wentworth, Joan; Ironstand, Laurie; Hartman, Susan; Hoppe, Jackie; Whiting, Judi; Kennedy, Janice; McAllister, Colin; Kiss, Alex; Perkins, Nancy; Vincent, Lloyd; Pylypchuk, George; Lewanczuk, Richard Z

2009-05-09

The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel) study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Protocol NCT00325624.

Radionuclide evaluation of the liver in diabetes

International Nuclear Information System (INIS)

Abdel-Razzak, M.; El-Ashmawy, A.

1982-01-01

Hepatic involvement in diabetes has been previously demonstrated in experimental animals and in patients by clinical examination as well as by autopsy. The aim of the present work is to investigate the extent and type of hepatic involvement in diabetics by radionuclide scanning which is objective and not liable to the errors and difficulties inherent in the method of physical examination. The present study was performed on 40 diabetics, comprising 24 females and 16 males, aged between 17 and 80 years. Scanning was performed with 99m - Tc sulphur colloid using a rectilinear scanner and the gamma camera. The liver size was assessed from the scan pictures by the application of certain measurements and by surface area determination. The obtained results demonstrated marked discrepancy between the liver size as determined clinically and that evaluated by radionuclide scanning. By scintiscanning, the incidence of hepatic enlargement varied according to the parameter used. It amounted to 48% on the basis of the maximum vertical dimension and 37% with hepatic surface area measurement. Using the vertical dimension at halfway between the xiphoid and right lateral hepatic margin, the incidence of liver enlargement was 35%. Uneven distribution of radioactivity was seen in the right and/or left lobe in 20/40 patients. Furthermore, in 10 patients the ratio of hepatic to splenic radioactivity was below one. These changes could be explained by fatty infiltration and/or cirrhosis. Accordingly, hepatic scanning could be used to select diabetes having abnormal scan picture whether regarding liver dimensions or distribution of radioactivity and subjecting them to liver biopsy in order to define the nature of liver involvement. (Author)

Evaluation of an intra-institutional diabetes disease management program for the glycemic control of elderly long-term care diabetic patients.

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Lubart, Emily; Segal, Refael; Wainstein, Julio; Marinov, Galina; Yarovoy, Alexandra; Leibovitz, Arthur

2014-04-01

Increasing numbers of nursing home elderly patients suffer from diabetes requiring individually optimized glycemic control. This is a complicated challenge because of their high comorbidity level, and heterogeneous and changing eating status varying from independent to dysphagia and enteral feeding. In order to cope with these complex needs, we developed and implemented a diabetes disease management program. The purpose of the present study was to evaluate this program. We used the point prevalence approach by checking for fasting blood glucose, glycated hemoglobin and other routine biochemical tests. Eating status was evaluated by the Functional Outcome Swallowing Scale. Details about the diabetes disease management program are given in the text. A total of 86 (36%) of the 234 patients on the study day were diabetics. Of these, 80 were eligible for the study. Their mean fasting blood glucose was 143.1 ± 60.6 mg/dL. The mean glycated hemoglobin level was 7.23 ± 1.39%. No case of hypoglycemia was detected on the examination day, or during the preceding 3 weeks. No significant difference was found among the different Functional Outcome Swallowing Scale categories. These results are within satisfactory range for this category of patients suggesting that our diabetes disease management program contributes to a better glycemic control. © 2013 Japan Geriatrics Society.

Evaluation of Urinary Tryptophan Metabolite Levels in Non-diabetic Compared to Diabetic Rats

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Loredana Elena OLAR

2017-11-01

Full Text Available Diabetes mellitus is one of the most common metabolic disorders in animals. Thus, currently, it is imperative to introduce non-invasive, economical and rapid methods for the investigation of diabetes in animals. In this study, the urine samples collected from 10 non-diabetic and 10 streptozotocin-induced diabetic rats were investigated by the spectrofluorimetric technique. Emission spectra for the urine samples were obtained following an excitation wavelength of 280 and 400 nm. The investigated fluorophores were mainly tryptophan metabolites, and significant differences resulted between the mean heights of the emission bands attributed to these fluorophore compounds in diabetic compared to non-diabetic rats. The shape of the spectral windings after the utilization of these two excitation wavelengths was almost similar for diabetic and non-diabetic rats; however, there were some discriminatory elements between the two types of investigated samples. In conclusion, the obtained urine fluorescence spectra allow a clear differentiation between diabetic and non-diabetic rats.

Neurology in Asia.

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Tan, Chong-Tin

2015-02-10

Asia is important as it accounts for more than half of the world population. The majority of Asian countries fall into the middle income category. As for cultural traditions, Asia is highly varied, with many languages spoken. The pattern of neurologic diseases in Asia is largely similar to the West, with some disease features being specific to Asia. Whereas Asia constitutes 60% of the world's population, it contains only 20% of the world's neurologists. This disparity is particularly evident in South and South East Asia. As for neurologic care, it is highly variable depending on whether it is an urban or rural setting, the level of economic development, and the system of health care financing. To help remedy the shortage of neurologists, most counties with larger populations have established training programs in neurology. These programs are diverse, with many areas of concern. There are regional organizations serving as a vehicle for networking in neurology and various subspecialties, as well as an official journal (Neurology Asia). The Asian Epilepsy Academy, with its emphasis on workshops in various locations, EEG certification examination, and fellowships, may provide a template of effective regional networking for improving neurology care in the region. © 2015 American Academy of Neurology.

Asia-MIP: Multi Model-data Synthesis of Terrestrial Carbon Cycles in Asia

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Ichii, K.; Kondo, M.; Ito, A.; Kang, M.; Sasai, T.; SATO, H.; Ueyama, M.; Kobayashi, H.; Saigusa, N.; Kim, J.

2013-12-01

Asia, which is characterized by monsoon climate and intense human activities, is one of the prominent understudied regions in terms of terrestrial carbon budgets and mechanisms of carbon exchange. To better understand terrestrial carbon cycle in Asia, we initiated multi-model and data intercomparison project in Asia (Asia-MIP). We analyzed outputs from multiple approaches: satellite-based observations (AVHRR and MODIS) and related products, empirically upscaled estimations (Support Vector Regression) using eddy-covariance observation network in Asia (AsiaFlux, CarboEastAsia, FLUXNET), ~10 terrestrial biosphere models (e.g. BEAMS, Biome-BGC, LPJ, SEIB-DGVM, TRIFFID, VISIT models), and atmospheric inversion analysis (e.g. TransCom models). We focused on the two difference temporal coverage: long-term (30 years; 1982-2011) and decadal (10 years; 2001-2010; data intensive period) scales. The regions of covering Siberia, Far East Asia, East Asia, Southeast Asia and South Asia (60-80E, 10S-80N), was analyzed in this study for assessing the magnitudes, interannual variability, and key driving factors of carbon cycles. We will report the progress of synthesis effort to quantify terrestrial carbon budget in Asia. First, we analyzed the recent trends in Gross Primary Productivities (GPP) using satellite-based observation (AVHRR) and multiple terrestrial biosphere models. We found both model outputs and satellite-based observation consistently show an increasing trend in GPP in most of the regions in Asia. Mechanisms of the GPP increase were analyzed using models, and changes in temperature and precipitation play dominant roles in GPP increase in boreal and temperate regions, whereas changes in atmospheric CO2 and precipitation are important in tropical regions. However, their relative contributions were different. Second, in the decadal analysis (2001-2010), we found that the negative GPP and carbon uptake anomalies in 2003 summer in Far East Asia is one of the largest

Evaluation of current trends and recent development in insulin therapy for management of diabetes mellitus.

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Nawaz, Muhammad Sarfraz; Shah, Kifayat Ullah; Khan, Tahir Mehmood; Rehman, Asim Ur; Rashid, Haroon Ur; Mahmood, Sajid; Khan, Shahzeb; Farrukh, Muhammad Junaid

2017-12-01

Diabetes mellitus is a major health problem in developing countries. There are various insulin therapies to manage diabetes mellitus. This systematic review evaluates various insulin therapies for management of diabetes mellitus worldwide. This review also focuses on recent developments being explored for better management of diabetes mellitus. We reviewed a number of published articles from 2002 to 2016 to find out the appropriate management of diabetes mellitus. The paramount parameters of the selected studies include the insulin type & its dose, type of diabetes, duration and comparison of different insulin protocols. In addition, various newly developed approaches for insulin delivery with potential output have also been evaluated. A great variability was observed in managing diabetes mellitus through insulin therapy and the important controlling factors found for this therapy include; dose titration, duration of insulin use, type of insulin used and combination therapy of different insulin. A range of research articles on current trends and recent advances in insulin has been summarized, which led us to the conclusion that multiple daily insulin injections or continuous subcutaneous insulin infusion (insulin pump) is the best method to manage diabetes mellitus. In future perspectives, development of the oral and inhalant insulin would be a tremendous breakthrough in Insulin therapy. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Evaluation of Cognitive Functions in Iranian Children and Adolescents With Diabetes Mellitus.

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Pourabbasi, Ata; Tehrani-Doost, Mehdi; Ebrahimi Qavam, Soqra; Farzami, Jalal; Larijani, Bagher

2017-06-01

Diabetes in children and adolescents is a chronic condition with an expanding trend in the community. Several studies have shown cognitive dysfunctions are the most important side effects of diabetes among individuals of younger ages. Due to cultural differences and their impact on cognitive issues, the authors decided to assess the cognitive functions of Iranian children and adolescents with diabetes. Cognitive functions including memory, attention and executive functions were evaluated in 62 diabetic children and adolescents and healthy peers using CANTAB cognitive tests. Other data such as demographic, school performance and medical information were collected by questionnaires. Except in the case of few variables in RVP, SSP and SST, no significant difference exists between diabetic children and the control group in terms of different cognitive domains. But cognitive variables, especially in PRM, SWM and SOC test, has been shown to be deteriorated with increasing HbA1C values in serum levels. Diabetes has no impact on the cognitive functioning of children provided by maintaining a glycemic control. It is proposed that the adoption of appropriate parenting styles and family and social support can prevent cognitive changes in children with diabetes.

Evaluation of Cognitive Functions in Iranian Children and Adolescents With Diabetes Mellitus

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Ata Pourabbasi

2017-08-01

Full Text Available Diabetes in children and adolescents is a chronic condition with an expanding trend in the community. Several studies have shown cognitive dysfunctions are the most important side effects of diabetes among individuals of younger ages. Due to cultural differences and their impact on cognitive issues, the authors decided to assess the cognitive functions of Iranian children and adolescents with diabetes. Cognitive functions including memory, attention and executive functions were evaluated in 62 diabetic children and adolescents and healthy peers using CANTAB cognitive tests. Other data such as demographic, school performance and medical information were collected by questionnaires. Except in the case of few variables in RVP, SSP and SST, no significant difference exists between diabetic children and the control group in terms of different cognitive domains. But cognitive variables, especially in PRM, SWM and SOC test, has been shown to be deteriorated with increasing HbA1C values in serum levels. Diabetes has no impact on the cognitive functioning of children provided by maintaining a glycemic control. It is proposed that the adoption of appropriate parenting styles and family and social support can prevent cognitive changes in children with diabetes.

Prevalence of food allergies in South Asia.

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Arakali, Schweta R; Green, Todd D; Dinakar, Chitra

2017-01-01

To evaluate the published medical literature on the prevalence and types of food allergies in South Asia. A PubMed search was performed using the keywords India and food allergy, Asia and food allergy, and South Asia and food allergy for any period. Articles cited in selected studies were reviewed for their appropriateness of inclusion into this review. Publications were included that were original research and fit the topic of food allergy and South Asia. South Asia is defined as region inclusive of India, Pakistan, Bangladesh, and Sri Lanka. A total of 169 articles were initially identified, and 47 were reviewed in detail for inclusion in this review. The primary focus was placed on 10 studies that consisted of case reports of newly reported or documented food allergy, survey studies that investigated food allergy prevalence in specific demographics, and prospective and cross-sectional studies with case controls, all of which investigated food allergy prevalence by allergy testing in a selected population. The medical literature on the prevalence and types of food allergy in South Asia indicates that there is a variety of unusual and unique allergens and an overall low incidence of food allergy. There is also an association of increased food allergy prevalence in individuals who live in metropolitan regions or who migrate to communities that have adopted westernization. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Community Evaluation of the National Diabetes Education Program's Diabetes HealthSense Website.

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Sadler, Michele DeBarthe; Saperstein, Sandra L; Carpenter, Carrie; Devchand, Roshni; Tuncer, Diane; O'Brian, Catherine; Nicols, Christina; Gallivan, Joanne

2017-10-01

Purpose The purpose of this study was to assess the impact of Diabetes HealthSense on knowledge, attitudes, and behavior changes that prevent, delay, or manage diabetes among people at risk (PAR) for diabetes and people with diabetes (PWD). Methods Using a 2-group pretest-posttest design, 15 community sites were randomly assigned to either an intervention or comparison group. Intervention participants attended a group education session with a diabetes educator, followed by 4 weeks of independent use of the Diabetes HealthSense website. The comparison group received no intervention. A total of 311 adults (n = 135 intervention, n = 176 comparison) completed both a pretest and posttest. Outcome measures examined changes in self-reported knowledge, self-efficacy, and behaviors that support diabetes prevention or management. Results Statistically significant within-group pretest to posttest changes were found for almost all outcome measures in the intervention group, with no significant changes in the comparison group. Significant between-group differences were also found for almost all outcome measures at posttest, with the intervention group having more positive outcomes than the comparison group. Conclusions Patient referral to online tools is considered one key component of initial and ongoing diabetes self-management education and support (DSME/S) and is recommended as a way to enhance and extend the reach of in-person diabetes education. Positive outcomes were found for PWD/PAR who used Diabetes HealthSense following a guided education session. Study results suggested that with guided exploration, Diabetes HealthSense provided a valuable tool for educators to use with patients to support and extend the reach of DSME/S.

Assesment of propolis supplementation on insulin resistance in diabetic patients

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nazli samadi

2017-05-01

Full Text Available Introduction: Diabetes mellitus is a common endocrine disease . The number of people with diabetes over the last twenty years has doubled . Asia as a result of rapid economic growth , as the center of the epidemic in the world . Iran is among the countries with a high prevalence of diabetes mellitus . Use of medicinal plants as adjunctive therapy along with medication always been original . In recent years the tendency of patients to alternative therapies and traditional medicine has increased. Methods : Among patients referred to clinics of University of Medical Sciences, Yazd, Iran , 67 people were selected and randomly divided into two groups,intervention or placebo. Patients in the intervention group received 3 tablets of 300 mg bee propolis and in the control group received placebo . The study lasted 12 weeks . Serum insulin and insulin resistance index were evaluated at the beginning and end of the study. Results: 57 patients completed the study . The average demographic characteristics , anthropometric indices , serum insulin and insulin resistance index at the beginning and end of the study between the two groups showed no significant difference. Conclusion : In this study , supplementation with bee propolis for 12 weeks , on the serum insulin and indices of insulin resistance in patients with type II diabetes is not effective . Further studies are needed to make a final decision.

MR evaluation of diabetes insipidus

International Nuclear Information System (INIS)

Tien, R.D.; Newton, T.H.; Kucharczyk, J.

1989-01-01

The authors have used MR imaging to evaluate the hypothalamic/pituitary region in 21 patients with central diabetes insipidus. Diagnoses included histiocytosis-X, germ cell tumors trauma, metastases, tuberculosis, pituitary abscess, and Erdheim-Chester disease. Gd-DTPA was administered in eight patients. Seventeen of 21 patients had a pituitary infundibular stalk that was thicker than that of normal subjects, but the signal intensity of the abnormal stalk was normal. The pituitary stalk was uniformly thickened in the histiocytosis-X and tuberculosis patients. Asymmetric thickening was seen in the patients with germ cell tumors, metastases, and Erdheim-Chester disease. Pituitary stalk was disrupted in the posterior pituitary lobe was absent in all patients

Multiple Sclerosis Epidemiology in East Asia, South East Asia and South Asia: A Systematic Review.

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Eskandarieh, Sharareh; Heydarpour, Pouria; Minagar, Alireza; Pourmand, Shadi; Sahraian, Mohammad Ali

2016-01-01

Multiple sclerosis (MS) is one of the most common chronic immune-mediated diseases of the human central nervous system and an important cause of non-traumatic neurologic disability among young population in several countries. Recent reports from East Asia, South East Asia and South Asia have proposed a low to moderate prevalence of MS in these countries. A literature review search was carried out in December 2014 in Medline, Embase, Scopus and Cochrane library to recover original population-based studies on MS epidemiology in East Asia, South East Asia and South Asia countries published between January 1, 1950 and December 30, 2014. We intended search strategies using the key words: multiple sclerosis, prevalence, incidence and epidemiology. Based on our inclusion criteria, 68 epidemiologic studies were included in this systematic review. The most extensively used diagnostic criteria in the studies were McDonald's criteria. Most studies were performed in a multi-center hospital setting. The female to male ratio varied and ranged from 0.7 in India to 9.0 in China. The mean age at disease onset ranged from the lowest age of 25.3 in Iran to the highest age of 46.4 in China. MS prevalence ranged from 0.77 in 100,000 populations in Hong Kong (1999) to 85.80 in 100,000 in Iran (2013). Advances in MS registries around the globe allow nationwide population-based studies and will allow worldly comparisons between the prevalence and incidence in different regions that are provided to monitor estimation. © 2016 S. Karger AG, Basel.

Prevalence and trends of metabolic syndrome among adults in the asia-pacific region: a systematic review

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P. Ranasinghe

2017-01-01

Full Text Available Abstract Background The Asia-Pacific region is home to nearly half of the world’s population. The region has seen a recent rapid increase in the prevalence of obesity, type-2 diabetes and cardiovascular disease. The present systematic review summarizes the recent prevalence and trends of Metabolic Syndrome (MetS among adults in countries of the Asia-Pacific Region. Methods Data on MetS in Asia-Pacific countries were obtained using a stepwise process by searching the online Medline database using MeSH terms ‘Metabolic Syndrome X’ and ‘Epidemiology/EP’. For the purpose of describing prevalence data for the individual countries, studies that were most recent, nationally representative or with the largest sample size were included. When evaluating secular trends in prevalence in a country we only considered studies that evaluated the temporal change in prevalence between similar populations, prospective studies based on the same population or National surveys conducted during different time periods. Results This literature search yielded a total of 757 articles, and five additional article were identified by screening of reference lists. From this total, 18 studies were eligible to be included in the final analysis. Of the 51 Asia-Pacific countries (WHO we only located data for 15. There was wide between country variation in prevalence of MetS. A national survey from Philippines conducted in 2003 revealed the lowest reported prevalence of 11.9% according to NCEP ATP III criteria. In contrast, the highest recorded prevalence in the region (49.0% came from a study conducted in urban Pakistan (Karachchi, 2004. Most studies reported a higher prevalence of MetS in females and urban residents. Data on secular trends were available for China, South Korea and Taiwan. An increase in the prevalence of MetS was observed in all three countries. Conclusion Despite differences in methodology, diagnostic criteria and age of subjects studied, the Asia

DreamTel; Diabetes risk evaluation and management tele-monitoring study protocol

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Kiss Alex

2009-05-01

Full Text Available Abstract Background The rising prevalence of type 2 diabetes underlines the importance of secondary strategies for the prevention of target organ damage. While access to diabetes education centers and diabetes intensification management has been shown to improve blood glucose control, these services are not available to all that require them, particularly in rural and northern areas. The provision of these services through the Home Care team is an advance that can overcome these barriers. Transfer of blood glucose data electronically from the home to the health care provider may improve diabetes management. Methods and design The study population will consist of patients with type 2 diabetes with uncontrolled A1c levels living on reserve in the Battlefords region of Saskatchewan, Canada. This pilot study will take place over three phases. In the first phase over three months the impact of the introduction of the Bluetooth enabled glucose monitor will be assessed. In the second phase over three months, the development of guidelines based treatment algorithms for diabetes intensification will be completed. In the third phase lasting 18 months, study subjects will have diabetes intensification according to the algorithms developed. Discussion The first phase will determine if the use of the Bluetooth enabled blood glucose devices which can transmit results electronically will lead to changes in A1c levels. It will also determine the feasibility of recruiting subjects to use this technology. The rest of the Diabetes Risk Evaluation and Management Tele-monitoring (DreamTel study will determine if the delivery of a diabetes intensification management program by the Home Care team supported by the Bluetooth enabled glucose meters leads to improvements in diabetes management. Trial Registration Protocol NCT00325624

Evaluative coping, emotional distress, and adherence in couples with Type 2 diabetes.

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Trump, Lisa J; Novak, Joshua R; Anderson, Jared R; Mendenhall, Tai J; Johnson, Matthew D; Scheufler, Ann C; Wilcox, Allison; Lewis, Virginia L; Robbins, David C

2018-03-01

Spousal support is one of the strongest and most consistent predictors of Type 2 diabetes treatment adherence. However, the effects of both spouses' evaluations of dyadic coping on emotional distress and patients' physical health remain largely unknown. Dyadic data from 117 married couples in which one member is diagnosed with Type 2 diabetes were evaluated in two separate models to explore the associations between (a) patients' and spouses' depression symptoms and patients' adherence to dietary and exercise regimens, and (b) patients' and spouses' acute stress levels and patients' adherence to dietary and exercise regimens. Finally, evaluative dyadic coping was included as a possible moderator between these associations. Results from an actor-partner interdependence model revealed significant actor effects of patients' depression symptoms on patients' adherence to dietary and exercise regimens. Spouses' evaluation of dyadic coping attenuated the direct paths between spouses' depression symptoms and patients' adherence to dietary regimens. No direct pathways were found from patients' or spouses' acute stress to patients' adherence to dietary and exercise regimens. However, spouses' evaluation of dyadic coping attenuated the direct paths between spouses' acute stress and patients' adherence to dietary regimens. Tapping into spouses' evaluations of dyadic coping has significant implications for patients' diabetes health outcomes (e.g., adherence to dietary and exercise treatment regimens). Findings from this study highlight the need for systemic interventions targeting both partners. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Sonographic evaluation of the shoulder in asymptomatic elderly subjects with diabetes

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Salini Vincenzo

2010-12-01

Full Text Available Abstract Background The prevalence of rotator cuff tears increases with age and several studies have shown that diabetes is associated with symptomatic shoulder pathologies. Aim of our research was to evaluate the prevalence of shoulder lesions in a population of asymptomatic elderly subjects, normal and with non insulin - dependent diabetes mellitus. Methods The study was performed on 48 subjects with diabetes and 32 controls (mean age: 71.5 ± 4.8 and 70.7 ± 4.5, respectively, who did not complain shoulder pain or dysfunction. An ultrasound examination was performed on both shoulders according to a standard protocol, utilizing multiplanar scans. Results Tendons thickness was greater in diabetics than in controls (Supraspinatus Tendon: 6.2 ± 0.09 mm vs 5.2 ± 0.7 mm, p vs 3.2 ± 0.4 mm, p vs 20.3%, p vs 7.8%, p Subjects with diabetes exhibited more tears in the Supraspinatus Tendon (Minor tears: 15 (15.8% vs 2 (3.1%, p vs 5 (7.8%, p = ns, but not in the long head of Biceps. More effusions in subacromial bursa were observed in diabetics (23.9% vs 10.9%, p vs 10.9%, p In both groups, pathological findings were prevalent on the dominant side, but no difference related to duration of diabetes was found. Conclusions Our results suggest that age - related rotator cuff tendon degenerative changes are more common in diabetics. Ultrasound is an useful tool for discovering in pre - symptomatic stages the subjects that may undergo shoulder symptomatic pathologies.

Early evaluation of renal hemodynamic alterations in type I diabetes mellitus with duplex ultrasound

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Saif Aasem

2010-01-01

Full Text Available To evaluate the role of renal duplex ultrasonography in the detection of early alte-ration of renal blood flow in type I diabetic patients, we studied with duplex ultrasound 32 patients with type I diabetes mellitus (19 males, 13 females, age range 8-19 years and 35 age and sex-matched controls. The resistivity indices (RIs and pulsatility indices (PIs of the main renal as well as intra-renal arteries were calculated. Compared with the healthy control subjects, diabetic patients had significantly higher resistivity indices (RIs in the intrarenal (segmental, arcuate and interlobar ar-teries (P= 0.001. The study, also revealed a significantly positive correlation between the RIs in the intrarenal arteries in diabetics and the albumin/creatinine ratio (r= 0.54, 0.52 and 0.51 respectively, glycated hemoglobin (r= 0.61, 0.59 and 0.63 respectively, as well as the estimated GFR (e-GFR (r= 0.53, 0.51 and 0.57 respectively. We conclude that the current study documented early intra-renal hemodynamic alterations in the form of pathologically elevated intrarenal RIs. This denotes the potential usefulness of duplex evaluation of the intrarenal arteries, as a noninvasive procedure, for monitoring type 1 diabetic patients to predict those at risk of diabetic nephropathy.

Evaluation the index of ophthalmic arteries in diabetic patients with retinopathy compared to diabetic patients without retinopathy using color Doppler ultrasound

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Mohammad Ghasem Hanafi

2016-12-01

Full Text Available Diabetic retinopathy is the most common eye complication in diabetic patients that early detection of this complication is essential. The aim of this study was to evaluate ophthalmic artery index in diabetic retinopathy by Doppler ultrasound. . In this cross-sectional study, 64 patients were studied in 4 groups (healthy, diabetic without retinopathy, background retinopathy and proliferative retinopathy. Resistance index (RI and Pulsatile Index (PI were assessed by color Doppler ultrasound. The obtained data were analyzed by ANOVA and chi-square test and ROC curve. RI in diabetic patients with proliferative retinopathy has the highest mean (0.83 and the lowest mean was observed in healthy subjects (0.54 (P <0.001 as well as in PI, the highest rate was in diabetic patients with proliferative retinopathy (1.41 and the lowest was in healthy subjects (0.92 (P <0.001. The results of our study showed that the sensitivity, specificity, positive and negative predictive values and overall accuracy of RI and PI in diabetic patients with proliferative retinopathy in the best cut-off points (0.645 and 1.0175 respectively were 100%.Ophthalmic artery index RI and PI was significantly increased in patients with diabetic retinopathy and the sensitivity and specificity for detection retinopathy was 100%. Color Doppler ultrasound method is more efficient for screening diabetic patients with retinopathy.

Evaluation of a Worksite Diabetes Education Program at a Large Urban Medical Center.

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Renda, Susan; Baernholdt, Marianne; Becker, Kathleen

2016-01-01

Evidence suggests that diabetes education can be delivered at the worksite to better support employees' diabetes self-management and improve productivity and health care costs. This study was conducted to address the feasibility of a diabetes worksite education program for employees at a large urban academic health care institution. The diabetes education program was delivered in the diabetes center at the institution, a resource that was previously underutilized by employees. Through collaboration with groups in the institution, 20 employees of diverse ethnicity participated in the worksite diabetes education program with positive outcomes: improved glycemic control measured (HbA1c), attainment of self-management goals, and satisfaction with the program. Work absences trended downward, but numbers of hospitalizations and emergency department visits were unchanged in the 3 months following education. Recommendations include replication of the study with more employee participation and program evaluation over a longer period of time to continue assessment of employees' educational needs. © 2015 The Author(s).

Thyroidal radio autographic evaluation in experimental diabetes mellitus

International Nuclear Information System (INIS)

Nascimento-Saba, C.C.A.; Brito, A.C.; Pereira, M.J.S.; Carvalho, J.J.; Roshental, D.

1997-01-01

Full text. There is a well known correlation between diabetes mellitus (DM) and thyroid diseases. Previous studies have shown that the thyroid peroxidase (TPO) 'in vitro' iodide-oxidation activity is decreased and the thyroid T 4-dasanide is increased 15 days after induction of experimental DM. In the present study we evaluated radioautography, an indirect assay of 'in vivo' T P O activity. D M was induced in male Wistar rats (circa 250 g body weight) by a single i.p. streptozotocin injection (45 mg/kg). One group of D M animals received insulin (2 U/day, N P H), starting 48 h after streptozotocin. 2μ Ci of 125 I were given by i.p. injection, 2.5 h before thyroid excision, after 7 or 30 days of diabetes. The glands were counted, weighed, fixed in Bouin's solution, embedded in paraffin, cut and HE-stained. The sections were covered with NTB-2 emulsion (Kodak), incubated at 4 deg C for 7 days, before revelation. Quantitative distribution of silver grains was evaluated using the Image Pro-Plus program. The thyroidal 125 I uptake is significantly decreased in diabetic animals after 30 days. The 'in vative P O activity is significantly decreased 7 and 30 days D M induction. This decrease was also present in the insulin-treated animals and the exogenous insulin administration was unable to revert changes induced by experimental D M, at least in the dosage/periodicity used. It seems that the activity of basal membrane is affected after 30 days of D M, however the T P O activity is already affected after 7 days of DM

South Asian women with diabetes: Psychosocial challenges and management: Consensus statement.

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Bajaj, Sarita; Jawad, Fatema; Islam, Najmul; Mahtab, Hajera; Bhattarai, Jyoti; Shrestha, Dina; Wijeyaratne, Chandrika; Muthukuda, Dimuthu T; Widanage, Niranjala Weegoda; Aye, Than Than; Aung, Moe Wint; Kalra, Bharti; Anjana, R M; Sreedevi, Aswathy; Verma, Komal

2013-07-01

Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death. Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier. There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect of sexual issues

South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

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Sarita Bajaj

2013-01-01

Full Text Available Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death.Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier.There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect

South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

Science.gov (United States)

Bajaj, Sarita; Jawad, Fatema; Islam, Najmul; Mahtab, Hajera; Bhattarai, Jyoti; Shrestha, Dina; Wijeyaratne, Chandrika; Muthukuda, Dimuthu T.; Widanage, Niranjala Weegoda; Aye, Than Than; Aung, Moe Wint; Kalra, Bharti; Anjana, R. M.; Sreedevi, Aswathy; Verma, Komal

2013-01-01

Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death. Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier. There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect of sexual issues

Theming Asia

NARCIS (Netherlands)

Erb, Maribeth; Ong, Chin Ee

2017-01-01

This paper introduces a special issue on Theme Parks in Asia with reflections on how the various theoretical ideas on theming and theme parks that are found in the social science literature can help us to understand the proliferation of theming and theme parks in contemporary Asia. How does theming

Evaluación periodontal de pacientes portadores de diabetes mellitus Periodontal evaluation of patients with diabetes mellitus.

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Carlos Rogério Ribeiro Fontanini

2006-08-01

Full Text Available Los portadores de diabetes mellitus presentan manifestaciones sistémicas que pueden interferir en la atención odontológica. El riesgo de periodontitis aumenta cuando el paciente está descompensado metabólicamente. El objetivo de nuestra investigación fue evaluar las condiciones periodontales relacionadas en pacientes con diabetes mellitus. Se examinaron 57 pacientes portadores de diabetes. Las condiciones periodontales fueron evaluadas por el índice CPITN. Se constató un inadecuado control metabólico, pues 38 pacientes (66,67 % se encontraban con niveles glicémicos alterados. Se evaluaron en total 342 sextantes y 49 fueron considerados válidos para examen. Los códigos 0 y 1 estuvieron representados por un paciente cada uno; el código 2 fue observado en 11 sextantes examinados; el código 3 en 18 y el código 4 en 22 de estos. Concluimos que la enfermedad periodontal es muy severa en diabéticos. En función de las manifestaciones bucales encontradas en esos pacientes, podemos sugerir que individuos portadores de diabetes mellitus representan un grupo especial que requiere medidas odontológicas preventivas y terapéuticas específicas.Diabetes mellitus carriers show systemic manifestations that may interfere with odontological care. The risk of periodontitis increases with metabolic decompensation of a patient. The objective of our research work was to evaluate the periodontal condition in patients with diabetes mellitus. Fifty seven diabetic patients were examined. CPITN index served to assess the periodontal conditions. It was established that metabolic control was inadequate since 38 patients (66,67% presented with altered glycemic levels. Three hundred and forty two sextants were assessed, 49 of which were considered valid for test. Codes 0 and 1 were represented by one patient each; code 2 was observed in 11 analyzed sextants; code 3 in 18 and code 4 in 22. We concluded that periodontal disease is very severe in diabetics

The Use of an Adapted Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Consumer Reported Ratings of Diabetes mHealth Applications: Implications for Diabetes Care and Management.

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Househ, Mowafa S; Shubair, Mamdouh M; Yunus, Faisel; Jamal, Amr; Aldossari, Bakheet

2015-10-01

The aim of this paper is to present a usability analysis of the consumer ratings of key diabetes mHealth applications using an adapted Health IT Usability Evaluation Model (Health-ITUEM). A qualitative content analysis method was used to analyze publicly available consumer reported data posted on the Android Market and Google Play for four leading diabetes mHealth applications. Health-ITUEM concepts including information needs, flexibility/customizability, learnability, performance speed, and competency guided the categorization and analysis of the data. Health impact was an additional category that was included in the study. A total of 405 consumers' ratings collected from January 9, 2014 to February 17, 2014 were included in the study. Overall, the consumers' ratings of the leading diabetes mHealth applications for both usability and health impacts were positive. The performance speed of the mHealth application and the information needs of the consumers were the primary usability factors impacting the use of the diabetes mHealth applications. There was also evidence on the positive health impacts of such applications. Consumers are more likely to use diabetes related mHealth applications that perform well and meet their information needs. Furthermore, there is preliminary evidence that diabetes mHealth applications can have positive impact on the health of patients.

Diabetes-Related Distress, Depression and Distress-Depression among Adults with Type 2 Diabetes Mellitus in Malaysia.

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Boon-How Chew

Full Text Available Type 2 diabetes mellitus (T2DM brings about an increasing psychosocial problem in adult patients. Prevalence data on and associated factors of diabetes related distress (DRD and depression have been lacking in Asia. This study aimed to examine the prevalence of DRD and depression, and their associated factors in Asian adult T2DM patients. This study was conducted in three public health clinics measuring DRD (Diabetes Distress Scale, DDS, and depression (Patient Health Questionnaire, PHQ. Patients who were at least 30 years of age, had T2DM for more than one year, with regular follow-up and recent laboratory results ( 130/80 mmHg (OR 0.53, 95% CI 0.32 to 0.89 were less likely to experience both DRD and depression. DRD and depression were common and correlated in Asian adults with T2DM at primary care level. Socio-demographic more than clinical characteristics were related to DRD and depression.

Evaluation of Salivary Glucose, IgA and Flow Rate in Diabetic Patients: A Case-Control Study

OpenAIRE

Bakianian Vaziri, P.; Vahedi, M.; Mortazavi, H.; Abdollahzadeh, Sh.; Hajilooi, M.

2010-01-01

Objective: An association between diabetes mellitus and alterations in the oral cavity has been noted. In this study, we evaluated differences between salivary IgA, glucose and flow rate in diabetic patients compared with healthy controls. Materials and Methods: Forty patients with type 1 diabetes, 40 patients with type 2 diabetes and 40 healthy controls were selected. Whole unstimulated saliva samples were collected by the standard method and the salivary flow rate was determined. Nephelomet...

Asia Pacific energy derivatives

International Nuclear Information System (INIS)

Fusaro, P.C.

1997-09-01

Asia Pacific Energy Derivatives, from FT Energy, is the first report of its kind to examine the growth of energy derivatives within Asia Pacific and their increasing importance within this region. It provides a comprehensive overview of the subject, including analysis of: deregulation as a market driver; the impact of privatisation; the future for energy risk management tools; the unique characteristics of the Asia Pacific energy market; the role of futures exchanges in Asia; existing indexes and their performance; the differences between the Asia Pacific markets and their more mature counterparts in London and New York; non-oil derivatives, project finance and cross commodity arbitrage; the thriving Pacific Rim Over the Counter (OTC) markets. (author)

ASIAS - Some History

Data.gov (United States)

National Aeronautics and Space Administration — The ASIAS effort builds on demonstrations that an open exchange of information contributes to improved aviation safety. ASIAS is a comprehensive effort, covering the...

Evaluation of the DNA barcodes in Dendrobium (Orchidaceae) from mainland Asia.

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Xu, Songzhi; Li, Dezhu; Li, Jianwu; Xiang, Xiaoguo; Jin, Weitao; Huang, Weichang; Jin, Xiaohua; Huang, Luqi

2015-01-01

DNA barcoding has been proposed to be one of the most promising tools for accurate and rapid identification of taxa. However, few publications have evaluated the efficiency of DNA barcoding for the large genera of flowering plants. Dendrobium, one of the largest genera of flowering plants, contains many species that are important in horticulture, medicine and biodiversity conservation. Besides, Dendrobium is a notoriously difficult group to identify. DNA barcoding was expected to be a supplementary means for species identification, conservation and future studies in Dendrobium. We assessed the power of 11 candidate barcodes on the basis of 1,698 accessions of 184 Dendrobium species obtained primarily from mainland Asia. Our results indicated that five single barcodes, i.e., ITS, ITS2, matK, rbcL and trnH-psbA, can be easily amplified and sequenced with the currently established primers. Four barcodes, ITS, ITS2, ITS+matK, and ITS2+matK, have distinct barcoding gaps. ITS+matK was the optimal barcode based on all evaluation methods. Furthermore, the efficiency of ITS+matK was verified in four other large genera including Ficus, Lysimachia, Paphiopedilum, and Pedicularis in this study. Therefore, we tentatively recommend the combination of ITS+matK as a core DNA barcode for large flowering plant genera.

A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support.

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Greenwood, Deborah A; Gee, Perry M; Fatkin, Kathy J; Peeples, Malinda

2017-09-01

Since the introduction of mobile phones, technology has been increasingly used to enable diabetes self-management education and support. This timely systematic review summarizes how currently available technology impacts outcomes for people living with diabetes. A systematic review of high quality review articles and meta analyses focused on utilizing technology in diabetes self-management education and support services was conducted. Articles were included if published between January 2013 and January 2017. Twenty-five studies were included for analysis. The majority evaluated the use of mobile phones and secure messaging. Most studies described healthy eating, being active and metabolic monitoring as the predominant self-care behaviors evaluated. Eighteen of 25 reviews reported significant reduction in A1c as an outcome measure. Four key elements emerged as essential for improved A1c: (1) communication, (2) patient-generated health data, (3) education, and (4) feedback. Technology-enabled diabetes self-management solutions significantly improve A1c. The most effective interventions incorporated all the components of a technology-enabled self-management feedback loop that connected people with diabetes and their health care team using 2-way communication, analyzed patient-generated health data, tailored education, and individualized feedback. The evidence from this systematic review indicates that organizations, policy makers and payers should consider integrating these solutions in the design of diabetes self-management education and support services for population health and value-based care models. With the widespread adoption of mobile phones, digital health solutions that incorporate evidence-based, behaviorally designed interventions can improve the reach and access to diabetes self-management education and ongoing support.

Panel discussion: LNG's future in Asia

International Nuclear Information System (INIS)

Ohashi, Tadahiko

1992-01-01

The panelists convened to: (1) identify and evaluate the role which LNG is likely to play in the changing energy scene; (2) to examine the future supply and demand structure of the LNG trade; (3) to discover the key obstacles to continued growth in LNG trade; and (4) to find solutions to these problems. The panelists identified and outlined growing opportunities for LNG utilization in Asia during the next two decades. They shared the opinion that the structure of the supply and demand balance for LNG in Asia will shift during the next decade, providing considerable room for new projects. The key obstacles to continued growth in LNG trade are the lack of: long-distance transmission networks and an efficient competitive market pricing mechanism for LNG in the Asian region. The major importers in the region are keen on developing a range of new long-term supply alternatives, not simply within the Asia-Pacific region, but also from a wider perspective. These alternatives include: financing the expansion of production from existing facilities, development of new fields, and construction of long-distance pipelines

Psychometric evaluation of the Problem Areas in Diabetes (PAID survey in Southern, rural African American women with Type 2 diabetes

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Elasy Tom A

2008-02-01

Full Text Available Abstract Background The Problem Areas in Diabetes (PAID survey is a measure of diabetes-related stress for which reported use has been in largely Caucasian populations. Our purpose was to assess the psychometric properties of the PAID in Southern rural African American women with Type 2 diabetes. Methods A convenience sample of African American women (N = 131 ranging from 21–50 years of age and diagnosed with Type 2 diabetes were recruited for a survey study from two rural Southern community health centers. Participants completed the PAID, Center for Epidemiological Studies-Depression Scale (CES-D, and the Summary of Diabetes Self-Care Activities Scale (SDSCA. Factor analysis, Cronbach's coefficient alpha, and construct validation facilitated psychometric evaluation. Results A principle component factor analysis of the PAID yielded two factors, 1 a lack of confidence subscale, and 2 a negative emotional consequences subscale. The Lack of Confidence and Negative Emotional Consequences subscales, but not the overall PAID scale, were associated with glycemic control and body mass index, respectively. Relationships with measures of depression and diabetes self-care supported construct validity of both subscales. Both subscales had acceptable (alpha = 0.85 and 0.94 internal consistency measures. Conclusion A psychometrically sound two-factor solution to the PAID survey is identified in Southern, rural African American women with Type 2 diabetes. Lack of confidence in and negative emotional consequences of diabetes self-care implementation provide a better understanding of determinants of glycemic control and weight than an aggregate of the two scales.

Economic evaluations of pharmacist-managed services in people with diabetes mellitus: a systematic review.

