WorldWideScience

Sample records for reach glycemic goals

  1. BROOKHAVEN: Proton goal reached

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    On March 30 the 35-year old Alternating Gradient Synchrotron (AGS) exceeded its updated design goal of 6 x 10 13 protons per pulse (ppp), by accelerating 6.3 x 10 13 ppp, a world record intensity. This goal was set 11 years ago and achieving it called for the construction of a new booster and the reconstruction of much of the AGS. The booster was completed in 1991, and reached its design intensity of 1.5 x 10 13 ppp in 1993. The AGS reconstruction was finished in 1994, and by July of that year the AGS claimed a new US record intensity for a proton synchrotron of 4 x 10 13 ppp, using four booster pulses. Reaching the design intensity was scheduled for 1995. In 1994, the AGS had seemed to be solidly limited to 4 x 10 13 ppp, but in 1995 the operations crew, working on their own in the quiet of the owl shift, steadily improved the intensity, regularly setting new records, much to the bemusement of the machine physicists. The physicists, however, did contribute. A second harmonic radiofrequency cavity in the booster increased the radiofrequency bucket area for capture, raising the booster intensity from 1.7 to 2.1 x 10 13 ppp. In the AGS, new radiofrequency power supplies raised the available voltage from 8 to 13 kV, greatly enhancing the beam loading capabilities of the system. A powerful new transverse damping system successfully controlled instabilities that otherwise would have destroyed the beam in less than a millisecond. Also in the AGS, 35th harmonic octupole resonances were found

  2. BROOKHAVEN: Proton goal reached

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1995-09-15

    On March 30 the 35-year old Alternating Gradient Synchrotron (AGS) exceeded its updated design goal of 6 x 10{sup 13} protons per pulse (ppp), by accelerating 6.3 x 10{sup 13} ppp, a world record intensity. This goal was set 11 years ago and achieving it called for the construction of a new booster and the reconstruction of much of the AGS. The booster was completed in 1991, and reached its design intensity of 1.5 x 10{sup 13} ppp in 1993. The AGS reconstruction was finished in 1994, and by July of that year the AGS claimed a new US record intensity for a proton synchrotron of 4 x 10{sup 13} ppp, using four booster pulses. Reaching the design intensity was scheduled for 1995. In 1994, the AGS had seemed to be solidly limited to 4 x 10{sup 13} ppp, but in 1995 the operations crew, working on their own in the quiet of the owl shift, steadily improved the intensity, regularly setting new records, much to the bemusement of the machine physicists. The physicists, however, did contribute. A second harmonic radiofrequency cavity in the booster increased the radiofrequency bucket area for capture, raising the booster intensity from 1.7 to 2.1 x 10{sup 13} ppp. In the AGS, new radiofrequency power supplies raised the available voltage from 8 to 13 kV, greatly enhancing the beam loading capabilities of the system. A powerful new transverse damping system successfully controlled instabilities that otherwise would have destroyed the beam in less than a millisecond. Also in the AGS, 35th harmonic octupole resonances were found.

  3. Reaching the Millennium Development Goals : Mauritania Should Care

    OpenAIRE

    Magnoli Bocchi, Alessandro; Pontara, Nicola; Fall, Khayar; Tejada, Catalina M.; Gallego Cuervo, Pablo

    2008-01-01

    Mauritania is a resource-rich developing country. As many other African nations, it will not reach most of the Millennium Development Goals, unless the authorities commit to accelerating progress. To succeed by 2015, the government needs to: mobilize additional financial resources, introduce policy changes at the sector level, and strengthen the links between strategic objectives and the b...

  4. Reaching Into the Unknown: Actions, Goal Hierarchies, and Explorative Agency

    Directory of Open Access Journals (Sweden)

    Davood G. Gozli

    2018-03-01

    Full Text Available Action is widely characterized as possessing a teleological dimension. The dominant way of describing goal-directed action and agency is in terms of exploitation, i.e., pursuing pre-specified goals using existing strategies. Recent theoretical developments emphasize the place of exploration, i.e., discovering new goals or acquiring new strategies. The exploitation-exploration distinction poses questions with regard to goals and agency: Should exploration, as some authors have suggested, be regarded as acting without a goal? We argue that recognizing the hierarchical nature of goals is crucial in distinguishing the two kinds of activity, because this recognition prevents the claim that exploration is goal-free, while allowing for a homogeneous account of both exploitative and explorative actions. An action typically causes relatively low-level/proximal (i.e., sensorimotor, immediate and relatively high-level/distal (i.e., in the environment, at a wider timescale outcomes. In exploitation, one relies on existing associations between low- and high-level states, whereas in exploration one does not have the ability or intention to control high-level/distal states. We argue that explorative action entails the capacity to exercise control within the low-level/proximal states, which enables the pursuit of indeterminate goals at the higher levels of a goal hierarchy, and the possibility of acquiring new goals and reorganization of goal hierarchies. We consider how the dominant models of agency might accommodate this capacity for explorative action.

  5. Grip type and task goal modify reach-to-grasp performance in post-stroke hemiparesis.

    Science.gov (United States)

    Schaefer, Sydney Y; DeJong, Stacey L; Cherry, Kendra M; Lang, Catherine E

    2012-04-01

    This study investigated whether grip type and/or task goal influenced reaching and grasping performance in poststroke hemiparesis. Sixteen adults with poststroke hemiparesis and twelve healthy adults reached to and grasped a cylindrical object using one of two grip types (3-finger or palmar) to achieve one of two task goals (hold or lift). Performance of the stroke group was characteristic of hemiparetic limb movement during reach-to-grasp, with more curved handpaths and slower velocities compared with the control group. These effects were present regardless of grip type or task goal. Other measures of reaching (reach time and reach velocity at object contact) and grasping (peak thumb-index finger aperture during the reach and peak grip force during the grasp) were differentially affected by grip type, task goal, or both, despite the presence of hemiparesis, providing new evidence that changes in motor patterns after stroke may occur to compensate for stroke-related motor impairment.

  6. Grip type and task goal modify reach-to-grasp performance in post-stroke hemiparesis

    Science.gov (United States)

    Schaefer, Sydney Y.; DeJong, Stacey L.; Cherry, Kendra M.; Lang, Catherine E.

    2011-01-01

    This study investigated whether grip type and/or task goal influenced reaching and grasping performance in post-stroke hemiparesis. Sixteen adults with post-stroke hemiparesis and twelve healthy adults reached to and grasped a cylindrical object using one of two grip types (3-finger or palmar) to achieve one of two task goals (hold or lift). Performance of the stroke group was characteristic of hemiparetic limb movement during reach-to-grasp, with more curved handpaths and slower velocities compared to the control group. These effects were present regardless of grip type or task goal. Other measures of reaching (reach time and reach velocity at object contact) and grasping (peak thumb-index finger aperture during the reach and peak grip force during the grasp) were differentially affected by grip type, task goal, or both, despite the presence of hemiparesis, providing new evidence that changes in motor patterns after stroke may occur to compensate for stroke-related motor impairment. PMID:22357103

  7. Prediction of Reach Goals in Depth and Direction from the Parietal Cortex

    Directory of Open Access Journals (Sweden)

    Matteo Filippini

    2018-04-01

    Full Text Available Summary: The posterior parietal cortex is well known to mediate sensorimotor transformations during the generation of movement plans, but its ability to control prosthetic limbs in 3D environments has not yet been fully demonstrated. With this aim, we trained monkeys to perform reaches to targets located at various depths and directions and tested whether the reach goal position can be extracted from parietal signals. The reach goal location was reliably decoded with accuracy close to optimal (>90%, and this occurred also well before movement onset. These results, together with recent work showing a reliable decoding of hand grip in the same area, suggest that this is a suitable site to decode the entire prehension action, to be considered in the development of brain-computer interfaces. : Filippini et al. show that it is possible to use parietal cortex activity to predict in which direction the arm will move and how far it will reach. This opens up the possibility of neural prostheses that can accurately guide reach and grasp using signals from this part of the brain. Keywords: neuroprosthetics, offline neural decoding, reaching in depth, monkey, V6A, machine learning, visuomotor transformations, hand guidance, prehension, robotics

  8. Goal-selection and movement-related conflict during bimanual reaching movements.

    Science.gov (United States)

    Diedrichsen, Jörn; Grafton, Scott; Albert, Neil; Hazeltine, Eliot; Ivry, Richard B

    2006-12-01

    Conflict during bimanual movements can arise during the selection of movement goals or during movement planning and execution. We demonstrate a behavioral and neural dissociation of these 2 types of conflict. During functional magnetic resonance imaging scanning, participants performed bimanual reaching movements with symmetric (congruent) or orthogonal (incongruent) trajectories. The required movements were indicated either spatially, by illuminating the targets, or symbolically, using centrally presented letters. The processing of symbolic cues led to increased activation in a left hemisphere network including the intraparietal sulcus, premotor cortex, and inferior frontal gyrus. Reaction time cost for incongruent movements was substantially larger for symbolic than for spatial cues, indicating that the cost was primarily associated with the selection and assignment of movement goals, demands that are minimized when goals are directly specified by spatial cues. This goal-selection conflict increased activity in the pre-supplementary motor area and cingulate motor areas. Both cueing conditions led to larger activation for incongruent movements in the convexity of the superior parietal cortex, bilaterally, making this region a likely neural site for conflict that arises during the planning and execution of bimanual movements. These results suggest distinct neural loci for 2 forms of constraint on our ability to perform bimanual reaching movements.

  9. U.N. climate convention goals may be out of reach

    Science.gov (United States)

    Wakefield, J.

    The chief goal of the 1992 Rio climate convention may be unobtainable, recent reports indicate, as nations are gearing up for the first conference on the U.N. framework in Geneva, August 22—September 2. And even if the convention goal of reducing carbon dioxide emissions to 1990 levels by the year 2000 is reached, some experts say, little would actually be accomplished to stabilize global climate change.For starters, reports earlier this month revealed that Japan and Australia, to name a couple, may be off the target. On a national level, Japan is projected to come in about 3% above the mark. Australia may even withdraw from the convention for economic reasons, according to Australian Foreign Minister Gareth Evans.

  10. Reaching Agreement on Advisory Goals Using a Card Sorting and a Goal Ranking Approach: A Professional Development School Inquiry.

    Science.gov (United States)

    Galassi, John P.; Thornton, Beryl; Sheffield, Anne; Bryan, Michael; Oliver, Joyce

    1998-01-01

    Goal card sort and ranking task was given to middle school teachers and a sample of sixth- through eighth-grade students to generate data relevant to revising goals of an advisory program. Study categories included advocacy, community, skills, invigoration, academic and administrative. Community and advocacy goals received highest student ranking,…

  11. A 1% Solution: Establishing and Reaching Enrollment Goals in Geoscience Departments

    Science.gov (United States)

    Rhodes, D. D.

    2005-12-01

    of majors in the program began to increase and that upturn has continued through the present. In December 2004, the number of majors topped 100 (almost evenly split between geography and geology) for the first time in the history of the Department. By the end of the Spring 2005 semester, the department had reached its original goal of 124 majors. Other activities during the period contributed to the Department's success. Adding a Bachelor of Arts degree in geography attracted students interested in cultural geography. Far ranging field trips (e.g., Hawaii, Ecuador) have added greatly to our majors' breadth of experience. Social events, including an annual awards dinner and gatherings for alumni, have helped the students to feel a part of the Department. Undergraduate research experiences increased in quality and students began to present their work at professional meetings at all levels. All of these activities have helped to give majors a stronger attachment to the Department and have made them better recruiters of other motivated students. The survey given to graduating seniors asks about the importance of a number of activities in the student's decision to major in either geology or geography. No single event stands out as crucial. So although there is a clear temporal connection between the recruiting talks and increased enrollments, students do not consider it decisive in their choice. While recruitment efforts focused on career opportunities may not be the magic bullet to cure low enrollments, they certainly move students in our direction when the time comes to select a major.

  12. Efficiency in Reaching the Millennium Development Goals. World Bank Working Paper.

    Science.gov (United States)

    Jayasuriya, Ruwan, Ed.; Wodon, Quentin, Ed.

    The Millennium Development Goals (MDGs) provide clear targets and areas of focus for international organizations such as the World Bank. At a conceptual level, to reduce poverty and hunger, to improve education and health indicators, and to promote gender equality and sustainable development, countries can either increase the resources they…

  13. Treatment goals for ambulatory blood pressure and plasma lipids after stroke are often not reached

    DEFF Research Database (Denmark)

    Engberg, Aase Worså; Kofoed, Klaus

    2013-01-01

    In Danish health care, secondary prevention after stroke is currently handled mainly by general practitioners using office blood pressure (OBP) assessment of hypertension. The aim of this study was to compare the OBP approach to 24-hour assessment by ambulatory blood pressure (ABP) monitoring....... Furthermore, we aimed to record the degree of adherence to recommended therapy goals for blood pressure and plasma lipids....

  14. Utilizing Earth Observations for Reaching Sustainable Development Goals in Water, Sanitation and Public Health

    Science.gov (United States)

    Akanda, A. S.; Hasan, M. A.; Nusrat, F.; Jutla, A.; Huq, A.; Alam, M.; Colwell, R. R.

    2016-12-01

    The United Nations Sustainable Development Goals call for universal and equitable access to safe and affordable drinking water, improvement of water quality, and adequate and equitable sanitation for all, with special attention to the needs of women and girls and those in vulnerable situations (Goal 6). In addition, the world community also aims to end preventable deaths of newborns and children under 5 years of age, and end the epidemics of neglected tropical diseases and combat hepatitis, water-borne diseases and other infectious diseases (Goal 3). Water and sanitation-related diseases remain the leading causes of death in children under five, mostly in South Asia and sub-Saharan Africa, due to diarrheal diseases linked to poor sanitation and hygiene. Water scarcity affects more than 40 per cent of the global population and is projected to rise substantially. More than 80 per cent of wastewater resulting from human activities is also discharged into rivers or sea without any treatment and poor water quality controls. As a result, around 1.8 billion people globally are still forced to use a source of drinking water that is fecally contaminated. Earth observation techniques provide the most effective and encompassing tool to monitor both regional and local scale changes in water quality and quantity, impacts of droughts and flooding, and water resources vulnerabilities in delta regions around the globe. University of Rhode Island, along with partners in the US and Bangladesh, is using satellite remote sensing datasets and earth observation techniques to develop a series of tools for surveillance, analysis and decision support for various government, academic, and non-government stakeholder organizations in South-Asia to achieve sustainable development goals in 1) providing safe water and sanitation access in vulnerable regions through safe water resources mapping, 2) providing increasing access to medicine and vaccines through estimation of disease burden and

  15. Is the goal of mastication reached in young dentates, aged dentates and aged denture wearers?

    Science.gov (United States)

    Mishellany-Dutour, Anne; Renaud, Johanne; Peyron, Marie-Agnès; Rimek, Frank; Woda, Alain

    2008-01-01

    The objective of the present study was to assess the impact of age and dentition status on masticatory function. A three-arm case-control study was performed. Group 1 (n 14) was composed of young fully dentate subjects (age 35.6 +/- 10.6 years), group 2 (n 14) of aged fully dentate subjects (age 68.8 +/- 7.0 years) and group 3 (n 14) of aged full denture wearers (age 68.1 +/- 7.2 years). Mastication adaptation was assessed in the course of chewing groundnuts and carrots to swallowing threshold. Particle size distribution of the chewed food, electromyographic (EMG) activity of the masseter and temporalis muscles during chewing, and resting and stimulated whole saliva rates were measured. Aged dentate subjects used significantly more chewing strokes to reach swallowing threshold than younger dentate subjects (P < 0.05), with increased particle size reduction, longer chewing sequence duration (P < 0.05) and greater total EMG activity (P < 0.05) for both groundnuts and carrots. In addition, aged denture wearers made significantly more chewing strokes than aged dentate subjects (P < 0.001) to reach swallowing threshold for groundnuts. Particle size reduction at time of swallowing was significantly poorer for denture wearers than for their aged dentate counterparts, despite an increase in chewing strokes, sequence duration and EMG activity per sequence. Masticatory function was thus adapted to ageing, but was impaired in denture wearers, who failed to adapt fully to their deficient masticatory apparatus.

  16. Real-time decreased sensitivity to an audio-visual illusion during goal-directed reaching.

    Directory of Open Access Journals (Sweden)

    Luc Tremblay

    Full Text Available In humans, sensory afferences are combined and integrated by the central nervous system (Ernst MO, Bülthoff HH (2004 Trends Cogn. Sci. 8: 162-169 and appear to provide a holistic representation of the environment. Empirical studies have repeatedly shown that vision dominates the other senses, especially for tasks with spatial demands. In contrast, it has also been observed that sound can strongly alter the perception of visual events. For example, when presented with 2 flashes and 1 beep in a very brief period of time, humans often report seeing 1 flash (i.e. fusion illusion, Andersen TS, Tiippana K, Sams M (2004 Brain Res. Cogn. Brain Res. 21: 301-308. However, it is not known how an unfolding movement modulates the contribution of vision to perception. Here, we used the audio-visual illusion to demonstrate that goal-directed movements can alter visual information processing in real-time. Specifically, the fusion illusion was linearly reduced as a function of limb velocity. These results suggest that cue combination and integration can be modulated in real-time by goal-directed behaviors; perhaps through sensory gating (Chapman CE, Beauchamp E (2006 J. Neurophysiol. 96: 1664-1675 and/or altered sensory noise (Ernst MO, Bülthoff HH (2004 Trends Cogn. Sci. 8: 162-169 during limb movements.

  17. Predictors of reaching a serum uric acid goal in patients with gout and treated with febuxostat

    Directory of Open Access Journals (Sweden)

    Sheer R

    2017-10-01

    Full Text Available Richard Sheer,1 Kyle D Null,2 Keith A Szymanski,2 Lavanya Sudharshan,1 Jennifer Banovic,2 Margaret K Pasquale1 1Comprehensive Health Insights, Inc., Louisville, KY, 2Takeda Pharmaceuticals U.S.A., Inc., Deerfield, IL, USA Purpose: Clinical guidelines recommend febuxostat as first-line pharmacologic urate-lowering therapy for patients with gout to achieve a goal serum uric acid (sUA <6 mg/dL; however, little is known about other contributing factors. This study identified clinical characteristics of patients treated with febuxostat to develop and validate a predictive model for achieving a goal sUA.Patients and methods: Patients with Humana Medicare or commercial insurance, diagnosed with gout and newly initiated on febuxostat (index date February 1, 2009 – December 31, 2013, were identified for a retrospective cohort study. Patients were followed for 365 days and the first valid sUA test result ≥120 days after index was retained. A stepwise logistic regression with backward elimination was estimated to model sUA goal attainment, and a linear model was estimated to model the impact of predictor variables on sUA level.Results: The study sample (n=678 was divided into a development (training dataset (n=453 and a validation (holdout dataset (n=225. In the training sample, patients in the sUA <6 mg/dL group were on febuxostat for a longer time, were more adherent, and had a lower average baseline sUA level (all p<0.0001 vs patients in the sUA ≥6 mg/dL group. In the logistic model, febuxostat adherence (odds ratio [OR]=1.03, p<0.0001 and baseline sUA level (OR=0.84, p<0.0001 increased the odds of attaining sUA <6 mg/dL. In the linear regression model, increase in febuxostat adherence (p<0.0001, baseline sUA level (p<0.0001, advanced age (p=0.0021, and not having congestive heart failure (p<0.05 were associated with a reduction of sUA level. Pre-index allopurinol use was a marginally significant predictor of sUA level reduction (p=0

  18. Type 2 Diabetes Patients Reach Target Glycemic Control Faster Using IDegLira than Either Insulin Degludec or Liraglutide Given Alone

    DEFF Research Database (Denmark)

    Lauritsen, Tina Vilsbøll; Vora, Jiten; Jarlov, Henrik

    2016-01-01

    BACKGROUND AND OBJECTIVES: The time-course when changes in glycemic control and body weight were first manifest in patients with type 2 diabetes mellitus (T2DM) treated with a combination of insulin degludec and liraglutide (IDegLira) was assessed, comparing IDegLira to its individual components...

  19. What's Your Position? Strategies for Safely Reaching Patient Comfort Goals After Cardiac Catheterization via Femoral Approach.

    Science.gov (United States)

    Suggs, Patricia M; Lewis, Rebecca; Hart, Ann C; Troutman-Jordan, Meredith; Hardin, Sonya R

    Patients frequently complain of back pain after cardiac catheterization, and there is a lack of evidence to guide practice regarding patient comfort while maintaining hemostasis at femoral access site after cardiac catheterization. The aim of this study was to examine if frequent position changes affect a patient's pain level or increase incidents of bleeding in the recovery period after cardiac catheterization. A quasi-experimental pretest/posttest design was used to evaluate a patient's reported pain levels and positioning changes during bed rest period postprocedure. Twenty charts were reviewed to note documentation of patient position, self-reported pain rating related to pain relief goals, and occurrence of bleeding at the procedure site. A survey was conducted to reveal nurse attitudes, knowledge, and beliefs regarding positioning and pain management for patients in the post-cardiac catheterization period. Results from this survey were used to develop education and data collection tools. Education regarding perceived barriers and importance of maximizing activity orders for patient comfort was provided to nursing staff. After nurse education, an additional 20 charts were reviewed to note if increasing frequency of position change affects pain levels reported by patients or if any increased incidence of bleeding was noted with greater frequency of position change. Data were analyzed using correlation analyses. Greater levels of pain were associated with higher pain ratings (r = 0.796, P position change only as a comfort measure was negatively associated with pain ratings; in other words, lower patient pain ratings were associated with use of positioning only without addition of medications to address complaint (r = -0.493, P position changes for comfort after cardiac catheterization. This initial analysis suggests position changes in conjunction with pain medication are beneficial in managing pain after cardiac catheterization. There was no increase in

  20. Alternatives to reach safeguards goals at Atucha I nuclear power plant

    International Nuclear Information System (INIS)

    Palacios, E.; Orpet, P.; Marzo, M.; Valentino, L.; Vicens, H.

    2001-01-01

    Full text: This paper describes the main features of Atucha I Nuclear Power Plant and the current safeguards' approach applied to this installation by the International Atomic Energy Agency (IAEA) and the Brazilian-Argentine Agency for Accounting and Control of Nuclear Materials (ABACC). The reasons for not completely fulfilling the IAEA safeguards criteria with the current approach are also described and a conceptual proposal of an unattended system developed jointly by ABACC and the Nuclear Regulatory Authority of Argentina (ARN) is presented. Finally, the paper addresses an alternative proposal to the previous one aiming at fulfilling the above mentioned objectives. Atucha I Nuclear Power Plant (NPP) was built in the 70's and has been under operation since 1974, This is an On Load Reactor, moderated and refrigerated with heavy water (PHWR). From its starting up to about a year ago, this NPP operated with natural uranium fuel assemblies but presently the reactor core is fed with slightly enriched uranium fuel assemblies (0,85 %). This Plant generates up to 357 Mwe. An outstanding operating characteristic of this power reactor is that low burn-up fuels assemblies already discharged into the pond may be re-used when necessary upon neutron flux requirements (re-shuffling). This installation has a pond storage capacity of about 10,000 fuel assemblies. At the highest power rate, the reactor core must be fed with a frequency of about 0,72 fuel assemblies per day. Before the application of the Agency Safeguards Criteria (IAEA-SC) in (1991), Atucha l had always satisfied the IAEA safeguards goals. Since 1991 the IAEA-SC demanded for On Load Reactors the control of the flow of irradiated fuel assemblies that leave or enter into the core (re-shuffling). By that time, Atucha I had been working for about seventeen years and there was no possibilities to install specific safeguards equipment without making significant construction modifications on this installation. Under the

  1. A Mixed Methods Study Exploring the Factors and Behaviors That Affect Glycemic Control Following a Structured Education Program: The Irish DAFNE Study

    Science.gov (United States)

    Casey, Dympna; O'Hara, Mary Clare; Meehan, Ben; Byrne, Molly; Dinneen, Sean F.; Murphy, Kathy

    2016-01-01

    Aim: To explain the factors affecting glycemic control (measured by HbA1c) following the Dose Adjustment for Normal Eating (DAFNE) program. Background: DAFNE is a structured education program designed to assist persons with type 1 diabetes mellitus achieve optimal glycemic control. However, not all participants reach this goal. Few studies…

  2. Functional Magnetic Resonance Imaging of Goal-Directed Reaching in Children with Autism Spectrum Disorders: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Nicole M. G. Salowitz

    2014-04-01

    Full Text Available An unanswered question concerning the neural basis of autism spectrum disorders (ASD is how sensorimotor deficits in individuals with ASD are related to abnormalities of brain function. We previously described a robotic joystick and video game system that allows us to record functional magnetic resonance images (FMRI while adult humans make goal-directed wrist motions. We anticipated several challenges in extending this approach to studying goal-directed behaviors in children with ASD and in typically developing (TYP children. In particular we were concerned that children with autism may express increased levels of anxiety as compared to typically developing children due to the loud sounds and small enclosed space of the MRI scanner. We also were concerned that both groups of children might become restless during testing, leading to an unacceptable amount of head movement. Here we performed a pilot study evaluating the extent to which autistic and typically developing children exhibit anxiety during our experimental protocol as well as their ability to comply with task instructions. Our experimental controls were successful in minimizing group differences in drop-out due to anxiety. Kinematic performance and head motion also were similar across groups. Both groups of children engaged cortical regions (frontal, parietal, temporal, occipital while making goal-directed movements. In addition, the ASD group exhibited task-related correlations in subcortical regions (cerebellum, thalamus, whereas correlations in the TYP group did not reach statistical significance in subcortical regions. Four distinct regions in frontal cortex showed a significant group difference such that TYP children exhibited positive correlations between the hemodynamic response and movement, whereas children with ASD exhibited negative correlations. These findings demonstrate feasibility of simultaneous application of robotic manipulation and functional imaging to study goal

  3. Two Years after Molecular Diagnosis of Familial Hypercholesterolemia: Majority on Cholesterol-Lowering Treatment but a Minority Reaches Treatment Goal

    Science.gov (United States)

    Huijgen, Roeland; Kindt, Iris; Verhoeven, Sjoerd B. J.; Sijbrands, Eric J. G.; Vissers, Maud N.; Kastelein, John J. P.; Hutten, Barbara A.

    2010-01-01

    Background The risk of premature cardiovascular disease in patients with familial hypercholesterolemia (FH) can be profoundly reduced by cholesterol-lowering therapy, and current guidelines for FH advocate ambitious low-density lipoprotein cholesterol (LDL-C) goals. In the present study, we determined whether these goals are reflected in current clinical practice once FH has been diagnosed. Methodology/Principal Findings In 2008, we sent questionnaires to all subjects (aged 18–65 years) who were molecularly diagnosed with FH in the year 2006 through the screening program in the Netherlands. Of these 1062 subjects, 781 completed the questionnaire (46% males; mean age: 42±12 years; mean LDL-C at molecular diagnosis (baseline): 4.1±1.3 mmol/L). The number of persons that used cholesterol-lowering therapy increased from 397 (51%) at baseline to 636 (81%) after diagnosis. Mean treated LDL-C levels decreased significantly to 3.2±1.1 mmol/L two years after diagnosis. Only 22% achieved the LDL-C target level of ≤2.5 mmol/L. Conclusions/Significance The proportion of patients using cholesterol-lowering medication was significantly increased after FH diagnosis through genetic cascade screening. The attained LDL-C levels were lower than those reported in previous surveys on medication use in FH, which could reflect the effect of more stringent lipid target levels. However, only a minority of the medication users reached the LDL-C target. PMID:20169164

  4. Leveraging strengths to reach your goals: a skills-building workshop for women in dentistry and other professions.

    Science.gov (United States)

    Albino, Judith E

    2015-05-01

    This skills-building workshop at the 5(th) American Dental Education Association (ADEA) International Women's Leadership Conference engaged participants in a series of structured experiences designed to support learning about personal leadership strengths and areas for development, as well as setting and attaining leadership goals. The session was introduced with a brief reflective exercise focused on developing statements of personal goals for professional growth. An Appreciative Inquiry process then was used to explore participants' areas of strength, examining both self-perceptions and the perceptions of others who listened to their descriptions of "peak experiences" in work settings. The next part of the program utilized a Johari Window exercise to clarify the extent to which participants' self-perceived strengths and others' perceptions were shared, making those strengths visible to the world at large or hidden from the general view of others. This exercise allowed further exploration of individual competencies and characteristics and provided an opportunity for participants to visualize the potential for development in new areas. Finally, two very different peer coaching strategies were employed to expand on participants' learning. The experience proved to be a lively, socially engaging, and personally meaningful one for participants, whatever the stage of their careers or their country of origin.

  5. The effect of illicit financial flows on time to reach the fourth Millennium Development Goal in Sub-Saharan Africa: a quantitative analysis.

    Science.gov (United States)

    O'Hare, Bernadette; Makuta, Innocent; Bar-Zeev, Naor; Chiwaula, Levison; Cobham, Alex

    2014-04-01

    This paper sets out to estimate the cost of illicit financial flows (IFF) in terms of the amount of time it could take to reach the fourth Millennium Development Goal (MDG) in 34 African countries. We have calculated the percentage increase in gross domestic product (GDP) if IFFs were curtailed using IFF/GDP ratios. We applied the income (GDP) elasticity of child mortality to the increase in GDP to estimate the reduction in time to reach the fourth MDG in 34 African countries. children aged under five years. 34 countries in SSA. Reduction in time to reach the first indicator of the fourth MDG, under-five mortality rate in the absence of IFF. We found that in the 34 SSA countries, six countries will achieve their fourth MDG target at the current rates of decline. In the absence of IFF, 16 countries would reach their fourth MDG target by 2015 and there would be large reductions for all other countries. This drain on development is facilitated by financial secrecy in other jurisdictions. Rich and poor countries alike must stem the haemorrhage of IFF by taking decisive steps towards improving financial transparency.

  6. The effect of illicit financial flows on time to reach the fourth Millennium Development Goal in Sub-Saharan Africa: a quantitative analysis

    Science.gov (United States)

    Makuta, Innocent; Bar-Zeev, Naor; Chiwaula, Levison; Cobham, Alex

    2014-01-01

    Objectives This paper sets out to estimate the cost of illicit financial flows (IFF) in terms of the amount of time it could take to reach the fourth Millennium Development Goal (MDG) in 34 African countries. Design We have calculated the percentage increase in gross domestic product (GDP) if IFFs were curtailed using IFF/GDP ratios. We applied the income (GDP) elasticity of child mortality to the increase in GDP to estimate the reduction in time to reach the fourth MDG in 34 African countries. Participants children aged under five years. Settings 34 countries in SSA. Main outcome measures Reduction in time to reach the first indicator of the fourth MDG, under-five mortality rate in the absence of IFF. Results We found that in the 34 SSA countries, six countries will achieve their fourth MDG target at the current rates of decline. In the absence of IFF, 16 countries would reach their fourth MDG target by 2015 and there would be large reductions for all other countries. Conclusions This drain on development is facilitated by financial secrecy in other jurisdictions. Rich and poor countries alike must stem the haemorrhage of IFF by taking decisive steps towards improving financial transparency. PMID:24334911

  7. California Plug-In Electric Vehicle Infrastructure Projections: 2017-2025 - Future Infrastructure Needs for Reaching the State's Zero Emission-Vehicle Deployment Goals

    Energy Technology Data Exchange (ETDEWEB)

    Wood, Eric W [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Rames, Clement L [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Bedir, Abdulkadir [California Energy Commission; Crisostomo, Noel [California Energy Commission; Allen, Jennifer [California Energy Commission

    2018-03-27

    This report analyzes plug-in electric vehicle (PEV) infrastructure needs in California from 2017 to 2025 in a scenario where the State's zero-emission vehicle (ZEV) deployment goals are achieved by household vehicles. The statewide infrastructure needs are evaluated by using the Electric Vehicle Infrastructure Projection tool, which incorporates representative statewide travel data from the 2012 California Household Travel Survey. The infrastructure solution presented in this assessment addresses two primary objectives: (1) enabling travel for battery electric vehicles and (2) maximizing the electric vehicle-miles traveled for plug-in hybrid electric vehicles. The analysis is performed at the county-level for each year between 2017 and 2025 while considering potential technology improvements. The results from this study present an infrastructure solution that can facilitate market growth for PEVs to reach the State's ZEV goals by 2025. The overall results show a need for 99k-130k destination chargers, including workplaces and public locations, and 9k-25k fast chargers. The results also show a need for dedicated or shared residential charging solutions at multi-family dwellings, which are expected to host about 120k PEVs by 2025. An improvement to the scientific literature, this analysis presents the significance of infrastructure reliability and accessibility on the quantification of charger demand.

  8. THI: goal reached with a carbon beam, and some results of beam tests and theoretical studies related to longitudinal space charge effects

    International Nuclear Information System (INIS)

    Anon.

    1999-01-01

    During the first semester of this year, two tests were devoted to high intensity beams: 1) trying to reach the ultimate goal with a carbon beam and 2) going further into the study of perturbing phenomena. A 1.3 x 10 13 pps 13 C beam was successfully extracted from SSC2 and sustained for 13 hours with an excellent stability. Then, the current was increased to 2 x 10 13 pps with no major problem. Therefore, it is possible from now on to bombard the 2 kW target which is prepared for the production of helium isotopes and subsequent acceleration in the new cyclotron CIME. Both experimental and simulation studies were carried in parallel, in the frame of the last year expertise, in order to get a better knowledge and control of the effect of longitudinal space charge forces. It appears that these effects affect the beam width mostly in SSC2, while a discrepancy between computer simulations and measurements seems to show up concerning the effect of neighbouring bunches. (author)

  9. The impact of a primary care e-communication intervention on the participation of chronic disease patients who had not reached guideline suggested treatment goals.

    Science.gov (United States)

    Lussier, Marie-Thérèse; Richard, Claude; Glaser, Emma; Roberge, Denis

    2016-04-01

    To evaluate the efficacy of two web-based educational approaches on doctor-patient communication. The study focused on chronic disease (CD) patients in a lengthy relationship with their family physician (FP) who had not reached guideline suggested treatment goals (off-target) for their CDs. 322 hypertensive, diabetic, or dyslipidemic patients of 18 FPs were randomised into three groups: Usual Care (UC), e-Learning (e-L) and e-Learning+Workshop (e-L+W). Interventions were based on Cegala's PACE system: Prepare, Ask questions, Check understanding, Express concerns. Communication was evaluated using the Roter Interaction Analysis System (RIAS), MEDICODE and questionnaires. Encounter length was similar across groups. RIAS showed that e-L+W group engaged in more socio-emotional talk and PACE-like utterances. MEDICODE showed that interventions increased frequency, initiative and dialogue for selected CD medication themes. Quality of communication was perceived as satisfactory at baseline and did not change. Following interventions, CD patients were more activated even in well-established doctor-patient relationships. PACE web-based interventions are accessible and effective at increasing CD patients' participation. They increase legitimacy to express the patient experience. FPs should present this type of training to CD patients as an integral part of their routine practice and consider referring patients to complete it. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Glycemic index and diabetes

    Science.gov (United States)

    ... Most snack foods Potatoes White rice Watermelon Meal Planning with the Glycemic Index When planning your meals: ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  11. A Staff Development Program Designed To Reach the Partnership School's Goals: Cooperative Learning Strategies, Coaching Sessions and a Narrowed Academic Performance Gap among Student Populations.

    Science.gov (United States)

    Cook, Kathy; Karr-Kidwell, PJ

    This paper describes the design and implementation of a staff-development program at Vivian Field Junior High School in Carrollton, Texas. The school is a member of the Texas Partnership School Initiative, which was created to give schools latitude in raising student achievement. The goal of the staff-development program was to identify gains in…

  12. Diets with high or low protein content and glycemic index for weight-loss maintenance

    DEFF Research Database (Denmark)

    Larsen, Thomas Meinert; Dalskov, Stine-Mathilde; Baak, Marleen van

    2010-01-01

    Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power.......Studies of weight-control diets that are high in protein or low in glycemic index have reached varied conclusions, probably owing to the fact that the studies had insufficient power....

  13. Does knowledge on diabetes management influence glycemic control? A nationwide study in patients with type 1 diabetes in Brazil

    Directory of Open Access Journals (Sweden)

    Gomes MB

    2018-01-01

    Full Text Available Marilia Brito Gomes,1 Deborah Conte Santos,1 Marcela H Pizarro,1 Bianca Senger V Barros,1 Laura G Nunes de Melo,2 Carlos A Negrato3 1Department of Internal Medicine, Diabetes Unit, State University Hospital of Rio de Janeiro, 2Department of Ophthalmology, State University of Rio de Janeiro, Rio de Janeiro, 3Department of Internal Medicine, Bauru’s Diabetics Association, Bauru, São Paulo, Brazil Objective: The purpose of this study is to establish demographic and clinical data associated with the knowledge on diabetes management and its influence on glycemic control in patients with type 1 diabetes.Methods: This was a retrospective, observational, multicenter study conducted with 1,760 patients between August 2011 and August 2014 in 10 cities of Brazil.Results: Overall, 1,190 (67.6% patients knew what glycated hemoglobin (HbA1c means. These patients were older, had longer disease duration, longer follow-up in each center, reported lower frequency of self-reported hypoglycemia, and were more frequently Caucasians and at glycemic goal. Multivariate analysis showed that knowledge on what HbA1c means was related to more years of school attendance, self-reported ethnicity (Caucasians, severe hypoglycemia, economic status, follow-up time in each center, and participation on diabetes educational programs. Good glycemic control was related to older age, more years of school attendance, higher frequency of daily self-monitoring of blood glucose, higher adherence to diet, and knowledge on what HbA1c means.Conclusion: Patients with a knowledge on what HbA1c means had a better chance of reaching an adequate glycemic control that was not found in the majority of our patients. Diabetes care teams should rethink the approaches to patients and change them to more proactive schedules, reinforcing education, patients’ skills, and empowerment to have positive attitudes toward reaching and maintaining a better glycemic control. Finally, the glucocentric

  14. Alternative Assessment of Glycemic Control

    NARCIS (Netherlands)

    Greven, W.L.

    2015-01-01

    Diabetes mellitus is a chronic disease associated with development of microvascular and macrovascular complications. Optimal glycemic control, usually measured by HbA1c is the cornerstone for prevention of complications. In this thesis glycemic variability (which resembles actual glucose levels,

  15. Glycemic control in diabetes in three Danish counties.

    Science.gov (United States)

    Jørgensen, Lone G M; Petersen, Per Hyltoft; Heickendorff, Lene; Møller, Holger Jon; Hendel, Jørn; Christensen, Cramer; Schmitz, Anita; Reinholdt, Birgitte; Lund, Erik D; Christensen, Niels J; Hansen, Erik Kjaersgaard; Hastrup, Jens; Skjødt, Hanne; Eriksen, Ebbe Wendel; Brandslund, Ivan

    2005-01-01

    Hemoglobin A1c (HbA1c) is a proxy measure for glycemic control in diabetes. We investigated the trend for glycemic control in patients from three Danish counties using HbA1c measurements. We studied 2454 patients from a population of 807,000 inhabitants for whom routine monitoring of diabetes using HbA1c-DCCT aligned was initiated in 2001. We estimated the incidence of monitored patients in the population. The progress in patients with originally diabetic HbA1c levels was investigated by cumulative probability plots, and the individual trend in clinical outcome was investigated by a modified difference plot. The age-standardized incidence of monitored patients was or=6.62% HbA1c) showed on average 15% improved glycemic control in the first year. Further improvement was limited. The overall percentage above the treatment target (>or=6.62% HbA1c) was 51% in 2003 compared to 59% in 2001, and the percentage with poor glycemic control (>or=10.0% HbA1c) was reduced from 19% to 4%. Of patients with originally diabetic HbA1c levels, 15% showed progress in glycemic control, and 28% reached treatment targets. In patients with originally normal HbA1c, 75% showed an upward trend in HbA1c levels, which reached diabetic concentrations in 17%. Patients with diabetic first HbA1c concentrations (>or=6.62% HbA1c) showed on average 15% improved glycemic control in the first year. Further improvement was limited. In individual patients, 75% with originally diabetic HbA1c levels showed improved glycemic control after 3 years, while 78% with originally normal concentrations showed an upward trend in HbA1c levels.

  16. Chromium supplements for glycemic control in type 2 diabetes: limited evidence of effectiveness

    Science.gov (United States)

    Dwyer, Johanna T.; Bailey, Regan L.

    2016-01-01

    Some adults with type 2 diabetes mellitus (T2DM) believe that chromium-containing supplements will help control their disease, but the evidence is mixed. This narrative review examines the efficacy of chromium supplements for improving glycemic control as measured by decreases in fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c). Using systematic search criteria, 20 randomized controlled trials of chromium supplementation in T2DM patients were identified. Clinically meaningful treatment goals were defined as an FPG of ≤7.2 mmol/dL, a decline in HbA1c to ≤7%, or a decrease of ≥0.5% in HbA1c. In only a few randomized controlled trials did FPG (5 of 20), HbA1c (3 of 14), or both (1 of 14) reach the treatment goals with chromium supplementation. HbA1c declined by ≥0.5% in 5 of 14 studies. On the basis of the low strength of existing evidence, chromium supplements have limited effectiveness, and there is little rationale to recommend their use for glycemic control in patients with existing T2DM. Future meta-analyses should include only high-quality studies with similar forms of chromium and comparable inclusion/exclusion criteria to provide scientifically sound recommendations for clinicians. PMID:27261273

  17. Counting Carbs? Understanding Glycemic Index and Glycemic Load

    Science.gov (United States)

    ... compare how single servings of different foods affect blood sugar. It takes into account both the quality and quantity of carbs in a serving. . Some studies suggest that sticking to foods with a low glycemic index may help prevent ...

  18. IMPROVING GLYCEMIC CONTROL SAFELY IN CRITICAL CARE PATIENTS: A COLLABORATIVE SYSTEMS APPROACH IN NINE HOSPITALS.

    Science.gov (United States)

    Maynard, Gregory A; Holdych, Janet; Kendall, Heather; Harrison, Karen; Montgomery, Patricia A; Kulasa, Kristen

    2017-05-01

    Safely improve glycemic control in the critical care units of nine hospitals. Critical care adult inpatients from nine hospitals with ≥4 point-of-care blood glucose (BG) readings over ≥2 days were targeted by collaborative improvement efforts to reduce hyper- and hypoglycemia. Balanced glucometric goals for each hospital were set targeting improvement from baseline or goals deemed desirable from Society of Hospital Medicine (SHM) benchmarking data. Collaborative interventions included standardized insulin infusion protocols, hypoglycemia prevention bundles, audit and feedback, education, and measure-vention (coupling measurement of patients "off protocol" with concurrent interventions to correct suboptimal care). All sites improved glycemic control. Six reached prespecified levels of improvement of the day-weighted mean BG. The day-weighted mean BG for the cohort decreased by 7.7 mg/dL (95% confidence interval [CI], 7.0 mg/dL to 8.4 mg/dL) to 151.3 mg/dL. Six of nine sites showed improvement in the percent intensive care unit (ICU) days with severe hyperglycemia (any BG >299 mg/dL). ICU severe hyperglycemic days declined from 8.6 to 7.2% for the cohort (relative risk, 0.84; 95% CI, 0.80 to 0.88). Patient days with any BG <70 mg/dL were reduced by 0.4% (95% CI, 0.06% to 0.6%), from 4.5 to 4.1%, for a small but statistically significant reduction in hypoglycemia. Seven of nine sites showed improvement. Multihospital improvements in ICU glycemic control, severe hyperglycemia, and hypoglycemia are feasible. Balanced goals for glycemic control and hypoglycemia in the ICU using SHM benchmarks and metrics enhanced successful improvement efforts with good staff acceptance and sustainability. BG = blood glucose CMI = case-mix index CY = calendar year DKA = diabetic ketoacidosis EMR = electronic medical record GBMF = Gordon and Betty Moore Foundation ICU = intensive care unit IIP = insulin infusion protocol SHM = Society of z Hospital Medicine.

  19. Glycemic indices, glycemic load and glycemic response for seventeen varieties of dates grown in Saudi Arabia.

    Science.gov (United States)

    AlGeffari, Metab Ali; Almogbel, Ebtehal Solaiman; Alhomaidan, Homaidan Turki; El-Mergawi, Ragab; Barrimah, Issam Alsaed

    2016-01-01

    Dates are consumed worldwide, and are an important fruit for many individuals in Saudi Arabia. Currently, limited information is available on the glycemic indices of different date varieties. To determine the glycemic index (GI), glycemic load (GL) and glycemic response for 17 common date varieties in Saudi Arabia. Prospective clinical trial on healthy subjects. College of Medicine, Qassim University, Buraydah, Saudi Arabia. The available carbohydrate content of Tamer stage dates was determined using standard laboratory methods. Healthy subjects (ten males and nine females) received 50 g of glucose (on three separate occasions) and 50 g equivalent of available carbohydrates from the seventeen varieties of date (each once). The GI and GL were then calculated. GI, GL, and glycemic response. The mean (SEM) GI of the date samples was 55.2 (7.7) (range, 42.8-74.6). Sellaj and Maktoomi exhibited the highest GI (74.6 [10.1] and 71.0 [11.1]), respectively, whereas Shaqra, Sukkary, and Sag'ai had the lowest GI (42.8 [5.5], 43.4 [4.7] and 44.6 [6]), respectively. The GL of the date samples ranged from 8.5 to 24. Sellaj had a high GL (24), whereas Ajwah and Shaqra had a low GL (8.5 and 9.2). The analyses suggested no significant difference in GI between the date varieties. However, the GL values differed significantly between the 17 date varieties (P Saudi Arabia. The identification of date varieties with lower glycemic responses may help lower the GI of the diet of both healthy and diabetic Saudi individuals. We used dates at the Tamer stage, which may not be translatable to all types of dates.

  20. Glycemic Index and Diabetes

    Science.gov (United States)

    ... and lifestyle and helps achieve goals for blood glucose, cholesterol and triglycerides levels, blood pressure, and weight management. Research shows that both the amount and the type of carbohydrate in food affect blood glucose levels. Studies also show that the total amount ...