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Wang, Y; Yeo, Q Q; Ko, Y

2016-04-01

To review and evaluate the most recent literature on the economic outcomes of pharmacist-managed services in people with diabetes. The global prevalence of diabetes is increasing. Although pharmacist-managed services have been shown to improve people's health outcomes, the economic impact of these programmes remains unclear. A systematic review was conducted of six databases. Study inclusion criteria were: (1) original research; (2) evaluation of pharmacist-managed services in people with diabetes; (3) an economic evaluation; (4) English-language publication; and (5) full-text, published between January 2006 and December 2014. The quality of the full economic evaluations reviewed was evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist. A total of 2204 articles were screened and 25 studies were selected. These studies were conducted in a community pharmacy (n = 10), a clinic- /hospital-based outpatient facility (n = 8), or others. Pharmacist-managed services included targeted education (n = 24), general pharmacotherapeutic monitoring (n = 21), health screening or laboratory testing services (n = 9), immunization services (n = 2) and pharmacokinetic monitoring (n = 1). Compared with usual care, pharmacist-managed services resulted in cost savings that varied from $7 to $65,000 ($8 to $85,000 in 2014 US dollars) per person per year, and generated higher quality-adjusted life years with lower costs. Benefit-to-cost ratios ranged from 1:1 to 8.5:1. Among the 25 studies reviewed, 11 were full economic evaluations of moderate quality. Pharmacist-managed services had a positive return in terms of economic viability. With the expanding role of pharmacists in the healthcare sector, alongside increasing health expenditure, future economic studies of high quality are needed to investigate the cost-effectiveness of these services. © 2015 Diabetes UK.

Evaluation of anti-diabetic effects of hydroalcoholic extract of green tea and cinnamon on streptozotocin-induced diabetic rats

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Ghasem Shokri

2015-06-01

Full Text Available Today diabetes is one of the most common diseases in the world that affects half of the world population. The use of medicinal herbs especially green tea and cinnamon has been taken into consideration for relieving the symptoms of diabetes, but there were some different ideas about their effectiveness. So, this study was conducted to evaluate the effect of cinnamon and green tea extract, individually and in combination, on blood glucose and weight loss in diabetic mice with Streptozotocin (STZ. The experiment was performed on 50 Wistar rats.  A total of 50 rats were divided into 10 groups of 5 and STZ was injected at the dose of 40 mg/kg/day for 5 days intraperitoneally. After diabetes induction, three groups received, 50, 100 and 200 mg doses of green tea extract,  three groups received 50, 100 and 200 mg doses of cinnamon extract  and three final groups received 50, 100 and 200 mg doses of  cinnamon  and green tea in combination by gavages daily for 6 weeks. After each period of treatments, blood glucose and the weight of animals were determined. At the end of the sixth week, blood glucose and weight loss were improved in diabetic rats in a dose-dependent manner and the dose of 200 mg/kg extract cinnamon with green tea had the most appropriate synergic effect.

An evaluation of diabetes targeted apps for Android smartphone in relation to behaviour change techniques.

Science.gov (United States)

Hoppe, C D; Cade, J E; Carter, M

2017-06-01

Mobile applications (apps) could support diabetes management through dietary, weight and blood glucose self-monitoring, as well as by promoting behaviour change. The present study aimed to evaluate diabetes apps for content, functions and behaviour change techniques (BCTs). Diabetes self-management apps for Android smartphones were searched for on the Google Play Store. Ten apps each from the following search terms were included; 'diabetes', 'diabetes type 1', 'diabetes type 2', 'gestational diabetes'. Apps were evaluated by being scored according to their number of functions and BCTs, price, and user rating. The mean (SD) number of functions was 8.9 (5.9) out of a possible maximum of 27. Furthermore, the mean (SD) number of BCTs was 4.4 (2.6) out of a possible maximum of 26. Apps with optimum BCT had significantly more functions [13.8; 95% confidence interval (CI) = 11.9-15.9] than apps that did not (4.7; 95% CI = 3.2-6.2; P < 0.01) and significantly more BCTs (5.8; 95% CI = 4.8-7.0) than apps without (3.1; 95% CI = 2.2-4.1; P < 0.01). Additionally, apps with optimum BCT also cost more than other apps. In the adjusted models, highly rated apps had an average of 4.8 (95% CI = 0.9-8.7; P = 0.02) more functions than lower rated apps. 'Diabetes apps' include few functions or BCTs compared to the maximum score possible. Apps with optimum BCTs could indicate higher quality. App developers should consider including both specific functions and BCTs in 'diabetes apps' to make them more helpful. More research is needed to understand the components of an effective app for people with diabetes. © 2016 The British Dietetic Association Ltd.

Central Asia in Asia: Charting growing trans-regional linkages

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Nicola P. Contessi

2016-01-01

Full Text Available As the so-called ‘Asian Century’ unfolds, Central Asian countries are increasingly directing their foreign relations eastward. Meanwhile, Asian states are equally turning to Central Asia in their search for energy resources and new markets. This dual dynamic is giving rise to closer and deeper ties in three key areas. As far as infrastructures are concerned, various Asian powers have adopted Silk Road policies that see Central Asia as a fundamental transit route for their long-haul connectivity projects. In the field of trade, Central Asia's exchanges with other Asian countries have been growing steadily since the 1990s, in some cases even coming to rival, in comparative terms, exchanges with the West. Lastly, in terms of multilateralism, Central Asia is increasingly enmeshed in a web of overlapping institutions with a strong Asian identity, coexisting with the region's Western institutional references. The article then problematizes this emerging pattern by sketching out some of the possible ramifications that could stem from the sustainment and consolidation of these trends for the international order and the global balance of power.

Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

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Korbel, Lindsey; Spencer, John David

2015-03-01

The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

The Asia 2 specific signal peptide region and other domains in fusion protein genes characterized Asia 1 and Asia 2 canine distemper viruses

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Sultan, Serageldeen; Charoenvisal, Nataya; Lan, Nguyen Thi; Yamaguchi, Ryoji; Maeda, Ken; Kai, Kazushige

2009-01-01

Background Although the presence of Asia 2 group of canine distemper virus (CDV) was known by the sequencing and phylogenetic analysis of hemagglutinin (H) gene, the fusion (F) protein gene sequence of Asia 2 group had not been identified. So, the sequence analysis of F gene was carried out to elucidate the genotypic varaitons among Asian isolates. Results The phylogenetic analysis of F and H gene sequences from fourteen CDV isolates obtained from diseased dogs in Japan and Thailand indicated that the F genes had a new initiation codon and extra 27 nucleotides upstream of the usual open reading frame (ORF) and the F proteins had extra 9 amino acids at the N-terminal position only in Asia 2 isolates. On the contrary, the Asia 1 isolates had three extra putative N-glycosylation sites (two sites in the signal peptide region and one site in the F1 region) except for two strains of Th12 and Ac96I (two sites in signal peptide region) adding to four putative N-glycosylation sites that were conserved among all Asian isolates and Onderstepoort strain. In addition to this difference in N-glycosylation sites, the signal peptide region had a great diversity between Asia 1 and Asia 2 isolates. Also, characteristic amino acids were detected for some strains. Conclusion Asia 2 isolates were distinguished from other CDV lineages by the extra 27 nucleotide sequence. The signal peptide region of F gene gives a remarkable differentiation between Asia 1 and Asia 2 isolates. Strains Th12 and Ac96I were differentiated from other Asia 1 strains by the F protein glycosylation sites. PMID:19807927

An international research program on acid rain and emissions in Asia

International Nuclear Information System (INIS)

Foell, W.K.

1992-01-01

Strong economic and population growth will accelerate the rapid development of fossil fuel energy systems throughout Asia. If the present trends continue, by early next century Asian emissions of SO 2 will exceed the present emission levels in North America and Europe combined. In response to the concern that these emissions have the potential to cause significant damage in Asia, a group of international specialists has established a project on Acid Rain and Emissions in Asia. In the initial phase of this project, work is underway to develop an integrated assessment model to assist policy makers in evaluating options to reduce precursor emissions and to catalyze the process of international policy dialogue on acid rain in Asia. 8 refs., 3 figs., 1 tab

Coronary triglyceride deposition in contemporary advanced diabetics.

Science.gov (United States)

Ikeda, Yoshihiko; Zaima, Nobuhiro; Hirano, Ken-ichi; Mano, Masayuki; Kobayashi, Kunihisa; Yamada, Sohsuke; Yamaguchi, Satoshi; Suzuki, Akira; Kanzaki, Hideaki; Hamasaki, Toshimitsu; Kotani, Jun-ichi; Kato, Seiya; Nagasaka, Hironori; Setou, Mitsutoshi; Ishibashi-Ueda, Hatsue

2014-07-01

It is of importance to clarify pathophysiology of diabetic heart diseases such as heart failure and coronary artery disease. We reported a novel clinical phenotype called triglyceride deposit cardiomyovasculopathy (TGCV), showing aberrant TG accumulation in both coronary arteries and myocardium, in a cardiac transplant recipient. Here, we examined autopsied diabetics for TG deposition in cardiovasculature. Consecutive series of hearts from advanced diabetes mellitus (DM) subjects (DM group: DMG, n = 20) and those from age- and sex-matched non-diabetic controls (non DM group: NDMG, n = 20) were examined. The diagnostic criteria of 'advanced DM' was made based on 2014 Clinical Practice Recommendations proposed by the American Diabetes Association. The mean duration of DM was 15.8 years. All DMG suffered from heart diseases including coronary artery diseases and 14 subjects had multi-vessel disease. Tissue TG contents were measured biochemically. Coronary arterial TG contents was significantly higher in DMG compared with NDMG. Spatial distribution of TG in transverse sections of coronary arteries showed TG deposition mainly in smooth muscle cells by Imaging Mass Spectrometry. Abundant TG deposition in coronary artery might be associated with advanced DM. © 2014 Japanese Society of Pathology and Wiley Publishing Asia Pty Ltd.

Adaptation of the Diabetes Health Profile (DHP-1) for use with patients with Type 2 diabetes mellitus: psychometric evaluation and cross-cultural comparison

DEFF Research Database (Denmark)

Meadows, K A; Abrams, C; Sandbaek, A

2000-01-01

AIMS: To adapt the Diabetes Health Profile (DHP-1) for use with English speaking patients with Type 2 diabetes mellitus and to evaluate the psychometric properties of the adapted measure in a UK and Danish sample of insulin, tablet and diet-treated patients with Type 2 diabetes. METHODS: Following...... items (56.25%) were retained following initial item analysis. A three-factor solution accounting for 45.6% and 40.3% of the total explained variance was identified in the UK and Danish samples, respectively. Factors were interpreted as psychological distress (PD), barriers to activity (BA...

Evaluating Parents' Self-Efficacy for Diabetes Management in Pediatric Type 1 Diabetes.

Science.gov (United States)

Noser, Amy E; Patton, Susana R; Van Allen, Jason; Nelson, Michael B; Clements, Mark A

2017-04-01

To examine the factor structure and construct validity of the Maternal Self-Efficacy for Diabetes Management Scale (MSED) in 135 youth ( Mage  = 13.50  ±  1.83 years), with type 1 diabetes mellitus. The study used exploratory factor analysis (EFA) to examine the factor structure and correlations to examine relationships among MSED factors and select parent and child diabetes-related health behaviors and outcomes. EFA identified an 11-item three-factor solution (χ 2 (25, n  = 133)  = 40.22, p  manage their child's diabetes (MSED-M), problem-solve issues surrounding glycemic control (MSED-P), and teach their child about diabetes care (MSED-T). Correlational analyses revealed significant associations between the MSED-M and MSED-T and parent-reported optimism and youth's diabetes-specific self-efficacy. The MSED-T was also associated with glycated hemoglobin and self-monitoring blood glucose. Results provide preliminary evidence for the reliability and validity of a three-factor solution of the MSED. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Overview of Coronary Heart Disease Risk Initiatives in South Asia.

Science.gov (United States)

Kalra, Ankur; Bhatt, Deepak L; Rajagopalan, Sanjay; Suri, Kunal; Mishra, Sundeep; Iqbal, Romaina; Virani, Salim S

2017-06-01

Cardiovascular disease (CVD) is now the leading cause of morbidity and mortality worldwide. Industrialization and economic growth have led to an unprecedented increment in the burden of CVD and their risk factors in less industrialized regions of the world. While there are abundant data on CVD and their risk factors from longitudinal cohort studies done in the West, good-quality data from South Asia are lacking. Several multi-institutional, observational, prospective registries, and epidemiologic cohorts in South Asia have been established to systematically evaluate the burden of CVD and their risk factors. The PINNACLE (Practice Innovation and Clinical Excellence) India Quality Improvement Program (PIQIP), the Kerala Acute Coronary Syndrome (ACS), and Trivandrum Heart Failure registries have focused on secondary prevention of CVD and performance measurement in both outpatient and inpatient settings, respectively. The Prospective Urban and Rural Epidemiology (PURE), Centre for Cardiometabolic Risk Reduction in South Asia (CARRS), and other epidemiologic and genetic studies have focused on primary prevention of CVD and evaluated variables such as environment, smoking, physical activity, health systems, food and nutrition policy, dietary consumption patterns, socioeconomic factors, and healthy neighborhoods. The international cardiovascular community has been responsive to a burgeoning cardiovascular disease burden in South Asia. Several collaborations have formed between the West (North America in particular) and South Asia to catalyze evidence-based and data-driven changes in the federal health policy in this part of the world to promote cardiovascular health and mitigate cardiovascular risk.

Impact Assessment of Biomass Burning on Air Quality in Southeast and East Asia During BASE-ASIA

Science.gov (United States)

Huang, Kan; Fu, Joshua S.; Hsu, N. Christina; Gao, Yang; Dong, Xinyi; Tsay, Si-Chee; Lam, Yun Fat

2013-01-01

A synergy of numerical simulation, ground-based measurement and satellite observation was applied to evaluate the impact of biomass burning originating from Southeast Asia (SE Asia) within the framework of NASA's 2006 Biomass burning Aerosols in Southeast Asia: Smoke Impact Assessment (BASE-ASIA). Biomass burning emissions in the spring of 2006 peaked in MarcheApril when most intense biomass burning occurred in Myanmar, northern Thailand, Laos, and parts of Vietnam and Cambodia. Model performances were reasonably validated by comparing to both satellite and ground-based observations despite overestimation or underestimation occurring in specific regions due to high uncertainties of biomass burning emission. Chemical tracers of particulate K(+), OC concentrations, and OC/EC ratios showed distinct regional characteristics, suggesting biomass burning and local emission dominated the aerosol chemistry. CMAQ modeled aerosol chemical components were underestimated at most circumstances and the converted AOD values from CMAQ were biased low at about a factor of 2, probably due to the underestimation of biomass emissions. Scenario simulation indicated that the impact of biomass burning to the downwind regions spread over a large area via the Asian spring monsoon, which included Southern China, South China Sea, and Taiwan Strait. Comparison of AERONET aerosol optical properties with simulation at multi-sites clearly demonstrated the biomass burning impact via longrange transport. In the source region, the contribution from biomass burning to AOD was estimated to be over 56%. While in the downwind regions, the contribution was still significant within the range of 26%-62%.

The nuclear Asia

International Nuclear Information System (INIS)

Cordonnier, I.; Tertrais, B.

2001-01-01

Since the demolition of the Berlin wall, Asia has become the theater of nuclear rivalry, with as main actors: india, Pakistan, China and South Korea. This book analyzes the geo-political situation in this region of the world and asks some important questions about the new strategic map of Asia: what is the impact of the development of nuclear activities on the security of Asia? Will the deployment of anti-missile defenses lead to a new weapons rush? Is there a nuclear warfare risk? (J.S.)

The Use of an Adapted Health IT Usability Evaluation Model (Health-ITUEM) for Evaluating Consumer Reported Ratings of Diabetes mHealth Applications: Implications for Diabetes Care and Management

Science.gov (United States)

Househ, Mowafa S.; Shubair, Mamdouh M.; Yunus, Faisel; Jamal, Amr; Aldossari, Bakheet

2015-01-01

Background: The aim of this paper is to present a usability analysis of the consumer ratings of key diabetes mHealth applications using an adapted Health IT Usability Evaluation Model (Health-ITUEM). Methods: A qualitative content analysis method was used to analyze publicly available consumer reported data posted on the Android Market and Google Play for four leading diabetes mHealth applications. Health-ITUEM concepts including information needs, flexibility/customizability, learnability, performance speed, and competency guided the categorization and analysis of the data. Health impact was an additional category that was included in the study. A total of 405 consumers’ ratings collected from January 9, 2014 to February 17, 2014 were included in the study. Results: Overall, the consumers’ ratings of the leading diabetes mHealth applications for both usability and health impacts were positive. The performance speed of the mHealth application and the information needs of the consumers were the primary usability factors impacting the use of the diabetes mHealth applications. There was also evidence on the positive health impacts of such applications. Conclusions: Consumers are more likely to use diabetes related mHealth applications that perform well and meet their information needs. Furthermore, there is preliminary evidence that diabetes mHealth applications can have positive impact on the health of patients. PMID:26635437

Choice of Insulin in Type 2 Diabetes: A Southeast Asian Perspective.

Science.gov (United States)

Kalra, Sanjay; Thai, Hong Quang; Deerochanawong, Chaicharn; Su-Yen, Goh; Mohamed, Mafauzy; Latt, Tint Swe; Aye, Than Than; Latif, Zafar Ahmed; Katulanda, Prasad; Khun, Touch; Satha, Sum; Vongvandy, Vadsana

2017-01-01

Southeast Asia faces a diabetes epidemic, which has created significant challenges for health care. The unique Asian diabetes phenotype, coupled with peculiar lifestyle, diet, and healthcare-seeking behavior, makes it imperative to develop clinical pathways and guidelines which address local needs and requirements. From an insulin-centric viewpoint, the preparations prescribed in such pathways should be effective, safe, well tolerated, nonintrusive, and suitable for the use in multiple clinical situations including initiation and intensification. This brief communication describes the utility of premixed or dual action insulin in such clinical pathways and guidelines.

Choice of insulin in type 2 diabetes: A Southeast Asian perspective

Directory of Open Access Journals (Sweden)

Sanjay Kalra

2017-01-01

Full Text Available Southeast Asia faces a diabetes epidemic, which has created significant challenges for health care. The unique Asian diabetes phenotype, coupled with peculiar lifestyle, diet, and healthcare-seeking behavior, makes it imperative to develop clinical pathways and guidelines which address local needs and requirements. From an insulin-centric viewpoint, the preparations prescribed in such pathways should be effective, safe, well tolerated, nonintrusive, and suitable for the use in multiple clinical situations including initiation and intensification. This brief communication describes the utility of premixed or dual action insulin in such clinical pathways and guidelines.

HUBUNGAN SELF CARE DENGAN KUALITAS HIDUP PASIEN DIABETES MELITUS

Directory of Open Access Journals (Sweden)

Reny Chaidir

2017-06-01

Full Text Available Indonesia merupakan daerah terbanyak nomor dua penderita diabets melitus di kawasan Asia Tenggara dengan angka kejadian sebesar 9,116.03 kasus. Puskesmas Tigo Baleh angka kunjungan penderita diabetes melitus pada tahun 2015 mengalami peningkatan yaitu sebesar 408 kunjungan. Pasien diabetes melitus rentan mengalami komplikasi yang disebabkan oleh peningkatan kadar gula darah. Peningkatan kadar gula darah dapat dicegah dengan melakukan self care terdiri dari pengaturan diet, olah raga, terapi obat, perawatan kaki, dan pemantauan gula darah. Tujuan penelitian ini adalah untuk mengetahui adanya hubungan self care dengan kualitas hidup pasien diabetes mellitus. Penelitian ini menggunakan pendekatan cross sectional yang dilakukan terhadap 89 orang responden dengan menggunakan teknik simple random sampling. Pengumpulan data menggunakan kuesioner The Summary of Diabetes Self-Care Activities (SDSCA dan kuesioner The Diabetes Quality of Life Brief Clinical Inventory. Hasil penelitian ini menggunakan uji product moment (pearson correlation, diperoleh nilai r = 0.432. Kesimpulan dari penelitian ini adalah terdapat hubungan antara self care dengan kualitas hidup pasien diabetes melitus di wilayah kerja Puskesmas Tigo Baleh yang berbanding lurus dan memiliki tingkat korelasi yang sedang. Terdapat faktor yang mempengaruhi korelasi dengan kualitas hidup. Diharapkan agar pasien diabetes melitus dapat meningkatkan aktivitas self care sehingga dapat menjalankan kehidupan secara normal.

The Diabetes Self-management Assessment Report Tool (D-SMART): process evaluation and patient satisfaction.

Science.gov (United States)

Charron-Prochownik, Denise; Zgibor, Janice C; Peyrot, Mark; Peeples, Malinda; McWilliams, Janis; Koshinsky, Janice; Noullet, William; Siminerio, Linda M

2007-01-01

The purpose of this article is to present the results of the process evaluation and patient experience in completing the Diabetes Self-management Assessment Report Tool (D-SMART), an instrument within the AADE Outcome System to assist diabetes educators to assess, facilitate, and track behavior change in the provision of diabetes self-management education (DSME). The D-SMART was integrated into computer and telephonic systems at 5 sites within the Pittsburgh Regional Initiative for Diabetes Education (PRIDE) network. Data were obtained from 290 patients with diabetes using the system at these programs via paper-and-pencil questionnaires following baseline D-SMART assessments and electronic system measurement of system performance. Process evaluation included time of completion, understanding content, usability of technology, and satisfaction with the system. Patients were 58% female and 85% Caucasian and had a mean age of 58 years. Fifty-six percent of patients had no more than a high school education, and 78% had Internet access at home. Most patients reported completing the D-SMART at home (78%), in 1 attempt (86%) via the Internet (55%), and in less than 30 minutes. Seventy-six percent believed the questions were easy to understand, and 80% did not need assistance. Age was negatively associated with ease of use. Moreover, 76% of patients believed the D-SMART helped them think about their diabetes, with 67% indicating that it gave the diabetes educator good information about themselves and their diabetes. Most (94%) were satisfied with the D-SMART. Level of satisfaction was independent of the system being used. The D-SMART was easily completed at home in 1 attempt, content was understandable, and patients were generally satisfied with the wording of questions and selection of answers. The D-SMART is easy to use and enhanced communication between the patient and clinician; however, elderly patients may need more assistance. Computer-based and telephonic D

Micronutrients evaluation in Bidens pilosa L., a plant applied in diabetes treatments

Energy Technology Data Exchange (ETDEWEB)

Goncalves, Rodolfo D.M.R.; Silva, Paulo S.C. da, E-mail: rdmrg89@usp.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

2015-07-01

Diabetes mellitus is a disease that has increasingly affected individuals over the last years. World Health Organization estimates that the worldwide number of diabetes cases will rise from 171 million in 2000 to 366 million in 2030. Besides the therapy with pharmaceutical drugs, many diabetic patients use medicinal plants to control the glycemic levels. This herb has anti-diabetic action due to the presence of organic compounds and micronutrients. Among the plants applied in diabetes treatment, Bidens pilosa L., popularly known in Brazil as picao preto, belongs to the family of Asteraceaes, grows fast and is globally distributed. The aim of this study was evaluate the concentration of Cr, Fe, Mg, Mn, V and Zn in aerial parts of Bidens pilosa samples, as well as its growth substrate by means of instrumental neutron activation analysis (INAA). The samples were separated into two groups named control and treatment. During the plant development, micronutrient solution, containing Cr, Fe, Mg, Mn, V and Zn, was added to the treatment group. It was observed that micronutrient solution added to the Biden pilosa samples may had contributed to the preferentially absorption of Fe, Mg and V, as well as to decrease Zn absorption. (author)

Micronutrients evaluation in Bidens pilosa L., a plant applied in diabetes treatments

International Nuclear Information System (INIS)

Goncalves, Rodolfo D.M.R.; Silva, Paulo S.C. da

2015-01-01

Diabetes mellitus is a disease that has increasingly affected individuals over the last years. World Health Organization estimates that the worldwide number of diabetes cases will rise from 171 million in 2000 to 366 million in 2030. Besides the therapy with pharmaceutical drugs, many diabetic patients use medicinal plants to control the glycemic levels. This herb has anti-diabetic action due to the presence of organic compounds and micronutrients. Among the plants applied in diabetes treatment, Bidens pilosa L., popularly known in Brazil as picao preto, belongs to the family of Asteraceaes, grows fast and is globally distributed. The aim of this study was evaluate the concentration of Cr, Fe, Mg, Mn, V and Zn in aerial parts of Bidens pilosa samples, as well as its growth substrate by means of instrumental neutron activation analysis (INAA). The samples were separated into two groups named control and treatment. During the plant development, micronutrient solution, containing Cr, Fe, Mg, Mn, V and Zn, was added to the treatment group. It was observed that micronutrient solution added to the Biden pilosa samples may had contributed to the preferentially absorption of Fe, Mg and V, as well as to decrease Zn absorption. (author)

Transperitoneal transport in diabetic and non-diabetic patients on peritoneal dialysis

DEFF Research Database (Denmark)

Graff, J; Fugleberg, Steen; Nielsen, S L

1999-01-01

To investigate differences in the transport characteristics of the peritoneal membrane between diabetic and non-diabetic patients on chronic peritoneal dialysis, a study was conducted in 21 non-diabetic and 18 diabetic patients. Transperitoneal transport of small solutes was evaluated in terms...... of the mass transfer area coefficients (urea, creatinine and glucose), ultra-filtration sieving coefficients (urea and creatinine) and by peritoneal equilibration test results. The capacity of the peritoneal membrane to transport macromolecules was evaluated by albumin mass transfer rates and clearances......-labelled human albumin. Despite a significantly increased transcapillary escape rate of albumin in the diabetic patients, no differences in peritoneal membrane characteristics could be demonstrated between diabetic and non-diabetic patients on peritoneal dialysis....

Clinical diagnosis of diabetic polyneuropathy with the diabetic neuropathy symptom and diabetic neuropathy examination scores

NARCIS (Netherlands)

Meijer, J.W.; Lefrandt, J.D.; Links, T.P.; Smit, J.A.; Stewart, R.E.; van der Hoeven, J.H.; Hoogenberg, K.

OBJECTIVE - To evaluate the discriminative power of the Diabetic Neuropathy Symptom (DNS) and Diabetic Neuropathy Examination (DNE) scores for diagnosing diabetic polyneuropathy (PNP), as well as their relation with cardiovascular autonomic function testing (cAFT) and electro-diagnostic studies

Lack of individualized perspective: a qualitative study of diabetes care for immigrants in Sweden.

Science.gov (United States)

Brämberg, Elisabeth Björk; Dahlborg-Lyckhage, Elisabeth; Määttä, Sylvia

2012-06-01

This study describes the care provided by a diabetes nurse specialist, and the care needs expressed by people with type 2 diabetes mellitus and an immigrant background. Clinical encounters between a diabetes nurse specialist and 10 people diagnosed with type 2 diabetes mellitus were observed and analyzed by means of qualitative content analysis. One theme, "the diabetes nurse specialist as the conductor of the visit", and four categories emerged from the findings, illustrating the power imbalance between the patients and the diabetes nurse specialist, as well as the lack of an individual perspective. Shifting from a medical perspective to one of openness towards the people's experiences provides a possibility for caregivers to empower patients suffering from type 2 diabetes mellitus. The medical perspective seemed to steer the visit towards curative activities. Thus, technique-centered care should be developed by including individualized care. © 2012 Blackwell Publishing Asia Pty Ltd.

Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes and its predictors in general population aged 15 to 75 years: A community-based study (KERCADRS) in southeastern Iran.

Science.gov (United States)

Najafipour, Hamid; Sanjari, Mojgan; Shokoohi, Mostafa; Haghdoost, Ali-Akbar; Afshari, Mehdi; Shadkam, Mitra; Etemad, Koorosh; Mirzazade, Ali

2015-09-01

The goal of this research was to measure the age-sex standardized prevalence of pre-diabetes (pre-DM) and diabetes (DM), and the effectiveness of diabetes management (using HbA1C as the indicator) in an urban area in Iran. Using a randomized cluster household survey, we recruited 5900 individuals whose age ranged from 15 to 75 from Kerman for assessing coronary artery disease risk factors (KERCADRS) including diabetes. In 2010 and 2011, all of the participants were interviewed by trained staff for medical history and physical activities, and were then examined for blood pressure and anthropometric measures. Venus blood sample was also collected for fasting plasma glucose and HbA1c. The age-sex standardized prevalence of pre-diabetes, diagnosed and undiagnosed was 18.7%, 6.3% and 2.7%, respectively. Diabetes increased by age (from 14.7% in the 15-24 years old group to 28.4% in the 65-75 years old group), particularly after 40 years. Occasional opium users had the highest prevalence of Pre-DM (34.6%). Seventy-nine percent of the depressed and 75.5% of the anxious participants with diagnosed-DM were identified as uncontrolled-DM. More than 60% of diagnosed diabetic cases had impaired HbA1c. Overweight and obesity (adjusted odds ratio (AOR) 1.6) and low physical activity (AOR 1.5) were the most preventable risk factors associated with diabetes. Considerable prevalence of diabetes, susceptibility in progressing to diabetes and uncontrolled diabetes among individuals living in Kerman, suggested ineffective prevention and treatment of diabetes in urban areas in Iran. Successful experience regarding primary health-care in rural areas should be expanded to urban settings. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

The Diabetes Surgery Summit consensus conference: recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus.

Science.gov (United States)

Rubino, Francesco; Kaplan, Lee M; Schauer, Philip R; Cummings, David E

2010-03-01

To develop guidelines for the use of gastrointestinal surgery to treat type 2 diabetes and to craft an agenda for further research. Increasing evidence demonstrates that bariatric surgery can dramatically ameliorate type 2 diabetes. Not surprisingly, gastrointestinal operations are now being used throughout the world to treat diabetes in association with obesity, and increasingly, for diabetes alone. However, the role for surgery in diabetes treatment is not clearly defined and there are neither clear guidelines for these practices nor sufficient plans for clinical trials to evaluate the risks and benefits of such "diabetes surgery." A multidisciplinary group of 50 voting delegates from around the world gathered in Rome, Italy for the first International Conference on Gastrointestinal Surgery to Treat Type 2 Diabetes--(the "Diabetes Surgery Summit"). During the meeting, available scientific evidence was examined and critiqued by the entire group to assess the strength of evidence and to draft consensus statements. Through an iterative process, draft statements were then serially discussed, debated, edited, reassessed, and finally presented for formal voting. After the Rome meeting, statements that achieved consensus were summarized and distributed to all voting delegates for further input and final approval. These statements were then formally critiqued by representatives of several sientific societies at the 1st World Congress on Interventional Therapies for T2DM (New York, Sept 2008). Input from this discussion was used to generate the current position statement. A Diabetes Surgery Summit (DSS) Position Statement consists of recommendations for clinical and research issues, as well as general concepts and definitions in diabetes surgery. The DSS recognizes the legitimacy of surgical approaches to treat diabetes in carefully selected patients. For example, gastric bypass was deemed a reasonable treatment option for patients with poorly controlled diabetes and a

BAHAYA LATEN INFEKSI GONORE DAN KLAMIDIA DI ASIA SELATAN & ASIA TENGGARA, DI INDONESIA DAN KOTA MANADO

Directory of Open Access Journals (Sweden)

Aron Pirade

2014-04-01

menempati urutan tertinggi. Wilayah Asia Selatan dan Asia Timur-Selatan (juga disebut Asia Tenggara adalah wilayah dengan prevalensi Gonore dan Klamidia terbesar. Prevalensi Gonore di tahun 1995 dan 1999 yaitu 29.11 dan 27.2 juta penduduk wilayah Asia Selatan dan Asia Tenggara. Klamidia, di tahun 1995 dan tahun 1999 yaitu 40.48 dan 42.89 juta penduduk wilayah Asia Selatan dan Asia Tenggara. Di Indonesia sendiri, pada 11 area penelitian menunjukkan bahwa prevalensi Gonore dalam wilayah Indonesia menunjukkan rata-rata prosentasenya 20%-40% dari keseluruhan STI pada wanita beresiko tinggi terkena STI. Sedangkan infeksi oleh Klamidia prosentasenya 15%- 45% dari keseluruhan STI pada wanita beresiko tinggi terkena penyakit kelamin. Prosentase Gonore dan Klamidia di Kota Manado rata-rata 15-30%. Tingginya prevalensi infeksi Gonore dan Klamidia di Asia Tenggara, ternyata diikuti juga dengan tingginya perkembangan infeksi Gonore dan Klamidia di Indonesia dan Kota Manado.

Integrasi Ekonomi Asia: Solusi Asia Menghadapi Krisis Global 2008

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Adrian Hidayat

2008-09-01

Full Text Available No economies throughout the region managed to escape from the "global economic crisis in 2008" that was initiated in the United States. This is a logical consequence of the global economy that has been rolling along. The world economy is increasingly becoming more integrated and interdependent with one another. Exposure stems from the economic crisis in the prolonged United States subprime mortgage financial crisis, and eventually dragged the European economy, and also Asia. The Asian region was only affected, but even if only the impact of course, was enough to overwhelm the Asian region since the crisis has a major impact on a country's foreign exchange reserves. Therefore, after the G-20 summit held in Washington on November 15, 2008, the three major Asian countries, namely China, Japan and South Korea held a summit in Fukuoka Japanese initiative, which was attended by the three heads of government. This summit was to bring fresh air for the Asian region, because in addition to having a positive impact on Asian stocks, it also provides a new self confidence that Asia has formed an alliance that would at least fortify themselves (region with the resulting stimulus policy. This initiative to find a solution is eventually expanded, and was welcomed by ASEAN countries, known as ASEAN Plus Three. Since in Asia there is already the East Asia Summit (East Asia Summit, the negotiations and the name of the group changed into the 6 partner countries of ASEAN. These six countries are Japan, China, South Korea, Australia, New Zealand, and India.

Evaluation of the DNA barcodes in Dendrobium (Orchidaceae from mainland Asia.

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Songzhi Xu

Full Text Available DNA barcoding has been proposed to be one of the most promising tools for accurate and rapid identification of taxa. However, few publications have evaluated the efficiency of DNA barcoding for the large genera of flowering plants. Dendrobium, one of the largest genera of flowering plants, contains many species that are important in horticulture, medicine and biodiversity conservation. Besides, Dendrobium is a notoriously difficult group to identify. DNA barcoding was expected to be a supplementary means for species identification, conservation and future studies in Dendrobium. We assessed the power of 11 candidate barcodes on the basis of 1,698 accessions of 184 Dendrobium species obtained primarily from mainland Asia. Our results indicated that five single barcodes, i.e., ITS, ITS2, matK, rbcL and trnH-psbA, can be easily amplified and sequenced with the currently established primers. Four barcodes, ITS, ITS2, ITS+matK, and ITS2+matK, have distinct barcoding gaps. ITS+matK was the optimal barcode based on all evaluation methods. Furthermore, the efficiency of ITS+matK was verified in four other large genera including Ficus, Lysimachia, Paphiopedilum, and Pedicularis in this study. Therefore, we tentatively recommend the combination of ITS+matK as a core DNA barcode for large flowering plant genera.

Toxicological and safety evaluation of Nigella sativa lipid and volatile fractions in streptozotocin induced diabetes mellitus

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Muhammad Tauseef Sultan

2014-09-01

Full Text Available Objective: To evaluate the toxicological aspects of Nigella sativa (N. sativa lipid and volatile fractions in streptozotocin induced diabetes mellitus. Methods: National Institute of Health (NIH, Islamabad provided us thirty Sprague Dawley rats that were further divided into three groups, i.e. control, N. sativa lipid fraction (4% and N. sativa volatile fraction (0.3%, respectively. The serological and haematological indices were evaluated at 4-week intervals during 56 d study. Results: The results indicated that the diabetes mellitus imparted negative effects on various serological and haematological attributes. However, supplementation of the N. sativa lipid fraction and N. sativa volatile fraction ameliorated the adverse consequences of diabetes mellitus. The diabetes induced renal toxicity and imbalanced serum chemistry were slightly modulated by experimental diets. However, the impact of essential oil was more significant as compared to the fixed oil. Conclusions: In a nutshell, experimental diets containing N. sativa lipid fraction and N. sativa volatile fraction are effective without having any toxicological effects, and experimental diets reduced toxicological and adverse consequences of diabetes mellitus.

Asia-Pacific lube oil markets

International Nuclear Information System (INIS)

Yamaguchi, N.

2001-01-01

An overview of the Asia-Pacific (AP) lubricating oils market, its special characteristics, and its role in the global economy are presented. In the 'boom and bust' years of 1997-1999, the Asia-Pacific market was even bigger then the US market. For the short-term, the scenario is surplus capacity and poor margins, but in the long term there is enormous potential for growth. How fuel demand and quality is related to engine type is discussed. The three basic grades of baseoils are described, and the Asia-Pacific lube demand and the Asia-Pacific lube oil supply are discussed. There are 15 diagrams giving data on: (i) finished lubes in world markets as a percentage of total; (ii) how lube demand follows GDP per capita in Asia; (iii) AP baseoil capacity relationships; (iv) AP baseoil disposition by end use; (v) AP changing shares of baseoil demand; (vi) AP finished lube demand by subregion; (vii) AP finished lube demand growth, indexed; (viii) AP baseoil capacity by region; Singapore baseoil vs. Dubai crude prices, 1992-99; (ix) Singapore baseoil vs. crude prices, 1992-99; (x) AP baseoil deficit moved to surplus; (xi) AP baseoil production; (xii) East Asia net percentage change in lube sales, 1997-1999. (xiii) Southeast Asia net percentage change in lube sales, 1997-1999; (xiv) South East Asia and Australia net percentage change in lube sales, 1997-1999 and (xv) Asia-Pacific major lube marketers

Vasijas conectadas: Asia Occidental y Asia Oriental en la Geopolítica de China

OpenAIRE

Yitzhak Shichor

2016-01-01

Las regiones de Asia Oriental y Asia Occidental (Oriente Medio) son normalmente tratadas en la literatura académica como dos asuntos separados y distintos dentro de la política exterior china. Los estudios acerca de la política de China en Asia Oriental apenas si mencionan Oriente Medio, mientras que los estudios de Oriente Medio apenas mencionan Asia Occidental. Pero de hecho ambas regiones no sólo están interconectadas en la visión geopolítica de Chin...

Transition of maternal and child nutrition in Asia: implications for public health.

Science.gov (United States)

Winichagoon, Pattanee

2015-05-01

This article reviews the maternal and child nutrition situation in Asia in transition and its public health implications. Countries in Asia are facing a double burden of malnutrition. Accessibility to high energy, less nutrient-dense foods or processed foods affects current dietary patterns, whereas industrialization is leading to more sedentary lifestyles both in rural and urban areas. Stunting and wasting among young children persist but have declined in severity, whereas overweight and obesity have risen rapidly. Growth faltering in height during the first 2 years of life has affected muscle mass accretion, but rapid weight gain after 2 years of age has led to more fat accretion, imposing risks of childhood obesity and consequent metabolic disorders. The number of women entering pregnancy with low BMI has decreased, but increasing BMI is noticeable. Prepregnancy BMI and gestational weight gain are important determinants of maternal nutrition during pregnancy, the risk of gestational diabetes and postpartum weight retention, as well as obesity and diet-related noncommunicable diseases in later adulthood. Asia in transition is faced with persistent undernutrition and increasing trends of obesity and metabolic disorders among children and women. The first 1000 days from conception is a critical period, but it is also a window of opportunity for preventing double burden of malnutrition in Asian countries characterized by a nutrition transition.

[Evaluation of nopal capsules in diabetes mellitus].

Science.gov (United States)

Frati Munari, A C; Vera Lastra, O; Ariza Andraca, C R

1992-01-01

To find out if commercial capsules with dried nopal (prickle-pear cactus, Opuntia ficus indica may have a role in the management of diabetes mellitus, three experiments were performed: 30 capsules where given in fasting condition to 10 diabetic subjects and serum glucose was measured through out 3 hours; a control test was performed with 30 placebo capsules. OGTT with previous intake of 30 nopal or placebo capsules was performed in ten healthy individuals. In a crossover and single blinded study 14 diabetic patients withdrew the oral hypoglycemic treatment and received 10 nopal or placebo capsules t.i.d. during one week; serum glucose, cholesterol and tryglycerides levels were measured before and after each one-week period. Five healthy subjects were also studied in the same fashion. Opuntia capsules did not show acute hypoglycemic effect and did not influence OGTT. In diabetic patients serum glucose, cholesterol and tryglycerides levels did not change with Opuntia, but they increased with placebo (P nopal, while cholesterol and triglycerides decreased (P < 0.01 vs. placebo). The intake of 30 Opuntia capsules daily in patients with diabetes mellitus had a discrete beneficial effect on glucose and cholesterol. However this dose is unpractical and at present it is not recommended in the management of diabetes mellitus.

A web-based dietary intervention for people with type 2 diabetes: development, implementation, and evaluation.

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Ramadas, Amutha; Chan, Carina Ka Yee; Oldenburg, Brian; Hussien, Zanariah; Quek, Kia Fatt

2015-06-01

Diabetes is becoming a very important health issue in rapidly developing nations and there is an urgent need to improve overall diabetes self-management education in these countries. Although e-health is an emerging theme, only a few successful web-based studies on diabetes self-management have been reported. We describe the development, implementation, and process evaluation of an Internet-delivered dietary intervention program (myDIDeA) for diabetic patients in a developing country. Specific dietary components to be included in the intervention module were first identified through a comprehensive review of literature and guidelines. The lesson plans and the study website were then developed based on the evidence, Transtheoretical Model's Stages of Change and user-centered design approach. Finally, the effectiveness of the website was tested through a randomized-controlled trial to promote dietary change in patients with type 2 diabetes. The participants in the intervention group (n = 66) were given access to myDIDeA for 6 months. Process evaluation in form of intervention adherence and program reception were conducted at post intervention. The response rate for the process evaluation was 89%. On average, each participant logged in at least once for each lesson plan and spent almost 12 min on the site. The participants' content satisfaction, acceptability, and usability scores were satisfactory. The primary outcome of the trial, Dietary Knowledge, Attitude, and Behavior score was strongly correlated with content satisfaction (r = 0.826, p social media, and other means to stimulate the interest of participants can be explored.

Dose-ranging evaluation of intravitreal siRNA PF-04523655 for diabetic macular edema (the DEGAS study)

DEFF Research Database (Denmark)

Nguyen, Quan Dong; Schachar, Ronald A; Nduaka, Chudy I

2012-01-01

To evaluate the safety and efficacy of three doses of PF-04523655, a 19-nucleotide methylated double stranded siRNA targeting the RTP801 gene, for the treatment of diabetic macular edema (DME) compared to focal/grid laser photocoagulation.......To evaluate the safety and efficacy of three doses of PF-04523655, a 19-nucleotide methylated double stranded siRNA targeting the RTP801 gene, for the treatment of diabetic macular edema (DME) compared to focal/grid laser photocoagulation....