  1. Skin Autofluorescence and Glycemic Variability

    NARCIS (Netherlands)

    Noordzij, M. J.; Lefrandt, J. D.; Graaff, R.; Smit, A. J.

    Background: Accumulation of advanced glycation end products (AGEs) is accelerated during glycemic and oxidative stress and is an important predictor of complications in diabetes mellitus (DM). Study Design: Here we both review and present original data on the relationship between skin

  2. Reaching the hard to reach.

    Science.gov (United States)

    Bhiwandi, P; Campbell, M; Potts, M

    1994-01-01

    The 1994 International Conference on Population and Development proposed increasing contraceptive couple protection from 550 million in 1995 to 880 million in 2015. The task for family planning (FP) programs is to provide access to services for, sometimes, inaccessible rural populations. FP need based on desire for no more children has ranged from under 20% in Senegal to almost 80% in Peru. Socioeconomic development was found not to be a prerequisite for fertility change. Gender inequalities in education and social autonomy must be changed. FP access is very important among women with a disadvantaged background or among women unsure about FP. Bangladesh is a good example of a country with increased contraceptive prevalence despite low income. The rule of thumb is that contraception increases of 15% contribute to a drop in family size of about one child. Program effectiveness is related to a variety of factors: contraceptive availability at many locations, acceptable price of contraception, delivery of the oral contraceptives without prescriptions, and other strategies. FP is a service not a medical treatment. A range of methods must be promoted and available from a range of facilities. Contraceptive use is dependent on the woman's stage in her lifecycle and is dependent on informed choice. Community-based distribution systems are effective, whereas free distribution by poorly-trained field workers is not always very effective because patient payment of all or part of the cost assures quality and freedom of choice. Effective programs for underprivileged groups involve aggressive, easy to manage programs that can be replicated rapidly. FP serves a useful function in depressing maternal mortality among the poor in Africa, who have no access to quality health services. Social marketing is an effective strategy for reaching remote areas. Political will and robust management are necessary commodities.

  3. When you have to climb downhill to reach the top: The effect of action versus state orientation on solving a goal-subgoal conflict in the Tower of Hanoi task

    NARCIS (Netherlands)

    Jostmann, N.B.; Gieselmann, A.

    2014-01-01

    Complex problems often include a response conflict between a subgoal and a final goal. The present experiment investigated the roles of situational demands and individual differences in self-regulation on solving goal-subgoal conflicts in a computerized Tower of Hanoi task. Action-oriented versus

  4. Reaching the hard-to-reach.

    Science.gov (United States)

    Valdes, C

    1992-01-01

    Guatemala's family planning (FP) programs are innovative but contraceptive use is only 23%. Total fertility is 5.3 children/woman, and the 9.5 million population will double in 23 years. The problem is poverty and illiteracy among rural residents removed from health services. 80% live in poverty and 80% are illiterate. Government effort is devoted to combating diseases such as diarrhea so there are few funds for implementing a comprehensive population policy. There is support within the national government but FP lacks priority status. APROFAM's goals are to use innovative marketing methods to inform the rural population who lack access to and knowledge about FP. Service delivery is constrained by the difficulty in reaching remote areas where 4 out of 10 indigenous Guatemalans live. Infant mortality can reach as high as 200/1000 live births. Population growth has slowed, and APROFAM plans to reach 16,000 more in the future. Promotions are conducted in several languages and aired on radio, television, and in the print media. It has been found that market research is the most effective strategy in reaching indigenous families. APROFAM has also been effective in upgrading service facilities through training, client surveys, and setting improved clinic standards. Breastfeeding, training, and voluntary sterilization programs contribute to the primary care effort. The example is given of Paulina Lebron from a very poor area who has learned how to space her children and thus improve the standard of living for her family. Eventually, she convinced herself and her family that sterilization was necessary, and now the couple enjoy the bliss of newlyweds without fear of pregnancy.

  5. Glycemic index and glycemic load in relation to glucose intolerance among Greenland's Inuit population

    DEFF Research Database (Denmark)

    van Aerde, Marieke A; Witte, Daniel Rinse; Jeppesen, Charlotte

    2012-01-01

    Intake of carbohydrates which elicit a large glycemic response is hypothesized to increase the risk of diabetes. However, studies assessing the relationship between glycemic index (GI) and glycemic load (GL) and diabetes are inconsistent. Only few studies have studied the relationship between GI ...

  6. When you have to climb downhill to reach the top: the effect of action versus state orientation on solvinga goal-subgoal conflict in the Tower of Hanoi task.

    Science.gov (United States)

    Jostmann, Nils B; Gieselmann, Annika

    2014-01-01

    Complex problems often include a response conflict between a subgoal and a final goal. The present experiment investigated the roles of situational demands and individual differences in self-regulation on solving goal-subgoal conflicts in a computerized Tower of Hanoi task. Action-oriented versus state-oriented individuals were randomly assigned to a demanding condition in which they deliberated about a personal decision problem, or to a nondemanding control condition. In line with expectations state-oriented individuals had greater difficulties to solve goal-subgoal conflicts in the demanding compared to the nondemanding condition. Action-oriented individuals performed well in both conditions. In line with Personality Systems Interactions theory (Kuhl, 2000) the findings show that complex problem solving depends on how well people are able to deal with situational demands.

  7. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

    OpenAIRE

    Di Pierro, Francesco; Villanova,Nicola; Agostini,Federica; Soverini,Valentina; Marchesini,Giulio; Marzocchi,Rebecca

    2012-01-01

    Francesco Di Pierro,1 Nicola Villanova,2 Federica Agostini,2 Rebecca Marzocchi,2 Valentina Soverini,2 Giulio Marchesini21Scientific Department, Velleja Research, Milano, 2Diseases of Metabolism, S Orsola Malpighi Hospital, Bologna, ItalyBackground: Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which coul...

  8. MOTIVATION: Goals and Goal Setting

    Science.gov (United States)

    Stratton, Richard K.

    2005-01-01

    Goal setting has great impact on a team's performance. Goals enable a team to synchronize their efforts to achieve success. In this article, the author talks about goals and goal setting. This articles complements Domain 5--Teaching and Communication (p.14) and discusses one of the benchmarks listed therein: "Teach the goal setting process and…

  9. Setting goals in psychotherapy

    DEFF Research Database (Denmark)

    Emiliussen, Jakob; Wagoner, Brady

    2013-01-01

    The present study is concerned with the ethical dilemmas of setting goals in therapy. The main questions that it aims to answer are: who is to set the goals for therapy and who is to decide when they have been reached? The study is based on four semi-­‐structured, phenomenological interviews...

  10. Evaluation of a New Digital Automated Glycemic Pattern Detection Tool.

    Science.gov (United States)

    Comellas, María José; Albiñana, Emma; Artes, Maite; Corcoy, Rosa; Fernández-García, Diego; García-Alemán, Jorge; García-Cuartero, Beatriz; González, Cintia; Rivero, María Teresa; Casamira, Núria; Weissmann, Jörg

    2017-11-01

    Blood glucose meters are reliable devices for data collection, providing electronic logs of historical data easier to interpret than handwritten logbooks. Automated tools to analyze these data are necessary to facilitate glucose pattern detection and support treatment adjustment. These tools emerge in a broad variety in a more or less nonevaluated manner. The aim of this study was to compare eDetecta, a new automated pattern detection tool, to nonautomated pattern analysis in terms of time investment, data interpretation, and clinical utility, with the overarching goal to identify early in development and implementation of tool areas of improvement and potential safety risks. Multicenter web-based evaluation in which 37 endocrinologists were asked to assess glycemic patterns of 4 real reports (2 continuous subcutaneous insulin infusion [CSII] and 2 multiple daily injection [MDI]). Endocrinologist and eDetecta analyses were compared on time spent to analyze each report and agreement on the presence or absence of defined patterns. eDetecta module markedly reduced the time taken to analyze each case on the basis of the emminens eConecta reports (CSII: 18 min; MDI: 12.5), compared to the automatic eDetecta analysis. Agreement between endocrinologists and eDetecta varied depending on the patterns, with high level of agreement in patterns of glycemic variability. Further analysis of low level of agreement led to identifying areas where algorithms used could be improved to optimize trend pattern identification. eDetecta was a useful tool for glycemic pattern detection, helping clinicians to reduce time required to review emminens eConecta glycemic reports. No safety risks were identified during the study.

  11. Glycemic index and glycemic load of selected Chinese traditional foods.

    Science.gov (United States)

    Chen, Ya-Jun; Sun, Feng-Hua; Wong, Stephen Heung-Sang; Huang, Ya-Jun

    2010-03-28

    To determine the glycemic index (GI) and glycemic load (GL) values of Chinese traditional foods in Hong Kong. Fifteen healthy subjects (8 males and 7 females) volunteered to consume either glucose or one of 23 test foods after 10-14 h overnight fast. The blood glucose concentrations were analyzed immediately before, 15, 30, 45, 60, 90 and 120 min after food consumption using capillary blood samples. The GI value of each test food was calculated by expressing the incremental area under the blood glucose response curve (IAUC) value for the test food as a percentage of each subject's average IAUC value for the glucose. The GL value of each test food was calculated as the GI value of the food multiplied by the amount of the available carbohydrate in a usual portion size, divided by 100. Among all the 23 Chinese traditional foods tested, 6 of them belonged to low GI foods (Tuna Fish Bun, Egg Tart, Green Bean Dessert, Chinese Herbal Jelly, Fried Rice Vermicelli in Singapore-style, and Spring Roll), 10 of them belonged to moderate GI foods (Baked Barbecued Pork Puff, Fried Fritter, "Mai-Lai" Cake, "Pineapple" Bun, Fried Rice Noodles with Sliced Beef, Barbecue Pork Bun, Moon Cakes, Glutinous Rice Ball, Instant Sweet Milky Bun, and Salted Meat Rice Dumpling), the others belonged to high GI foods (Fried Rice in Yangzhou-Style, Sticky Rice Wrapped in Lotus Leaf, Steamed Glutinous Rice Roll, Jam and Peanut Butter Toast, Plain Steamed Vermicelli Roll, Red Bean Dessert, and Frozen Sweet Milky Bun). The GI and GL values for these Chinese traditional foods will provide some valuable information to both researchers and public on their food preference.

  12. Glycemic index and glycemic load of commercial Italian foods.

    Science.gov (United States)

    Scazzina, F; Dall'Asta, M; Casiraghi, M C; Sieri, S; Del Rio, D; Pellegrini, N; Brighenti, F

    2016-05-01

    The glycemic index (GI) and glycemic load (GL) are useful parameters in the nutritional classification of carbohydrate foods. Diets characterized by a low GI and/or a low GL have been repeatedly and independently associated with decreased risk of diabetes and other chronic diseases. The aim of this study is to report the GI and GL value of carbohydrate-rich foods available on the Italian market and mostly consumed in Italy. GI values were determined according to FAO/WHO (1997) and ISO (2010). Overall, the 141 commercial foods that were analyzed represent food categories that are the source of >80% carbohydrate intake in Italy. The food items chosen were based mainly on the market share of the brand within each food category and grouped into 13 food categories: 1) beverages: fermented milk drink, juice, smoothie, soft drink; 2) biscuits; 3) breads; 4) bread substitutes; 5) breakfast cereals; 6) cakes and snacks; 7) candy and confectionery; 8) cereals; 9) desserts and ice-creams; 10) marmalade and jam; 11) pasta; 12) pizza; 13) sugar and sweetener. This database of commercial Italian foods partly overcomes the lack of information on GI and GL of local foods, contributing to a better understanding of the association between GI/GL and health and providing a more informed choice to Italian consumers and health practitioners. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  13. Does a patient-managed insulin intensification strategy with insulin glargine and insulin glulisine provide similar glycemic control as a physician-managed strategy? Results of the START (Self-Titration With Apidra to Reach Target) Study: a randomized noninferiority trial.

    Science.gov (United States)

    Harris, Stewart B; Yale, Jean-François; Berard, Lori; Stewart, John; Abbaszadeh, Babak; Webster-Bogaert, Susan; Gerstein, Hertzel C

    2014-01-01

    OBJECTIVE Diabetes self-management is universally regarded as a foundation of diabetes care. We determined whether comparable glycemic control could be achieved by self-titration versus physician titration of a once-daily bolus insulin dose in patients with type 2 diabetes who are unable to achieve optimal glycemia control with a basal insulin. RESEARCH DESIGN AND METHODS Patients with type 2 diabetes, an HbA1c level >7% (53 mmol/mol), and either nocturnal hypoglycemia episodes or an insufficient basal insulin glargine level (with or without oral agents) to achieve a fasting plasma glucose level ≤6 mmol/L (108 mg/dL) were studied. Participants all had bolus insulin glulisine added at breakfast and were allocated to either algorithm-guided patient self-titration or physician titration. The primary outcome was an HbA1c level ≤7% (53 mmol/mol) without severe hypoglycemia. RESULTS After a mean (SD) follow-up of 159.4 days (36.2 days), 28.4% of participants in the self-titration arm vs. 21.2% in the physician titration arm achieved an HbA1c level of ≤7% (53 mmol/mol) without severe hypoglycemia (between-group absolute difference 7.2%; 95% CI -3.2 to 17.7). The lower end of this 95% confidence interval was within the predetermined noninferiority boundary of -5% (P noninferiority = 0.011). CONCLUSIONS In stable patients with type 2 diabetes who are receiving doses of basal insulin glargine who require bolus insulin, a simple bolus insulin patient-managed titration algorithm is as effective as a physician-managed algorithm.

  14. Coal's role in worldwide energy supply. Reaching the climate protection goals with renewable energies and coal as a partner; Die Rolle der Kohle fuer die weltweite Energieversorgung. Klimaschutzziele erreichen mit erneuerbaren Energien und Kohle als Partner

    Energy Technology Data Exchange (ETDEWEB)

    Schiffer, Hans-Wilhelm [World Energy Council, London (United Kingdom). World Energy Resources; Thielemann, Thomas [RWE Power AG, Koeln (Germany)

    2016-04-01

    In 2014, coal covered 30 % of the global consumption of primary energy. More than 40 % of the worldwide electricity production were based on coal. This makes coal the second most important source for primary energy - after oil. Looking at the types of energy sources used for electricity production, coal ranks first, before gas and renewables. The latter two both have a share of 23 % each. Coal is thus making a key contribution to the security of energy supply and to the affordability of energy. Coal is securing the competitiveness of industry. With the use of advanced technologies, coal can contribute to the compatibility of energy supply with the goals of environmental and climate protection.

  15. Reply #1 to: Glycemic Choreoballism

    Directory of Open Access Journals (Sweden)

    Carlos Cosentino

    2016-12-01

    Full Text Available This Author Reply Letter was written in response to a Letter to the Editor:Lee D, Ahn T. Glycemic choreoballism. Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D8QJ7HNFThe Letter to the Editor, above, was written in response to these two Case Reports:Roy U, Das SK, Mukherjee A, et al. Irreversible hemichoreahemiballism in a case of nonketotic hyperglycemia presenting as the initial manifestation of diabetes mellitus. Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D8QZ2B3FCosentino C, Torres L, Nuñez Y, et al. Hemichorea/hemiballism associated with hyperglycemia: report of twenty cases. Tremor Other Hyperkinet Mov. 2016; 6. doi: 10.7916/D8DN454P

  16. Relation of Dietary Glycemic Index and Glycemic Load to Coronary Artery Calcium in Asymptomatic Korean Adults.

    Science.gov (United States)

    Choi, Yuni; Chang, Yoosoo; Ryu, Seungho; Cho, Juhee; Kim, Mi Kyung; Ahn, Younjhin; Lee, Jung Eun; Sung, Eunju; Kim, Boyoung; Ahn, Jiin; Kim, Chan-Won; Rampal, Sanjay; Zhao, Di; Zhang, Yiyi; Pastor-Barriuso, Roberto; Lima, Joao A C; Chung, Eun Chul; Shin, Hocheol; Guallar, Eliseo

    2015-08-15

    The relation between glycemic index, glycemic load, and subclinical coronary atherosclerosis is unknown. The aim of the study was to evaluate the associations between energy-adjusted glycemic index, glycemic load, and coronary artery calcium (CAC). This study was cross-sectional analysis of 28,429 asymptomatic Korean men and women (mean age 41.4 years) without a history of diabetes or cardiovascular disease. All participants underwent a health screening examination between March 2011 and April 2013, and dietary intake over the preceding year was estimated using a validated food frequency questionnaire. Cardiac computed tomography was used for CAC scoring. The prevalence of detectable CAC (CAC score >0) was 12.4%. In multivariable-adjusted models, the CAC score ratios (95% confidence intervals) comparing the highest to the lowest quintile of glycemic index and glycemic load were 1.74 (1.08 to 2.81; p trend = 0.03) and 3.04 (1.43 to 6.46; p trend = 0.005), respectively. These associations did not differ by clinical subgroups, including the participants at low cardiovascular risk. In conclusion, these findings suggest that high dietary glycemic index and glycemic load were associated with a greater prevalence and degree of CAC, with glycemic load having a stronger association. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Kyoung Jin Kim

    2017-08-01

    Full Text Available BackgroundLong-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM. We evaluated the factors associated with durable glycemic control in a real clinical setting.MethodsWe retrospectively reviewed the medical records of 194 new-onset, drug-naïve patients with T2DM who were diagnosed between January 2011 and March 2013, and were followed up for >2 years. Glycemic durability was defined as the maintenance of optimal glycemic control (glycosylated hemoglobin [HbA1c] <7.0% for 2 years without substitution or adding other glucose-lowering agents. Clinical factors and glycemic markers associated with glycemic durability were compared between two groups: a durability group and a non-durability group.ResultsPatients in the durability group had a higher baseline body mass index (26.1 kg/m2 vs. 24.9 kg/m2 and lower HbA1c (8.6% vs. 9.7% than the non-durability group. The initial choice of glucose-lowering agents was similar in both groups, except for insulin and sulfonylureas, which were more frequently prescribed in the non-durability group. In multiple logistic regression analyses, higher levels of education, physical activity, and homeostasis model assessment of β-cell function (HOMA-β were associated with glycemic durability. Notably, lower HbA1c (<7.0% at baseline and first follow-up were significantly associated with glycemic durability (adjusted odds ratio [OR], 7.48; 95% confidence interval [CI], 2.51 to 22.3 (adjusted OR, 9.27; 95% CI, 1.62 to 53.1, respectively, after adjusting for confounding variables including the types of glucose-lowering agents.ConclusionEarly achievement of HbA1c level within the glycemic target was a determinant of long-term glycemic durability in new-onset T2DM, as were higher levels of education, physical activity, and HOMA-β.

  18. Reaching the unreached.

    Science.gov (United States)

    Ariyaratne, A T

    1989-01-01

    Embodied in the child survival revolution are ideological, methodological, and organizational innovations aimed at radical change in the condition of the world's children as rapidly as possible. In countries such as Sri Lanka, child survival and health for all by the year 2000 often seem to be impossible goals, given the tumultuous socioeconomic and political conditions. In Sri Lanka, the quality of life has been eroded, not enhanced, by the importation of Western technology and managerial capitalism and the destruction of indigenous processes. The chaos and violence that have been brought into the country have made it difficult to reach the poor children, women, and refugees in rural areas with primary health care interventions. Sri Lanka's unreachable--the decision making elites--have blocked access to the unreached--the urban and rural poor. If governments are to reach the unreached, they must remove the obstacles to a people-centered, community development process. It is the people themselves, and the institutions of their creation, that can reach the children amidst them in greatest need. To achieve this task, local communities must be provided with basic human rights, the power to make decisions that affect their lives, necessary resources, and appropriate technologies. Nongovernmental organizations can play a crucial role as bridges between the unreached and the unreachable by promoting community empowerment, aiding in the formation of networks of community organizations, and establishing linkages with government programs. If the ruling elites in developing countries can be persuaded to accommodate the needs and aspirations of those who, to date, have been excluded from the development process, the child survival revolution can be a nonviolent one.

  19. Understanding the Glycemic Index and Glycemic Load and Their Practical Applications

    Science.gov (United States)

    Lazarim, Fernanda Lorenzi; Stancanelli, Mirtes; Brenzikofer, Rene; de Macedo, Denise Vaz

    2009-01-01

    We have introduced the study of synthesis pathways using two experiments: 1--the determination of the glycemic index (GI) of some foods and the effects of fiber and fat on the GI; 2--the determination of blood glucose levels after the ingestion of meals with high and low glycemic loads (GL). After a practice assembly, when the foods and meals that…

  20. Optimizing Glycemic Control Through Titration of Insulin Glargine 100 U/mL: A Review of Current and Future Approaches with a Focus on Asian Populations.

    Science.gov (United States)

    Deerochanawong, Chaicharn; Bajpai, Shailendra; Dwipayana, I Made Pande; Hussein, Zanariah; Mabunay, Maria Aileen; Rosales, Reynaldo; Tsai, Shih-Tzer; Tsang, Man Wo

    2017-12-01

    Various data have demonstrated inadequate glycemic control amongst Asians with type 2 diabetes mellitus (T2DM), possibly on account of suboptimal titration of basal insulin-an issue which needs to be further examined. Here we review the available global and Asia-specific data on titration of basal insulin, with a focus on the use of insulin glargine 100 U/mL (Gla-100). We also discuss clinical evidence on the efficacy and safety of titrating Gla-100, different approaches to titration, including some of the latest technological advancements, and guidance on the titration of basal insulin from international and local Asian guidelines. The authors also provide their recommendations for the initiation and titration of basal insulin for Asian populations. Discussion of the data included in this review and in relation to the authors' clinical experience with treating T2DM in Asian patients is also included. Briefly, clinical studies demonstrate the achievement of adequate glycemic control in adults with T2DM through titration of Gla-100. However, studies investigating approaches to titration, specifically in Asian populations, are lacking and need to be conducted. Given that the management of insulin therapy is a multidisciplinary team effort involving endocrinologists, primary care physicians, nurse educators, and patients, greater resources and education targeted at these groups are needed regarding the optimal titration of basal insulin. Technological advancements in the form of mobile or web-based applications for automated dose adjustment can aid different stakeholders in optimizing the dose of basal insulin, enabling a larger number of patients in Asia to reach their target glycemic goals with improved outcomes.

  1. Goal Definition

    DEFF Research Database (Denmark)

    Bjørn, Anders; Laurent, Alexis; Owsianiak, Mikołaj

    2018-01-01

    The goal definition is the first phase of an LCA and determines the purpose of a study in detail. This chapter teaches how to perform the six aspects of a goal definition: (1) Intended applications of the results, (2) Limitations due to methodological choices, (3) Decision context and reasons...... for carrying out the study, (4) Target audience , (5) Comparative studies to be disclosed to the public and (6) Commissioner of the study and other influential actors. The instructions address both the conduct and reporting of a goal definition and are largely based on the ILCD guidance document (EC...

  2. Legitimacy: a new goal to reach in risk management

    International Nuclear Information System (INIS)

    Sicard, M.N.

    1992-01-01

    In a crisis situation, the prestige of companies whose industries are potentially hazardous (chemical and nuclear) is insufficient, even useless, for efficient communication if the companies involved are not legitimized in the way they act within society and if their power is not justified. One assumes their legitimacy, that is to say, their responsibility toward external and internal publics, consists of knowing how to deliver significant information about what they are doing, to whom, why, and how. These companies not only have an economic function, but also a societal one. They have to assume responsibility as citizens because their business is closely involved in the economic, social, and cultural care of their environment

  3. Effect of glycemic control on diabetic dyslipidemia

    International Nuclear Information System (INIS)

    Ahmed, W.; Arshad, A.R.

    2010-01-01

    To determine whether good glycemic control has an effect on lipid profile in diabetics After taking relevant history and physical examination, serum urea, creatinine, thyroid stimulating hormone, bilirubin, alanine transaminase and HbA1c were measured. Blood samples for determination of fasting plasma glucose, serum total cholesterol, triglycerides, HDL and LDL levels were collected in a fasting state. Patients were divided into two groups based on HbA1c levels. They were compared using SPSS 13. 42 patients had good glycemic control and 58 had poor control. The two groups were age and weight matched. 43 patients had abnormal lipid profiles. Serum total cholesterol and triglycerides were lower and HDL levels higher in the good control group but serum LDL levels were equal. Conclusion: Good glycemic control improves lipid profile in patients with type 2 diabetes mellitus. (author)

  4. Effect of glycemic control on diabetic dyslipidemia

    Energy Technology Data Exchange (ETDEWEB)

    Ahmed, W [Military Hospital Rawalpindi, Rawalpindi (Pakistan); Arshad, A R [Combined Military Hospital, Lahore (Pakistan)

    2010-03-15

    To determine whether good glycemic control has an effect on lipid profile in diabetics After taking relevant history and physical examination, serum urea, creatinine, thyroid stimulating hormone, bilirubin, alanine transaminase and HbA1c were measured. Blood samples for determination of fasting plasma glucose, serum total cholesterol, triglycerides, HDL and LDL levels were collected in a fasting state. Patients were divided into two groups based on HbA1c levels. They were compared using SPSS 13. 42 patients had good glycemic control and 58 had poor control. The two groups were age and weight matched. 43 patients had abnormal lipid profiles. Serum total cholesterol and triglycerides were lower and HDL levels higher in the good control group but serum LDL levels were equal. Conclusion: Good glycemic control improves lipid profile in patients with type 2 diabetes mellitus. (author)

  5. Correlation bethealtyy ween dietary glycemic index and glycemic load and blood lipid levels in a group of women from Ahvaz

    OpenAIRE

    Farideh Shishebor; Zahra Shamekhi; Majid Karandish; Seyed Mahmood Latifi

    2011-01-01

    Background & Objectives: There are limited number of studies conducted on the correlation between Glycemic index and Glycemic load of a food program and metabolic factors such as blood lipids in Asian countries including Iran. Therefore, this study aimed at analyzing the correlation between Glycemic index and Glycemic load of Iranian food program and blood lipids. Materials & Methods: The subjects were 95 women working in Ahvaz University of Medical Sciences in the range of 20 to 55 years old...

  6. Reach Address Database (RAD)

    Data.gov (United States)

    U.S. Environmental Protection Agency — The Reach Address Database (RAD) stores the reach address of each Water Program feature that has been linked to the underlying surface water features (streams,...

  7. Relationships Between Glycemic Control and Cardiovascular Fitness.

    Science.gov (United States)

    Moxley, Elizabeth W; Smith, Donald; Quinn, Lauretta; Park, Chang

    2018-07-01

    Diabetes is a serious health problem affecting approximately 29.1 million individuals in the United States. Another 86 million have prediabetes. The development and implementation of lifestyle modifications such as physical activity for these persons are among the most effective methods for prevention and treatment. The aim of this study was to examine relationships between glycemic control (HbA1c) and cardiovascular fitness (peak maximal oxygen uptake [VO 2 peak] and ventilatory threshold [VT]) in overweight/obese subjects with and without type 2 diabetes (T2DM). In addition, the influences of body mass index (BMI) and insulin sensitivity (homeostasis model assessment [HOMA %S]) on the relationship between glycemic control and cardiovascular fitness were explored. Data were abstracted from a completed study that included 51 overweight or obese subjects with T2DM ( n = 18), impaired glucose tolerance ( n = 8), or normal glucose tolerance ( n = 25). Relationships between glycemic control (HbA1c) and cardiovascular fitness (VO 2 peak and VT) were determined using correlational analysis and multiple linear regression analyses. A statistically significant relationship was observed between HbA1c and cardiovascular fitness. However, BMI and HOMA %S did not influence the relationship between glycemic control and cardiovascular fitness. HbA1c contributes to VO 2 peak and VT in obese and overweight subjects across glucose tolerance categories. Significant results were achieved despite the fact that there was a limited range of HbA1c based on the study inclusion criteria. This finding suggests that even a mild decrease in glycemic control can negatively influence cardiovascular fitness.

  8. Industrial goals

    International Nuclear Information System (INIS)

    Martin, P.

    2005-01-01

    The aim of the third seminar on pellet-clad interaction, which held at Aix en Provence (France) from 9-11 march 2004, was to draw a comprehensive picture of current understanding of pellet clad interaction and its impact on the fuel rod under the widest possible conditions. This document provides the summaries of the five sessions: opening and industrial goals, fuel material behaviour in PCI situation, cladding behaviour relevant to PCI, in-pile rod behaviour, modelling of the mechanical interaction between pellet and cladding. (A.L.B.)

  9. Diurnal glycemic profile in obese and normal weight nondiabetic pregnant women.

    Science.gov (United States)

    Yogev, Yariv; Ben-Haroush, Avi; Chen, Rony; Rosenn, Barak; Hod, Moshe; Langer, Oded

    2004-09-01

    A paucity of data exists concerning the normal glycemic profile in nondiabetic pregnancies. Using a novel approach that provides continuous measurement of blood glucose, we sought to evaluate the ambulatory daily glycemic profile in the second half of pregnancy in nondiabetic women. Fifty-seven obese and normal weight nondiabetic subjects were evaluated for 72 consecutive hours with continuous glucose monitoring by measurement interstitial glucose levels in subcutaneous tissue every 5 minutes. Subjects were instructed not to modify their lifestyle or to follow any dietary restriction. For each woman, mean and fasting blood glucose values were determined; for each meal during the study period, the first 180 minutes were analyzed. For the study group, the fasting blood glucose level was 75 +/- 12 mg/dL; the mean blood glucose level was 83.7 +/- 18 mg/dL; the postprandial peak glucose value level was 110 +/- 16 mg/dL, and the time interval that was needed to reach peak postprandial glucose level was 70 +/- 13 minutes. A similar postprandial glycemic profile was obtained for breakfast, lunch, and dinner. Obese women were characterized by a significantly higher postprandial glucose peak value, increased 1- and 2-hour postprandial glucose levels, increased time interval for glucose peak, and significantly lower mean blood glucose during the night. No difference was found in fasting and mean blood glucose between obese and nonobese subjects. Glycemic profile characterization in both obese and normal weight nondiabetic subjects provide a measure for the desired level of glycemic control in pregnancy that is complicated with diabetes mellitus.

  10. Glycemic load, glycemic index, bread and incidence of overweight/obesity in a Mediterranean cohort: the SUN project.

    Science.gov (United States)

    de la Fuente-Arrillaga, Carmen; Martinez-Gonzalez, Miguel Angel; Zazpe, Itziar; Vazquez-Ruiz, Zenaida; Benito-Corchon, Silvia; Bes-Rastrollo, Maira

    2014-10-22

    To evaluate prospectively the relationship between white, or whole grain bread, and glycemic index, or glycemic load from diet and weight change in a Mediterranean cohort. We followed-up 9 267 Spanish university graduates for a mean period of 5 years. Dietary habits at baseline were assessed using a semi-quantitative 136-item food-frequency questionnaire. Average yearly weight change was evaluated according to quintiles of baseline glycemic index, glycemic load, and categories of bread consumption. We also assessed the association between bread consumption, glycemic index, or glycemic load, and the incidence of overweight/obesity. White bread and whole-grain bread were not associated with higher weight gain. No association between glycemic index, glycemic load and weight change was found.White bread consumption was directly associated with a higher risk of becoming overweight/obese (adjusted OR (≥2 portions/day) versus (≤1 portion/week): 1.40; 95% CI: 1.08-1.81; p for trend: 0.008). However, no statistically significant association was observed between whole-grain bread, glycemic index or glycemic load and overweight/obesity. Consumption of white bread (≥2 portions/day) showed a significant direct association with the risk of becoming overweight/obese.

  11. RECORDS REACHING RECORDING DATA TECHNOLOGIES

    Directory of Open Access Journals (Sweden)

    G. W. L. Gresik

    2013-07-01

    Full Text Available The goal of RECORDS (Reaching Recording Data Technologies is the digital capturing of buildings and cultural heritage objects in hard-to-reach areas and the combination of data. It is achieved by using a modified crane from film industry, which is able to carry different measuring systems. The low-vibration measurement should be guaranteed by a gyroscopic controlled advice that has been , developed for the project. The data were achieved by using digital photography, UV-fluorescence photography, infrared reflectography, infrared thermography and shearography. Also a terrestrial 3D laser scanner and a light stripe topography scanner have been used The combination of the recorded data should ensure a complementary analysis of monuments and buildings.

  12. Records Reaching Recording Data Technologies

    Science.gov (United States)

    Gresik, G. W. L.; Siebe, S.; Drewello, R.

    2013-07-01

    The goal of RECORDS (Reaching Recording Data Technologies) is the digital capturing of buildings and cultural heritage objects in hard-to-reach areas and the combination of data. It is achieved by using a modified crane from film industry, which is able to carry different measuring systems. The low-vibration measurement should be guaranteed by a gyroscopic controlled advice that has been , developed for the project. The data were achieved by using digital photography, UV-fluorescence photography, infrared reflectography, infrared thermography and shearography. Also a terrestrial 3D laser scanner and a light stripe topography scanner have been used The combination of the recorded data should ensure a complementary analysis of monuments and buildings.

  13. Glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases

    Directory of Open Access Journals (Sweden)

    Tatiana Uchôa Passos

    2015-03-01

    Full Text Available The objective was to determine the glycemic index and glycemic load of tropical fruits and the potential risk for chronic diseases. Nine fruits were investigated: coconut water (for the purpose of this study, coconut water was classified as a “fruit”, guava, tamarind, passion fruit, custard apple, hog plum, cashew, sapodilla, and soursop. The GI and GL were determined according to the Food and Agriculture Organization protocol. The GL was calculated taking into consideration intake recommendation guidelines; 77.8% of the fruits had low GI although significant oscillations were observed in some graphs, which may indicate potential risks of disease. Coconut water and custard apple had a moderate GI, and all fruits had low GL. The fruits evaluated are healthy and can be consumed following the daily recommended amount. However, caution is recommended with fruits causing early glycemic peak and the fruits with moderated GI (coconut water and custard apple.

  14. Goal setting: Eating, Physical activity & Weight loss

    Science.gov (United States)

    No matter what your weight loss goal is, the key to reaching your goals is to make changes to your lifestyle behaviors like eating and physical activity. This involves setting realistic expectations and making a plan.

  15. Citizen Goals Online

    Directory of Open Access Journals (Sweden)

    Catalin Vrabie

    2013-01-01

    Full Text Available The purpose of this paper is to give to public institution Web designers a better understanding of the citizens’ objectives when accessing a Web page. Understanding citizen online goals is critical because it gets to the heart of what the public institution website should or could “do.” Approach: The challenge for e-marketers is that for most agencies/institutions, there are likely to be multiple goals that represent the “reason why” citizens could come to the website. For example, a national theatre website might be very effective for people who have already been there, they know effectively what place is the best, who are the actors, etc. Research limitations: The nature of a public institution activity almost dictates the different types of goals that consumers have when visiting the site. It is clear that a citizen has a different goal when accessing a theatre Web page or when he’s accessing a municipality Web page. This is the biggest impediment for drawing a good conceptual model for a public institution Web page. Practical implications: there are likely to be many other goals that could lead people to visit the site, like receiving customer service or leaving a remark. Value: Since citizen online goals represent the starting point for Web design efforts (for public institutions, this article has attempted to highlight the nature and types of goals that e-marketers might consider when planning what their website should do in order to create. Findings: The goal a site visitor has when arriving at a website tends to be very action oriented. If the visitor has never visited the site before, the goal may simply be to evaluate the website and figure out what the site is and if it will help him. On the other hand, if the visitor has reached the site as the result of a directed search or is a repeat visitor, the user goal is likely to be specific and functional. If important citizen goals are not supported by the website, the public

  16. Citizen Goals Online

    Directory of Open Access Journals (Sweden)

    Catalin Vrabie

    2012-07-01

    Full Text Available The purpose of this paper is to give to public institution Web designers a better understanding of the citizens’ objectives when accessing a Web page. Understanding citizen online goals is critical because it gets to the heart of what the public institution website should or could “do.”Approach: The challenge for e-marketers is that for most agencies/institutions, there are likely to be multiple goals that represent the “reason why” citizens could come to the website. For example, a national theatre website might be very effective for people who have already been there, they know effectively what place is the best, who are the actors, etc.Research limitations: The nature of a public institution activity almost dictates the different types of goals that consumers have when visiting the site. It is clear that a citizen has a different goal when accessing a theatre Web page or when he’s accessing a municipality Web page. This is the biggest impediment for drawing a good conceptual model for a public institution Web page.Practical implications: there are likely to be many other goals that could lead people to visit the site, like receiving customer service or leaving a remark.Value: Since citizen online goals represent the starting point for Web design efforts (for public institutions, this article has attempted to highlight the nature and types of goals that e-marketers might consider when planning what their website should do in order to create.Findings: The goal a site visitor has when arriving at a website tends to be very action oriented. If the visitor has never visited the site before, the goal may simply be to evaluate the website and figure out what the site is and if it will help him. On the other hand, if the visitor has reached the site as the result of a directed search or is a repeat visitor, the user goal is likely to be specific and functional. If important citizen goals are not supported by the website, the public

  17. Teratology testing under REACH.

    Science.gov (United States)

    Barton, Steve

    2013-01-01

    REACH guidelines may require teratology testing for new and existing chemicals. This chapter discusses procedures to assess the need for teratology testing and the conduct and interpretation of teratology tests where required.

  18. Global reach and engagement

    Science.gov (United States)

    2016-09-01

    Popular culture reflects both the interests of and the issues affecting the general public. As concerns regarding climate change and its impacts grow, is it permeating into popular culture and reaching that global audience?

  19. Studies on the glycemic response of wheat at various level of ...

    African Journals Online (AJOL)

    CLEMENT O BEWAJI

    estimating the glycemic index of various processing effect subjected to wheat ... Over-consumption of milled cereals is sometimes blamed for obesity ... Glycemic index (GI) is a measure of the glycemic effect of carbohydrate in a particular food,.

  20. Eight is enough. The 8 millennium development goals for cutting poverty are affordable and within reach... if we can renew the push to do it. The push includes a special global effort to build up science and technology in the poorest countries

    International Nuclear Information System (INIS)

    Sachs, J.D.; McArthur, J.W.

    2005-01-01

    This year marks a pivotal moment in international efforts to fight extreme poverty. During the United Nations (UN) Millennium Summit in 2000, a total of 147 Heads of State gathered and adopted the Millennium Development Goals (MDGs) to address extreme poverty in its many dimensions - income poverty, hunger, disease, lack of adequate shelter, and exclusion - while promoting education, gender equality, and environmental sustainability, with quantitative targets set for the year 2015. The UN committed to reviewing progress towards the goals in 2005, recognising that by this time only a decade would be left to fulfil the MDGs. We are now at the 5-year juncture with a stark realisation: many of the poorest regions of the world, most notably in sub-Saharan Africa, are far off-track to achieve the goals. Yet the MDGs are still achievable. The lives of hundreds of millions of people could be dramatically improved and millions could be saved every year, but only if the world takes bold steps in 2005. The UN Millennium Project, an independent advisory body of Secretary-General Kofi Annan, was launched in 2002 to identify practical steps for achieving the Goals. In the course of the project's work, it became clear that the scarcity of financial resources is a critical constraint in the poorest countries. Increased financing, linked to effective governance structures in low-income countries, can produce dramatic results.Reaching the MDGs will bring tremendous benefits worldwide. If the goals are achieved over the next ten years: More than 500 million people will be lifted out of poverty in 2015; More than 300 million people will no longer suffer from hunger; Roughly 30 million fewer children will die before their fifth birthdays, and about 20 million fewer will die compared with the current declining trajectory of child mortality. More than 2 million others will be saved. Safe drinking water will become accessible for another 350 million people, and the benefits of basic

  1. Equivalent glycemic load (EGL: a method for quantifying the glycemic responses elicited by low carbohydrate foods

    Directory of Open Access Journals (Sweden)

    Spolar Matt

    2006-08-01

    Full Text Available Abstract Background Glycemic load (GL is used to quantify the glycemic impact of high-carbohydrate (CHO foods, but cannot be used for low-CHO foods. Therefore, we evaluated the accuracy of equivalent-glycemic-load (EGL, a measure of the glycemic impact of low-CHO foods defined as the amount of CHO from white-bread (WB with the same glycemic impact as one serving of food. Methods Several randomized, cross-over trials were performed by a contract research organization using overnight-fasted healthy subjects drawn from a pool of 63 recruited from the general population by newspaper advertisement. Incremental blood-glucose response area-under-the-curve (AUC elicited by 0, 5, 10, 20, 35 and 50 g CHO portions of WB (WB-CHO and 3, 5, 10 and 20 g glucose were measured. EGL values of the different doses of glucose and WB and 4 low-CHO foods were determined as: EGL = (F-B/M, where F is AUC after food and B is y-intercept and M slope of the regression of AUC on grams WB-CHO. The dose-response curves of WB and glucose were used to derive an equation to estimate GL from EGL, and the resulting values compared to GL calculated from the glucose dose-response curve. The accuracy of EGL was assessed by comparing the GL (estimated from EGL values of the 4 doses of oral-glucose with the amounts actually consumed. Results Over 0–50 g WB-CHO (n = 10, the dose-response curve was non-linear, but over the range 0–20 g the curve was indistinguishable from linear, with AUC after 0, 5, 10 and 20 g WB-CHO, 10 ± 1, 28 ± 2, 58 ± 5 and 100 ± 6 mmol × min/L, differing significantly from each other (n = 48. The difference between GL values estimated from EGL and those calculated from the dose-response curve was 0 g (95% confidence-interval, ± 0.5 g. The difference between the GL values of the 4 doses of glucose estimated from EGL, and the amounts of glucose actually consumed was 0.2 g (95% confidence-interval, ± 1 g. Conclusion EGL, a measure of the glycemic impact of

  2. Glycemic Index values of some Jaffna fruits

    Directory of Open Access Journals (Sweden)

    Selladurai Pirasath

    2012-02-01

    Full Text Available Background: The incidence of diabetes mellitus has recently increased in developing countries. Scientific data on glycemic index values of common meals is essential to modify the diets for diabetes mellitus patients. This study aimed to evaluate the glycemic index (GI values of fruits such as ‘Kathali’ (Yellow plantain, ‘Kappal’ (Golden plantain, and ‘Itharai’ (Green plantain varieties of plantains, jack fruit and papaya. The results will be helpful to physicians and the general public to decide the benefits ofthe consumption of fruits, particularly by diabetic and coronary heart disease patients.Methods: Healthy volunteers (20 Nos. of 21.05(±0.92 years, 53.90 (±9.36 kg body weights, 153.92 (±9.15 m heights, and 20.55 (±2.22 kgm-2body mass indexes were selected with their written consent. After overnight fasting, 75g glucose and each test fruit containing 75g digestible carbohydrate were administered at different instances and blood glucose levels were measured half hourly for two hours. The glycemic response and GI values were calculated and analyzed by Randomized Complete Block Design using SAS analytical package.Results: The mean GI values of the ‘Kathali’, ‘Kappal’, ‘Itharai’ varieties of plantains, jack fruit and papaya were 54.45 (±9.26, 50.43 (±5.79, 48.47 (±10.13, 65.36 (±8.00 and 34.80 (±12.78 % respectively. The GI value of papaya differed significantly (P<0.05 from other fruits. The GI value of ‘Itharai’ variety of plantain differed significantly (P<0.05 from other fruits except the ‘Kappal’ varietyof plantain.Conclusion: The three varieties of plantains and papaya were low GI fruits, and jack fruit was found to be an intermediate GI fruit. The presence of dietary fiber, esp. soluble fiber, reduces the glycemicresponse and glycemic index of foods.

  3. Glycemic allostasis during mental activities on fasting in non alcohol ...

    African Journals Online (AJOL)

    Glycemic allostasis is the process by which blood glucose stabilization is achieved through the balancing of glucose consumption rate and release into the blood stream under a variety of stressors.This paper reviews findings on the dynamics of glycemic levels during mental activities on fasting in non‑alcohol users and ...

  4. [Glycemic response to consumption of a cereals and legume (Phaseolus vulgaris) bar on healthy individuals].

    Science.gov (United States)

    Zambrano, Rosaura; Granito, Marisela; Valero, Yolmar

    2013-06-01

    The objective of this work was to formulate a cereals and legume (Phaseolus vulgaris) bar and assess its impact on the glycemic response of healthy individuals, in order to contribute to the healthy food supply beneficial to consumers. A mixture of cereals (corn and oats) and different percentages (20 and 30%) of Phaseolus vulgaris was used to formulate the bar. Additionally, a legume cereal bar without legumes (bar control) was prepared. The bar with 30% of Phaseolus vulgaris was selected through sensory evaluation, being scored with better flavor and texture. This combination of cereals and legumes aminoacid improves complementation and reaches the formulation criteria previously established. Chemical characterization indicated a higher protein content in the bar with 30% of Phaseolus vulgaris (13.55%) relative to the bar control (8.5%). The contents of fat, ash and dietary fiber did not differ between the two bars evaluated. However, the soluble fiber and resistant starch of the selected bar was a 32.05% and 18.67%, respectively, than in the control bar; this may contribute to decreasing the rate of glucose uptake. The selected bar presented a low glycemic index (49) and intermediate glycemic load (12.0) in healthy volunteers, which could lead to a possible reduction in the rate of absorption of glucose into the bloodstream, associated with a carbohydrate content of slow absorption. This bar represents a proposal of a healthy snack for the consumer.

  5. [Glycemic targets and cardiovascular morbi-mortality].