Clinical usefulness of multidetector-row CT to evaluate coronary artery calcium score in type 2 diabetes

International Nuclear Information System (INIS)

Nishioka, Makiko; Sakuma, Toru; Sano, Hironari; Utsunomiya, Kazunori; Agata, Toshihiko; Shimizu, Keisuke; Tajima, Naoko

2004-01-01

According to recent studies, multidetector-row CT (MDCT) with a retrospective electrocardiogram (ECG)-gating reconstruction algorithm shows a high correlation with coronary artery calcium score determined using electron-beam CT. Diabetes leads to many macrovascular complications, including coronary artery disease. The aim of this study was to evaluate risk factors for cardiac macroangiopathy in type 2 diabetes using MDCT. An observational cross-sectional study was performed in 90 patients with diabetes mellitus. Coronary calcium data was acquired by MDCT (SOMATOM Volume Zoom, Siemens AG, Medical Solutions, Germany). Physical examinations, laboratory data, glycemic control, and control of other risk factors were analyzed. The coronary artery calcium score increased with age. Multivariant analysis revealed that the coronary calcium score was closely correlated with electrocardiogram evaluation and control of hypertension. Coronary artery calcium score as determined by MDCT can be used as a screening radiological examination for cardiac macroangiopathy in diabetes patients with electrocardiogram abnormality and hypertension. (author)

Evaluation of the spoken knowledge in low literacy in diabetes scale for use with Mexican Americans.

Science.gov (United States)

Garcia, Alexandra A; Zuniga, Julie; Reynolds, Raquel; Cairampoma, Laura; Sumlin, Lisa

2015-05-01

This article evaluates the Spoken Knowledge in Low Literacy in Diabetes (SKILLD) questionnaire, a measure of essential knowledge for type 2 diabetes self-management, after it was modified for English- and Spanish-speaking Mexican Americans. We collected surveys (SKILLD, demographic, acculturation) and blood for A1C analysis from 72 community-recruited participants to analyze the SKILLD's internal consistency, interrater reliability, item analysis, and construct validity. Clinical experts evaluated content validity. The SKILLD demonstrated low internal consistency but high interrater reliability and content and construct validity. There were significant correlations in expected directions between SKILLD scores and acculturation, education, and A1C and significant differences in SKILLD scores between and within groups after an educational intervention and between high- and low-acculturated participants. The SKILLD generates useful information about Mexican Americans' diabetes knowledge. Lower SKILLD scores suggest less diabetes knowledge, lower health literacy, and participants' difficulties understanding items. Further modifications should improve use with low-acculturated Mexican Americans. © The Author(s) 2014.

Energy in Asia. An Outline of Some Strategic Energy Issues in Asia

International Nuclear Information System (INIS)

Kiesow, Ingolf

2003-01-01

The Asian countries are expected to generate 45% of the world energy consumption and Japan is the absolutely greatest consumer in Asia, but China is the country that will be most important as a new consumer on the world energy markets. China, like India and later possibly even Japan try to change to natural gas as a source of energy as much as possible. This is causing a competition about the resources that can be reached by pipelines for gas, which in practice means those in Russia and Central Asia. Russia is trying to control the gas in Central Asia. The competition is also increasing about oil. China is becoming heavily dependent on Muslim countries in the Middle East and Central Asia. This also leads to an effort to increase the safety along the sea lanes, which may collide with the interests of other countries. Territorial conflicts with gas and oil as underlying elements exist in Asia. USA is a player on the energy market, who is using military means as well, but it is possible that in the short perspective, the American acting may not seriously disturb European interests. In the long term perspective, however, the American activity can cause potential conflicts between USA and the Muslim world, that also affects the relations between Europe and its Muslim neighbours. China and other Asian countries may choose a more pro-islamic line of policy in order to gain advantages in the competition about oil and gas. Europe (and Sweden) ought not to wait until the countries of Asia have finalised their negotiations with Russia and Central Asia about access to resources of natural gas but instead form a clear strategy for negotiations built on its own present demand and act accordingly

Energy in Asia. An Outline of Some Strategic Energy Issues in Asia

Energy Technology Data Exchange (ETDEWEB)

Kiesow, Ingolf

2003-01-01

The Asian countries are expected to generate 45% of the world energy consumption and Japan is the absolutely greatest consumer in Asia, but China is the country that will be most important as a new consumer on the world energy markets. China, like India and later possibly even Japan try to change to natural gas as a source of energy as much as possible. This is causing a competition about the resources that can be reached by pipelines for gas, which in practice means those in Russia and Central Asia. Russia is trying to control the gas in Central Asia. The competition is also increasing about oil. China is becoming heavily dependent on Muslim countries in the Middle East and Central Asia. This also leads to an effort to increase the safety along the sea lanes, which may collide with the interests of other countries. Territorial conflicts with gas and oil as underlying elements exist in Asia. USA is a player on the energy market, who is using military means as well, but it is possible that in the short perspective, the American acting may not seriously disturb European interests. In the long term perspective, however, the American activity can cause potential conflicts between USA and the Muslim world, that also affects the relations between Europe and its Muslim neighbours. China and other Asian countries may choose a more pro-lslamic line of policy in order to gain advantages in the competition about oil and gas. Europe (and Sweden) ought not to wait until the countries of Asia have finalised their negotiations with Russia and Central Asia about access to resources of natural gas but instead form a clear strategy for negotiations built on its own present demand and act accordingly.

Evaluation of peripheral vasodilative indices in skin tissue of type 1 diabetic rats by use of RGB images

Science.gov (United States)

Tanaka, Noriyuki; Nishidate, Izumi; Nakano, Kazuya; Aizu, Yoshihisa; Niizeki, Kyuichi

2016-04-01

We investigated a method to evaluate the arterial inflow and the venous capacitance in the skin tissue of streptozotocin-induced type 1 diabetic rats from RGB digital color images. The arterial inflow and the venous capacitance in the dorsal reversed McFarlane skin flap are calculated based on the responses of change in the total blood concentration to occlusion of blood flow to and from the flap tissues at a pressure of 50 mmHg. The arterial inflow and the venous capacitance in the skin flap tissue were significantly reduced in type 1 diabetic rat group compared with the non-diabetic rat group. The results of the present study indicate the possibility of using the proposed method for evaluating the peripheral vascular dysfunctions in diabetes mellitus.

Evaluation of the Impact of a Diabetes Education Curriculum for School Personnel on Disease Knowledge and Confidence in Caring for Students

Science.gov (United States)

Smith, Cory T.; Chen, Aleda M. H.; Plake, Kimberly S.; Nash, Christiane L.

2012-01-01

Background: School personnel may lack knowledge of diabetes and be unprepared to address the needs of students with type 1 diabetes. This project evaluated the effectiveness of a type 1 diabetes education program for school personnel on increasing knowledge of diabetes and confidence in caring for students with diabetes. Methods: Two types of…

Autoradiographic thyroid evaluation in short-term experimental diabetes mellitus

Directory of Open Access Journals (Sweden)

Nascimento-Saba C.C.A.

1998-01-01

Full Text Available Previous studies have shown that in vitro thyroid peroxidase (TPO iodide oxidation activity is decreased and thyroid T4-5'-deiodinase activity is increased 15 days after induction of experimental diabetes mellitus (DM. In the present study we used thyroid histoautoradiography, an indirect assay of in vivo TPO activity, to determine the possible parallelism between the in vitro and in vivo changes induced by experimental DM. DM was induced in male Wistar rats (about 250 g body weight by a single ip streptozotocin injection (45 mg/kg, while control (C animals received a single injection of the vehicle. Seven and 30 days after diabetes induction, each diabetic and control animal was given ip a tracer dose of 125I (2 µCi, 2.5 h before thyroid excision. The glands were counted, weighed, fixed in Bouin's solution, embedded in paraffin and cut. The sections were stained with HE and exposed to NTB-2 emulsion (Kodak. The autohistograms were developed and the quantitative distribution of silver grains was evaluated with a computerized image analyzer system. Thyroid radioiodine uptake was significantly decreased only after 30 days of DM (C: 0.38 ± 0.05 vs DM: 0.20 ± 0.04%/mg thyroid, P<0.05 while in vivo TPO activity was significantly decreased 7 and 30 days after DM induction (C: 5.3 and 4.5 grains/100 µm2 vs DM: 2.9 and 1.6 grains/100 µm2, respectively, P<0.05 . These data suggest that insulin deficiency first reduces in vivo TPO activity during short-term experimental diabetes mellitus

Estimating the incremental net health benefit of requirements for cardiovascular risk evaluation for diabetes therapies.

Science.gov (United States)

Chawla, Anita J; Mytelka, Daniel S; McBride, Stephan D; Nellesen, Dave; Elkins, Benjamin R; Ball, Daniel E; Kalsekar, Anupama; Towse, Adrian; Garrison, Louis P

2014-03-01

To evaluate the advantages and disadvantages of pre-approval requirements for safety data to detect cardiovascular (CV) risk contained in the December 2008 U.S. Food and Drug Administration (FDA) guidance for developing type 2 diabetes drugs compared with the February 2008 FDA draft guidance from the perspective of diabetes population health. We applied the incremental net health benefit (INHB) framework to quantify the benefits and risks of investigational diabetes drugs using a common survival metric (life-years [LYs]). We constructed a decision analytic model for clinical program development consistent with the requirements of each guidance and simulated diabetes drugs, some of which had elevated CV risk. Assuming constant research budgets, we estimate the impact of increased trial size on drugs investigated. We aggregate treatment benefit and CV risks for each approved drug over a 35-year horizon under each guidance. The quantitative analysis suggests that the December 2008 guidance adversely impacts diabetes population health. INHB was -1.80 million LYs, attributable to delayed access to diabetes therapies (-0 .18 million LYs) and fewer drugs (-1.64 million LYs), but partially offset by reduced CV risk exposure (0.02 million LYs). Results were robust in sensitivity analyses. The health outcomes impact of all potential benefits and risks should be evaluated in a common survival measure, including health gain from avoided adverse events, lost health benefits from delayed or for gone efficacious products, and impact of alternative policy approaches. Quantitative analysis of the December 2008 FDA guidance for diabetes therapies indicates that negative impact on patient health will result. Copyright © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

Evaluation of salivary glucose, IgA and flow rate in diabetic patients: a case-control study.

Science.gov (United States)

Bakianian Vaziri, P; Vahedi, M; Mortazavi, H; Abdollahzadeh, Sh; Hajilooi, M

2010-01-01

An association between diabetes mellitus and alterations in the oral cavity has been noted. In this study, we evaluated differences between salivary IgA, glucose and flow rate in diabetic patients compared with healthy controls. Forty patients with type 1 diabetes, 40 patients with type 2 diabetes and 40 healthy controls were selected. Whole unstimulated saliva samples were collected by the standard method and the salivary flow rate was determined. Nephelometric and Pars method were used to measure salivary IgA and salivary glucose concentrations, respectively. Statistical analysis was performed by Chi-square and t test. There were no significant differences in salivary IgA and glucose concentrations between type 1 and type 2 diabetic patients and their matched control subjects (P>0.05). Salivary flow rate was significantly lower in diabetic patients (Pdiabetic patients than the controls. Determination of salivary constituents may be useful in the description and management of oral findings in diabetic patients.

Evaluation of Salivary Glucose, IgA and Flow Rate in Diabetic Patients: A Case-Control Study

Directory of Open Access Journals (Sweden)

P. Bakianian Vaziri

2010-03-01

Full Text Available Objective: An association between diabetes mellitus and alterations in the oral cavity has been noted. In this study, we evaluated differences between salivary IgA, glucose and flow rate in diabetic patients compared with healthy controls.Materials and Methods: Forty patients with type 1 diabetes, 40 patients with type 2 diabetes and 40 healthy controls were selected. Whole unstimulated saliva samples were collected by the standard method and the salivary flow rate was determined. Nephelometricand Pars method were used to measure salivary IgA and salivary glucose concentrations,respectively. Statistical analysis was performed by Chi-square and t test.Results: There were no significant differences in salivary IgA and glucose concentrations between type 1 and type 2 diabetic patients and their matched control subjects (P>0.05.Salivary flow rate was significantly lower in diabetic patients (P<0.05. In addition,DMFT was higher in diabetic patients than the controls.Conclusion: Determination of salivary constituents may be useful in the description and management of oral findings in diabetic patients.

Mobile applications for diabetics: a systematic review and expert-based usability evaluation considering the special requirements of diabetes patients age 50 years or older.

Science.gov (United States)

Arnhold, Madlen; Quade, Mandy; Kirch, Wilhelm

2014-04-09

A multitude of mhealth (mobile health) apps have been developed in recent years to support effective self-management of patients with diabetes mellitus type 1 or 2. We carried out a systematic review of all currently available diabetes apps for the operating systems iOS and Android. We considered the number of newly released diabetes apps, range of functions, target user groups, languages, acquisition costs, user ratings, available interfaces, and the connection between acquisition costs and user ratings. Additionally, we examined whether the available applications serve the special needs of diabetes patients aged 50 or older by performing an expert-based usability evaluation. We identified relevant keywords, comparative categories, and their specifications. Subsequently, we performed the app review based on the information given in the Google Play Store, the Apple App Store, and the apps themselves. In addition, we carried out an expert-based usability evaluation based on a representative 10% sample of diabetes apps. In total, we analyzed 656 apps finding that 355 (54.1%) offered just one function and 348 (53.0%) provided a documentation function. The dominating app language was English (85.4%, 560/656), patients represented the main user group (96.0%, 630/656), and the analysis of the costs revealed a trend toward free apps (53.7%, 352/656). The median price of paid apps was €1.90. The average user rating was 3.6 stars (maximum 5). Our analyses indicated no clear differences in the user rating between free and paid apps. Only 30 (4.6%) of the 656 available diabetes apps offered an interface to a measurement device. We evaluated 66 apps within the usability evaluation. On average, apps were rated best regarding the criterion "comprehensibility" (4.0 out of 5.0), while showing a lack of "fault tolerance" (2.8 out of 5.0). Of the 66 apps, 48 (72.7%) offered the ability to read the screen content aloud. The number of functions was significantly negative correlated

Mobile Applications for Diabetics: A Systematic Review and Expert-Based Usability Evaluation Considering the Special Requirements of Diabetes Patients Age 50 Years or Older

Science.gov (United States)

Quade, Mandy; Kirch, Wilhelm

2014-01-01

Background A multitude of mhealth (mobile health) apps have been developed in recent years to support effective self-management of patients with diabetes mellitus type 1 or 2. Objective We carried out a systematic review of all currently available diabetes apps for the operating systems iOS and Android. We considered the number of newly released diabetes apps, range of functions, target user groups, languages, acquisition costs, user ratings, available interfaces, and the connection between acquisition costs and user ratings. Additionally, we examined whether the available applications serve the special needs of diabetes patients aged 50 or older by performing an expert-based usability evaluation. Methods We identified relevant keywords, comparative categories, and their specifications. Subsequently, we performed the app review based on the information given in the Google Play Store, the Apple App Store, and the apps themselves. In addition, we carried out an expert-based usability evaluation based on a representative 10% sample of diabetes apps. Results In total, we analyzed 656 apps finding that 355 (54.1%) offered just one function and 348 (53.0%) provided a documentation function. The dominating app language was English (85.4%, 560/656), patients represented the main user group (96.0%, 630/656), and the analysis of the costs revealed a trend toward free apps (53.7%, 352/656). The median price of paid apps was €1.90. The average user rating was 3.6 stars (maximum 5). Our analyses indicated no clear differences in the user rating between free and paid apps. Only 30 (4.6%) of the 656 available diabetes apps offered an interface to a measurement device. We evaluated 66 apps within the usability evaluation. On average, apps were rated best regarding the criterion “comprehensibility” (4.0 out of 5.0), while showing a lack of “fault tolerance” (2.8 out of 5.0). Of the 66 apps, 48 (72.7%) offered the ability to read the screen content aloud. The number of

Diabetes and Cognitive Decline in Older Adults: The Ginkgo Evaluation of Memory Study.

Science.gov (United States)

Palta, Priya; Carlson, Michelle C; Crum, Rosa M; Colantuoni, Elizabeth; Sharrett, A Richey; Yasar, Sevil; Nahin, Richard L; DeKosky, Steven T; Snitz, Beth; Lopez, Oscar; Williamson, Jeff D; Furberg, Curt D; Rapp, Stephen R; Golden, Sherita Hill

2017-12-12

Previous studies have shown that individuals with diabetes exhibit accelerated cognitive decline. However, methodological limitations have limited the quality of this evidence. Heterogeneity in study design, cognitive test administration, and methods of analysis of cognitive data have made it difficult to synthesize and translate findings to practice. We analyzed longitudinal data from the Ginkgo Evaluation of Memory Study to test our hypothesis that older adults with diabetes have greater test-specific and domain-specific cognitive declines compared to older adults without diabetes. Tests of memory, visuo-spatial construction, language, psychomotor speed, and executive function were administered. Test scores were standardized to z-scores and averaged to yield domain scores. Linear random effects models were used to compare baseline differences and changes over time in test and domain scores among individuals with and without diabetes. Among the 3,069 adults, aged 72-96 years, 9.3% reported diabetes. Over a median follow-up of 6.1 years, participants with diabetes exhibited greater baseline differences in a test of executive function (trail making test, Part B) and greater declines in a test of language (phonemic verbal fluency). For the composite cognitive domain scores, participants with diabetes exhibited lower baseline executive function and global cognition domain scores, but no significant differences in the rate of decline. Identifying cognitive domains most affected by diabetes can lead to targeted risk modification, possibly in the form of lifestyle interventions such as diet and physical activity, which we know to be beneficial for improving vascular risk factors, such as diabetes, and therefore may reduce the risk of executive dysfunction and possible dementia. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evaluating the "Healthy Diabetes" Caribbean Food Plate and Website Portal for Diabetes Prevention and Management: Results of an Online Study and Implications for Reducing Health Disparities

Science.gov (United States)

Thomas, Nigel M.

2013-01-01

Given the challenge of cooking traditional Caribbean meals so they are consistent with the goals of diabetes prevention and management, the researcher created and evaluated a new website portal as e-health tailored to be culturally appropriate and teach the following: how to cook and prepare "Healthy Diabetes" Caribbean Plates. A social…

Glaucoma in Asia: regional prevalence variations and future projections.

Science.gov (United States)

Chan, Errol Wei'en; Li, Xiang; Tham, Yih-Chung; Liao, Jiemin; Wong, Tien Yin; Aung, Tin; Cheng, Ching-Yu

2016-01-01

To evaluate glaucoma prevalence and disease burden across Asian subregions from 2013 to 2040. We conducted a systematic review and meta-analysis of 23 population-based studies of 1318 primary open angle glaucoma (POAG) cases in 66,800 individuals and 691 primary angle closure glaucoma (PACG) cases in 72,767 individuals in Asia. Regions in Asia were defined based on United Nations' (UN) classification of macro-geographic regions. PubMed, Medline and Web of Science databases were searched for population-based glaucoma prevalence studies using standardised criteria published to 31 December 2013. Pooled glaucoma prevalence for individuals aged 40-80 years was calculated using hierarchical Bayesian approaches. Prevalence differences by geographic subregion, subtype and habitation were examined with random effects meta-regression models. Estimates of individuals with glaucoma from 2013 to 2040 were based on the UN World Population Prospects. In 2013, pooled overall glaucoma prevalence was 3.54% (95% credible interval (CrI) 1.83 to 6.28). POAG (2.34%, 95% CrI 0.96 to 4.55) predominated over PACG (0.73%, 95% CrI 0.18 to 1.96). With age and gender adjustment, PACG prevalence was higher in East than South East Asia (OR 5.55, 95% CrI 1.52 to 14.73), and POAG prevalence was higher in urban than rural populations (OR 2.11, 95% CrI 1.57 to 2.38). From 2013 to 2040, South Central Asia will record the steepest increase in number of glaucoma individuals from 17.06 million to 32.90 million compared with other Asian subregions. In 2040, South-Central Asia is also projected to overtake East Asia for highest overall glaucoma and POAG burden, while PACG burden remains highest in East Asia. Across the Asian subregions, there was greater glaucoma burden in South-Central and East Asia. Sustainable public health strategies to combat glaucoma in Asia are needed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

A systematic review of the experience of older women living and coping with type 2 diabetes.

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Li, Jiemin; Drury, Vicki; Taylor, Beverley

2014-04-01

This paper reports on a systematic review that sought to answer the research question: what is the experience of women living and coping with type 2 diabetes? A range of relevant terms were identified and electronic databases were searched. Only qualitative studies that explored the meaning of living and coping with type 2 diabetes and that included adult women aged ≥ 18 years were considered. We found evidence that women are challenged by their multi-caregiving roles and the complexities of managing their diabetes simultaneously. For female patients with diabetes, holistic care and individual psycho-education programmes appear to be facilitate more effective and successful diabetes management. In addition, carer programmes that provide information so that family and friends can support and assist the woman with diabetes are required. © 2013 Wiley Publishing Asia Pty Ltd.

Clinical Evaluation of OneTouch Diabetes Management Software System in Patients with Type 2 Diabetes Mellitus

Directory of Open Access Journals (Sweden)

Jung Min Kim

2016-04-01

Full Text Available BackgroundOneTouch Diabetes Management Software (OTDMS is an efficient way to track and monitor the blood glucose level. It is possible to download data from the OneTouch Ultra via the meter's data port, and to transform the numbers of the blood glucose level into a graph, a chart, or statistics. The objectives of this study were to evaluate whether the use of OTDMS in consultation hours would improve patients' knowledge of diabetes mellitus (DM, compliance, satisfaction with doctor and medical treatment, doctor-patient reliability, and glucose control.MethodsAll patients were randomized into either the OTDMS group using OneTouch Ultra or the control groups not using it. Both groups had conventional DM education and only the OTDMS group used data from OTDMS as explanation materials during consultation hours. At enrollment and after 6 months, we performed a questionnaire survey consisting of the diabetes knowledge test, items for compliance of treatment, patient's satisfaction, doctor-patient reliability, and glycosylated hemoglobin (HbA1c.ResultsWe analyzed 6-month follow-up data from 92 patients (OTDMS 42 vs. control 50. Both groups showed significant improvements in HbA1c, diabetes knowledge, compliance, reliability, and satisfaction after 6 months. However, there were no significant differences between OTDMS and control groups overall. Only "weekly frequency of checking blood glucose level" of compliance and "trying to follow doctor's order" of reliability showed better results in the OTDMS group.ConclusionUsing the OTDMS system for explanation during consultation hours seems to be more helpful to improve patient's compliance and reliability, especially for checking blood glucose level and trying to follow the doctor's order.

Evaluation of antioxidant status of female diabetic patients in Nnamdi Azikiwe University Teaching Hospital, Anambra State, Nigeria.

Science.gov (United States)

Okuonghae, E O P; Onyenekwe, C C; Ahaneku, J E; Ukibe, N R; Nwani, P O; Asomugha, A L; Osakue, N O; Aidomeh, F; Awalu, C C

2015-01-01

Diabetes mellitus has become an onerous disease to developing countries such as Nigeria. Rapid acceptance of urbanisation and sedentary life styles pose an encumbrance to its prevention and management. Increased oxidative stress in diabetes mellitus has been implicated as a culprit in perpetuating antioxidant depletion and diabetic complications in diabetes mellitus individuals. This study aims to evaluate the level of antioxidant status in type 2 diabetes mellitus (DM) female participants visiting the out-patient diabetic clinic of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Anambra State, Nigeria. A total of 86 participants aged 51±10 years were recruited for this study. The test group consists of 43 already confirmed type 2 diabetes mellitus females, while the control group consists of 43 apparently healthy females. The test subjects were further subgrouped into good and poor glycaemic control groups, using a cut-off of 0.05). This study concludes that there is antioxidant depletion in females with type 2 diabetes.

Patients' education, and its impact on care outcomes, resource consumption and working conditions: data from the International Diabetes Management Practices Study (IDMPS).

Science.gov (United States)

Gagliardino, J J; Aschner, P; Baik, S H; Chan, J; Chantelot, J M; Ilkova, H; Ramachandran, A

2012-04-01

To evaluate the impact of diabetes education provided to patients with type 2 diabetes mellitus (T2DM) in non-controlled studies ("real-world conditions") on quality of care, resource consumption and conditions of employment. This cross-sectional study and longitudinal follow-up describe the data (demographic and socioeconomic profiles, clinical characteristics, treatment of hyperglycaemia and associated cardiovascular risk factors, resource consumption) collected during the second phase (2006) of the International Diabetes Management Practices Study (IDMPS). Patients received diabetes education directly from the practice nurse, dietitian or educator, or were referred to ad hoc group-education programmes; all programmes emphasized healthy lifestyle changes, self-care and active participation in disease control and treatment. Educated vs non-educated T2DM patients (n=5692 in each group), paired by age, gender and diabetes duration, were randomly recruited for the IDMPS by participating primary-care physicians from 27 countries in Eastern Europe, Asia, Latin America and Africa. Outcome measures included clinical (body weight, height, waist circumference, blood pressure, foot evaluation), metabolic (HbA(1c) levels, blood lipid profile) and biochemical control measures. Treatment goals were defined according to American Diabetes Association guidelines. T2DM patients' education significantly improved the percentage of patients achieving target values set by international guidelines. Educated patients increased their insulin use and self-care performance, had a lower rate of chronic complications and a modest increase in cost of care, and probably higher salaries and slightly better productivity. Diabetes education is an efficient tool for improving care outcomes without having a major impact on healthcare costs. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Design and Usability Evaluation of Social Mobile Diabetes Management System in the Gulf Region.

Science.gov (United States)

Alanzi, Turki; Istepanian, Robert; Philip, Nada

2016-09-26

The prevalence of diabetes in the Gulf States is one of the highest globally. It is estimated that 20% of the population in the region has been diagnosed with diabetes and according to the International Diabetes Federation (IDF), five of the IDF's "top 10" countries for diabetes prevalence in 2011 and projected for 2030 are in this region. In recent years, there have been an increasing number of clinical studies advocating the use of mobile phone technology for diabetes self-management with improved clinical outcomes. However, there are few studies to date addressing the application of mobile diabetes management in the Gulf region, particularly in the Kingdom of Saudi Arabia (KSA), where there is exponential increase in mobile phone usage and access to social networking. The objective of this paper is to present the design and development of a new mobile health system for social behavioral change and management tailored for Saudi patients with diabetes called Saudi Arabia Networking for Aiding Diabetes (SANAD). A usability study for the SANAD system is presented to validate the acceptability of using mobile technologies among patients with diabetes in the KSA and the Gulf region. The SANAD system was developed using mobile phone technology with diabetes management and social networking modules. For the usability study the Questionnaire for User Interaction Satisfaction was used to evaluate the usability aspect of the SANAD system. A total of 33 users with type 2 diabetes participated in the study. The key modules of the SANAD system consist of (1) a mobile diabetes management module; (2) a social networking module; and (3) a cognitive behavioral therapy module for behavioral change issues. The preliminary results of the usability study indicated general acceptance of the patients in using the system with higher usability rating in patients with type 2 diabetes. We found that the acceptability of the system was high among Saudi patients with diabetes, and ongoing

Toward Synchronous Evaluation of Source Apportionments for Atmospheric Concentration and Deposition of Sulfate Aerosol Over East Asia

Science.gov (United States)

Itahashi, S.

2018-03-01

Source apportionments for atmospheric concentration, dry deposition, and wet deposition of sulfate aerosol (SO42-) were synchronously evaluated over East Asia, a main source of anthropogenic sulfur dioxide (SO2) emissions. Estimating dry deposition was difficult owing to the difficulty of measuring deposition velocity directly; therefore, sensitivity simulations using two dry deposition schemes were conducted. Moreover, sensitivity simulations for different emission inventories, the largest uncertainty source in the air quality model, were also conducted. In total, four experimental settings were used. Model performance was verified for atmospheric concentration and wet deposition using a ground-based observation network in China, Korea, and Japan, and all four model settings captured the observations. The underestimation of wet deposition over China was improved by an adjusted approach that linearly scaled the modeled precipitation values to observations. The synchronous evaluation of source apportionments for atmospheric concentration and dry and wet deposition showed the dominant contribution of anthropogenic emissions from China to the atmospheric concentration and deposition in Japan. The contributions of emissions from volcanoes were more important for wet deposition than for atmospheric concentration. Differences in the dry deposition scheme and emission inventory did not substantially influence the relative ratio of source apportionments over Japan. Because the dry deposition was more attributed to local factors, the differences in dry deposition may be an important determinant of the source contributions from China to Japan. Verification of these findings, including the dry deposition velocity, is necessary for better understanding of the behavior of sulfur compound in East Asia.

Evaluation of the Effects of Novel Nafimidone Derivatives on Thermal Hypoalgesia in Mice with Diabetic Neuropathy

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Suat Kamışlı

2013-03-01

Full Text Available Objective: Diabetic neuropathy (DN is a common complication in Diabetes Mellitus. The streptozotocin-induced diabetic rodent is the most commonly used animal model of diabetes and increased sodium channel expression and activity were revealed in this model. At this study, we evaluated the effect of three different nafimidone derivatives which have possible anticonvulsant activity on disorders of thermal pain sensation in diabetic mice. Study Design: Randomized animal experiment. Material and Methods: Mice were divided randomly into five groups (5 mice per group: Control, Diabetes, Dibetes+C1, Diabetes+C2, Diabetes+C3. We used hot and cold plate, and tail-immersion tests for assessment of thermal nociceptive responses. Results: Compared with the control group, the hot-plate response time and the number of paw liftings on cold plate as important indicators of loss of sensation increased, but no significant difference (p>0.05 was found in tail-immersion response time test in diabetes group. C3 compound moved it back to control group levels in the all of three tests. C1 and C2 compounds were effective only in cold-plate test. Conclusion: Nafimidone derivatives may be effective in the cases where epilepsy and diabetes occur together since it has shown efficacy against “loss of sensation” which evolves in diabetic neuropathy over time as well as its antiepileptic effect.

Sumatera Air Asia Training Center (Arsitektur Metafora)

OpenAIRE

Susanto, William

2015-01-01

Sumatera Air Asia Training Center as Air Asia training facility’s construction have a propose to train the Air Asia air craft crew who will be the employee of the Air Asia Airlines.Beside the main function;training facility for the Air Asia Crew; the other airline’s crew can be train by a cooperation with Air Asia.The aircraft crew that can be train in this facility is pilot initial, pilot type-rating, pilot recurrent, ATPL, Flight attendant initial and recurrent..This facility ha...

Medical care of type 2 diabetes in German disease management programmes: a population-based evaluation.

Science.gov (United States)

Stark, Reneé G; Schunk, Michaela V; Meisinger, Christine; Rathmann, Wolfgang; Leidl, Reiner; Holle, Rolf

2011-05-01

Type 2 diabetes disease management programmes (DDMPs) are offered by German social health insurance to promote healthcare consistent with evidence-based medical guidelines. The aim of this study was to compare healthcare quality and medical endpoints between diabetes management programme participants and patients receiving usual care designated as controls. All patients with type 2 diabetes (age range: 36-81) in a cross-sectional survey of a cohort study, performed by the Cooperative Health Research in the Region of Augsburg, received a self-administered questionnaire regarding their diabetes care. Physical examination and laboratory tests were also performed. The analysis only included patients with social health insurance and whose participation status in a diabetes disease management program was validated by the primary physician (n = 166). Regression analyses, adjusting for age, sex, education, diabetes duration, baseline waist circumference and clustering regarding primary physician were conducted. Evaluation of healthcare processes showed that those in diabetes disease management programmes (n = 89) reported medical examination of eyes and feet and medical advice regarding diet [odds ratio (OR): 2.39] and physical activity (OR: 2.87) more frequently, received anti-diabetic medications (OR: 3.77) and diabetes education more often (OR: 2.66) than controls. Both groups had satisfactory HbA(1c) control but poor low-density lipoprotein cholesterol control. Blood pressure goals (management programmes (OR: 2.21). German diabetes disease management programmes are associated with improved healthcare processes and blood pressure control. Low-density lipoprotein cholesterol control must be improved for all patients with diabetes. Further research will be required to assess the long-term effects of this diabetes disease management programme. Copyright © 2011 John Wiley & Sons, Ltd.

Proliferative diabetic retinopathy is associated with microalbuminuria in patients with type 2 diabetes

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M.C. Boelter

2006-08-01

Full Text Available Diabetic retinopathy is one of the leading causes of blindness in working-age individuals. Diabetic patients with proteinuria or those on dialysis usually present severe forms of diabetic retinopathy, but the association of diabetic retinopathy with early stages of diabetic nephropathy has not been entirely established. A cross-sectional study was conducted on 1214 type 2 diabetic patients to determine whether microalbuminuria is associated with proliferative diabetic retinopathy in these patients. Patients were evaluated by direct and indirect ophthalmoscopy and grouped according to the presence or absence of proliferative diabetic retinopathy. The agreement of diabetic retinopathy classification performed by ophthalmoscopy and by stereoscopic color fundus photographs was 95.1% (kappa = 0.735; P < 0.001. Demographic information, smoking history, anthropometric and blood pressure measurements, glycemic and lipid profile, and urinary albumin were evaluated. On multiple regression analysis, diabetic nephropathy (OR = 5.18, 95% CI = 2.91-9.22, P < 0.001, insulin use (OR = 2.52, 95% CI = 1.47-4.31, P = 0.001 and diabetes duration (OR = 1.04, 95% CI = 1.01-1.07, P = 0.011 were positively associated with proliferative diabetic retinopathy, and body mass index (OR = 0.90, 95% CI = 0.86-0.96, P < 0.001 was negatively associated with it. When patients with macroalbuminuria and on dialysis were excluded, microalbuminuria (OR = 3.3, 95% CI = 1.56-6.98, P = 0.002 remained associated with proliferative diabetic retinopathy. Therefore, type 2 diabetic patients with proliferative diabetic retinopathy more often presented renal involvement, including urinary albumin excretion within the microalbuminuria range. Therefore, all patients with proliferative diabetic retinopathy should undergo an evaluation of renal function including urinary albumin measurements.

[Multicenter evaluation of the Nutri-Expert Telematic System in diabetic patients].

Science.gov (United States)

Turnin, M C; Bolzonella-Pene, C; Dumoulin, S; Cerf, I; Charpentier, G; Sandre-Banon, D; Valensi, P; Grenier, J L; Cathelineau, G; Mattei, C

1995-02-01

Nutri-Expert is a system for self-monitoring and dietetic education, accessible through Minitel. A preliminary randomised evaluation of one hundred diabetic patients in the Midi-Pyrénées region showed that Nutri-Expert improved dietetic knowledge, dietary habits and metabolic balance. The aim of the present study was to show that the system can be successfully prescribed to patients by physicians outside the center which originated it, indicating the benefit of a wider use of Nutri-Expert, among the diabetic population. One hundred and fifty-five patients, recruited by six French centres of diabetology, used Nutri-Expert from their homes for six months. Clinical examination, tests of dietetic knowledge and biological tests, including lipid fractions, were carried out before and after six months of use. After six months, there was a significant improvement in the patients' dietetic knowledge and in some biological parameters. Nutri-Expert is thus useful even when prescribed by a centre other than the hospital which devised the system. It is an additional beneficial tool in the ambulatory management of diabetic patients.

Colloquium on Central Asia

International Nuclear Information System (INIS)

2005-01-01

This colloquium on Azerbaijan was organized by the direction of international relations of the French Senate and the French center of foreign trade (CFCE). This document gathers the interventions of the participants and the debates with the audience following these interventions. The topics treated concern: - the present day political-economical situation of Central Asia countries (problem of borders, relations with Russia and China); - the economies of Central Asia countries: short term problems and medium-term perspectives; - the relations with the European Union (political, economical, trade and investments, perspectives); - the European energy stakes of Caspian sea (oil and gas reserves, development of hydrocarbon resources, exploitation and transport constraints, stakes for Europe and France); - TotalFinaElf company in Central Asia (Kazakhstan, Azerbaijan, enclavement problem); - the economical impacts of the TRACECA pathway (Transport Corridor Europe Caucasus Asia). (J.S.)

Evaluating the Association between Diabetes, Cognitive Decline and Dementia

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Omorogieva Ojo

2015-07-01

Full Text Available The aim of this article is to review the association between diabetes mellitus, cognitive decline and dementia, including the effects of cognitive decline and dementia on self management of diabetes. This is a literature review of primary research articles. A number of contemporary research articles that met the inclusion criteria were selected for this review paper. These articles were selected using a number of search strategies and electronic databases, such as EBSCOhost Research and SwetsWise databases. The duration of diabetes, glycated haemoglobin levels and glycaemic fluctuations were associated with cognitive decline and dementia. Similarly, hypoglycaemia was significantly related to increased risk of developing cognitive decline and dementia. Furthermore, cognitive decline and dementia were associated with poorer diabetes management. There is evidence of the association between diabetes, cognitive decline and dementia including the shared pathogenesis between diabetes and Alzheimer’s disease. In addition, the self management of diabetes is affected by dementia and cognitive decline. It could be suggested that the association between diabetes and dementia is bidirectional with the potential to proceed to a vicious cycle. Further studies are needed in order to fully establish the relationship between diabetes, cognitive decline and dementia. Patients who have diabetes and dementia could benefit from structured education strategies, which should involve empowerment programmes and lifestyle changes. The detection of cognitive decline should highlight the need for education strategies.

Zika virus in Asia

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Veasna Duong

2017-01-01

Full Text Available Zika virus (ZIKV is an emerging mosquito-borne virus that was first isolated from a sentinel rhesus monkey in the Zika Forest in Uganda in 1947. In Asia, the virus was isolated in Malaysia from Aedes aegypti mosquitoes in 1966, and the first human infections were reported in 1977 in Central Java, Indonesia. In this review, all reported cases of ZIKV infection in Asia as of September 1, 2016 are summarized and some of the hypotheses that could currently explain the apparently low incidence of Zika cases in Asia are explored.

Evaluation of VIIRS, GOCI, and MODIS Collection 6 AOD Retrievals Against Ground Sunphotometer Observations Over East Asia

Science.gov (United States)

Xiao, Q.; Zhang, H.; Choi, M.; Li, S.; Kondragunta, S.; Kim, J.; Holben, B.; Levy, R. C.; Liu, Y.

2016-01-01

Persistent high aerosol loadings together with extremely high population densities have raised serious air quality and public health concerns in many urban centers in East Asia. However, ground-based air quality monitoring is relatively limited in this area. Recently, satellite-retrieved Aerosol Optical Depth (AOD) at high resolution has become a powerful tool to characterize aerosol patterns in space and time. Using ground AOD observations from the Aerosol Robotic Network (AERONET) and the Distributed Regional Aerosol Gridded Observation Networks (DRAGON)-Asia Campaign, as well as from handheld sunphotometers, we evaluated emerging aerosol products from the Visible Infrared Imaging Radiometer Suite (VIIRS) aboard the Suomi National Polar-orbiting Partnership (S-NPP), the Geostationary Ocean Color Imager (GOCI) aboard the Communication, Ocean, and Meteorology Satellite (COMS), and Terra and Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) (Collection 6) in East Asia in 2012 and 2013. In the case study in Beijing, when compared with AOD observations from handheld sunphotometers, 51% of VIIRS Environmental Data Record (EDR) AOD, 37% of GOCI AOD, 33% of VIIRS Intermediate Product (IP) AOD, 26% of Terra MODIS C6 3km AOD, and 16% of Aqua MODIS C6 3km AOD fell within the reference expected error (EE) envelope (+/-0.05/+/- 0.15 AOD). Comparing against AERONET AOD over the JapanSouth Korea region, 64% of EDR, 37% of IP, 61% of GOCI, 39% of Terra MODIS, and 56% of Aqua MODIS C6 3km AOD fell within the EE. In general, satellite aerosol products performed better in tracking the day-to-day variability than tracking the spatial variability at high resolutions. The VIIRS EDR and GOCI products provided the most accurate AOD retrievals, while VIIRS IP and MODIS C6 3km products had positive biases.

Evaluation of VIIRS, GOCI, and MODIS Collection 6 AOD retrievals against ground sunphotometer observations over East Asia

Science.gov (United States)

Xiao, Q.; Zhang, H.; Choi, M.; Li, S.; Kondragunta, S.; Kim, J.; Holben, B.; Levy, R. C.; Liu, Y.

2016-02-01

Persistent high aerosol loadings together with extremely high population densities have raised serious air quality and public health concerns in many urban centers in East Asia. However, ground-based air quality monitoring is relatively limited in this area. Recently, satellite-retrieved Aerosol Optical Depth (AOD) at high resolution has become a powerful tool to characterize aerosol patterns in space and time. Using ground AOD observations from the Aerosol Robotic Network (AERONET) and the Distributed Regional Aerosol Gridded Observation Networks (DRAGON)-Asia Campaign, as well as from handheld sunphotometers, we evaluated emerging aerosol products from the Visible Infrared Imaging Radiometer Suite (VIIRS) aboard the Suomi National Polar-orbiting Partnership (S-NPP), the Geostationary Ocean Color Imager (GOCI) aboard the Communication, Ocean, and Meteorology Satellite (COMS), and Terra and Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) (Collection 6) in East Asia in 2012 and 2013. In the case study in Beijing, when compared with AOD observations from handheld sunphotometers, 51 % of VIIRS Environmental Data Record (EDR) AOD, 37 % of GOCI AOD, 33 % of VIIRS Intermediate Product (IP) AOD, 26 % of Terra MODIS C6 3 km AOD, and 16 % of Aqua MODIS C6 3 km AOD fell within the reference expected error (EE) envelope (±0.05 ± 0.15 AOD). Comparing against AERONET AOD over the Japan-South Korea region, 64 % of EDR, 37 % of IP, 61 % of GOCI, 39 % of Terra MODIS, and 56 % of Aqua MODIS C6 3 km AOD fell within the EE. In general, satellite aerosol products performed better in tracking the day-to-day variability than tracking the spatial variability at high resolutions. The VIIRS EDR and GOCI products provided the most accurate AOD retrievals, while VIIRS IP and MODIS C6 3 km products had positive biases.

Computed tomographical evaluation of diabetic nephropathy

International Nuclear Information System (INIS)

Ubara, Yoshifumi; Hara, Shigeko; Arizono, Kenji; Katori, Hideyuki; Yamada, Akira; Mimura, Nobuhide; Hagura, Ryoko.

1996-01-01

Diabetic nephropathy can be regarded mainly as a type of microangiopathy, but is a disease that may also include aspects of macroangiopathy. This is especially true of renal disease in non-insulin dependent diabetes mellitus (NIDDM), which is characterized not only by diabetic glomerulosclerosis, but also by atherosclerosis. We performed morphological studies on the kidney, using computed tomography (CT), focusing on such points as: abdominal aortic calcifications at the level of kidney, calcifications in the renal artery, and wedge-shaped defects on the renal surface. We noted that these findings became more prominent in NIDDM patients during end-stage renal failure than during normal renal function, and were significantly more common in those two NIDDM groups than in age-matched nondiabetic patients without hypertension, hyperlipidemia or gout. NIDDM patients exhibited these features more frequently than IDDM patients. (author)

South Asia | Page 93 | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

An innovative IDRC initiative is improving evaluation capacities of researchers studying Information and Communication Technologies for Development (ICTD). ... An IDRC-funded project in Asia found that distance education can be as effective as traditional face-to-face education in delivering quality teaching and a good ...

Characteristics of gastric cancer in Asia.

Science.gov (United States)

Rahman, Rubayat; Asombang, Akwi W; Ibdah, Jamal A

2014-04-28

Gastric cancer (GC) is the fourth most common cancer in the world with more than 70% of cases occur in the developing world. More than 50% of cases occur in Eastern Asia. GC is the second leading cause of cancer death in both sexes worldwide. In Asia, GC is the third most common cancer after breast and lung and is the second most common cause of cancer death after lung cancer. Although the incidence and mortality rates are slowly declining in many countries of Asia, GC still remains a significant public health problem. The incidence and mortality varies according to the geographic area in Asia. These variations are closely related to the prevalence of GC risk factors; especially Helicobacter pylori (H. pylori) and its molecular virulent characteristics. The gradual and consistent improvements in socioeconomic conditions in Asia have lowered the H. pylori seroprevalence rates leading to a reduction in the GC incidence. However, GC remains a significant public health and an economic burden in Asia. There has been no recent systemic review of GC incidence, mortality, and H. pylori molecular epidemiology in Asia. The aim of this report is to review the GC incidence, mortality, and linkage to H. pylori in Asia.

Asia electricity study

International Nuclear Information System (INIS)

Priddle, R.

1997-01-01

Electricity demand in Asia has grown and continues to grow rapidly. Over 40 per cent of the world's growth in electricity output up to 2010 is expected to come from China and East and South Asia. The need to build the additional production capacity to meet demand is the driving force behind the major structural and institutional changes that are presently transforming the electricity sectors throughout the region. The Asia Electricity Study looks in detail at the current and future role of the electricity sectors in Indonesia, the Philippines and Thailand. It analyses existing and planned electricity policies in areas such as financing regulation, environment and end-use efficiency. To build the region's power infrastructure will require large investments, well beyond what governments or multilateral lending institutions can provide. Consequently, mobilizing private sector participation in the process is vital. Independent Power Producers (IPPs) are being allowed to enter what has, until recently, been a government-dominated field. State-owned utilities are being corporatized and/or privatized to improve their competitiveness. Developing the regulatory environment to match the changes taking place is a key challenge. The significant expansion of generation capacity in Asia will have implications well beyond the region. Changes in energy trade volumes and patterns, caused by the need to obtain fuel for power stations, will have an impact on the energy security of Asia and the world as a whole Similarly, fuel and technology choices will have important consequences for both the regional and global environment. (author)

International tuberculosis research collaborations within Asia.

Science.gov (United States)

Molton, James S; Singh, Shweta; Chen, Ling Jun; Paton, Nicholas I

2017-09-07

Asia bears more than half the global tuberculosis (TB) burden. Economic development in the region has increased available funding for biomedical research and opportunity for collaboration. We explored the extent of international tuberculosis research collaborations between institutions within Asia. We conducted a Pubmed search for all articles with tuberculosis in the title published during a 12 month period with at least one author affiliation listed in Asia, then identified international collaborations from institution websites and internet searches. We identified 99 international collaborations involving an institution within Asia, of which only 8 (8.1%) were collaborations between Asian institutions. The remainder were with institutions outside of Asia. The paucity of intra-Asian international research collaboration represents a lost opportunity to optimise regional research funding, capacity building and the development of an Asia-relevant TB research agenda.

How people with diabetes evaluate participation of their family in their health care

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Aliny de Lima Santos

2014-07-01

Full Text Available Objective. To understand how individuals with diabetes evaluate the participation of their family in their health care. Methodology. This was a descriptive study with a qualitative approach involving 26 individuals in the Diabetes Association of Maringá. Participating in the study were 9 women and 17 men (age range, 38 to 83 years who had attended at least one educational meeting of the "culture circles" of the association. We used the methodological reference of Paulo Freire for implementing an educational proposal directed at persons with type 2 diabetes mellitus that overcame the limitations of conventional health education approaches. Data were collected between May and July 2011. Testimonials given in meetings were recorded, transcribed, and analyzed according to thematic structures. Results. Three thematic structures appeared: 1 Recognizing the importance of family in the care of patients with diabetes, 2 blaming the family for non-adherence to healthy practices, and 3 perceiving a secondary gain of the disease: feeling cared for by family members. Conclusion. Patients with diabetes perceive family as a source of support and stimulus for adherence and healthy practice, which enable them to control the disease. Family participation in a patient's care plan should be encouraged.

Mobile banking in Asia

OpenAIRE

Anne Ho

2010-01-01

Technology has transformed the banking industry with the introduction of mobile banking services that offer unprecedented convenience and accessibility to customers. This Asia Focus report describes the various approaches to mobile banking in Asia, and examines how particular countries have addressed regulatory issues.

Evaluation of thyroid dysfunction and autoimmunity in gestational diabetes mellitus and its relationship with postpartum thyroiditis.

Science.gov (United States)

Maleki, N; Tavosi, Z

2015-02-01

To evaluate thyroid dysfunction and autoimmunity in women with gestational diabetes and to investigate the frequency of postpartum thyroiditis in women with gestational diabetes. A total of 350 women with gestational diabetes and 350 healthy pregnant women were enrolled in the study. We studied the thyroid hormone profiles of the women in each group during pregnancy (at 24-28 weeks' gestation) and after delivery (at 6 weeks, 3, 6 and 9 months, and 1 year postpartum). A total of 342 women with gestational diabetes and 313 healthy pregnant women completed the follow-up during pregnancy and 1 year after delivery. Of the women with gestational diabetes, 16.6% had thyroid dysfunction, while of the healthy pregnant women, 6.1% had thyroid dysfunction. The prevalence of postpartum thyroiditis was higher in the women with a history of gestational diabetes (19.6%) than in the healthy pregnant women (10.2%), and this difference was statistically significant. According to the results of the present study, the prevalence of postpartum thyroiditis was higher in women with a history of gestational diabetes than in healthy women. We recommend that all women with gestational diabetes and women who have previous thyroid dysfunction should be screened for thyroid hormonal abnormalities during pregnancy and for 1 year after pregnancy. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

Evaluation of Diabetes Quality of Care Based on a Care Scoring System among People Referring to Diabetes Clinic in Ardabil, 2014

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J Ataei

2015-06-01

Full Text Available Background & objectives: Successful implementation of diabetes care can reduce acute and chronic complications of diabetes. This study was conducted to evaluate the quality of care according to a care scoring system among people with type 2 diabetes referring to the diabetes clinic in Ardabil. Methods: This cross sectional study was conducted in 2014 and a total of 300 people with type 2 diabetes in age range of 20-70 years old were included via convenience sampling. Data were collected by an interviewer using a structured questionnaire and checklist. Each patient was classified according to a quality of care scoring system into 3 categories: ≤10, 15-20, >20. Statistical analysis performed by SPSS v.20 software and descriptive analysis used to display data as frequency tables and graphs. Analytical tests such as ANOVA, Kruskal-Wallis, Chi squared, and fisher exact test were also used to analyze the data. Results: The mean age of patients was 54.13 ± 9.13 and the majority of them were women (72.3%. The mean of BMI and HbA1c was 29.58 ± 4.77 and 8.93± 2.13, respectively. The mean of FBS was 191.18 ± 84.23 and the average length of disease was 7.74±5.89 years. The mean of quality of care score among participants was 23.20±9.99. About one-third of patients (29.7% had a quality care score ≤10, half of them (51% had a score between 15-20, and only 19.35% had a score >20. There was an association between HbA1c, FBS, diastolic blood pressure, cholesterol and LDL with a quality of care score which was statistically significant (p<0.05. Conclusion: In this study there was a gap between the current quality of care of patients and recommended standards. Therefore in order to minimize the current barriers and problems it is recommended to implement an effective interventional program. In addition, using a quality care scoring system is a rapid, easy and valid method for evaluating diabetes quality of care.

MR imaging evaluation of diabetic foot

International Nuclear Information System (INIS)

Beltran, J.; Campanini, D.S.; McCalla, M.; Knight, C.T.

1988-01-01

Fourteen diabetic patients with suspected foot infection and/or neuropathic joint were evaluated with MR imaging to identify the presence and extent of infection and also to exclude coexistent infection in the neuropathic joint. Osteomyelitis (n = 8), abscess (n = 7), septic arthritis (n = 4), tenosynovitis (n = 4), and neuropathic joint (n = 5) were diagnosed with MR imaging. Osteomyelitis and/or abscess were excluded by MR findings in 13 instances. Most patients with infection had one more than one site of involvement. Clinical or surgical confirmation of the MR diagnoses was obtained in all but nine of the infection sites or cases of neuropathic joint. Only one false-negative diagnosis of osteomyelitis was made in this series. It is concluded that MR imaging provided accurate information regarding the presence and extent of infection and that this information was decisive in patient management

Evaluation of Glycemic and Lipid Profile of Offspring of Diabetic Wistar Rats Treated with Malpighia emarginata Juice

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Sandra M. Barbalho

2011-01-01

Full Text Available Knowing that maternal diabetes is related to hyperglycemia and fetal hyperinsulinemia, which affect the lipid metabolism, the aim of this study was to evaluate the effects of Malpighia emarginata (acerola juice on the glycemic and lipid profile of offspring of diabetic and nondiabetic Wistar rats. The adult offspring of non-diabetic dams and of dams with severe streptozotocin-induced diabetes were divided into groups: G1, offspring (of control dams treated with water, G2, offspring (of diabetic dams treated with water, G3, male offspring (of control dams treated with acerola juice, and G4, male offspring (of diabetic dams treated with acerola juice. The offspring of diabetic dams treated with acerola juice showed significantly decreased levels of glucose, cholesterol, triglycerides, and increased HDL-c. The use of acerola juice is a potential strategy to aid in the prevention of DM and dyslipidemia and its complications or to act as an auxiliary in the treatment of these diseases.

A radioactive aerosols in air monitoring system - 'ASIA'

International Nuclear Information System (INIS)

Belaish, I.; Levinson, S.; Pelled, O.; German, U.; Laichter, Y.; Gonen, E.; Wengrowicz, U.; Tirosh, D.; Barak, D.

1997-01-01

A continuous air monitoring system called 'ASIA' (Aerosols Sampler In Air) was developed at the NRCN for monitoring and measuring the concentration of airborne alpha emitting radionuclides such as Radon or natural Uranium. The 'ASIA' is a stationary multi-channel analyzer based system. The air passes through a 2.5 cm diameter filter and the radioactivity accumulated on it is monitored by a Silicon solid state detector. The sampling unit can be separated from the display and control unit to enable environment sampling close to the workers. The ASIA uses modern hardware and software in order to improve noise and background reduction and to allow friendly and flexible use. Remote communication is also available. The spectrum and additional data are displayed on line. The system was checked according to ANSI N42.17B -1989. The linearity and efficiency were evaluated by using various alpha sources. The Minimum Detectable Activity (MDA) and Decision Limit (Lc) were calculated according to ANSI N13.30. Long time stability measurements were performed using a natural Uranium source. (authors)

Far East Asia | Page 96 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Far East Asia. Extrême-Orient. Read more about Toward an Innovation-led Development Path in the Philippines. Language English. Read more about Vers un développement axé sur l'innovation aux Philippines. Language French. Read more about Evaluating a Real-Time Bio Surveillance Program : Pilot Project.

Evidence into practice: evaluating a child-centred intervention for diabetes medicine management The EPIC Project

Directory of Open Access Journals (Sweden)

Rycroft-Malone Joanne

2010-09-01

Full Text Available Abstract Background There is a lack of high quality, child-centred and effective health information to support development of self-care practices and expertise in children with acute and long-term conditions. In type 1 diabetes, clinical guidelines indicate that high-quality, child-centred information underpins achievement of optimal glycaemic control with the aim of minimising acute readmissions and reducing the risk of complications in later life. This paper describes the development of a range of child-centred diabetes information resources and outlines the study design and protocol for a randomized controlled trial to evaluate the information resources in routine practice. The aim of the diabetes information intervention is to improve children and young people's quality of life by increasing self-efficacy in managing their type 1 diabetes. Methods/Design We used published evidence, undertook qualitative research and consulted with children, young people and key stakeholders to design and produce a range of child-centred, age-appropriate children's diabetes diaries, carbohydrate recording sheets, and assembled child-centred, age-appropriate diabetes information packs containing published information in a folder that can be personalized by children and young people with pens and stickers. Resources have been designed for children/young people 6-10; 11-15; and 16-18 years. To evaluate the information resources, we designed a pragmatic randomized controlled trial to assess the effectiveness, cost effectiveness, and implementation in routine practice of individually tailored, age-appropriate diabetes diaries and information packs for children and young people age 6-18years, compared with currently available standard practice. Children and young people will be stratified by gender, length of time since diagnosis ( 2years and age (6-10; 11-15; and 16-18 years. The following data will be collected at baseline, 3 and 6 months: PedsQL (generic

Catastrophe risk data scoping for disaster risk finance in Asia

Science.gov (United States)

Millinship, Ian; Revilla-Romero, Beatriz

2017-04-01

Developing countries across Latin America, Africa, and Asia are some of the most exposed to natural catastrophes in the world. Over the last 20 years, Asia has borne almost half the estimated global economic cost of natural disasters - around 53billion annually. Losses from natural disasters can damage growth and hamper economic development and unlike in developed countries where risk is reallocated through re/insurance, typically these countries rely on budget reallocations and donor assistance in order to attempt to meet financing needs. There is currently an active international dialogue on the need to increase access to disaster risk financing solutions in Asia. The World Bank-GFDRR Disaster Risk Financing and Insurance Program with financial support from the Rockefeller Foundation, is currently working to develop regional options for disaster risk financing for developing countries in Asia. The first stage of this process has been to evaluate available catastrophe data suitable to support the design and implementation of disaster risk financing mechanisms in selected Asian countries. This project was carried out by a consortium of JBA Risk Management, JBA Consulting, ImageCat and Cat Risk Intelligence. The project focuses on investigating potential data sources for fourteen selected countries in Asia, for flood, tropical cyclone, earthquake and drought perils. The project was carried out under four stages. The first phase focused to identify and catalogue live/dynamic hazard data sources such as hazard gauging networks, or earth observations datasets which could be used to inform a parametric trigger. Live data sources were identified that provide credibility, transparency, independence, frequent reporting, consistency and stability. Data were catalogued at regional level, and prioritised at local level for five countries: Bangladesh, Indonesia, Pakistan, Sri Lanka and Viet Nam. The second phase was to identify, catalogue and evaluate catastrophe risk models

Ultrastructural evaluation of the effects of cinnamon on the nervus ischiadicus in diabetic rats

International Nuclear Information System (INIS)

Bahceci, Selen; Akkus, Murat; Aluclu, Mehmet U; Canoruc, Naime; Bahceci, Mithat; Gokalp, Deniz; Baran, Sedat; Akbalik, Mehmet E

2009-01-01

To investigate the effects of oral cinnamon supplementation on the nervus ischiadicus at the electron microscopical level in rats. This study was performed between 2004-2006 in Dicle University School of Medicine, Diyarbakir, Turkey in 15 adult Sprague-Dawley rats. Rats were divided into 3 groups; control (C) (n=5), diabetic without cinnamon (D) (n=5), and diabetic with cinnamon (D-C) (n=5). Diabetes was induced with intraperitoneal alloxan administration. All diabetic rats were treated with human insulin. All rats were fed with standard pellet chow. The D-C group rats were fed with standard pellet chow plus Cinnamomum cassia at the dose of 400mg/kg. All rats were sacrificed after 3 months and we obtained the nervus ischiadicus of all rats. Contrast stained thin sections evaluated by Jeol-TEM-1010 electron microscope, were not statistically different in both groups and photo samples were obtained. Mean blood glucose, hemoglobin A1C, and lipid profile were not statistically different in both groups. Marked detachment of myelin lamellae at Schmidt-Lanterman clefts, lysis in cristae mitochondrialis and degenerative changes, severe dispersion of organelles in neurolemma, mesoaxon region, and remarkable edema at the endoneurium were found in diabetic rats. On the contrary, mesoaxon, nucleus, nucleolus and myelin sheet were almost of normal appearance at the ultra-structural level in the D-C group. Cinnamon extracts may have beneficial effects on the development of diabetic neuropathy in alloxan induced diabetic rats. (author)

Confidence-building in the Asia-Pacific region. Report of working group II

International Nuclear Information System (INIS)

Cotton, J.

1992-01-01

Detailed presentations of South and North Korea offers positive evaluation concerning bilateral agreements, which aim both reconciliation between the two states and denuclearization of the Korean peninsula. Consideration was given to confidence building measures in the Asia-Pacific region as a whole as well as to the progress made in introducing such measures in various Subregions of Asia-Pacific. The concept of confidence building actually implies a two-part agenda, particular procedures and general process

Powerful together with diabetes : The development and evaluation of a social network based intervention for Dutch, Surinamese, Turkish and Moroccan people with type 2 diabetes living in socioeconomically deprived neighbourhoods

NARCIS (Netherlands)

Vissenberg, C.

2017-01-01

This thesis describes the development and evaluation of the social network based intervention Powerful Together with Diabetes (PTWD) targeted at Dutch, Turkish, Moroccan and Surinamese patients with type 2 diabetes living in socioeconomically deprived neighbourhoods. This intervention aims to

Current status of intravenous thrombolysis for acute ischemic stroke in Asia.

Science.gov (United States)

Sharma, Vijay K; Ng, Kay W P; Venketasubramanian, Narayanaswamy; Saqqur, Maher; Teoh, Hock L; Kaul, Subash; Srivastava, Padma M V; Sergentanis, Theodoris; Suwanwela, Nijasri; Nguyen, Thang H; Lawrence Wong, K S; Chan, Bernard P L

2011-12-01

Data regarding thrombolysis for acute ischemic stroke in Asia are scarce and only a small percentage of patients are thrombolysed. The dose of intravenous tissue plasminogen activator (IV-tPA) in Asia remains controversial. Case-controlled observation studies in Asia included only Japanese patients and suggested the clinical efficacy and safety of low-dose IV-tPA (0.6 mg/kg body weight; max 60 mg) comparable to standard dose (0.9 mg/kg body weight; max. 90 mg). Reduced treatment cost, lower symptomatic intracerebral hemorrhage risk and comparable efficacy encouraged many Asian centers to adopt low-dose or even variable-dose IV-tPA regimens. We evaluated various Asian thrombolysis studies and compared with SITS-MOST registry and NINDS trial. We included the published studies on acute ischemic stroke thrombolysis in Asia. Unadjusted relative risks and 95% Confidence intervals were calculated for each study. Pooled estimates from random effects models were used because the tests for heterogeneity were significant. We found only 18 publications regarding acute ischemic stroke thrombolysis in Asia that included total of 9300 patients. Owing to ethnic differences, stroke severity, small number of cases in individual reports, outcome measures and tPA dose regimes, it is difficult to compare these studies. Functional outcomes were almost similar (to Japanese studies) when lower-dose IV-tPA was used in non-Japanese populations across Asia. Interestingly, with standard dose IV-tPA, considerably better functional outcomes were observed, without increasing symptomatic intracerebral hemorrhage rates. Variable dose regimens of IV-tPA are used across Asia without any reliable or established evidence. Establishing a uniform IV-tPA regimen is essential since the rapid improvements in health-care facilities and public awareness are expected to increase the rates of thrombolysis in Asia. © 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization.

Economic evaluation of chronic disease self-management for people with diabetes: a systematic review.

Science.gov (United States)

Teljeur, C; Moran, P S; Walshe, S; Smith, S M; Cianci, F; Murphy, L; Harrington, P; Ryan, M

2017-08-01

To systematically review the evidence on the costs and cost-effectiveness of self-management support interventions for people with diabetes. Self-management support is the provision of education and supportive interventions to increase patients' skills and confidence in managing their health problems, potentially leading to improvements in HbA 1c levels in people with diabetes. Randomized controlled trials, observational studies or economic modelling studies were eligible for inclusion in the review. The target population was adults with diabetes. Interventions had to have a substantial component of self-management support and be compared with routine care. Study quality was evaluated using the Consensus on Health Economic Criteria and International Society of Pharmacoeconomic Outcomes Research questionnaires. A narrative review approach was used. A total of 16 costing and 21 cost-effectiveness studies of a range of self-management support interventions were identified. There was reasonably consistent evidence across 22 studies evaluating education self-management support programmes suggesting these interventions are cost-effective or superior to usual care. Telemedicine-type interventions were more expensive than usual care and potentially not cost-effective. There was insufficient evidence regarding the other types of self-management interventions, including pharmacist-led and behavioural interventions. The identified studies were predominantly of poor quality, with outcomes based on short-term follow-up data and study designs at high risk of bias. Self-management support education programmes may be cost-effective. There was limited evidence regarding other formats of self-management support interventions. The poor quality of many of the studies undermines the evidence base regarding the economic efficiency of self-management support interventions for people with diabetes. © 2016 Diabetes UK.

Development and psychometric evaluation of a new instrument to assess nutritional perceptions and behaviors of diabetic men.

Science.gov (United States)

Zamani-Alavijeh, Fereshteh; Araban, Marzieh; Mohammadi, Vida; Goodarzi, Fataneh

2017-12-01

It is obvious that unhealthy nutritional behaviors have caused the increasing incidence of diabetes. This study aimed to design the Measure of Nutritional Perceptions and Behaviors in diabetic men and to evaluate its psychometric properties. A questionnaire was developed within 7 factors. Three methods of face validity, content validity, and construct validity were employed to ensure the validity of the scale. 206 men with diabetes completed the questionnaires. Internal was used to evaluate the reliability of the scale. The mean age of men was 58.26 (9.74) years. Results showed that each item in the final questionnaire was highly correlated with the total score of each dimension Pnutritional behaviors were desired and the overall structure of the questions was confirmed. This questionnaire can be used to identify individuals at risk for unhealthy nutritional behaviors and also to conduct and evaluate the impact of educational interventions. Copyright © 2017. Published by Elsevier Ltd.

Incidence of diabetes mellitus in various population groups in Israel (1989 and 1990).

Science.gov (United States)

Laron, Z; Mansour, T; Slepon, R; Karp, M; Shohat, T

1994-10-01

A prospective survey of all newly diagnosed insulin-dependent diabetes mellitus (IDDM) children and adolescents aged 0-17 years in Israel was conducted for the years 1989 and 1990. All diabetic clinics in Israel treating young diabetics were contacted and they returned written reports to us. Each clinic was also visited regularly by a member of the team who reviewed the individual charts to obtain data on population origin as well as medical and demographic data. A total of 187 patients were identified (164 Jews and 23 Arabs), giving a total incidence rate of 5.46/10(5). Analysis of the incidence rates by population groups showed that Arabs and Jews originating in Asia had the lowest incidence (2.77 and 4.58/10(5) respectively), followed by Jews whose fathers were born in Israel (5.61/10(5)). The highest incidence was registered for Jews originating from Europe and North America (9.34/10(5)). The female-to-male preponderance ratio was higher in the Jews originating in Asia (2.1) than in Jews originating in Europe and North America (1.2). Comparing the present data with a survey performed for the years 1975-80 we found a statistically significant increase in incidence in all population groups. Our findings strongly suggest an influence of genetic factors on the incidence of childhood IDDM.

Retinal changes in diabetic patients without diabetic retinopathy.

Science.gov (United States)

Dumitrescu, Alina Gabriela; Istrate, Sinziana Luminita; Iancu, Raluca Claudia; Guta, Oana Maria; Ciuluvica, Radu; Voinea, Liliana

2017-01-01

The purpose of this study was to measure retinal vessel caliber and to examine early changes in macular thickness using optical coherence tomography (OCT). We evaluated to what extend vascular caliber and macular thickness differed between patients with type 2 diabetes mellitus without diabetic retinopathy compared with healthy individuals. 26 diabetic patients without diabetic retinopathy and 26 normal participants without any retinal and optic nerve diseases underwent ophthalmic examination, fundus photography, and OCT imaging. Temporal inferior retinal vessel diameters were measured using OCT. Also, we measured macular thickness in nine ETDRS subfields using Cirrus OCT. The mean age in the diabetic group was 61.5 years and in the control group, 55.5 years. Wider retinal arterioles and venules were found in patients with diabetes compared with healthy subjects (120 µm versus 96 µm, pdiabetes mellitus, central macular thickness was significantly thinner than that of control eyes (243.5 µm versus 269.9 µm, p value diabetes without diabetic retinopathy.

[Evaluation of diabetic microangiopathy using optical coherence tomography angiography].

Science.gov (United States)

Czakó, Cecília; Sándor, Gábor László; Ecsedy, Mónika; Szepessy, Zsuzsanna; Borbándy, Ágnes; Resch, Miklós; Papp, András; Récsán, Zsuzsa; Horváth, Hajnalka; Nagy, Zoltán Zsolt; Kovács, Illés

2018-02-01

Optical coherence tomography angiography is a non-invasive imaging technique that is able to visualize the different retinal vascular layers using motion contrast to detect blood flow without intravenous dye injection. This method might help to assess microangiopathy in diabetic retinopathy during screening and follow-up. To quantify retinal microvasculature alterations in both eyes of diabetic patients in relation to systemic risk factors using optical coherence tomography angiography. Both eyes of 36 diabetic patients and 45 individuals without diabetes were examined. Duration of diabetes, insulin therapy, blood pressure, HbA 1c , dyslipidemia, axial length and the presence of diabetic retinopathy were recorded. Retinal vessel density was measured by optical coherence tomography angiography. The effect of risk factors on vessel density and between-eye asymmetry was assessed using multivariable regression analysis. Vessel density was significantly lower and between-eye difference was significantly higher in diabetic patients compared to controls (pdiabetes duration (pdiabetic retinopathy compared to control subjects (pdiabetes compared to healthy subjects. By using optical coherence tomography angiography, the detection of these microvascular alterations is possible before clinically detectable diabetic retinopathy and might serve as a useful tool in both screening and timing of treatment. Orv Hetil. 2018; 159(8): 320-326.

Human Migration through Bottlenecks from Southeast Asia into East Asia during Last Glacial Maximum Revealed by Y Chromosomes

Science.gov (United States)

Wen, Bo; Xu, Shuhua; Wang, Yi; Lu, Yan; Wei, Lanhai; Wang, Chuanchao; Li, Shilin; Huang, Xingqiu; Jin, Li; Li, Hui

2011-01-01

Molecular anthropological studies of the populations in and around East Asia have resulted in the discovery that most of the Y-chromosome lineages of East Asians came from Southeast Asia. However, very few Southeast Asian populations had been investigated, and therefore, little was known about the purported migrations from Southeast Asia into East Asia and their roles in shaping the genetic structure of East Asian populations. Here, we present the Y-chromosome data from 1,652 individuals belonging to 47 Mon-Khmer (MK) and Hmong-Mien (HM) speaking populations that are distributed primarily across Southeast Asia and extend into East Asia. Haplogroup O3a3b-M7, which appears mainly in MK and HM, indicates a strong tie between the two groups. The short tandem repeat network of O3a3b-M7 displayed a hierarchical expansion structure (annual ring shape), with MK haplotypes being located at the original point, and the HM and the Tibeto-Burman haplotypes distributed further away from core of the network. Moreover, the East Asian dominant haplogroup O3a3c1-M117 shows a network structure similar to that of O3a3b-M7. These patterns indicate an early unidirectional diffusion from Southeast Asia into East Asia, which might have resulted from the genetic drift of East Asian ancestors carrying these two haplogroups through many small bottle-necks formed by the complicated landscape between Southeast Asia and East Asia. The ages of O3a3b-M7 and O3a3c1-M117 were estimated to be approximately 19 thousand years, followed by the emergence of the ancestors of HM lineages out of MK and the unidirectional northward migrations into East Asia. PMID:21904623

Evaluation of Smoking Status among Diabetes Patients in the State ...

African Journals Online (AJOL)

HP

Purpose: To determine the prevalence of smoking among diabetes patients attending Diabetes. Outpatient Clinic at Penang .... (2,547) medical records of type 1 and 2 diabetes patients were .... American Diabetes Association. Standards of ...

Uranium resources potential for Asia and the Pacific

International Nuclear Information System (INIS)

Tauchid, M.

1988-01-01

Only four countries in Asia, India, Japan, the Republic of Korea and Turkey, reported having uranium resources in response to a Nuclear Energy Agency of the OECD/International Atomic Energy Agency questionnaire circulated before preparation of the report on Uranium: Resources, Production and Demand (the 'Red Book'). The reasonably assured resources (RAR) of these countries, which are recoverable at costs of up to US $130/kg U, amount to 67,690 t U or 3% of the total for the World Outside the Centrally Planned Economies Area (WOCA). It is believed that the largest uranium resources in Asia are in China; however, no official published figures are available to substantiate this fact. Within the framework of the International Uranium Resources Evaluation Project (IUREP) it was estimated that the speculative resources (SR) for Asia and the Far East outside the Centrally Planned Economies Area (CPEA) are of the order of 300,000 t U. This is 4.7% of the total for WOCA. With the exception of Proterozoic unconformity related deposits, all types of uranium deposits and occurrences are known to exist in Asia. Most deposits are of the vein and sandstone hosted types. Several published reports indicate that deposits in China are mainly of the volcanic type and those associated with granitic intrusion. For undiscovered deposits, probably India and China have the best possibility of finding deposits of the Precambrian quartz-pebble conglomerate and Proterozoic unconformity related types. In South-East Asia the deposits most likely to be found are those associated with Mesozoic granites and those in the intramontane basin sediments adjacent to these intrusions. The less known acid volcanic type is also a possibility. Only in China, India and Pakistan does there appear to be the possibility of finding calcrete type deposits. Uranium can still be recovered as a by-product of the phosphate rocks, monazite placer deposits and carbonatite known in many parts of Asia. (author). 21 refs

Evaluation of Smoking, Diabetes Mellitus and Obesity associations with Degenerative Lumbar Spinal Stenosis in Elderly

Directory of Open Access Journals (Sweden)

Laith Thamer Al-Ameri

2018-05-01

Full Text Available Background: Degenerative lumbar spinal stenosis (LSS is a common condition affecting mainly old age group with high incidence and prevalence, and is associated with many factors. Aim: Our study aimed to evaluate smoking, diabetes mellitus and obesity associations with degenerative LSS. Patients and methods: A comparative crosssectional study with participants aged 60 years or older. Participants suffering from degenerative LSS were enrolled as the diseased group after diagnosis with MRI, healthy persons (age and gender matched were considered as control group. Smoking, diabetes mellitus and obesity variables were collected and analyzed using chi-square and odds ratio. Results: Around 162 participants enrolled the study, 62 were considered as degenerative LSS group, whereas 100 were considered as the control group. In LSS group, a picture obtained was of 20:42 smokers to non-smoker, 22:20 diabetic to non-diabetic, 37:25 obese to non-obese. While in the controlled group a picture was obtained with 18:82 smokers to non-smoker, 18-82 diabetic to non-diabetic, 34:66 obese to non-obese. Chi-square p-value was of 0.037, 0.012 and 0.001 for smoking, diabetes mellitus, and obesity, respectively. The odd ratio was 2.17, 2.5 and 2.87 for smoking, diabetes mellitus, and obesity, respectively. All above results were significant. Conclusion: Each of smoking, diabetes mellitus, and obesity has a great association with the development of degenerative LSS in elderly age group. Obesity shows the highest association among them

Zika virus in Asia.

Science.gov (United States)

Duong, Veasna; Dussart, Philippe; Buchy, Philippe

2017-01-01

Zika virus (ZIKV) is an emerging mosquito-borne virus that was first isolated from a sentinel rhesus monkey in the Zika Forest in Uganda in 1947. In Asia, the virus was isolated in Malaysia from Aedes aegypti mosquitoes in 1966, and the first human infections were reported in 1977 in Central Java, Indonesia. In this review, all reported cases of ZIKV infection in Asia as of September 1, 2016 are summarized and some of the hypotheses that could currently explain the apparently low incidence of Zika cases in Asia are explored. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Kedrostis Medik. in Asia

Directory of Open Access Journals (Sweden)

W.J.J.O. De Wilde

2013-04-01

Full Text Available DE WILDE, W.J.J.O.  & DUYFJES, BRIGITTA E.E. 2004. Kedrostis Medik. in Asia. Reinwardtia 12(2:129 – 133. — Kedrostis (Cucurbitaceae occurs in Africa and Madagascar and comprises 4 (5 species in Asia. Of these 2 species are found in India and Sri Lanka and 2 (3 species in western Malesia. One Malesian species is for the first time included in Kedrostis here, Kedrostis bennettii (Miq. W.J. de Wilde & Duyfjes, and one species is described as new here, Kedrostis hirta W.J. de Wilde & Duyfjes. One more Malesian species is insufficiently known to be formally described.  Keywords: Kedrostis, Cucurbitaceae, SE Asia, taxonomy

Blood pressure control with amlodipine add-on therapy in patients with hypertension and diabetes: results of the Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial.

Science.gov (United States)

Kloner, Robert A; Neutel, Joel; Roth, Eli M; Weiss, Robert; Weinberger, Myron H; Thakker, Kamlesh M; Schwartz, Brian; Shi, Harry; Gregg, Anne-Marie

2008-11-01

Attainment of blood pressure (BP) goals in patients with diabetes is critical both to reduce the risk of cardiovascular events and to delay the progression of renal disease. While therapeutic guidelines advise initial therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, monotherapy with these agents may not be sufficient to attain target BP. The ADHT (Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial) evaluated the efficacy and safety of adding amlodipine to the treatment regimen of patients with hypertension and diabetes who were already receiving either quinapril or losartan as monotherapy. ADHT was a double-blind, double-dummy, 22-week trial conducted in the US. After a washout period of 7-13 days, patients (aged 30-75 y) with hypertension and diabetes were randomized to receive quinapril 20 mg/day plus placebo or losartan 50 mg/day plus placebo for 4 weeks, titrated to 40 mg or 100 mg (if required), respectively, for an additional 4 weeks to achieve their BP goals (<130/80 mm Hg). At week 8, either amlodipine 5 mg/day or placebo was added for an additional 12 weeks, with titration to 10 mg at week 14 if the BP goal was not achieved. Efficacy of add-on therapy was evaluated in 411 patients (amlodipine 211, placebo 200). BP goal was reached by 27.5% of patients when amlodipine was added to quinapril or losartan monotherapy, compared with 12.5% when placebo was added (OR 2.73; 95% CI 1.61 to 4.64; p < 0.001). When added to quinapril or losartan monotherapy, amlodipine reduced BP by 8.1/5.4 mm Hg, compared with a 1.6/0.7 mm Hg decrease with add-on placebo (p < 0.001). Amlodipine, quinapril, and losartan were well tolerated. Amlodipine is safe and effective when added to quinapril or losartan monotherapy to help lower BP toward therapeutic targets in patients with hypertension and diabetes.

Origin and distribution of Sporothrix globosa causing sapronoses in Asia.

Science.gov (United States)

Moussa, Tarek A A; Kadasa, Naif M S; Al Zahrani, Hassan S; Ahmed, Sarah Abdallah; Feng, Peiying; Gerrits van den Ende, Albertus H G; Zhang, Yu; Kano, Rui; Li, Fuqiu; Li, Shanshan; Song, Yang; Dong, Bilin; Rossato, Luana; Dolatabadi, Somayeh; Hoog, Sybren de

2017-05-01

The aim of the study was to evaluate the main sources and epidemiological patterns and speculate on the evolutionary origin of Sporothrix globosa in Asia. Case and case series literature on sporotrichosis in Asia from January 2007 onwards were reviewed using meta-analysis. Phylogenetic analysis of relevant S. globosa was carried out on the basis of concatenated sequences of ITS, TEF3 and CAL. A haplotype network of CAL sequences of 281 Sporothrix isolates was analysed to determine the population structure of S. globosa. Nearly all cases of sporotrichosis caused by S. globosa in Asia were human. In contrast to the remaining pathogenic Sporothrix species, feline transmission was exceptional; nearly all regional cat-associated cases were caused by Sporothrix schenckii. While the latter species was highly variable and showed recombination, S. globosa seemed to be a clonal offshoot, as was Sporothrix brasiliensis. The origin of the segregants was located in an area of high variability in S. schenckii with a relatively high frequency of Asian strains. In Asia, S. globosa was the prevalent species. The low diversity of S. globosa suggested a recent divergence with a founder effect of low variability from the variable ancestral species, S. schenckii.

Demyelinating diseases in Asia.

Science.gov (United States)

Ochi, Hirofumi; Fujihara, Kazuo

2016-06-01

The present review aims to discuss the recent advances in inflammatory demyelinating diseases of the central nervous system in Asia. Prevalence of multiple sclerosis (MS) in Asia is lower than that in Western countries, although it has been increasing recently. Meanwhile, there seems to be no major difference in neuromyelitis optica (NMO) prevalence in various regions or ethnicities. Thus, the ratios of NMO/NMO spectrum disorder (NMOSD) to MS are higher in Asia as compared with Western countries, indicating that the differential diagnosis between NMO/NMOSD and MS is a major challenge in Asia. Although the detection of aquaporin-4 (AQP4)-antibody is critical in distinguishing NMO/NMOSD from MS, some patients with NMO/NMOSD phenotype are seronegative for AQP4-antibody, and a fraction of those patients possess autoantibody against myelin oligodendrocyte glycoprotein. The clinical profile of Asian MS seems to be essentially similar to that in Western MS after careful exclusion of NMO/NMOSD, although some unique genetic and/or environmental factors may modify the disease in Asians. MS prevalence has been low but is increasing in Asia. In contrast, NMO/NMOSD prevalence seems relatively constant in the world. Asian MS is not fundamentally different from Western MS, but some genetic and/or environmental differences may cause some features unique to Asian patients.

Developing an objective evaluation method to estimate diabetes risk in community-based settings.

Science.gov (United States)

Kenya, Sonjia; He, Qing; Fullilove, Robert; Kotler, Donald P

2011-05-01

Exercise interventions often aim to affect abdominal obesity and glucose tolerance, two significant risk factors for type 2 diabetes. Because of limited financial and clinical resources in community and university-based environments, intervention effects are often measured with interviews or questionnaires and correlated with weight loss or body fat indicated by body bioimpedence analysis (BIA). However, self-reported assessments are subject to high levels of bias and low levels of reliability. Because obesity and body fat are correlated with diabetes at different levels in various ethnic groups, data reflecting changes in weight or fat do not necessarily indicate changes in diabetes risk. To determine how exercise interventions affect diabetes risk in community and university-based settings, improved evaluation methods are warranted. We compared a noninvasive, objective measurement technique--regional BIA--with whole-body BIA for its ability to assess abdominal obesity and predict glucose tolerance in 39 women. To determine regional BIA's utility in predicting glucose, we tested the association between the regional BIA method and blood glucose levels. Regional BIA estimates of abdominal fat area were significantly correlated (r = 0.554, P < 0.003) with fasting glucose. When waist circumference and family history of diabetes were added to abdominal fat in multiple regression models, the association with glucose increased further (r = 0.701, P < 0.001). Regional BIA estimates of abdominal fat may predict fasting glucose better than whole-body BIA as well as provide an objective assessment of changes in diabetes risk achieved through physical activity interventions in community settings.

A systematic review of innovative diabetes care models in low-and middle-income countries (LMICs).

Science.gov (United States)

Esterson, Yonah B; Carey, Michelle; Piette, John D; Thomas, Nihal; Hawkins, Meredith

2014-02-01

Over 70% of the world's patients with diabetes reside in low-and middle-income countries (LMICs), where adequate infrastructure and resources for diabetes care are often lacking. Therefore, academic institutions, health care organizations, and governments from Western nations and LMICs have worked together to develop a variety of effective diabetes care models for resource-poor settings. A focused search of PubMed was conducted with the goal of identifying reports that addressed the implementation of diabetes care models or initiatives to improve clinical and/or biochemical outcomes in patients with diabetes mellitus. A total of 15 published manuscripts comprising nine diabetes care models in 16 locations in sub-Saharan Africa, Latin America, and Asia identified by the above approach were systematically reviewed. The reviewed models shared a number of principles including collaboration, education, standardization, resource optimization, and technological innovation. The most comprehensive models used a number of these principles, which contributed to their success. Reviewing the principles shared by these successful programs may help guide the development of effective future models for diabetes care in low-income settings.

China's Economic Engagement with Southeast Asia

DEFF Research Database (Denmark)

Kokko, Ari

2014-01-01

Review of: China’s Economic Engagement with Southeast Asia: Indonesia / by John Lee. Trends in Southeast Asia. Singapore: Institute of Southeast Asian Studies, 2013. Pp. 40. Paperback: $9.90/S$12.90. PDF available: http://www.iseas.edu.sg/documents/publication/Trends_2013-3.pdf......Review of: China’s Economic Engagement with Southeast Asia: Indonesia / by John Lee. Trends in Southeast Asia. Singapore: Institute of Southeast Asian Studies, 2013. Pp. 40. Paperback: $9.90/S$12.90. PDF available: http://www.iseas.edu.sg/documents/publication/Trends_2013-3.pdf...