    Science.gov (United States)

    Bordier, Lyse; Bauduceau, Bernard

    2013-05-01

    The 2008-year was full of learning experience and suspense in diabetologia. The past studies, UKPDS in type 2 diabetic patients and DCCT in type 1 diabetic patients have shown that intensive treatment during a short period did reduce the incidence of microvascular events and in the long term, the incidence of macrovascular events linked to diabetes. The conclusions of recent studies quote, from ACCORD, an increased mortality in the type 2 diabetic patients using intensive therapy, from ADVANCE, a reduction of microvascular complications and from VADT, no effect. The analysis of studies published since 2008 brings lessons for the clinical practice: presence of glycemic memory, absence of tensional memory, usefulness of control of every cardiovascular risk factors, need of early treatment of diabetes. Moreover, to define HbA1c objective, age, duration of diabetes, presence of cardiovascular risk factors, former HbA1c level and potential undesirable effects, such hypoglycaemia, must be considered. The management of type 2 diabetic patients requires an early, not to quick intensive treatment, which avoids hypoglycaemia and is combined with a strict control of cardiovascular risk factors. So, the recent position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consideres needs and preferences of each patient and individualizes glycemic targets and treatments. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  6. Nutritional composition, glycemic index, glycemic load, and organoleptical quality of glucomannan-enriched soy milk ice cream

    Science.gov (United States)

    Sa'adah, S.; Candra, O. M.; Nugrahani, G.; Pramono, A.; Afifah, D. N.

    2018-01-01

    Over the past decades, the number of childhood obesity cases has increased significantly, which led to an increase in the number of adults suffering from degenerative diseases such as diabetes mellitus (DM). Glucomannan-Enriched Soy Milk Ice Cream (GSMIC) may prevent obesity in children. The aim of the study was to test the level of carbohydrates, protein, fat, dietary fiber, glycemic index, glycemic load, and organoleptic quality of GSMIC. This experiment used a completely randomized design to test three formulations of glucomannan flour and soy milk (0.5%, 1.5%, and 2.5%). The products were tested for nutritional composition, and evaluated on glycemic index, glycemic load, and organoleptic quality. GSMIC 2.5% had higher levels of dietary fiber and high carbohydrate, protein, and fat content compared to ice cream (3.99%, 30.7%, 1.50%, 1.33%, respectively). The glycemic index of ice cream and 2.5% GSMIC were 75.83 (75%) and 51.48 (51%), respectively, while the glycemic load of ice cream and 2.5% GSMIC were 9.04 and 11.61, respectively. Based on the organoleptic analysis, formulation preferred by the panellists was 2.5% glucomannan flour. Glucomannan flour affected the level of carbohydrates, protein, fat, dietary fiber, glycemic index, glycemic load, and organoleptic quality in soy milk ice cream.

  7. Predictors of glycemic control among patients with Type 2 diabetes: A longitudinal study

    Directory of Open Access Journals (Sweden)

    Philis-Tsimikas Athena

    2005-04-01

    Full Text Available Abstract Background Diabetes is the sixth leading cause of death and results in significant morbidity. The purpose of this study is to determine what demographic, health status, treatment, access/quality of care, and behavioral factors are associated with poor glycemic control in a Type 2 diabetic, low-income, minority, San Diego population. Methods Longitudinal observational data was collected on patients with Type 2 diabetes from Project Dulce, a program in San Diego County designed to care for an underserved diabetic population. The study sample included 573 patients with a racial/ethnic mix of 53% Hispanic, 7% black, 18% Asian, 20% white, and 2% other. We utilized mixed effects models to determine the factors associated with poor glycemic control using hemoglobin A1C (A1C as the outcome of interest. A multi-step model building process was used resulting in a final parsimonious model with main effects and interaction terms. Results Patients had a mean age of 55 years, 69% were female, the mean duration of diabetes was 7.1 years, 31% were treated with insulin, and 57% were obese. American Diabetes Association (ADA recommendations for blood pressure and total cholesterol were met by 71% and 68%, respectively. Results of the mixed effects model showed that patients who were uninsured, had diabetes for a longer period of time, used insulin or multiple oral agents, or had high cholesterol had higher A1C values over time indicating poorer glycemic control. The younger subjects also had poorer control. Conclusion This study provides factors that predict glycemic control in a specific low-income, multiethnic, Type 2 diabetic population. With this information, subgroups with high risk of disease morbidity were identified. Barriers that prevent these patients from meeting their goals must be explored to improve health outcomes.

  8. Variable classifications of glycemic index determined by glucose meters.

    Science.gov (United States)

    Lin, Meng-Hsueh Amanda; Wu, Ming-Chang; Lin, Jenshinn

    2010-07-01

    THE STUDY EVALUATED AND COMPARED THE DIFFERENCES OF GLUCOSE RESPONSES, INCREMENTAL AREA UNDER CURVE (IAUC), GLYCEMIC INDEX (GI) AND THE CLASSIFICATION OF GI VALUES BETWEEN MEASURED BY BIOCHEMICAL ANALYZER (FUJI AUTOMATIC BIOCHEMISTRY ANALYZER (FAA)) AND THREE GLUCOSE METERS: Accue Chek Advantage (AGM), BREEZE 2 (BGM), and Optimum Xceed (OGM). Ten healthy subjects were recruited for the study. The results showed OGM yield highest postprandial glucose responses of 119.6 +/- 1.5, followed by FAA, 118.4 +/- 1.2, BGM, 117.4 +/- 1.4 and AGM, 112.6 +/- 1.3 mg/dl respectively. FAA reached highest mean IAUC of 4156 +/- 208 mg x min/dl, followed by OGM (3835 +/- 270 mg x min/dl), BGM (3730 +/- 241 mg x min/dl) and AGM (3394 +/- 253 mg x min/dl). Among four methods, OGM produced highest mean GI value than FAA (87 +/- 5) than FAA, followed by BGM and AGM (77 +/- 1, 68 +/- 4 and 63 +/- 5, pOGM are more variable methods to determine IAUC, GI and rank GI value of food than FAA. The present result does not necessarily apply to other glucose meters. The performance of glucose meter to determine GI value of food should be evaluated and calibrated before use.

  9. Relationship of glycemic and triglycerides with BMI in diabetic patients

    International Nuclear Information System (INIS)

    Parvez, A.; Ihsanullah; Rafiq, A.; Ahmad, N.; Khan, E.H.

    2010-01-01

    Background: Diabetes mellitus (DM) is a metabolic disorder characterised by chronic hyperglycaemia with disturbances in carbohydrate, fat and protein metabolism arising from defect in insulin secretion or action or both. The clinical guidelines recommend measurement of BMI as vital signs for evaluating the obese and diabetic patients. Methods: This study was carried out on 160 diabetics, which were divided on the basis of BMI into obese (120) and non-obese (40) diabetics from Peshawar district. All patients had their triglycerides and glucose checked after over night fast. Results: The serum triglyceride in diabetics having BMI >30 (obese) was increased as compared to patients having BMI <30 (non-obese). The comparison of serum glucose level in obese diabetics was found to be significantly raised as compared to non-obese diabetics. Conclusions and Recommendations: It was concluded that dyslipidemia is common in all diabetics. The abnormal triglyceride level can improve with good glycemic control, but do not reach the normal state. Good glycaemic control, Reducing BMI, periodic checkups of lipids and blood glucose are recommended for all diabetics in order to avoid complications. (author)

  10. Relationship of glycemic and triglycerides with BMI in diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Parvez, A; Ihsanullah,; Rafiq, A; Ahmad, N; Khan, E H [Khyber Teaching Hospital, Peshawar (Pakistan). Department of Pathology

    2010-04-15

    Background: Diabetes mellitus (DM) is a metabolic disorder characterised by chronic hyperglycaemia with disturbances in carbohydrate, fat and protein metabolism arising from defect in insulin secretion or action or both. The clinical guidelines recommend measurement of BMI as vital signs for evaluating the obese and diabetic patients. Methods: This study was carried out on 160 diabetics, which were divided on the basis of BMI into obese (120) and non-obese (40) diabetics from Peshawar district. All patients had their triglycerides and glucose checked after over night fast. Results: The serum triglyceride in diabetics having BMI >30 (obese) was increased as compared to patients having BMI <30 (non-obese). The comparison of serum glucose level in obese diabetics was found to be significantly raised as compared to non-obese diabetics. Conclusions and Recommendations: It was concluded that dyslipidemia is common in all diabetics. The abnormal triglyceride level can improve with good glycemic control, but do not reach the normal state. Good glycaemic control, Reducing BMI, periodic checkups of lipids and blood glucose are recommended for all diabetics in order to avoid complications. (author)

  11. Using a mentoring approach to implement an inpatient glycemic control program in United States hospitals.

    Science.gov (United States)

    Rushakoff, Robert J; Sullivan, Mary M; Seley, Jane Jeffrie; Sadhu, Archana; O'Malley, Cheryl W; Manchester, Carol; Peterson, Eric; Rogers, Kendall M

    2014-09-01

    establishing an inpatient glycemic control program is challenging, requires years of work, significant education and coordination of medical, nursing, dietary, and pharmacy staff, and support from administration and Performance Improvement departments. We undertook a 2 year quality improvement project assisting 10 medical centers (academic and community) across the US to implement inpatient glycemic control programs. the project was comprised of 3 interventions. (1) One day site visit with a faculty team (MD and CDE) to meet with key personnel, identify deficiencies and barriers to change, set site specific goals and develop strategies and timelines for performance improvement. (2) Three webinar follow-up sessions. (3) Web site for educational resources. Updates, challenges, and accomplishments for each site were reviewed at the time of each webinar and progress measured at the completion of the project with an evaluation questionnaire. as a result of our intervention, institutions revised and simplified formularies and insulin order sets (with CHO counting options); implemented glucometrics and CDE monitoring of inpatient glucoses (assisting providers with orders); added new protocols for DKA and perinatal treatment; and implemented nursing, physician and patient education initiatives. Changes were institution specific, fitting the local needs and cultures. As to the extent to which Institution׳s goals were satisfied: 2 reported "completely", 4 "mostly," 3 "partially," and 1 "marginally". Institutions continue to move toward fulfilling their goals. an individualized, structured, performance improvement approach with expert faculty mentors can help facilitate change in an institution dedicated to implementing an inpatient glycemic control program. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Characterization of Factors Affecting Attainment of Glycemic Control in Asian Americans With Diabetes in a Culturally Specific Program

    Science.gov (United States)

    Le, Hung; Wong, Sophia; Iftikar, Tracy; Keenan, Hillary; King, George L.; Hsu, William C.

    2014-01-01

    Purpose The purpose of this study is to examine the effectiveness of a culturally specific pilot clinic for Asian Americans (AA) in reaching glycemic target and to characterize factors affecting the attainment of glycemic control in comparison with white counterparts. Methods This electronic health record review included all new AA patients with type 2 diabetes (n = 109) in a culturally specific program and a randomly selected sample of new white patients with type 2 diabetes (n = 218) in the adult clinic within the same time period and diabetes center. Results AA and whites had a comparable proportion of patients with A1C ≤7% (32.1%, 34.9%; P = .621) at baseline and after 12 months of care (48.6%, 56.0%; P = .210), with a similar A1C decline (−0.9% ± 1.6%, −0.8% ± 1.7%, P = .710) by 12 months. Factors associated with the lack of success in reaching target in AA but not in whites included older age, lower educational attainment, less likelihood of having health insurance, and a need for more educational visits. The percentage of AA reaching A1C ≤7%, as compared to whites, worsened among those with highest initial A1C when stratified by ascending quartiles (96.7% vs 85.2%, P = .101; 61.9% vs 58.9%, P = .813; 24.0% vs 37.7%, P = .230; 15.2% vs 35.4%, P = .044). Conclusion While a culturally specific diabetes program in a specialty setting achieved a similar glycemic outcome for AA compared with whites, reasons for not reaching glycemic target differed. The findings suggest that the elimination of diabetes disparities requires not only culturally and linguistically specific programs, but must also identify and address the socio-environmental differences unique to each population. PMID:23771841

  13. Solar Hydrogen Reaching Maturity

    Directory of Open Access Journals (Sweden)

    Rongé Jan

    2015-09-01

    Full Text Available Increasingly vast research efforts are devoted to the development of materials and processes for solar hydrogen production by light-driven dissociation of water into oxygen and hydrogen. Storage of solar energy in chemical bonds resolves the issues associated with the intermittent nature of sunlight, by decoupling energy generation and consumption. This paper investigates recent advances and prospects in solar hydrogen processes that are reaching market readiness. Future energy scenarios involving solar hydrogen are proposed and a case is made for systems producing hydrogen from water vapor present in air, supported by advanced modeling.

  14. Glycemic index, glycemic load and mammographic breast density: the EPIC Florence longitudinal study.

    Directory of Open Access Journals (Sweden)

    Giovanna Masala

    Full Text Available A few studies have evaluated the association between diet and mammographic breast density (MBD and results are inconsistent. MBD, a well-recognized risk factor for breast cancer, has been proposed as a marker of cumulative exposure to hormones and growth factors. Diets with a high glycemic index (GI or glycemic load (GL may increase breast cancer risk, via an effect on the insulin-like growth factor axis. We have investigated the association between carbohydrate intake, GI, GL and MBD in a prospective study. We identified a large series of women, in the frame of the EPIC-Florence cohort, with a mammogram taken five years after enrolment, when detailed information on dietary and lifestyle habits and anthropometric measurements had been collected. Mammograms have been retrieved (1,668, 83% and MBD assessed according to Wolfe's classification. We compared women with high MBD (P2+DY Wolfe's categories with those with low MBD (N1+P1 through logistic models adjusted for age, education, body mass index, menopause, number of children, breast feeding, physical activity, non-alcohol energy, fibers, saturated fat and alcohol. A direct association between GL and high MBD emerged in the highest quintile of intake in comparison with the lowest quintile (OR = 1.73, 95%CI 1.13-2.67, p for trend = 0.048 while no association with glycemic index was evident. These results were confirmed after exclusion of women reporting to be on a diet or affected with diabetes, and when Hormone Replacement Therapy at the date of mammographic examination used to assess MBD was considered. The effect was particularly evident among leaner women, although no interaction was found. A positive association was suggested for increasing simple sugar and total carbohydrates intakes limited to the highest quintiles. In this Italian population we observed an association between glycemic load, total and rapidly absorbed carbohydrates and high MBD. These novel results warrant further

  15. Quality of life and glycemic profile of type 2 diabetes mellitus patients of Indonesian: a descriptive study

    Science.gov (United States)

    Amelia, R.; Lelo, A.; Lindarto, D.; Mutiara, E.

    2018-03-01

    The prevalence of diabetes type 2 is increasing globally. Quality of life (QOL) in diabetic patients is the primary goal of care. Today, there is an increasing awareness suggesting that patient’sQOLand treatment satisfaction were improved after good glycemic control. This study aimed to demonstrate the quality of life and the glycemic profiles of type 2 Diabetes Mellitus patients. This study was a descriptive study of across-sectional design. A sample of 115 out-patients attending eight public health centers in Binjai City, Indonesia. Patient’s quality of life was assessedin four domains of role limitation due to physical health, psychosocial, social and environment in a four Likert point. Two glycemic profiles which are blood sugar level and glycated hemoglobin (HbA1c) were measured by Spectrophotometer Colorimeter + Full Automatic method and affinity Doronad + Modified HPLC technique, respectively. In the results, we confirmed that almost 80.0% of diabetes mellitus type 2 patients are in good QOL(score 81-100) in three QOL dimensions; Physical health, Social relationship and Environment health but not in Psychological health dimension. The blood sugar level and HbA1clevel are beyond the normal value, 267.5±103.2mg/dLand9.9±2.3%,respectively. The better controlled glycemic index, the better patient’s QOL.

  16. Shared Responsibility for Type 1 Diabetes Care Is Associated With Glycemic Variability and Risk of Glycemic Excursions in Youth.

    Science.gov (United States)

    Marker, Arwen M; Noser, Amy E; Clements, Mark A; Patton, Susana R

    2018-01-01

    We examined how parent and youth responsibility for type 1 diabetes (T1D) care is related to adherence and glycemic outcomes, namely, glycemic variability and risk of glycemic excursions. One hundred thirty-five parent-youth dyads (10-16 years old; diagnosed with T1D for at least 6 months) participated in this study. Percent responsibility of T1D care attributed to the youth, parent, or shared was measured using the Diabetes Family Responsibility Questionnaire. We collected youth's hemoglobin A1c (HbA1c) and glucometer downloads to examine relationships between responsibility and HbA1c, frequency of blood glucose monitoring (self-monitoring blood glucose, SMBG), risk of glycemic excursions, and actual glycemic variability using bivariate correlations and path analysis. Participants reported shared responsibility for almost half of T1D self-care tasks. Bivariate correlations showed shared responsibility was associated with less variability, whereas parent responsibility was associated with greater glycemic variability and risk for glycemic excursions. Youth responsibility was associated with lower frequency of SMBG. The path analyses confirmed our correlational findings (pshypothesis that shared T1D responsibility is associated with better diabetes outcomes in youth. © The Author 2017. 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

  17. Probability of Achieving Glycemic Control with Basal Insulin in Patients with Type 2 Diabetes in Real-World Practice in the USA.

    Science.gov (United States)

    Blonde, Lawrence; Meneghini, Luigi; Peng, Xuejun Victor; Boss, Anders; Rhee, Kyu; Shaunik, Alka; Kumar, Supriya; Balodi, Sidhartha; Brulle-Wohlhueter, Claire; McCrimmon, Rory J

    2018-06-01

    Basal insulin (BI) plays an important role in treating type 2 diabetes (T2D), especially when oral antidiabetic (OAD) medications are insufficient for glycemic control. We conducted a retrospective, observational study using electronic medical records (EMR) data from the IBM ® Explorys database to evaluate the probability of achieving glycemic control over 24 months after BI initiation in patients with T2D in the USA. A cohort of 6597 patients with T2D who started BI following OAD(s) and had at least one valid glycated hemoglobin (HbA1c) result recorded both within 90 days before and 720 days after BI initiation were selected. We estimated the changes from baseline in HbA1c every 6 months, the quarterly conditional probabilities of reaching HbA1c < 7% if a patient had not achieved glycemic control prior to each quarter (Q), and the cumulative probability of reaching glycemic control over 24 months. Our cohort was representative of patients with T2D who initiated BI from OADs in the USA. The average HbA1c was 9.1% at BI initiation, and decreased robustly (1.5%) in the first 6 months after initiation with no further reductions thereafter. The conditional probability of reaching glycemic control decreased rapidly in the first year (26.6% in Q2; 17.6% in Q3; 8.6% in Q4), and then remained low (≤ 6.1%) for each quarter in the second year. Cumulatively, about 38% of patients reached HbA1c < 7% in the first year; only approximately 8% more did so in the second year. Our study of real-world data from a large US EMR database suggested that among patients with T2D who initiated BI after OADs, the likelihood of reaching glycemic control diminished over time, and remained low from 12 months onwards. Additional treatment options should be considered if patients do not reach glycemic control within 12 months of BI initiation. Sanofi Corporation.

  18. Postural hypotension in type 1 diabetes: The influence of glycemic ...

    African Journals Online (AJOL)

    2013-06-04

    saharan ... Key words: Diabetes mellitus, duration, glycemic control, postural hypotension. Date of ... or older) provided informed consent before enrolment in the study. .... asymptomatic despite significant falls in blood pressure.[26].

  19. Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations123

    Science.gov (United States)

    Meng, Huicui; Matthan, Nirupa R; Ausman, Lynne M; Lichtenstein, Alice H

    2017-01-01

    Background: The potential confounding effect of different amounts and proportions of macronutrients across eating patterns on meal or dietary glycemic index (GI) and glycemic load (GL) value determinations has remained partially unaddressed. Objective: The study aimed to determine the effects of different amounts of macronutrients and fiber on measured meal GI and GL values. Design: Four studies were conducted during which participants [n = 20–22; women: 50%; age: 50–80 y; body mass index (in kg/m2): 25–30)] received food challenges containing different amounts of the variable nutrient in a random order. Added to the standard 50 g available carbohydrate from white bread was 12.5, 25, or 50 g carbohydrate; 12.5, 25, or 50 g protein; and 5.6, 11.1, or 22.2 g fat from rice cereal, tuna, and unsalted butter, respectively, and 4.8 or 9.6 g fiber from oat cereal. Arterialized venous blood was sampled for 2 h, and measured meal GI and GL and insulin index (II) values were calculated by using the incremental area under the curve (AUCi) method. Results: Adding carbohydrate to the standard white-bread challenge increased glucose AUCi (P < 0.0001), measured meal GI (P = 0.0066), and mean GL (P < 0.0001). Adding protein (50 g only) decreased glucose AUCi (P = 0.0026), measured meal GI (P = 0.0139), and meal GL (P = 0.0140). Adding fat or fiber had no significant effect on these variables. Adding carbohydrate (50 g), protein (50 g), and fat (11.1 g) increased the insulin AUCi or II; fiber had no effect. Conclusions: These data indicate that uncertainty in the determination of meal GI and GL values is introduced when carbohydrate-containing foods are consumed concurrently with protein (equal amount of carbohydrate challenge) but not with carbohydrate-, fat-, or fiber-containing foods. Future studies are needed to evaluate whether this uncertainty also influences the prediction of average dietary GI and GL values for eating patterns. This trial was registered at

  20. Effect of macronutrients and fiber on postprandial glycemic responses and meal glycemic index and glycemic load value determinations.

    Science.gov (United States)

    Meng, Huicui; Matthan, Nirupa R; Ausman, Lynne M; Lichtenstein, Alice H

    2017-04-01

    Background: The potential confounding effect of different amounts and proportions of macronutrients across eating patterns on meal or dietary glycemic index (GI) and glycemic load (GL) value determinations has remained partially unaddressed. Objective: The study aimed to determine the effects of different amounts of macronutrients and fiber on measured meal GI and GL values. Design: Four studies were conducted during which participants [ n = 20-22; women: 50%; age: 50-80 y; body mass index (in kg/m 2 ): 25-30)] received food challenges containing different amounts of the variable nutrient in a random order. Added to the standard 50 g available carbohydrate from white bread was 12.5, 25, or 50 g carbohydrate; 12.5, 25, or 50 g protein; and 5.6, 11.1, or 22.2 g fat from rice cereal, tuna, and unsalted butter, respectively, and 4.8 or 9.6 g fiber from oat cereal. Arterialized venous blood was sampled for 2 h, and measured meal GI and GL and insulin index (II) values were calculated by using the incremental area under the curve (AUC i ) method. Results: Adding carbohydrate to the standard white-bread challenge increased glucose AUC i ( P < 0.0001), measured meal GI ( P = 0.0066), and mean GL ( P < 0.0001). Adding protein (50 g only) decreased glucose AUC i ( P = 0.0026), measured meal GI ( P = 0.0139), and meal GL ( P = 0.0140). Adding fat or fiber had no significant effect on these variables. Adding carbohydrate (50 g), protein (50 g), and fat (11.1 g) increased the insulin AUC i or II; fiber had no effect. Conclusions: These data indicate that uncertainty in the determination of meal GI and GL values is introduced when carbohydrate-containing foods are consumed concurrently with protein (equal amount of carbohydrate challenge) but not with carbohydrate-, fat-, or fiber-containing foods. Future studies are needed to evaluate whether this uncertainty also influences the prediction of average dietary GI and GL values for eating patterns. This trial was registered at

  1. Pilot study on the additive effects of berberine and oral type 2 diabetes agents for patients with suboptimal glycemic control

    Directory of Open Access Journals (Sweden)

    Di Pierro F

    2012-07-01

    Full Text Available Francesco Di Pierro,1 Nicola Villanova,2 Federica Agostini,2 Rebecca Marzocchi,2 Valentina Soverini,2 Giulio Marchesini21Scientific Department, Velleja Research, Milano, 2Diseases of Metabolism, S Orsola Malpighi Hospital, Bologna, ItalyBackground: Suboptimal glycemic control is a common situation in diabetes, regardless of the wide range of drugs available to reach glycemic targets. Basic research in diabetes is endeavoring to identify new actives working as insulin savers, use of which could delay the introduction of injectable insulin or reduce the insulin dose needed. Commonly available as a nutraceutical, berberine is a potential candidate.Methods and results: Because its low oral bioavailability can be overcome by P-glycoprotein inhibitors like herbal polyphenols, we have tested the nutraceutical combination of Berberis aristata extract and Silybum marianum extract (Berberol® in type 2 diabetes in terms of its additive effect when combined with a conventional oral regimen for patients with suboptimal glycemic control. After 90 days of treatment, the nutraceutical association had a positive effect on glycemic and lipid parameters, significantly reducing glycosylated hemoglobin, basal insulin, homeostatic model assessment of insulin resistance, total and low-density lipoprotein cholesterol, and triglycerides. A relevant effect was also observed in terms of liver function by measuring aspartate transaminase and alanine transaminase. The product had a good safety profile, with distinctive gastrointestinal side effects likely due to its acarbose-like action.Conclusion: Although further studies should be carried out to confirm our data, Berberol could be considered a good candidate as an adjunctive treatment option in diabetes, especially in patients with suboptimal glycemic control.Keywords: berberine, silymarin, glycosylated hemoglobin, diabetes

  2. Reaching Beyond The Stars

    Science.gov (United States)

    Baker, Mariah; Rosenthal, L.; Gaughan, A.; Hopkins, E.

    2014-01-01

    Strawbridge Observatory at Haverford College is home to a undergraduate-led public observing program. Our program holds ~once monthly public events throughout the academic year that take advantage of eyepiece observing on our 16-inch and 12-inch telescopes as well as of the classroom, library, and projection system. These resources allow us to organize a variety of astronomy related activities that are engaging for individuals of all ages: accessible student talks, current film screenings and even arts and crafts for the families who attend with young children. These events aim to spark curiosity in others about scientific discovery and about the remarkable nature of the world in which we live. In addition to exciting local families about astronomy, this program has excited Haverford students from a range of disciplines about both science and education. Being entirely student led means that we are able to take the initiative in planning, coordinating and running all events, fostering an atmosphere of collaboration, experimentation and commitment amongst our volunteers. Additionally, this program is one of the few at Haverford that regularly reaches beyond the campus walls to promote and build relationships with the outside community. In light of this, our program presents a distinctive and enlightening opportunity for student volunteers: we get to use our scientific backgrounds to educate a general audience, while also learning from them about how to communicate and inspire in others the excitement we feel about the subject of astronomy. The work on this project has been supported by NSF AST-1151462.

  3. GAP-REACH

    Science.gov (United States)

    Lewis-Fernández, Roberto; Raggio, Greer A.; Gorritz, Magdaliz; Duan, Naihua; Marcus, Sue; Cabassa, Leopoldo J.; Humensky, Jennifer; Becker, Anne E.; Alarcón, Renato D.; Oquendo, María A.; Hansen, Helena; Like, Robert C.; Weiss, Mitchell; Desai, Prakash N.; Jacobsen, Frederick M.; Foulks, Edward F.; Primm, Annelle; Lu, Francis; Kopelowicz, Alex; Hinton, Ladson; Hinton, Devon E.

    2015-01-01

    Growing awareness of health and health care disparities highlights the importance of including information about race, ethnicity, and culture (REC) in health research. Reporting of REC factors in research publications, however, is notoriously imprecise and unsystematic. This article describes the development of a checklist to assess the comprehensiveness and the applicability of REC factor reporting in psychiatric research publications. The 16-itemGAP-REACH© checklist was developed through a rigorous process of expert consensus, empirical content analysis in a sample of publications (N = 1205), and interrater reliability (IRR) assessment (N = 30). The items assess each section in the conventional structure of a health research article. Data from the assessment may be considered on an item-by-item basis or as a total score ranging from 0% to 100%. The final checklist has excellent IRR (κ = 0.91). The GAP-REACH may be used by multiple research stakeholders to assess the scope of REC reporting in a research article. PMID:24080673

  4. UX-15 Reaches LEP

    CERN Multimedia

    2001-01-01

    The creation of the world's largest sandstone cavern, not a small feat! At the bottom, cave-in preventing steel mesh can be seen clinging to the top of the tunnel. The digging of UX-15, the cavern that will house ATLAS, reached the upper ceiling of LEP on October 10th. The breakthrough which took place nearly 100 metres underground occurred precisely on schedule and exactly as planned. But much caution was taken beforehand to make the LEP breakthrough clean and safe. To prevent the possibility of cave-ins in the side tunnels that will eventually be attached to the completed UX-15 cavern, reinforcing steel mesh was fixed into the walls with bolts. Obviously no people were allowed in the LEP tunnels below UX-15 as the breakthrough occurred. The area was completely evacuated and fences were put into place to keep all personnel out. However, while personnel were being kept out of the tunnels below, this has been anything but the case for the work taking place up above. With the creation of the world's largest...

  5. Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study

    Directory of Open Access Journals (Sweden)

    Somayyeh Firouzi

    2015-01-01

    Full Text Available Background: The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. Materials and Methods: A total of 104 type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Results: Subjects were on average 56.7±9.9 years old with a mean duration of diabetes of 6.5 ± 5.0 years. The mean hemoglobin A1c of the subjects was 7.6% ± 1.4%, with only 20.2% achieving the target goal of <6.5% with no significant differences between genders. The mean body mass index was 26.9 ± 4.7 kg/m 2 , with 86.5% either were overweight or obese. Only 10.6% of the subjects exercised daily. The proportions of macronutrients relative to total energy intake were consistent with the recommendations of most diabetes associations. The adjusted odds of having poor glycemic control were 3.235 (1.043-10.397 (P < 0.05 higher among those who had high density lipoprotein cholesterol levels below the normal range. Those taking one or two types of oral anti-diabetic drugs had 19.9 (2.959-87.391 (P < 0.01 and 14.3 (2.647-77.500 (P < 0.01 higher odds of poor glycemic control respectively compared to those who were being treated by diet alone. Conclusion: Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents.

  6. Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study.

    Science.gov (United States)

    Firouzi, Somayyeh; Barakatun-Nisak, Mohd Yusof; Azmi, Kamaruddin Nor

    2015-01-01

    The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. A total of 104 type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Subjects were on average 56.7±9.9 years old with a mean duration of diabetes of 6.5 ± 5.0 years. The mean hemoglobin A1c of the subjects was 7.6% ± 1.4%, with only 20.2% achieving the target goal of 10.6% of the subjects exercised daily. The proportions of macronutrients relative to total energy intake were consistent with the recommendations of most diabetes associations. The adjusted odds of having poor glycemic control were 3.235 (1.043-10.397) (P types of oral anti-diabetic drugs had 19.9 (2.959-87.391) (P 1) and 14.3 (2.647-77.500) (P 1) higher odds of poor glycemic control respectively compared to those who were being treated by diet alone. Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents.

  7. Nutritional status, glycemic control and its associated risk factors among a sample of type 2 diabetic individuals, a pilot study

    Science.gov (United States)

    Firouzi, Somayyeh; Barakatun-Nisak, Mohd Yusof; Azmi, Kamaruddin Nor

    2015-01-01

    Background: The prevalence of type 2 diabetes is increasing in Malaysia, with most patients poorly controlled. Hence, this study aimed to determine nutritional and metabolic status as well as blood pressure of Malaysian patients with type 2 diabetes mellitus and identify associated risk factors for poor glycemic control. Materials and Methods: A total of 104 type 2 diabetic patients were recruited and completed a questionnaire covering socio-demographic status, 3-day diet records, and physical activity. Anthropometry and glycemic control parameters, lipid profile and blood pressure were also measured. Results: Subjects were on average 56.7±9.9 years old with a mean duration of diabetes of 6.5 ± 5.0 years. The mean hemoglobin A1c of the subjects was 7.6% ± 1.4%, with only 20.2% achieving the target goal of exercised daily. The proportions of macronutrients relative to total energy intake were consistent with the recommendations of most diabetes associations. The adjusted odds of having poor glycemic control were 3.235 (1.043-10.397) (P < 0.05) higher among those who had high density lipoprotein cholesterol levels below the normal range. Those taking one or two types of oral anti-diabetic drugs had 19.9 (2.959-87.391) (P < 0.01) and 14.3 (2.647-77.500) (P < 0.01) higher odds of poor glycemic control respectively compared to those who were being treated by diet alone. Conclusion: Poor glycemic control was prevalent among Malaysian diabetic patients, and this could be associated with low levels of HDL and being treated with oral anti-diabetes agents. PMID:25767521

  8. Glycemic control and adherence to basal insulin therapy in Taiwanese patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Chien, Ming-Nan; Chen, Yen-Ling; Hung, Yi-Jen; Wang, Shu-Yi; Lu, Wen-Tsung; Chen, Chih-Hung; Lin, Ching-Ling; Huang, Tze-Pao; Tsai, Ming-Han; Tseng, Wei-Kung; Wu, Ta-Jen; Ho, Cheng; Lin, Wen-Yu; Chen, Bill; Chuang, Lee-Ming

    2016-11-01

    The aim of the present study was to assess the glycemic control, adherence and treatment satisfaction in a real-world setting with basal insulin therapy in type 2 diabetes patients in Taiwan. This was a multicenter, prospective, observational registry. A total of 836 patients with type 2 diabetes taking oral antidiabetic drugs with glycated hemoglobin (HbA1c) >7% entered the study. Basal insulin was given for 24 weeks. All treatment choices and medical instructions were at the physician's discretion to reflect real-life practice. After 24-week treatment, 11.7% of patients reached set HbA1c goals without severe hypoglycemia (primary effectiveness end-point). HbA1c and fasting blood glucose were significantly decreased from (mean ± SD) 10.1 ± 1.9% to 8.7 ± 1.7% (-1.4 ± 2.1%, P 1) and from 230.6 ± 68.8 mg/dL to 159.1 ± 55.6 mg/dL (-67.4 ± 72.3 mg/dL, P 1), respectively. Patients received insulin therapy at a frequency of nearly one shot per day on average, whereas self-monitoring of blood glucose was carried out approximately four times a week. Hypoglycemia was reported by 11.4% of patients, and only 0.7% of patients experienced severe hypoglycemia. Slight changes in weight (0.7 ± 2.4 kg) and a low incidence of adverse drug reactions (0.4%) were also noted. The score of 7-point treatment satisfaction rated by patients was significantly improved by 1.9 ± 1.7 (P 1). Basal insulin therapy was associated with a decrease in HbA1c and fasting blood glucose, and an improved treatment satisfaction. Most patients complied with physicians' instructions. The treatment was generally well tolerated by patients with type 2 diabetes, but findings pointed out the need to reinforce the early and appropriate uptitration to achieve treatment targets. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  9. Comparative study of goal contents and goal characteristics between medical and business students.

    Science.gov (United States)

    Park, Soowon; Kim, Ji Eun; Lee, Jun-Young; Shin, Jongho

    2016-03-01

    Medical and business are one of the most popular majors among students, and both fields require intensive training to reach certain level of expertise. During the development of professionalism, goal can become a crucial role in psychological impetus. The purpose of this study is to compare goal contents, goal characteristics, and effect of goal characteristics on student's major satisfaction between medical and business. A total of 193 undergraduate students (97 medical students, 96 business students) answered survey questions including goal contents, goal characteristics (goal autonomy, goal attainability, social value of goal) and satisfaction on their majors. Qualitative analysis of goal contents and quantitative analysis of goal characteristics, and their effects on student major satisfaction were performed. Goal content analysis showed percentage of social concern goal was higher in medical students (25.8%) than business students (6.3%), whereas percentage of wealth goal was higher business students (24.0%) than medical students (3.1%). Among goal characteristics, goal attainability and social value of goal were higher in medical students than business students. In both groups, social value of goal was significantly predict major satisfaction. Goal contents and goal characteristics are different between medical and business students. Curriculum and educational interventions that concerning students' goal and developing programs to enhance students' social value of goal is necessary.

  10. Association between dietary glycemic index, glycemic load, and body mass index in the Inter99 study: is underreporting a problem?

    DEFF Research Database (Denmark)

    Lau, C.; Toft, U.; Tetens, Inge

    2006-01-01

    Background: The few studies examining the potential associations between glycemic index (GI), glycemic load (GL), and body mass index (BMI) have provided no clear pictures. Underreporting of energy intake may be one explanation for this. Objective: We examined the associations between GI, GL...... a positive association between GI, GL, and BMI. Energy adjustment and the exclusion of LERs significantly affected the results of the analysis; thus, we stress the importance of energy adjustment....

  11. Acute effect of meal glycemic index and glycemic load on blood glucose and insulin responses in humans

    Directory of Open Access Journals (Sweden)

    Díaz Erik

    2006-09-01

    Full Text Available Abstract Objective Foods with contrasting glycemic index when incorporated into a meal, are able to differentially modify glycemia and insulinemia. However, little is known about whether this is dependent on the size of the meal. The purposes of this study were: i to determine if the differential impact on blood glucose and insulin responses induced by contrasting GI foods is similar when provided in meals of different sizes, and; ii to determine the relationship between the total meal glycemic load and the observed serum glucose and insulin responses. Methods Twelve obese women (BMI 33.7 ± 2.4 kg/m2 were recruited. Subjects received 4 different meals in random order. Two meals had a low glycemic index (40–43% and two had a high-glycemic index (86–91%. Both meal types were given as two meal sizes with energy supply corresponding to 23% and 49% of predicted basal metabolic rate. Thus, meals with three different glycemic loads (95, 45–48 and 22 g were administered. Blood samples were taken before and after each meal to determine glucose, free-fatty acids, insulin and glucagon concentrations over a 5-h period. Results An almost 2-fold higher serum glucose and insulin incremental area under the curve (AUC over 2 h for the high- versus low-glycemic index same sized meals was observed (p Conclusion This study showed that foods of contrasting glycemic index induced a proportionally comparable difference in serum insulin response when provided in both small and large meals. The same was true for the serum glucose response but only in large meals. Glycemic load was useful in predicting the acute impact on blood glucose and insulin responses within the context of mixed meals.

  12. Dietary glycemic index, glycemic load, fiber, simple sugars, and insulin resistance - The Inter99 study

    DEFF Research Database (Denmark)

    Lau, Cathrine; Pedersen, Oluf; Færch, Kristine

    2005-01-01

    , and insulin resistance was estimated using the homeostasis model assessment of insulin resistance (HOMA-IR). Multiple regressions were performed with HOMA-IR as the dependent variable and carbohydrate-related factors as explanatory variables. All models were adjusted for age, sex, smoking, physical activity......, total energy intake, BMI, and waist circumference. RESULTS - intake of lactose was positively associated with HOMA-IR (P < 0.0001), whereas daily glycemic load and intake of glucose, fructose, dietary fiber, total carbohydrate, fruit, and vegetables were inversely associated with HOMA-IR (P < 0...

  13. Large-scale association analyses identify new loci influencing glycemic traits and provide insight into the underlying biological pathways

    Science.gov (United States)

    Scott, Robert A; Lagou, Vasiliki; Welch, Ryan P; Wheeler, Eleanor; Montasser, May E; Luan, Jian’an; Mägi, Reedik; Strawbridge, Rona J; Rehnberg, Emil; Gustafsson, Stefan; Kanoni, Stavroula; Rasmussen-Torvik, Laura J; Yengo, Loïc; Lecoeur, Cecile; Shungin, Dmitry; Sanna, Serena; Sidore, Carlo; Johnson, Paul C D; Jukema, J Wouter; Johnson, Toby; Mahajan, Anubha; Verweij, Niek; Thorleifsson, Gudmar; Hottenga, Jouke-Jan; Shah, Sonia; Smith, Albert V; Sennblad, Bengt; Gieger, Christian; Salo, Perttu; Perola, Markus; Timpson, Nicholas J; Evans, David M; Pourcain, Beate St; Wu, Ying; Andrews, Jeanette S; Hui, Jennie; Bielak, Lawrence F; Zhao, Wei; Horikoshi, Momoko; Navarro, Pau; Isaacs, Aaron; O’Connell, Jeffrey R; Stirrups, Kathleen; Vitart, Veronique; Hayward, Caroline; Esko, Tönu; Mihailov, Evelin; Fraser, Ross M; Fall, Tove; Voight, Benjamin F; Raychaudhuri, Soumya; Chen, Han; Lindgren, Cecilia M; Morris, Andrew P; Rayner, Nigel W; Robertson, Neil; Rybin, Denis; Liu, Ching-Ti; Beckmann, Jacques S; Willems, Sara M; Chines, Peter S; Jackson, Anne U; Kang, Hyun Min; Stringham, Heather M; Song, Kijoung; Tanaka, Toshiko; Peden, John F; Goel, Anuj; Hicks, Andrew A; An, Ping; Müller-Nurasyid, Martina; Franco-Cereceda, Anders; Folkersen, Lasse; Marullo, Letizia; Jansen, Hanneke; Oldehinkel, Albertine J; Bruinenberg, Marcel; Pankow, James S; North, Kari E; Forouhi, Nita G; Loos, Ruth J F; Edkins, Sarah; Varga, Tibor V; Hallmans, Göran; Oksa, Heikki; Antonella, Mulas; Nagaraja, Ramaiah; Trompet, Stella; Ford, Ian; Bakker, Stephan J L; Kong, Augustine; Kumari, Meena; Gigante, Bruna; Herder, Christian; Munroe, Patricia B; Caulfield, Mark; Antti, Jula; Mangino, Massimo; Small, Kerrin; Miljkovic, Iva; Liu, Yongmei; Atalay, Mustafa; Kiess, Wieland; James, Alan L; Rivadeneira, Fernando; Uitterlinden, Andre G; Palmer, Colin N A; Doney, Alex S F; Willemsen, Gonneke; Smit, Johannes H; Campbell, Susan; Polasek, Ozren; Bonnycastle, Lori L; Hercberg, Serge; Dimitriou, Maria; Bolton, Jennifer L; Fowkes, Gerard R; Kovacs, Peter; Lindström, Jaana; Zemunik, Tatijana; Bandinelli, Stefania; Wild, Sarah H; Basart, Hanneke V; Rathmann, Wolfgang; Grallert, Harald; Maerz, Winfried; Kleber, Marcus E; Boehm, Bernhard O; Peters, Annette; Pramstaller, Peter P; Province, Michael A; Borecki, Ingrid B; Hastie, Nicholas D; Rudan, Igor; Campbell, Harry; Watkins, Hugh; Farrall, Martin; Stumvoll, Michael; Ferrucci, Luigi; Waterworth, Dawn M; Bergman, Richard N; Collins, Francis S; Tuomilehto, Jaakko; Watanabe, Richard M; de Geus, Eco J C; Penninx, Brenda W; Hofman, Albert; Oostra, Ben A; Psaty, Bruce M; Vollenweider, Peter; Wilson, James F; Wright, Alan F; Hovingh, G Kees; Metspalu, Andres; Uusitupa, Matti; Magnusson, Patrik K E; Kyvik, Kirsten O; Kaprio, Jaakko; Price, Jackie F; Dedoussis, George V; Deloukas, Panos; Meneton, Pierre; Lind, Lars; Boehnke, Michael; Shuldiner, Alan R; van Duijn, Cornelia M; Morris, Andrew D; Toenjes, Anke; Peyser, Patricia A; Beilby, John P; Körner, Antje; Kuusisto, Johanna; Laakso, Markku; Bornstein, Stefan R; Schwarz, Peter E H; Lakka, Timo A; Rauramaa, Rainer; Adair, Linda S; Smith, George Davey; Spector, Tim D; Illig, Thomas; de Faire, Ulf; Hamsten, Anders; Gudnason, Vilmundur; Kivimaki, Mika; Hingorani, Aroon; Keinanen-Kiukaanniemi, Sirkka M; Saaristo, Timo E; Boomsma, Dorret I; Stefansson, Kari; van der Harst, Pim; Dupuis, Josée; Pedersen, Nancy L; Sattar, Naveed; Harris, Tamara B; Cucca, Francesco; Ripatti, Samuli; Salomaa, Veikko; Mohlke, Karen L; Balkau, Beverley; Froguel, Philippe; Pouta, Anneli; Jarvelin, Marjo-Riitta; Wareham, Nicholas J; Bouatia-Naji, Nabila; McCarthy, Mark I; Franks, Paul W; Meigs, James B; Teslovich, Tanya M; Florez, Jose C; Langenberg, Claudia; Ingelsson, Erik; Prokopenko, Inga; Barroso, Inês

    2012-01-01

    Through genome-wide association meta-analyses of up to 133,010 individuals of European ancestry without diabetes, including individuals newly genotyped using the Metabochip, we have raised the number of confirmed loci influencing glycemic traits to 53, of which 33 also increase type 2 diabetes risk (q fasting insulin showed association with lipid levels and fat distribution, suggesting impact on insulin resistance. Gene-based analyses identified further biologically plausible loci, suggesting that additional loci beyond those reaching genome-wide significance are likely to represent real associations. This conclusion is supported by an excess of directionally consistent and nominally significant signals between discovery and follow-up studies. Functional follow-up of these newly discovered loci will further improve our understanding of glycemic control. PMID:22885924

  14. Effect of glycemic index on obesity control.

    Science.gov (United States)

    Pereira, Elisângela Vitoriano; Costa, Jorge de Assis; Alfenas, Rita de Cássia Gonçalves

    2015-06-01

    Evaluate the effect of glycemic index (GI) on biochemical parameters, food intake, energy metabolism, anthropometric measures and body composition in overweight subjects. Simple blind study, in which nineteen subjects were randomly assigned to consume in the laboratory two daily low GI (n = 10) or high GI (n = 9) meals, for forty-five consecutive days. Habitual food intake was assessed at baseline. Food intake, anthropometric measures and body composition were assessed at each 15 days. Energy metabolism and biochemical parameters were evaluated at baseline and the end of the study. Low GI meals increased fat oxidation, and reduced waist circumference and HOMA-IR, while high GI meals increased daily dietary fiber and energy intake compared to baseline. There was a higher reduction on waist circumference and body fat, and a higher increase on postprandial fat oxidation in response to the LGI meals than after high GI meals. High GI meals increased fasting respiratory coefficient compared to baseline and low GI meals. The results of the present study showed that the consumption of two daily low GI meals for forty-five consecutive days has a positive effect on obesity control, whereas, the consumption of high GI meals result has the opposite effect.

  15. Does glycemic variability impact mood and quality of life?

    Science.gov (United States)

    Penckofer, Sue; Quinn, Lauretta; Byrn, Mary; Ferrans, Carol; Miller, Michael; Strange, Poul

    2012-04-01

    Diabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied. A descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72 h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as "energy," and (3) mood (depression, anxiety, anger) and quality of life by questionnaires. Women with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions. Data suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life.