Anti-diabetic effects of rice hull smoke extract in alloxan-induced diabetic mice

Science.gov (United States)

We investigated the protective effect of a liquid rice hull smoke extract (RHSE) against diabetes in alloxan-induced diabetic mice. Anti-diabetic effects of RHSE were evaluated in both the rat insulinoma-1 cell line (INS-1) and diabetic ICR mice induced by inraperitoneal (ip) injection of alloxan. ...

Towards a sustainable Asia. Environment and climate change

Energy Technology Data Exchange (ETDEWEB)

NONE

2011-07-01

This series of books are the output of the research project called ''Sustainable Development in Asia (SDA)'', which was initiated by the Association of Academies of Sciences in Asia (AASA). They are comprised of one synthesis report, which entitled ''Towards a Sustainable Asia: Green Transition and Innovation'', and four thematic reports on natural resources, energy, the environment and climate change, and culture from particular perspectives of agriculture. They aim to: (1) investigate common sustainability issues faced by all Asian countries, including population increase, poverty alleviation, pollution control, ecological restoration, as well as regional problems, such as water shortage in West and Central Asia, energy security in Northeast Asia, development model and transformation in East Asia; (2) analyze and summarize of best practices towards sustainable development in Asia; (3) bring forward suggestions and policy options for promoting green transition, system innovation and sustainable development of Asia. With best practice guidelines for a sustainable Asia, this series of reports, for the first time systematically address the common challenges and regional problems in regard to Asia's natural resources use, pollution reduction and climate protection, sustainable energy development, and innovations for environment-friendly and culture-compatible agriculture. They will provide handy and useful information to researchers, government policy makers and the general public who have concerns about Asia's sustainable development. AASA is a scientific and technological organization in Asia, established in 2000, comprising of 26 member academies all over Asia. Its vision is to provide a forum for the discussion of all issues relevant to science and technology development and its application on national level within Asia. (orig.)

Diabetes and associated disorders in Cambodia: two epidemiological surveys.

Science.gov (United States)

King, Hilary; Keuky, Lim; Seng, Serey; Khun, Touch; Roglic, Gojka; Pinget, Michel

2005-11-05

The Asia-Pacific region is thought to be severely affected by diabetes. However, reliable, standardised data on prevalence and characteristics of glucose intolerance in Asian populations remain sparse. We describe the results of two field surveys undertaken in Cambodia in 2004. 2246 randomly selected adults aged 25 years and older were examined in two communities, one rural (Siemreap) and one semi-urban (Kampong Cham). The diagnosis of diabetes and impaired glucose tolerance was based on 2-h blood glucose estimation using criteria recommended by the latest report of a WHO Expert Group. Blood pressure, anthropometry, habitual diet, and other relevant characteristics were also recorded. Prevalence of diabetes was 5% in Siemreap and 11% in Kampong Cham. Prevalence of impaired glucose tolerance was 10% in Siemreap and 15% in Kampong Cham. About two-thirds of all cases of diabetes were undiagnosed before the survey. Prevalence of hypertension was 12% at Siemreap and 25% at Kampong Cham. People in Kampong Cham had higher estimates of central obesity than those in Siemreap. Diabetes and hypertension are not uncommon in Cambodia. A quarter of all adults in the chosen suburban community had some degree of glucose intolerance. Since Cambodian society is relatively poor, and lifestyle is fairly traditional by international standards, these findings are unexpected.

Future regional nuclear fuel cycle cooperation in East Asia: Energy security costs and benefits

International Nuclear Information System (INIS)

Hippel, David von; Hayes, Peter; Kang, Jungmin; Katsuta, Tadahiro

2011-01-01

Economic growth in East Asia has rapidly increased regional energy, and especially, electricity needs. Many of the countries of East Asia have sought or are seeking to diversify their energy sources and bolster their energy supply and/or environmental security by developing nuclear power. Rapid development of nuclear power in East Asia brings with it concerns regarding nuclear weapons proliferation associated with uranium enrichment and spent nuclear fuel management. This article summarizes the development and analysis of four different scenarios of nuclear fuel cycle management in East Asia, including a scenario where each major nuclear power user develops uranium enrichment and reprocessing of spent fuel individually, scenarios featuring cooperation in the full fuel cycle, and a scenario where reprocessing is avoided in favor of dry cask storage of spent fuel. The material inputs and outputs and costs of key fuel cycle elements under each scenario are summarized. - Highlights: → We evaluate four scenarios of regional nuclear fuel cycle cooperation in East Asia and the Pacific. → The scenarios cover fuel supply, enrichment, transport, reprocessing, and waste management. → We evaluate nuclear material flows, energy use, costs, and qualitative energy security impacts. → Regional cooperation on nuclear fuel cycle issues can help to enhance energy security. → A regional scenario in which reprocessing is rapidly phased out shows security and cost advantages.

Evaluation of Salivary Secretory Immunoglobulin A Levels in Diabetic Patients and Association with Oral and Dental Manifestations

Directory of Open Access Journals (Sweden)

Shahla Kakoei

2015-11-01

Full Text Available Objectives: Oral and dental manifestations in diabetic patients can arise due to numerous factors, including elevated salivary secretory immunoglobulin A (s-IgA levels. This study aimed to evaluate s-IgA concentrations in patients with type 2 diabetes mellitus (T2DM and to investigate the association between s-IgA levels and oral and dental manifestations of T2DM. Methods: This cross-sectional descriptive study was carried out between October 2011 and September 2012 in Kerman, Iran, and included 260 subjects (128 patients with T2DM and 132 healthy controls. Unstimulated salivary samples were collected from all subjects and s-IgA levels were determined using the immunoturbidimetric method. The oral cavities and teeth of T2DM patients were evaluated for oral and dental manifestations. Results: Both diabetic and control subjects with higher concentrations of s-IgA had significantly higher numbers of decayed, missing or filled teeth (DMFT and periodontal index (PDI scores (P <0.050. s-IgA levels were significantly higher in subjects with oral candidiasis (P <0.050. Among diabetic patients, significantly higher s-IgA levels were concomitant with xerostomia and denture stomatitis (P ≤0.050. There were no significant differences between s-IgA concentrations and other oral or dental manifestations in either group. Conclusion: Individuals with a greater number of DMFT, a higher PDI score and oral candidiasis had significantly higher s-IgA levels. s-IgA levels were not significantly higher among diabetic patients in comparison to the control group. However, significantly higher s-IgA levels occurred with xerostomia and denture stomatitis in diabetic patients. In addition, s-IgA was significantly higher in patients with uncontrolled diabetes compared to those with controlled diabetes.

Religion, faith and the empowerment process: stories of Iranian people with diabetes.

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Abdoli, Samereh; Ashktorab, Tahereh; Ahmadi, Fazlollah; Parvizy, Soroor; Dunning, Trisha

2011-06-01

Empowerment concerning people with diabetes is well researched. However, few researchers specifically focus on the barriers to and facilitators of empowerment in Iranian people with diabetes. Understanding the factors could help health professionals facilitate self-empowerment more effectively. This study aims to determine the barriers to and facilitators of empowerment in Iranian people with diabetes. A qualitative exploratory study was conducted using in-depth interviews to collect the data from 11 women and men in 2007. Themes were identified using constant comparative analysis method. Common barriers to empowerment were similar to other chronic diseases: prolonged stress, negative view about diabetes, ineffective health-care systems, poverty and illiteracy. Diabetes education, fear of diabetes' complications, self-efficacy and hope for a better future emerged as being crucial to empowerment. Facilitators specific to Iranians were: the power of religion and faith, the concept of the doctor as holy man, accepting diabetes as God's will, caring for the body because it was God's gift and support from families especially daughters. Empowerment was strongly influenced by cultural and religious beliefs in Iran and the power of faith emerged as an important facilitator of diabetes empowerment. The findings will help health professionals understand how Iranian people with diabetes view life and the factors that facilitate empowerment. © 2011 Blackwell Publishing Asia Pty Ltd.

Evaluation of BAG3 levels in healthy subjects, hypertensive patients, and hypertensive diabetic patients.

Science.gov (United States)

Derosa, Giuseppe; Maffioli, Pamela; Rosati, Alessandra; M, De Marco; Basile, Anna; D'Angelo, Angela; Romano, Davide; Sahebkar, Amirhossein; Falco, Antonia; Turco, Maria C

2018-03-01

BAG3 is a member of human BAG (Bcl-2-associated athanogene) proteins and plays a role in apoptosis, cell adhesion, cytoskeleton remodeling, and autophagy. The aim of this study was to evaluate BAG3 levels in healthy subjects, hypertensive patients, and hypertensive diabetic patients. We enrolled 209 Caucasian adults, of both sex, 18-75 years of age, 77 were healthy controls, 62 were affected by hypertension, and 70 were affected by hypertension and type 2 diabetes. All patients underwent an assessment that included medical history, physical examination, vital signs, a 12-lead electrocardiogram, measurements of systolic (SBP), and diastolic blood pressure (DBP), heart rate (HR), fasting plasma glucose (FPG), glycated hemoglobin (HbA 1c ), triglycerides (TG), transaminases, high sensitivity C-reactive protein (Hs-CRP), and BAG3. We observed higher blood pressure values in hypertensive, and hypertensive diabetic patients compared to controls. As expected, FPG and HbA 1c were higher in diabetic hypertensive patients, compared to the other two groups. No Tg levels differences were recorded among the three groups. Hs-CRP was higher in diabetic hypertensive patients compared to healthy subjects. Finally, BAG3 levels were higher in hypertensives, and hypertensive diabetic patients compared to controls. We observed higher levels of BAG3 in hypertensive patients compared to healthy controls, and even higher levels in hypertensive diabetic patients compared to healthy subjects. This paper could be the first of a long way to identify potential involvement of deregulated BAG3 levels in cardiometabolic diseases. © 2017 Wiley Periodicals, Inc.

Practical approaches for self-monitoring of blood glucose: an Asia-Pacific perspective.

Science.gov (United States)

Chowdhury, Subhankar; Ji, Linong; Suwanwalaikorn, Sompongse; Yu, Neng-Chun; Tan, Eng Kiat

2015-03-01

Comprehensive glycemic control is necessary to improve outcomes and avoid complications in individuals with diabetes. Self-monitoring of blood glucose (SMBG) is a key enabler of glycemic assessment, providing real-time information that complements HbA1c monitoring and supports treatment optimization. However, SMBG is under-utilized by patients and physicians within the Asia-Pacific region, because of barriers such as the cost of monitoring supplies, lack of diabetes self-management skills, or concerns about the reliability of blood glucose readings. Practice recommendations in international and regional guidelines vary widely, and may not be detailed or specific enough to guide SMBG use effectively. This contributes to uncertainty among patients and physicians about how best to utilize this tool: when and how often to test, and what action(s) to take in response to high or low readings. In developing a practical SMBG regimen, the first step is to determine the recommended SMBG frequency and intensity needed to support the chosen treatment regimen. If there are practical obstacles to monitoring, such as affordability or access, physicians should identify the most important aspects of glycemic control to target for individual patients, and modify monitoring patterns accordingly. This consensus paper proposes a selection of structured, flexible SMBG patterns that can be tailored to the clinical, educational, behavioral, and financial requirements of individuals with diabetes.

Epilepsy: Asia versus Africa.

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Bhalla, Devender; Tchalla, Achille Edem; Marin, Benoît; Ngoungou, Edgard Brice; Tan, Chong Tin; Preux, Pierre-Marie

2014-09-01

Is epilepsy truly an "African ailment"? We aimed to determine this, since international health agencies often refer to epilepsy as an African disease and the scientific literature has spoken the same tone. Various published materials, mainly reports, articles, were used to gather Asian and African evidence on various aspects of epilepsy and many of its risk and associated factors. Our results suggest that in no way can epilepsy be considered as an African ailment and such characterization is most likely based on popular beliefs rather than scientific evidence. In comparison to Africa, Asia has a 5.0% greater burden from all diseases, and is 17.0% more affected from neuropsychiatric disorders (that include epilepsy). Given that more countries in Asia are transitioning, there may be large demographic and lifestyle changes in the near future. However these changes are nowhere close to those expected in Africa. Moreover, 23 million Asians have epilepsy in comparison to 3.3 million Africans and 1.2 million sub-Saharan Africans. In comparison to Africa, Asia has more untreated patients, 55.0% more additional epilepsy cases every year, because of its larger population, with greater treatment cost and possibly higher premature mortality. Of several associated factors discussed herein, many have more importance for Asia than Africa. The current state of epilepsy in Asia is far less than ideal and there is an urgent need to recognize and accept the importance of epilepsy in Asia. In no way can epilepsy be considered as an African ailment. This is most likely based on popular beliefs rather than scientific evidence. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

Prevalence of self-reported diagnosis of diabetes mellitus and associated risk factors in a national survey in the US population: SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes).

Science.gov (United States)

Bays, Harold E; Bazata, Debbra D; Clark, Nathaniel G; Gavin, James R; Green, Andrew J; Lewis, Sandra J; Reed, Michael L; Stewart, Walter; Chapman, Richard H; Fox, Kathleen M; Grandy, Susan

2007-10-03

Studies derived from continuous national surveys have shown that the prevalence of diagnosed diabetes mellitus in the US is increasing. This study estimated the prevalence in 2004 of self-reported diagnosis of diabetes and other conditions in a community-based population, using data from the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD). The initial screening questionnaire was mailed in 2004 to a stratified random sample of 200,000 households in the US, to identify individuals, age > or = 18 years of age, with diabetes or risk factors associated with diabetes. Follow-up disease impact questionnaires were then mailed to a representative, stratified random sample of individuals (n = 22,001) in each subgroup of interest (those with diabetes or different numbers of risk factors for diabetes). Estimated national prevalence of diabetes and other conditions was calculated, and compared to prevalence estimates from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. Response rates were 63.7% for the screening, and 71.8% for the follow-up baseline survey. The SHIELD screening survey found overall prevalence of self-reported diagnosis of diabetes (either type 1 or type 2) was 8.2%, with increased prevalence with increasing age and decreasing income. In logistic regression modeling, individuals were more likely to be diagnosed with type 2 diabetes if they had abdominal obesity (odds ratio [OR] = 3.50; p or =28 kg/m2 (OR = 4.04; p self-report only) to those from NHANES 1999-2002 (self-report, clinical and laboratory evaluations), the prevalence of diabetes was similar. SHIELD allows the identification of respondents with and without a current diagnosis of the illness of interest, and potential longitudinal evaluation of risk factors for future diagnosis of that illness.

Games and Diabetes: A Review Investigating Theoretical Frameworks, Evaluation Methodologies, and Opportunities for Design Grounded in Learning Theories.

Science.gov (United States)

Lazem, Shaimaa; Webster, Mary; Holmes, Wayne; Wolf, Motje

2015-09-02

Here we review 18 articles that describe the design and evaluation of 1 or more games for diabetes from technical, methodological, and theoretical perspectives. We undertook searches covering the period 2010 to May 2015 in the ACM, IEEE, Journal of Medical Internet Research, Studies in Health Technology and Informatics, and Google Scholar online databases using the keywords "children," "computer games," "diabetes," "games," "type 1," and "type 2" in various Boolean combinations. The review sets out to establish, for future research, an understanding of the current landscape of digital games designed for children with diabetes. We briefly explored the use and impact of well-established learning theories in such games. The most frequently mentioned theoretical frameworks were social cognitive theory and social constructivism. Due to the limitations of the reported evaluation methodologies, little evidence was found to support the strong promise of games for diabetes. Furthermore, we could not establish a relation between design features and the game outcomes. We argue that an in-depth discussion about the extent to which learning theories could and should be manifested in the design decisions is required. © 2015 Diabetes Technology Society.

Online social networking by patients with diabetes: a qualitative evaluation of communication with Facebook.

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Greene, Jeremy A; Choudhry, Niteesh K; Kilabuk, Elaine; Shrank, William H

2011-03-01

Several disease-specific information exchanges now exist on Facebook and other online social networking sites. These new sources of knowledge, support, and engagement have become important for patients living with chronic disease, yet the quality and content of the information provided in these digital arenas are poorly understood. To qualitatively evaluate the content of communication in Facebook communities dedicated to diabetes. We identified the 15 largest Facebook groups focused on diabetes management. For each group, we downloaded the 15 most recent "wall posts" and the 15 most recent discussion topics from the 10 largest groups. Four hundred eighty unique users were identified in a series of 690 comments from wall posts and discussion topics. Posts were abstracted and aggregated into a database. Two investigators evaluated the posts, developed a thematic coding scheme, and applied codes to the data. Patients with diabetes, family members, and their friends use Facebook to share personal clinical information, to request disease-specific guidance and feedback, and to receive emotional support. Approximately two-thirds of posts included unsolicited sharing of diabetes management strategies, over 13% of posts provided specific feedback to information requested by other users, and almost 29% of posts featured an effort by the poster to provide emotional support to others as members of a community. Approximately 27% of posts featured some type of promotional activity, generally presented as testimonials advertising non-FDA approved, "natural" products. Clinically inaccurate recommendations were infrequent, but were usually associated with promotion of a specific product or service. Thirteen percent of posts contained requests for personal information from Facebook participants. Facebook provides a forum for reporting personal experiences, asking questions, and receiving direct feedback for people living with diabetes. However, promotional activity and personal

Evaluation of a pilot study to influence medication adherence of patients with diabetes mellitus type-2 by the pharmacy

NARCIS (Netherlands)

Adhien, P.; van Dijk, L.; de Vegter, M.; Westein, M.; Nijpels, G.; Hugtenburg, J.G.

2013-01-01

Background Interventions aimed to increase adherence to drug treatment usually are not tailored to the needs of individual patients. A modular pharmacy intervention, named 'Support for Diabetes', was developed to improve adherence to type 2 diabetes treatment. Objective To evaluate the

The USA and proliferation in Northeast Asia

International Nuclear Information System (INIS)

Weeks, S.B.

1995-01-01

United States policy on proliferation in Northeast Asia poses a test of balance between general US global non-proliferation goals and specific US regional security goals for Northeast Asia. US policy on proliferation in Northeast Asia further poses a test of priorities for US bilateral relations with the key Northeast Asian states, as non-proliferation and regional security goals must be weighed against other (e.g., economic, human rights) declared US policy goals. The result is a US policy equation for Northeast Asia proliferation that is considerably more complex in execution than might be expected from the simple statement of the US goal to avoid nuclear proliferation in Northeast Asia. The question of security assurances - both negative and positive - may be closely related to US policies to avoid proliferation in Northeast Asia

Promising Practices in Drug Treatment: Findings from Southeast Asia

Science.gov (United States)

Libretto, Salvatore; Nemes, Susanna; Namur, Jenny; Garrett, Gerald; Hess, Lauren; Kaplan, Linda

2005-01-01

In a study to evaluate the drug treatment and aftercare efforts sponsored by the State Department's International Narcotics and Law Enforcement Affairs Bureau, residential Therapeutic Community (TC) treatment programs in three countries in Southeast Asia--Malaysia, Singapore, and Thailand--were examined to identify promising practices and to…

Emerging Pollutant of Concern: Occurrence of Pharmaceutical Compounds in Asia with Particular Preference to Southeast Asia Countries

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Hashim Nor Haslina

2016-01-01

Full Text Available Southeast Asia countries were developing countries, with the rapid development for a better living condition leads to longer life expectancy, which increased total population. It may result in increased the demand of pharmaceutical in domestic use and or in hospital. Although most wastewater treatment plants (WWTPs met the local authority’s regulatory requirement, there are still many pharmaceutical compound incompletely removed and discharge to the water stream and enter the environment. Recently many studies and researches have published on the occurrence and source as well as the fate of pharmaceuticals all over the world including Asia. As part of Asia region, Southeast Asia countries (Malaysia, Philippines, Singapore, Thailand, Vietnam, Brunei, Cambodia, and Lao PDR seem has lack of research knowledge and information regarding this emerging pollutant issues compared to developed Asia country as China, Korea and Hong Kong. In this paper, it will review recent studies occurrences (surface and wastewater on most common pharmaceuticals with several recommendations to overcome and thus summarise the actual situation in Southeast Asia.

Myocardial involvement in diabetic patients evaluated by exercise thallium-201 scintigraphy and cardiac catheterization

International Nuclear Information System (INIS)

Mizuno, Sumio; Genda, Akira; Nakayama, Akira; Igarashi, Yutaka; Takeda, Ryoyu

1985-01-01

To evaluate myocardial involvement in diabetes mellitus, we studied 39 patients with negative double-Master's test and without hypertension by exercise thallium-201 (Tl-201) myocardial scintigraphy using a bicycle ergometer. Among the 39 patients, 12 (30.8 %) showed filling defects in the scintigrams (positive cases), including eight with stress-induced defects and four with fixed defects. The positive cases had higher scores of diabetic complications (3.6 +- 2.4 vs 2.1 +- 1.8; p < 0.05) and longer durations of diabetes as compared with those of the negative cases. The frequency of insulin therapy was also greater in the positive cases. Eleven patients (5 positive and 6 negative cases) who underwent cardiac catheterization had no significant stenotic lesions of their coronary arteries. However, all of the positive cases showed abnormal wall motion, mainly hypokinesis, by left ventriculography (LVG). The abnormalities of the LVG corresponded to the findings of the scintigrams (i.e. filling defects and decrease in washout ratios by circumferential profile analysis). These results suggest that in some diabetics myocardial involvement exists in the early stage without overt cardiac disease and exercise Tl-201 scintigraphy is useful in detecting pre-clinical cardiomyopathy. Cardiomyopathy in diabetics seems to be due to disturbances of the myocardial microcirculation. (author)

Development and validation of a questionnaire to evaluate patient satisfaction with diabetes disease management.

Science.gov (United States)

Paddock, L E; Veloski, J; Chatterton, M L; Gevirtz, F O; Nash, D B

2000-07-01

To develop a reliable and valid questionnaire to measure patient satisfaction with diabetes disease management programs. Questions related to structure, process, and outcomes were categorized into 14 domains defining the essential elements of diabetes disease management. Health professionals confirmed the content validity. Face validity was established by a patient focus group. The questionnaire was mailed to 711 patients with diabetes who participated in a disease management program. To reduce the number of questionnaire items, a principal components analysis was performed using a varimax rotation. The Scree test was used to select significant components. To further assess reliability and validity; Cronbach's alpha and product-moment correlations were calculated for components having > or =3 items with loadings >0.50. The validated 73-item mailed satisfaction survey had a 34.1% response rate. Principal components analysis yielded 13 components with eigenvalues > 1.0. The Scree test proposed a 6-component solution (39 items), which explained 59% of the total variation. Internal consistency reliabilities computed for the first 6 components (alpha = 0.79-0.95) were acceptable. The final questionnaire, the Diabetes Management Evaluation Tool (DMET), was designed to assess patient satisfaction with diabetes disease management programs. Although more extensive testing of the questionnaire is appropriate, preliminary reliability and validity of the DMET has been demonstrated.

Psychometric evaluation of the short version of the Personal Diabetes Questionnaire to assess dietary behaviors and exercise in patients with type 2 diabetes.

Science.gov (United States)

Akohoue, Sylvie A; Wallston, Kenneth A; Schlundt, David G; Rothman, Russell L

2017-08-01

Patients with diabetes and of lower socioeconomic status have difficulty adhering to dietary recommendations. Practical and effective tools assessing self-management behaviors are needed to help evaluate interventions tailored to the needs of individual patients or population groups. This study examined the psychometric properties of a short 11-item version of the Personal Diabetes Questionnaire scale (PDQ-11) using data from the Public-Private Partnership to Improve Diabetes Education trial. Patients (n=411) with type 2 diabetes from ten safety net primary care clinics in the Mid-Cumberland Region of Tennessee completed the PDQ-11, the Summary of Diabetes Self-Care Activities (SDSCA), the Perceived Diabetes Self-Management Scale (PDSMS), and the Adherence to Refills and Medications Scale (ARMS). Statistical analyses were conducted to explore the subscale structure of the PDQ-11, and the internal consistency and validity of its subscales. Exploratory factor analysis of the PDQ-11 revealed four components (Cronbach's α=0.50 to 0.81): Eating Behavior Problems; Use of Information for Dietary Decision Making; Calorie Restriction; and Activity and Exercise. Eating Behavior Problems and Use of Information for Dietary Decision Making had the strongest associations with the diet subscales of the SDSCA and were also correlated with the PDSMS and the ARMS scores (all ps<0.001). Different PDQ-11 subscales were correlated with BMI (Calorie Restriction Activity and Exercise) and blood pressure (Eating Behavior Problems). The PDQ-11 is a useful measure of dietary behaviors in patients with type 2 diabetes; its use may help providers tailor individual nutrition intervention strategies to patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Helicobacter pylori in Diabetic and Non-Diabetic Patients with Dyspepsia

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Mohammad Hossein Hashemi

2012-05-01

Full Text Available Helicobacter pylori (H. pylori is one of the most common chronic infections in patients with gastrointestinal disorders. Recent reports suggested that H. pylori might have high prevalence among patients with diabetes. The aim of this cross-sectional study was to assess the prevalence of H. pylori infection in diabetes mellitus and to study the relationship between histological findings and H. pylori infection in diabetic patients. Eighty patients with dyspepsia that were referred to our gastrointestinal department between May 2007 and May 2008 were included in our study. We checked fasting blood sugar for all of the study samples. All of patients underwent upper endoscopy and biopsy specimens were obtained from the antrum and the corpus. The specimens for the presence of H. pylori were colored by Giemsa stains. A single pathologist evaluated the histology slides. We found that prevalence of H. pylori infection was significantly higher in diabetics than in non-diabetics (P=0.001. Indeed, the prevalence of gastritis did differ significantly between the two groups (P=0.001. According to our results diabetes mellitus is one of the risk factor that must be considered in evaluation of H. pylori infection in diabetic patients with dyspepsia.

Evaluation of cardiovascular autonomic nervous functions in diabetics: Study in a rural teaching hospital

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Ashutosh Pathak

2017-01-01

Full Text Available Introduction: Cardiovascular autonomic neuropathy (CAN is a least understood complication of diabetes which is often underdiagnosed. It causes resting tachycardia, orthostatic hypotension, and exercise intolerance and is associated with higher cardiovascular mortality in diabetic patients. This stresses the need of early diagnosis of CAN to prevent higher mortality rates. Materials and Methods: Fifty cases of diabetes mellitus with no clinical evidence of cardiac disease were subjected to cardiac autonomic function (CAF tests according to Ewing's criteria which included heart rate (HR variability during deep breathing, Valsalva maneuver ratio, HR response on standing, blood pressure (BP response to standing, and BP response to sustained handgrip to find the prevalence of CAN. Results: In this study, among 100 patients (50 case and 50 control, we found CAN in 52%. Out of which, parasympathetic neuropathy was seen in 52% of cases, and sympathetic neuropathy was seen in 26% of cases. CAF tests of HR variability during deep breathing, Valsalva maneuver ratio, HR response to standing, BP response to standing, and BP response to sustained handgrip found abnormal response in 68%, 40%, 52%, 12%, and 14%, respectively. Diabetic retinopathy and nephropathy were significantly associated with CAN (P = 0.0001, S. Conclusion: Prevalence of CAN among diabetics was 52%, and parasympathetic CAF tests are more sensitive for the detection of CAN than sympathetic CAF tests. Development of CAN in diabetic patients may lead to increased morbidity; thence, they should be routinely evaluated for CAN using these bedside tests.

Nuclear nonproliferation strategy in Asia

International Nuclear Information System (INIS)

Jenkins, F.W.

1989-07-01

The most immediate danger of a further spread of nuclear weapons in Asia is in South Asia, where both India and Pakistan have developed the means of producing nuclear explosive materials. In East Asia, North Korea appears to be in the early stages of a weapon-related nuclear program, and before the end of the century South Korea or Taiwan could revive their past efforts to move closer to a nuclear weapons capability. Over the longer run, Japan could conceivably decide to abandon its present strong opposition to the acquisition of nuclear Weapons. At present, the United States has largely separate approaches to the nuclear weapon proliferation problems in South Asia and in East Asia. This paper argues that these separate approaches should be strengthened and integrated into a broader regional nonproliferation strategy. This regional strategy would have three major strands: inducing India and Pakistan to agree not to produce nuclear weapons or test nuclear explosive devices for a specific period; bolstering the existing nonproliferation regime, principally by maintaining nonproliferation incentives and involving China more in the nonproliferation regime; and encouraging regional cooperation in peaceful uses of nuclear energy

An Evaluation of the Impact of the U.S. Rebalancing Policy on the Stability of Northeast Asia

Science.gov (United States)

2015-12-01

The Intention of the Asia Rebalancing Policy Since former U.S. Secretary of State Hillary Clinton first discussed the “pivot to Asia” in 2011, there...included emphasizing the usefulness of the Asia-Pacific Economic Cooperation (APEC), 3 Hillary Clinton , “America’s Pacific Century,” Foreign Policy 189...environment for the improvement of relations. This idea of the rebalancing policy can be noted in the article that Hillary Clinton wrote in Foreign

CORRUPTION AND FOREIGN DIRECT INVESTMENT IN EAST ASIA AND SOUTH ASIA: AN ECONOMETRIC STUDY

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Rahim M. Quazi

2014-04-01

Full Text Available Many recent FDI studies have focused on the effects of corruption on FDI inflows. Theoretically, corruption can act as either a grabbing hand by raising uncertainty and transaction costs, which should impede FDI, or a helping hand by “greasing” the wheels of commerce in the presence of weak regulatory framework, which should facilitate FDI. This study analyzes the impact of corruption on FDI inflows in East Asia and South Asia – two regions that have recently received huge FDI inflows. Using GLS methodology with 1995-2011 panel data, this study finds that the impact of corruption on FDI is significantly negative and robust, which validates the “grabbing hand” hypothesis. It is also found that, even after accounting for the economic fundamentals, East Asia seems to enjoy a locational advantage in attracting FDI vis-à-vis South Asia. These results further our knowledge of the FDI dynamics, which policymakers should find helpful in devising pro-FDI strategies.

Managing International Migration for Development in East Asia

OpenAIRE

Adams, Richard H., Jr.; Ahsan, Ahmad

2014-01-01

The objective of this book is to analyze the economic and social impact of international migration on labor sending and labor receiving countries in the East Asia region. More specifically, the book seeks: (a) to examine the impact of international migration on key development indicators, including poverty, investment, labor force participation, labor productivity and wages; (b) to evaluate ...

Perspectives on diagnostic strategies for hyperglycemia in pregnancy - Dealing with the barriers and challenges in South Asia.

Science.gov (United States)

Kapur, Anil; Divakar, Hema; Seshiah, Veeraswamy

2018-02-02

Estimates indicate that south Asia accounts for over two fifths of the global burden of hyperglycemia in pregnancy (HIP) and the ongoing nutritional and epidemiological transition may make the situation worse. Given their higher risk, all women of south Asian decent require to be tested for HIP. With approximately 37 million births annually in the region requires that 37 million women be tested annually; thereby placing a huge burden on the fragile inadequately resourced health systems in the region with poor awareness and lack of trained manpower. Recommendation for testing must therefore be pragmatic, feasible, convenient and cost effective. Diabetes in pregnancy study group India (DIPSI) has proposed a simple testing protocol that is endorsed by the Indian National Guideline on GDM, and by the FIGO guideline on HIP for use in South Asia. This testing protocol has received widespread support in the region. Despite the many challenges it is encouraging to note that in the four large countries in the region - Bangladesh, India, Pakistan and Sri Lanka which account for over 80% of the estimated burden of HIP in south Asia, large scale credible programs have been initiated to address the identified barriers. Copyright © 2018. Published by Elsevier B.V.

Therapeutic Potential of Ginsenosides as an Adjuvant Treatment for Diabetes

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Bai, Litao; Gao, Jialiang; Wei, Fan; Zhao, Jing; Wang, Danwei; Wei, Junping

2018-01-01

Ginseng, one of the oldest traditional Chinese medicinal herbs, has been used widely in China and Asia for thousands of years. Ginsenosides extracted from ginseng, which is derived from the roots and rhizomes of Panax ginseng C. A. Meyer, have been used in China as an adjuvant in the treatment of diabetes mellitus. Owing to the technical complexity of ginsenoside production, the total ginsenosides are generally extracted. Accumulating evidence has shown that ginsenosides exert antidiabetic effects. In vivo and in vitro tests revealed the potential of ginsenoside Rg1, Rg3, Rg5, Rb1, Rb2, Rb3, compound K, Rk1, Re, ginseng total saponins, malonyl ginsenosides, Rd, Rh2, F2, protopanaxadiol (PPD) and protopanaxatriol (PPT)-type saponins to treat diabetes and its complications, including type 1 diabetes mellitus, type 2 diabetes mellitus, diabetic nephropathy, diabetic cognitive dysfunction, type 2 diabetes mellitus with fatty liver disease, diabetic cerebral infarction, diabetic cardiomyopathy, and diabetic erectile dysfunction. Many effects are attributed to ginsenosides, including gluconeogenesis reduction, improvement of insulin resistance, glucose transport, insulinotropic action, islet cell protection, hepatoprotective activity, anti-inflammatory effect, myocardial protection, lipid regulation, improvement of glucose tolerance, antioxidation, improvement of erectile dysfunction, regulation of gut flora metabolism, neuroprotection, anti-angiopathy, anti-neurotoxic effects, immunosuppression, and renoprotection effect. The molecular targets of these effects mainly contains GLUTs, SGLT1, GLP-1, FoxO1, TNF-α, IL-6, caspase-3, bcl-2, MDA, SOD, STAT5-PPAR gamma pathway, PI3K/Akt pathway, AMPK-JNK pathway, NF-κB pathway, and endoplasmic reticulum stress. Rg1, Rg3, Rb1, and compound K demonstrated the most promising therapeutic prospects as potential adjuvant medicines for the treatment of diabetes. This paper highlights the underlying pharmacological mechanisms of the

The DISC (Diabetes in Social Context) Study-evaluation of a culturally sensitive social network intervention for diabetic patients in lower socioeconomic groups: a study protocol.

Science.gov (United States)

Vissenberg, Charlotte; Nierkens, Vera; Uitewaal, Paul J M; Geraci, Diana; Middelkoop, Barend J C; Nijpels, Giel; Stronks, Karien

2012-03-19

Compared to those in higher socioeconomic groups, diabetic patients in lower socioeconomic groups have less favourable metabolic control and experience more diabetes-related complications. They encounter specific barriers that hinder optimal diabetes self-management, including a lack of social support and other psychosocial mechanisms in their immediate social environments. Powerful Together with Diabetes is a culturally sensitive social network intervention specifically targeted to ethnic Dutch, Moroccan, Turkish, and Surinamese diabetic patients in lower socioeconomic groups. For ten months, patients will participate in peer support groups in which they will share experiences, support each other in maintaining healthy lifestyles, and learn skills to resist social pressure. At the same time, their significant others will also receive an intervention, aimed at maximizing support for and minimizing the negative social influences on diabetes self-management. This study aims to test the effectiveness of Powerful Together with Diabetes. We will use a quasi-experimental design with an intervention group (Group 1) and two comparison groups (Groups 2 and 3), N = 128 in each group. Group 1 will receive Powerful Together with Diabetes. Group 2 will receive Know your Sugar, a six-week group intervention that does not focus on the participants' social environments. Group 3 receives standard care only. Participants in Groups 1 and 2 will be interviewed and physically examined at baseline, 3, 10, and 16 months. We will compare their haemoglobin A1C levels with the haemoglobin A1C levels of Group 3. Main outcome measures are haemoglobin A1C, diabetes-related quality of life, diabetes self-management, health-related, and intermediate outcome measures. We will conduct a process evaluation and a qualitative study to gain more insights into the intervention fidelity, feasibility, and changes in the psychosocial mechanism in the participants' immediate social environments. With this

Evaluation of TGF beta1 expression and comparison the thickness of different aorta layers in experimental diabetes.

Science.gov (United States)

Cuce, G; Kalkan, S S; Esen, H H

2011-01-01

It was aimed to investigate the effects of experimental diabetes on TGF beta1 expression and tunica intima and media thickness in abdominal and thoracic aorta. Fourteen three months old female rats were divided into two groups, non-diabetic and streptozotocin (STZ) induced diabetic group. Hematoxylin-Eosin and Verhoeff's Van Gieson elastic staining and TGF beta1 immunohistochemistry staining were performed. Abdominal and thoracic intima and media thickness of aortas were measured with the oculometer. Evaluation of intima and media thickness measurements showed no significant statistical differences between non-diabetic and diabetic groups. TGF beta1 expression increased significantly in thoracic diabetic (TD) group. The 60 day duration of diabetes is not sufficiently enough time for the development of pathological changes that could lead to thickening in aortic intima-media layers. TGF beta1 expression was negative in the abdominal aorta that can predispose to the development of atherosclerosis, which could develop overtime. This finding may be interpreted as an appropriate basis for the development of atherosclerosis. In the thoracic aorta TGF beta1 may coordinate cellular events such as tissue repair (Fig. 5, Ref. 23).

Diabetic Nephropathy and Microalbuminuria in Pregnant Women With Type 1 and Type 2 Diabetes

DEFF Research Database (Denmark)

Damm, Julie Agner; Asbjörnsdóttir, Björg; Callesen, Nicoline Foged

2013-01-01

To evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol....

Differences in the associations of anthropometric measures with insulin resistance and type 2 diabetes mellitus between Korean and US populations: Comparisons of representative nationwide sample data.

Science.gov (United States)

Yoon, Yeong Sook; Choi, Han Seok; Kim, Jin Kuk; Kim, Yu Il; Oh, Sang Woo

Variation among ethnic groups in the association between obesity and insulin resistance (IR)/diabetes has been suggested, but studies reported inconsistent results. We evaluated ethnic differences in the association between obesity and insulin resistance (IR)/diabetes. We conducted a cross-sectional analysis using Korea (n=18,845) and the USA (n=4657) National Health and Nutrition Examination Survey(NHANES) 2007-2010. We performed statistical comparisons of AUC-ROC (area under the curve in a receiver operating characteristic curve) values for body mass index (BMI), waist circumference (WC) and homeostasis model assessment of insulin resistance (HOMA-IR) to predict IR or diabetes among different ethnic groups. AUC-ROC values for BMI and WC for predicting IR were highest in Whites (0.8324 and 0.8468) and lowest in Koreans (0.7422 and 0.7367). Whites showed the highest AUC-ROC values for BMI (0.6869) and WC (0.7421) for predicting diabetes, while the AUC-ROC for HOMA-IR was highest in Koreans (0.8861). Linear regression showed significant interactions between ethnicity and the main effects (all Pdiabetes was highest in Whites, while the ability of HOMA-IR to predict diabetes was highest in Koreans. Copyright © 2015 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

Influence of non-alcoholic fatty liver disease on the development of diabetes mellitus.

Science.gov (United States)

Kasturiratne, Anuradhani; Weerasinghe, Sanjaya; Dassanayake, Anuradha S; Rajindrajith, Shaman; de Silva, Arjuna P; Kato, Norihiro; Wickremasinghe, A Rajitha; de Silva, H Janaka

2013-01-01

Non-alcoholic fatty liver disease (NAFLD) is linked to metabolic syndrome, and is known to be associated with impaired fasting glycemia and diabetes mellitus. This prospective community-based study was conducted to determine the association between NAFLD and incidence of diabetes mellitus in an urban adult population in Sri Lanka. Participants of the Ragama Health Study cohort were assessed for NAFLD using established ultrasound criteria in 2007. Those who were free of diabetes at baseline were followed up for 3 years. Incidence rates of diabetes mellitus were compared between subjects with and without NAFLD at baseline. Out of 2984 subjects, 926 had NAFLD and 676 had diabetes in 2007. Of the 2276 subjects who were free of diabetes in 2007, 1914 were re-assessed in 2010. After 3 years, 104 out of 528 subjects with NAFLD and 138 out of 1314 subjects without NAFLD had developed diabetes mellitus de novo. Incidence rates of diabetes were respectively 64.2 and 34 per 1000 person-years of follow up for those with and without NAFLD. NAFLD was an independent predictor of developing diabetes mellitus. Other independent predictors were impaired fasting glycemia and dyslipidemia. Subjects with ultrasonically diagnosed NAFLD have an increased risk of developing diabetes mellitus. Intervention for NAFLD through lifestyle modification may prevent progression of the current diabetes epidemic. © 2012 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Evaluation of a program to improve diabetes care through intensified care management activities and diabetes medication copayment reduction.

Science.gov (United States)

Kogut, Stephen J; Johnson, Scott; Higgins, Tara; Quilliam, Brian

2012-05-01

Medication copayment reduction can be integrated with disease management programs to incentivize patient engagement in chronic care management. While disease management programs in diabetes have been evaluated across a range of settings and designs, less is known regarding the effectiveness of copayment reduction as a component of disease management. To evaluate the short-term results of a diabetes-focused disease management program that included copayment reduction, care coordination, and patient goal setting, focusing on rates of evidence-based care processes and all-cause pharmacy and health care costs. Blue Cross Blue Shield of Rhode Island offered large employer groups the opportunity to participate in a diabetes disease management initiative that featured reduced copayments (from $7/$25/$40 for generic, tier 2, and tier 3 drugs, respectively, to $0 for generic and $0-$2 for brand drugs) for diabetes-related medications. In return for the copayment reduction, participants agreed to the following: (a) participate in care coordination with a case manager, (b) have an annual physical examination, (c) have a hemoglobin A1c blood test at least twice annually, and (d) have a low-density lipoprotein cholesterol (LDL-C) test at least once annually. Patients received personalized support provided by a registered nurse and dietician, disease-related education provided by nurses, and intensified case management services, including working with a health coach to establish healthy behavioral change goals. All study subjects were aged 18 years or older and had at least 1 ICD-9-CM code for diabetes and at least 1 claim for an antidiabetic drug during a 12-month measurement period, which was each subject's most recent 12-month period of continuous enrollment from January 1, 2008, through May 31, 2010. Administrative claims data were used to determine the percentage of intervention (participating) and nonintervention (nonparticipating) subjects from among all of the plan

U.S. coal outlook in Asia

International Nuclear Information System (INIS)

Johnson, C.J.

1997-02-01

Coal exports from the US to Asia are declining over time as a result of (1) increased competition from coal suppliers within the Asia-Pacific region, (2) changing steel making technologies, (3) decreased emphasis on security of coal supplies, and (4) deregulation of the energy industry--particularly electric utilities. There are no major changes on the horizon that are likely to alter the role of the US as a modest coal supplier to the Asia-Pacific region. The downward trend in US coal exports to Asia is expected to continue over the 1997--2010 period. But economic and policy changes underway in Asia are likely to result in periodic coal shortages, lasting a few months to a year, and short term increased export opportunities for US coal. US coal exports to Asia are projected to fluctuate within the following ranges over the 2000--2010 period: 10--17 million tons in total exports, 6--12 million tons in thermal coal exports, and 4--9 million tons in coking coal exports. The most important role for US coal, from the perspective of Asian coal importing countries, is to ensure a major alternative source of coal supplies that can be turned to in the event of unforeseen disruptions in coal supplies from the Asia-Pacific region or South Africa. However, the willingness of consumers to pay a premium to ensure US export capacity is declining, with increased emphasis on obtaining the lowest cost coal supplies

Enhancing the effectiveness of diabetes self-management education: the diabetes literacy project.

Science.gov (United States)

Van den Broucke, S; Van der Zanden, G; Chang, P; Doyle, G; Levin, D; Pelikan, J; Schillinger, D; Schwarz, P; Sørensen, K; Yardley, L; Riemenschneider, H

2014-12-01

Patient empowerment through self-management education is central to improving the quality of diabetes care and preventing Type 2 Diabetes. Although national programs exist, there is no EU-wide strategy for diabetes self-management education, and patients with limited literacy face barriers to effective self-management. The Diabetes Literacy project, initiated with the support of the European Commission, aims to fill this gap. The project investigates the effectiveness of diabetes self-management education, targeting people with or at risk of Type 2 Diabetes in the 28 EU Member States, as part of a comprehensive EU-wide diabetes strategy. National diabetes strategies in the EU, US, Taiwan, and Israel are compared, and diabetes self-management programs inventorized. The costs of the diabetes care pathway are assessed on a per person basis at national level. A comparison is made of the (cost)-effectiveness of different methods for diabetes self-management support, and the moderating role of health literacy, organization of the health services, and implementation fidelity of education programs are considered. Web-based materials are developed and evaluated by randomized trials to evaluate if interactive internet delivery can enhance self-management support for people with lower levels of health literacy. The 3-year project started in December 2012. Several literature reviews have been produced and protocol development and research design are in the final stages. Primary and secondary data collection and analysis take place in 2014. The results will inform policy decisions on improving the prevention, treatment, and care for persons with diabetes across literacy levels. © Georg Thieme Verlag KG Stuttgart · New York.

ANTI-DIABETIC EFFECTS OF TURMERIC IN ALLOXAN INDUCE D DIABETIC RATS

OpenAIRE

Jeevangi; Manjunath; Deepak D; Prakash G; Prashant; Chetan

2013-01-01

ABSTRACT: OBJECTIVE AND BACKGROUND: Turmeric (Curcuma longa) is one of the common constituents of our daily food. The present study wa s undertaken to evaluate the anti-diabetic effects of ethanolic extract of Rhizomes of curcuma longa in alloxan induced diabetic rats and compared with of Pioglitazone, which is the standard anti-diabetic agent. METHODS: Alloxan monohydrate is used to induce diabetes mellitus in albino rats in the dose of 120mg/kg i.p. and ...

Central Asia's raging waters the prospects of water conflict in Central Asia

OpenAIRE

Hartman, William B.

2007-01-01

This thesis examines the prospects of conflict caused by water scarcity in Central Asia. The thesis analyzes the three most recent political eras of Central Asia, Tsarist Russia, the Soviet Union and independence, utilizing indicators of water tensions including: water quality, water quantity, the management of water for multiple uses, the political divisions and geopolitical setting, state institutions and national water ethos. Although water is not likely to be the sole cause of a majo...

Different faces of inequality across Asia: Decomposition of income gaps across demographic Groups

OpenAIRE

Hlasny, Vladimir

2017-01-01

Substantial evidence exists that economic inequality in Asia has been growing, but the dimensions of this inequality and its growth are far less clear. This paper evaluates inequality in household incomes per capita across various demographic groups in income surveys from six middle- and high-income countries across Asia: the People's Republic of China (PRC) (2002); India (2004); Japan (2008); Republic of Korea (2006); the Russian Federation (2004, 2007, and 2010); and Taipei,China (2005, 200...

Evaluating the Effect of Knowledge, Attitude, and Practice on Self-Management in Type 2 Diabetic Patients on Dialysis

Directory of Open Access Journals (Sweden)

Shima Ghannadi

2016-01-01

Full Text Available Background. Type 2 diabetes is an increasingly common condition with several preventable microvascular complications such as kidney damage. Nephropathy is expensive to manage, especially as hospital dialysis treatment. Improving patients’ knowledge, attitude, and practice (KAP toward their condition can achieve better control, delay complications, and improve their quality of life. This study evaluated the KAP and self-care behaviors of diabetic patients on dialysis and variables that affect it. Methods. This cross-sectional study was conducted at Shahid Beheshti academic hospitals of Tehran, Iran. Face-to-face interviews were held to fill five validated questionnaires: three evaluating KAP, one evaluating self-management, and one evaluating quality of life. Result. 117 diabetic patients on hemodialysis (42 females with mean (SD age of 68.70±9.26 years were enrolled in the survey. The scores for patient’s KAP, self-care, and quality of life were 59.90±11.23, 44.27±8.35, 45.06±12.87, 46.21±10.23, and 26.85±13.23, respectively. There was significant negative correlation between patients’ knowledge and attitude with their glycosylated hemoglobin level and their fasting blood sugar. There was significant correlation between patients’ knowledge and practice with their self-care activities. Conclusion. The present study suggests that patients’ KAP scores have a practical effect upon self-care behavior. This highlights the needs for effective diabetes education programs in developing countries like Iran.

Malaria successes and challenges in Asia.

Science.gov (United States)

Bhatia, Rajesh; Rastogi, Rakesh Mani; Ortega, Leonard

2013-12-01

Asia ranks second to Africa in terms of malaria burden. In 19 countries of Asia, malaria is endemic and 2.31 billion people or 62% of the total population in these countries are at risk of malaria. In 2010, WHO estimated around 34.8 million cases and 45,600 deaths due to malaria in Asia. In 2011, 2.7 million cases and > 2000 deaths were reported. India, Indonesia, Myanmar and Pakistan are responsible for >85% of the reported cases (confirmed) and deaths in Asia. In last 10 yr, due to availability of donor's fund specially from Global fund, significant progress has been made by the countries in Asia in scaling-up malaria control interventions which were instrumental in reducing malaria morbidity and mortality significantly. There is a large heterogeneity in malaria epidemiology in Asia. As a result, the success in malaria control/elimination is also diverse. As compared to the data of the year 2000, out of 19 malaria endemic countries, 12 countries were able to reduce malaria incidence (microscopically confirmed cases only) by 75%. Two countries, namely Bangladesh and Malaysia are projected to reach 75% reduction by 2015 while India is projected to reach 50-75% only by 2015. The trend could not be assessed in four countries, namely Indonesia, Myanmar, Pakistan and Timor-Leste due to insufficient consistent data. Numerous key challenges need to be addressed to sustain the gains and eliminate malaria in most parts of Asia. Some of these are to control the spread of resistance in Plasmodium falciparum to artemisinin, control of outdoor transmission, control of vivax malaria and ensuring universal coverage of key interventions. Asia has the potential to influence the malaria epidemiology all over the world as well as to support the global efforts in controlling and eliminating malaria through production of quality-assured ACTs, RDTs and long-lasting insecticidal nets.

Evaluation of a Diabetes Coach Program Aimed to Improve the Care of Children and Youth With Type 1 Diabetes and With Compromised Control.

Science.gov (United States)

Luca, Paola; Haugrud, Bodiel; Husband, Allison; Dawrant, Jonathan; Pacaud, Danièle

2018-01-31

To evaluate the impact of the Diabetes Coach Program (DCP) on glycated hemoglobin (A1C) levels in youth with type 1 diabetes. The youth were referred to and participated in the DCP between October 2011 and May 2016. The Diabetes Coach visited families in their homes every 1 to 2 weeks and updated patients' diabetes teams regularly. A1C levels before the DCP were compared with A1C levels during and after discharge from the DCP. Six participating families completed satisfaction surveys via telephone. The DCP included 23 participants (43% male; median age, 11 years; range, 8.8 to 14.5 years); median duration of type 1 diabetes, 1.7 years (range, 0.1 to 6.3 years); median time in the DCP, 1.5 years (range, 0.2 to 2.5 years). During involvement in the program, median A1C levels decreased from baselines of 11.1% (range, 8.9% to 15.3%) to 10.2% (range, 7.6% to 12.4%) (p=0.0028). For 11 of 13 patients discharged from the DCP, the most recent median A1C levels, 11.2% (range, 9.1% to 13.6%), an average of 2.4 years later, were not different from the initial A1C levels (p=0.85). Family feedback was overwhelmingly positive. Participation in the DCP decreased A1C values in pediatric patients; however, the levels were not sustained after visits stopped. Pediatric health coaches may play an important role in the management of type 1 diabetes, but further research is needed to explore their benefits and how positive effects can be sustained. Copyright © 2018 Diabetes Canada. Published by Elsevier Inc. All rights reserved.

Establishing bioinformatics research in the Asia Pacific

OpenAIRE

Ranganathan, Shoba; Tammi, Martti; Gribskov, Michael; Tan, Tin Wee

2006-01-01

Abstract In 1998, the Asia Pacific Bioinformatics Network (APBioNet), Asia's oldest bioinformatics organisation was set up to champion the advancement of bioinformatics in the Asia Pacific. By 2002, APBioNet was able to gain sufficient critical mass to initiate the first International Conference on Bioinformatics (InCoB) bringing together scientists working in the field of bioinformatics in the region. This year, the InCoB2006 Conference was organized as the 5th annual conference of the Asia-...

Japanese strategic thought toward asia

CERN Document Server

Rozman, Gilbert; Ferguson, Joseph

2007-01-01

Japanese leaders and often the media too have substituted symbols for strategy in dealing with Asia. This comprehensive review of four periods over twenty years exposes the strategic gap in viewing individually and collectively China, Taiwan, the Korean peninsula, Russia, Central Asia, and regionalism.

China, Southeast Asia, and the United States

Directory of Open Access Journals (Sweden)

Lowell Dittmer

2016-04-01

Full Text Available Southeast Asia has historically been a meeting point between East Asia and South Asia before Western colonialism opened the region to the West and to the winds of global modernization. Since Japan’s coercive decolonization during the Second World War, the dominant outside influences have come from the United States and from the People’s Republic of China. The post-Cold War era began with a withdrawal of both China’s and US power projection from Southeast Asia, facilitating the configuration of a triangular ménage à trios, with ASEAN expanding to include all of Southeast Asia and introducing a number of extended forums intended to socialize the rest of East Asia into the ASEAN way. The “rise of China” occurred within this friendly context, though beginning around 2010 its strategic implications began to appear more problematic with the mounting dispute over the issue of the South China Sea.

GFR, serum creatinine and 24-hour urine protein in evaluating renal function of patients with diabetes mellitus

International Nuclear Information System (INIS)

Chi Xiaohua; Li Guiping; Liu Feng; Wang Bing; Du Li; Deng Zhifang; Li Wei

2013-01-01

Background: Diabetes nephropathy is a common complication of diabetes mellitus patients. Early detection of renal impairment can improve the quality of life of patients. Purpose: The value of total GFR, serum creatinine, 24-hour urine protein excretion in diabetes mellitus patients with renal impairment were evaluated. Methods: A retrospective analysis of 147 patients with diabetes undergoing routine renal dynamic imaging was undertaken. The cases were divided into three groups according to the illness duration: group I of not more than five years, group 2 of five to ten years, Gr.3: more than ten years. The 22 renal transplant donors were selected as the normal control group, The total GFR, serum creatinine and 24-hour urinary protein excretion of all patients were measured before the treatments, and the data were statistically analyzed. Results: There was no significant differences in renal function between the two kidneys of in the diabetes mellitus patients (P=0.536). Serum creatinine and total GFR had significant correlation (R 2 =0.762), but no significant relationship between the 24-hour urine protein and the total GFR or serum creatinine. In the early and middle times of renal function impairment, the total GFR and serum creatinine have significant difference in different time periods (P<0.05). During the mid-late times of renal function impairment, total GFR and serum creatinine have no statistically significant differences (P value is 0.781, 0.297). 24-hour urine protein quality had no statistical differences in each stage. However: the total GFR is more sensitive than the serum creatinine in evaluation of early impairing of renal function. Conclusions: There is significant correlation between serum creatinine and total GFR. Both of them can reflect the degree of diabetic renal injury, but the total GFR is more sensitive than serum creatinine in early degree. 24-hour urine protein quantitative can not evaluate the degree of impaired renal function alone

Security of water, energy, and food nexus in the Asia-Pacific region

Science.gov (United States)

Taniguchi, M.; Endo, A.; Fujii, M.; Shoji, J.; Baba, K.; Gurdak, J. J.; Allen, D. M.; Siringan, F. P.; Delinom, R.

2014-12-01

Water, energy, and food are the most important and fundamental resources for human beings and society. Demands for these resources are escalating rapidly because of increases in populations and changes in lifestyles. Therefore intensive demand for those resources makes conflicts between resources. Securities of water, energy, and food are treated separately, however they should be considered as one integrated matter, because water-energy-food are connected and it makes nexus and tradeoff. Security in terms of self-production, diversity of alternatives, and variability are evaluated for water, energy and food for thirty two countries in the Asia-Pacific region. The water and energy nexus includes water consumption for the cooling of power plant systems, water use for hydro power generation, and energy consumption for water allocation and pumping. The water and food nexus consists of water consumption for agriculture and aquaculture. The energy and food nexus includes energy consumption for food production and biomass for energy. Analyses of 11 countries within the Asia- Pacific region show that energy consumption for fish is the largest among foods in Japan, Philippines, and Peru, while energy consumption for cereals is the largest among foods in Canada, US, Indonesia, and others. Water consumption for different types of food and energy are also analyzed, including nexus ratio to total water consumption. The water-energy-food nexus at a local level in the Asia Pacific region are examined by the Research Institute for Humanity and Nature project "Human environmental security in Asia Pacific Ring of Fire". Themes including geothermal power plants for energy development and hot springs as water, shale gas for energy development and water consumption/contamination, aquaculture for food and water contamination are used to evaluate the water-energy-food nexus in the Asia-Pacific region.

Southeast Asia and U.S. Security

National Research Council Canada - National Science Library

Byers, Michael; Clark, Jr., R. W; Sporn, James

1996-01-01

The Southeast Asia region consists of the following countries Brunei, Burma Cambodia Indonesia Laos, Malaysia Philippines, Singapore Thailand and Vietnam For the purpose of this paper, Southeast Asia...

Comparison of the clinical parameters of benign prostate hyperplasia in diabetic and non diabetic patients

Directory of Open Access Journals (Sweden)

Levent Ozcan

2017-03-01

Full Text Available Objective: We evaluated the correlation between benign prostate hyperplasia (BPH measures and diabetes mellitus in men with benign prostate hyperplasia in a prospective study. Materials and methods: Between 2008-2012, 100 diabetic and 200 non diabetic patients undergoing surgery due to benign prostate hyperplasia were enrolled in the study. The parameters evaluated for each patients included prostate volume, fasting blood glucose, HbA1c, total testosterone, total prostatic specific antigen (T-PSA, triglicerides, total cholesterol and body mass index (BMI. A questionnaire including international prostate symptom score (IPSS was sdministered and uroflow test measuring the peak urinary flow rate was performed to appreciate the complaints of the patients objectively. Results: Diabetic patients are more likely to have larger prostate volume. The symptom score evaluated by IPSS and post micturition residual volume were also significantly higher in diabetic groups. The other statistically significant different parameter between two groups was total testosterone that diabetic patients tend to have lower levels. Diabetic counterparts were established to have higher BMI. No statistically significant differentiation was observed about trigliceryde and total cholesterol levels and uroflow rates. Conclusions: Our study suggests a positive correlation between high prostate volume and diagnosis of diabetes mellitus in patients with benign prostatic hyperplasia. We also observed a positive correlation between symptom scores and post micturion residual volumes and diagnosis of diabetes mellitus suggesting that the presence of diabetes is related to both static and dynamic components of benign prostate hyperplasia. Additionally testosterone levels were lower in diabetic patients. Further studies need to confirm these relationship in a larger population.

Financial Shenanigans : Evidence from Developing Countries In East Asia and South Asia

OpenAIRE

Leong, Siew Yean

2014-01-01

This study investigates the reported cases involved in financial shenanigans which subject to the enforcement actions by the authorities of selected developing countries in East Asia and South Asia between 2010 and 2012. The scope of this study includes the attempts used and causes of the financial shenanigans. This study finds that the most common attempt used by the sample companies is overstating the revenue and follows by manipulation of expenses and discretionary accounting. Revenue and ...

Future Heat Waves In Asia

Science.gov (United States)

Eltahir, E. A. B.

2017-12-01

I will review recent work from my group on the impact of climate change on the intensity and frequency of heat waves in Asia. Our studies covered Southwest Asia, South Asia, East China, and the Maritime continent. In any of these regions, the risk associated with climate change impact reflects intensity of natural hazard and level of human vulnerability. Previous work has shown that the wet-bulb temperature is a useful variable to consider in describing the natural hazard from heat waves since it can be easily compared to the natural threshold that defines the upper limit on human survivability. Based on an ensemble of high resolution climate change simulations, we project extremes of wet-bulb temperature conditions in each of these four regions of Asia. We consider the business-as-usual scenario of future greenhouse gas emissions, as well as a moderate mitigation scenario. The results from these regions will be compared and lessons learned summarized.

NASA's East and Southeast Asia Initiatives: BASE-ASIA and EAST-AIRE

Science.gov (United States)

Tsay, S.; Maring, H.

2005-01-01

Airborne dust from northern China influences air quality and regional climate in Asia during springtime. However, with the economic growth in China, increased emission of particulate air pollutants from industrial and vehicular sources will not only impact the earth's radiation balance, but also adversely affect human health year round. In addition, both of dust and aerosol pollutants can be transported swiftly across the Pacific affecting North America within a few days. Asian dust and pollutant aerosols can be detected by their colored appearance using current Earth observing satellites (e.g., MODIS, SeaWiFS, TOMS, etc.) and by sunphotometers deployed on the surface of the earth. Biomass burning has been a regular practice for land clearing and conversion in many countries, especially those in Africa, South America, and Southeast Asia. However, the climatology of Southeast Asia is very different than that of Africa and South America, such that large-scale biomass burning causes smoke to interact extensively with clouds during the peak-burning season of March to April. Globally significant sources of greenhouse gases (eg., CO2, CH4), chemically active gases (e.g., NO, CO, HC, CH3Br), and atmospheric aerosols are produced by biomass burning. These gases influence the Earth-atmosphere system, impacting both global climate and tropospheric chemistry. Some aerosols can serve as cloud condensation nuclei, which play a role in determining cloud lifetime and precipitation, altering the earth's radiation and water budgets. Biomass burning also affects the biogeochemical cycling of nitrogen and carbon compounds; the hydrological cycle; land surface reflectivity and emissivity; and ecosystem biodiversity and stability. Two NASA initiatives, EAST-AIRE (East Asian Study of Tropospheric Aerosols: an International Regional Experiment) and BASE-ASIA (Biomass-burning Aerosols in South East-Asia: Smoke Impact Assessment) will be presented. The objectives of these initiatives is to

Evaluation of a target region capture sequencing platform using monogenic diabetes as a study-model

DEFF Research Database (Denmark)

Gao, Rui; Liu, Yanxia; Gjesing, Anette Marianne Prior

2014-01-01

Monogenic diabetes is a genetic disease often caused by mutations in genes involved in beta-cell function. Correct sub-categorization of the disease is a prerequisite for appropriate treatment and genetic counseling. Target-region capture sequencing is a combination of genomic region enrichment...... and next generation sequencing which might be used as an efficient way to diagnose various genetic disorders. We aimed to develop a target-region capture sequencing platform to screen 117 selected candidate genes involved in metabolism for mutations and to evaluate its performance using monogenic diabetes...

Swedish pediatric diabetes teams' perception of fathers' involvement: A Grounded Theory study.

Science.gov (United States)

Boman, Ase; Povlsen, Lene; Dahlborg-Lyckhage, Elisabeth; Borup, Ina

2013-06-01

The purpose of this study was to analyze how Swedish pediatric diabetes teams perceived and discussed fathers' involvement in the care of their child with type 1 diabetes. It also aimed to discuss how the teams' attitudes towards the fathers' involvement developed during the data collection process. The Constructivist Grounded Theory design was used and data were collected during three repeated focus group discussions with three Swedish pediatric diabetes teams. The core category of the teams' perception of fathers' involvement emerged as: If dad attends, we are happy - if mom doesn't, we become concerned. Initially the teams balanced their perception of fathers' involvement on the mother's role as the primary caregiver. In connection with the teams' directed attention on fathers, in the focus group discussions, the teams' awareness of the importance of fathers increased. As a consequence, the team members began to encourage fathers' engagement in their child's care. We conclude that by increasing the teams' awareness of fathers as a health resource, an active health promotion perspective could be implemented in pediatric diabetes care. © 2012 Wiley Publishing Asia Pty Ltd.

JPRS Report: East Asia, Southeast Asia, LPDR Criminal Code, Courts, and Criminal Procedure.

Science.gov (United States)

1991-03-05

1941 - 1991 JPRS Repor East Asia Southeast Asia LPDR Criminal Code, Courts, and Criminal Procedure mom m £C QUALITY »ra^r...prostitution, will be impris- oned for three to five years. Article 124. Incest . Anyone who has sexual intercourse with parents, step- parents...This consists of facts which indicate whether there have been actions dangerous to society, the guilt of the per- sons who undertook the

Regional and ethnic differences among patients with heart failure in Asia: the Asian sudden cardiac death in heart failure registry.

Science.gov (United States)

Lam, Carolyn S P; Teng, Tiew-Hwa Katherine; Tay, Wan Ting; Anand, Inder; Zhang, Shu; Shimizu, Wataru; Narasimhan, Calambur; Park, Sang Weon; Yu, Cheuk-Man; Ngarmukos, Tachapong; Omar, Razali; Reyes, Eugene B; Siswanto, Bambang B; Hung, Chung-Lieh; Ling, Lieng H; Yap, Jonathan; MacDonald, Michael; Richards, A Mark

2016-11-01

To characterize regional and ethnic differences in heart failure (HF) across Asia. We prospectively studied 5276 patients with stable HF and reduced ejection fraction (≤40%) from 11 Asian regions (China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Philippines, Singapore, Taiwan, and Thailand). Mean age was 59.6 ± 13.1 years, 78.2% were men, and mean body mass index was 24.9 ± 5.1 kg/m 2 . Majority (64%) of patients had two or more comorbid conditions such as hypertension (51.9%), coronary artery disease (CAD, 50.2%), or diabetes (40.4%). The prevalence of CAD was highest in Southeast Asians (58.8 vs. 38.2% in Northeast Asians). Compared with Chinese ethnicity, Malays (adjusted odds ratio [OR] 1.97, 95% CI 1.63-2.38) and Indians (OR 1.44, 95% CI 1.24-1.68) had higher odds of CAD, whereas Koreans (OR 0.38, 95% CI 0.29-0.50) and Japanese (OR 0.44, 95% CI 0.36-0.55) had lower odds. The prevalence of hypertension and diabetes was highest in Southeast Asians (64.2 and 49.3%, respectively) and high-income regions (59.7 and 46.2%, respectively). There was significant interaction between ethnicity and region, where the adjusted odds were 3.95 (95% CI 2.51-6.21) for hypertension and 4.91 (95% CI 3.07-7.87) for diabetes among Indians from high- vs. low-income regions; and 2.60 (95% CI 1.66-4.06) for hypertension and 2.62 (95% CI 1.73-3.97) for diabetes among Malays from high- vs. low-income regions. These first prospective multi-national data from Asia highlight the significant heterogeneity among Asian patients with stable HF, and the important influence of both ethnicity and regional income level on patient characteristics. NCT01633398. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Role of Clinical Neuropsychologists in the Evaluation and Management of Diabetes Mellitus in Ghana: A Position Statement

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Jacob Owusu Sarfo

2014-10-01

Full Text Available Ghana’s Ministry of Health is gradually improving the state of mental health among patients with biomedical conditions. Nonetheless, many recent studies have showed that some chronic medical conditions present cognitive deficits that need specialist evaluation and care. The aim of this paper is to provide a summary analysis regarding the current need for neuropsychologists in Ghana’s diabetes care. The rationale is to move for a paradigm shift with regards to the current state of diabetes care in Ghana. Thus, it advocates for policy reform in the management of DM and the inclusion of neuropsychologists among Ghana’s existing structure for diabetes care.

The DISC (Diabetes in Social Context Study-evaluation of a culturally sensitive social network intervention for diabetic patients in lower socioeconomic groups: a study protocol

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Vissenberg Charlotte

2012-03-01

Full Text Available Abstract Background Compared to those in higher socioeconomic groups, diabetic patients in lower socioeconomic groups have less favourable metabolic control and experience more diabetes-related complications. They encounter specific barriers that hinder optimal diabetes self-management, including a lack of social support and other psychosocial mechanisms in their immediate social environments. Powerful Together with Diabetes is a culturally sensitive social network intervention specifically targeted to ethnic Dutch, Moroccan, Turkish, and Surinamese diabetic patients in lower socioeconomic groups. For ten months, patients will participate in peer support groups in which they will share experiences, support each other in maintaining healthy lifestyles, and learn skills to resist social pressure. At the same time, their significant others will also receive an intervention, aimed at maximizing support for and minimizing the negative social influences on diabetes self-management. This study aims to test the effectiveness of Powerful Together with Diabetes. Methods/Design We will use a quasi-experimental design with an intervention group (Group 1 and two comparison groups (Groups 2 and 3, N = 128 in each group. Group 1 will receive Powerful Together with Diabetes. Group 2 will receive Know your Sugar, a six-week group intervention that does not focus on the participants' social environments. Group 3 receives standard care only. Participants in Groups 1 and 2 will be interviewed and physically examined at baseline, 3, 10, and 16 months. We will compare their haemoglobin A1C levels with the haemoglobin A1C levels of Group 3. Main outcome measures are haemoglobin A1C, diabetes-related quality of life, diabetes self-management, health-related, and intermediate outcome measures. We will conduct a process evaluation and a qualitative study to gain more insights into the intervention fidelity, feasibility, and changes in the psychosocial mechanism in the

Diabetes knowledge among Greek Type 2 Diabetes Mellitus patients.

Science.gov (United States)

Poulimeneas, Dimitrios; Grammatikopoulou, Maria G; Bougioukli, Vasiliki; Iosifidou, Parthena; Vasiloglou, Maria F; Gerama, Maria-Assimina; Mitsos, Dimitrios; Chrysanthakopoulou, Ioanna; Tsigga, Maria; Kazakos, Kyriakos

2016-01-01

Diabetes knowledge has been shown to improve glycemic control and associate with several demographic parameters. In Greece, a country with high obesity rates, disease knowledge has never been evaluated in diabetic patients. This cross sectional study aimed to assess diabetes knowledge and its associations between social and demographic parameters, among Greek type 2 diabetes mellitus (T2DM) patients. One hundred fifty nine patients with T2DM were recruited from an urban and a rural clinic in Greece. Diabetes knowledge was assessed with the Brief Diabetes Knowledge Test (DKT). Basic anthropometry was performed. Data regarding glycemic control and sociodemographic characteristics were collected from the patients' medical files. Greek T2DM patients demonstrated poor disease knowledge (mean DKT score 8.3±2.2/14.0 and mean DKT as a percent of correct answers 59.6±15.8%). No differences were observed between sex, place of residence, or glycemic control, among subjects. Patients with higher education demonstrated greater diabetes knowledge. Simple obesity with concurrent central obesity or suboptimal glycemic control decreased diabetes knowledge among participants. Additionally, waist circumference was inversely correlated to diabetes knowledge. Based on the DKT, Greek patients exhibit poor diabetes knowledge. This study provides evidence for the need for better diabetes education in order to ameliorate disease outcome. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Evaluation of VIIRS, GOCI, and MODIS Collection 6 AOD retrievals against ground sunphotometer observations over East Asia

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Q. Xiao

2016-02-01

Full Text Available Persistent high aerosol loadings together with extremely high population densities have raised serious air quality and public health concerns in many urban centers in East Asia. However, ground-based air quality monitoring is relatively limited in this area. Recently, satellite-retrieved Aerosol Optical Depth (AOD at high resolution has become a powerful tool to characterize aerosol patterns in space and time. Using ground AOD observations from the Aerosol Robotic Network (AERONET and the Distributed Regional Aerosol Gridded Observation Networks (DRAGON-Asia Campaign, as well as from handheld sunphotometers, we evaluated emerging aerosol products from the Visible Infrared Imaging Radiometer Suite (VIIRS aboard the Suomi National Polar-orbiting Partnership (S-NPP, the Geostationary Ocean Color Imager (GOCI aboard the Communication, Ocean, and Meteorology Satellite (COMS, and Terra and Aqua Moderate Resolution Imaging Spectroradiometer (MODIS (Collection 6 in East Asia in 2012 and 2013. In the case study in Beijing, when compared with AOD observations from handheld sunphotometers, 51 % of VIIRS Environmental Data Record (EDR AOD, 37 % of GOCI AOD, 33 % of VIIRS Intermediate Product (IP AOD, 26 % of Terra MODIS C6 3 km AOD, and 16 % of Aqua MODIS C6 3 km AOD fell within the reference expected error (EE envelope (±0.05 ± 0.15 AOD. Comparing against AERONET AOD over the Japan–South Korea region, 64 % of EDR, 37 % of IP, 61 % of GOCI, 39 % of Terra MODIS, and 56 % of Aqua MODIS C6 3 km AOD fell within the EE. In general, satellite aerosol products performed better in tracking the day-to-day variability than tracking the spatial variability at high resolutions. The VIIRS EDR and GOCI products provided the most accurate AOD retrievals, while VIIRS IP and MODIS C6 3 km products had positive biases.

A new order in northeast Asia

International Nuclear Information System (INIS)

Segal, G.

1991-01-01

The fate of northeast Asia is central to the global balance of power. But just as the Cold War took a different course in northeast Asia than it did in its central battleground in Europe, so the post-Cold War world in northeast Asia is taking on a different shape. In Europe, formal arms control was a feature of the political landscape both before and after sweeping changes began altering the face of the continent in 1989. In contrast, northeast Asia saw only informal arms control measures before 1989. But in the post-Cold War world, the opportunity for more formal accords seems to be growing as the changing political environment makes them possible. In the rapidly developing virtuous circle of detente in northeast Asia, the prospects for arms control progress are better than ever, although considerable obstacles remain in the way. One of the unique features of northeast Asia is the convergence of interests of four of the world's most powerful nations - the US, the Soviet Union, Japan, and China. But unlike Europe, where the interests of the Soviet Union and the US have intermingled with those of the diverse members of the European Community (EC) and resulted in far-reaching arms reduction and confidence-building accords, northeast Asia has known only limited regional efforts at reducing tension and enhancing regional security. Nevertheless, unilateral moves and bilateral discussions among the four powers have produced a Sino-Soviet detente, reductions in US and Soviet forces in the Pacific region, the beginning of a Soviet-Japanese dialogue aimed at normalizing relations, and an overall trend toward closer diplomatic and economic relations throughout the region

Evaluation of the effectiveness of diabetic nephropathy stage III in patients with type 2 diabetes mellitus therapy with sulodexide

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V. G. Kadzharyan

2013-08-01

Full Text Available Introduction. Diabetes mellitus (DM - takes the main place in the structure of endocrine diseases, and the third after cardiovascular and cancer pathology. In Ukraine 1.2 million of people suffer from diabetes and type 2 diabetes occurs in 85-90% of them. In 2004, 3.4 million of people died from diabetes complications. Diabetic nephropathy (DN is a serious chronic complication of diabetes that leads to the formation of nodular or diffuse glomerulosclerosis. It is the most frequent cause of terminal chronic renal failure (CRF in the world, accounting for over 25% of all cases of CRF. The generally accepted classification is Moggensen`s classification (1983, WHO, according to which five stages of diabetic nephropathy are identified, the first two stages of them are preclinical. Leading role in the pathogenesis of DN takes hyperglycemia, which is implemented by the phenomenon of glucosetoxicity. A lot of facts underscore the importance of inflammatory mechanisms triggered by cytokines. There's immune and non-immune theory of DN. The basis of non-immune theory is a violation of the synthesis of glycosaminoglycans (GAGs that are a major component of the glomerular basement membrane (GMB. GAGs create its negative charge, which prevents the passage through the renal filter small negatively charged molecules, including albumin. In hemodynamic regulation leading role belongs to the renin-angiotensin-aldosterone system (RAAS. The blockade of the RAAS system with ACE inhibitors is the basis of a treatment strategy of DN. All mentioned above became a reason for study of the possibility of a new direction in the treatment of DN using the drug sulodexid, which is a natural mixture of GAGs. Objective of the research. Evaluating the effectiveness of sulodexide therapy of DN stage III in patients with type 2 diabetes. Materials and methods. The patients were divided into 2 groups. Group I consisted of 24 patients aged 40 to 68 years. 5 of them were women and 19

Home-Based Diabetes Symptom Self-Management Education for Mexican Americans with Type 2 Diabetes

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García, Alexandra A.; Brown, Sharon A.; Horner, Sharon D.; Zuñiga, Julie; Arheart, Kristopher L.

2015-01-01

This pilot study evaluated an innovative diabetes symptom awareness and self-management educational program for Mexican Americans, a fast growing minority population experiencing a diabetes epidemic. Patients with diabetes need assistance interpreting and managing symptoms, which are often annoying and potentially life-threatening. A repeated…

Göttingen minipig model of diet-induced atherosclerosis: influence of mild streptozotocin-induced diabetes on lesion severity and markers of inflammation evaluated in obese, obese and diabetic, and lean control animals

DEFF Research Database (Denmark)

Ludvigsen, Trine Pagh; Kirk, Rikke Kaae; Christoffersen, Berit Østergaard

2015-01-01

in human patients, inclusion of this disease aspect in the characterization of a such model, is highly relevant. The objective of this study was to evaluate the effect of mild streptozotocin-induced diabetes on ex- and in vivo end-points in a diet-induced atherosclerotic minipig model. Castrated male...... Göttingen minipigs were fed standard chow (CD), atherogenic diet alone (HFD) or with superimposed mild streptozotocin-induced diabetes (HFD-D). Circulating markers of inflammation (C-reactive protein (CRP), oxidized low-density lipoprotein (oxLDL), plasminogen activator inhibitor-1, lipid and glucose......From a pharmacological perspective, readily-available, well-characterized animal models of cardiovascular disease, including relevant in vivo markers of atherosclerosis are important for evaluation of novel drug candidates. Furthermore, considering the impact of diabetes mellitus on atherosclerosis...

High-Resolution Near Real-Time Drought Monitoring in South Asia

Science.gov (United States)

Aadhar, S.; Mishra, V.

2017-12-01

Drought in South Asia affect food and water security and pose challenges for millions of people. For policy-making, planning and management of water resources at the sub-basin or administrative levels, high-resolution datasets of precipitation and air temperature are required in near-real time. Here we develop a high resolution (0.05 degree) bias-corrected precipitation and temperature data that can be used to monitor near real-time drought conditions over South Asia. Moreover, the dataset can be used to monitor climatic extremes (heat waves, cold waves, dry and wet anomalies) in South Asia. A distribution mapping method was applied to correct bias in precipitation and air temperature (maximum and minimum), which performed well compared to the other bias correction method based on linear scaling. Bias-corrected precipitation and temperature data were used to estimate Standardized precipitation index (SPI) and Standardized Precipitation Evapotranspiration Index (SPEI) to assess the historical and current drought conditions in South Asia. We evaluated drought severity and extent against the satellite-based Normalized Difference Vegetation Index (NDVI) anomalies and satellite-driven Drought Severity Index (DSI) at 0.05˚. We find that the bias-corrected high-resolution data can effectively capture observed drought conditions as shown by the satellite-based drought estimates. High resolution near real-time dataset can provide valuable information for decision-making at district and sub- basin levels.

PCDD/F measurement at a high-altitude station in Central Taiwan: evaluation of long-range transport of PCDD/Fs during the Southeast Asia biomass burning event.

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Chi, Kai Hsien; Lin, Chuan-Yao; Yang, Chang-Feng Ou; Wang, Jia-Lin; Lin, Neng-Heui; Sheu, Guey-Rong; Lee, Chung-Te

2010-04-15

Recent biomass burning in Southeast Asia has raised global concerns over its adverse effects on visibility, human health, and global climate. The concentrations of total suspended particles (TSPs) and other vapor-phase pollutants (CO and ozone) were monitored at Lulin, an atmospheric background station in central Taiwan in 2008. To evaluate the long-range transport of persistent organic pollutants (POPs) during the Southeast Asia biomass burning event, the atmospheric polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) were also measured at Lulin station. The atmospheric PCDD/F and TSP concentrations measured at Lulin station ranged from 0.71-3.41 fg I-TEQ/m(3) and 5.32-55.6 microg/m(3), respectively, during the regular sampling periods. However, significantly higher concentrations of PCDD/Fs, TSPs, CO, and ozone were measured during the spring season. These high concentrations could be the result of long-range transport of the products of Southeast Asia biomass burning. During the Southeast Asia biomass burning event (March 18-24, 2008), an intensive observation program was also carried out at the same station. The results of this observation program indicated that the atmospheric PCDD/F concentration increased dramatically from 2.33 to 390 fg I-TEQ/m(3) (March 19, 2008). The trace gas (CO) of biomass burning also significantly increased to 232 ppb during the same period, while the particle-bound PCDD/Fs in the TSP increased from 28.7 to 109 pg I-TEQ/g-TSP at Lulin station during the burning event. We conclude that there was a significant increase in the PCDD/F concentration in ambient air at a high-altitude background station in central Taiwan during the Southeast Asia biomass burning event.

Pharmacological Evaluation of Chrozophora tinctoria as Wound Healing Potential in Diabetic Rat’s Model

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Harikesh Maurya

2016-01-01

Full Text Available Objective. The study was designed to evaluate pharmacological potential of hydroalcoholic leaves extract of Chrozophora tinctoria intended for wound healing in diabetic rats’ model. Methods. The method used to evaluate the pharmacological potential of hydroalcoholic leave extract was physical incision rat model. In this model, cutting of the skin and/or other tissues with a sharp blade has been made and the rapid disruption of tissue integrity with minimal collateral damage was observed shortly. Animals used in the study were divided into four groups that consist of six animals in each group. Group I serves as normal control, Group II serves as disease control, Group III was used as standard treatment (Povidone iodine 50 mg/kg b.w., and Group IV was used for test drug (C. tinctoria 50 mg/kg b.w.. Result. The hydroalcoholic leave extract of Chrozophora tinctoria has been significantly observed to heal the wound (98% in diabetic rats within 21 days, while standard drug (Povidone iodine healed the wound about 95% in the same condition. The oral dose (50 mg/kg b.w. of Chrozophora tinctoria was also found to improve the elevated blood glucose level in comparison to disease control group, which increased after the oral administration of Streptozotocin. Conclusion. The Chrozophora tinctoria has significant wound healing potential in the animal having physically damaged tissue in diabetic condition.

Glomerular size- and charge selectivity in type 2 (non-insulin-dependent) diabetic patients with diabetic nephropathy

DEFF Research Database (Denmark)

Gall, M A; Rossing, P; Kofoed-Enevoldsen, A

1994-01-01

In an attempt to evaluate the mechanisms of proteinuria in diabetic kidney disease, we measured the renal clearances of albumin, total IgG, and IgG4 in 20 male Type 2 (non-insulin-dependent) diabetic patients with diabetic glomerulosclerosis (biopsy proven), in 10 male Type 2 diabetic patients...

Estimates of biomass burning emissions in tropical Asia based on satellite-derived data

OpenAIRE

D. Chang; Y. Song

2009-01-01

Biomass burning in tropical Asia emits large amounts of trace gases and particulate matter into the atmosphere, which has significant implications for atmospheric chemistry and climatic change. In this study, emissions from open biomass burning over tropical Asia were evaluated during seven fire years from 2000 to 2006 (1 March 2000–31 February 2007). The size of the burned areas was estimated from newly published 1-km L3JRC and 500-m MODIS burned area products (MCD45A1). Available fuel loads...

Asia

OpenAIRE

Lindsay, Richard

2014-01-01

This document explores some of the examples of peatland restoration under different circumstances around the World in order to present an overview of the variety of benefits and inspiring ways in which peatland restoration can be delivered, and so avoid serious and costly consequences for society. Richard Lindsay wrote the Asia and Americas sections of this edited publication.

Inpatient treatment of diabetic patients in Asia: evidence from India, China, Thailand and Malaysia.