  16. A Review of the Relationship between Dietary Glycemic Index and Glycemic Load and Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Fahime Zeinali

    2016-10-01

    Full Text Available Background: In recent decades, studies on type 2 diabetes (T2D, have adopted a new approach to the field of a more complete collection of variables related to the lifestyles and diet of people. Diet is an important factor in increasing the rate of T2D among individuals. Considering the consumption of a high-carbohydrate diet, little attention has been paid to the type of carbohydrates consumed in the incidence of T2D. The present study aimed to review the literature on the relationship between the glycemic index (GI, the glycemic load, (GL and T2D, it also targets at evaluating and comparing the results of similar studies in other countries Methods: Using search engines, including PubMed, Science Direct, Embase and Scopus, and key words such as GI, GL, diabetes; articles with cross-sectional, clinical trial, Prospective and retrospective cohort designs between 2000 to 2016 were selected. Moreover, non-English language articles were not investigate. Results: The results of these studies showed that a diet containing low GI and GL has beneficial effects on the metabolism of glucose in the body and is also considered as a factor to protect the body against T2D and its complications. Conclusions: Monitoring eating habits of people with T2D can have beneficial effects on T2D and its associated risk factors.

  17. Overall glycemic index and glycemic load of vegan diets in relation to plasma lipoproteins and triacylglycerols.

    Science.gov (United States)

    Waldmann, Annika; Ströhle, Alexander; Koschizke, Jochen W; Leitzmann, Claus; Hahn, Andreas

    2007-01-01

    To investigate the overall glycemic index (GI), glycemic load (GL), and intake of dietary fiber, and to examine the associations between these factors and plasma lipoproteins and triacylglycerols in adult vegans in the German Vegan Study (GVS). Cross-sectional study, Germany. Healthy men (n = 67) and women (n = 87), who fulfilled the study criteria (vegan diet for >or=1 year prior to study start; minimum age of 18 years; no pregnancy/childbirth during the last 12 months) and who participated in all study segments. The average dietary GL of the GVS population was 144, and the average GI was 51.4. The adjusted geometric mean total, HDL, and LDL cholesterol concentrations decreased across the increasing quartiles of GL, carbohydrate and dietary fiber intake. The associations between total cholesterol, HDL cholesterol, LDL cholesterol and GL density and GI were inconsistent. Also, associations between GI, GL, the intake of carbohydrates, and triacylglycerol concentration were not observed. Fiber-rich vegan diets are characterized by a low GI and a low to moderate GL. The data do not support the hypothesis that a carbohydrate-rich diet per se is associated with unfavorable effects on triaclyglycerols that would be predicted to increase the risk of coronary heart disease. Copyright (c) 2007 S. Karger AG, Basel.

  18. Glycemic index and glycemic load in the Opuntia ficus-indica fruit

    Science.gov (United States)

    Ibarra-Salas, María de Jesús; Novelo-Huerta, Hilda Irene; De León-Salas, Marcela Alejandra; Sánchez-Murillo, Mayra Elisa; Mata-Obregón, María Del Carmen; Garza-Juárez, Aurora de Jesús

    2017-01-01

    There is evidence that support the clinical usage of glycemic index (GI) and glycemic load (GL) in the prevention of chronic disease. To determine the GI and GL of the Opuntia ficus-indica fruit. An analytic, transversal study was made involving 25 healthy volunteers accepted by an informed consent with a normal body mass index, glucose, glycoside hemoglobin, cholesterol and serum triglycerides. The homogeneity of the population was evaluated with anthropometrical and biochemical data using principal component analysis (PCA). The equivalent of 50 g of carbohydrates test food (tuna) and 50 g of dextrose as food standard was provided for the measure of the glucose curve. The GI was determined by calculating the area under the curve by the triangulation method. The CG was reported as the product of IG by carbohydrate loading provided. The IG of the tuna was 48.01 ± 17.4, classified as low, while the CG was 24.0 ± 8.7 rated as high. The chemometric analysis by PCA showed that the selection of the normal population for determining the IG, it is important to consider the values of cholesterol and triglycerides. Copyright: © 2017 SecretarÍa de Salud

  19. Impact of Glucose Meter Error on Glycemic Variability and Time in Target Range During Glycemic Control After Cardiovascular Surgery.

    Science.gov (United States)

    Karon, Brad S; Meeusen, Jeffrey W; Bryant, Sandra C

    2015-08-25

    We retrospectively studied the impact of glucose meter error on the efficacy of glycemic control after cardiovascular surgery. Adult patients undergoing intravenous insulin glycemic control therapy after cardiovascular surgery, with 12-24 consecutive glucose meter measurements used to make insulin dosing decisions, had glucose values analyzed to determine glycemic variability by both standard deviation (SD) and continuous overall net glycemic action (CONGA), and percentage glucose values in target glucose range (110-150 mg/dL). Information was recorded for 70 patients during each of 2 periods, with different glucose meters used to measure glucose and dose insulin during each period but no other changes to the glycemic control protocol. Accuracy and precision of each meter were also compared using whole blood specimens from ICU patients. Glucose meter 1 (GM1) had median bias of 11 mg/dL compared to a laboratory reference method, while glucose meter 2 (GM2) had a median bias of 1 mg/dL. GM1 and GM2 differed little in precision (CV = 2.0% and 2.7%, respectively). Compared to the period when GM1 was used to make insulin dosing decisions, patients whose insulin dose was managed by GM2 demonstrated reduced glycemic variability as measured by both SD (13.7 vs 21.6 mg/dL, P meter error (bias) was associated with decreased glycemic variability and increased percentage of values in target glucose range for patients placed on intravenous insulin therapy following cardiovascular surgery. © 2015 Diabetes Technology Society.

  20. [The glycemic index of some foods common in Mexico].

    Science.gov (United States)

    Frati-Munari, A C; Roca-Vides, R A; López-Pérez, R J; de Vivero, I; Ruiz-Velazco, M

    1991-01-01

    To investigate the increase of glycemia due to the ingestion of usual food in Mexico, portions with 50 g of carbohydrate form white corn tortilla, yellow corn tortilla, spaghetti, rice, potatoes, beans brown and black, nopal (prickle pear cactus) and peanuts, compared with white bread, were given to 21 healthy and 27 non-insulin-dependent diabetic subjects. Serum glucose and insulin were measured every 30 min for 180 min long. Glycemic index was obtained as: (area under curve of glucose with test food/area under curve of glucose with white bread) X 100. A corrected index was calculated subtracting the area corresponding to initial values. Insulin index was obtained similarly. Each sample was studied 14-18 times. Glycemic and insulin indexes of white and yellow corn tortilla, spaghetti, rice and potatoes were not different from bread (P greater than 0.05). Corrected glycemic indexes of brown beans (54 +/- 15, +/- SE) and black beans (43 +/- 17) were low (p less than 0.05), as well as corrected insulin indexes (69 +/- 11 and 64 +/- 10 respectively, (P less than 0.02). Peanuts had low glycemic (33 +/- 17, P less than 0.01), but normal insulin index. Nopal had very low glycemic and insulin indexes (10 +/- 17 and 10 +/- 16, P less than 0.0001). These data might be useful in prescribing diets for diabetic subjects.

  1. Intensive glycemic control and cardiovascular disease: an update.

    Science.gov (United States)

    Brown, Aparna; Reynolds, L Raymond; Bruemmer, Dennis

    2010-07-01

    Cardiovascular complications constitute the major cause of morbidity and mortality in patients with diabetes. The Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) provided consistent evidence that intensive glycemic control prevents the development and progression of microvascular complications in patients with type 1 or type 2 diabetes. However, whether intensive glucose lowering also prevents macrovascular disease and major cardiovascular events remains unclear. Extended follow-up of participants in these studies demonstrated that intensive glycemic control reduced the long-term incidence of myocardial infarction and death from cardiovascular disease. By contrast, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial, Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) trial, and Veterans Affairs Diabetes Trial (VADT) results suggested that intensive glycemic control to near normoglycemia had either no, or potentially even a detrimental, effect on cardiovascular outcomes. This article discusses the effects of intensive glycemic control on cardiovascular disease, and examines key differences in the design of these trials that might have contributed to their disparate findings. Recommendations from the current joint ADA, AHA, and ACCF position statement on intensive glycemic control and prevention of cardiovascular disease are highlighted.

  2. Goals are not selfish.

    Science.gov (United States)

    von Hippel, William; von Hippel, Frank A

    2014-04-01

    The metaphor of selfish goals is misguided. Organisms can be considered vessels that further the interests of their genes, but not vessels that further the interests of their goals. Although goals can act at cross-purposes to each other and to longevity, such trade-offs are predicted by evolutionary theory. The metaphor of selfish goals provides no purchase on this problem.

  3. Comparing Three Models of Achievement Goals: Goal Orientations, Goal Standards, and Goal Complexes

    Science.gov (United States)

    Senko, Corwin; Tropiano, Katie L.

    2016-01-01

    Achievement goal theory (Dweck, 1986) initially characterized mastery goals and performance goals as opposites in a good-bad dualism of student motivation. A later revision (Harackiewicz, Barron, & Elliot, 1998) contended that both goals can provide benefits and be pursued together. Perhaps both frameworks are correct: Their contrasting views…

  4. Diabetes treatment satisfaction, medication adherence, and glycemic control among ambulatory type 2 diabetic nigerians in a primary care clinic of a tertiary hospital situated in a resource-limited environment of Southeast Nigeria

    Directory of Open Access Journals (Sweden)

    Iloh Gabriel Uche Pascal

    2016-01-01

    Full Text Available Background: Diabetic treatment satisfaction, medication adherence, and glycemic control are widely recognized as the cornerstones for successful management of diabetes and proxy indicators of quality of care. However, in Nigeria, nothing is known on the role of diabetic treatment satisfaction on medication adherence and blood glucose control. Aim: The study was aimed at determining the role of diabetes treatment satisfaction in medication adherence and glycemic control among ambulatory type 2 diabetic Nigerians in a primary care clinic in Southeast Nigeria. Materials and Methods: This was a descriptive study that was carried out on 120 type 2 diabetic Nigerians who were on treatment for at least 3 months at the primary care clinic of a tertiary hospital in Nigeria. Diabetes treatment satisfaction and medication adherence were assessed in the previous 30 days using pretested, interviewer-administered questionnaire on self-reported satisfaction and adherence to therapy, respectively. Glycemic control was assessed in the previous 1 month. A patient was defined to have goal glycemic control if the fasting blood glucose at the end of the study, visit was between 70 and 130 mg/dL. Results: Diabetic treatment satisfaction, medication adherence, and glycemic control rates were 85.8%, 72.5%, and 61.7%, respectively. Diabetic treatment satisfaction was significantly associated with medication adherence (P = 0.025 and glycemic control (P = 0.04. Conclusion: Diabetic treatment satisfaction was significantly associated with medication adherence and glycemic control. However, treatment satisfaction did not translate marginally to higher medication and glycemic control. Diabetic treatment satisfaction should be integrated into a standard care package for diabetic patients in primary care settings.

  5. Correlation between glycemic excursion by CGMS and diabetic retinopathy among Type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Pu Li; Ji Ning; Zhu Wei

    2011-01-01

    Objective: To investigate correlation between glycemic excursion by CGMS and diabetic retinopathy among type 2 diabetes mellitus. Methods: Used continuous glucose monitoring system (CGMS) to monitoring glycemic excursion within a day of twenty four patients with type 2 diabetes mellitus, and inspect fundus photography, correlation was analyzed. Results: Glycemic excursion might reveal the risk for diabetic retinopathy better than HbA1c does. Conclusion: Diabetic retinopathy may correlate with glycemic excursion. (authors)

  6. Effects of hypocaloric diets with different glycemic indexes on endothelial function and glycemic variability in overweight and in obese adult patients at increased cardiovascular risk.

    Science.gov (United States)

    Buscemi, Silvio; Cosentino, Loretta; Rosafio, Giuseppe; Morgana, Manuela; Mattina, Alessandro; Sprini, Delia; Verga, Salvatore; Rini, Giovam Battista

    2013-06-01

    The role of glycemic index of the diet in glucose control and cardiovascular prevention is still not clear. The aim of this study was to determine the effects of hypocaloric diets with different glycemic indexes and glycemic loads on endothelial function and glycemic variability in nondiabetic participants at increased cardiovascular risk. Forty nondiabetic obese participants were randomly assigned to a three-month treatment with either a low glycemic index (LGI; n=19) or high glycemic index (HGI; n=21) hypocaloric diet with similar macronutrient and fiber content. Endothelial function was measured as flow-mediated dilatation (FMD) of the brachial artery before and after dieting. In addition, 48-h continuous subcutaneous glucose monitoring was done before and after dieting in a subgroup of 24 participants. The amount of weight loss after dieting was similar in both groups. The glycemic index of the diet significantly influenced the FMD (Pdiet, and -0.9±3.6% after the HGI diet (Pdiet on results was observed. The glycemic index of the diet significantly influenced the 48-h glycemic variability measured as coefficient of variability (CV%; Pdiet (from 23.5 to 20.0%) and increased after the HGI diet (from 23.6 to 26.6%). The change in percentage of FMD was inversely correlated with the change in the 48-h glycemic CV% (r=-0.45; Phypocaloric diet in nondiabetic obese persons. ISRCTN56834511. Copyright © 2012 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  7. Impact of night sleep duration on glycemic and triglyceride levels in Chinese with different glycemic status.

    Science.gov (United States)

    Zheng, Yu; Wang, Anping; Pan, Changyu; Lu, Juming; Dou, Jingtao; Lu, Zhaohui; Ba, Jianming; Wang, Baoan; Mu, Yiming

    2015-01-01

    The aim of the present study was to assess the relationship between night sleep duration and glycemic and triglyceride (TG) levels among people with different glycemic status. In all, 18,121 subjects aged ≥40 years were enrolled in this cross-sectional study, including 4318 with impaired glucose regulation (IGR), 4225 with diabetes, and 9578 with normal glucose regulation (NGR). The IGR + diabetes and NGR groups were divided into three subgroups according to self-reported night sleep duration as follows: (i) 9 h. The associations of sleep duration with HbA1c, fasting plasma glucose (FPG), 2-h post-load plasma glucose (PPG), and TG levels were examined. Long night sleep duration (>9 h) was associated with higher HbA1c, FPG, PPG, and TG levels compared with sleep duration of 6-9 h (P index and depressive symptoms, and remained significant even after adjusting for snoring. A significant interaction between sleep duration and TG or snoring was observed for HbA1c levels, which attenuated the sleep-HbA1c association in the IGR + diabetes group. However, no significant association was observed between short night sleep duration and HbA1c levels. Long night sleep duration is associated with higher HbA1c, FPG, PPG, and TG levels in IGR and diabetes patients, independent of potential confounders. This may be important in clinical management of IGR and diabetes patients. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  8. Dietary glycemic index, glycemic load and metabolic profile in children with phenylketonuria.

    Science.gov (United States)

    Moretti, F; Pellegrini, N; Salvatici, E; Rovelli, V; Banderali, G; Radaelli, G; Scazzina, F; Giovannini, M; Verduci, E

    2017-02-01

    No data exist in the current literature on the glycemic index (GI) and glycemic load (GL) of the diet of phenylketonuric (PKU) children. The aims of this study were to examine the dietary GI and GL in PKU children on a low-phenylalanine (Phe)-diet and to evaluate whether an association may exist between the carbohydrate quality and the metabolic profile. Twenty-one PKU children (age 5-11 years) and 21 healthy children, gender and age matched, were enrolled. Dietary (including GI and GL) and blood biochemical assessments were performed. No difference was observed for daily energy intake between PKU and healthy children. Compared to healthy controls, PKU children consumed less protein (p = 0.001) and fat (p = 0.028), and more carbohydrate (% of total energy, p = 0.004) and fiber (p = 0.009). PKU children had higher daily GI than healthy children (mean difference (95% confidence interval), 13.7 (9.3-18.3)) and higher GL (31.7 (10.1-53.2)). PKU children exhibited lower blood total and low density lipoprotein cholesterol (LDL) levels (p triglyceride level (p = 0.014) than healthy children, while glucose and insulin concentrations did not differ. In PKU children the dietary GL was associated with triglyceride glucose index (Spearman's correlation coefficient = 0.515, p = 0.034). In PKU children a relationship of the dietary treatment with GI and GL, blood triglycerides and triglyceride glucose index may exist. Improvement towards an optimal diet for PKU children could include additional attention to the management of dietary carbohydrate quality. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

  9. Low-glycemic-load diets: impact on obesity and chronic diseases.

    Science.gov (United States)

    Bell, Stacey J; Sears, Barry

    2003-01-01

    Historically, carbohydrates have been thought to play only a minor role in promoting weight gain and in predicting the risk of development of chronic disease. Most of the focus had been on reducing total dietary fat. During the last 20 years, fat intake decreased, while the number of individuals who were overweight or developed a chronic conditions have dramatically increased. Simultaneously, the calories coming from carbohydrate have also increased. Carbohydrates can be classified by their post-prandial glycemic effect, called the glycemic index or glycemic load. Carbohydrates with high glycemic indexes and high glycemic loads produce substantial increases in blood glucose and insulin levels after ingestion. Within a few hours after their consumption, blood sugar levels begin to decline rapidly due to an exaggerated increase in insulin secretion. A profound state of hunger is created. The continued intake of high-glycemic load meals is associated with an increased risk of chronic diseases such as obesity, cardiovascular disease, and diabetes. In this review, the terms glycemic index and glycemic load are defined, coupled with an overview of short- and long-term changes that occur from eating diets of different glycemic indexes and glycemic loads. Finally, practical strategies for how to design low-glycemic-load diets consisting primarily of low-glycemic carbohydrates are provided.

  10. Serum GGT activity and hsCRP level in patients with type 2 diabetes mellitus with good and poor glycemic control: An evidence linking oxidative stress, inflammation and glycemic control.

    Science.gov (United States)

    Gohel, Mukesh G; Chacko, Anusha N

    2013-12-20

    Diabetes is undoubtedly one of the most challenging health problems in 21st century. Understanding the pathogenesis and preventing long term complications have been major goals of research in diabetes mellitus (DM). Research in the past few years has linked oxidative stress and inflammation to beta cell dysfunction. Aim of this study is to evaluate serum gamma-glutamyl transferase (GGT) activity (marker of oxidative stress) and high sensitivity C reactive protein (hsCRP) level (an inflammatory marker) in type 2 DM subjects with good and poor glycemic control. Further, we investigated correlation between serum GGT and hsCRP level with glycemic control (FBS, PP2BS, HbA1c) in subjects. A cross sectional study consists of 150 patients out of them 50 patients having type 2 DM with good control (Group II), 50 patients with type 2 DM with poor control (Group III) and 50 normal healthy control (Group I) were selected. Serum GGT, serum hsCRP, FBS, PP2BS, HbA1c, and other biochemical investigations include serum liver enzymes and lipids were measured. Mean serum GGT and hsCRP concentration were statistically significantly higher in group III patients compared to group I and group II subjects as well as increased in group II compared to group I (p stress and inflammation appears to be a key component and also associated with poor glycemic control and further pathogenesis of diabetes and its complications. All our finding suggesting a link between oxidative stress, inflammation and glycemic control in patient with type 2 diabetes mellitus.

  11. Academic goals in surgery.

    Science.gov (United States)

    Bleier, Joshua I S; Kann, Brian

    2013-12-01

    The development of an academic surgical career can be an overwhelming prospect, and one that is not intuitive. Establishing a structured plan and support structure is critical to success. Starting a successful academic surgical career begins with defining one's academic goals within several broad categories: personal goals, academic goals, research goals, educational goals, and financial goals. Learning the art of self-promotion is the means by which many of these goals are achieved. It is important to realize that achieving these goals requires a delicate personal balance between work and home life, and the key ways in which to achieve success require establishment of well thought-out goals, a reliable support structure, realistic and clear expectations, and frequent re-evaluation.

  12. Effectiveness of an Interprofessional Glycemic Optimization Clinic on Preoperative Glycated Hemoglobin Levels for Adult Patients with Type 2 Diabetes Undergoing Bariatric Surgery.

    Science.gov (United States)

    Houlden, Robyn L; Yen, Joy L; Moore, Sarah

    2017-12-26

    Bariatric surgery is an effective treatment for patients with type 2 diabetes and refractory obesity; however, many patients have nonoptimal glycemic control preoperatively. We created an interprofessional bariatric glycemic optimization clinic. Patients were seen monthly and received weekly phone calls. We analyzed the effectiveness in assisting patients reach a preoperative glycated hemoglobin (A1C) level of weight was 134.4±29.2 kg. Baseline body mass index was 48.2±8.3 kg/m 2 . Duration of diabetes was 9±7.9 years. Baseline A1C level was 9.0±1.2%. Number of antihyperglycemic agents at baseline was 2.7±0.96. Seventy-five percent reached a target A1C level of ≤7.5%, 92% reached a target of ≤8.0% and 95% reached a target of ≤8.5%; 32% had achieved A1C levels ≤7.5% at 1 month, 59% at 2 months, 70% at 3 months, 73% at 4 months and 75% at 5 months. Mean number of antihyperglycemic agents at target A1C levels was 3.6±1.1. Mean absolute decrease in A1C levels from baseline to target A1C levels was 1.7±1.2. Mean absolute change in weight was -1.9±8.0 kg. Percent change in body weight from baseline to target A1C level was -1.3±4.9%. Glycemic optimization for candidates with diabetes for bariatric surgery is possible in a short time by an interprofessional diabetes team and without weight gain. Further research is needed to determine whether better preoperative glycemic control improves bariatric surgery outcomes. Copyright © 2018. Published by Elsevier Inc.

  13. Goals and Psychological Accounting

    DEFF Research Database (Denmark)

    Koch, Alexander Karl; Nafziger, Julia

    We model how people formulate and evaluate goals to overcome self-control problems. People often attempt to regulate their behavior by evaluating goal-related outcomes separately (in narrow psychological accounts) rather than jointly (in a broad account). To explain this evidence, our theory...... of endogenous narrow or broad psychological accounts combines insights from the literatures on goals and mental accounting with models of expectations-based reference-dependent preferences. By formulating goals the individual creates expectations that induce reference points for task outcomes. These goal......-induced reference points make substandard performance psychologically painful and motivate the individual to stick to his goals. How strong the commitment to goals is depends on the type of psychological account. We provide conditions when it is optimal to evaluate goals in narrow accounts. The key intuition...

  14. 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.

  15. Evaluation of the utility of a glycemic pattern identification system.

    Science.gov (United States)

    Otto, Erik A; Tannan, Vinay

    2014-07-01

    With the increasing prevalence of systems allowing automated, real-time transmission of blood glucose data there is a need for pattern recognition techniques that can inform of deleterious patterns in glycemic control when people test. We evaluated the utility of pattern identification with a novel pattern identification system named Vigilant™ and compared it to standard pattern identification methods in diabetes. To characterize the importance of an identified pattern we evaluated the relative risk of future hypoglycemic and hyperglycemic events in diurnal periods following identification of a pattern in a data set of 536 patients with diabetes. We evaluated events 2 days, 7 days, 30 days, and 61-90 days from pattern identification, across diabetes types and cohorts of glycemic control, and also compared the system to 6 pattern identification methods consisting of deleterious event counts and percentages over 5-, 14-, and 30-day windows. Episodes of hypoglycemia, hyperglycemia, severe hypoglycemia, and severe hyperglycemia were 120%, 46%, 123%, and 76% more likely after pattern identification, respectively, compared to periods when no pattern was identified. The system was also significantly more predictive of deleterious events than other pattern identification methods evaluated, and was persistently predictive up to 3 months after pattern identification. The system identified patterns that are significantly predictive of deleterious glycemic events, and more so relative to many pattern identification methods used in diabetes management today. Further study will inform how improved pattern identification can lead to improved glycemic control. © 2014 Diabetes Technology Society.

  16. Comparison of glycemic control and variability in patients with type 2 and posttransplantation diabetes mellitus.

    Science.gov (United States)

    Werzowa, Johannes; Pacini, Giovanni; Hecking, Manfred; Fidler, Catharina; Haidinger, Michael; Brath, Helmut; Thomas, Andreas; Säemann, Marcus D; Tura, Andrea

    2015-01-01

    Posttransplantation diabetes mellitus (PTDM) is a common complication after renal transplantation leading to increased cardiovascular morbidity and mortality. In subjects with type 2 diabetes (T2DM) increased glycemic variability and poor glycemic control have been associated with cardiovascular complications. We therefore aimed at determining glycemic variability and glycemic control in subjects with PTDM in comparison to T2DM subjects. In this observational study we analyzed 10 transplanted subjects without diabetes (Control), 10 transplanted subjects with PTDM, and 8 non-transplanted T2DM subjects using Continuous Glucose Monitoring (CGM). Several indices of glycemic control quality and variability were computed. Many indices of both glycemic control quality and variability were different between control and PTDM subjects, with worse values in PTDM. The indices of glycemic control, such as glucose mean, GRADE and M-value, were similar in PTDM and T2DM, but some indices of glycemic variability, that is CONGA, lability index and shape index, showed a markedly higher (i.e., worse) value in T2DM than in PTDM (P value range: 0.001-0.035). Although PTDM and T2DM subjects showed similar glycemic control quality, glycemic variability was significantly higher in T2DM. These data underscore potential important pathophysiological differences between T2DM and PTDM indicating that increased glycemic variability may not be a key factor for the excess cardiovascular mortality in patients with PTDM. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. New therapeutic horizons: mapping the future of glycemic control with incretin-based therapy.

    Science.gov (United States)

    Campbell, R Keith; Miller, Sara

    2009-01-01

    More than 24 million adults and children in the United States are living with diabetes, and the vast majority of those individuals have type 2 diabetes. The clinical benefits of good glycemic control have been well established. Most patients eventually require the use of multiple hyperglycemic drugs in combination to approach or achieve the American Diabetes Association's recommended target A1C value of 7%. The role of incretin-based therapies for both glycemic control and beta-cell protection has become an area of intense interest and development. Although current practice guidelines do not include specific recommendations about when and how to incorporate incretin-based agents, a consensus statement published by the American Diabetes Association/European Association for the Study of Diabetes suggests the addition of a glucagon-like peptide-1 (GLP-1) agonist for patients not at goal A1C with metformin and lifestyle changes. The goal of this article is to review this class of agents, discuss their role in the treatment of type 2 diabetes, and address the practical aspects of integrating incretin-based agents into the management of patients with diabetes. Currently, 3 incretin-based therapies are available and widely used in clinical practice. Several more agents are either under review by the Food and Drug Administration (FDA) or are in the very late stages of development. For diabetes educators trying to help their patients understand the differences among their antidiabetic medications, a comprehensive understanding of these agents and their role in therapy is imperative.

  18. Reaching ignition in the tokamak

    International Nuclear Information System (INIS)

    Furth, H.P.

    1985-06-01

    This review covers the following areas: (1) the physics of burning plasmas, (2) plasma physics requirements for reaching ignition, (3) design studies for ignition devices, and (4) prospects for an ignition project

  19. Tougher containment design goals

    International Nuclear Information System (INIS)

    O'Farrelly, C.

    1978-01-01

    Present day LWR containment design goals are reviewed, together with their potential failure modes. Rasmussen's estimates of failure probabilities are discussed and the concept of ''delayed failure'' is seen to be a valuable safety goal for hypothetical accidents. The paper investigates the inherent coremelt resistance capability of various containment designs and suggests improvements, with special emphasis on increasing the failure delay times. (author)

  20. Shared goals and development

    DEFF Research Database (Denmark)

    Blomberg, Olle

    2015-01-01

    undemanding for children to engage in, and therefore has the potential to play a part in fostering their understanding of other minds. Part of the functional role of shared goals is to enable agents to choose means that are appropriate to realising a goal with others rather than individually. By offering...

  1. Preservation of renal function by intensive glycemic control

    Directory of Open Access Journals (Sweden)

    Naoya Toriu

    2018-01-01

    Full Text Available We report the case of a 67-year-old Japanese woman with type 1 diabetes mellitus. At 47 years of age, her hemoglobin A1c (HbA1c was 10.0%, and she had overt nephropathy. The first renal biopsy yielded a diagnosis of diabetic nephropathy. Intensive glycemic control was initiated and her HbA1c improved to 6.0%. Renal dysfunction showed no progression for 15 years. At 62 years of age, a second renal biopsy was performed. Glomerular lesions did not show progression but tubulointerstitial fibrosis and vascular lesions showed progression compared with the first biopsy. Intensive glycemic control can prevent the progression of glomerular lesions, but might not be effective for interstitial and vascular lesions.

  2. Motivational Goal Bracketing

    DEFF Research Database (Denmark)

    Nafziger, Julia; Koch, Alexander

    It is a puzzle why people often evaluate consequences of choices separately (narrow bracketing) rather than jointly (broad bracketing). We study the hypothesis that a present-biased individual, who faces two tasks, may bracket his goals narrowly for motivational reasons. Goals motivate because th...... of the tasks. Narrow goals have a stronger motivational force and thus can be optimal. In particular, if one task outcome becomes known before working on the second task, narrow bracketing is always optimal.......It is a puzzle why people often evaluate consequences of choices separately (narrow bracketing) rather than jointly (broad bracketing). We study the hypothesis that a present-biased individual, who faces two tasks, may bracket his goals narrowly for motivational reasons. Goals motivate because...

  3. Diabetes, glycemic control, and urinary incontinence in women

    Science.gov (United States)

    Wang, Rui; Lefevre, Roger; Hacker, Michele R.; Golen, Toni H.

    2015-01-01

    OBJECTIVES To estimate the association between urinary incontinence and glycemic control in women ages 20 to 85. METHODS We included 7,270 women from the 2005–2010 National Health and Nutrition Examination Survey, stratified into three groups of glycemic control defined by hemoglobin A1c (HbA1c): i) those below the diagnostic threshold (HbA1c8.5%) to allow for a different relationship between glycemic control and urinary incontinence within each group. The primary outcomes were the presence of any, only stress, only urgency, and mixed urinary incontinence. We calculated adjusted risk ratios using Poisson regressions with robust variance estimates. RESULTS The survey-weighted prevalence was 52.9% for any, 27.2% for only stress, 9.9% for only urgency, and 15.8% for mixed urinary incontinence. Among women with relatively controlled diabetes, each one-unit increase in HbA1c was associated with a 13% (95% CI: 1.03–1.25) increase for any urinary incontinence and a 34% (95% CI 1.06–1.69) increase in risk for only stress incontinence but was not significantly associated with only urgency and mixed incontinence. Other risk factors included body mass index, hormone replacement therapy, smoking, and physical activity. CONCLUSIONS Worsening glycemic control is associated with an increased risk for stress incontinence for women with relatively controlled diabetes. For those either below the diagnostic threshold or with poorly controlled diabetes, the risk may be driven by other factors. Further prospective investigation of HbA1c as a modifiable risk factor may motivate measures to improve continence in women with diabetes. PMID:26313496

  4. Salivary function and glycemic control in older persons with diabetes.

    Science.gov (United States)

    Chavez, E M; Taylor, G W; Borrell, L N; Ship, J A

    2000-03-01

    There is no consensus on the possible association between diabetes and salivary dysfunction in older persons with diabetes. This study's purpose was to investigate the effect of diabetes and glycemic control on salivary function in an older population. Twenty nine persons with type 2 diabetes and 23 nondiabetic control subjects participated (age range, 54-90 years). Diabetic status was determined by a glycosylated hemoglobin (HbA(1c)) test and a 2-hour glucose tolerance test. Poor glycemic control was defined as HbA(1c) >9%. Unstimulated whole saliva, unstimulated parotid, and stimulated parotid flow rates were measured, and subjects completed a standardized xerostomia questionnaire. Persons with poorly controlled diabetes had lower (P =.01) stimulated parotid flow rates than persons with well-controlled diabetes and nondiabetic control subjects. There were no significant differences in xerostomic complaints based on diabetic or glycemic control status or salivary flow rates. These results provide some evidence that poorly controlled diabetes may be associated with salivary dysfunction in older adults who have no concomitant complaints of xerostomia.

  5. Variability in Glycemic Control with Temperature Transitions during Therapeutic Hypothermia

    Directory of Open Access Journals (Sweden)

    Krystal K. Haase

    2017-01-01

    Full Text Available Purpose. Patients treated with therapeutic hypothermia (TH and continuous insulin may be at increased risk of hyperglycemia or hypoglycemia, particularly during temperature transitions. This study aimed to evaluate frequency of glucose excursions during each phase of TH and to characterize glycemic control patterns in relation to survival. Methods. Patients admitted to a tertiary care hospital for circulatory arrest and treated with both therapeutic hypothermia and protocol-based continuous insulin between January 2010 and June 2013 were included. Glucose measures, insulin, and temperatures were collected through 24 hours after rewarming. Results. 24 of 26 patients experienced glycemic excursions. Hyperglycemic excursions were more frequent during initiation versus remaining phases (36.3%, 4.3%, 2.5%, and 4.0%, p=0.002. Hypoglycemia occurred most often during rewarming (0%, 7.7%, 23.1%, and 3.8%, p=0.02. Patients who experienced hypoglycemia had higher insulin doses prior to rewarming (16.2 versus 2.1 units/hr, p=0.03. Glucose variation was highest during hypothermia and trended higher in nonsurvivors compared to survivors (13.38 versus 9.16, p=0.09. Frequency of excursions was also higher in nonsurvivors (32.3% versus 19.8%, p=0.045. Conclusions. Glycemic excursions are common and occur more often in nonsurvivors. Excursions differ by phase but risk of hypoglycemia is increased during rewarming.

  6. Chemical compositions and glycemic responses to banana varieties.

    Science.gov (United States)

    Hettiaratchi, U P K; Ekanayake, S; Welihinda, J

    2011-06-01

    Chemical compositions and glycemic indices of four varieties of banana (Musa spp.) (kolikuttu-Silk AAB, embul-Mysore AAB, anamalu-Gros Michel AAA, seeni kesel-Pisang Awak ABB) were determined. Silk, Gros Michel, Pisang Awak and Mysore contained the highest percentages of starch (14%), sucrose (38%), free glucose (29%) and fructose (58%) as a percentage of the total available carbohydrate content respectively. Total dietary fiber contents of four varieties ranged from 2.7 to 5.3%. Glycemic indices of Silk, Mysore, Gros Michel and Pisang Awak were 61 ± 5, 61 ± 6, 67 ± 7, 69 ± 9 and can be categorized as low against white bread as the standard. A single banana of the four varieties elicited a low glycemic load. Thus, consumption of a banana from any of these varieties can be recommended as a snack for healthy or diabetic patients who are under dietary management or pharmacological drugs to regulate blood glucose responses in between meals.

  7. Role of Vitamin D on glycemic control and oxidative stress in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mostafa Saif-Elnasr

    2017-01-01

    Full Text Available Background: Vitamin D deficiency may play a key role in the development of impaired glucose tolerance, type 2 diabetes mellitus (T2DM, and metabolic syndrome. Several studies have shown that Vitamin D has an antioxidant property. We aimed to investigate 25-hydroxy Vitamin D (25[OH]D levels in patients with T2DM and in nondiabetic healthy controls and to ascertain the impact of 25(OHD levels on glycemic control and oxidative stress in T2DM patients. Materials and Methods: Thirty male patients with T2DM and twenty age- and socioeconomic status-matched male healthy controls were included in the study. Fasting and postprandial blood sugar and glycated hemoglobin (HbA1c were measured. Enzyme activity of superoxide dismutase (SOD and glutathione peroxidase (GPx was determined by spectrophotometric assay, and serum levels of 25(OHD were measured using radioimmunoassay. Results: Serum Vitamin D levels were significantly lower in patients with T2DM than healthy controls (P = 0.015. There was a significantly lower GPx activity in patients with T2DM than controls (P = 0.048, but the difference in SOD activity did not reach statistical significance. There was a significant negative correlation between serum Vitamin D levels and HbA1c (P = 0.016, but no statistical correlation was shown between serum Vitamin D levels and GPx and SOD. Conclusion: We conclude that low level of Vitamin D might play a significant role in T2DM pathogenesis. Hence, Vitamin D supplementation may improve glycemic control and oxidative stress in T2DM.

  8. Practical goal programming

    CERN Document Server

    Jones, Dylan

    2010-01-01

    This book and its treatment of goal programming will help organizations meet targets and objectives. The book includes many worked-out examples and tutorial exercises, and is designed to demostrate and teach its readers good modeling practice.

  9. Individual differences and day-to-day fluctuations in goal planning and type 1 diabetes management.

    Science.gov (United States)

    Wiebe, Deborah J; Baker, Ashley C; Suchy, Yana; Stump, Tammy K; Berg, Cynthia A

    2018-04-26

    To examine whether individual differences and day-to-day fluctuations in diabetes goal planning are associated with Type 1 diabetes (T1D) management during late adolescence, and whether lapses in daily diabetes goal planning are more disruptive to diabetes management among those with poorer executive functioning (EF). Late adolescents with T1D (N = 236, Mage = 17.77 years) completed survey measures assessing individual differences in levels of diabetes goal planning and adherence, as well as survey and performance-based measures of EF; glycemic control was assessed through glycated hemoglobin (HbA1c) assays. Participants then completed a 2-week daily diary, rating items measuring daily diabetes goal planning, goal effort, and adherence, and recording blood-glucose tests from their glucometer at the end of each day. Analyses of survey measures indicated that higher individual differences in diabetes goal planning were associated with better adherence and glycemic control. Analyses of daily data using hierarchical linear modeling indicated that adolescents displayed higher daily adherence and lower blood-glucose levels on days when they had higher-than-their-average levels of daily goal planning and daily goal effort. EF moderated the association between daily goal planning and daily adherence, indicating that lapses in daily goal planning were more disruptive for adolescents with poorer EF. Both individual differences and day-to-day fluctuations in diabetes goal planning are associated with diabetes management, highlighting the challenges of managing T1D in daily life. Youth in late adolescence with poorer EF may especially benefit from planning to attain diabetes goals on a daily basis. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Yogurt Is a Low-Glycemic Index Food.

    Science.gov (United States)

    Wolever, Thomas Ms

    2017-07-01

    High yogurt intake is associated with a reduced risk of type 2 diabetes (T2DM). Although several mechanisms could explain this association, this paper addresses the glycemic and insulinemic impact of yogurt. There is evidence that low-glycemic index (GI) and low-glycemic load (GL) diets are associated with a reduced risk of T2DM. The 93 GI values for yogurt in the University of Sydney's GI database have a mean ± SD of 34 ± 13, and 92% of the yogurts are low-GI (≤55). The 43 plain yogurts in the database have a lower GI than the 50 sweetened yogurts, 27 ± 11 compared with 41 ± 11 ( P yogurt. Although yogurt has a low GI, its insulinemic index (II) is higher than its GI. High insulin responses may be deleterious because hyperinsulinemia is associated with an increased risk of T2DM. Nevertheless, this may not be a concern for yogurt because, although its II is higher than its GI, the II of yogurt is within the range of II values for nondairy low-GI foods. In addition, mixed meals containing dairy protein elicit insulin responses similar to those elicited by mixed meals of similar composition containing nondairy protein. Because the GI of yogurt is lower than that of most other carbohydrate foods, exchanging yogurt for other protein and carbohydrate sources can reduce the GI and GL of the diet, and is in line with recommended dietary patterns, which include whole grains, fruits, vegetables, nuts, legumes, fish, vegetable oils, and yogurt. © 2017 American Society for Nutrition.

  11. Vasculogenesis and Diabetic Erectile Dysfunction: How Relevant Is Glycemic Control?

    Science.gov (United States)

    Castela, Angela; Gomes, Pedro; Silvestre, Ricardo; Guardão, Luísa; Leite, Liliana; Chilro, Rui; Rodrigues, Ilda; Vendeira, Pedro; Virag, Ronald; Costa, Carla

    2017-01-01

    Erectile dysfunction (ED) is a complication of diabetes, condition responsible for causing endothelial dysfunction (EDys) and hampering repair mechanisms. However, scarce information is available linking vasculogenesis mediated by Endothelial Progenitor Cells (EPCs) and diabetes-associated ED. Furthermore, it remains to be elucidated if glycemic control plays a role on EPCs functions, EPCs modulators, and penile vascular health. We evaluated the effects of diabetes and insulin therapy on bone marrow (BM) and circulating EPCs, testosterone, and systemic/penile Stromal Derived Factor-1 alpha (SDF-1α) expression. Male Wistar rats were divided into groups: age-matched controls, 8-weeks streptozotocin-induced type 1 diabetics, and insulin-treated 8-weeks diabetics. EPCs were identified by flow cytometry for CD34/CD133/VEGFR2/CXCR4 antigens. Systemic SDF-1α and testosterone levels were evaluated by ELISA. Penile SDF-1α protein expression was assessed, in experimental and human diabetic cavernosal samples, by immunohistochemical techniques. Diabetic animals presented a reduction of BM-derived EPCs and an increase in putative circulating endothelial cells (CECs) sloughed from vessels wall. These alterations were rescued by insulin therapy. In addition, glycemic control promoted an increase in systemic testosterone and SDF-1α levels, which were significantly decreased in animals with diabetes. SDF-1α protein expression was reduced in experimental and human cavernosal diabetic samples, an effect prevented by insulin in treated animals. Insulin administration rescued the effects of diabetes on BM function, CECs levels, testosterone, and plasmatic/penile SDF-1α protein expression. This emphasizes the importance of glycemic control in the prevention of diabetes-induced systemic and penile EDys, by the amelioration of endothelial damage, and increase in protective pathways. J. Cell. Biochem. 118: 82-91, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. REACH and nanomaterials: current status

    International Nuclear Information System (INIS)

    Alessandrelli, Maria; Di Prospero Fanghella, Paola; Polci, Maria Letizia; Castelli, Stefano; Pettirossi, Flavio

    2015-01-01

    New challenges for regulators are emerging about a specific assessment and appropriate management of the potential risks of nanomaterials. In the framework of European legislation on chemicals, Regulation (EC) No. 1907/2006 REACH aims to ensure the safety of human health and the environment through the collection of information on the physico-chemical characteristics of the substances and on their profile (eco) toxicological and the identification of appropriate risk management linked to 'exposure to these substances without impeding scientific progress and the competitiveness of industry. In order to cover the current shortage of information on the safety of nanomaterials and tackle the acknowledged legal vacuum, are being a rich activities, carried out both by regulators both by stake holders, and discussions on the proposals for adapting the European regulatory framework for chemicals . The European Commission is geared to strengthen the REACH Regulation by means of updates of its annexes. The importance of responding to the regulatory requirements has highlighted the need for cooperation between European organizations, scientists and industries to promote and ensure the safe use of nanomaterials. [it

  13. Interaction between functional health literacy, patient activation, and glycemic control

    Directory of Open Access Journals (Sweden)

    Woodard LD

    2014-07-01

    Full Text Available LeChauncy D Woodard, Cassie R Landrum, Amber B Amspoker, David Ramsey, Aanand D Naik Veterans Affairs Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Michael E DeBakey Veterans Affairs Medical Center, and Section of Health Services Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA Background: Functional health literacy (FHL and patient activation can impact diabetes control through enhanced diabetes self-management. Less is known about the combined effect of these characteristics on diabetes outcomes. Using brief, validated measures, we examined the interaction between FHL and patient activation in predicting glycosylated hemoglobin (HbA1c control among a cohort of multimorbid diabetic patients.Methods: We administered a survey via mail to 387 diabetic patients with coexisting ­hypertension and ischemic heart disease who received outpatient care at one regional VA medical center between November 2010 and December 2010. We identified patients with the study conditions using the International Classification of Diseases-Ninth Revision-Clinical ­Modification (ICD-9-CM diagnoses codes and Current Procedure Terminology (CPT ­procedures codes. Surveys were returned by 195 (50.4% patients. We determined patient activation levels based on participant responses to the 13-item Patient Activation Measure and FHL levels using the single-item screening question, “How confident are you filling out medical forms by yourself?” We reviewed patient medical records to assess glycemic control. We used multiple logistic regression to examine whether activation and FHL were individually or jointly related to HbA1c control.Results: Neither patient activation nor FHL was independently related to glycemic control in the unadjusted main effects model; however, the interaction between the two was significantly associated with glycemic control (odds ratio 1.05 [95% confidence

  14. Tight glycemic control in the ICU - is the earth flat?

    Science.gov (United States)

    Steil, Garry M; Agus, Michael S D

    2014-06-27

    Tight glycemic control in the ICU has been shown to reduce mortality in some but not all prospective randomized control trials. Confounding the interpretation of these studies are differences in how the control was achieved and underlying incidence of hypoglycemia, which can be expected to be affected by the introduction of continuous glucose monitoring (CGM). In this issue of Critical Care, a consensus panel provides a list of the research priorities they believe are needed for CGM to become routine practice in the ICU. We reflect on these recommendations and consider the implications for using CGM today.

  15. Perception of future goals

    DEFF Research Database (Denmark)

    Ottsen, Christina L.; Berntsen, Dorthe

    The current study: a cross-cultural comparison between the Middle East and Scandinavia. Two societies that offer a unique opportunity to examine gender and cultural differences in perception of personal goals. Previous studies show that imagined future events are affected by memories of personal...

  16. Materialistic Values and Goals.

    Science.gov (United States)

    Kasser, Tim

    2016-01-01

    Materialism comprises a set of values and goals focused on wealth, possessions, image, and status. These aims are a fundamental aspect of the human value/goal system, standing in relative conflict with aims concerning the well-being of others, as well as one's own personal and spiritual growth. Substantial evidence shows that people who place a relatively high priority on materialistic values/goals consume more products and incur more debt, have lower-quality interpersonal relationships, act in more ecologically destructive ways, have adverse work and educational motivation, and report lower personal and physical well-being. Experimentally activating materialistic aims causes similar outcomes. Given these ills, researchers have investigated means of decreasing people's materialism. Successful interventions encourage intrinsic/self-transcendent values/goals, increase felt personal security, and/or block materialistic messages from the environment. These interventions would likely be more effective if policies were also adopted that diminished contemporary culture's focus on consumption, profit, and economic growth.

  17. Reaching goals of managed competition? The challenge of free health plan choice.

    NARCIS (Netherlands)

    Bes, R.; Crufs, E.; Groenewegen, P.; Jong, J. de

    2015-01-01

    Introduction: In the last decades, several countries have implemented a health care system based on managed competition. In such a system, health insurers are supposed to be prudent buyers of care on behalf of their enrolees. Selective contracting and channelling patients to contracted care

  18. [Advance directives in Italy: a goal not yet reached but already passed?].

    Science.gov (United States)

    Riccioni, Luigi; Gristina, Giuseppe

    2015-10-01

    The advance directives (ADs) have been adopted in many countries to defend patients' autonomy. In Italy, in the past, this topic gave rise to a heated debate involving philosophers, theologians, and politicians. In 2009, the government presented a bill of law on ADs firmly criticized from a scientific, moral and juridical point of view because the bill's content is against the principles of Italian Constitution, Italian Code of Medical Ethics, Oviedo Convention, and official statements of many scientific societies. Although the bill has passed the Low Chamber it lies, even since, in the Senate, lacking in regard any agreement among the political parties. The purpose of this article is to highlight that, in our country, patients, relatives and doctors deserve a law not only related to the specific topic of ADs, but - as in other European countries (Germany, Spain, France, UK) - aimed to deal with the complex issue of end of life care as a whole. This law should take into account the sound evidence existing in regard to the four fundamental principles supporting the best scientific and ethical approaches to the end of life issues: shared decision making process between doctors and patients/relatives; rejection of dying process marked by the suffering; withholding/withdrawing futile treatments together with palliative sedation as two crucial contributions to suppress the patient suffering and pain; clear-cut difference between these clinical/ethical options and euthanasia. At the same time, this law should be able to provide physicians with a legal coverage to make all the clinical and ethical decisions more and more complex because of the continuous evolution of medical science on one hand, and the impressive development of biotechnology on the other hand.

  19. How to Reach Decision Makers: Build a network of educators and practitioners with common goals

    Science.gov (United States)

    Boudrias, M. A.; Estrada, M.; Anders, S.; Silva-Send, N. J.; Gershunov, A.

    2013-12-01

    In San Diego County, the Climate Education Partners (CEP) includes climate scientists, science educators, behavioral scientists, environmental practitioners and community organizations that are dedicated to providing local decision makers (elected officials, business leaders, community leaders) with sound climate science learning opportunities and resources that promote informed decision making. Their work over the past three years has found that effective climate education programs are designed for specific audiences with tailored information that is relevant to them, while simultaneously building community efficacy, identity and values. An integrated approach that blends rigorous scientific facts, local climate change impact, and social science education theory is contributing towards the development of a cadre of engaged leaders and communities. To track project progress and to inform the project strategy, local Key Influentials are being interviewed to gauge their current understanding of climate change and their interest in either becoming messengers to their community or becoming the portal to their constituency. Innovation comes from productive collaboration. For this reason, CEP has been working with leading scientists (climatologists, hydrologists, meteorologists, ecologists), environmental groups, museums and zoos, media experts and government agencies (Water Authority, CalFire) to develop and refine a program of learning activities and resources geared specifically for Key Influentials. For example, a water tour has been designed to bring 25 key influential leaders in San Diego County to a dam, a pumping station and a reservoir and provide climate change facts, impacts and potential solutions to the critical issue of water supply for the San Diego Region. While learning local facts about the causes and impacts of climate change, participants also learn about what they can do (increasing efficacy), that they can be a part of a solution centered community (building identity), and that everything - the education and the use of this knowledge to promote informed decisions - is connected to doing what is best for the next generation (tying learning to values). In addition, CEP developed locally focused videos, one on heat waves and one on water resources, which are being experimentally tested for their impact on informed decision-making and utilized with various KI audiences. Climate Education Partners is finding that linking excellent science with healthy community partnerships is resulting in San Diego leaders and their communities making more informed decisions on how to adapt to climate change and preserve the quality of life enjoyed in San Diego for all future generations.

  20. Is there a need to optimize glycemic control in hemodialyzed diabetic patients?

    DEFF Research Database (Denmark)

    Feldt-Rasmussen, B

    2006-01-01

    The report of Williams et al. gives rise to at least two important questions regarding diabetic patients on maintenance hemodialysis: (1) Does glycemic control play a significant role? (2) Is HbA1c a reliable measure of glycemic control? These questions are discussed. It is recommended that you t...

  1. ASHP therapeutic position statement on strict glycemic control in patients with diabetes.

    Science.gov (United States)

    2003-11-15

    The deleterious effects of hyperglycemia have been documented from the biochemical to the pathophysiologic level. Given the research findings and the guidelines for glycemic control established by ADA and ACE, ASHP supports and encourages strict glycemic control in all appropriate patients with diabetes mellitus to reduce the progression of chronic complications.

  2. Glycemic and lipid control in hospitalized type 2 diabetic patients: evaluation of 2 enteral nutrition formulas (low carbohydrate-high monounsaturated fat vs high carbohydrate).

    Science.gov (United States)

    León-Sanz, Miguel; García-Luna, Pedro P; Sanz-París, Alejandro; Gómez-Candela, Carmen; Casimiro, César; Chamorro, José; Pereira-Cunill, José L; Martin-Palmero, Angeles; Trallero, Roser; Martínez, José; Ordóñez, Francisco Javier; García-Peris, Pilar; Camarero, Emma; Gómez-Enterría, Pilar; Cabrerizo, Lucio; Perez-de-la-Cruz, Antonio; Sánchez, Carmen; García-de-Lorenzo, Abelardo; Rodríguez, Nelly; Usán, Luis

    2005-01-01

    Type 2 diabetic patients may need enteral nutrition support as part of their treatment. The objective was to compare glycemic and lipid control in hospitalized patients with type 2 diabetes requiring feeding via nasogastric tube using enteral feedings with either a highcarbohydrate or a high-monounsaturated-fat content. This trial included type 2 diabetes patients admitted to the hospital for neurologic disorders or head and neck cancer surgery who received either a low-carbohydrate-high-mono-unsaturated-fat (Glucerna) or a high-carbohydrate diet (Precitene Diabet). Glycemic and lipid control was determined weekly. Safety and gastrointestinal tolerance were also assessed. A total of 104 patients were randomized and 63 were evaluable according to preestablished protocol criteria. Median duration of therapy was 13 days in both groups. Mean glucose was significantly increased at 7 days of treatment (p = .006) in the Precitene arm, with no significant variations in the Glucerna arm. Mean weekly blood triglycerides levels in the Precitene arm were increased without reaching statistical significance, whereas patients in the Glucerna arm showed a stable trend. Patients in the Precitene arm showed a significantly higher incidence of diarrhea than patients in Glucerna arm (p = .008), whereas the incidence of nausea was smaller in the Precitene arm than in the Glucerna arm (p = .03). An enteral formula with lower carbohydrate and higher monounsaturated fat (Glucerna) has a neutral effect on glycemic control and lipid metabolism in type 2 diabetic patients compared with a high-carbohydrate and a lower-fat formula (Precitene Diabet).

  3. Factors associated with glycemic control in people with diabetes at the Family Health Strategy in Pernambuco

    Directory of Open Access Journals (Sweden)

    Rodrigo Fonseca Lima

    Full Text Available Abstract OBJECTIVE Identifying factors associated with glycemic control in people with type 2 Diabetes Mellitus (DM registered in the Family Health Strategy (FHS in Pernambuco, Brazil. METHOD Associations between glycemic control (glycosylated hemoglobin A lower or equal to 7% presented by people with DM and variables related to sociodemographic conditions, lifestyle, characteristics of diabetes, treatment and follow-up of patients by health services were investigated by multiple regression. RESULTS More than 65% of the participants presented inadequate glycemic control, especially those with lower age, longer illness duration, more annual contacts with FHS and complex therapeutic regimen. People with DM without referrals to specialists presented greater glycemic control. Associations with education level and obesity did not remain significant in the multivariate model. CONCLUSION The evolution of diabetes hinders adequate control, however, attention to younger people with DM and referrals to specialists are factors that can improve glycemic control.

  4. Selfish goals serve more fundamental social and biological goals.

    Science.gov (United States)

    Becker, D Vaughn; Kenrick, Douglas T

    2014-04-01

    Proximate selfish goals reflect the machinations of more fundamental goals such as self-protection and reproduction. Evolutionary life history theory allows us to make predictions about which goals are prioritized over others, which stimuli release which goals, and how the stages of cognitive processing are selectively influenced to better achieve the aims of those goals.

  5. Geriatric Family Support and Diabetic Type-2 Glycemic Control

    Directory of Open Access Journals (Sweden)

    Shiva Heidari

    2008-07-01

    Full Text Available Objectives: As the most part of geriatric (65 years and older diabetic care is given at home, family support has an important role in their blood sugar level control care. This study aimed to assess the relationship between family support and blood sugar level control in such elderly suffering type-2 diabetes. Methods & Materials: Via descriptive-correlative study, one hundred fifty geriatric patients with type-2 diabetes, who referred to Institute of Endocrinology and Metabolism in Iran University of Medical Sciences were selected. Samplings based on nonrandomized and convenience. The questionnaire consisted of three sections: demographic data glucose-labeled hemoglobin (HbA1C and received-perceived family support by applying the standard questionnaire of "Diabetes Social Support-Family Version" format. Data were analyzed by SPSS version 15 by using Chi-square and Pierson Tests. Results: Results showed a significant relationship between family support and glycemic control (r=-0.56, P<0.0001. Also there were significant relationships between family support, gender and marital status (P<0.0001. There were also significant relationships between glycemic control and marital status (P=0.02, financial status (P=0.04 and educational level (P=0.05. Conclusion: Findings of this research added further evidence about the impact of family support on the health of older adults with diabetes. These findings suggest using family centered nursing interventions and collaboration of family members in care of the elderly with type-2 diabetes.

  6. From abstract goals to concrete rules : Regulating nursing home care in Sweden and the Netherlands

    NARCIS (Netherlands)

    Enequist, Anna Louise Elisabeth

    2015-01-01

    To legislate complex topics, both the Dutch and Swedish legislature use goal legislation. Goal acts contain abstract goals which the regulatee should reach instead of detailed prescriptions of how the regulatee should act. Goal acts combine these abstract goal rules with an assignment to other

  7. Assessment of patient knowledge of diabetic goals, self-reported medication adherence, and goal attainment

    Directory of Open Access Journals (Sweden)

    Whitley HP

    2006-12-01

    Full Text Available Background: Medication adherence is an integral aspect of disease state management for patients with chronic illnesses, including diabetes mellitus. It has been hypothesized that patients with diabetes who have poor medication adherence may have less knowledge of overall therapeutic goals and may be less likely to attain these goals. Objective: The purpose of this study was to assess self-reported medication adherence, knowledge of therapeutic goals (hemoglobin A1C [A1C], low density lipoprotein cholesterol [LDL-C] and blood pressure [BP], and goal attainment in adult patients with diabetes. Methods: A survey was created to assess medication adherence, knowledge of therapeutic goals, and goal attainment for adult patients with diabetes followed at an internal medicine or a family medicine clinic. Surveys were self-administered prior to office visits. Additional data were collected from the electronic medical record. Statistical analysis was performed. Results: A total of 149 patients were enrolled. Knowledge of therapeutic goals was reported by 14%, 34%, and 18% of survived patients for LDL-C, BP, and A1C, respectively. Forty-six percent, 37%, and 40% of patients achieved LDL-C, BP, and A1C goals, respectively. Low prescribing of cholesterol-lowering medications was an interesting secondary finding; 36% of patients not at LDL-C goal had not been prescribed a medication targeted to lower cholesterol. Forty-eight percent of patients were medication non-adherent; most frequently reported reasons for non-adherence were forgot (34% and too expensive (14%. Patients at A1C goal were more adherent than patients not at goal (p=0.025. Conclusion: The majority did not reach goals and were unknowledgeable of goals; however, most were provided prescriptions to treat these parameters. Goal parameters should be revisited often amongst multidisciplinary team members with frequent and open communications. Additionally, it is imperative that practitioners discuss

  8. Reaching for the red planet

    Science.gov (United States)

    David, L

    1996-05-01

    The distant shores of Mars were reached by numerous U.S. and Russian spacecraft throughout the 1960s to mid 1970s. Nearly 20 years have passed since those successful missions which orbited and landed on the Martian surface. Two Soviet probes headed for the planet in July, 1988, but later failed. In August 1993, the U.S. Mars Observer suddenly went silent just three days before it was to enter orbit around the planet and was never heard from again. In late 1996, there will be renewed activity on the launch pads with three probes departing for the red planet: 1) The U.S. Mars Global Surveyor will be launched in November on a Delta II rocket and will orbit the planet for global mapping purposes; 2) Russia's Mars '96 mission, scheduled to fly in November on a Proton launcher, consists of an orbiter, two small stations which will land on the Martian surface, and two penetrators that will plow into the terrain; and finally, 3) a U.S. Discovery-class spacecraft, the Mars Pathfinder, has a December launch date atop a Delta II booster. The mission features a lander and a microrover that will travel short distances over Martian territory. These missions usher in a new phase of Mars exploration, setting the stage for an unprecedented volley of spacecraft that will orbit around, land on, drive across, and perhaps fly at low altitudes over the planet.

  9. Metasurface holograms reaching 80% efficiency.

    Science.gov (United States)

    Zheng, Guoxing; Mühlenbernd, Holger; Kenney, Mitchell; Li, Guixin; Zentgraf, Thomas; Zhang, Shuang

    2015-04-01

    Surfaces covered by ultrathin plasmonic structures--so-called metasurfaces--have recently been shown to be capable of completely controlling the phase of light, representing a new paradigm for the design of innovative optical elements such as ultrathin flat lenses, directional couplers for surface plasmon polaritons and wave plate vortex beam generation. Among the various types of metasurfaces, geometric metasurfaces, which consist of an array of plasmonic nanorods with spatially varying orientations, have shown superior phase control due to the geometric nature of their phase profile. Metasurfaces have recently been used to make computer-generated holograms, but the hologram efficiency remained too low at visible wavelengths for practical purposes. Here, we report the design and realization of a geometric metasurface hologram reaching diffraction efficiencies of 80% at 825 nm and a broad bandwidth between 630 nm and 1,050 nm. The 16-level-phase computer-generated hologram demonstrated here combines the advantages of a geometric metasurface for the superior control of the phase profile and of reflectarrays for achieving high polarization conversion efficiency. Specifically, the design of the hologram integrates a ground metal plane with a geometric metasurface that enhances the conversion efficiency between the two circular polarization states, leading to high diffraction efficiency without complicating the fabrication process. Because of these advantages, our strategy could be viable for various practical holographic applications.

  10. Glycemic Index and Glycemic Load and Their Association with C-Reactive Protein and Incident Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Geertruida J. van Woudenbergh

    2011-01-01

    Full Text Available Objective. To investigate whether the Glycemic Index (GI or Glycemic Load (GL of a diet is associated with C-reactive Protein (CRP and risk of type 2 diabetes in a prospective study. Materials and Methods. Our analysis included 4,366 participants who did not have diabetes at baseline. During follow-up 456 diabetes cases were confirmed. Dietary GI and GL were derived from a food-frequency questionnaire and its association with CRP was examined cross-sectionally using linear regression models. The association of GI and GL with diabetes incidence was examined using Cox proportional hazard models. Results. GL, but not GI, was associated with lnCRP at baseline (bGL=0.11 per 50 units; P=.01. When comparing the highest to the lowest tertile of GI with respect to diabetes incidence, a Relative Risk (RR of 0.95 [95%CI 0.75, 1.21] was found after adjustment for lifestyle and nutritional factors. For GL the RR for diabetes incidence was 1.00 [95%CI 0.74, 1.36]. Additional adjustment for CRP did not change RRs. Conclusion. Since GI was not associated with CRP and risk of type 2 diabetes, it is unlikely that a high GI diet induces the previously shown positive association between CRP and risk of type 2 diabetes by increasing CRP concentrations.

  11. Patterns of glycemic control using glycosylated hemoglobin in diabetics

    Directory of Open Access Journals (Sweden)

    Arunpreet Singh Kahlon

    2011-01-01

    Full Text Available Aim : Till now estimation of blood glucose is the highly effective method for diagnosing diabetes mellitus but it provides a short-term picture of control. More evidence is required to prove that plasma glucose and glycosylated hemoglobin levels together gives a better estimate of glycemic control and compliance with treatment. Indian diabetes risk score (IDRS is a simplified screening tool for identifying undiagnosed diabetic subjects, requires minimum time, and effort and can help to considerably reduce the costs of screening. Objective : To study patterns of glycemic control using glycosylated hemoglobin in diabetic patients. To find out correlation between levels of plasma glucose and glycosylated hemoglobin in diabetics and to calculate IDRS of the study population. Materials and Methods : A cross sectional study was conducted among 300 known diabetic patients attending outpatient department of a rural medical college in Haryana, India. Following standard procedures and protocols FPG and glycosylated hemoglobin were measured to find out a pattern of glycemic control in them after taking their written and informed consent. A correlation between the levels of glycosylated hemoglobin and fasting blood glucose was also calculated. These patients were made to fill a performa and their demographic and clinical risk factors were noted and based on this, their IDRS was calculated. This was done to validate the IDRS in Indian rural population. Results : Fifty-two percent of the population had fasting plasma glucose level between 125-150 mg/dl, 21% had this level between 151-175 mg/dl. Thirteen percent of the study subjects had HbA1C between 6.5-7.5, more than half (57.3% had this value between 7.5-8.5, 12% and 18% had values between 8.5-9.5 and 9.5-10.5, respectively. Twelve percent of the participants had HbA1C level higher than 10.5. Correlation of fasting plasma glucose level and HbA1C was also studied and found that correlation coefficient came

  12. Patterns of glycemic control using glycosylated hemoglobin in diabetics.

    Science.gov (United States)

    Kahlon, Arunpreet Singh; Pathak, Rambha

    2011-07-01

    Till now estimation of blood glucose is the highly effective method for diagnosing diabetes mellitus but it provides a short-term picture of control. More evidence is required to prove that plasma glucose and glycosylated hemoglobin levels together gives a better estimate of glycemic control and compliance with treatment. Indian diabetes risk score (IDRS) is a simplified screening tool for identifying undiagnosed diabetic subjects, requires minimum time, and effort and can help to considerably reduce the costs of screening. To study patterns of glycemic control using glycosylated hemoglobin in diabetic patients. To find out correlation between levels of plasma glucose and glycosylated hemoglobin in diabetics and to calculate IDRS of the study population. A cross sectional study was conducted among 300 known diabetic patients attending outpatient department of a rural medical college in Haryana, India. Following standard procedures and protocols FPG and glycosylated hemoglobin were measured to find out a pattern of glycemic control in them after taking their written and informed consent. A correlation between the levels of glycosylated hemoglobin and fasting blood glucose was also calculated. These patients were made to fill a performa and their demographic and clinical risk factors were noted and based on this, their IDRS was calculated. This was done to validate the IDRS in Indian rural population. Fifty-two percent of the population had fasting plasma glucose level between 125-150 mg/dl, 21% had this level between 151-175 mg/dl. Thirteen percent of the study subjects had HbA1C between 6.5-7.5, more than half (57.3%) had this value between 7.5-8.5, 12% and 18% had values between 8.5-9.5 and 9.5-10.5, respectively. Twelve percent of the participants had HbA1C level higher than 10.5. Correlation of fasting plasma glucose level and HbA1C was also studied and found that correlation coefficient came out to be .311. This correlation was found to be statistically

  13. Glycemic Index Biscuits Formulation of Pedada Flour (Sonneratia caseolaris) with Tubers Starch

    Science.gov (United States)

    Jariyah; Susiloningsih, E. K. B.; Nilasari, K.

    2018-01-01

    The glycemic index of food is the level of food according to its effect on blood glucose levels. Foods with low glycemic index have been shown to improve glucose and fat levels in people with diabetes mellitus and improve insulin resistance. Pedada Fruits (Sonneratia caseolaris) is the one of mangrove fruits has a high fiber content, so it can be used as a raw material in biscuits production. The aim of this research to evaluate the glycemic index on the formula biscuit from the pedada flour and starch from white sweet potato, arrowroot, taro, potato and cassava mixed. This research used completely randomized design in factorial patern with one factor and five levels on formulation biscuit of pedada flour with tubers starch (20% : 80%). The biscuits product were measured of the proximate, crude fiber, glycemic index and glycemic load on wistar rats. The best treatment was 20% of pedada flour with 80% of taro starch which produced biscuit with 76.24% of yield, 2.58% of protein, 15.55% of fat, 2.72% of crude fiber, 48.83 of glycemic index and 7.39 of glycemic load.

  14. Factors associated with glycemic control among diabetic adult out-patients in Northeast Ethiopia.

    Science.gov (United States)

    Fiseha, Temesgen; Alemayehu, Ermiyas; Kassahun, Wongelawit; Adamu, Aderaw; Gebreweld, Angesom

    2018-05-18

    The aim of this study was to determine the status of glycemic control and identify factors associated with poor glycemic control among diabetic out-patients. A hospital based cross-sectional study was conducted among randomly selected 384 (126 type 1 and 258 type 2) diabetic adults attending a hospital in Northeast Ethiopia from January 1 to April 30, 2017. Of the total participants, 70.8% had poor status of glycemic control (defined as mean fasting blood glucose level above 130 mg/dl). In the multivariate analysis, rural residence (AOR = 2.61, 95% CI 1.37-4.96), low educational level (AOR = 7.10, 95% CI 2.94-17.17) and longer duration of diabetes (AOR = 2.20, 95% CI 1.18-4.08) were significantly associated with increased odds of poor glycemic control. Moreover, merchants (AOR = 3.39, 95% CI 1.16-9.96) were significantly more likely to have poor glycemic control compared to government employee. Diabetic patients receiving oral anti-diabetics (AOR = 5.12, 95% CI 2.10-12.52) or insulin (AOR = 3.26, 95% CI 1.26-8.48) were more likely to be poorly controlled. These results highlight the needed for appropriate management of patients focusing on associated factors identified for poor glycemic control to maintain good glycemic control and improve adverse outcomes of the disease in this study setting.

  15. FACTORS ASSOCIATED WITH POOR GLYCEMIC CONTROL AMONG TYPE 2 DIABETES MELLITUS IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Rian Adi Pamungkas

    2017-07-01

    Full Text Available Background: Type 2 Diabetes mellitus becomes the public health problem in the wide world. Reasons for poor glycemic control in Type 2 diabetes are complex. Objective: To determine factors contributed to poor glycemic control among Indonesian patients with Type 2 Diabetes Methods: This was a cross sectional regression study. There were 70 respondents selected using purposive sampling. Pre-structured questionnaires were used to measure socio demographic, clinical characteristics, self-care management behaviors, medication adherence, barriers to adherence, and family support. Data were analyzed using chi-square and binary logistic regression. Results: Poor glycemic control was defined as HbA1c ≥7% or FBG ≥200 mg/dl. Findings of this study reported that 83% patients had or FBG ≥200 mg/dl, which confirmed as poor glycemic control. Logistic regression showed that increasing duration of diabetes (> 5 years, non-adherence to dietary behaviors recommendation through selecting healthy diet, arranging a meal plan, recognizing the amount calorie needs, managing dietary behaviors challenges, medication adherence, and family support were significantly influence poor glycemic control with increased odds ratio scores. Conclusion: The proportion of patients with poor glycemic control was raised. Increasing duration of diabetes, non- adherence to medication and dietary behaviors management, and lack of family support were associated with poor glycemic control. Thus, integration of diabetes self-management program with social support is needed to deal with patients’ need to achieve the great benefits in diabetes care.

  16. Environmental stressors afflicting tailwater stream reaches across the United States

    Science.gov (United States)

    Miranda, Leandro E.; Krogman, R. M.

    2014-01-01

    The tailwater is the reach of a stream immediately below an impoundment that is hydrologically, physicochemically and biologically altered by the presence and operation of a dam. The overall goal of this study was to gain a nationwide awareness of the issues afflicting tailwater reaches in the United States. Specific objectives included the following: (i) estimate the percentage of reservoirs that support tailwater reaches with environmental conditions suitable for fish assemblages throughout the year, (ii) identify and quantify major sources of environmental stress in those tailwaters that do support fish assemblages and (iii) identify environmental features of tailwater reaches that determine prevalence of key fish taxa. Data were collected through an online survey of fishery managers. Relative to objective 1, 42% of the 1306 reservoirs included in this study had tailwater reaches with sufficient flow to support a fish assemblage throughout the year. The surface area of the reservoir and catchment most strongly delineated reservoirs maintaining tailwater reaches with or without sufficient flow to support a fish assemblage throughout the year. Relative to objective 2, major sources of environmental stress generally reflected flow variables, followed by water quality variables. Relative to objective 3, zoogeography was the primary factor discriminating fish taxa in tailwaters, followed by a wide range of flow and water quality variables. Results for objectives 1–3 varied greatly among nine geographic regions distributed throughout the continental United States. Our results provide a large-scale view of the effects of reservoirs on tailwater reaches and may help guide research and management needs.

  17. Evaluation of glycemic control in patients with type 2 diabetes mellitus in Chinese communities: a cross-sectional study.

    Science.gov (United States)

    Shan, Shan; Gu, Liubao; Lou, Qinglin; Ouyang, Xiaojun; Yu, Yun; Wu, Haidi; Bian, Rongwen

    2017-02-01

    This study aimed to evaluate the glycemic levels in Chinese patients with type 2 diabetes mellitus (T2DM) and to explore the factors related to the results of glycemic control. A total of 2454 T2DM patients from 11 communities were examined for glycosylated hemoglobin levels and glycemic control options. Potential factors related to the results of glycemic control were analyzed using logistic regression. Of all the patients, 55.3 % achieved the glycemic control target of HbA1c 1.345, 95 % CI 1.022-1.769; P = 0.034), higher levels of fasting blood glucose (OR 1.954, 95 % CI 1.778-2.147; P 1), and low-density lipoprotein cholesterol (OR 1.181, 95 % CI 1.020-1.367; P = 0.026) were significantly associated with poor glycemic control. The complexity of antidiabetics was also associated with poor glycemic control (P insulin injection was most strongly associated with poor glycemic control (OR 6.210, 95 % CI 4.054-9.514; P 1). Male patients with higher levels of total cholesterol, lower levels of high-density lipoprotein cholesterol, or longer diabetic durations showed poor glycemic control, which was not found in female patients. Glycemic control was not satisfactory in T2DM patients of Nanjing communities. Various factors are associated with poor results of glycemic control.

  18. CAST reaches milestone but keeps on searching

    CERN Multimedia

    CERN Courier (september 2011 issue)

    2011-01-01

    After eight years of searching for the emission of a dark matter candidate particle, the axion, from the Sun, the CERN Axion Solar Telescope (CAST) has fulfilled its original physics programme.   Members of the CAST collaboration in July, together with dipole-based helioscope. CAST, the world’s most sensitive axion helioscope, points a recycled prototype LHC dipole magnet at the Sun at dawn and dusk, looking for the conversion of axions to X-rays. It incorporates four state-of-the-art X-ray detectors: three Micromegas detectors and a pn-CCD imaging camera attached to a focusing X-ray telescope that was recovered from the German space programme (see CERN Courier April 2010).  Over the years, CAST has operated with the magnet bores - the location of the axion conversion - in different conditions: first in vacuum, covering axion masses up to 20 meV/c2, and then with a buffer gas (4He and later 3He) at various densities, finally reaching the goal of 1.17 eV/c2 on 22 ...

  19. Predicting Subsequent Task Performance From Goal Motivation and Goal Failure

    Directory of Open Access Journals (Sweden)

    Laura Catherine Healy

    2015-07-01

    Full Text Available Recent research has demonstrated that the cognitive processes associated with goal pursuit can continue to interfere with unrelated tasks when a goal is unfulfilled. Drawing from the self-regulation and goal-striving literatures, the present study explored the impact of goal failure on subsequent cognitive and physical task performance. Furthermore, we examined if the autonomous or controlled motivation underpinning goal striving moderates the responses to goal failure. Athletes (75 male, 59 female, Mage = 19.90 years, SDage = 3.50 completed a cycling trial with the goal of covering a given distance in 8 minutes. Prior to the trial, their motivation was primed using a video. During the trial they were provided with manipulated performance feedback, thus creating conditions of goal success or failure. No differences emerged in the responses to goal failure between the primed motivation or performance feedback conditions. We make recommendations for future research into how individuals can deal with failure in goal striving.

  20. Motivational Goal Bracketing: An Experiment

    DEFF Research Database (Denmark)

    Koch, Alexander; Nafziger, Julia

    We study in an online, real-effort experiment how the bracketing of non-binding goals affects performance in a work-leisure self-control problem. We externally induce the goal bracket - daily goals or a weekly goal - and within that bracket let subjects set goals for how much they want to work over...... a one-week period. Our theoretical model predicts (i) that weekly goals create incentives to compensate for a lower than desired performance today with the promise to work harder tomorrow, whereas daily goals exclude such excuses; (ii) that subjects with daily goals set higher goals in aggregate...... and work harder than those with weekly goals. Our data support these predictions. Surprisingly, however, when goals are combined with an externally enforced commitment that requires subjects to spend less than a minute each day on the task to get started working, performance deteriorates because of high...

  1. Probabilistic safety assessment goals in Canada

    International Nuclear Information System (INIS)

    Snell, V.G.

    1986-01-01

    CANDU safety philosphy, both in design and in licensing, has always had a strong bias towards quantitative probabilistically-based goals derived from comparative safety. Formal probabilistic safety assessment began in Canada as a design tool. The influence of this carried over later on into the definition of the deterministic safety guidelines used in CANDU licensing. Design goals were further developed which extended the consequence/frequency spectrum of 'acceptable' events, from the two points defined by the deterministic single/dual failure analysis, to a line passing through lower and higher frequencies. Since these were design tools, a complete risk summation was not necessary, allowing a cutoff at low event frequencies while preserving the identification of the most significant safety-related events. These goals gave a logical framework for making decisions on implementing design changes proposed as a result of the Probabilistic Safety Analysis. Performing this analysis became a regulatory requirement, and the design goals remained the framework under which this was submitted. Recently, there have been initiatives to incorporate more detailed probabilistic safety goals into the regulatory process in Canada. These range from far-reaching safety optimization across society, to initiatives aimed at the nuclear industry only. The effectiveness of the latter is minor at very low and very high event frequencies; at medium frequencies, a justification against expenditures per life saved in other industries should be part of the goal setting

  2. Creatine supplementation and glycemic control: a systematic review.

    Science.gov (United States)

    Pinto, Camila Lemos; Botelho, Patrícia Borges; Pimentel, Gustavo Duarte; Campos-Ferraz, Patrícia Lopes; Mota, João Felipe

    2016-09-01

    The focus of this review is the effects of creatine supplementation with or without exercise on glucose metabolism. A comprehensive examination of the past 16 years of study within the field provided a distillation of key data. Both in animal and human studies, creatine supplementation together with exercise training demonstrated greater beneficial effects on glucose metabolism; creatine supplementation itself demonstrated positive results in only a few of the studies. In the animal studies, the effects of creatine supplementation on glucose metabolism were even more distinct, and caution is needed in extrapolating these data to different species, especially to humans. Regarding human studies, considering the samples characteristics, the findings cannot be extrapolated to patients who have poorer glycemic control, are older, are on a different pharmacological treatment (e.g., exogenous insulin therapy) or are physically inactive. Thus, creatine supplementation is a possible nutritional therapy adjuvant with hypoglycemic effects, particularly when used in conjunction with exercise.

  3. Adiposity and Glycemic Control in Children Exposed to Perfluorinated Compounds

    DEFF Research Database (Denmark)

    Timmermann, Clara Amalie G.; Rossing, Laura I.; Grontved, Anders

    2014-01-01

    , waist circumference, leptin, adiponectin, insulin, glucose, and triglyceride concentrations were assessed in 8- to 10-year-old children in 1997 in a subset of the European Youth Heart Study, Danish component. Plasma PFC concentrations were available from 499 children. Linear regression models were......Objective: Our objective was to explore whether childhood exposure to perfluorinated and polyfluorinated compounds (PFCs), widely used stain- and grease-repellent chemicals, is associated with adiposity and markers of glycemic control. Materials and Methods: Body mass index, skinfold thickness...... perfluorooctane sulfonic acid/mL plasma was associated with 16.2% (95% confidence interval [CI], 5.2%-28.3%) higher insulin concentration, 12.0% (95% CI, 2.4%-22.4%) higher β-cell activity, 17.6% (95% CI, 5.8%-30.8%) higher insulin resistance, and 8.6% (95% CI, 1.2%-16.5%) higher triglyceride concentrations...

  4. Transformational and transactional leadership and followers' achievement goals

    NARCIS (Netherlands)

    Hamstra, M.R.W.; van Yperen, N.W.; Wisse, B.; Sassenberg, K.

    2014-01-01

    Purpose: Achievement goals, or the standards of competence employees pursue in their work, have far-reaching consequences for employee and organizational functioning. In the current research, we investigated whether employees’ achievement goals can be predicted from their supervisor’s leadership

  5. Tuberculosis elimination in the post Millennium Development Goals era

    DEFF Research Database (Denmark)

    Wejse, Christian

    2015-01-01

    The Millennium Development Goal for tuberculosis (TB) is to stop the increase in incidence and halve the mortality of TB between 1990 and 2015. This goal has now been reached on a global scale, although not in the most affected region of Africa. The new target is TB elimination, defined as one case...

  6. Property company's sustainability goals.

    Science.gov (United States)

    Ormsby, Kim

    2014-11-01

    In a keynote presentation on the second morning of this year's Healthcare Estates conference, Kim Ormsby (pictured), national corporate social responsibility (CSR) and sustainability manager at NHS Property Services, discussed how, as part of its broader goals of 'supporting the NHS in delivering clinical services', and 'helping to enhance the experience' of patients visiting its buildings, the organization would continue to pursue and embed in its activities sustainable policies wherever and whenever possible, encouraging both its staff and tenants to take a similar approach. In an informative address, she highlighted some of the key steps the property company had already taken to encourage a proactive approach. Echoing the sentiments of Day One keynote speaker, Julian Hartley (see pages 55-60), she argued that one of the fundamentals to success was wide-ranging staff engagement.

  7. Different way, same goal

    CERN Multimedia

    Antonella Del Rosso & Fabio Capello

    2012-01-01

    Radio-oncologists and radiotherapists represented a large proportion of the doctors and clinicians who attended the ICTR-PHE 2012 conference. With them were also biologists and doctors of nuclear medicine. They presented the state of the art of their research that touches on the genetics and biology of tumours as well as on futuristic drugs that selectively target malignant cells. The future of cancer treatment seems to lie in the personalised approach.   When the members of the life sciences community took over from the physicists, the focus remained basically the same. Just another sign of the fact that the different communities are leading the same battle and have the same goal. However, the methodologies and issues can be very different. The example of hadrontherapy illustrates the situation well: while for physicists this is a relatively well-established concept, medical doctors consider that the amount of patient data available is still very small. Several clinical trials are in progress ...

  8. DOE goals: Excellence, openness

    International Nuclear Information System (INIS)

    Isaacs, T.H.

    1989-01-01

    The author feels that the benefit of the experience and programmatic resources it has developed since passage of the Nuclear Waste Policy Act in 1982 and of the sound and flexible policy framework provided by the amendments, DOE is confident that program objectives can be met on a schedule that balances the needs for technical excellence, institutional openness, and timely acceptance. As the program evolves, DOE will continue to assess how effectively policies are serving program objectives. The need for flexibility in developing a first-of-a-kind system is essential. But flexibility does not alter the need for program stability, which, in turn, requires a commonly shared commitment to realizing the program's goals. This commitment must rest upon a pragmatic understanding of the realities of waste-management system development

  9. Seismic analysis - what goal

    International Nuclear Information System (INIS)

    Tagart, S.W.

    1978-01-01

    The seismic analysis of nuclear components is characterized today by extensive engineering computer calculations in order to satisfy both the component standard codes such as ASME III as well as federal regulations and guides. The current nuclear siesmic design procedure has envolved in a fragmented fashion and continues to change its elements as improved technology leads to changing standards and guides. The dominant trend is a monotonic increase in the overall conservation with time causing a similar trend in costs of nuclear power plants. Ironically the improvements in the state of art are feeding a process which is eroding the very incentives that attracted us to nuclear power in the first place. This paper examines the cause of this process and suggests that what is needed is a realistic goal which appropriately addresses the overall uncertainty of the seismic design process. (Auth.)

  10. Abscisic Acid: A Novel Nutraceutical for Glycemic Control

    Science.gov (United States)

    Zocchi, Elena; Hontecillas, Raquel; Leber, Andrew; Einerhand, Alexandra; Carbo, Adria; Bruzzone, Santina; Tubau-Juni, Nuria; Philipson, Noah; Zoccoli-Rodriguez, Victoria; Sturla, Laura; Bassaganya-Riera, Josep

    2017-01-01

    Abscisic acid is naturally present in fruits and vegetables, and it plays an important role in managing glucose homeostasis in humans. According to the latest U.S. dietary survey, about 92% of the population might have a deficient intake of ABA due to their deficient intake of fruits and vegetables. This review summarizes the in vitro, preclinical, mechanistic, and human translational findings obtained over the past 15 years in the study of the role of ABA in glycemic control. In 2007, dietary ABA was first reported to ameliorate glucose tolerance and obesity-related inflammation in mice. The most recent findings regarding the topic of ABA and its proposed receptor lanthionine synthetase C-like 2 in glycemic control and their interplay with insulin and glucagon-like peptide-1 suggest a major role for ABA in the physiological response to a glucose load in humans. Moreover, emerging evidence suggests that the ABA response might be dysfunctional in diabetic subjects. Follow on intervention studies in healthy individuals show that low-dose dietary ABA administration exerts a beneficial effect on the glycemia and insulinemia profiles after oral glucose load. These recent findings showing benefits in humans, together with extensive efficacy data in mouse models of diabetes and inflammatory disease, suggest the need for reference ABA values and its possible exploitation of the glycemia-lowering effects of ABA for preventative purposes. Larger clinical studies on healthy, prediabetic, and diabetic subjects are needed to determine whether addressing the widespread dietary ABA deficiency improves glucose control in humans. PMID:28660193

  11. Glycemic Variation in Tumor Patients with Total Parenteral Nutrition

    Directory of Open Access Journals (Sweden)

    Jin-Cheng Yang

    2015-01-01

    Full Text Available Background: Hyperglycemia is associated with poor clinical outcomes and mortality in several patients. However, studies evaluating hyperglycemia variation in tumor patients receiving total parenteral nutrition (TPN are scarce. The aim of this study was to assess the relationship between glycemia and tumor kinds with TPN by monitoring glycemic variation in tumor patients. Methods: This retrospective clinical trial selected 312 patients with various cancer types, whose unique nutrition treatment was TPN during the monitoring period. All patients had blood glucose (BG values assessed at least six times daily during the TPN infusion. The glycemic variation before and after TPN was set as the indicator to evaluate the factors influencing BG. Results: The clinical trial lasted 7.5 ± 3.0 days adjusted for age, gender, family cancer history and blood types. There were six cancer types: Hepatic carcinoma (HC, 21.8%, rectal carcinoma (17.3%, colon carcinoma (CC, 14.7%, gastric carcinoma (29.8%, pancreatic carcinoma (11.5%, and duodenal carcinoma (DC, 4.8%. The patients were divided into diabetes and nondiabetes groups. No statistical differences in TPN glucose content between diabetes and nondiabetes groups were found; however, the tumor types affected by BG values were obvious. With increasing BG values, DC, HC and CC were more represented than other tumor types in this sequence in diabetic individuals, as well as in the nondiabetic group. BG was inclined to be more easily influenced in the nondiabetes group. Other factors did not impact BG values, including gender, body mass index, and TPN infusion duration time. Conclusions: When tumor patients are treated with TPN, BG levels should be monitored according to different types of tumors, besides differentiating diabetes or nondiabetes patients. Special BG control is needed for DC, HC and CC in both diabetic and nondiabetic patients. If BG overtly increases, positive measurements are needed to control BG

  12. Human glycemic response and phenolic content of unsweetened cranberry juice.

    Science.gov (United States)

    Wilson, Ted; Singh, Ajay P; Vorsa, Nicholi; Goettl, Christopher D; Kittleson, Katrina M; Roe, Cindy M; Kastello, Gary M; Ragsdale, Frances R

    2008-03-01

    This cross-sectional study determined the phenolic composition of an over-the-counter cranberry juice (CBJ) with high-performance liquid chromatography and examined the effects of low- and normal-calorie CBJ formulations on the postprandial glycemic response in healthy humans. The CBJ used in this study contained seven phenolic acids, with 3- and 5-caffeoylquinic acid being the primary components, and 15 flavonol glycosides, with myricetin-3-galactoside and quercetin-3-galactoside being the most prevalent. CBJ proanthocyanidins consisted of three different tetramers and a heptamer, which were confirmed with matrix-assisted laser desorption ionization-time of flight-mass spectrometry analysis. Participants received one of the following six treatments: nothing (no water/beverage), water (480 mL), unsweetened low-calorie CBJ (38 Cal/480 mL), normal-calorie CBJ (280 Cal/480 mL), isocaloric normal calorie (high fructose corn syrup [HFCS]), or isocaloric low-calorie beverages. No significant differences in postprandial blood glucose or insulin were observed in the groups receiving nothing, water, or low-calorie treatments. In contrast, the ingestion of normal-calorie CBJ and normal-calorie control beverage resulted in significantly higher blood glucose concentrations 30 minutes postprandially, although the differences were no longer significant after 180 minutes. Plasma insulin of normal-calorie CBJ and control (HFCS) recipients was significantly higher 60 minutes postprandially, but not significantly different 120 minutes postprandially. CBJ ingestion did not affect heart rate or blood pressure. This study suggests that the consumption of a low-calorie CBJ rich in previously uncharacterized trimer and heptamer proanthocyanidins is associated with a favorable glycemic response and may be beneficial for persons with impaired glucose tolerance.

  13. Seventh meeting of the Global Alliance to Eliminate Lymphatic Filariasis: reaching the vision by scaling up, scaling down, and reaching out

    Science.gov (United States)

    2014-01-01

    This report summarizes the 7th meeting of the Global Alliance to Eliminate Lymphatic Filariasis (GAELF), Washington DC, November 18–19, 2012. The theme, “A Future Free of Lymphatic Filariasis: Reaching the Vision by Scaling Up, Scaling Down and Reaching Out”, emphasized new strategies and partnerships necessary to reach the 2020 goal of elimination of lymphatic filariasis (LF) as a public-health problem. PMID:24450283

  14. The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mavropoulos John C

    2008-12-01

    Full Text Available Abstract Objective Dietary carbohydrate is the major determinant of postprandial glucose levels, and several clinical studies have shown that low-carbohydrate diets improve glycemic control. In this study, we tested the hypothesis that a diet lower in carbohydrate would lead to greater improvement in glycemic control over a 24-week period in patients with obesity and type 2 diabetes mellitus. Research design and methods Eighty-four community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (1c. Results Forty-nine (58.3% participants completed the study. Both interventions led to improvements in hemoglobin A1c, fasting glucose, fasting insulin, and weight loss. The LCKD group had greater improvements in hemoglobin A1c (-1.5% vs. -0.5%, p = 0.03, body weight (-11.1 kg vs. -6.9 kg, p = 0.008, and high density lipoprotein cholesterol (+5.6 mg/dL vs. 0 mg/dL, p Conclusion Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrate led to greater improvements in glycemic control, and more frequent medication reduction/elimination than the low glycemic index diet. Lifestyle modification using low carbohydrate interventions is effective for improving and reversing type 2 diabetes.

  15. Relative Effects of Forward and Backward Planning on Goal Pursuit.

    Science.gov (United States)

    Park, Jooyoung; Lu, Fang-Chi; Hedgcock, William M

    2017-11-01

    Considerable research has shown that planning plays an important role in goal pursuit. But how does the way people plan affect goal pursuit? Research on this question is scarce. In the current research, we examined how planning the steps required for goal attainment in chronological order (i.e., forward planning) and reverse chronological order (i.e., backward planning) influences individuals' motivation for and perceptions of goal pursuit. Compared with forward planning, backward planning not only led to greater motivation, higher goal expectancy, and less time pressure but also resulted in better goal-relevant performance. We further demonstrated that this motivational effect occurred because backward planning allowed people to think of tasks required to reach their goals more clearly, especially when goals were complex to plan. These findings suggest that the way people plan matters just as much as whether or not they plan.

  16. ALMA Telescope Reaches New Heights

    Science.gov (United States)

    2009-09-01

    ball at a distance of nine miles, and to keep their smooth reflecting surfaces accurate to less than the thickness of a human hair. Once the transporter reached the high plateau it carried the antenna to a concrete pad -- a docking station with connections for power and fiber optics -- and positioned it with an accuracy of a small fraction of an inch. The transporter is guided by a laser steering system and, just like some cars, also has ultrasonic collision detectors. These sensors ensure the safety of the state-of-the-art antennas as the transporter drives them across what will soon be a rather crowded plateau. Ultimately, ALMA will have at least 66 antennas distributed over about 200 pads, spread over distances of up to 11.5 miles and operating as a single, giant telescope. Even when ALMA is fully operational, the transporters will be used to move the antennas between pads to reconfigure the telescope for different kinds of observations. This first ALMA antenna at the high site will soon be joined by others, and the ALMA team looks forward to making their first observations from the Chajnantor plateau. They plan to link three antennas by early 2010, and to make the first scientific observations with ALMA in the second half of 2011. ALMA will help astronomers answer important questions about our cosmic origins. The telescope will observe the Universe using light with millimeter and submillimeter wavelengths, between infrared light and radio waves in the electromagnetic spectrum. Light at these wavelengths comes from some of the coldest, and from some of the most distant objects in the cosmos. These include cold clouds of gas and dust where new stars are being born, or remote galaxies towards the edge of the observable universe. The Universe is relatively unexplored at submillimeter wavelengths, as the telescopes need extremely dry atmospheric conditions, such as those at Chajnantor, and advanced detector technology. The Atacama Large Millimeter/submillimeter Array

  17. on Goal Framing

    Directory of Open Access Journals (Sweden)

    Eulàlia P. Abril

    2014-01-01

    Full Text Available En respuesta a la enorme y algunas veces conceptualmente inconsistente literatura sobre valence framing,Levin y sus colegas (1998 desarrollaron una tipología de encuadre de valencia que organiza los diferentesresultados a partir de elección arriesgada, atributo, y encuadre de los resultados (goal framing. Este estudiofavorece la literatura sobre encuadre de los resultados mediante (a su aplicación en el contexto de una cuestiónsocial como la pobreza infantil extrema; y (b el examen de los mecanismos afectivos sobre el cual el encuadrede los resultados es de eficacia persuasiva. Los resultados experimentales (N = 197 mostraron que la exposiciónal mensaje de encuadre de pérdida permitió un apoyo mayor hacia las políticas públicas que buscan erradicar lapobreza infantil, en comparación con el mensaje de encuadre de ganancia. Los resultados también revelaronque el afecto negativo sirve como herramienta mediadora de apoyo hacia las políticas públicas. Estos hallazgossugieren que, en el contexto del apoyo social hacia la población pobre, la capacidad de persuasión dentro delencuadre de pérdida se facilita cuando los participantes experimentan afectos negativos.