Science.gov (United States)

Goldhaber-Fiebert, J D; Li, H; Ratanawijitrasin, S; Vidyasagar, S; Wang, X Y; Aljunid, S; Shah, N; Wang, Z; Hirunrassamee, S; Bairy, K L; Wang, J; Saperi, S; Nur, A M; Eggleston, K

2010-01-01

The prevalence of Type 2 diabetes mellitus (DM) has grown rapidly, but little is known about the drivers of inpatient spending in low- and middle-income countries. This study aims to compare the clinical presentation and expenditure on hospital admission for inpatients with a primary diagnosis of Type 2 DM in India, China, Thailand and Malaysia. We analysed data on adult, Type 2 DM patients admitted between 2005 and 2008 to five tertiary hospitals in the four countries, reporting expenditures relative to income per capita in 2007. Hospital admission spending for diabetic inpatients with no complications ranged from 11 to 75% of per-capita income. Spending for patients with complications ranged from 6% to over 300% more than spending for patients without complications treated at the same hospital. Glycated haemoglobin was significantly higher for the uninsured patients, compared with insured patients, in India (8.6 vs. 8.1%), Hangzhou, China (9.0 vs. 8.1%), and Shandong, China (10.9 vs. 9.9%). When the hospital admission expenditures of the insured and uninsured patients were statistically different in India and China, the uninsured always spent less than the insured patients. With the rising prevalence of DM, households and health systems in these countries will face greater economic burdens. The returns to investment in preventing diabetic complications appear substantial. Countries with large out-of-pocket financing burdens such as India and China are associated with the widest gaps in resource use between insured and uninsured patients. This probably reflects both overuse by the insured and underuse by the uninsured.

Pleistocene Palaeoart of Asia

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Robert G. Bednarik

2013-06-01

Full Text Available This comprehensive overview considers the currently known Pleistocene palaeoart of Asia on a common basis, which suggests that the available data are entirely inadequate to form any cohesive synthesis about this corpus. In comparison to the attention lavished on the corresponding record available from Eurasia’s small western appendage, Europe, it is evident that Pleistocene palaeoart from the rest of the world has been severely neglected. Southern Asia, in particular, holds great promise for the study of early cognitive development of hominins, and yet this potential has remained almost entirely unexplored. Asia is suggested to be the key continent in any global synthesis of ‘art’ origins, emphasising the need for a comprehensive pan-continental research program. This is not just to counter-balance the incredible imbalance in favour of Europe, but to examine the topic of Middle Pleistocene palaeoart development effectively.

SECURITY THREATS IN CENTRAL ASIA

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Çağla Gül Yesevi

2013-07-01

Full Text Available This study will analyze main security threats in Central Asia. It is obvious thatsince the end of Cold War, there have been many security threats in Central Asiaas internal weakness of Central Asian states, terrorism, transnational crime,economic insecurity, environmental issues, drug trafficking, ethnic violence,regional instability. This study will propose thatwith increasing interdependence,states need each other to solve these global security problems. In that sense,regional and sub-regional cooperation between Central Asian states and with otherregional actors has been witnessed. It is clear that the withdrawal of NATO fromAfghanistan will destabilize Central Asia. This study will investigate overallsecurity situation in Central Asia and affects andcontributions of regionalorganizations to Eurasian security

Diabetes Distress Among Persons With Type 1 Diabetes.

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Powers, Margaret A; Richter, Sara A; Ackard, Diann M; Craft, Cheryl

2017-02-01

Purpose The purpose of this study is to evaluate associations between diabetes distress and a range of psychological health behaviors and concerns among persons with type 1 diabetes for the benefit of enhancing early identification and intervention of at-risk individuals. Methods Persons with type 1 diabetes (n = 268; 57.1% female, 91.0% white, 76.8% satisfaction with life, self-esteem, self-efficacy, depression, perfectionism, body image satisfaction, dietary restraint and eating, and shape and weight concerns. Each subscale score was compared within age groups (depression scores and eating, and shape and weight concerns than those with low or moderate distress. For patients satisfaction with life, self-esteem, and self-efficacy and higher on dietary restraint and several areas of perfectionism than those with low or moderate distress. Conclusions Individuals with type 1 diabetes who have high diabetes distress also report higher A1C values and poorer psychological health concerns. A brief diabetes distress questionnaire can help to identify those who need additional screening, education and support, and treatment for overall health and well-being.

Cardiovascular disease risk factor profiles of 263,356 older Australians according to region of birth and acculturation, with a focus on migrants born in Asia.

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Shuyu Guo

Full Text Available Risk factors for cardiovascular disease (CVD, such as obesity, diabetes, hypertension and physical inactivity, are common in Australia, but the prevalence varies according to cultural background. We examined the relationship between region of birth, measures of acculturation, and CVD risk profiles in immigrant, compared to Australian-born, older Australians. Cross-sectional data from 263,356 participants aged 45 and over joining the population-based 45 and Up Study cohort from 2006-2008 were used. Prevalence ratios for CVD risk factors in Australian- versus overseas-born participants were calculated using modified Poisson regression, adjusting for age, sex and socioeconomic factors and focusing on Asian migrants. The association between time resident in Australia and age at migration and CVD risk factors in Asian migrants was also examined. Migrants from Northeast (n = 3,213 and Southeast Asia (n = 3,942 had lower levels of overweight/obesity, physical activity and female smoking than Australian-born participants (n = 199,356, although differences in prevalence of overweight/obesity were sensitive to body-mass-index cut-offs used. Compared to Australian-born participants, migrants from Northeast Asia were 20-30% less likely, and from Southeast Asia 10-20% more likely, to report being treated for hypertension and/or hypercholesterolaemia; Southeast Asian migrants were 40-60% more likely to report diabetes. Northeast Asian-born individuals were less likely than Australian-born to have 3 or more CVD risk factors. Diabetes, treated hypertension and hypercholesterolaemia occurred at relatively low average body-mass-index in Southeast Asian migrants. The CVD risk factor profiles of migrants tended to approximate those of Australian-born with increasing acculturation, in both favourable (e.g., increased physical activity and unfavourable directions (e.g., increased female smoking. Minimizing CVD risk in migrant populations may be achieved through

How are qualitative methods used in diabetes research? A 30-year systematic review.

Science.gov (United States)

Hennink, Monique M; Kaiser, Bonnie N; Sekar, Swathi; Griswold, Emily P; Ali, Mohammed K

2017-02-01

We aimed to describe how qualitative methods are used in global research on diabetes and identify opportunities whereby qualitative methods could further benefit our understanding of the human experience of diabetes and interventions to address it. We conducted a systematic review of National Library of Medicine, EMBASE, and Web of Science electronic databases to identify original research articles that used qualitative methods to study diabetes between 1980 and 2011. We identified 554 eligible articles and categorised these by geographic region, year of publication, study population, study design, research question, qualitative data collection methods, and journal type. Results show low use of qualitative methods in diabetes research over the past 30 years. The majority of articles (75%) reported using substantive qualitative research, while mixed-methods research has remained underutilised. Eighty-five per cent of articles reported studies conducted in North America or Europe, with few studies in developing countries. Most articles reported recruiting clinic-based populations (58%). Over half (54%) of research questions focused on patient experience and 24% on diabetes management. Qualitative methods can provide important insights about socio-cultural aspects of disease to improve disease management. However, they remain underutilised for understanding the diabetes experience, especially in Africa and Asia and amongst non-clinic populations.

Pregnancy-induced increase in circulating IGF-I is associated with progression of diabetic retinopathy in women with type 1 diabetes

DEFF Research Database (Denmark)

Nielsen, Lene Ringholm; Vestgaard, Marianne; Laugesen, Caroline S

2011-01-01

To evaluate the influence of Insulin-like Growth factor-I (IGF-I) and Placental Growth Hormone (GH) on progression of diabetic retinopathy during pregnancy in women with type 1 diabetes.......To evaluate the influence of Insulin-like Growth factor-I (IGF-I) and Placental Growth Hormone (GH) on progression of diabetic retinopathy during pregnancy in women with type 1 diabetes....

Closing the gap in Asia

International Nuclear Information System (INIS)

Meade, W.; Bailly, H.C.

1991-01-01

This article examines the market for independent power plants in Asia and the financing available for these projects. The topics of the article include making room for non-utility generation; the markets in India, Indonesia, Pakistan, the Philippines, Thailand; third-party ownership, 1989 installed capacity, capacity additions 1989-1990, and the outlook for the market in Asia

South Asia | Page 30 | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

Read more about Trauma, Development and Peacebuilding : Toward an Integrated Psychological Approach. Language English. Read more about Information Society Innovation Fund Asia. Language English. Read more about Information Society Innovation Fund Asia (ISIF Asia). Language French. Read more about Liens ...

Hospital Guidelines for Diabetes Management and the Joint Commission-American Diabetes Association Inpatient Diabetes Certification.

Science.gov (United States)

Arnold, Pamela; Scheurer, Danielle; Dake, Andrew W; Hedgpeth, Angela; Hutto, Amy; Colquitt, Caroline; Hermayer, Kathie L

2016-04-01

The Joint Commission Advanced Inpatient Diabetes Certification Program is founded on the American Diabetes Association's Clinical Practice Recommendations and is linked to the Joint Commission Standards. Diabetes currently affects 29.1 million people in the USA and another 86 million Americans are estimated to have pre-diabetes. On a daily basis at the Medical University of South Carolina (MUSC) Medical Center, there are approximately 130-150 inpatients with a diagnosis of diabetes. The program encompasses all service lines at MUSC. Some important features of the program include: a program champion or champion team, written blood glucose monitoring protocols, staff education in diabetes management, medical record identification of diabetes, a plan coordinating insulin and meal delivery, plans for treatment of hypoglycemia and hyperglycemia, data collection for incidence of hypoglycemia, and patient education on self-management of diabetes. The major clinical components to develop, implement, and evaluate an inpatient diabetes care program are: I. Program management, II. Delivering or facilitating clinical care, III. Supporting self-management, IV. Clinical information management and V. performance measurement. The standards receive guidance from a Disease-Specific Care Certification Advisory Committee, and the Standards and Survey Procedures Committee of the Joint Commission Board of Commissioners. The Joint Commission-ADA Advanced Inpatient Diabetes Certification represents a clinical program of excellence, improved processes of care, means to enhance contract negotiations with providers, ability to create an environment of teamwork, and heightened communication within the organization. Published by Elsevier Inc.

Cardiac sympathetic innervation assessed with (123)I-MIBG retains prognostic utility in diabetic patients with severe left ventricular dysfunction evaluated for primary prevention implantable cardioverter-defibrillator.

Science.gov (United States)

García-González, P; Fabregat-Andrés, Ó; Cozar-Santiago, P; Sánchez-Jurado, R; Estornell-Erill, J; Valle-Muñoz, A; Quesada-Dorador, A; Payá-Serrano, R; Ferrer-Rebolleda, J; Ridocci-Soriano, F

2016-01-01

Scintigraphy with iodine-123-metaiodobenzylguanidine ((123)I-MIBG) is a non-invasive tool for the assessment of cardiac sympathetic innervation (CSI) that has proven to be an independent predictor of survival. Recent studies have shown that diabetic patients with heart failure (HF) have a higher deterioration in CSI. It is unknown if (123)I-MIBG has the same predictive value for diabetic and non-diabetic patients with advanced HF. An analysis is performed to determine whether CSI with (123)I-MIBG retains prognostic utility in diabetic patients with HF, evaluated for a primary prevention implantable cardioverter-defibrillator (ICD). Seventy-eight consecutive HF patients (48 diabetic) evaluated for primary prevention ICD implantation were prospectively enrolled and underwent (123)I-MIBG to assess CSI (heart-to-mediastinum ratio - HMR). A Cox proportional hazards multivariate analysis was used to determine the influence of (123)I-MIBG images for prediction of cardiac events in both diabetic and non-diabetic patients. The primary end-point was a composite of arrhythmic event, cardiac death, or admission due to HF. During a mean follow-up of 19.5 [9.3-29.3] months, the primary end-point occurred in 24 (31%) patients. Late HMR was significantly lower in diabetic patients (1.30 vs. 1.41, p=0.014). Late HMR≤1.30 was an independent predictor of cardiac events in diabetic (hazard ratio 4.53; p=0.012) and non-diabetic patients (hazard ratio 12.31; p=0.023). Diabetic patients with HF evaluated for primary prevention ICD show a higher deterioration in CSI than non-diabetics; nevertheless (123)I-MIBG imaging retained prognostic utility for both diabetic and non-diabetic patients. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

Evaluation of diabetes determinants in woolly monkeys (Lagothrix lagotricha)

NARCIS (Netherlands)

Ange-van Heugten, K.D.; Burns, R.; Verstegen, M.W.A.; Jansen, W.L.; Ferket, P.R.; Heugten, E.

2007-01-01

Woolly monkeys (Lagothrix lagotricha) are a threatened specie in the wild with limited successful management in captivity due to diagnosed hypertension and suspected diabetic conditions. Six woolly monkeys with known hypertension problems were tested to determine if diabetes mellitus and current

Evaluation of dermal myelinated nerve fibers in diabetes mellitus

Science.gov (United States)

Peltier, Amanda C.; Myers, M. Iliza; Artibee, Kay J.; Hamilton, Audra D.; Yan, Qing; Guo, Jiasong; Shi, Yaping; Wang, Lily; Li, Jun

2013-01-01

Skin biopsies have primarily been used to study the non-myelinated nerve fibers of the epidermis in a variety of neuropathies. In the present study, we have expanded the skin biopsy technique to glabrous, non-hairy skin to evaluate myelinated nerve fibers in the most highly prevalent peripheral nerve disease, diabetic polyneuropathy (DPN). Twenty patients with DPN (Type I, n=9; Type II, n=11) and sixteen age-matched healthy controls (ages 29–73) underwent skin biopsy of the index finger, nerve conduction studies, and composite neuropathy scoring. In patients with DPN, we found a statistically significant reduction of both mechanoreceptive Meissner corpuscles (MC) and their afferent myelinated nerve fibers (p=0.01). This myelinated nerve fiber loss was correlated with the decreased amplitudes of sensory/motor responses in nerve conduction studies. This study supports the utilization of skin biopsy to quantitatively evaluate axonal loss of myelinated nerve fibers in patients with DPN. PMID:23781963

Diabetes øger risikoen for frakturer

DEFF Research Database (Denmark)

Starup-Linde, Jakob; Karahasanovic, Azra; Vestergaard, Peter

2016-01-01

Diabetes is associated with an increased risk of fracture, however, neither bone mineral density, falls, diabetes complications nor other risk factors can explain why. Among patients with diabetes, hyperglycaemia may have detrimental effects on bone, but also use of anti-diabetic treatment may have...... an impact on fracture risk. In this article we assess the relationship between diabetes, bone and fracture and the effects of hyperglycaemia and anti-diabetic treatment on bone. Furthermore, fracture preventive measures in patients with diabetes are evaluated....

Diabetes øger risikoen for frakturer

DEFF Research Database (Denmark)

Starup-Linde, Jakob; Karahasanovic, Azra; Vestergaard, Peter

2015-01-01

Diabetes is associated with an increased risk of fracture, however, neither bone mineral density, falls, diabetes complications nor other risk factors can explain why. Among patients with diabetes, hyperglycaemia may have detrimental effects on bone, but also use of anti-diabetic treatment may have...... an impact on fracture risk. In this article we assess the relationship between diabetes, bone and fracture and the effects of hyperglycaemia and anti-diabetic treatment on bone. Furthermore, fracture preventive measures in patients with diabetes are evaluated....

Southeast Asia Report

National Research Council Canada - National Science Library

1987-01-01

Partial Contents: Southeast Asia, Exchange Dealer, Budget Review, Declared Nonactive, Candidacy, Finance Minister, Economic Policy, Exchange Rate, Farm, Defense Ministers, Labor Party,Local Car Manufacturer...

Evaluation of the Hypoglycaemic Activity of Petiveria alliacea (Guinea Hen Weed) Extracts in Normoglycaemic and Diabetic Rat Models.

Science.gov (United States)

Christie, S-L; Levy, A

2013-11-01

Petiveria alliacea (P alliacea) has ethno-traditional use as a hypoglycaemic agent in Jamaica and is yet to be scientifically validated as such. Therefore, extracts of aerial parts of the plant were evaluated for hypoglycaemic activity in normoglycaemic and diabetic rats. Aqueous and hexane extracts prepared from leaves of P alliacea were tested for hypoglycaemic activity. An acute administration of the extracts (200 and 400 mg/kg body weight) was evaluated in normoglycaemic rats. Additionally, the hypoglycaemic effect of sub-chronic administration was assessed in streptozotocin-induced diabetic rats. Blood glucose was recorded using a glucometer and test strips. Data were analysed using Student's t-test (p ≤ 0.05). The aqueous and hexane extracts demonstrated no significant reduction of fasting blood glucose (FBG) and no significant improvement of glucose tolerance in normal rats. The aqueous extract (400 mg/kg body weight) increased FBG from 4.75 ± 0.28 mmol/L to 5.88 ± 0.46 when compared to control (p ≤ 0.001). In diabetic rats, the hexane extract (400 mg/kg body weight) caused reduction of FBG after two weeks of treatment (p ≤ 0.010), but this was not sustained. The aqueous extract showed no reduction of FBG in diabetic rats. The aqueous extract of P alliacea demonstrated a hyperglycaemic effect in normoglycaemic rats and showed no hypoglycaemic activity in diabetic rats. The hexane extract caused no hypoglycaemic action in normal rats and failed to sustain an initial hypoglycaemic action in diabetic rats. This study presents evidence that does not support significant hypoglycaemic activity of P alliacea; this could hold significant implications for its use in ethno-traditional medicine.

Knowledge of diabetic complications in patients with diabetes mellitus

International Nuclear Information System (INIS)

Ullah, F.; Afridi, A.K.; Rahim, F.; Ashfaq, M.; Khan, S.

2015-01-01

The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. Limited data is available regarding the awareness and knowledge about these complications in our population. This study was carried out to evaluate the knowledge of diabetic complications in patients with diabetes mellitus. Methods: This cross-sectional study was conducted in the Medical B Unit of Department of Medicine Khyber Teaching Hospital, Peshawar. All admitted diabetic patients above 15 years of age with duration of diabetes mellitus more than one year were included. Results: Out of the 96 patients questioned, 58 were females and 38 were males. Mean age was 53.29 ± 10.821 years while the mean duration of diabetes mellitus was 9.75 ± 7.729 years. Of the total 76 (79.1%) of the patients were illiterate; 36 (37.50%) had good, 24 (25%) had average and 36 (37.50%) had poor knowledge about diabetic complications. Males and university graduate patients had slightly better knowledge. Between 50-60% patients were aware of different cardiac complications of diabetes mellitus. Awareness regarding other complications was foot ulcer/gangrene 70 (72.91%), poor wound healing 68 (70.83%), stroke 54 (56.25%), renal diseases 64 (66.66%), eye diseases 53 (55.20%), gastroparesis and other gastrointestinal problems 45 (46.87%), diabetic ketoacidosis 55 (57.29%), hypoglycaemia 50 (52.08%), lipid abnormalities 26 (27.08%) and symptoms of diabetic neuropathy ranging from 47-65%. Conclusions: Majority of diabetic patients are unaware of diabetic complications. Therefore, hospital and community based awareness programs should be launched to decrease the morbidity and mortality associated with diabetes mellitus. (author)

KNOWLEDGE OF DIABETIC COMPLICATIONS IN PATIENTS WITH DIABETES MELLITUS.

Science.gov (United States)

Ullah, Fahim; Afridi, Ayesha Khan; Rahim, Fawad; Ashfaq, Muhammad; Khan, Sheema; Shabbier, Ghulam; Rahman, Sadiq Ur

2015-01-01

The prevalence of diabetes mellitus has risen exponentially over the last three decades, with resultant increase in morbidity and mortality mainly due to its complications. Limited data is available regarding the awareness and knowledge about these complications in our population. This study was carried out to evaluate the knowledge of diabetic complications in patients with diabetes mellitus. This cross-sectional study was conducted in the Medical B Unit of Department of Medicine Khyber Teaching Hospital, Peshawar. All admitted diabetic patients above 15 years of age with duration of diabetes mellitus more than one year were included. Out of the 96 patients questioned, 58 were females and 38 were males. Mean age was 53.29 +/- 10.821 years while the mean duration of diabetes mellitus was 9.75 +/- 7.729 years. Of the total 76 (79.1%) of the patients were illiterate; 36 (37.50%) had good, 24 (25%) had average and 36 (37.50%) had poor knowledge about diabetic complications. Males and university graduate patients had slightly better knowledge. Between 50-60% patients were aware of different cardiac complications of diabetes mellitus. Awareness regarding other complications was foot ulcer/gangrene 70 (72.91%), poor wound healing 68 (70.83%), stroke 54 (56.25%), renal diseases 64 (66.66%), eye diseases 53 (55.20%), gastroparesis and other gastrointestinal problems 45 (46.87%), diabetic ketoacidosis 55 (57.29%), hypoglycaemia 50 (52.08%), lipid abnormalities 26 (27.08%) and symptoms of diabetic neuropathy ranging from 47-65%. Majority of diabetic patients are unaware of diabetic complications. Therefore, hospital and community based awareness programs should be launched to decrease the morbidity and mortality associated with diabetes mellitus.

Hypoglycemia evaluation and reporting in diabetes: Importance for the development of new therapies.

Science.gov (United States)

Klonoff, David C; Alexander Fleming, G; Muchmore, Douglas B; Frier, Brian M

2017-07-01

Hypoglycemia complicating diabetes therapy is well recognized to be an ever-present threat to patients, their families, providers, payers, and regulators. Despite this being widely acknowledged, the regulatory stance on hypoglycemia as an endpoint in clinical trials to support new product registration has not evolved in any meaningful way since the publication of a position paper by an American Diabetes Association (ADA) Workgroup in 2005. As the impact of hypoglycemia on persons affected by diabetes is of major importance when assessing new treatments, the historical position of regulatory agencies on hypoglycemia is reviewed with respect to product approvals. The purpose of this article is to present proposals for facilitating development of therapies that reduce hypoglycemia risk through (1) development of composite measures of benefit for regulatory endpoints and (2) facilitation of the fulfillment of an unmet clinical need for reducing hypoglycemia. In view of greater comprehension of the effects of hypoglycemia, coupled with improved methodology to assess its frequency, the authors recommend: (1) a numerical cut point of <54 mg/dl (<3.0 mmol/L) as a clinically relevant level with which to define meaningful hypoglycemia for trials of diabetes therapies; (2) utilization in clinical trials of mature glucose monitoring technologies for purposes of regulatory evaluation and clinical decision-making; and (3) development of primary efficacy endpoint composites that include hypoglycemia rates and glycemic control. Copyright © 2017 John Wiley & Sons, Ltd.

Evaluation of an international faculty development program for developing countries in Asia: the Seoul Intensive Course for Medical Educators.

Science.gov (United States)

Kim, Do-Hwan; Yoon, Hyun Bae; Sung, Minsun; Yoo, Dong-Mi; Hwang, Jinyoung; Kim, Eun Jung; Lee, Seunghee; Shin, Jwa-Seop

2015-12-18

The issue of collaboration in medical education is becoming prominent. Some faculty development programs have suggested an approach for promoting collaboration on a global level. However, non-English-speaking developing countries in Asia, especially in Southeast Asia, do not take advantage of them due to their unique context, such as language and culture. To address these issues, Seoul National University College of Medicine initiated a 6-week international faculty development program called the "Seoul Intensive Course for Medical Educators" for 16 fellows from five Asian countries (Cambodia, Laos, Mongolia, Myanmar, and Vietnam). The aim of this study is to report the evaluation results of the outcome of the program and discuss better ways of collaborating with developing countries. Three levels of collaboration-intraorganizational, intranational, and international-were central initiatives of the program. Prior to setting up the program details, we first established four design principles, following which the contents, materials, and facilitators were determined to maintain consistency with the design principles. The evaluation of the program was done with Kirkpatrick's four-level model. Most of the evaluation data for level 1 were collected by two questionnaires, the post-module survey and the post-program survey. Portfolios and progress reports were mainly used to collect outcome data for levels 2 and 3, respectively. The reaction was generally positive throughout the program and there was a significant correlation between satisfaction and relevance to one's job or needs. Despite the fellows' propensity for overestimating themselves, both the evaluators and fellows reported that there was significant improvement in learning. Opinions on the impact or urgency of the topics were slightly different from country to country; however, the answers regarding feasibility were fairly similar. Moreover, we could observe from the post-program progress reports that the

Zika virus in Asia

OpenAIRE

Veasna Duong; Philippe Dussart; Philippe Buchy

2017-01-01

Zika virus (ZIKV) is an emerging mosquito-borne virus that was first isolated from a sentinel rhesus monkey in the Zika Forest in Uganda in 1947. In Asia, the virus was isolated in Malaysia from Aedes aegypti mosquitoes in 1966, and the first human infections were reported in 1977 in Central Java, Indonesia. In this review, all reported cases of ZIKV infection in Asia as of September 1, 2016 are summarized and some of the hypotheses that could currently explain the apparently low incidence of...

Comprehensive Evaluation of Anti-hyperglycemic Activity of Fractionated Momordica charantia Seed Extract in Alloxan-Induced Diabetic Rats

Directory of Open Access Journals (Sweden)

Shailesh Kumar Choudhary

2012-01-01

Full Text Available The present study evaluates anti-hyperglycemic activity of fractionated Momordica charantia (bitter gourd seed extracts. Fasting blood glucose levels were evaluated before and after administration of different fractions of the seed extract. Among the three fractions tested, fraction Mc-3 (15 mg/kg b.wt. showed the maximum anti-hyperglycemic activity and reduced blood glucose levels in experimental diabetic rats significantly. The activities of the key regulatory enzymes of glucose metabolism (hexokinase, pyruvate kinase, lactate dehydrogenase, and glucose-6-phosphate dehydrogenase were determined in Mc-3-treated diabetic animals. Once-daily administration of the fraction Mc-3 for prolonged period of 18 days to the experimental diabetic animals did not result in any nephrotoxicity or hepatotoxicity as evident from insignificant changes in biochemical parameters indicative of liver and kidney functions. Further fractionation of the fraction Mc-3 by size exclusion chromatography resulted in a fraction, designated Mc-3.2, possessing anti-hyperglycemic activity. The fraction Mc-3.2 showed the presence of a predominant protein band of ~11 kDa on SDS-PAGE. Loss in anti-hyperglycemic activity of the Mc-3.2 upon protease treatment indicates the proteinaceous nature of the anti-hyperglycemic principles. Overall, the results suggest that Momordica charantia seeds contain an effective anti-hyperglycemic protein(s which may find application in treatment of diabetes without evident toxic effects.

Comprehensive Evaluation of Anti-hyperglycemic Activity of Fractionated Momordica charantia Seed Extract in Alloxan-Induced Diabetic Rats

Science.gov (United States)

Choudhary, Shailesh Kumar; Chhabra, Gagan; Sharma, Dipali; Vashishta, Aruna; Ohri, Sujata; Dixit, Aparna

2012-01-01

The present study evaluates anti-hyperglycemic activity of fractionated Momordica charantia (bitter gourd) seed extracts. Fasting blood glucose levels were evaluated before and after administration of different fractions of the seed extract. Among the three fractions tested, fraction Mc-3 (15 mg/kg b.wt.) showed the maximum anti-hyperglycemic activity and reduced blood glucose levels in experimental diabetic rats significantly. The activities of the key regulatory enzymes of glucose metabolism (hexokinase, pyruvate kinase, lactate dehydrogenase, and glucose-6-phosphate dehydrogenase) were determined in Mc-3-treated diabetic animals. Once-daily administration of the fraction Mc-3 for prolonged period of 18 days to the experimental diabetic animals did not result in any nephrotoxicity or hepatotoxicity as evident from insignificant changes in biochemical parameters indicative of liver and kidney functions. Further fractionation of the fraction Mc-3 by size exclusion chromatography resulted in a fraction, designated Mc-3.2, possessing anti-hyperglycemic activity. The fraction Mc-3.2 showed the presence of a predominant protein band of ~11 kDa on SDS-PAGE. Loss in anti-hyperglycemic activity of the Mc-3.2 upon protease treatment indicates the proteinaceous nature of the anti-hyperglycemic principles. Overall, the results suggest that Momordica charantia seeds contain an effective anti-hyperglycemic protein(s) which may find application in treatment of diabetes without evident toxic effects. PMID:23320026

EVALUATION OF DIABETIC MACULAR OEDEMA WITH SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY AND FUNDUS FLUORESCEIN ANGIOGRAPHY

Directory of Open Access Journals (Sweden)

Mallika Venkitasubramanian

2017-02-01

Full Text Available BACKGROUND Macular oedema is an important cause of visual morbidity in Diabetic Retinopathy. It can be assessed by both Fundus Fluorescein Angiography (FFA and Optical Coherence Tomography (OCT. The aims of this study were to evaluate the agreement between morphological features on spectral domain Optical Coherence Tomography and Fluorescein Angiographic leakage patterns in Diabetic Macular Oedema, and to study the correlation between the best corrected visual acuity and central foveal thickness measured by Optical Coherence Tomography. MATERIALS AND METHODS This was an observational study. All patients with Diabetic Macular Oedema underwent complete ophthalmic examination and subjected to FFA and OCT. Presence or absence of macular oedema by FFA and OCT was noted and agreement between two modalities of imaging was assessed. Sensitivity of these modalities were also found out using appropriate statistical methods. Best Corrected Visual Acuity (BCVA measured were converted to LogMAR scale and Central foveal thickness measured by OCT. Linear regression analysis was done with central foveal thickness and LogMAR visual acuity. RESULTS A total of 69 eyes of 39 patients were studied. OCT revealed Diabetic Macular Oedema in 97.5% of eyes. Fundus Fluorescein Angiography performed in these patients identified leakage in 95.6% of eyes. Sensitivity and specificity of FFA and OCT were calculated keeping one as the gold standard for sensitivity and specificity of the other. FFA and OCT had almost equal sensitivity (95.46 for OCT and 96.92 for FFA for detection of DME. Specificity of OCT was found to be slightly higher (33.33% compared to FFA (25%. Our results suggest that there is minimal agreement between these two imaging modalities in evaluating DME. Statistically, Kappa value was 0.248. Linear regression analysis showed that central foveal thickness had a significant correlation with visual acuity, with Pearson correlation coefficient r=0.442, p=0

Representation of Central Asia and Traveling Self in Vambery’s Travels in Central Asia

Directory of Open Access Journals (Sweden)

Ahmad Gholi

2016-03-01

Full Text Available In the course of the nineteenth century Arminius Vambery, an anglophile travel writer, in the guise of a mendicant dervish with a group of Tartar pilgrims departs to secluded and sealed Central Asia. After six months travel in the Khanates of Central Asia, he undertakes a journey to England where he offers his observations to the Royal Geographical Society and publishes his travelogue, Travel in Central Asia. Despite its literary merits and connection with British imperialism, the travelogue has not been scrutinized separately by the scholars of travel writing. To fill the gap, this article by drawing on the theories of post-structuralism: Orientalism and Postcolonialism, endeavors to unveil the political agenda behind the travel writer’s representation of his travelees, destination, and his own traveling self. Additionally, it argues that the travel writer in dialogue with other Western travel writers to deterritorialize his traversed region or justify the prospective presence of Britain in Central Asia, represents his journey destination as the locus of barbarity, a region under the grip of despotic rulers, as well as an area with frozen time, while to exhibit his Eurocentrism, he portrays his traveling subject as the a suffering hero and a benign traveler.

South Asia | Page 99 | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

South Asia. Asie du sud. Read more about Nanotechnology in South Asia : Building Capabilities and Governing the Technology in South Asia. Language English. Read more about La nanotechnologie en Asie du Sud : renforcement des capacités et encadrement des technologies. Language French. Read more about La ...

South Asia | Page 115 | IDRC - International Development Research ...

International Development Research Centre (IDRC) Digital Library (Canada)

Read more about Digital Review of Asia Pacific 2009–2010. Language French. Drawing on research and practical experiences from China, South Asia, and Southeast Asia, this book presents and analyzes novel approaches to collaborative learning and communities of practice. Case studies show how, through joint efforts ...

Far East Asia | Page 189 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Read more about Digital Review of Asia Pacific 2009–2010. Language French. Drawing on research and practical experiences from China, South Asia, and Southeast Asia, this book presents and analyzes novel approaches to collaborative learning and communities of practice. Case studies show how, through joint efforts ...

Far East Asia | Page 107 | IDRC - International Development ...

International Development Research Centre (IDRC) Digital Library (Canada)

Read more about Digital Review of Asia Pacific 2009–2010. Language French. Drawing on research and practical experiences from China, South Asia, and Southeast Asia, this book presents and analyzes novel approaches to collaborative learning and communities of practice. Case studies show how, through joint efforts ...

Modeling primary energy substitution in the Asia Pacific

International Nuclear Information System (INIS)

Aguilera, Roberto F.; Ripple, Ronald D.

2013-01-01

Highlights: • We model the market shares (i.e. energy mix) of gases, liquids and solids in the Asia Pacific. • The model matches the historical energy mix and projects three scenarios of the future mix to 2030. • We then model the past and future hydrogen to carbon ratio (a proxy for environmental quality). • Importance of natural gas in the region could increase significantly, depending on policy and tech progress. - Abstract: A Global Energy Market model (GEM) is used to analyze the market shares (i.e. the primary energy mix) of gases, liquids and solids in the Asia Pacific. The model is successful in matching the historical energy mix from 1850 to 2009. The model also provides a good match of the hydrogen to carbon ratio, which is a proxy for environmental quality. Given these validations, the GEM is then used to present scenarios of the Asia Pacific energy mix and hydrogen to carbon ratio until the year 2030. Three energy mix scenarios are presented – reference case; alternative case 1; alternative case 2. The reference case assumes limited divergence from current policies and technologies. It indicates that Asia Pacific energy needs will be met by approximately 46% solids, 34% liquids, and 20% gases by 2030. Alternative cases 1 and 2 represent policies and technologies that either encourage or discourage the use of gases. The good matches observed for historical data suggest the GEM can be used cautiously for evaluating outcomes and opportunities in the region. Although the model can be used for projecting far into the future, it is currently calibrated to what we consider a reasonable time horizon – until the year 2030. Given appropriate energy policies and sufficient technological advancement, the importance of natural gas in the region could increase significantly

[The methods within the evaluation of disease management programmes in control-group designs using the example of diabetes mellitus - a systematic literature review].

Science.gov (United States)

Drabik, A; Sawicki, P T; Müller, D; Passon, A; Stock, S

2012-08-01

Disease management programmes (DMPs) were implemented in Germany in 2002. Their evaluation is required by law. Beyond the mandatory evaluation, a growing number of published studies evaluate the DMP for diabetes mellitus type 2 in a control-group design. As patients opt into the programme on a voluntary basis it is necessary to adjust the inherent selection bias between groups. The aim of this study is to review published studies which evaluate the diabetes DMP using a control-group design with respect to the methods used. A systematic literature review of electronic databases (PUBMED, Cochrane Library, EMBASE, MEDPILOT) and a hand search of reference lists of the relevant publications was conducted to identify studies evaluating the DMP diabetes mellitus in a control-group design. 8 studies were included in the systematic literature review. 4 studies gathered retrospective claims data from sickness funds, one from physician's records, one study used prospective data from ambulatory care, and 2 studies were based on one patient survey. Methods used for adjustment of selection bias included exact matching, matching using propensity score methods, age-adjusted and sex-separated analysis, and adjustment in a regression model/analysis of covariance. One study did not apply adjustment methods. The intervention period ranged from 1 day to 4 years. Considered outcomes of studies (surrogate parameter, diabetes complications, mortality, quality of life, and claim data) depended on the database. In the evaluation of the DMP diabetes mellitus based on a control-group design neither the database nor the methods used for selection bias adjustment were consistent in the available studies. Effectiveness of DMPs cannot be judged based on this review due to heterogeneity of study designs. To allow for a comprehensive programme evaluation standardised minimum requirements for the evaluation of DMPs in the control group design are required. © Georg Thieme Verlag KG Stuttgart · New

Histomorphometric evaluation of bone regeneration using autogenous bone and beta-tricalcium phosphate in diabetic rabbits

Directory of Open Access Journals (Sweden)

Živadinović Milka

2016-01-01

Full Text Available Background/Aim. The mechanism of impaired bone healing in diabetes mellitus includes different tissue and cellular level activities due to micro- and macrovascular changes. As a chronic metabolic disease with vascular complications, diabetes affects a process of bone regeneration as well. The therapeutic approach in bone regeneration is based on the use of osteoinductive autogenous grafts as well as osteoconductive synthetic material, like a β-tricalcium phosphate. The aim of the study was to determine the quality and quantity of new bone formation after the use of autogenous bone and β-tricalcium phosphate in the model of calvarial critical-sized defect in rabbits with induced diabetes mellitus type I. Methods. The study included eight 4-month-old Chincilla rabbits with alloxan-induced diabetes mellitus type I. In all animals, there were surgically created two calvarial bilateral defects (diameter 12 mm, which were grafted with autogenous bone and β-tricalcium phosphate (n = 4 or served as unfilled controls (n = 4. After 4 weeks of healing, animals were sacrificed and calvarial bone blocks were taken for histologic and histomorphometric analysis. Beside descriptive histologic evaluation, the percentage of new bone formation, connective tissue and residual graft were calculated. All parameters were statistically evaluated by Friedman Test and post hock Wilcoxon Singed Ranks Test with a significance of p < 0.05. Results. Histology revealed active new bone formation peripherally with centrally located connective tissue, newly formed woven bone and well incorporated residual grafts in all treated defects. Control samples showed no bone bridging of defects. There was a significantly more new bone in autogeonous graft (53% compared with β-tricalcium phosphate (30%, (p < 0.030 and control (7%, (p < 0.000 groups. A significant difference was also recorded between β-tricalcium phosphate and control groups (p < 0.008. Conclusion. In the present

Effectiveness of a behavior modification program for older people with uncontrolled type 2 diabetes.

Science.gov (United States)

Ounnapiruk, Liwan; Wirojratana, Virapun; Meehatchai, Nitaya; Turale, Sue

2014-06-01

This quasi-experimental study examined the effectiveness of a behavior modification program for diabetic control in Thai elders with uncontrolled Type 2 Diabetes. Purposive sampling was used to select 30 elders from one community as an intervention group, and 30 from a neighboring community as a control group. The intervention group participated in a program of 12 weeks' duration involving activities related to group counseling, group discussion, and an empowerment process that enhanced appropriate consumption of healthy diet, medication taking, and exercise. Data were collected by interviews using a questionnaire to assess knowledge of diabetes, perceived self-efficacy, and diabetes control behavior, including fasting blood glucose and glycosylated hemoglobin, were examined at the baseline and three months thereafter. At program completion, the intervention group had significantly higher scores of knowledge, self-efficacy, and health behaviors than those in the control group, but blood glucose and glycosylated hemoglobin were not significantly different. Although nurses can use aspects of this program to benefit elders with diabetes who require support and education, further research is required to provide improved health outcomes such as better glycemic control. © 2013 Wiley Publishing Asia Pty Ltd.

Currency crises: Is Asia different?

OpenAIRE

Diehl, Markus; Schweickert, Rainer

1998-01-01

International investors' enthusiasm with respect to growth prospects in Southeast Asia has been followed by panic. Both the outstanding economic performance of Southeast Asian economies and their ability to master adjustment challenges had led most observers of these economies to the conclusion that "Asia is different". In comparison with previous currency crises, the macroeconomic fundamentals (GDP growth, inflation, fiscal deficit, external indebtedness, domestic savings, export performance...

Contemporary Evaluation and Management of the Diabetic Foot

Science.gov (United States)

Sumpio, Bauer E.

2012-01-01

Foot problems in patients with diabetes remain a major public health issue and are the commonest reason for hospitalization of patients with diabetes with prevalence as high as 25%. Ulcers are breaks in the dermal barrier with subsequent erosion of underlying subcutaneous tissue that may extend to muscle and bone, and superimposed infection is a frequent and costly complication. The pathophysiology of diabetic foot disease is multifactorial and includes neuropathy, infection, ischemia, and abnormal foot structure and biomechanics. Early recognition of the etiology of these foot lesions is essential for good functional outcome. Managing the diabetic foot is a complex clinical problem requiring a multidisciplinary collaboration of health care workers to achieve limb salvage. Adequate off-loading, frequent debridement, moist wound care, treatment of infection, and revascularization of ischemic limbs are the mainstays of therapy. Even when properly managed, some of the foot ulcers do not heal and are arrested in a state of chronic inflammation. These wounds can frequently benefit from various adjuvants, such as aggressive debridement, growth factors, bioactive skin equivalents, and negative pressure wound therapy. While these, increasingly expensive, therapies have shown promising results in clinical trials, the results have yet to be translated into widespread clinical practice leaving a huge scope for further research in this field. PMID:24278695

PolEASIA Project: Pollution in Eastern Asia - towards better Air Quality Prevision and Impacts' Evaluation

Science.gov (United States)

Dufour, Gaëlle; Albergel, Armand; Balkanski, Yves; Beekmann, Matthias; Cai, Zhaonan; Fortems-Cheiney, Audrey; Cuesta, Juan; Derognat, Claude; Eremenko, Maxim; Foret, Gilles; Hauglustaine, Didier; Lachatre, Matthieu; Laurent, Benoit; Liu, Yi; Meng, Fan; Siour, Guillaume; Tao, Shu; Velay-Lasry, Fanny; Zhang, Qijie; Zhang, Yuli

2017-04-01

The rapid economic development and urbanization of China during the last decades resulted in rising pollutant emissions leading to amongst the largest pollutant concentrations in the world for the major pollutants (ozone, PM2.5, and PM10). Robust monitoring and forecasting systems associated with downstream services providing comprehensive risk indicators are highly needed to establish efficient pollution mitigation strategies. In addition, a precise evaluation of the present and future impacts of Chinese pollutant emissions is of importance to quantify: first, the consequences of pollutants export on atmospheric composition and air quality all over the globe; second, the additional radiative forcing induced by the emitted and produced short-lived climate forcers (ozone and aerosols); third, the long-term health consequences of pollution exposure. To achieve this, a detailed understanding of East Asian pollution is necessary. The French PolEASIA project aims at addressing these different issues by providing a better quantification of major pollutants sources and distributions as well as of their recent and future evolution. The main objectives, methodologies and tools of this starting 4-year project will be presented. An ambitious synergistic and multi-scale approach coupling innovative satellite observations, in situ measurements and chemical transport model simulations will be developed to characterize the spatial distribution, the interannual to daily variability and the trends of the major pollutants (ozone and aerosols) and their sources over East Asia, and to quantify the role of the different processes (emissions, transport, chemical transformation) driving the observed pollutant distributions. A particular attention will be paid to assess the natural and anthropogenic contributions to East Asian pollution. Progress made with the understanding of pollutant sources, especially in terms of modeling of pollution over East Asia and advanced numerical approaches

A comparative analysis of renewable electricity support mechanisms for Southeast Asia

Energy Technology Data Exchange (ETDEWEB)

Sovacool, Benjamin K. [National University of Singapore, Energy Governance Program, Centre on Asia and Globalisation, Lee Kuan Yew School of Public Policy, 469C Bukit Timah Road, Singapore 259772 (Singapore)

2010-04-15

This study evaluates the applicability of eight renewable electricity policy mechanisms for Southeast Asian electricity markets. It begins by describing the methodology behind 90 research interviews of stakeholders in the electricity industry. It then outlines four justifications given by respondents for government intervention to support renewables in Southeast Asia: unpriced negative externalities, counteracting subsidies for conventional energy sources, the public goods aspect of renewable energy, and the presence of non-technical barriers. The article develops an analytical framework to evaluate renewable portfolio standards, green power programs, public research and development expenditures, systems benefits charges, investment tax credits, production tax credits, tendering, and feed-in tariffs in Southeast Asia. It assesses each of these mechanisms according to the criteria of efficacy, cost effectiveness, dynamic efficiency, equity, and fiscal responsibility. The study concludes that one mechanism, feed-in tariffs, is both the most preferred by respondents and the only one that meets all criteria. (author)

A comparative analysis of renewable electricity support mechanisms for Southeast Asia

International Nuclear Information System (INIS)

Sovacool, Benjamin K.