  18. The effects of goal variation on adult physical activity behaviour.

    Science.gov (United States)

    Moon, Dal-Hyun; Yun, Joonkoo; McNamee, Jeff

    2016-10-01

    The purposes of this study were to examine the effects of varying levels of goals on increasing daily steps and the frequency of goal achievement among middle-aged adults. Ninety-six adults participated in a randomised control study. Participants were randomly assigned to five different step goal groups: (1) Easy (n = 19), (2) Medium (n = 19), (3) Difficult (n = 19), (4) Do-your-best (n = 19), and (5) No goal (n = 20) based on previous research. The participants wore a pedometer and were asked to reach a pre-established goal during the experimental period. In order to examine the effectiveness of the goal difficulty, (a) an average number of steps taken by different goal conditions and (b) the number of days meeting the assigned goal were tested. A one-way ANCOVA revealed significant step count differences among goal groups. Post hoc analyses indicated that the change in step count in both the Medium and Difficult goal groups was significantly greater than the remaining groups. However, there was no significant difference between the medium and difficult goal conditions. In addition, a one-way ANOVA indicated that there were no significant differences in the frequency of goal achievement among the Easy, Medium, and Difficult goal groups. Results suggest that when promoting physical activity through increasing step counts, researchers and clinicians should design goals that are specific and challenging.

  19. Veganism Is a Viable Alternative to Conventional Diet Therapy for Improving Blood Lipids and Glycemic Control.

    Science.gov (United States)

    Trepanowski, John F; Varady, Krista A

    2015-01-01

    The American Diabetes Association (ADA) and the National Cholesterol Education Program (NCEP) have each outlined a set of dietary recommendations aimed at improving glycemic control and blood lipids, respectively. However, traditional vegan diets (low-fat diets that proscribe animal product consumption) are also effective at improving glycemic control, and dietary portfolios (vegan diets that contain prescribed amounts of plant sterols, viscous fibers, soy protein, and nuts) are also effective at improving blood lipids. The purpose of this review was to compare the effects of traditional vegan diets and dietary portfolios with ADA and NCEP diets on body weight, blood lipids, blood pressure, and glycemic control. The main findings are that traditional vegan diets appear to improve glycemic control better than ADA diets in individuals with type 2 diabetes mellitus (T2DM), while dietary portfolios have been consistently shown to improve blood lipids better than NCEP diets in hypercholesterolemic individuals.

  20. Perioperative glycemic control in diabetic patients undergoing coronary artery bypass graft surgery

    Directory of Open Access Journals (Sweden)

    Ehab A. Wahby

    2016-08-01

    Conclusion: Tight glycemic control improved perioperative outcome in diabetic CABG patients. Maintaining perioperative blood glucose level between 110 and 149 mg/dl is safe and should be recommended as a routine practice in diabetic patients undergoing CABG surgery.

  1. Pathways from emotional adjustment to glycemic control in youths with diabetes in Hong Kong.

    Science.gov (United States)

    Stewart, S M; Lee, P W; Low, L C; Cheng, A; Yeung, W; Huen, K F; O'Donnell, D

    2000-09-01

    To examine factors that influence emotional adjustment, adherence to diabetic care, and glycemic control in Hong Kong youths with insulin-dependent diabetes mellitus (IDDM). Seventy youths, their mothers, and matched controls provided information on health beliefs, authoritarian parenting style, parent-child conflict, emotional adjustment, and adherence to medical regimen. Glycosylated hemoglobin levels were obtained to measure glycemic control. Predictors explained 34% of the variance in emotional adjustment and 39% of the variance in glycemic control. The data supported a pathway from emotional adjustment to self-efficacy to adherence behaviors to glycemic control. In contrast to Western culture and consistent with prediction, parenting style did not associate with negative outcomes, and even relatively low levels of parent-child conflict correlated negatively with emotional adjustment in this culture. Management of conflict and self-efficacy enhancing interactions are suggested interventions to enhance adherence to diabetic care in Hong Kong youths with IDDM.

  2. Starch composition, glycemic indices, phenolic constituents, and antioxidative and antidiabetic properties of some common tropical fruits

    Directory of Open Access Journals (Sweden)

    Ganiyu Oboh

    2015-06-01

    Conclusion: The fruits' low glycemic indices, strong antioxidant properties, and inhibition of α-amylase and α-glucosidase activities could be possible mechanisms for their use in the management and prevention of type-2 diabetes.

  3. Alterations in hemostasis associated with pregnancy in patients with glycemic disorders

    Directory of Open Access Journals (Sweden)

    Irina Arkad'evna Bondar'

    2013-06-01

    Full Text Available In this review we present a comparative analysis of alterations in hemostasis and blood coagulation during normal pregnancy with those in pregnant women with glycemic disorders (diabetes mellitus type 1 and 2, gestational diabetes.

  4. Toxicological comments to the discussion about REACH.

    Science.gov (United States)

    Greim, Helmut; Arand, Michael; Autrup, Herman; Bolt, Hermann M; Bridges, James; Dybing, Erik; Glomot, Rémi; Foa, Vito; Schulte-Hermann, Rolf

    2006-03-01

    It is the ultimate goal of the intended REACH process (Registration, Evaluation and Authorization of Chemicals) of the European Union to identify substances of hazardous properties and to evaluate the risks of human and environmental exposure. During the last few months there has been a controversial discussion as to what extent in vitro studies and consideration of structure activity relationship provide sufficient information to waive repeated exposure studies. Industry as well as certain regulatory agencies or NGOs support this approach and propose that repeated dose studies may only be required beyond 100 t/a. From a toxicological point of view it has to be stressed that this discussion primarily considers the cost reduction and protection of animals, whereas protection of human health and the environment are secondary. In vitro studies only allow identification of specific hazardous properties which can be detected by the specific test system. Moreover, appropriate information on the dose response of adverse effects, identification of thresholds and NOELs that are essential for risk characterization cannot be obtained from these studies. Consequently, identification of all relevant hazardous properties and endpoints of adverse effects can only be determined in the intact animal by repeated dose studies such as 28-day or 90-day studies. In the absence of such information the hazard identification is incomplete and there is no basis for appropriate risk assessment of human exposure. Thus, any waiving of repeated dose studies in animals bears the probability of unforeseen effects in case of acute or continuous human exposure. From this the undersigning European Toxicologists conclude: 1. The intention of REACH is to identify hazardous properties in order that a reliable risk assessment can be made and measures taken to deal with chemicals posing a significant risk. 2. The recent debate has centered on ways in which the well established in vivo methods for risk

  5. Operational Reach: Is Current Army Doctrine Adequate?

    National Research Council Canada - National Science Library

    Heintzelman, Scott

    2003-01-01

    The term operational reach, an element of operational design, is new to U.S. Army doctrine. Operational reach is not found in the previous edition of the Army's basic operational doctrine, Field Manual...

  6. Stream Habitat Reach Summary - NCWAP [ds158

    Data.gov (United States)

    California Natural Resource Agency — The Stream Habitat - NCWAP - Reach Summary [ds158] shapefile contains in-stream habitat survey data summarized to the stream reach level. It is a derivative of the...

  7. The effect of protein and glycemic index on children's body composition

    DEFF Research Database (Denmark)

    Papadaki, Angeliki; Linardakis, Manolis; Larsen, Thomas Meinert

    2010-01-01

    To investigate the effect of protein and glycemic index (GI) on body composition among European children in the randomized, 6-month dietary intervention DiOGenes (diet, obesity, and genes) family-based study.......To investigate the effect of protein and glycemic index (GI) on body composition among European children in the randomized, 6-month dietary intervention DiOGenes (diet, obesity, and genes) family-based study....

  8. Early Glycemic Control in Critically Ill Emergency Department Patients: Pilot Trial

    Directory of Open Access Journals (Sweden)

    Cohen, Jason

    2010-02-01

    Full Text Available Objective: Glycemic control in the critically ill intensive care unit (ICU patient has been shown to improve morbidity and mortality. We sought to investigate the effect of early glycemic control in critically ill emergency department (ED patients in a small pilot trial.Methods: Adult non-trauma, non-pregnant ED patients presenting to a university tertiary referral center and identified as critically ill were eligible for enrollment on a convenience basis. Critical illness was determined upon assignment for ICU admission. Patients were randomized to either ED standard care or glycemic control. Glycemic control involved use of an insulin drip to maintain blood glucose levels between 80-140 mg/dL. Glycemic control continued until ED discharge. Standard patients were managed at ED attending physician discretion. We assessed severity of illness by calculation of APACHE II score. The primary endpoint was in-hospital mortality. Secondary endpoints included vasopressor requirement, hospital length of stay, and mechanical ventilation requirement.Results: Fifty patients were randomized, 24 to the glycemic group and 26 to the standard care cohort. Four of the 24 patients (17% in the treatment arm did not receive insulin despite protocol requirements. While receiving insulin, three of 24 patients (13% had an episode of hypoglycemia. By chance, the patients in the treatment group had a trend toward higher acuity by APACHE II scores. Patient mortality and morbidity were similar despite the acuity difference.Conclusion: There was no difference in morbidity and mortality between the two groups. The benefit of glycemic control may be subject to source of illness and to degree of glycemic control, or have no effect. Such questions bear future investigation. [West J Emerg Med. 2010; 11(1:20-23].

  9. Evaluation of the glycemic indices of three commonly eaten mixed meals in Okada, Edo State

    OpenAIRE

    Omage, Kingsley; Omage, Sylvia O.

    2017-01-01

    Abstract People do not generally eat single or individual meals; rather they eat mixed meals, consisting of two or more individual meals. These mixed meals usually have glycemic indices which differ from that of the individual food type. This study was aimed at evaluating the glycemic indices of three commonly consumed mixed meals eaten in Okada; rice and beans (test food 1), rice and plantain (test food 2), beans and plantain (test food 3). Two hundred and forty healthy subjects aged between...

  10. Linagliptin increases incretin levels, lowers glucagon, and improves glycemic control in type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Rauch, Thomas; Graefe-Mody, Ulrike; Deacon, Carolyn F

    2012-01-01

    Linagliptin is a xanthine-based dipeptidyl peptidase (DPP)-4 inhibitor that is now available in numerous countries worldwide for the treatment of type 2 diabetes mellitus (T2DM). The aim of this study was to evaluate further the mechanisms underlying the improvements in glycemic control observed...... with linagliptin. The effects of linagliptin on DPP-4, pharmacodynamic parameters, and glycemic control versus placebo were assessed in patients with inadequately controlled T2DM....

  11. Criteria for achieving actinide reduction goals

    International Nuclear Information System (INIS)

    Liljenzin, J.O.

    1996-01-01

    In order to discuss various criteria for achieving actinide reduction goals, the goals for actinide reduction must be defined themselves. In this context the term actinides is interpreted to mean plutonium and the so called ''minor actinides'' neptunium, americium and curium, but also protactinium. Some possible goals and the reasons behind these will be presented. On the basis of the suggested goals it is possible to analyze various types of devices for production of nuclear energy from uranium or thorium, such as thermal or fast reactors and accelerator driven system, with their associated fuel cycles with regard to their ability to reach the actinide reduction goals. The relation between necessary single cycle burn-up values, fuel cycle processing losses and losses to waste will be defined and discussed. Finally, an attempt is made to arrange the possible systems on order of performance with regard to their potential to reduce the actinide inventory and the actinide losses to wastes. (author). 3 refs, 3 figs, 2 tabs

  12. Goal difficulty and openness to interpersonal goal support.

    NARCIS (Netherlands)

    Righetti, F.; Kumashiro, M.; Campbell, S.

    2014-01-01

    When people pursue important goals, they are often surrounded by close others who could provide help and support for the achievement of these goals. The present work investigated whether people are more likely to be open to such interpersonal goal support from a romantic partner when they perceive

  13. The association between dietary glycemic index, glycemic load and diet quality indices in Iranian adults: results from Isfahan Healthy Heart Program.

    Science.gov (United States)

    Azadbakht, Leila; Mohammadifard, Noushin; Akhavanzanjani, Mohsen; Taheri, Marzieh; Golshahi, Jafar; Haghighatdoost, Fahimeh

    2016-01-01

    To assess the association between dietary glycemic index (GI), glycemic load (GL) and dietary quality indices in Iranian adults. This cross section was conducted among 1571 Iranian adults aged  ≥19 years. GI, GL and diet quality indices were estimated by 24-h recall and DDS was calculated using a validated 48-item food frequency questionnaire. Participants who were in the top tertile of GI had lower healthy eating index (HEI) (57.2 ± 7.8 versus 55.6 ± 8.7; p diet quality indices may suggest the relevance of carbohydrate source in determining the diet quality indices.

  14. Status of glycemic control in patients of type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Khan, A.U.; Fakhr, A.; Khan, Z.A.; Nadeem, M.; Bangash, R.Y.

    2013-01-01

    Objective: To determine the status of glycemic control in patients of type 2 diabetes mellitus. Design: Cross sectional descriptive study. Place and Duration of Study: Medical out-patient/ in -patient departments at Military Hospital Rawalpindi from January 2011 to December 2012. Methods: Six hundred and fifty patients of type 2 DM fulfilling the required criteria were included in the study. Glycemic control of these patients was determined by estimation of blood glucose (fasting and random) and glycosylated haemoglobin (HbA1c). The patients were grouped in three categories good, fair and poor diabetic control having their HbA1c values of being 6-7%, 7.1-8% and more than 8.1% respectively. Statistical package for social sciences (SPSS) version 15 was used for analysis. Results: Out of 650 patients 377 (58%) had poor glycemic control with mean HbA1c of 9.5% +- 0.95, 78 (12%) patients had fair control of glycemic control with mean HbA1c of 7.8 +- 0.25, and 195 (30%) patients had good glycemic control with mean HbA1c of 6.4 +- 0.17. Conclusion: Majority of patients had poor control of their glycemic status which is an important indicator and predictor of both micro and macrovascular complications. (author)

  15. Inpatient glycemic management in internal medicine: an observational multicenter study in Nanjing, China.

    Science.gov (United States)

    Hao, Shujie; Zhang, Ning; Fish, Anne Folta; Yuan, Xiaodan; Liu, Lin; Li, Fan; Fang, Zhaohui; Lou, Qingqing

    2017-08-01

    To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China. A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included. Aspects of glycemic management examined were (a) hyperglycemia, (b) endocrinology consultation for hyperglycemia and (c) hypoglycemia. The prevalence of hyperglycemia in internal medicine was 45.7% (886 out of 1939). A total of 741 (83.6%) patients were treated by non-endocrinology departments; of those, 230 (31.1%) were in poor glycemic control and needed an endocrinology consultation. Yet only 57 (24.8%) received one. In 4 cases, the physician did not follow the consultants' advice. Among the remaining 53 consulted patients, 35 (66.1%) were still in poor glycemic control, yet only about half received a second consultation. Finally, among patients treated in non-endocrinology departments, 58 (7.8%) had hypoglycemia; less than half retested their blood glucose after treatment. The majority of patients with hyperglycemia were in non-endocrinology departments. Their glycemic management was poor; the endocrinology consultation rate was low and the result was suboptimal. Also, the management of hypoglycemia was not ideal. Therefore, improving glycemic management is urgently needed in Chinese hospitals.

  16. Glycemic screening and recurrent carbohydrate metabolism disorders with endocrine pathology

    Directory of Open Access Journals (Sweden)

    L.А. Lutsenko

    2018-03-01

    analytical sensitivity of test system for thyroid-stimulating hormone. Screening for hyperparathyroidism is the detection of blood ionized calcium level. This examination is particularly relevant for patients from risk group for initial hyperparathyroidism — patients with gallstone disease, urolithiasis, stomach ulcer and/or duodenal ulcer, essential hypertension, etc. Free metanephrines of blood plasma and conjugated urine metanephrines are the screening tests for pheochromocytoma diagnosis. The level of methylated secondary catecholamines (metanephrines, normetanephrines shows the daily tumor activity of pheochromocytoma. Thus, glycemic screening and endocrynopathies screening with hypersecretion of counterregulatory hormones should be conducted together. This will allow detecting secondary forms of diabetes mellitus and compensating glycemic state of the patient.

  17. Achievement Goals and their Underlying Goal Motivation: Does it Matter Why Sport Participants Pursue their Goals?

    Directory of Open Access Journals (Sweden)

    Patrick Gaudreau

    2016-07-01

    Full Text Available This study examined whether the good or bad outcomes associated with mastery-approach (MAP and performance-approach (PAP goals depend on the extent to which they are motivated by autonomous or controlled motivation. A sample of 515 undergraduate students who participated in sport completed measures of achievement goals, motivation of achievement goals, perceived goal attainment, sport satisfaction, and both positive and negative affect. Results of moderated regression analyses revealed that the positive relations of both MAP and PAP goals with perceived goal attainment were stronger for athletes pursuing these goals with high level of autonomous goal motivation. Also, the positive relations between PAP goals and both sport satisfaction and positive affect were stronger at high levels of autonomous goal motivation and controlled goal motivation. The shape of all these significant interactions was consistent with tenets of Self-Determination Theory as controlled goal motivation was negatively associated with positive affect and sport satisfaction and positively associated with negative affect. Overall, these findings demonstrated the importance of considering goal motivation in order to better understand the conditions under which achievement goals are associated with better experiential and performance outcomes in the lives of sport participants.

  18. Punishment goals of crime victims.

    Science.gov (United States)

    Orth, Uli

    2003-04-01

    Research on subjective punishment goals has focused on the perspective of third-party observers of criminal offenses and neglected the perspective of victims. This study investigates punishment goals among 174 adult crime victims (rape and nonsexual assault) for each participant's real criminal case. Scales measuring support for punishment goals are constructed by factor analysis of an 18-item list. Results show that 5 highly supported goals can be distinguished: retaliation, recognition of victim status, confirmation of societal values, victim security, and societal security. Analysis of relations between punishment goal scales and personal variables, situational variables, and demanded punishment severity corroborates the view that the punishment goals revealed can be classified according to the two independent dichotomies of moral versus instrumental goals, and micro versus macro goals.

  19. REACH: impact on the US cosmetics industry?

    Science.gov (United States)

    Pouillot, Anne; Polla, Barbara; Polla, Ada

    2009-03-01

    The Registration, Evaluation, Authorization and restriction of Chemicals (REACH) is a recent European regulation on chemical substances meant to protect human health and the environment. REACH imposes the "precautionary principle" where additional data and definitive action are required when uncertainty is identified. The cosmetics industry is only partially concerned by REACH: while the stages of registration and evaluation apply to cosmetics, those of authorization and restriction most likely will not, as cosmetic ingredients are already subject to regulation by various agencies and directives. REACH has potential benefits to the industry including the possibility of reassuring consumers and improving their image of chemicals and cosmetics. However, REACH also has potential disadvantages, mainly with regard to impeding innovation. The American cosmetics industry will be affected by REACH, because all US manufacturers who export substances to Europe will have to fully comply with REACH.

  20. Teachers' goal orientations: Effects on classroom goal structures and emotions.

    Science.gov (United States)

    Wang, Hui; Hall, Nathan C; Goetz, Thomas; Frenzel, Anne C

    2017-03-01

    Prior research has shown teachers' goal orientations to influence classroom goal structures (Retelsdorf et al., 2010, Learning and Instruction, 20, 30) and to also impact their emotions (Schutz et al., 2007, Emotion in education, Academic Press, Amsterdam, the Netherlands). However, empirical research evaluating possible causal ordering and mediation effects involving these variables in teachers is presently lacking. The present 6-month longitudinal study investigated the relations between varied motivational, behavioural, and emotional variables in practising teachers. More specifically, this study examined the reciprocal, longitudinal relations between teachers' achievement goals, classroom goal structures, and teaching-related emotions, as well as cumulative mediational models in which observed causal relations were evaluated. Participants were 495 practising teachers from Canada (86% female, M = 42 years). Teachers completed a web-based questionnaire at two time points assessing their instructional goals, perceived classroom goal structures, achievement emotions, and demographic items. Results from cross-lagged analyses and structural equation modelling showed teachers' achievement goals to predict their perceived classroom goal structures that, in turn, predicted their teaching-related emotions. The present results inform both Butler's (2012, Journal of Educational Psychology, 104, 726) theory on teachers' achievement goals and Frenzel's (2014, International handbook of emotions in education, Routledge, New York, NY) model of teachers' emotions in showing teachers' instructional goals to both directly predict their teaching-related emotions, as well as indirectly through the mediating effects of classroom goal structures. © 2016 The British Psychological Society.

  1. Teachers' Understanding of Learning Goals

    DEFF Research Database (Denmark)

    Krog Skott, Charlotte; Slot, Marie Falkesgaard; Carlsen, Dorthe

    will be presented. We expect to deepen our understanding of the relations between the various parameters in the teachers' practice in relation to learning goals and goal-oriented teaching. There is conducted research on the effects of goal-oriented teaching on students' learning both internationally...

  2. Financial Planning with Fractional Goals

    OpenAIRE

    Goedhart, Marc; Spronk, Jaap

    1995-01-01

    textabstractWhen solving financial planning problems with multiple goals by means of multiple objective programming, the presence of fractional goals leads to technical difficulties. In this paper we present a straightforward interactive approach for solving such linear fractional programs with multiple goal variables. The approach is illustrated by means of an example in financial planning.

  3. Differential Recruitment of Parietal Cortex during Spatial and Non-spatial Reach Planning

    Directory of Open Access Journals (Sweden)

    Pierre-Michel Bernier

    2017-05-01

    Full Text Available The planning of goal-directed arm reaching movements is associated with activity in the dorsal parieto-frontal cortex, within which multiple regions subserve the integration of arm- and target-related sensory signals to encode a motor goal. Surprisingly, many of these regions show sustained activity during reach preparation even when target location is not specified, i.e., when a motor goal cannot be unambiguously formed. The functional role of these non-spatial preparatory signals remains unresolved. Here this process was investigated in humans by comparing reach preparatory activity in the presence or absence of information regarding upcoming target location. In order to isolate the processes specific to reaching and to control for visuospatial attentional factors, the reaching task was contrasted to a finger movement task. Functional MRI and electroencephalography (EEG were used to characterize the spatio-temporal pattern of reach-related activity in the parieto-frontal cortex. Reach planning with advance knowledge of target location induced robust blood oxygenated level dependent and EEG responses across parietal and premotor regions contralateral to the reaching arm. In contrast, reach preparation without knowledge of target location was associated with a significant BOLD response bilaterally in the parietal cortex. Furthermore, EEG alpha- and beta-band activity was restricted to parietal scalp sites, the magnitude of the latter being correlated with reach reaction times. These results suggest an intermediate stage of sensorimotor transformations in bilateral parietal cortex when target location is not specified.

  4. Effect of improved glycemic control on health care costs and utilization.

    Science.gov (United States)

    Wagner, E H; Sandhu, N; Newton, K M; McCulloch, D K; Ramsey, S D; Grothaus, L C

    2001-01-10

    Because of the additional costs associated with improving diabetes management, there is interest in whether improved glycemic control leads to reductions in health care costs, and, if so, when such cost savings occur. To determine whether sustained improvements in hemoglobin A(1c) (HbA(1c)) levels among diabetic patients are followed by reductions in health care utilization and costs. Historical cohort study conducted in 1992-1997 in a staff-model health maintenance organization (HMO) in western Washington State. All diabetic patients aged 18 years or older who were continuously enrolled between January 1992 and March 1996 and had HbA(1c) measured at least once per year in 1992-1994 (n = 4744). Patients whose HbA(1c) decreased 1% or more between 1992 and 1993 and sustained the decline through 1994 were considered to be improved (n = 732). All others were classified as unimproved (n = 4012). Total health care costs, percentage hospitalized, and number of primary care and specialty visits among the improved vs unimproved cohorts in 1992-1997. Diabetic patients whose HbA(1c) measurements improved were similar demographically to those whose levels did not improve but had higher baseline HbA(1c) measurements (10.0% vs 7.7%; Pcosts were $685 to $950 less each year in the improved cohort for 1994 (P =.09), 1995 (P =.003), 1996 (P =.002), and 1997 (P =.01). Cost savings in the improved cohort were statistically significant only among those with the highest baseline HbA(1c) levels (>/=10%) for these years but appeared to be unaffected by presence of complications at baseline. Beginning in the year following improvement (1994), utilization was consistently lower in the improved cohort, reaching statistical significance for primary care visits in 1994 (P =.001), 1995 (Pcost savings within 1 to 2 years of improvement.

  5. Brewer's Yeast Improves Glycemic Indices in Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Hosseinzadeh, Payam; Javanbakht, Mohammad Hassan; Mostafavi, Seyed-Ali; Djalali, Mahmoud; Derakhshanian, Hoda; Hajianfar, Hossein; Bahonar, Ahmad; Djazayery, Abolghassem

    2013-10-01

    Brewer's yeast may have beneficial effects on insulin receptors because of itsglucose tolerance factor in diabetic patients. This study was conducted to investigate the effects of brewer's yeast supplementation on glycemic indices in patients with type 2 diabetes mellitus. In a randomized double-blind controlled clinical trial, 84 adults (21 men and 63 women) aged 46.3 ± 6.1 years old with type 2 diabetes mellitus were recruited and divided randomly into two groups: Supplement group receiving brewer's yeast (six 300mg tablets/day, total 1800 mg) and control group receiving placebo (six 300mg tablets/day) for 12 weeks. Body weight, height, body mass index, food consumption (based on 24h food record), fasting blood sugar (FBS), glycosylated hemoglobin, insulin sensitivity, and insulin resistance were measured before and after the intervention. Data analysis was performed using the Statistical Package for Social Sciences (version 18.0). The changes in FBS, glycosylated hemoglobin, and insulin sensitivity were significantly different between the two groups during the study (respectively P brewer›s yeast besides the usual treatment of diabetes can ameliorate blood glucose variables in type 2 diabetes mellitus.

  6. Fibrinogen titer and glycemic status in women using contraceptives

    International Nuclear Information System (INIS)

    Syed, S.; Qureshi, M.A.

    2002-01-01

    Objective: To assess the coagulation and glycemic status in Pakistani women using contraceptives. Design: The study was conducted prospectively on 70 women and compared with 10 age-matched controls. Place and Duration of Study: The study was conducted at Karachi. Period of study was 18 month. Subjects and Methods: Eighty women aged between 20-45 years selected from low socioeconomic class and poor family background were categorized in control (n=10) and oral and injectable contraceptive users (n = 70). The contraceptives used were tablet Lofemenal, injection Norigest and Norplant implant. Their blood was tested for fibrinogen titer and random blood glucose. Results: There was no appreciable difference either in fibrinogen titer or plasma glucose levels in injectable users as compared to controls, but increased incidence of high fibrinogen titer and borderline blood glucose was observed in oral contraceptive users 25% and 20 % respectively. Conclusion: It was concluded that long-term use of oral contraceptives (> 3 years) might increase the thrombotic tendency and elevate the plasma glucose levels especially in women above 30 years of age. (author)

  7. Glycemic index and glycemic load are associated with some cardiovascular risk factors among the PREMIER study participants

    Directory of Open Access Journals (Sweden)

    Pao-Hwa Lin

    2012-06-01

    Full Text Available Background: The clinical significance of glycemic index (GI and glycemic load (GL is inconclusive. Objective : This study was conducted to examine the association of GI and GL with clinical cardiovascular disease (CVD risk factors including body weight, blood pressure (BP, serum lipids, fasting glucose, insulin and homocysteine over time among the PREMIER participants. Design: PREMIER was an 18-month randomized lifestyle intervention trial, conducted from 2000 to 2002, designed to help participants reduce BP by following the Dietary Approaches to Stop Hypertension (DASH dietary pattern, losing weight, reducing sodium and increasing physical activity. GI and GL were estimated from 24 h diet recall data at baseline, 6 and 18 months after intervention. PROC MIXED model was used to examine the association of changes in GI or GL with changes in CVD risk factors. Results: A total of 756 randomized participants, 62% females and 34% African Americans and who averaged 50.0±0.3 years old and 95.3±0.7 kg, were included in this report. Neither GI nor GL changes was associated with changes in any risk factors at 6 months. At 18 months, however, the GI change was significantly and positively associated with total cholesterol (TC change only (p<0.05, β = 23.80±12.11 mg/dL or 0.62±0.31 mmol/L with a significant age interaction. The GL change was significantly associated with TC (p=0.02, β = 0.28±0.15 mg/dL or 0.01±0.00 mmol/L positively and with low density lipoprotein cholesterol (LDL-C changes negatively (p=0.03, β = − 0.01±0.00 mg/dL or −0.00±0.00 mmol/L, and significant age interactions were observed for both. Conclusion: GI and GL was associated with TC and LDL-C after controlling for energy, fat and fiber intake and other potential confounders and the associations were modified by age. Further investigation into this relationship is important because of its potential clinical impact.

  8. Interface design and human factors considerations for model-based tight glycemic control in critical care.

    Science.gov (United States)

    Ward, Logan; Steel, James; Le Compte, Aaron; Evans, Alicia; Tan, Chia-Siong; Penning, Sophie; Shaw, Geoffrey M; Desaive, Thomas; Chase, J Geoffrey

    2012-01-01

    Tight glycemic control (TGC) has shown benefits but has been difficult to implement. Model-based methods and computerized protocols offer the opportunity to improve TGC quality and compliance. This research presents an interface design to maximize compliance, minimize real and perceived clinical effort, and minimize error based on simple human factors and end user input. The graphical user interface (GUI) design is presented by construction based on a series of simple, short design criteria based on fundamental human factors engineering and includes the use of user feedback and focus groups comprising nursing staff at Christchurch Hospital. The overall design maximizes ease of use and minimizes (unnecessary) interaction and use. It is coupled to a protocol that allows nurse staff to select measurement intervals and thus self-manage workload. The overall GUI design is presented and requires only one data entry point per intervention cycle. The design and main interface are heavily focused on the nurse end users who are the predominant users, while additional detailed and longitudinal data, which are of interest to doctors guiding overall patient care, are available via tabs. This dichotomy of needs and interests based on the end user's immediate focus and goals shows how interfaces must adapt to offer different information to multiple types of users. The interface is designed to minimize real and perceived clinical effort, and ongoing pilot trials have reported high levels of acceptance. The overall design principles, approach, and testing methods are based on fundamental human factors principles designed to reduce user effort and error and are readily generalizable. © 2012 Diabetes Technology Society.

  9. Associations between bolus infusion of hydrocortisone, glycemic variability and insulin infusion rate variability in critically Ill patients under moderate glycemic control

    NARCIS (Netherlands)

    van Hooijdonk, Roosmarijn T. M.; Binnekade, Jan M.; Bos, Lieuwe D. J.; Horn, Janneke; Juffermans, Nicole P.; Abu-Hanna, Ameen; Schultz, Marcus J.

    2015-01-01

    We retrospectively studied associations between bolus infusion of hydrocortisone and variability of the blood glucose level and changes in insulin rates in intensive care unit (ICU) patients. 'Glycemic variability' and 'insulin infusion rate variability' were calculated from and expressed as the

  10. Relative contributions of preprandial and postprandial glucose exposures, glycemic variability, and non-glycemic factors to HbA in individuals with and without diabetes

    DEFF Research Database (Denmark)

    Færch, Kristine; Alssema, Marjan; Mela, David J

    2018-01-01

    BACKGROUND/OBJECTIVE: There is substantial interest in dietary approaches to reducing postprandial glucose (PPG) responses, but the quantitative contribution of PPG to longer-term glycemic control (reflected in glycated hemoglobin, HbA1c) in the general population is not known. This study quantif...

  11. A high-glycemic diet is associated with cerebral amyloid burden in cognitively normal older adults.

    Science.gov (United States)

    Taylor, Matthew K; Sullivan, Debra K; Swerdlow, Russell H; Vidoni, Eric D; Morris, Jill K; Mahnken, Jonathan D; Burns, Jeffrey M

    2017-12-01

    Background: Little is known about the relation between dietary intake and cerebral amyloid accumulation in aging. Objective: We assessed the association of dietary glycemic measures with cerebral amyloid burden and cognitive performance in cognitively normal older adults. Design: We performed cross-sectional analyses relating dietary glycemic measures [adherence to a high-glycemic-load diet (HGLDiet) pattern, intakes of sugar and carbohydrates, and glycemic load] with cerebral amyloid burden (measured by florbetapir F-18 positron emission tomography) and cognitive performance in 128 cognitively normal older adults who provided eligibility screening data for the University of Kansas's Alzheimer's Prevention through Exercise (APEX) Study. The study began in November 2013 and is currently ongoing. Results: Amyloid was elevated in 26% ( n = 33) of participants. HGLDiet pattern adherence ( P = 0.01), sugar intake ( P = 0.03), and carbohydrate intake ( P = 0.05) were significantly higher in participants with elevated amyloid burden. The HGLDiet pattern was positively associated with amyloid burden both globally and in all regions of interest independently of age, sex, and education (all P ≤ 0.001). Individual dietary glycemic measures (sugar intake, carbohydrate intake, and glycemic load) were also positively associated with global amyloid load and nearly all regions of interest independently of age, sex, and educational level ( P ≤ 0.05). Cognitive performance was associated only with daily sugar intake, with higher sugar consumption associated with poorer global cognitive performance (global composite measure and Mini-Mental State Examination) and performance on subtests of Digit Symbol, Trail Making Test B, and Block Design, controlling for age, sex, and education. Conclusion: A high-glycemic diet was associated with greater cerebral amyloid burden, which suggests diet as a potential modifiable behavior for cerebral amyloid accumulation and subsequent Alzheimer

  12. Effect of Linagliptin Versus Metformin on Glycemic Variability in Patients with Impaired Glucose Tolerance.

    Science.gov (United States)

    González-Heredia, Tonatiuh; Hernández-Corona, Diana M; González-Ortiz, Manuel; Martínez-Abundis, Esperanza

    2017-08-01

    Impaired glucose tolerance (IGT) and glycemic variability may be associated with increased risk of micro- and macrovascular complications. The aim of this study was to assess the effect of linagliptin versus metformin on glycemic variability in patients with IGT. A randomized, double-blind clinical trial with parallel groups was carried out in 16 adult patients with IGT, overweight or obesity. All patients signed an informed consent. The therapies were randomly assigned: (a) metformin 500 mg bid (n = 8) or (b) linagliptin 5 mg a.m. and placebo p.m. (n = 8), both for 90 days. At the beginning of the trial and 3 months later, fasting glucose, glycated hemoglobin A1c, oral glucose tolerance test (OGTT), and glycemic variability [area under the curve (AUC) of glucose, mean amplitude of glycemic excursion (MAGE), standard deviation (SD) of glucose, coefficient of variation (CV) of glucose, and mean blood glucose (MBG)] were measured. Mann-Whitney U, Wilcoxon, and Fisher exact tests were used for statistical analyses. Both groups were similar in basal characteristics. After linagliptin administration, a significant decrease in glucose levels at 120 min of OGTT (9.0 ± 0.9 vs. 6.9 ± 2.2 mmol/L, P = 0.012) was observed. Glycemic variability showed a similar behavior and there were no significant differences in the AUC, MAGE, SD of glucose, CV of glucose, and MBG between groups. Linagliptin administration resulted in better glycemic control according to the decrease of glucose levels by the OGTT at 120 min in patients with IGT. Meanwhile, glycemic variability was not modified in any of the study groups.

  13. Effect of Financial Incentives on Glucose Monitoring Adherence and Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes: A Randomized Clinical Trial.

    Science.gov (United States)

    Wong, Charlene A; Miller, Victoria A; Murphy, Kathryn; Small, Dylan; Ford, Carol A; Willi, Steven M; Feingold, Jordyn; Morris, Alexander; Ha, Yoonhee P; Zhu, Jingsan; Wang, Wenli; Patel, Mitesh S

    2017-12-01

    Glycemic control often deteriorates during adolescence and the transition to young adulthood for patients with type 1 diabetes. The inability to manage type 1 diabetes effectively during these years is associated with poor glycemic control and complications from diabetes in adult life. To determine the effect of daily financial incentives on glucose monitoring adherence and glycemic control in adolescents and young adults with type 1 diabetes. The Behavioral Economic Incentives to Improve Glycemic Control Among Adolescents and Young Adults With Type 1 Diabetes (BE IN CONTROL) study was an investigator-blinded, 6-month, 2-arm randomized clinical trial conducted between January 22 and November 2, 2016, with 3-month intervention and follow-up periods. Ninety participants (aged 14-20) with suboptimally controlled type 1 diabetes (hemoglobin A1c [HbA1c] >8.0%) were recruited from the Diabetes Center for Children at the Children's Hospital of Philadelphia. All participants were given daily blood glucose monitoring goals of 4 or more checks per day with 1 or more level within the goal range (70-180 mg/dL) collected with a wireless glucometer. The 3-month intervention consisted of a $60 monthly incentive in a virtual account, from which $2 was subtracted for every day of nonadherence to the monitoring goals. During a 3-month follow-up period, the intervention was discontinued. The primary outcome was change in HbA1c levels at 3 months. Secondary outcomes included adherence to glucose monitoring and change in HbA1c levels at 6 months. All analyses were by intention to treat. Of the 181 participants screened, 90 (52 [57.8%] girls) were randomized to the intervention (n = 45) or control (n = 45) arms. The mean (SD) age was 16.3 (1.9) years. The intervention group had significantly greater adherence to glucose monitoring goals in the incentive period (50.0% vs 18.9%; adjusted difference, 27.2%; 95% CI, 9.5% to 45.0%; P = .003) but not in the follow-up period (15

  14. The Predictiveness of Achievement Goals

    Directory of Open Access Journals (Sweden)

    Huy P. Phan

    2013-11-01

    Full Text Available Using the Revised Achievement Goal Questionnaire (AGQ-R (Elliot & Murayama, 2008, we explored first-year university students’ achievement goal orientations on the premise of the 2 × 2 model. Similar to recent studies (Elliot & Murayama, 2008; Elliot & Thrash, 2010, we conceptualized a model that included both antecedent (i.e., enactive learning experience and consequence (i.e., intrinsic motivation and academic achievement of achievement goals. Two hundred seventy-seven university students (151 women, 126 men participated in the study. Structural equation modeling procedures yielded evidence that showed the predictive effects of enactive learning experience and mastery goals on intrinsic motivation. Academic achievement was influenced intrinsic motivation, performance-approach goals, and enactive learning experience. Enactive learning experience also served as an antecedent of the four achievement goal types. On the whole, evidence obtained supports the AGQ-R and contributes, theoretically, to 2 × 2 model.

  15. Glycemic control and antidiabetic drugs in type 2 diabetes mellitus patients with renal complications

    Directory of Open Access Journals (Sweden)

    Huri HZ

    2015-08-01

    Full Text Available Hasniza Zaman Huri,1,2 Lay Peng Lim,1 Soo Kun Lim3 1Department of Pharmacy, Faculty of Medicine, University of Malaya, 2Clinical Investigation Centre, University Malaya Medical Centre, 3Renal Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Background: Good glycemic control can delay the progression of kidney diseases in type 2 diabetes mellitus (T2DM patients with renal complications. To date, the association between antidiabetic agents and glycemic control in this specific patient population is not well established.Purpose: This study aimed to identify antidiabetic regimens as well as other factors that associated with glycemic control in T2DM patients with different stages of chronic kidney disease (CKD.Patients and methods: This retrospective, cross-sectional study involved 242 T2DM inpatients and outpatients with renal complications from January 2009 to March 2014 and was conducted in a tertiary teaching hospital in Malaysia. Glycated hemoglobin (A1C was used as main parameter to assess patients’ glycemic status. Patients were classified to have good (A1C <7% or poor glycemic control (A1C ≥7% based on the recommendations of the American Diabetes Association.Results: Majority of the patients presented with CKD stage 4 (43.4%. Approximately 55.4% of patients were categorized to have poor glycemic control. Insulin (57.9% was the most commonly prescribed antidiabetic medication, followed by sulfonylureas (43%. Of all antidiabetic regimens, sulfonylureas monotherapy (P<0.001, insulin therapy (P=0.005, and combination of biguanides with insulin (P=0.038 were found to be significantly associated with glycemic control. Other factors including duration of T2DM (P=0.004, comorbidities such as anemia (P=0.024 and retinopathy (P=0.033, concurrent medications such as erythropoietin therapy (P=0.047, a-blockers (P=0.033, and antigouts (P=0.003 were also correlated with A1C.Conclusion: Identification of

  16. Frequency and predictors of suboptimal glycemic control in an African diabetic population

    Directory of Open Access Journals (Sweden)

    Kibirige D

    2017-02-01

    Full Text Available Davis Kibirige,1 George Patrick Akabwai,2 Leaticia Kampiire,3 Daniel Ssekikubo Kiggundu,4 William Lumu5 1Department of Medicine/Diabetic and Hypertension Clinics, Our Lady of Consolota Hospital, Kisubi, 2Baylor College of Medicine, Children’s Foundation, 3Infectious Diseases Research Collaboration, Kampala, 4Nephrology Unit, Mulago National Referral and Teaching Hospital, Kampala, 5Department of Medicine and Diabetes/Endocrine Unit, Mengo Hospital, Mengo, Uganda Background: Persistent suboptimal glycemic control is invariably associated with onset and progression of acute and chronic diabetic complications in diabetic patients. In Uganda, studies documenting the magnitude and predictors of suboptimal glycemic control in adult ambulatory diabetic patients are limited. This study aimed at determining the frequency and predictors of suboptimal glycemic control in adult diabetic patients attending three urban outpatient diabetic clinics in Uganda. Methods: In this hospital-based cross-sectional study, eligible ambulatory adult diabetic patients attending outpatient diabetic clinics of three urban hospitals were consecutively enrolled over 11 months. Suboptimal glycemic control was defined as glycated hemoglobin (HbA1c level ≥7%. Multivariable analysis was applied to determine the predictors. Results: The mean age of the study participants was 52.2±14.4 years, and the majority of them were females (283, 66.9%. The median (interquartile range HbA1c level was 9% (6.8%–12.4%. Suboptimal glycemic control was noted in 311 study participants, accounting for 73.52% of the participants. HbA1c levels of 7%–8%, 8.1%–9.9%, and ≥10% were noted in 56 (13.24%, 76 (17.97%, and 179 (42.32% study participants, respectively. The documented predictors of suboptimal glycemic control were metformin monotherapy (odds ratio: 0.36, 95% confidence interval: 0.21–0.63, p<0.005 and insulin therapy (odds ratio: 2.41, 95% confidence interval: 1.41–4.12, p=0

  17. (Goal Number 8) in achieving the Millennium Development Goals

    African Journals Online (AJOL)

    In 2000, the United Nations (UN) made a Millennium Declaration that commits governments across the globe to develop the lives of the people by 2015. This declaration is known as Millennium Development Goals (MDGs). This paper will examine the role that every government has to play in achieving the goals by focusing ...

  18. Systemic consultation and goal setting

    OpenAIRE

    Carr, Alan

    1993-01-01

    Over two decades of empirical research conducted within a positivist framework has shown that goal setting is a particularly useful method for influencing task performance in occupational and industrial contexts. The conditions under which goal setting is maximally effective are now clearly established. These include situations where there is a high level of acceptance and commitment, where goals are specific and challenging, where the task is relatively simple rather than ...

  19. APPLICATION OF GOAL SETTING THEORY

    OpenAIRE

    Yurtkoru, E. Serra; Bozkurt, Tulay; Bekta, Fatos; Ahmed, Mahir Jibril; Kola, Vehap

    2017-01-01

    The purpose of this study is to test the goal theorymodel originally developed by Locke and Latham in organizational setting inTurkey, and explain its influence on job satisfaction and affective commitment.Also mediating role of task specific strategy and moderating role ofselfefficacy are examined. Locke and Latham’s goal setting measure is adaptedto Turkish. Survey method is employed to collect data from 222 respondents fromautomotive industry. Goal setting dimensions predicted affective co...

  20. Alcohol myopia and goal commitment

    OpenAIRE

    Sevincer, A. Timur; Oettingen, Gabriele

    2014-01-01

    According to alcohol myopia theory, acute alcohol consumption leads people to disproportionally focus on the salient rather than the peripheral aspects of a situation. We summarize various studies exploring how myopic processes resulting from acute alcohol intake affect goal commitment. After consuming alcohol student participants felt strongly committed to an important personal goal even though they had low expectations of successfully attaining the goal. However, once intoxicated participan...

  1. REACH: Evaluation Report and Executive Summary

    Science.gov (United States)

    Sibieta, Luke

    2016-01-01

    REACH is a targeted reading support programme designed to improve reading accuracy and comprehension in pupils with reading difficulties in Years 7 and 8. It is based on research by the Centre for Reading and Language at York and is delivered by specially trained teaching assistants (TAs). This evaluation tested two REACH interventions, one based…

  2. [Influence on glycemic control of improved diabetic gastroparesis by long-term cisapride therapy].

    Science.gov (United States)

    Ishii, K; Tanabe, S; Mitsuhashi, T; Saigenji, K

    1995-10-01

    To investigate the effect on glycemic control of improving diabetic gastroparesis, we evaluated symptoms (scored), gastric motor functions (solid and liquid gastric emptying studies and electrogastrography), and glycemic control in 11 patients with diabetic gastroparesis (5 men, 6 women, 50.4 +/- 4.5 years old) before and after treatment with cisapride (15 mg/day p.o., 12 weeks). None of the patients had organic abnormalities on gastrointestinal endoscopy. The dysmotility symptom score (maximum: 18) on cisapride significantly improved from 13.1 to 4.0 (p instant noodles labeled with 37 MBq (1 mCi) technetium-99m (both p < 0.05). Liquid gastric emptying, evaluated using a sulfamethizole technique, also improved but not significantly. Electrogastrography revealed no significant changes after treatment, but the postprandial rate of normal frequency waves tended to increase. Glycemic control was assessed based on HbA1C, fructosamine and M value. There were no significant changes in glycemic control after treatment with cisapride. We conclude that long-term administration of cisapride reduced dysmotility symptoms and improved solid and liquid gastric emptying without adversely affecting glycemic control.

  3. Cr-enriched yeast: beyond fibers for the management of postprandial glycemic response to bread.

    Science.gov (United States)

    Yanni, Amalia E; Stamataki, Nikoleta; Stoupaki, Maria; Konstantopoulos, Panagiotis; Pateras, Irene; Tentolouris, Nikolaos; Perrea, Despoina; T Karathanos, Vaios

    2017-06-01

    Efforts regarding the amelioration of postprandial glycemic response to bread are mainly focused in the addition of soluble dietary fibers. The current study presents another approach which is based on the supplementation of flour with Cr-enriched yeast. Cr is known for its beneficial effects on improvement of glucose tolerance and enhancement of insulin sensitivity. Twelve normoglycemic subjects were provided with white bread (WB, reference food) or whole wheat bread with Cr-enriched yeast (WWCrB, rich in insoluble fibers) or white wheat bread with Cr-enriched yeast (WCrB, poor in fibers) or whole wheat-rye-barley bread enriched with oat beta glucans (BGB, rich in soluble fibers) with 1-week intervals in amounts that yielded 50 g of available carbohydrates. Postprandial glucose, insulin and ghrelin responses as well as glycemic index (GI) were evaluated. Ingestion of WWCrB, WCrB and BGB elicited lower incremental area under the curve (iAUC) for 120-min glycemic response compared to WB (1033.02 ± 282.32, 701.69 ± 330.86 and 748.95 ± 185.42 vs 2070.87 ± 518.44 mg/dL min, respectively, P yeast induces milder postprandial glycemic response to bread without the necessity of high fiber amounts, providing with another strategy for the management of glycemic control.

  4. Model-based analysis of postprandial glycemic response dynamics for different types of food

    Directory of Open Access Journals (Sweden)

    Yvonne J. Rozendaal

    2018-06-01

    Full Text Available Summary: Background & aims: Knowledge of postprandial glycemic response (PPGR dynamics is important in nutrition management and diabetes research, care and (selfmanagement. In daily life, food intake is the most important factor influencing the occurrence of hyperglycemia. However, the large variability in PPGR dynamics to different types of food is inadequately predicted by existing glycemic measures. The objective of this study was therefore to quantitatively describe PPGR dynamics using a systems approach. Methods: Postprandial glucose and insulin data were collected from literature for many different food products and mixed meals. The predictive value of existing measures, such as the Glycemic Index, was evaluated. A physiology-based dynamic model was used to reconstruct the full postprandial response profiles of both glucose and insulin simultaneously. Results: We collected a large range of postprandial glucose and insulin dynamics for 53 common food products and mixed meals. Currently available glycemic measures were found to be inadequate to describe the heterogeneity in postprandial dynamics. By estimating model parameters from glucose and insulin data, the physiology-based dynamic model accurately describes the measured data whilst adhering to physiological constraints. Conclusions: The physiology-based dynamic model provides a systematic framework to analyze postprandial glucose and insulin profiles. By changing parameter values the model can be adjusted to simulate impaired glucose tolerance and insulin resistance. Keywords: Postprandial glycemic response, Physiology-based dynamic model, Food intake, Computational modeling, Glucose, Insulin

  5. Cushing's syndrome in type 2 diabetes patients with poor glycemic control.

    Science.gov (United States)

    Gungunes, Askin; Sahin, Mustafa; Demirci, Taner; Ucan, Bekir; Cakir, Evrim; Arslan, Muyesser Sayki; Unsal, Ilknur Ozturk; Karbek, Basak; Calıskan, Mustafa; Ozbek, Mustafa; Cakal, Erman; Delibasi, Tuncay

    2014-12-01

    Cushing's syndrome may be more frequent in some specific patient groups such as type 2 diabetes and obesity. The aim of this study was to investigate the prevalence of Cushing's syndrome in outpatients with type 2 diabetes with poor glycemic control despite at least 3-months insulin therapy. Outpatients with type 2 diabetes whose glycemic control is poor (Hb Alc value >7 %) despite receiving at least 3-months long insulin treatment (insulin alone or insulin with oral antidiabetics) were included. Patients with classic features of Cushing's syndrome were excluded. Overnight 1 mg dexamethasone suppression test (DST) was performed as a screening test. A total of 277 patients with type 2 diabetes whose glycemic control is poor (Hb Alc value >7 %) despite insulin therapy were included. Two of the 277 patients with type 2 diabetes were diagnosed with Cushing's syndrome (0.72 %). Hypertension was statistically more frequent in the patients with cortisol levels ≥1.8 μg/dL than the patients with cortisol levels Cushing's syndrome among patients with type 2 diabetes with poor glycemic control despite insulin therapy is much higher than in the general population. The patients with type 2 diabetes with poor glycemic control despite at least three months of insulin therapy should be additionally tested for Cushing's syndrome if they have high dose insülin requirements.

  6. A randomized controlled trial to prevent glycemic relapse in longitudinal diabetes care: Study protocol (NCT00362193

    Directory of Open Access Journals (Sweden)

    Davis Dianne

    2006-10-01

    Full Text Available Abstract Background Diabetes is a common disease with self-management a key aspect of care. Large prospective trials have shown that maintaining glycated hemoglobin less than 7% greatly reduces complications but translating this level of control into everyday clinical practice can be difficult. Intensive improvement programs are successful in attaining control in patients with type 2 diabetes, however, many patients experience glycemic relapse once returned to routine care. This early relapse is, in part, due to decreased adherence in self-management behaviors. Objective This paper describes the design of the Glycemic Relapse Prevention study. The purpose of this study is to determine the optimal frequency of maintenance intervention needed to prevent glycemic relapse. The primary endpoint is glycemic relapse, which is defined as glycated hemoglobin greater than 8% and an increase of 1% from baseline. Methods The intervention consists of telephonic contact by a nurse practitioner with a referral to a dietitian if indicated. This intervention was designed to provide early identification of self-care problems, understanding the rationale behind the self-care lapse and problem solve to find a negotiated solution. A total of 164 patients were randomized to routine care (least intensive, routine care with phone contact every three months (moderate intensity or routine care with phone contact every month (most intensive. Conclusion The baseline patient characteristics are similar across the treatment arms. Intervention fidelity analysis showed excellent reproducibility. This study will provide insight into the important but poorly understood area of glycemic relapse prevention.

  7. Achievement goals affect metacognitive judgments

    Science.gov (United States)

    Ikeda, Kenji; Yue, Carole L.; Murayama, Kou; Castel, Alan D.

    2017-01-01

    The present study examined the effect of achievement goals on metacognitive judgments, such as judgments of learning (JOLs) and metacomprehension judgments, and actual recall performance. We conducted five experiments manipulating the instruction of achievement goals. In each experiment, participants were instructed to adopt mastery-approach goals (i.e., develop their own mental ability through a memory task) or performance-approach goals (i.e., demonstrate their strong memory ability through getting a high score on a memory task). The results of Experiments 1 and 2 showed that JOLs of word pairs in the performance-approach goal condition tended to be higher than those in the mastery-approach goal condition. In contrast, cued recall performance did not differ between the two goal conditions. Experiment 3 also demonstrated that metacomprehension judgments of text passages were higher in the performance-approach goal condition than in the mastery-approach goals condition, whereas test performance did not differ between conditions. These findings suggest that achievement motivation affects metacognitive judgments during learning, even when achievement motivation does not influence actual performance. PMID:28983496

  8. Supplementation with Glucosamine Has no Adverse Effects on Glycemic Level and Insulin Resistance in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Zohreh Mazloom

    2015-10-01

    Full Text Available Background: Use of glucosamine as an alternative treatment for osteoarthritis is becoming more frequent, including in those who have diabetes at the same time. The results from in vitro and animal studies propose that glucosamine may inversely affect glucose metabolism. However, the recommended dose of oral glucosamine in healthy people or diabetics did not have such effects consistently. The aim of the present study was to assess the effect of glucosamine on glycemic control and insulin resistance in type 2 diabetic patients. Methods: Fifty-four patients with type 2 diabetes participated in this randomized, double-blind, placebo-controlled study. The participants were assigned to receive 1500 mg glucosamine hydrochloride or placebo for 12 weeks. After determining their baseline characteristics, body mass index and dietary intake components, fasting blood glucose and fasting insulin were measured at weeks of 0, 8, and 12. Indices of insulin function including quantitative insulin sensitivity check index (QUICKI and homeostasis model assessment of insulin resistance (HOMA-IR were calculated by specific formulas. Independent t-test and general linear model repeated measures were used to analyze the data. Results: In the glucosamine group, the means of fasting blood glucose and insulin were 107.31±24.07 mg/dl and 8.75±4.37 μu/ ml, respectively at baseline, which reached 112.38±31.50 and 9.10±4.17 at week 12. In the placebo group, the mean for fasting blood glucose and insulin were 103.84±24.15 and 9.79±4.02 at the beginning of the study, which reached to 111.40±26.43 and 8.58±3.68 at week 12. The results showed that there were no significant differences in fasting blood glucose, insulin, HOMA-IR and QUICKI indices at all the studied time points (weeks of 0, 8 and 12 within or between the groups. Conclusion: Twelve weeks of a normal recommended dose of glucosamine supplements may not have adverse effects on glycemic control and insulin

  9. The database for reaching experiments and models.

    Directory of Open Access Journals (Sweden)

    Ben Walker

    Full Text Available Reaching is one of the central experimental paradigms in the field of motor control, and many computational models of reaching have been published. While most of these models try to explain subject data (such as movement kinematics, reaching performance, forces, etc. from only a single experiment, distinct experiments often share experimental conditions and record similar kinematics. This suggests that reaching models could be applied to (and falsified by multiple experiments. However, using multiple datasets is difficult because experimental data formats vary widely. Standardizing data formats promises to enable scientists to test model predictions against many experiments and to compare experimental results across labs. Here we report on the development of a new resource available to scientists: a database of reaching called the Database for Reaching Experiments And Models (DREAM. DREAM collects both experimental datasets and models and facilitates their comparison by standardizing formats. The DREAM project promises to be useful for experimentalists who want to understand how their data relates to models, for modelers who want to test their theories, and for educators who want to help students better understand reaching experiments, models, and data analysis.

  10. Goals and Personality in Adolescents

    Science.gov (United States)

    Sanz de Acedo Lizarraga, M. L.; Ugarte, M. D.; Lumbreras, M. Victoria; Sanz de Acedo Baquedano, M. T.

    2006-01-01

    The purpose of this study was to investigate the influence of personality factors in the value allotted by adolescents to various groups of goals. For this purpose, the "Cuestionario de Personalidad Situacional, CPS" (Situational Personality Questionnaire) and the "Cuestionario de Metas para Adolescentes, CMA" (Goals for…

  11. Alcohol myopia and goal commitment

    Directory of Open Access Journals (Sweden)

    A. Timur Sevincer

    2014-03-01

    Full Text Available According to alcohol-myopia theory, acute alcohol consumption leads people to disproportionally focus on the salient rather than the peripheral aspects of a situation. We summarize various studies exploring how myopic processes resulting from acute alcohol intake affect goal commitment. After consuming alcohol student participants felt strongly committed to an important personal goal even though they had low expectations of successfully attaining the goal. However, once intoxicated participants were sober again (i.e., not myopic anymore they failed to act on their goal commitment. In line with alcohol-myopia theory, strong goal commitment as a result of alcohol intake was mediated by intoxicated (vs. sober participants disproportionally focusing on the desirability rather than the feasibility of their goal. Further supporting alcohol-myopia theory, when the low feasibility of attaining a particular goal was experimentally made salient (either explicitly or implicitly by subliminal priming, intoxicated participants felt less committed than those who consumed a placebo. We discuss these effects of acute alcohol intake in the context of research on the effects of chronic alcohol consumption on goal commitment.

  12. Goal Theory and Individual Productivity.

    Science.gov (United States)

    Frost, Peter J.

    The paper provides a review of goal theory as articulated by Edwin Locke. The theory is evaluated in terms of laboratory and field research and its practical usefulnes is explored as a means to improving individual productivity in "real world" organizations Research findings provide support for some goal theory propositions but suggest also the…

  13. Genome-Wide Association Study Identifies Two Novel Loci with Sex-Specific Effects for Type 2 Diabetes Mellitus and Glycemic Traits in a Korean Population

    Directory of Open Access Journals (Sweden)

    Min Jin Go

    2014-10-01

    Full Text Available BackgroundUntil recently, genome-wide association study (GWAS-based findings have provided a substantial genetic contribution to type 2 diabetes mellitus (T2DM or related glycemic traits. However, identification of allelic heterogeneity and population-specific genetic variants under consideration of potential confounding factors will be very valuable for clinical applicability. To identify novel susceptibility loci for T2DM and glycemic traits, we performed a two-stage genetic association study in a Korean population.MethodsWe performed a logistic analysis for T2DM, and the first discovery GWAS was analyzed for 1,042 cases and 2,943 controls recruited from a population-based cohort (KARE, n=8,842. The second stage, de novo replication analysis, was performed in 1,216 cases and 1,352 controls selected from an independent population-based cohort (Health 2, n=8,500. A multiple linear regression analysis for glycemic traits was further performed in a total of 14,232 nondiabetic individuals consisting of 7,696 GWAS and 6,536 replication study participants. A meta-analysis was performed on the combined results using effect size and standard errors estimated for stage 1 and 2, respectively.ResultsA combined meta-analysis for T2DM identified two new (rs11065756 and rs2074356 loci reaching genome-wide significance in CCDC63 and C12orf51 on the 12q24 region. In addition, these variants were significantly associated with fasting plasma glucose and homeostasis model assessment of β-cell function. Interestingly, two independent single nucleotide polymorphisms were associated with sex-specific stratification in this study.ConclusionOur study showed a strong association between T2DM and glycemic traits. We further observed that two novel loci with multiple diverse effects were highly specific to males. Taken together, these findings may provide additional insights into the clinical assessment or subclassification of disease risk in a Korean population.

  14. The obesity epidemic: is glycemic index the key to unlocking a hidden addiction?

    Science.gov (United States)

    Thornley, Simon; McRobbie, Hayden; Eyles, Helen; Walker, Natalie; Simmons, Greg

    2008-11-01

    High body mass index (BMI) is an important cause of a range of diseases and is estimated to be the seventh leading cause of death globally. In this paper we discuss evidence that food consumption shows similarities to features of other addictive behaviours, such as automaticity and loss of control. Glycemic index is hypothesised to be the element of food that predicts its addictive potential. Although we do not have substantive evidence of a withdrawal syndrome from high glycemic food abstinence, anecdotal reports exist. Empirical scientific and clinical studies support an addictive component of eating behaviour, with similar neurotransmitters and neural pathways triggered by food consumption, as with other drugs of addiction. The public health implications of such a theory are discussed, with reference to tobacco control. Subtle changes in the preparation and manufacturing of commonly consumed food items, reducing glycemic index through regulatory channels, may break such a cycle of addiction and draw large public health benefits.

  15. Breaking down patient and physician barriers to optimize glycemic control in type 2 diabetes.

    Science.gov (United States)

    Ross, Stuart A

    2013-09-01

    Approximately half of patients with type 2 diabetes (T2D) do not achieve globally recognized blood glucose targets, despite the availability of a wide range of effective glucose-lowering therapies. Failure to maintain good glycemic control increases the risk of diabetes-related complications and long-term health care costs. Patients must be brought under glycemic control to improve treatment outcomes, but existing barriers to optimizing glycemic control must first be overcome, including patient nonadherence to treatment, the failure of physicians to intensify therapy in a timely manner, and inadequacies in the health care system itself. The reasons for such barriers include treatment side effects, complex treatment regimens, needle anxiety, poor patient education, and the absence of an adequate patient care plan; however, newer therapies and devices, combined with comprehensive care plans involving adequate patient education, can help to minimize barriers and improve treatment outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Exercise and Glycemic Control: Focus on Redox Homeostasis and Redox-Sensitive Protein Signaling

    Science.gov (United States)

    Parker, Lewan; Shaw, Christopher S.; Stepto, Nigel K.; Levinger, Itamar

    2017-01-01

    Physical inactivity, excess energy consumption, and obesity are associated with elevated systemic oxidative stress and the sustained activation of redox-sensitive stress-activated protein kinase (SAPK) and mitogen-activated protein kinase signaling pathways. Sustained SAPK activation leads to aberrant insulin signaling, impaired glycemic control, and the development and progression of cardiometabolic disease. Paradoxically, acute exercise transiently increases oxidative stress and SAPK signaling, yet postexercise glycemic control and skeletal muscle function are enhanced. Furthermore, regular exercise leads to the upregulation of antioxidant defense, which likely assists in the mitigation of chronic oxidative stress-associated disease. In this review, we explore the complex spatiotemporal interplay between exercise, oxidative stress, and glycemic control, and highlight exercise-induced reactive oxygen species and redox-sensitive protein signaling as important regulators of glucose homeostasis. PMID:28529499

  17. Safety goals for nuclear power

    International Nuclear Information System (INIS)

    Fischhoff, B.

    1984-02-01

    The key policy question in managing hazardous technologies is often some variant of How safe is safe enough. The US Nuclear Regulatory Commission has recently broached this topic by adopting safety goals defining acceptable risk levels for nuclear power plants. These goals are analyzed here with a general theory of standard setting (Fischhoff, 1983) which asks: (1) Are standards an appropriate policy tool in this case. (2) Can the Commission's safety philosophy be defended. (3) Do the operational goals capture that philosophy. The anlaysis shows the safety goals proposal to be sophisticated in some respects, incomplete in others. More generally, it points to difficulties with the concept of acceptable risk and any attempt to build policy instruments around it. Although focused on the NRC's safety goals, the present analysis is a prototype of what can be learned by similarly detailed consideration of other standards, not only for nuclear power but also for other hazardous technologies, as well as for issues unrelated to safety

  18. Calculating meal glycemic index by using measured and published food values compared with directly measured meal glycemic index.

    Science.gov (United States)

    Dodd, Hayley; Williams, Sheila; Brown, Rachel; Venn, Bernard

    2011-10-01

    Glycemic index (GI) testing is normally based on individual foods, whereas GIs for meals or diets are based on a formula using a weighted sum of the constituents. The accuracy with which the formula can predict a meal or diet GI is questionable. Our objective was to compare the GI of meals, obtained by using the formula and by using both measured food GI and published values, with directly measured meal GIs. The GIs of 7 foods were tested in 30 healthy people. The foods were combined into 3 meals, each of which provided 50 g available carbohydrate, including a staple (potato, rice, or spaghetti), vegetables, sauce, and pan-fried chicken. The mean (95% CI) meal GIs determined from individual food GI values and by direct measurement were as follows: potato meal [predicted, 63 (56, 70); measured, 53 (46, 62)], rice meal [predicted, 51 (45, 56); measured, 38 (33, 45)], and spaghetti meal [predicted, 54 (49, 60); measured, 38 (33, 44)]. The predicted meal GIs were all higher than the measured GIs (P < 0.001). The extent of the overestimation depended on the particular food, ie, 12, 15, and 19 GI units (or 22%, 40%, and 50%) for the potato, rice, and spaghetti meals, respectively. The formula overestimated the GI of the meals by between 22% and 50%. The use of published food values also overestimated the measured meal GIs. Investigators using the formula to calculate a meal or diet GI should be aware of limitations in the method. This trial is registered with the Australian and New Zealand Clinical Trials Registry as ACTRN12611000210976.

  19. Methodologic considerations in the measurement of glycemic index: glycemic response to rye bread, oatmeal porridge, and mashed potato.

    Science.gov (United States)

    Hätönen, Katja A; Similä, Minna E; Virtamo, Jarmo R; Eriksson, Johan G; Hannila, Marja-Leena; Sinkko, Harri K; Sundvall, Jouko E; Mykkänen, Hannu M; Valsta, Liisa M

    2006-11-01

    Methodologic choices affect measures of the glycemic index (GI). The effects on GI values of blood sampling site, reference food type, and the number of repeat tests have been insufficiently determined. The objective was to study the effect of methodologic choices on GI values. Comparisons were made between venous and capillary blood sampling and between glucose and white bread as the reference food. The number of tests needed for the reference food was assessed. Rye bread, oatmeal porridge, and instant mashed potato were used as the test foods. Twelve healthy volunteers were served each test food once and both reference foods 3 times at 1-wk intervals in a random order after they had fasted overnight. Capillary and venous blood samples were drawn at intervals for 3 h after each study meal. GIs and their CVs based on capillary samples were lower than those based on venous samples. Two tests of glucose solution as the reference provided stable capillary GIs for the test foods. The capillary GIs did not differ significantly when white bread was used as the reference 1, 2, or 3 times, but the variation was lower when tests were performed 2 and 3 times. Capillary GIs with white bread as the reference were 1.3 times as high as those with glucose as the reference. The capillary GIs of rye bread, oatmeal porridge, and mashed potato were 77, 74, and 80, respectively, with glucose as the reference. Capillary blood sampling should be used in the measurement of GI, and reference tests with glucose or white bread should be performed at least twice.

  20. Impact of weight loss and maintenance with ad libitum diets varying in protein and glycemic index content on metabolic syndrome

    DEFF Research Database (Denmark)

    Papadaki, Angeliki; Linardakis, Manolis; Plada, Maria

    2014-01-01

    We investigated the effects of weight loss and maintenance with diets that varied with regard to protein content and glycemic index (GI) on metabolic syndrome (MetSyn) status.......We investigated the effects of weight loss and maintenance with diets that varied with regard to protein content and glycemic index (GI) on metabolic syndrome (MetSyn) status....

  1. The Importance of Social Support on Glycemic Control in Low-Income Latinos with Type 2 Diabetes

    Science.gov (United States)

    Rotberg, Britt; Junqueira, Yasmine; Gosdin, Lucas; Mejia, Roberto; Umpierrez, Guillermo E.

    2016-01-01

    Background: The U.S. Latino population exhibits poorer glycemic control than the white population, leading to more frequent health complications and greater disease severity. Social support has been shown a significant factor in health and well-being. Purpose: To determine the association between glycemic control and social support in patients…

  2. Glycemic control and all-cause mortality risk in type 1 diabetes patients: the EURODIAB prospective complications study

    NARCIS (Netherlands)

    Schoenaker, D.A.J.M.; Simon, D.; Chaturvedi, N.; Fuller, J.H.; Soedamah-Muthu, S.S.

    2014-01-01

    Context: Glycemic targets and the benefit of intensive glucose control are currently under debate because intensive glycemic control has been suggested to have negative effects on mortality risk in type 2 diabetes patients. Objective: We examined the association between glycated hemoglobin (HbA1c)

  3. Effects of diabetes-related family stress on glycemic control in young patients with type 1 diabetes: Systematic review.

    Science.gov (United States)

    Tsiouli, Elina; Alexopoulos, Evangelos C; Stefanaki, Charikleia; Darviri, Christina; Chrousos, George P

    2013-02-01

    To investigate the way that family stress influences glycemic control among patients with diabetes who are younger than 18 years of age. PubMed and Scopus were searched for relevant studies published since 1990 using the following key words: diabetes type 1, glycemic control, family stress, family conflict, and family function. In total, 1478 papers were identified in the initial search. The final review included 6 cohort studies, 3 cross-sectional studies, and 1 qualitative review in which family stress was assessed using specific diabetes-related conflict measurement instruments, and glycemic control was evaluated by glycosylated hemoglobin measurement. In most studies family stress was negatively correlated with patients' glycemic control. Family function was strongly related to patients' glycemic control, while family conflict was adversely associated with glycemic control. Families of low socioeconomic status, those of adolescents with diabetes, and those of single parents were more prone to diabetes-related stress and thus more susceptible to worse glycemic control. Therapeutic psychological interventions and educational programs can help alleviate family diabetes-related stress and will likely improve glycemic control.

  4. The influence of aspirin dose and glycemic control on platelet inhibition in patients with type 2 diabetes mellitus

    NARCIS (Netherlands)

    Lemkes, B. A.; Bahler, L.; Kamphuisen, P. W.; Stroobants, A. K.; van den Dool, E. J.; Hoekstra, J. B.; Nieuwland, R.; Gerdes, V. E.; Holleman, F.

    Background: Low-dose aspirin seems to offer no benefit in the primary prevention of cardiovascular disease in type 2 diabetes mellitus (DM2). The anti-platelet effect may be diminished by poor glycemic control or inadequate dosing of aspirin. Objectives: To study the effects of both glycemic control

  5. Dietary Glycemic Index during Pregnancy Is Associated with Biomarkers of the Metabolic Syndrome in Offspring at Age 20 Years

    DEFF Research Database (Denmark)

    Danielsen, Inge; Granström, Charlotta; Haldorsson, Thorhallur

    2013-01-01

    Growing evidence indicates that metabolic syndrome is rooted in fetal life with a potential key role of nutrition during pregnancy. The objective of the study was to assess the possible associations between the dietary glycemic index (GI) and glycemic load (GL) during pregnancy and biomarkers...

  6. The effects of glycemic control on seizures and seizure-induced excitotoxic cell death

    Directory of Open Access Journals (Sweden)

    Schauwecker Paula

    2012-08-01

    Full Text Available Abstract Background Epilepsy is the most common neurological disorder after stroke, affecting more than 50 million persons worldwide. Metabolic disturbances are often associated with epileptic seizures, but the pathogenesis of this relationship is poorly understood. It is known that seizures result in altered glucose metabolism, the reduction of intracellular energy metabolites such as ATP, ADP and phosphocreatine and the accumulation of metabolic intermediates, such as lactate and adenosine. In particular, it has been suggested that the duration and extent of glucose dysregulation may be a predictor of the pathological outcome of status. However, little is known about neither the effects of glycemic control on brain metabolism nor the effects of managing systemic glucose concentrations in epilepsy. Results In this study, we examined glycemic modulation of kainate-induced seizure sensitivity and its neuropathological consequences. To investigate the relationship between glycemic modulation, seizure susceptibility and its neuropathological consequences, C57BL/6 mice (excitotoxin cell death resistant were subjected to hypoglycemia or hyperglycemia, followed by systemic administration of kainic acid to induce seizures. Glycemic modulation resulted in minimal consequences with regard to seizure severity but increased hippocampal pathology, irrespective of whether mice were hypoglycemic or hyperglycemic prior to kainate administration. Moreover, we found that exogenous administration of glucose following kainic acid seizures significantly reduced the extent of hippocampal pathology in FVB/N mice (excitotoxin cell death susceptible following systemic administration of kainic acid. Conclusion These findings demonstrate that modulation of the glycemic index can modify the outcome of brain injury in the kainate model of seizure induction. Moreover, modulation of the glycemic index through glucose rescue greatly diminishes the extent of seizure

  7. Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy.

    Science.gov (United States)

    Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

    2017-01-14

    To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

  8. Glycemic control in type 2 diabetes mellitus prevents coronary arterial wall infection

    Directory of Open Access Journals (Sweden)

    Morteza Izadi

    2014-05-01

    Full Text Available BACKGROUND: Diabetes mellitus (DM is a very well-known risk factor for development of atherosclerosis, and it has been hypothesized that poor glycemic control and hyperglycemia plays a major role in this process. In the current study, we aimed to evaluate the associates of poor glycemic control in Iranian patients who have already undergone coronary artery bypass grafting (CABG, with especial focus on the inhabitation of infectious agents within the coronary arterial wall. METHODS: In January 2010, 52 consecutive patients with type 2 DM who undergone CABG at the Department of Cardiovascular Surgery of Baqiyatallah University of Medical Sciences (Tehran, Iran were included into this cross-sectional study and biopsy specimens from their coronary plaques were taken and analyzed by polymerase chain reaction (PCR methods for detecting Helicobacter species, cytomegalovirus (CMV and Chlamydia pneumoniae, and their potential relation to the glycemic control status in these patients. RESULTS: Compared to that in diabetic patients with mean fasting blood sugar (FBS levels FBS < 126, atherosclerotic lesions in type 2 diabetic patients with poor glycemic control (FBS > 126 were significantly more likely to be positive for CMV PCR test (41% vs. 9%, respectively; P = 0.05. In laboratorial test results, mean triglyceride level was significantly higher among patients of poor glycemic control (168 ± 89 vs. 222 ± 125 mg/dl, respectively; P = 0.033. Hypertension was also significantly more prevalent in this population (73% vs. 36%, respectively; P = 0.034. CONCLUSION: Type 2 diabetic patients with poor glycemic control can be at higher risk for developing CMV infection in their coronary arterial wall, which can promote atherosclerosis formation process in this patient population. According to the findings of this study, we recommend better control of serum glucose levels in type 2 diabetic patients to prevent formation/progression of atherosclerosis.   Keywords

  9. Food insecurity is related to glycemic control deterioration in patients with type 2 diabetes.

    Science.gov (United States)

    Bawadi, Hiba Ahmad; Ammari, Fawaz; Abu-Jamous, Dima; Khader, Yousef Saleh; Bataineh, Safa'a; Tayyem, Reema Fayez

    2012-04-01

    Poor glycemic control has been shown to play a major role in the development and progression of diabetes complications. This cross-sectional study tested the hypothesis that food insecurity may deteriorate glycemic control in patients with type 2 diabetes. The objectives of this study were to assess the prevalence of food insecurity among type 2 diabetics in a major hospital that serves the area of northern Jordan, and to investigate its relation to glycemic control. A sample of 843 patients diagnosed with type 2 diabetes participated in the study. Socioeconomic and health data were collected by interview-based questionnaire. Weight and height were measured by a trained nutritionist. Dietary assessment was done using food frequency questionnaire. Dietary data were processed using food processor software. Food insecurity was assessed by the short form of the U.S. food security survey module. Glycemic control was assessed by measuring glycosyated hemoglobin (HbA1c). Statistical procedures used to analyze the data were chi-square, and post-hoc analysis of variance. About 22% of the tested sample were food secure (FS); 51% were moderately food insecure (MFIS); and 27% were severely food insecure (SFIS). Higher BMI was associated with SFIS patients. After adjusting for age, gender, income, education, and duration of diabetes, body mass index, and caloric consumption; moderate and severe food insecurity were associated with poor glycemic control (p = 0.04). food insecurity may be associated with glycemic control deterioration in patients with type 2 diabetes. Copyright © 2011 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. Health education via mobile text messaging for glycemic control in adults with type 2 diabetes: a systematic review and meta-analysis.

    Science.gov (United States)

    Saffari, Mohsen; Ghanizadeh, Ghader; Koenig, Harold G

    2014-12-01

    Diabetes type 2 is an increasing problem worldwide that may be managed through education. Text-messaging using a cell phone can assist with self-care. The aim of this study was to systematically review the impact of education through mobile text-messaging on glycemic control. The design was a systematic review with meta-analysis. Five electronic databases were searched to access English studies involving a randomized controlled trial design that used text-messaging educational interventions in patients with type 2 diabetes during an 11-year period (2003-2013). Studies were evaluated using a quality assessment scale adapted from Jadad scale and Cochrane handbook. Extraction of data was carried out by two reviewers. A random-effect model with a standardized mean difference and Hedges's g indices was used for conducting the meta-analysis. Subgroup analyses were conducted and a Funnel plot was used to examine publication bias. Ten studies overall were identified that fulfilled inclusion criteria, involving a total of 960 participants. The mean age of the sample was 52.8 years and majority were females. Data were heterogeneous (I(2)=67.6). Analyses suggested a publication bias based on Egger's regression (Peducating Type 2 diabetics appears to be effective on glycemic control. Further investigations on mobile applications to achieve educational goals involving other diseases are recommended. Copyright © 2014 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  11. A randomized controlled trial to compare the effects of sulphonylurea gliclazide MR (modified release) and the DPP-4 inhibitor vildagliptin on glycemic variability and control measured by continuous glucose monitoring (CGM) in Brazilian women with type 2 diabetes.

    Science.gov (United States)

    Vianna, Andre Gustavo Daher; Lacerda, Claudio Silva; Pechmann, Luciana Muniz; Polesel, Michelle Garcia; Marino, Emerson Cestari; Faria-Neto, Jose Rocha

    2018-05-01

    This study aims to evaluate whether there is a difference between the effects of vildagliptin and gliclazide MR (modified release) on glycemic variability (GV) in women with type 2 diabetes (T2DM) as evaluated by continuous glucose monitoring (CGM). An open-label, randomized study was conducted in T2DM women on steady-dose metformin monotherapy which were treated with 50 mg vildagliptin twice daily or 60-120 mg of gliclazide MR once daily. CGM and GV indices calculation were performed at baseline and after 24 weeks. In total, 42 patients (age: 61.9 ± 5.9 years, baseline glycated hemoglobin (HbA1c): 7.3 ± 0.56) were selected and 37 completed the 24-week protocol. Vildagliptin and gliclazide MR reduced GV, as measured by the mean amplitude of glycemic excursions (MAGE, p = 0.007 and 0.034, respectively). The difference between the groups did not reach statistical significance. Vildagliptin also significantly decreased the standard deviation of the mean glucose (SD) and the mean of the daily differences (MODD) (p = 0.007 and 0.030). Vildagliptin and gliclazide MR similarly reduced the MAGE in women with T2DM after 24 weeks of treatment. Further studies are required to attest differences between vildagliptin and gliclazide MR regarding glycemic variability. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Enhancing US Operational Reach in Southeast Asia

    National Research Council Canada - National Science Library

    Hitchcock, David

    2003-01-01

    .... While this treat continues to exist, the US Pacific Command (PACOM) must also pursue a neat term methodology to expand its operational reach and ability to respond to contingencies throughout the East Asian littoral, especially within Southeast Asia...

  13. Reaching the Overlooked Student in Physical Education

    Science.gov (United States)

    Esslinger, Keri; Esslinger, Travis; Bagshaw, Jarad

    2015-01-01

    This article describes the use of live action role-playing, or "LARPing," as a non-traditional activity that has the potential to reach students who are not interested in traditional physical education.

  14. Compact muon solenoid magnet reaches full field

    CERN Multimedia

    2006-01-01

    Scientist of the U.S. Department of Energy in Fermilab and collaborators of the US/CMS project announced that the world's largest superconducting solenoid magnet has reached full field in tests at CERN. (1 apge)

  15. Predictors of glycemic control in children with Type 1 diabetes mellitus in Assiut-Egypt

    Directory of Open Access Journals (Sweden)

    Hanaa A Mohammad

    2012-01-01

    Full Text Available Background : Type 1 diabetes mellitus (T1DM may lead to severe long-term health consequences, such as renal failure, blindness, as well as heart and cerebrovascular disease. Although a direct relationship between blood glucose control and diabetes complications remains to be established beyond doubt, most diabetologists aim to achieve the best possible glucose control in their patients with T1DM. The aim of this study was to detect the predictors of glycemic control among children with T1DM in Assiut Governorate-Egypt. Materials and Methods : We enrolled 415 children aged 2 to 18 years with type 1 diabetes of >1-year duration. They were subjected to full history including demographic factors and disease-related factors. Examination was done with determination of the body mass index, and assessment of stage of maturity. Investigations included hemoglobin A1c (HbA1c and lipid profile. Patients with HbA1c above the recommended values for age by the American Diabetes Association were considered as poor glycemic control group. Results : Of the studied cases, 190 cases (45.8% were of poor glycemic control. Patients with poor control had significantly higher mean age (16.83 ± 3.3 vs 9.77 ± 3.7, P<0.000. Girls aged 15 years or more had significantly higher prevalence of poor glycemic control than males of the same age group. As regard the disease-related factors, patients with poor control had significantly longer duration of disease (7.94 ± 2.6 vs 2.40 ± 2.0, P<0.000 and were older in age at onset of disease. Insulin regimen which consists of basal bolus insulin plus three injections of regular insulin was associated with more frequency of good glycemic control than other regimens. Patients with poor control had significantly higher mean of cholesterol, triglyceride (TG, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol than patients with good control. Adjusting for other variables, age of the patients, duration of

  16. Utility of different glycemic control metrics for optimizing management of diabetes.

    Science.gov (United States)

    Kohnert, Klaus-Dieter; Heinke, Peter; Vogt, Lutz; Salzsieder, Eckhard

    2015-02-15

    The benchmark for assessing quality of long-term glycemic control and adjustment of therapy is currently glycated hemoglobin (HbA1c). Despite its importance as an indicator for the development of diabetic complications, recent studies have revealed that this metric has some limitations; it conveys a rather complex message, which has to be taken into consideration for diabetes screening and treatment. On the basis of recent clinical trials, the relationship between HbA1c and cardiovascular outcomes in long-standing diabetes has been called into question. It becomes obvious that other surrogate and biomarkers are needed to better predict cardiovascular diabetes complications and assess efficiency of therapy. Glycated albumin, fructosamin, and 1,5-anhydroglucitol have received growing interest as alternative markers of glycemic control. In addition to measures of hyperglycemia, advanced glucose monitoring methods became available. An indispensible adjunct to HbA1c in routine diabetes care is self-monitoring of blood glucose. This monitoring method is now widely used, as it provides immediate feedback to patients on short-term changes, involving fasting, preprandial, and postprandial glucose levels. Beyond the traditional metrics, glycemic variability has been identified as a predictor of hypoglycemia, and it might also be implicated in the pathogenesis of vascular diabetes complications. Assessment of glycemic variability is thus important, but exact quantification requires frequently sampled glucose measurements. In order to optimize diabetes treatment, there is a need for both key metrics of glycemic control on a day-to-day basis and for more advanced, user-friendly monitoring methods. In addition to traditional discontinuous glucose testing, continuous glucose sensing has become a useful tool to reveal insufficient glycemic management. This new technology is particularly effective in patients with complicated diabetes and provides the opportunity to characterize

  17. Glycemic Variability Is Associated With Reduced Cardiac Autonomic Modulation in Women With Type 2 Diabetes

    DEFF Research Database (Denmark)

    Fleischer, Jesper; Lebech Cichosz, Simon; Hoeyem, Pernille

    2015-01-01

    OBJECTIVE: To investigate the sex differences in cardiac autonomic modulation in patients with newly diagnosed type 2 diabetes and to determine whether cardiac autonomic modulation is associated with glycemic variability. RESEARCH DESIGN AND METHODS: We investigated a cohort consisting of 48 men...... and 39 women with non-insulin-treated type 2 diabetes and a known duration of diabetes ... by the standard deviation of normal-to-normal intervals (P = 0.001), the root mean square of successive differences (P = 0.018), LF (P power (P = 0.008), RS ratio (P = 0.027), and expiration-to-inspiration ratio (P = 0.006) was significantly associated with increased glycemic...

  18. Association Between Cardiorespiratory Fitness and the Determinants of Glycemic Control Across the Entire Glucose Tolerance Continuum

    DEFF Research Database (Denmark)

    Solomon, Thomas P. J.; Malin, Steven K.; Karstoft, Kristian

    2015-01-01

    OBJECTIVE: Cardiorespiratory fitness (VO2max) is associated with glycemic control, yet the relationship between VO2max and the underlying determinants of glycemic control is less clear. Our aim was to determine whether VO2max is associated with insulin sensitivity, insulin secretion, and the disp...... fitness and compromised pancreatic β-cell compensation across the entire glucose tolerance continuum provides additional evidence highlighting the importance of fitness in protection against the onset of a fundamental pathophysiological event that leads to type 2 diabetes....

  19. [Socioeconomic, demographic, nutritional, and physical activity factors in the glycemic control of adolescents with type 1 diabetes mellitus].

    Science.gov (United States)

    Marques, Rosana de Morais Borges; Fornés, Nélida Schmid; Stringhini, Maria Luiza Ferreira

    2011-04-01

    To identify the association of socioeconomic, demographic, nutritional and of physical activity factors in the glycemic control of adolescents with T1DM. Sectional study of 71 adolescents with type 1 diabetes. Socioeconomic, demographic and anthropometric data were obtained. The glycemic control was classified by the index of glycated hemoglobin (A1C). Four 24-hours recalls of food consumption and physical activity were applied. The A1C was inadequate for the majority of the adolescents. The low educational level of the caregivers influenced the inadequate glycemic control. Patients with lower insulin dose presented better glycemic control. The food consumption was high of fat and poor of carbohydrate. Most of the patients were sedentary. Factors related to education, insulin and food consumption influenced the glycemic control.

  20. Career Goals in Young Adults: Personal Resources, Goal Appraisals, Attitudes, and Goal Management Strategies

    Science.gov (United States)

    Haratsis, Jessica M.; Hood, Michelle; Creed, Peter A.

    2015-01-01

    We tested a model based on the dual-process framework that assessed the relationships among personal resources, career goal appraisals, career attitudes, and career goal management, which have not been previously assessed together. The model (tested on a sample of 486 young adults: 74% female, M[subscript]age = 22 years) proposed that personal…

  1. Measuring the glycemic index of foods: interlaboratory study.

    Science.gov (United States)

    Wolever, Thomas M S; Brand-Miller, Jennie C; Abernethy, John; Astrup, Arne; Atkinson, Fiona; Axelsen, Mette; Björck, Inger; Brighenti, Furio; Brown, Rachel; Brynes, Audrey; Casiraghi, M Cristina; Cazaubiel, Murielle; Dahlqvist, Linda; Delport, Elizabeth; Denyer, Gareth S; Erba, Daniela; Frost, Gary; Granfeldt, Yvonne; Hampton, Shelagh; Hart, Valerie A; Hätönen, Katja A; Henry, C Jeya; Hertzler, Steve; Hull, Sarah; Jerling, Johann; Johnston, Kelly L; Lightowler, Helen; Mann, Neil; Morgan, Linda; Panlasigui, Leonora N; Pelkman, Christine; Perry, Tracy; Pfeiffer, Andreas F H; Pieters, Marlien; Ramdath, D Dan; Ramsingh, Rayna T; Robert, S Daniel; Robinson, Carol; Sarkkinen, Essi; Scazzina, Francesca; Sison, Dave Clark D; Sloth, Birgitte; Staniforth, Jane; Tapola, Niina; Valsta, Liisa M; Verkooijen, Inge; Weickert, Martin O; Weseler, Antje R; Wilkie, Paul; Zhang, Jian

    2008-01-01

    Many laboratories offer glycemic index (GI) services. We assessed the performance of the method used to measure GI. The GI of cheese-puffs and fruit-leather (centrally provided) was measured in 28 laboratories (n=311 subjects) by using the FAO/WHO method. The laboratories reported the results of their calculations and sent the raw data for recalculation centrally. Values for the incremental area under the curve (AUC) reported by 54% of the laboratories differed from central calculations. Because of this and other differences in data analysis, 19% of reported food GI values differed by >5 units from those calculated centrally. GI values in individual subjects were unrelated to age, sex, ethnicity, body mass index, or AUC but were negatively related to within-individual variation (P=0.033) expressed as the CV of the AUC for repeated reference food tests (refCV). The between-laboratory GI values (mean+/-SD) for cheese-puffs and fruit-leather were 74.3+/-10.5 and 33.2+/-7.2, respectively. The mean laboratory GI was related to refCV (P=0.003) and the type of restrictions on alcohol consumption before the test (P=0.006, r2=0.509 for model). The within-laboratory SD of GI was related to refCV (P<0.001), the glucose analysis method (P=0.010), whether glucose measures were duplicated (P=0.008), and restrictions on dinner the night before (P=0.013, r2=0.810 for model). The between-laboratory SD of the GI values is approximately 9. Standardized data analysis and low within-subject variation (refCV<30%) are required for accuracy. The results suggest that common misconceptions exist about which factors do and do not need to be controlled to improve precision. Controlled studies and cost-benefit analyses are needed to optimize GI methodology. The trial was registered at clinicaltrials.gov as NCT00260858.

  2. GOAL Agents Instantiate Intention Logic

    OpenAIRE

    Hindriks, Koen; van der Hoek, Wiebe

    2008-01-01

    It is commonly believed there is a big gap between agent logics and computational agent frameworks. In this paper, we show that this gap is not as big as believed by showing that GOAL agents instantiate Intention Logic of Cohen and Levesque. That is, we show that GOAL agent programs can be formally related to Intention Logic.We do so by proving that the GOAL Verification Logic can be embedded into Intention Logic. It follows that (a fragment of) Intention Logic can be used t...

  3. Low-glycemic load decreases postprandial insulin and glucose and increases postprandial ghrelin in white but not black women.

    Science.gov (United States)

    Brownley, Kimberly A; Heymen, Steve; Hinderliter, Alan L; Galanko, Joseph; Macintosh, Beth

    2012-07-01

    Alterations in appetite hormones favoring increased postprandial satiety have been implicated in both the glycemic control and potential weight-loss benefits of a low-glycemic diet. Racial differences exist in dietary glycemic load and appetite hormone concentrations. This study examined the impact of glycemic load on appetite hormones in 20 black women [10 normal weight, BMI = 22.8 ± 1.42 (mean ± SD); 10 obese, BMI = 35.1 ± 2.77] and 20 white women (10 normal weight, BMI = 22.9 ± 1.45; 10 obese, BMI = 34.3 ± 2.77). Each woman completed two 4.5-d weight-maintenance, mixed-macronutrient, high-glycemic vs. low-glycemic load diets that concluded with a test meal of identical composition. Blood samples collected before and serially for 3 h after each test meal were assayed for plasma ghrelin and serum insulin and glucose concentrations. Compared with the high-glycemic load meal, the low-glycemic load meal was associated with lower insulin(AUC) (P = 0.02), glucose(AUC) (P = 0.01), and urge to eat ratings (P = 0.05) but with higher ghrelin(AUC) (P = 0.008). These results suggest the satiating effect of a low-glycemic load meal is not directly linked to enhanced postprandial suppression of ghrelin. Notably, these effects were significant among white but not black women, suggesting that black women may be less sensitive than white women to the glucoregulatory effects of a low-glycemic load. These findings add to a growing literature demonstrating racial differences in postprandial appetite hormone responses. If reproducible, these findings have implications for individualized diet prescription for the purposes of glucose or weight control in women.