2010-01-01

This study evaluates the applicability of eight renewable electricity policy mechanisms for Southeast Asian electricity markets. It begins by describing the methodology behind 90 research interviews of stakeholders in the electricity industry. It then outlines four justifications given by respondents for government intervention to support renewables in Southeast Asia: unpriced negative externalities, counteracting subsidies for conventional energy sources, the public goods aspect of renewable energy, and the presence of non-technical barriers. The article develops an analytical framework to evaluate renewable portfolio standards, green power programs, public research and development expenditures, systems benefits charges, investment tax credits, production tax credits, tendering, and feed-in tariffs in Southeast Asia. It assesses each of these mechanisms according to the criteria of efficacy, cost effectiveness, dynamic efficiency, equity, and fiscal responsibility. The study concludes that one mechanism, feed-in tariffs, is both the most preferred by respondents and the only one that meets all criteria. (author)

Intimal permeability evaluated in a short-term organ culture of diabetic guinea pig aorta

International Nuclear Information System (INIS)

Schlosser, M.J.; Verlangieri, A.J.

1988-01-01

A novel short-term organ culture system was used to evaluate intimal permeability changes by measuring aortic [ 14 C]methylated albumin accumulation. Aortic plugs were removed from the upper thoracic aorta of male guinea pigs and maintained in serum-free media. The accumulation of [ 14 C]albumin in the intimal-medial layer was determined after a 5 h incubation. In preliminary studies, albumin recovered from intimal-injured aortic plugs was significantly greater than those from non-injured plugs. Aortic plugs from streptozotocin-treated guinea pigs, diabetic for 3 weeks, also accumulated significantly more [ 14 C]albumin than plugs from nondiabetic controls. Histological changes were not observed in the aorta of either the diabetic or control group. A strong significant inverse correlation was found between plasma ascorbic acid levels and [ 14 C]-activity recovered from aortic plugs. This study demonstrates a simple and rapid method for assessing aortic permeability changes under a well-defined in vitro system, and suggests that vascular permeability changes in the streptozotocin-diabetic guinea pig may be associated with an ascorbic acid deficit

Evaluation of a school-based diabetes education intervention, an extension of Program ENERGY

Science.gov (United States)

Conner, Matthew David

Background: The prevalence of both obesity and type 2 diabetes in the United States has increased over the past two decades and rates remain high. The latest data from the National Center for Health Statistics estimates that 36% of adults and 17% of children and adolescents in the US are obese (CDC Adult Obesity, CDC Childhood Obesity). Being overweight or obese greatly increases one's risk of developing several chronic diseases, such as type 2 diabetes. Approximately 8% of adults in the US have diabetes, type 2 diabetes accounts for 90-95% of these cases. Type 2 diabetes in children and adolescents is still rare, however clinical reports suggest an increase in the frequency of diagnosis (CDC Diabetes Fact Sheet, 2011). Results from the Diabetes Prevention Program show that the incidence of type 2 diabetes can be reduced through the adoption of a healthier lifestyle among high-risk individuals (DPP, 2002). Objectives: This classroom-based intervention included scientific coverage of energy balance, diabetes, diabetes prevention strategies, and diabetes management. Coverage of diabetes management topics were included in lesson content to further the students' understanding of the disease. Measurable short-term goals of the intervention included increases in: general diabetes knowledge, diabetes management knowledge, and awareness of type 2 diabetes prevention strategies. Methods: A total of 66 sixth grade students at Tavelli Elementary School in Fort Collins, CO completed the intervention. The program consisted of nine classroom-based lessons; students participated in one lesson every two weeks. The lessons were delivered from November of 2005 to May of 2006. Each bi-weekly lesson included a presentation and interactive group activities. Participants completed two diabetes knowledge questionnaires at baseline and post intervention. A diabetes survey developed by Program ENERGY measured general diabetes knowledge and awareness of type 2 diabetes prevention strategies

Elevated vascular endothelial growth factor in type 1 diabetic patients with diabetic nephropathy

DEFF Research Database (Denmark)

Hovind, P; Tarnow, L; Oestergaard, P B

2000-01-01

patients with and without proliferative retinopathy were detected. CONCLUSIONS: Our data suggest that VEGF is elevated early in the course of diabetic nephropathy in men with type 1 diabetes mellitus. Baseline albuminuria, arterial blood pressure and male gender was predictors of diabetic nephropathy......BACKGROUND: Growth factors have been suggested to play a role in the development and progression of diabetic nephropathy. Vascular endothelial growth factor (VEGF) is a potent cytokine family that induces angiogenesis and markedly increases endothelial permeability. The aim of the present study...... was to investigate plasma levels of VEGF in a large cohort of type 1 diabetic patients with diabetic nephropathy and in long-standing type 1 diabetic patients with persistent normoalbuminuria, and to evaluate VEGF as a predictor of nephropathy progression. METHODS: We measured VEGF with an enzyme...

Assessment of CMIP5 historical simulations of rainfall over Southeast Asia

Science.gov (United States)

Raghavan, Srivatsan V.; Liu, Jiandong; Nguyen, Ngoc Son; Vu, Minh Tue; Liong, Shie-Yui

2018-05-01

We present preliminary analyses of the historical (1986-2005) climate simulations of a ten-member subset of the Coupled Model Inter-comparison Project Phase 5 (CMIP5) global climate models over Southeast Asia. The objective of this study was to evaluate the general circulation models' performance in simulating the mean state of climate over this less-studied climate vulnerable region, with a focus on precipitation. Results indicate that most of the models are unable to reproduce the observed state of climate over Southeast Asia. Though the multi-model ensemble mean is a better representation of the observations, the uncertainties in the individual models are far high. There is no particular model that performed well in simulating the historical climate of Southeast Asia. There seems to be no significant influence of the spatial resolutions of the models on the quality of simulation, despite the view that higher resolution models fare better. The study results emphasize on careful consideration of models for impact studies and the need to improve the next generation of models in their ability to simulate regional climates better.

New data-driven estimation of terrestrial CO2 fluxes in Asia using a standardized database of eddy covariance measurements, remote sensing data, and support vector regression

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Ichii, Kazuhito; Ueyama, Masahito; Kondo, Masayuki; Saigusa, Nobuko; Kim, Joon; Alberto, Ma. Carmelita; Ardö, Jonas; Euskirchen, Eugénie S.; Kang, Minseok; Hirano, Takashi; Joiner, Joanna; Kobayashi, Hideki; Marchesini, Luca Belelli; Merbold, Lutz; Miyata, Akira; Saitoh, Taku M.; Takagi, Kentaro; Varlagin, Andrej; Bret-Harte, M. Syndonia; Kitamura, Kenzo; Kosugi, Yoshiko; Kotani, Ayumi; Kumar, Kireet; Li, Sheng-Gong; Machimura, Takashi; Matsuura, Yojiro; Mizoguchi, Yasuko; Ohta, Takeshi; Mukherjee, Sandipan; Yanagi, Yuji; Yasuda, Yukio; Zhang, Yiping; Zhao, Fenghua

2017-04-01

The lack of a standardized database of eddy covariance observations has been an obstacle for data-driven estimation of terrestrial CO2 fluxes in Asia. In this study, we developed such a standardized database using 54 sites from various databases by applying consistent postprocessing for data-driven estimation of gross primary productivity (GPP) and net ecosystem CO2 exchange (NEE). Data-driven estimation was conducted by using a machine learning algorithm: support vector regression (SVR), with remote sensing data for 2000 to 2015 period. Site-level evaluation of the estimated CO2 fluxes shows that although performance varies in different vegetation and climate classifications, GPP and NEE at 8 days are reproduced (e.g., r2 = 0.73 and 0.42 for 8 day GPP and NEE). Evaluation of spatially estimated GPP with Global Ozone Monitoring Experiment 2 sensor-based Sun-induced chlorophyll fluorescence shows that monthly GPP variations at subcontinental scale were reproduced by SVR (r2 = 1.00, 0.94, 0.91, and 0.89 for Siberia, East Asia, South Asia, and Southeast Asia, respectively). Evaluation of spatially estimated NEE with net atmosphere-land CO2 fluxes of Greenhouse Gases Observing Satellite (GOSAT) Level 4A product shows that monthly variations of these data were consistent in Siberia and East Asia; meanwhile, inconsistency was found in South Asia and Southeast Asia. Furthermore, differences in the land CO2 fluxes from SVR-NEE and GOSAT Level 4A were partially explained by accounting for the differences in the definition of land CO2 fluxes. These data-driven estimates can provide a new opportunity to assess CO2 fluxes in Asia and evaluate and constrain terrestrial ecosystem models.

Preventing progression from gestational diabetes mellitus to diabetes: A thought-filled review.

Science.gov (United States)

Kasher-Meron, Michal; Grajower, Martin M

2017-10-01

Women with a history of gestational diabetes are at high risk for developing type 2 diabetes mellitus. In studies with long periods of follow-up, diabetes incidence of up to 70% has been reported. The appropriate follow-up of women following a pregnancy complicated by gestational diabetes has not been studied. Published guidelines recommend that obstetrician/gynaecologists, who are often the de facto primary care physicians for these otherwise healthy young women, incorporate glucose monitoring in the post-partum period into their annual examinations. In reality, reported rates of screening have been low. There is also no clear evidence for any beneficial interventions to prevent diabetes in patients with prior history of gestational diabetes. Lifestyle intervention programmes for diabetes prevention among these patients yielded disappointing results. Metformin, pioglitazone, liraglutide, and bariatric surgery are possible options but based on inadequate data. There remains a need for randomized, placebo-controlled studies to evaluate various pharmacologic treatments, with and without lifestyle interventions, to prevent type 2 diabetes mellitus in women with a history of gestational diabetes. Copyright © 2017 John Wiley & Sons, Ltd.

Association of glycaemic variability evaluated by continuous glucose monitoring with diabetic peripheral neuropathy in type 2 diabetic patients.

Science.gov (United States)

Hu, Yu-Ming; Zhao, Li-Hua; Zhang, Xiu-Lin; Cai, Hong-Li; Huang, Hai-Yan; Xu, Feng; Chen, Tong; Wang, Xue-Qin; Guo, Ai-Song; Li, Jian-An; Su, Jian-Bin

2018-05-01

Diabetic peripheral neuropathy (DPN), a common microvascular complication of diabetes, is linked to glycaemic derangements. Glycaemic variability, as a pattern of glycaemic derangements, is a key risk factor for diabetic complications. We investigated the association of glycaemic variability with DPN in a large-scale sample of type 2 diabetic patients. In this cross-sectional study, we enrolled 982 type 2 diabetic patients who were screened for DPN and monitored by a continuous glucose monitoring (CGM) system between February 2011 and January 2017. Multiple glycaemic variability parameters, including the mean amplitude of glycaemic excursions (MAGE), mean of daily differences (MODD), standard deviation of glucose (SD), and 24-h mean glucose (24-h MG), were calculated from glucose profiles obtained from CGM. Other possible risks for DPN were also examined. Of the recruited type 2 diabetic patients, 20.1% (n = 197) presented with DPN, and these patients also had a higher MAGE, MODD, SD, and 24-h MG than patients without DPN (p diabetic duration, HOMA-IR, and hemoglobin A1c (HbA1c) were found to be independent contributors to DPN, and the corresponding odds ratios (95% confidence interval) were 4.57 (3.48-6.01), 1.10 (1.03-1.17), 1.24 (1.09-1.41), and 1.33 (1.15-1.53), respectively. Receiver operating characteristic analysis indicated that the optimal MAGE cutoff value for predicting DPN was 4.60 mmol/L; the corresponding sensitivity was 64.47%, and the specificity was 75.54%. In addition to conventional risks including diabetic duration, HOMA-IR and HbA1c, increased glycaemic variability assessed by MAGE is a significant independent contributor to DPN in type 2 diabetic patients.

Evaluation and uncertainties of global climate models as simulated in East Asia and China

International Nuclear Information System (INIS)

Zhao, Z.C.

1994-01-01

The assessments and uncertainties of the general circulation models (GCMs) as simulated in East Asia and China (15-60 N, 70-140 E) have been investigated by using seven GCMs. Four methods of assessment have been chosen. The variables for the validations for the GCMs include the annual, seasonal and monthly mean temperatures and precipitation. The assessments indicated that: (1) the simulations of seven GCMs for temperature are much better than those for precipitation; (2) the simulations in winter are much better than those in summer; (3) the simulations in eastern parts are much better than those in Western parts for both temperature and precipitation; (4) the best GCM for simulated temperature is the GISS model, and the best GCM for simulated precipitation is the UKMO-H model. The seven GCMs' means for both simulated temperature and precipitation provided good results. The range of uncertainties in East Asia and China due to human activities are presented. The differences between the GCMs for temperature and precipitation before the year 2050 are much smaller than those after the year 2050

Depressive symptoms in youth with type 1 or type 2 diabetes: Results of the Pediatric Diabetes Consortium screening assessment of depression in diabetes study

Science.gov (United States)

To evaluate the frequency of depressive symptoms and the diagnosis and management of depression in youth with type 1 diabetes (T1D) and type 2 diabetes (T2D) enrolled in the Pediatric Diabetes Consortium T1D and T2D registries. The Children's Depression Inventory (CDI) 2 Self-Report (Short) version ...

An updated hip fracture projection in Asia: The Asian Federation of Osteoporosis Societies study

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Ching-Lung Cheung

2018-03-01

Full Text Available Objectives: Hip fracture is a major public health problem. Earlier studies projected that the total number of hip fracture will increase dramatically by 2050, and most of the hip fracture will occur in Asia. To date, only a few studies provided the updated projection, and none of them focused on the hip fracture projection in Asia. Thus, it is essential to provide the most up to date prediction of hip fracture in Asia, and to evaluate the total direct medical cost of hip fracture in Asia. Methods: We provide the updated projection of hip fracture in 9 Asian Federation of Osteoporosis Societies members using the most updated incidence rate and projected population size. Results: We show that the number of hip fracture will increase from 1,124,060 in 2018 to 2,563,488 in 2050, a 2.28-fold increase. This increase is mainly due to the changes on the population demographics, especially in China and India, which have the largest population size. The direct cost of hip fracture will increase from 9.5 billion United State dollar (USD in 2018 to 15 billion USD in 2050, resulting a 1.59-fold increase. A 2%–3% decrease in incidence rate of hip fracture annually is required to keep the total number of hip fracture constant over time. Conclusions: The results show that hip fracture remains a key public health issue in Asia, despite the available of better diagnosis, treatment, and prevention of fracture over the recent years. Healthcare policy in Asia should be aimed to reduce the burden of hip fracture. Keywords: Hip fracture, Asia, Osteoporosis, Incidence

Asia Pacific Consensus Statements on Crohn's disease. Part 1: Definition, diagnosis, and epidemiology: (Asia Pacific Crohn's Disease Consensus--Part 1).

Science.gov (United States)

Ooi, Choon Jin; Makharia, Govind K; Hilmi, Ida; Gibson, Peter R; Fock, Kwong Ming; Ahuja, Vineet; Ling, Khoon Lin; Lim, Wee Chian; Thia, Kelvin T; Wei, Shu-chen; Leung, Wai Keung; Koh, Poh Koon; Gearry, Richard B; Goh, Khean Lee; Ouyang, Qin; Sollano, Jose; Manatsathit, Sathaporn; de Silva, H Janaka; Rerknimitr, Rungsun; Pisespongsa, Pises; Abu Hassan, Muhamad Radzi; Sung, Joseph; Hibi, Toshifumi; Boey, Christopher C M; Moran, Neil; Leong, Rupert W L

2016-01-01

Inflammatory bowel disease (IBD) was previously thought to be rare in Asia, but emerging data indicate rising incidence and prevalence of IBD in the region. The Asia Pacific Working Group on Inflammatory Bowel Disease was established in Cebu, Philippines, at the Asia Pacific Digestive Week conference in 2006 under the auspices of the Asian Pacific Association of Gastroenterology with the goal of developing best management practices, coordinating research, and raising awareness of IBD in the region. The consensus group previously published recommendations for the diagnosis and management of ulcerative colitis with specific relevance to the Asia-Pacific region. The present consensus statements were developed following a similar process to address the epidemiology, diagnosis, and management of Crohn's disease. The goals of these statements are to pool the pertinent literature specifically highlighting relevant data and conditions in the Asia-Pacific region relating to the economy, health systems, background infectious diseases, differential diagnoses, and treatment availability. It does not intend to be all comprehensive and future revisions are likely to be required in this ever-changing field. © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

Nuclear power in East Asia

International Nuclear Information System (INIS)

Abelson, P.H.

1996-01-01

This editorial discusses the shifting dominance in the nuclear reactor technology from the USA to new leadership in East Asia. With the expanding economies and electricity demand, Design, construction and operation of a large number of nuclear power plants in east Asia will support nuclear engineers, technologist, manufacturing facilities, and potential weapons experts. In contrast, the cessation of construction of power reactors in the US is leading to deminished nuclear capabilities

Evaluation of fiber intake in diabetes 2 patients of an asistencial center of Rosario city

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María Elisa Zapata

2013-09-01

Full Text Available Introduction: a diet high in fiber has associated with better glycaemic control in diabetes 2 patients, being the soluble fraction of the most effective in the control of blood sugar levels. The aim of the study is determine the amount of total, soluble and insoluble dietary fiber intake by patients with type 2 diabetes who attended a medical centre for diabetics in Rosario.Material and methods: descriptive, observational, cross-sectional study was conducted. It was determined a sample of 60 adults with a diagnosis of diabetes type 2 >6 months, 18 to 70 years old, with no disease or intestinal disorders. A semiquantitative food frequency questionnaire of foods source of dietary fiber, and a photo album was used to identify the portion size. Descriptive statistical analysis was performed and Chi-square and ANOVA test was used to evaluate the association.Results: the average consumption of total fiber was 18,8±5,9 g/d, 14, 8±4,6 g/d corresponded to insoluble fiber and 4,0±1,5 g/d to soluble fiber. Fruits and vegetables contributed 82% of soluble fiber. Most patients (62% had a consumption of fiber total less than the recommendation of the ADA, and 60% presented an inadequate relationship between intake of soluble and insoluble fiber.Conclusions: it is necessary to increase the contribution of total dietary fiber, especially the soluble fraction in diabetes 2 patients, because there are evidences that supports its benefits.

Establishing bioinformatics research in the Asia Pacific

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Tammi Martti

2006-12-01

Full Text Available Abstract In 1998, the Asia Pacific Bioinformatics Network (APBioNet, Asia's oldest bioinformatics organisation was set up to champion the advancement of bioinformatics in the Asia Pacific. By 2002, APBioNet was able to gain sufficient critical mass to initiate the first International Conference on Bioinformatics (InCoB bringing together scientists working in the field of bioinformatics in the region. This year, the InCoB2006 Conference was organized as the 5th annual conference of the Asia-Pacific Bioinformatics Network, on Dec. 18–20, 2006 in New Delhi, India, following a series of successful events in Bangkok (Thailand, Penang (Malaysia, Auckland (New Zealand and Busan (South Korea. This Introduction provides a brief overview of the peer-reviewed manuscripts accepted for publication in this Supplement. It exemplifies a typical snapshot of the growing research excellence in bioinformatics of the region as we embark on a trajectory of establishing a solid bioinformatics research culture in the Asia Pacific that is able to contribute fully to the global bioinformatics community.

A core outcome set for studies evaluating the effectiveness of prepregnancy care for women with pregestational diabetes.

LENUS (Irish Health Repository)

Egan, Aoife M

2017-04-01

The aim of this study was to develop a core outcome set (COS) for trials and other studies evaluating the effectiveness of prepregnancy care for women with pregestational (pre-existing) diabetes mellitus.

Drug problem in southeast and southwest Asia.

Science.gov (United States)

Kulsudjarit, Kongpetch

2004-10-01

In 2002, the drug problem in Southeast and Southwest Asia was serious, particularly in the production of opium and heroin in Afghanistan, Myanmar, and Laos, the three largest producers of illicit opium in the world. The increasing illicit manufacture of ATS, particularly methamphetamine, in Southeast Asia, mainly in China and Myanmar, was also a major concern. Some reports indicated that ephedrine, used for illicitly producing methamphetamine in Southeast Asia, is diverted and smuggled out of China and India, whereas caffeine, the adulterant used for producing methamphetamine tablets, is mainly smuggled into Myanmar through its border with Thailand. Seizure data showed a dramatic increase in trafficking in MDMA through Southeast Asia. In terms of the drug epidemic, in 2002, cannabis remained overall the main drug of abuse in all of the countries of Southeast and Southwest Asia. Opiates, mainly opium and heroin, were also the drugs of choice except in Thailand, where opiate abuse declined, but ATS was the main drug of abuse due to its low cost and availability. A significant increase in ATS abuse, amphetamine, methamphetamine, and MDMA among the youth who smoked, sniffed, and inhaled them was reported in Cambodia, China, Indonesia, Laos, Myanmar, the Philippines, and Thailand. Injecting drug use among opiate abusers has been identified as the prime cause of the rapid spread of HIV/AIDS in Southeast and Southwest Asia.

Menopause and risk of diabetes in the Diabetes Prevention Program.

Science.gov (United States)

Kim, Catherine; Edelstein, Sharon L; Crandall, Jill P; Dabelea, Dana; Kitabchi, Abbas E; Hamman, Richard F; Montez, Maria G; Perreault, Leigh; Foulkes, Mary A; Barrett-Connor, Elizabeth

2011-08-01

The study objectives were to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopause status modifies response to diabetes prevention interventions. The study population included women in premenopause (n = 708), women in natural postmenopause (n = 328), and women with bilateral oophorectomy (n = 201) in the Diabetes Prevention Program, a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose-intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance, and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy use. After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (hazard ratio [HR], 0.19; 95% CI, 0.04-0.94), although observations were too few to determine if this was independent of hormone therapy use. No significant differences were seen in the metformin (HR, 1.29; 95% CI, 0.63-2.64) or placebo arms (HR, 1.37; 95% CI, 0.74-2.55). Among women at high risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with a decreased diabetes risk.

Southeast Asia activity on the rise

International Nuclear Information System (INIS)

Khin, J.A.; Johnston, D.

1992-01-01

This paper reports that the Asia-Pacific region has gained favor in the increasingly competitive global market for drilling funds and technology. The level of activity in the region contrasts to the U.S., where political, fiscal, and geological conditions have caused an industry-wide depression. Consolidation and restructuring of the oil industry have also affected the Asia-Pacific area, but not as adversely as North America. The shifting focus of most U.S. oil companies to the international sector has increased attention on Southeast Asia. The number of production-sharing contracts and exploration licenses in the region has increased to almost 800, covering an area of 7 million sq km

Outcome of Diabetic and Non-Diabetic Patients Undergoing Successful Percutaneous Coronary Intervention of Chronic Total Occlusion

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Bahram Sohrabi

2011-05-01

Full Text Available Introduction: Diabetes mellitus is associated with an increased risk of adverse clinical outcomes after percutaneous coronary intervention (PCI. The prognosis of patients with diabetes mellitus and chronic total occlusion (CTO treated with PCI is poorly investigated. Current study evaluates outcome of successful PCI on CTO in patients with and without diabetes. Methods: One hundred and sixty three patients treated with successful PCI on CTO between January 2009 and March 2011 were prospectively identified from the PCI registry at the Madani Heart Center, Tabriz, Iran. Patients were followed for 15±3 months, were evaluated for the occurrence of major adverse cardiac events (MACE comprising death, acute myocardial infarction, and need for repeat revascularization.Results: No differences were found in baseline clinical and procedural variables between patients with (n=34 and without diabetes (n=129, unless for hypertension (p=0.03. Hospitalization period after PCI in diabetics (3.26±0.61 days and non-diabetics (2.86±0.52 days was similar. In-hospital MACE occurred in 8 (23.5% individuals of diabetics and 10 (7.8% individuals of non-diabetics (p=0.02, among them revascularization was significantly higher in diabetics (20.6% vs. 7%, p=0.04. Follow-up events in diabetic and non-diabetic groups were 12 (35.3% and 37 (28.5%, respectively (p was not significant. Conclusion: In patients undergoing successful PCI on CTO, diabetes is associated with higher in-hospital adverse events; however diabetes does not affect long term outcomes in these patients.

Jiangtang Xiaozhi Recipe () prevents diabetic retinopathy in streptozotocin-induced diabetic rats.

Science.gov (United States)

Li, Lin; Li, Yan-Lin; Zhou, Yun-Feng; Ge, Zheng-Yan; Wang, Li-Li; Li, Zhi-Qiang; Guo, Yu-Jie; Jin, Long; Ren, Ye; Liu, Jian-Xun; Xu, Yang

2017-06-01

To evaluate the prevention effect of diabetic retinopathy of Jiangtang Xiaozhi Recipe (, JXR) in streptozotocin (STZ)-induced diabetic rats. Sprague-Dawley rats were randomly divided into normal control group and diabetic group. Rats in the diabetic group were induced by intraperitoneal administration of STZ (50 mg/kg), and subdivided into 5 groups. Rats in the diabetic control group were given saline; four treatment groups were given metformin (300 mg/kg), JXR (2, 4 and 8 g/kg) respectively for 8 weeks, while rats in the normal control group were injected with citrate buffer and given the same volume of vehicle. Body weight and food intake were measured every week. The hypoglycaemic effects were determined by testing fasting blood glucose (FBG) every other week, and hemoglobin A1c (HbA1c), insulin, and glucagon at the end of the treatment. The preventive effects of JXR on STZ-induced diabetic rats were determined by histopathological examination with hematoxylin and eosin staining, and periodic acid-schiff staining. The effects were further evaluated by serum superoxide dismutase (SOD) activity and malondialdehyde (MDA). High-dose JXR significantly reduced FBG and HbA1c level at the 8th week of administration (Pdiabetic rats. Histopathological studies revealed that there were no basement membrane thickening and mild destruction in the treated groups. Morphometric measurements of retina microvascular showed that acellular capillary and capillary density decreased in treated rats while pericyte and endothelial cell increasing after the treatment. JXR have protective effect of diabetic retinopathy and its mechanism may be associated with the obvious hypoglycemic and antioxidant effect.

Acid precipitation in Europe and Asia

International Nuclear Information System (INIS)

Angell, Valter

2000-01-01

The article surveys acid precipitation problems in the region, discusses the sources, the pollutant composition and distribution, the work with the RAINS models as well as the organisation of and the results of joint incentives in the region. The acidification problems in China and some of the Norwegian participation efforts are reviewed. The author points out that much of the acidic precipitation and the environmental problems in Eurasia are due to the use of coal rich in sulphur, that the energy and environmental policies differs throughout the region because of differences in ecology and development levels and that Asia is far more heterogeneous than Europe as to the conditions for co-ordinated efforts against acid precipitation. The differences in economy, geopolitical situation, environmental policies etc. are larger than in Europe and a considerable international effort will be required in order to succeed. Should the regional model RAINS-Asia be used as basis for further co-ordinated efforts on acid precipitation thorough evaluations on costs and advantages are needed. The conditions and need for modelling as basis for international agreements between Asiatic countries are not the same as in Europe. Finally international development organisations have and will continue to play an important part in the work for reducing acid precipitation in Asia. The Asiatic countries may also greatly benefit in the battle against acid precipitation from the experiences of the industrialised countries. However, Asiatic countries will have to meet the major costs of emission reduction themselves. The main question is what emphasis will be put on the long term environmental profits and on the need for rapid economic growth of materially impoverished people. Other development directions than those used by the industrialised countries, seems to be needed

Off-loading strategies in diabetic foot syndrome-evaluation of different devices.

Science.gov (United States)

Götz, Jürgen; Lange, Mario; Dullien, Silvia; Grifka, Joachim; Hertel, Gernot; Baier, Clemens; Koeck, Franz

2017-02-01

Diabetic foot syndrome is one of the most dreaded complications in diabetes mellitus. The purpose of this study was to assess the value of different offloading devices compared to walking in barefoot condition and in normal shoes both in healthy subjects and in patients with diabetes and neuropathy. Twenty patients with diabetes and polyneuropathy and ten healthy probands were included. Pedobarographic examination was performed in barefoot condition, with sneakers, postoperative shoes, Aircast® Diabetic Pneumatic Walker™ and VACO®diaped. In the diabetic group, a total contact cast was additionally tested. The most effective reduction of force was achieved by TCC (75%) and VACOdiaped (64.3%) with the VACO®diaped resulting in the most homogeneous distribution of forces all over the foot. A customized device like the TCC is still the most proven offloading device. However, a removable cast walker being based on vacuum pads and a cushioning sole, provides better results concerning force distribution.

Evaluation of cardiac risk by oxidative stress and inflammatory markers in diabetic patients

International Nuclear Information System (INIS)

Khan, D.A.; Qayyum, S.

2010-01-01

Objectives: To evaluate the diabetic patients for cardiac risk by measuring oxidative stress and inflammatory markers in relation with glycaemic control. Methodology: A total of 140 subjects were included in this case-control study, comprising of 70 diabetic patients with coronary heart disease (CHD) and an equal number, age and sex matched controls. The patients were non-alcoholic and had age >40 years, BMI < 30 kg/m/sup 2/ and glycated hemoglobin (HbA1c) 7-10%. Serum total cholesterol (TC) and gamma glutamyltransferase (GGT) were analyzed on selectra-E auto analyzer. Serum nitrate was measured at 540 nm on ELISA. HbA1c on was analyzed by using Human kit. Serum high sensitivity C-reactive protein (hS-CRP) was analyzed on immulite 1000. Results: Patients mean age was 51 (range 40-73) years. Diabetic patients had significantly elevated median of HbA1c (7.9 vs 4.9), hS CRP (6.0 vs 2.12), TC (5.95 vs 4.45), nitrate (19.20vs 10.70) and GGT (29.50 vs 22.50) as compared to controls (p< 0.001). HbA1c showed a positive correlation (p <0.001) with hS-CRP (r=0.49), TC (r=0.69), nitrate (r=0.41) and GGT (r=0.30). Conclusion: Oxidative stress and inflammatory markers should be used in addition to HbA1c for assessment of increased cardiac risk in un-controlled diabetic patients because of accelerated atherosclerosis due to free radical injury. (author)

Evaluating Diabetes Care for Patients With Serious Mental Illness Using the Chronic Care Model

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Kelly Vaez

2017-10-01

Full Text Available People with serious mental illness (SMI have a higher incidence of type 2 diabetes mellitus (T2DM and shorter life span due to medical health problems. The chronic care model (CCM has been used to improve care of patients with T2DM. One clinical organization that provided primary care to patients with SMI had excellent diabetes outcomes but did not have information on how they achieved those outcomes. Thus, we conducted a pilot study chart review for 30 patients with T2DM and SMI to determine how well the clinic’s system aligned with the overall CCM components and which components correlated with diabetes control. We also evaluated use of the CCM using the Assessment of Chronic Illness Care provider survey. Results showed that the clinic had an overall basic implementation level of the CCM, which allows opportunity for improvement. Two elements of the CCM were correlated with hemoglobin A 1C and both were in an unexpected direction: self-management support in the variable of percentage of visits that included patient-specific goal-setting ( r s = .52; P = .004 and delivery system design in the variable of number of nurse practitioner visits per study period ( r s = .43; P = .02. These findings suggest that the clinic may have made more concentrated efforts to manage diabetes for patients who were not in good diabetes control. Providers noted the influence of SMI and social service organization support on these patients’ clinical outcomes. The findings will be reexamined after a fuller implementation of the CCM to further improve management in this population.

The Asia-Pacific Strategic Triangle

DEFF Research Database (Denmark)

Schmidt, Johannes Dragsbæk

2014-01-01

The objective of this paper is to give insight into the debate over the strategic triangle and how it impacts conflict and security in South Asia. First the new geopolitical motives of the United States in the Asia-Pacific are outlined. Then the concept of strategic triangle is elaborated and its...... applicability discussed; third, details about China and India’s relations and responses to the new US policy are being analyzed; the perspective turns to the implications for conflict and security in South Asia with a focus on Afghanistan and Iran where oil and energy security are the main denominators...... of foreign policy calculations and moves in the strategic triangle; and finally, some concluding remarks are offered to explain the recent shifts in interactions between these core players in the emerging world order and whether a new geopolitical architecture is emerging...

Higher mortality of patients on haemodialysis with pancreatic diabetes compared to type 2-diabetes

Directory of Open Access Journals (Sweden)

Bodlaj Gert

2012-03-01

Full Text Available Abstract In rare cases (1-8% diabetic patients with end-stage renal disease (ESRD suffer from diabetic nephropathy (dNP due to pancreatic diabetes mellitus (PDM. Aim of this study was to investigate differences in the outcome of patients with PDM and those with type 2 diabetes. In a retrospective study we evaluated 96 diabetic patients, who started hemodialysis (HD in our dialysis centre (1997-2005. In 12 patients PMD was diagnosed, and 84 patients had type 2 diabetes. In both groups we compared vascular risk factors and prevalence of vascular diseases at the start of dialysis. We also evaluated incidence of malnutrition, and 5-year survival in both patient groups. The vascular risk factors were similar in both patient groups, also the prevalence of vascular diseases at the initiation of HD was similar in both groups. In the patients with PDM the mean BMI (kg/m2 was lower (22 + 3 versus 25 + 3, and also their serum albumin was lower (2.7 + 0.3 versus 3.4 + 0.3 g/dl, p Conclusions in HD-treated patients with type 2 diabetes or PDM the prevalence of vascular diseases was not significantly different. The lower survival of PDM patients can be related to poor nutrition status.

Monitoring of Individual Needs in Diabetes (MIND)-2

DEFF Research Database (Denmark)

Snoek, Frank J; Kersch, Nancy Y A; Eldrup, Ebbe

2012-01-01

To test the effects of implementing computer-assisted Monitoring of Individual Needs in Diabetes (MIND) in routine diabetes care on psychological status and glycemic control, identify predictors of poor psychological outcomes, and evaluate care providers' experiences.......To test the effects of implementing computer-assisted Monitoring of Individual Needs in Diabetes (MIND) in routine diabetes care on psychological status and glycemic control, identify predictors of poor psychological outcomes, and evaluate care providers' experiences....

Measuring Health Literacy in Individuals with Diabetes: A Systematic Review and Evaluation of Available Measures

Science.gov (United States)

Al Sayah, Fatima; Williams, Beverly; Johnson, Jeffrey A.

2013-01-01

Objective: To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. Methods" A systematic literature review…

Developing Community Health Worker Diabetes Training

Science.gov (United States)

Ferguson, W. J.; Lemay, C. A.; Hargraves, J. L.; Gorodetsky, T.; Calista, J.

2012-01-01

We designed, implemented and evaluated a 48-hour training program for community health workers (CHWs) deployed to diabetes care teams in community health centers (CHCs). The curriculum included core knowledge/skills with diabetes content to assist CHWs in developing patient self-management goals. Our qualitative evaluation included…

CORRUPTION AND FOREIGN DIRECT INVESTMENT IN EAST ASIA AND SOUTH ASIA: AN ECONOMETRIC STUDY

OpenAIRE

Rahim M. Quazi

2014-01-01

Many recent FDI studies have focused on the effects of corruption on FDI inflows. Theoretically, corruption can act as either a grabbing hand by raising uncertainty and transaction costs, which should impede FDI, or a helping hand by “greasing” the wheels of commerce in the presence of weak regulatory framework, which should facilitate FDI. This study analyzes the impact of corruption on FDI inflows in East Asia and South Asia – two regions that have recently received huge FDI inflows. Using ...

Asia Section. Regional Activities Division. Paper.

Science.gov (United States)

International Federation of Library Associations, The Hague (Netherlands).

Two papers on library and information activities in developing nations, particularly in India and other Asian countries, were presented at the 1983 International Federation of Library Associations (IFLA) conference. In "IFLA in Asia: A Review of the Work of the Regional Section for Asia," Edward Lim Huck Tee (Malaysia) describes the low…

Sulfur dioxide emissions and sectorial contributions to sulfur deposition in Asia

Science.gov (United States)

Arndt, Richard L.; Carmichael, Gregory R.; Streets, David G.; Bhatti, Neeloo

Anthropogenic and volcanic emissions of SO 2 in Asia for 1987-1988 are estimated on a 1° × 1° grid. Anthropogenic sources are estimated to be 31.6 Tg of SO 2 with the regions' volcanoes emitting an additional 3.8 Tg. For Southeast Asia and the Indian sub-continent, the emissions are further partitioned into biomass, industrial, utilities, and non-specific sources. In these regions emissions from biomass, utilities and industrial sources account for 16.7, 21.7, and 12.2%, respectively. In Bangladesh, ˜ 90% of the SO 2 emissions result from biomass burning and nearly 20% of India's 5 Tg of SO 2 emissions are due to biomass burning. Malaysia and Singapore's emissions are dominated by the utilities with 42 and 62% of their respective emissions coming from that sector. The spatial distribution of sulfur deposition resulting from these emissions is calculated using an atmospheric transport and deposition model. Sulfur deposition in excess of 2 g m -2 yr -1 is predicted in vast regions of east Asia, India, Thailand, Malaysia, Taiwan, and Indonesia with deposition in excess of 5 g m -2 yr -1 predicted in southern China. For the Indian sub-continent and Southeast Asia the contribution of biomass burning, industrial activities, and utilities to total sulfur emissions and deposition patterns are evaluated. Biomass burning is found to be a major source of sulfur deposition throughout southeast Asia. Deposition in Bangladesh and northern India is dominated by this emissions sector. Deposition in Thailand, the Malay Peninsula and the island of Sumatra is heavily influenced by emissions from utilities. The ecological impact of the deposition, in 1988 and in the year 2020, is also estimated using critical loads data developed in the RAINS-ASIA projects. Much of eastern China, the Korean Peninsula, Japan, Thailand, and large regions of India, Nepal, Bangladesh, Taiwan, the Philippines, Malaysia, Indonesia, and sections of Vietnam are at risk due to deposition in excess of their

Insulin requirements in type 1 diabetic pregnancy

DEFF Research Database (Denmark)

Callesen, Nicoline; Ringholm, Lene; Stage, Edna

2012-01-01

To evaluate the insulin requirements in women with type 1 diabetes during twin pregnancy compared with singleton pregnancy.......To evaluate the insulin requirements in women with type 1 diabetes during twin pregnancy compared with singleton pregnancy....

Non-diabetic renal disease in patients with type-2 diabetes mellitus

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Sonia Yaqub

2012-01-01

Full Text Available Diabetic nephropathy (DN is the leading cause of end-stage renal disease in diabetics worldwide, yet most patients with type-2 diabetes mellitus are not formally evaluated with a renal biopsy. The diagnosis is almost always based on clinical grounds. A wide spectrum of non-diabetic renal disease (NDRD is reported to occur in patients with type-2 diabetes. It has been estimated that up to one-third of all diabetic patients who present with proteinuria are suffering from NDRD. The aim of this analysis was to evaluate the prevalence and etiology of NDRD in patients with type-2 diabetes. We retrospectively reviewed the medical records of patients with type-2 diabetes who underwent kidney biopsy on clinical suspicion of NDRD (absence of diabetic retinopathy and/or neuropathy; short duration of diabetes, i.e. less than five years from January 2003 through December 2007 at the Aga Khan University Hospital, Karachi. Based on the biopsy findings, patients were grouped as Group-I, isolated NDRD; Group-II, NDRD with underlying DN; and Group-III, isolated DN. Of 68 patients studied, 75% were males and the mean age was 56 years. The mean duration of diabetes was nine years. Group-I included 34 patients (52%, Group-II included 11 patients (17% and Group-III included 23 patients (31%. Among the Group-I patients, the mean age was 56 years (41-77 years. The most common NDRDs were acute interstitial nephritis (32%, diffuse proliferative glomerulonephritis (17%; membranous nephropathy (12% and crescentic glomerulonephritis (12%. Among Group-II, the mean age was 60 years (46-71 years, and the most common lesion was interstitial nephritis superimposed on underlying DN (63% cases. Among Group-III, the mean age was 53 years (42- 80 years. The mean proteinuria was 5, 6.3 and 7.3 g/24 h of urine collection in Groups I, II and III, respectively (P = NS. The mean duration of diabetes was 7.3, 11.7 and 10.7 years in Groups I, II and III, respectively. The duration of