  4. Task-dependent vestibular feedback responses in reaching.

    Science.gov (United States)

    Keyser, Johannes; Medendorp, W Pieter; Selen, Luc P J

    2017-07-01

    When reaching for an earth-fixed object during self-rotation, the motor system should appropriately integrate vestibular signals and sensory predictions to compensate for the intervening motion and its induced inertial forces. While it is well established that this integration occurs rapidly, it is unknown whether vestibular feedback is specifically processed dependent on the behavioral goal. Here, we studied whether vestibular signals evoke fixed responses with the aim to preserve the hand trajectory in space or are processed more flexibly, correcting trajectories only in task-relevant spatial dimensions. We used galvanic vestibular stimulation to perturb reaching movements toward a narrow or a wide target. Results show that the same vestibular stimulation led to smaller trajectory corrections to the wide than the narrow target. We interpret this reduced compensation as a task-dependent modulation of vestibular feedback responses, tuned to minimally intervene with the task-irrelevant dimension of the reach. These task-dependent vestibular feedback corrections are in accordance with a central prediction of optimal feedback control theory and mirror the sophistication seen in feedback responses to mechanical and visual perturbations of the upper limb. NEW & NOTEWORTHY Correcting limb movements for external perturbations is a hallmark of flexible sensorimotor behavior. While visual and mechanical perturbations are corrected in a task-dependent manner, it is unclear whether a vestibular perturbation, naturally arising when the body moves, is selectively processed in reach control. We show, using galvanic vestibular stimulation, that reach corrections to vestibular perturbations are task dependent, consistent with a prediction of optimal feedback control theory. Copyright © 2017 the American Physiological Society.

  5. Self-Chosen Goals : Incentives and Gender Differences (revision of 2015-021)

    NARCIS (Netherlands)

    Dalton, P.S.; Gonzalez Jimenez, V.H.; Noussair, Charles

    2016-01-01

    To boost employees’ performance, firms often offer monetary bonuses when production goals are reached. However, the available evidence indicates that the particular level at which a goal is set is critical to the effectiveness of this practice. Goals must be challenging yet achievable. Computing

  6. Reaching the hip-hop generation: Final (symposium proceedings) report

    Energy Technology Data Exchange (ETDEWEB)

    1993-05-01

    The goal of this final (closing) report is to capture the flavor of the symposium held March 1 and 2, 1993 in New York City convened by Motivational Educational Entertainment, Inc. (MEE), a black-owned communications research, consulting, and video production company based in Philadelphia, Pennsylvania. The mission of MEE is to understand, reach, and positively affect inner-city youth. Traditional communication approaches from mainstream sources to at-risk youth often don`t account for the unique way youth communicate among themselves and how they relate to the media. This understanding, however, is crucial. To understand youth communication, the people who create and send both entertaining and educational messages to urban youth must be brought into the dialogue. The meeting in New York was intended to provide an important opportunity for senders to meet and evaluate the appropriateness and effectiveness of their messages. In addition, the MEE symposium provided a forum for the continuing public debate about what needs to be done to reach today`s urban teens. Included in this document is a description of symposium goals/objectives, symposium activities, the reaction to and analysis of the symposium, recommendations for future MEE courses of action, and an appendix containing copies of press articles.

  7. Taking a low glycemic index multi-nutrient supplement as breakfast improves glycemic control in patients with type 2 diabetes mellitus: a randomized controlled trial.

    Science.gov (United States)

    Li, Di; Zhang, Peiwen; Guo, Honghui; Ling, Wenhua

    2014-12-10

    Dietary therapy is the mainstay of treatment for diabetes. This study examined the effect of a low glycemic index (GI) multi-nutrient supplement, consumed in place of breakfast, on glycemic control in patients with type 2 diabetes mellitus (T2DM). A total of 71 participants were randomized at a 2:1 ratio into either a breakfast replacement group or a normal breakfast group for a 12-week interventional study. The primary outcome measure was change in hemoglobin A1c (HbA1c). Nutrition status and somatometry were studied as secondary outcomes. The breakfast replacement group displayed a -0.2% absolute reduction in HbA1c (95% CI (confidence interval), -0.38% to -0.07%, p = 0.004), while the HbA1c of the control group increased 0.3% (95% CI, 0.1% to 0.5%, p = 0.005). The baseline Mini Nutritional Assessment score for both groups was 26.0 and no significant changes occurred following intervention. However, there was a statistically significant difference in body mass index between the treatment and control groups (p = 0.032) due to the weight gain in the control group (increased 0.5 kg, 95% CI was 0.2 to 0.9, p = 0.007). These data suggest that breakfast replacement with a low GI multi-nutrient supplement can improve glycemic and weight control in T2DM.

  8. The Millennium Development Goals, How Realistic Are They?

    NARCIS (Netherlands)

    Keyzer, M.A.; van Wesenbeeck, C.F.A.

    2006-01-01

    In its Millennium Declaration of September 2000, the United Nations adopted the Millennium Development Goals (MDG), to be reached in 2015 through concerted efforts worldwide. According to UN-calculations, the estimated costs in terms of additional development aid of meeting the MDGs in all countries

  9. Do working environment interventions reach shift workers?

    Science.gov (United States)

    Nabe-Nielsen, Kirsten; Jørgensen, Marie Birk; Garde, Anne Helene; Clausen, Thomas

    2016-01-01

    Shift workers are exposed to more physical and psychosocial stressors in the working environment as compared to day workers. Despite the need for targeted prevention, it is likely that workplace interventions less frequently reach shift workers. The aim was therefore to investigate whether the reach of workplace interventions varied between shift workers and day workers and whether such differences could be explained by the quality of leadership exhibited at different times of the day. We used questionnaire data from 5361 female care workers in the Danish eldercare sector. The questions concerned usual working hours, quality of leadership, and self-reported implementation of workplace activities aimed at stress reduction, reorganization of the working hours, and participation in improvements of working procedures or qualifications. Compared with day workers, shift workers were less likely to be reached by workplace interventions. For example, night workers less frequently reported that they had got more flexibility (OR 0.5; 95 % CI 0.3-0.7) or that they had participated in improvements of the working procedures (OR 0.6; 95 % CI 0.5-0.8). Quality of leadership to some extent explained the lack of reach of interventions especially among fixed evening workers. In the light of the evidence of shift workers' stressful working conditions, we suggest that future studies focus on the generalizability of results of the present study and on how to reach this group and meet their needs when designing and implementing workplace interventions.

  10. Pengaruh Goal Setting terhadap Performance : Tinjauan Teoritis

    OpenAIRE

    Ginting, Surya Dharma; Ariani, D. Wahyu

    2004-01-01

    This article is the conceptual view of goal setting theory and effects of goal setting on individual performance. Goal setting is recognized, and is a major theory of work motivation. Difficult goals have consistently been shown to lead to higher levels of performance than easy goals. If there is no commitment, a goal can have no motivational effect. Goals are central to current treatments of work motivation, and goal commitment is a necessary condition for difficult goals to result in higher...

  11. Association of Exercise Stages of Change with Glycemic Control in Individuals with Type 2 Diabetes.

    Science.gov (United States)

    Natarajan, Sundar; Clyburn, Ernest B.; Brown, Ronald T.

    2002-01-01

    Investigated the distribution of diabetic patients' stages of change to follow an exercise regimen, examining whether later stages of change were associated with better glycemic control. Data on participants from a primary care clinic (who were predominantly black, female, and indigent) indicated that over half of were in pre-contemplation,…

  12. Exercise and 24-h Glycemic Control: Equal Effects for All Type 2 Diabetes Patients?

    NARCIS (Netherlands)

    van Dijk, J.W.; Manders, R.J.F.; Canfora, E.E.; van Mechelen, W.; Hartgens, F.; Stehouwer, C.D.A.; van Loon, L.J.C.

    2013-01-01

    Purpose: We assessed the effect of a single bout of moderate-intensity exercise on subsequent 24-h glycemic control in 60 type 2 diabetes patients. Moreover, we examined whether individual responses to exercise were related to subjects' baseline characteristics, including age, body mass index,

  13. Glycemic control during consecutive days with prolonged walking exercise in individuals with type 1 diabetes mellitus.

    Science.gov (United States)

    van Dijk, Jan-Willem; Eijsvogels, Thijs M; Nyakayiru, Jean; Schreuder, Tim H A; Hopman, Maria T; Thijssen, Dick H; van Loon, Luc J C

    2016-07-01

    Despite its general benefits for health, exercise complicates the maintenance of stable blood glucose concentrations in individuals with type 1 diabetes. The aim of the current study was to examine changes in food intake, insulin administration, and 24-h glycemic control in response to consecutive days with prolonged walking exercise (∼8h daily) in individuals with type 1 diabetes. Ten individuals with type 1 diabetes participating in the worlds' largest walking event were recruited for this observational study. Simultaneous measurements of 24-h glycemic control (continuous glucose monitoring), insulin administration and food intake were performed during a non-walking day (control) and during three subsequent days with prolonged walking exercise (daily distance 40 or 50km). Despite an increase in daily energy (31±18%; p10 mmol/L) and hypoglycemia (blood glucose 0.05 for all variables). The prolonged walking exercise was associated with a modest increase in glycemic variability compared with the control day (pexercise allows for profound reductions in daily insulin administration in persons with type 1 diabetes, despite large increments in energy and carbohydrate intake. When taking such adjustments into account, prolonged moderate-intensity exercise does not necessarily impair 24-h glycemic control. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Effects on Glycemic Control in Impaired Wound Healing in Spontaneously Diabetic Torii (SDT) Fatty Rats.

    Science.gov (United States)

    Katsuhiro, Miyajima; Hui Teoh, Soon; Yamashiro, Hideaki; Shinohara, Masami; Fatchiyah, Fatchiyah; Ohta, Takeshi; Yamada, Takahisa

    2018-02-01

    Impaired diabetic wound healing is an important issue in diabetic complications. The present study aims to evaluate the protective effect on glycemic control against impaired diabetic wound healing using a diabetic rat model. We investigated the wound healing process and effect on the impaired wound repair by glycemic control in the Spontaneously Diabetic Torii (SDT) fatty rat, which is a new animal model of obese type 2 diabetes and may be a good model for study impaired wound healing. Male SDT fatty rats at 15 weeks of age were administered orally with sodium glucose co-transporter (SGLT) 2 inhibitor for 3 weeks. Wounds were induced at 2 weeks after SGLT 2 inhibitor treatment, and the wound areas were periodically examined in morphological and histological analyses. The SDT fatty rats showed a delayed wound healing as compared with the normal rats, but a glycemic control improved the impaired wound healing. In histological analysis in the skin of SDT fatty rats showed severe infiltration of inflammatory cell, hemorrhage and many bacterial masses in the remaining and slight fibrosis of crust on skin tissue . Thought that this results skin performance to be a delay of crust formation and regeneration of epithelium; however, these findings were ameliorated in the SGLT 2 inhibitor treated group. Glycemic control is effective for treatment in diabetic wounds and the SDT fatty rat may be useful to investigate pathophysiological changes in impaired diabetic wound healing.

  15. Glycemic control in diabetic children and adolescents after attending diabetic camp

    Directory of Open Access Journals (Sweden)

    Erwin P. Soenggono

    2011-10-01

    Conclusion Glycemic control in T1DM children and adolescents was significantly improved 3 months after attending diabetic camp compared to that before attending camp. According to subjects’ self-assessment by PedsQL questionnaire, no subjects indicated a poor quality of life for the duration of their illness. [Paediatr Indones. 2011;51:294-7].

  16. The influence of carbohydrate consumption on glycemic control in pregnant women with type 1 diabetes

    DEFF Research Database (Denmark)

    Asbjörnsdóttir, Björg; Akueson, Cecelia E.; Ronneby, Helle

    2017-01-01

    , as a part of routine care. The total daily carbohydrate consumption from the major sources (e.g. bread, potatoes, rice, pasta, dairy products, fruits, candy) was calculated. A dietician estimated the overall glycemic index score (scale 0–7). Results At least two days of diet recording were available in 75...

  17. Informing food choices and health outcomes by use of the dietary glycemic index

    Science.gov (United States)

    Considerable epidemiologic evidence links consuming lower glycemic index (GI) diets with good health, particularly upon aging. The GI is a kinetic parameter that reflects the ability of carbohydrate (CHO) contained in consumed foods to raise blood glucose in vivo. Newer nutritional, clinical, and ex...

  18. A low-glycemic-index diet reduces plasma PAI-1 activity in overweight women

    DEFF Research Database (Denmark)

    Jensen, Lotte

    diet. Still, the relevance of GI in preventing the metabolic syndrome is controversial. Objectives The main purpose of the present study was to investigate the effect of 10 weeks intake of a low glycemic index vs. a high glycemic index high-carbohydrate, low fat ad libitum diet on plasma PAI-1 activity...... to decrease during weight loss. However, the beneficial effects of healthy diets on PAI-1 levels may not solely depend on weight loss, but other factors may also play a role. For example better glycemic control has been observed in diabetic patients after a low glycemic index (GI) diet compared to a high GI...... and antigen levels in overweight women. Methods 45 healthy overweight women (BMI 27.6 ± 0.2 kg/m2) were randomly assigned to a parallel 10 week intervention with a low GI (n=23) or high GI (n=22) diet. Fasting blood samples were obtained before and after the 10 weeks. To study the postprandial effect of LGI...

  19. Dietary hyperglycemia, glycemic index and age-related metabolic retinal diseases

    Science.gov (United States)

    The glycemic index (GI) indicates how fast blood glucose is raised after consuming a carbohydrate-containing food. Human metabolic studies indicate that GI is related to patho-physiological responses after meals. Compared with a low-GI meal, a high-GI meal is characterized with hyperglycemia during ...

  20. Glycemic Control in a Clinic-Based Sample of Diabetics in M'Bour Senegal

    Science.gov (United States)

    BeLue, Rhonda; Ndiaye, Khadidiatou; NDao, Fatou; Ba, Fatou Niass Niang; Diaw, Mor

    2016-01-01

    Background: Sub-Saharan Africa (SSA) including Senegal is faced with a significant and increasing burden of type 2 diabetes. However, little information is available about diabetes management among Senegalese diabetics. Purpose: The current study aims to describe the level of glycemic control among a convenience sample of diabetics who receive…

  1. A Low-Glycemic Diet Lifestyle Intervention Improves Fat Utilization during Exercise in Older Obese Humans

    DEFF Research Database (Denmark)

    Solomon, Thomas; Haus, Jacob M; Cook, Marc A

    2013-01-01

    Objective: To determine the influence of dietary glycemic index on exercise training-induced adaptations in substrate oxidation in obesity. Design and Methods: Twenty older, obese individuals undertook 3 months of fully supervised aerobic exercise and were randomized to low- (LoGIX) or high-glyce...

  2. Association between Social Relationship and Glycemic Control among Older Japanese: JAGES Cross-Sectional Study

    Science.gov (United States)

    Kawachi, Ichiro; Kondo, Katsunori; Kondo, Naoki; Nagamine, Yuiko; Tani, Yukako; Shirai, Kokoro; Tazuma, Susumu

    2017-01-01

    Aim The present study examined whether social support, informal socializing and social participation are associated with glycemic control in older people. Methods Data for this population-based cross-sectional study was obtained from the Japan Gerontological Evaluation Study (JAGES) 2010 linked to the annual health check-up data in Japan. We analyzed 9,554 individuals aged ≥65 years without the certification of needed long-term care. Multivariate logistic regression models were used to assess the effect of social support, informal socializing and social participations on glycemic control. The outcome measure was HbA1c ≥8.4%. Results 1.3% of the participants had a level of HbA1c over 8.4%. Better glycemic control was significantly associated with meeting with friends one to four times per month (odds ratio [OR] 0.51, 95% confidence interval [CI]0.30–0.89, compared to meeting with friends a few times per year or less) and participation in sports groups (OR 0.50, 95% CI 0.26–0.97) even after adjusting for other variables. Meeting with friends more than twice per week, receiving social support, and being married were not associated with better control of diabetes. Conclusions Meeting with friends occasionally is associated with better glycemic control among older people. PMID:28060887

  3. Association between Social Relationship and Glycemic Control among Older Japanese: JAGES Cross-Sectional Study.

    Science.gov (United States)

    Yokobayashi, Kenichi; Kawachi, Ichiro; Kondo, Katsunori; Kondo, Naoki; Nagamine, Yuiko; Tani, Yukako; Shirai, Kokoro; Tazuma, Susumu

    2017-01-01

    The present study examined whether social support, informal socializing and social participation are associated with glycemic control in older people. Data for this population-based cross-sectional study was obtained from the Japan Gerontological Evaluation Study (JAGES) 2010 linked to the annual health check-up data in Japan. We analyzed 9,554 individuals aged ≥65 years without the certification of needed long-term care. Multivariate logistic regression models were used to assess the effect of social support, informal socializing and social participations on glycemic control. The outcome measure was HbA1c ≥8.4%. 1.3% of the participants had a level of HbA1c over 8.4%. Better glycemic control was significantly associated with meeting with friends one to four times per month (odds ratio [OR] 0.51, 95% confidence interval [CI]0.30-0.89, compared to meeting with friends a few times per year or less) and participation in sports groups (OR 0.50, 95% CI 0.26-0.97) even after adjusting for other variables. Meeting with friends more than twice per week, receiving social support, and being married were not associated with better control of diabetes. Meeting with friends occasionally is associated with better glycemic control among older people.

  4. Experience and acceptability of diets of varying protein content and glycemic index in an obese cohort

    DEFF Research Database (Denmark)

    McConnon, A; Horgan, G W; Lawton, C

    2013-01-01

    Background/Objectives:To investigate acceptability and tolerability of diets of different protein and glycemic index (GI) content aimed at weight maintenance following a phase of rapid weight loss, as part of a large pan-European dietary intervention trial.Subjects/Methods:The Diogenes study (www...

  5. Glycemic, insulinemic, and appetite responses of patients with type 2 diabetes to commonly consumed breads.

    Science.gov (United States)

    Breen, Cathy; Ryan, Miriam; Gibney, Michael J; Corrigan, Michelle; O'Shea, Donal

    2013-01-01

    The purpose of this study was to identify the breads most commonly consumed by adults with type 2 diabetes (T2DM) and then examine the postprandial glycemic, insulinemic, and appetite responses that these breads elicit. One hundred people with T2DM were surveyed to identify the varieties of bread they most frequently consumed. According to a randomized crossover design, 11 fasting participants with T2DM consumed 50 g of available carbohydrate from 4 breads. Glucose and insulin concentrations and appetite ratings were determined over 270 minutes. Three commonly consumed varieties (white, whole wheat buttermilk, whole grain) identified in the survey-plus a lower-glycemic-index "control" bread (pumpernickel rye)-were tested in the second phase. Despite perceived differences between "brown" and "white" breads, the white, whole wheat buttermilk, and wholegrain breads promoted similar glycemic and insulinemic responses. Pumpernickel bread resulted in a significantly lower peak glucose (P breads and a lower peak insulin (P bread. Similar appetite responses were found with all 4 breads. Adults with T2DM are choosing a variety of breads with perceived differential effects on glycemic, insulinemic, and appetite responses. Appreciable benefits, however, are not conferred by the commonly consumed breads. If breads known to promote favorable metabolic responses are unavailable, the primary emphasis in education should be placed on portion control. Conveying this information to patients is crucial if nutrition education is to achieve its aim of empowering individuals to manage their diabetes through their food choices.

  6. Glycemic control in the infectious diseases ward; role of clinical pharmacist interventions.

    Science.gov (United States)

    Farsaei, Shadi; Karimzadeh, Iman; Elyasi, Sepideh; Hatamkhani, Shima; Khalili, Hossein

    2014-04-15

    Hyperglycemia is one of the most frequent metabolic complications in hospitalized patients. Increased risk of infection following hyperglycemia has been reported in hospitalized patients and infections may also cause insulin resistance which complicates the control of blood glucose level. In this study the impact of the clinical pharmacist interventions on the glycemic control in patients admitted to infectious diseases ward has been evaluated. We conducted a prospective, pre-post interventional study among patients with hyperglycemia. The clinical pharmacist-led multidisciplinary team managed the glycemic profile of patients according to an established insulin protocol commonly used in internal wards. Clinical pharmacists reviewed patients' medical charts for proper insulin administration, evaluated nurses' technique for insulin injection and blood glucose measurement, and educated patients about symptoms of hypoglycemia and the importance of adherence to different aspects of their glycemic management. The percentage of controlled random blood sugar increased from 13.8% in the pre-intervention to 22.3% in the post-intervention group (p value percentage of controlled fasting blood sugars in the post-intervention group was non-significantly higher than in the pre-intervention group. Pharmacists and additional health care providers from other departments such as nursing and dietary departments need to be devoted to glycemic control service. Collaborative practice agreement between physicians is necessary to promote this service and help to increase the use of such services in different settings for diabetes control.

  7. Effect of Glycemic Index of a Pre-exercise Meal on Endurance Exercise Performance

    NARCIS (Netherlands)

    Burdon, Catriona A.; Spronk, Inge; Cheng, Hoi Lun; O’Connor, Helen T.

    2017-01-01

    Background: Low glycemic index (GI) pre-exercise meals may enhance endurance performance by maintaining euglycemia and altering fuel utilization. However, evidence for performance benefits is equivocal. Objective: To evaluate the effect of a low GI (LGI) versus a high GI (HGI) pre-exercise meal on

  8. Glycemic control during consecutive days with prolonged walking exercise in individuals with type 1 diabetes mellitus.

    NARCIS (Netherlands)

    Dijk, J.W.; Eijsvogels, T.M.H.; Nyakayiru, J.D.O.A.; Schreuder, T.H.A.; Hopman, M.T.E.; Thijssen, D.H.J.; Loon, L.J. van

    2016-01-01

    AIMS: Despite its general benefits for health, exercise complicates the maintenance of stable blood glucose concentrations in individuals with type 1 diabetes. The aim of the current study was to examine changes in food intake, insulin administration, and 24-h glycemic control in response to

  9. Guiding Warfare to Reach Sustainable Peace

    DEFF Research Database (Denmark)

    Vestenskov, David; Drewes, Line

    The conference report Guiding Warfare to Reach Sustainable Peace constitutes the primary outcome of the conference It is based on excerpts from the conference presenters and workshop discussions. Furthermore, the report contains policy recommendations and key findings, with the ambition of develo......The conference report Guiding Warfare to Reach Sustainable Peace constitutes the primary outcome of the conference It is based on excerpts from the conference presenters and workshop discussions. Furthermore, the report contains policy recommendations and key findings, with the ambition...... of developing best practices in the education and implementation of IHL in capacity building of security forces....

  10. Do working environment interventions reach shift workers?

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Jørgensen, Marie Birk; Garde, Anne Helene

    2016-01-01

    PURPOSE: Shift workers are exposed to more physical and psychosocial stressors in the working environment as compared to day workers. Despite the need for targeted prevention, it is likely that workplace interventions less frequently reach shift workers. The aim was therefore to investigate whether...... the reach of workplace interventions varied between shift workers and day workers and whether such differences could be explained by the quality of leadership exhibited at different times of the day. METHODS: We used questionnaire data from 5361 female care workers in the Danish eldercare sector...

  11. Goal-Oriented Ethics: Framing the Goal-Setting Concretely

    Directory of Open Access Journals (Sweden)

    Mathew Illathuparampil

    2017-10-01

    Full Text Available Joseph Selling, professor emeritus from KU Leuven, Belgium, recently made a significant contribution towards ethical methodology. It is in fact a continuation of the in-house conversations that have been in vogue about methods in moral reasoning since Vatican II in the discipline called theological ethics. What is specific about Selling’s attempt is that he re-orients or reframes the evaluation of the moral event to consider human intentionality or motivation before considering human behavior or human acts. He convincingly establishes his method by a meticulous reading of Thomas Aquinas. This paper is a response to the goal-oriented ethics that he has posited. As illustrated below, this paper evaluates the goal-oriented approach as solid and sufficient. While fully endorsing this approach, this paper argues that the process of ethical goal-setting is to be framed concretely. In a concrete historical context, so that a goal-oriented approach fully serves its purpose, this paper proposes that it is to be reinforced by four supportive pillars, which are in fact assumed by Selling in his work. They are openness to human sciences, conversation among various narratives, positing a theological frame for ethical reasoning, and recourse to non-discursive reasoning.

  12. [Moderate exercise and intake of either high or low glycemic index carbohydrates in sedentary women].

    Science.gov (United States)

    Ortiz-Rodríguez, Briseidy; De León, Lidia G; Esparza-Romero, Julián; Carrasco-Legleu, Claudia E; Candia-Luján, Ramón

    2018-05-25

    To analyze changes in blood glucose, insulin and triglyceride concentrations in relation to a moderate aerobic exercise in sedentary women of different body weight, exposed to either a high or low glycemic index carbohydrates diet. DISEñO: Cross-over type. SITE: Research was performed in the Exercise Physiology Laboratory at Facultad de Ciencias de la Cultura Física, Universidad Autónoma de Chihuahua, México. Twenty-six young sedentary women who did not exercise in the last year participated in the study. Four of adequate weight (AW) and 2 with obesity (OB) were excluded for not consuming the suggested carbohydrates (1gr/kg of weight) nor completed the programed exercise. There were n=10 in each group (AW/OB). Two treatments of 55minutes of aerobic exercise each were applied one day after consuming either high or low glycemic index carbohydrates. Plasmatic glucose, insulin, and triglycerides were determined before and after the scheduled exercise. Glucose, insulin, and triglycerides were higher in OB than in AW at baseline. Glucose was normalized in OB from 5.8±0.35 to 5.3±0.23 mmol/L (P=.001), only by eating foods with low glycemic index; triglycerides increased from 139.5±66.0 to 150.8±67.2mg/dl (P=.004) at the end of the exercise, after consumption of low glycemic index carbohydrates. Elevation of triglycerides secondary to exercise after consumption of low glycemic index seems to indicate an increase of lipid oxidation in OB. Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Fortification of seaweed (Eucheuma cottonii) flour on nutrition, iodine, and glycemic index of pasta

    Science.gov (United States)

    Firdaus, Muhamad; Yahya; Raditya Hardany Nugraha, Galih; Dwi Utari, Dyah

    2017-10-01

    Pasta is a nutritious and energy product which produced from the dough of wheat flour and water. It contains less of iodine and high of glycemic index. Euchema cottonii belongs of red seaweed is food substance that contains much of iodine and dietary fiber. The objective of this study was to know the fortification effect of E. cottonii flour on the nutrition, iodine, and glycemic index of pasta. E. cottonii was collected from the culture farm of E. cottonii on the Wongsorejo beach, District of Banyuwangi, East Java on April-June 2015. Wheat flour and pasta ingredients were obtained locally at shops of Pasar Besar, Malang. Pasta was produced by weighing of components, mixing, dough, milling, steaming and drying. E. cottonii flour was added on mixing process at 0; 7; 14 and 21 % of ingredients. The parameter of this study was the level of water, lipid, protein, ash, and carbohydrate (by difference), iodine, crude fiber, the total of dietary fiber, soluble fiber, insoluble fiber, and glycemic index, respectively. Data were analyzed by variance and the least square difference used to determine the difference between treatments. The highest concentration group showed more nutritious than other treatments. The characters of its product were water 6.70%, lipid 2.26%, protein 23.09%, ash 14.11%, carbohydrate 53.84%, iodine 3.71 ppm, crude fiber 8.02%, the total of dietary fiber 20.88%, soluble fiber 11.69%, insoluble fiber 9.19%, and glycemic index 44.45, respectively. In conclusion, the fortification of E. cottonii flour enhances the nutrition value, iodine content, and glycemic index of pasta.

  14. Antithyroid Therapy Improves Glycemic Control in Hyperthyroid Type 1 Diabetes Mellitus Patients

    Directory of Open Access Journals (Sweden)

    Vlad Mihaela

    2015-12-01

    Full Text Available Background and aims. Thyroid disorders are more frequently met in patients with diabetes mellitus than in general population. Thyroid hormones increase glycemia by several mechanisms, but the effect of antithyroid treatment on glucose control in type 1 diabetes mellitus (T1DM cases is not well studied. The aim of our work was to analyze the evolution of glycemic control of T1DM patients submitted to specific therapy when hyperthyroidism was diagnosed. Material and method. The study group comprised by 37 patients, 35 women (94.6% and 2 men (5.4%, known as having T1DM and diagnosed with hyperthyroidism during a 10-years interval. They were treated with antithyroid medication and reassessed after 6 months regarding thyroid function and glycemic control. Results. In the whole group, there was a significant decrease in mean HbA1c level (with 0.41% and a significant increase in the percentage of patients being in the glycemic target (from 10.8% to 35.1%. The better glycemic control was obtained with a lower mean insulin dose. Patients who became euthyroid had a better evolution regarding glucose control in comparison to those who remained hyperthyroid. Changes in other cardiovascular risk factors were noted: systolic blood pressure decreased; diastolic blood pressure, HDL cholesterol, LDL cholesterol, non-HDL cholesterol, triglycerides and body weight increased. TSH and HbA1c values were inversely correlated. Conclusions. The therapeutic control of excessive thyroid function significantly contributes to the improvement of glycemic control in patients with T1DM and induces changes in the cardiovascular risk factors profile.

  15. Serum bilirubin levels are positively associated with glycemic variability in women with type 2 diabetes.

    Science.gov (United States)

    Kim, Lee Kyung; Roh, Eun; Kim, Min Joo; Kim, Min Kyeong; Park, Kyeong Seon; Kwak, Soo Heon; Cho, Young Min; Park, Kyong Soo; Jang, Hak Chul; Jung, Hye Seung

    2016-11-01

    Glycemic variability is known to induce oxidative stress. We investigated the relationships between glycemic variability and serum bilirubin levels, an endogenous anti-oxidant, in patients with diabetes. A cross-sectional study was carried out with 77 patients with type 2 diabetes who had been recruited to two clinical studies from 2008 to 2014. There were no participants with diseases of the pancreas, liver, biliary tract and chronic renal insufficiency. Glycemic variation was calculated by a continuous glucose monitoring system, and correlation analyses were carried out to evaluate their association with bilirubin levels. Multiple linear regression was carried out to identify independent factors influencing bilirubin levels and glycemic variation. Among the participants, 42.3% were men. The mean (standard deviation) age was 61.5 years (10.4 years), body mass index was 24.2 kg/m 2 (2.8 kg/m 2 ), diabetes duration was 17.7 years (9.5 years), hemoglobin A 1c was 60.7 mmol/mol (7.1 mmol/mol; 7.7 [0.7]%) and bilirubin was 11.8 μmol/L (4.10 μmol/L). Serum bilirubin levels were not different according to age, body mass index and hemoglobin A 1c . However, the mean amplitude of glucose excursion was positively associated with bilirubin levels in women (r = 0.588, P bilirubin and mean amplitude of glucose excursion remained significant (r = 0.566, P bilirubin was an independent determinant for the mean amplitude of glucose excursion in women. 1,5-Anhydroglucitol was also associated with bilirubin levels in women. Bilirubin level within the physiological range might be an independent predictor for glycemic variability in women with type 2 diabetes. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  16. Plasma adiponectin concentrations are associated with dietary glycemic index in Malaysian patients with type 2 diabetes.

    Science.gov (United States)

    Loh, Beng-In; Sathyasuryan, Daniel Robert; Mohamed, Hamid Jan Jan

    2013-01-01

    Adiponectin, an adipocyte-derived hormone has been implicated in the control of blood glucose and chronic inflammation in type 2 diabetes. However, limited studies have evaluated dietary factors on plasma adiponectin levels, especially among type 2 diabetic patients in Malaysia. The aim of this study was to investigate the influence of dietary glycemic index on plasma adiponectin concentrations in patients with type 2 diabetes. A cross-sectional study was conducted in 305 type 2 diabetic patients aged 19-75 years from the Penang General Hospital, Malaysia. Socio-demographic information was collected using a standard questionnaire while dietary details were determined by using a pre-validated semi-quantitative food frequency questionnaire. Anthropometry measurement included weight, height, BMI and waist circumference. Plasma adiponectin concentrations were measured using a commercial ELISA kit. Data were analyzed using multiple linear regression. After multivariate adjustment, dietary glycemic index was inversely associated with plasma adiponectin concentrations (β =-0.272, 95% CI -0.262, - 0.094; pfoods containing high dietary glycemic index that plasma adiponectin level reduced by 0.3 μg/mL. Thirty two percent (31.9%) of the variation in adiponectin concentrations was explained by age, sex, race, smoking status, BMI, waist circumference, HDL-C, triglycerides, magnesium, fiber and dietary glycemic index according to the multiple linear regression model (R2=0.319). These results support the hypothesis that dietary glycemic index influences plasma adiponectin concentrations in patients with type 2 diabetes. Controlled clinical trials are required to confirm our findings and to elucidate the underlying mechanism.

  17. Reaching Reluctant Students: Insights from Torey Hayden.

    Science.gov (United States)

    Marlowe, Mike

    1999-01-01

    Illustrates principles of reaching students who fight or avoid adults by using examples drawn from the writings of Torey Hayden. Presents ten concepts that can serve as guidelines for building relationships with resistant children, and gives excerpts from Hayden's works to illustrate each concept. Demonstrates how books provide teachers with…

  18. ATLAS Barrel Toroid magnet reached nominal field

    CERN Multimedia

    2006-01-01

     On 9 November the barrel toroid magnet reached its nominal field of 4 teslas, with an electrical current of 21 000 amperes (21 kA) passing through the eight superconducting coils as shown on this graph

  19. Don't You Want to Do Better? Implementing a Goal-Setting Intervention in an Afterschool Program

    Science.gov (United States)

    Hallenbeck, Amy; Fleming, David

    2011-01-01

    Goal setting is not an innate skill. Adults who are successful at reaching their goals have learned to set realistic goals and to plan to attain them. Afterschool programs, because they have latitude in their curricular offerings and program elements, can provide strong backdrops for goal-setting initiatives. While studies have shown that goal…

  20. Defining safety goals. 2. Basic Consideration on Defining Safety Goals

    International Nuclear Information System (INIS)

    Hakata, T.

    2001-01-01

    The purpose of this study is to develop basic safety goals that are rational and consistent for all nuclear facilities, including nuclear power plants and fuel cycle facilities. Basic safety goals (risk limits) by an index of radiation dose are discussed, which are based on health effects of detriment and fatality and risk levels presumably accepted by society. The contents of this paper are the personal opinions of the author. The desirable structure of safety goals is assumed to be 'basic safety goals plus specific safety goals (or supplemental safety goals) for each sort of facility, which reflects their characteristics'. The requisites of the basic safety goals must include (a) rational bases (scientific and social), (b) comprehensiveness (common to all sorts of nuclear facilities covering from normal to accidental conditions), and (c) applicability. To meet the requirements, the basic safety goals might have to be a risk profile expression by an index of radiation dose. The societal rationality is consideration of absolute risk levels (10 -6 or 10 -7 /yr) and/or relative risk factors (such as 0.1% of U.S. safety goals) that the general public accepts as tolerable. The following quantitative objectives are adopted in this study for protection of average individuals in the vicinity of a nuclear facility: 1. The additive annual radiation dose during normal operation must be -4 /yr (health detriment), 2x10 -6 /yr (latent cancer and severe hereditary effects), and 10 -7 /yr (acute fatality) from the statistics in Japan. The radiation effects on human beings are determined by recommendations of UNSCEAR (Ref. 1) and ICRP. The health effects considered are non-severe stochastic health detriment, i.e., detectable opacities of lens of eye (threshold 5 0.5 to 2 Sv), depression of hematopoiesis of bone marrow (0.5 Sv), and depression of reproductive capability (temporary sterility of testes ) (0.15 Sv). The LD 50/60 of acute fatality is ∼4 Sv, and fatalities by latent

  1. The processing of visual and auditory information for reaching movements.

    Science.gov (United States)

    Glazebrook, Cheryl M; Welsh, Timothy N; Tremblay, Luc

    2016-09-01

    Presenting target and non-target information in different modalities influences target localization if the non-target is within the spatiotemporal limits of perceptual integration. When using auditory and visual stimuli, the influence of a visual non-target on auditory target localization is greater than the reverse. It is not known, however, whether or how such perceptual effects extend to goal-directed behaviours. To gain insight into how audio-visual stimuli are integrated for motor tasks, the kinematics of reaching movements towards visual or auditory targets with or without a non-target in the other modality were examined. When present, the simultaneously presented non-target could be spatially coincident, to the left, or to the right of the target. Results revealed that auditory non-targets did not influence reaching trajectories towards a visual target, whereas visual non-targets influenced trajectories towards an auditory target. Interestingly, the biases induced by visual non-targets were present early in the trajectory and persisted until movement end. Subsequent experimentation indicated that the magnitude of the biases was equivalent whether participants performed a perceptual or motor task, whereas variability was greater for the motor versus the perceptual tasks. We propose that visually induced trajectory biases were driven by the perceived mislocation of the auditory target, which in turn affected both the movement plan and subsequent control of the movement. Such findings provide further evidence of the dominant role visual information processing plays in encoding spatial locations as well as planning and executing reaching action, even when reaching towards auditory targets.

  2. Multi-scale glycemic variability: a link to gray matter atrophy and cognitive decline in type 2 diabetes.

    Directory of Open Access Journals (Sweden)

    Xingran Cui

    Full Text Available Type 2 diabetes mellitus (DM accelerates brain aging and cognitive decline. Complex interactions between hyperglycemia, glycemic variability and brain aging remain unresolved. This study investigated the relationship between glycemic variability at multiple time scales, brain volumes and cognition in type 2 DM.Forty-three older adults with and 26 without type 2 DM completed 72-hour continuous glucose monitoring, cognitive tests and anatomical MRI. We described a new analysis of continuous glucose monitoring, termed Multi-Scale glycemic variability (Multi-Scale GV, to examine glycemic variability at multiple time scales. Specifically, Ensemble Empirical Mode Decomposition was used to identify five unique ultradian glycemic variability cycles (GVC1-5 that modulate serum glucose with periods ranging from 0.5-12 hrs.Type 2 DM subjects demonstrated greater variability in GVC3-5 (period 2.0-12 hrs than controls (P<0.0001, during the day as well as during the night. Multi-Scale GV was related to conventional markers of glycemic variability (e.g. standard deviation and mean glycemic excursions, but demonstrated greater sensitivity and specificity to conventional markers, and was associated with worse long-term glycemic control (e.g. fasting glucose and HbA1c. Across all subjects, those with greater glycemic variability within higher frequency cycles (GVC1-3; 0.5-2.0 hrs had less gray matter within the limbic system and temporo-parietal lobes (e.g. cingulum, insular, hippocampus, and exhibited worse cognitive performance. Specifically within those with type 2 DM, greater glycemic variability in GVC2-3 was associated with worse learning and memory scores. Greater variability in GVC5 was associated with longer DM duration and more depression. These relationships were independent of HbA1c and hypoglycemic episodes.Type 2 DM is associated with dysregulation of glycemic variability over multiple scales of time. These time-scale-dependent glycemic fluctuations

  3. Effect of an Intensive Lifestyle Intervention on Glycemic Control in Patients With Type 2 Diabetes: A Randomized Clinical Trial.

    Science.gov (United States)

    Johansen, Mette Yun; MacDonald, Christopher Scott; Hansen, Katrine Bagge; Karstoft, Kristian; Christensen, Robin; Pedersen, Maria; Hansen, Louise Seier; Zacho, Morten; Wedell-Neergaard, Anne-Sophie; Nielsen, Signe Tellerup; Iepsen, Ulrik Wining; Langberg, Henning; Vaag, Allan Arthur; Pedersen, Bente Klarlund; Ried-Larsen, Mathias

    2017-08-15

    .5%) in the lifestyle group and 9 participants (26.4%) in the standard care group (difference, 47.1 percentage points [95% CI, 28.6-65.3]). There were 32 adverse events (most commonly musculoskeletal pain or discomfort and mild hypoglycemia) in the lifestyle group and 5 in the standard care group. Among adults with type 2 diabetes diagnosed for less than 10 years, a lifestyle intervention compared with standard care resulted in a change in glycemic control that did not reach the criterion for equivalence, but was in a direction consistent with benefit. Further research is needed to assess superiority, as well as generalizability and durability of findings. clinicaltrials.gov Identifier: NCT02417012.

  4. Reach-to-grasp movement as a minimization process.

    Science.gov (United States)

    Yang, Fang; Feldman, Anatol G

    2010-02-01

    It is known that hand transport and grasping are functionally different but spatially coordinated components of reach-to-grasp (RTG) movements. As an extension of this notion, we suggested that body segments involved in RTG movements are controlled as a coherent ensemble by a global minimization process associated with the necessity for the hand to reach the motor goal. Different RTG components emerge following this process without pre-programming. Specifically, the minimization process may result from the tendency of neuromuscular elements to diminish the spatial gap between the actual arm-hand configuration and its virtual (referent) configuration specified by the brain. The referent configuration is specified depending on the object shape, localization, and orientation. Since the minimization process is gradual, it can be interrupted and resumed following mechanical perturbations, at any phase during RTG movements, including hand closure. To test this prediction of the minimization hypothesis, we asked subjects to reach and grasp a cube placed within the reach of the arm. Vision was prevented during movement until the hand returned to its initial position. As predicted, by arresting wrist motion at different points of hand transport in randomly selected trials, it was possible to halt changes in hand aperture at any phase, not only during hand opening but also during hand closure. Aperture changes resumed soon after the wrist was released. Another test of the minimization hypothesis was made in RTG movements to an object placed beyond the reach of the arm. It has previously been shown (Rossi et al. in J Physiol 538:659-671, 2002) that in such movements, the trunk motion begins to contribute to hand transport only after a critical phase when the shifts in the referent arm configuration have finished (at about the time when hand velocity is maximal). The minimization rule suggests that when the virtual contribution of the arm to hand transport is completed

  5. Goal Setting as Teacher Development Practice

    Science.gov (United States)

    Camp, Heather

    2017-01-01

    This article explores goal setting as a teacher development practice in higher education. It reports on a study of college teacher goal setting informed by goal setting theory. Analysis of study participants' goal setting practices and their experiences with goal pursuit offers a framework for thinking about the kinds of goals teachers might set…

  6. Some predictors of life goals in Slovenia and Croatia

    Directory of Open Access Journals (Sweden)

    Olga Poljšak Škraban

    2008-04-01

    Full Text Available Personal goals and interests play an important role in human development because they orient people's life planning, decision-making and also, therefore, their future life course. The article presents the findings of a research which explores the eventual differences between Slovenian and Croatian sample in agency-oriented and communion-oriented life goals and the analysis of significant predictors of above mentioned life goals on both samples. The research included 924 adults of both genders, aged between 21 and 70 years from Slovenia and Croatia. In the study we used the scale of Goals (Pohlman and Brunstein, 1997 and a set of questions regarding various participant's life domains and their perceived importance. The results show significant differences on agency- oriented and communion-oriented life goals between the Slovenian and Croatian sample; in both cases croatian participants reach higher results than those from slovenina sample. As significant predictors in both samples were identified (a age and importance of effective use of free time for agency-oriented goals, and (b and gender, parenthood, importance of parenthood and importance of effective use of free time for communion-oriented life goals. The differences in results are explained by respective levels of social modernisation and social welfare, given the fact the Slovenian respondents are embedded in the social environment that offers more possibilities for fullfilment of their life goals, and are closer to postmaterialism and individualism.a

  7. Goals for nuclear waste management

    International Nuclear Information System (INIS)

    Watson, R.A.

    1978-01-01

    Establishing a publicly, politically, economically, and technologically acceptable waste management system for the fuel cycle is a necessary condition for accepting the nuclear program as a national energy option. Findings are given on the technology, politics, economics, morality, aesthetics, and societal impact of waste management. Proposed goals are outlined for the regulation of waste management

  8. New Goals of Sustainable Future

    Directory of Open Access Journals (Sweden)

    Arkady Ursul

    2017-02-01

    Full Text Available This article investigates the process of transition from the Millennium Development Goals to Sustainable Development Goals (SDGs. The authors have set an objective to demonstrate that SD as a future form of development of civilization from the very beginning had a “target orientation” and from the beginning and anticipated realization and staging of the whole hierarchy of objectives needed for the establishment of an effective global governance. In the future, global development in its “anthropogenic” aspect will be to implement the goals and principles of SD, which will be updated with each new stage of the implementation of this kind of socio-natural evolution. The paper argues the position that the concept of SD should be radically transformed into a “global dimension.” Attention is drawn to the fact that Russia recognized another distant, but very important in the conceptual and theoretical perspective, global goal of “sustainable transition” — formation of the noosphere.

  9. A Goal for Nursing Education.

    Science.gov (United States)

    Marcinkiw, Karen L.

    2003-01-01

    Culturally competent nurses enable clients to feel respected, valued, and motivated to achieve health goals. A model for nursing education should develop cultural awareness, knowledge, and skills; provide cultural immersion experiences; and foster the desire to work with diverse clients. (Contains 48 references.) (SK)

  10. Inactivation of Parietal Reach Region Affects Reaching But Not Saccade Choices in Internally Guided Decisions.

    Science.gov (United States)

    Christopoulos, Vassilios N; Bonaiuto, James; Kagan, Igor; Andersen, Richard A

    2015-08-19

    The posterior parietal cortex (PPC) has traditionally been considered important for awareness, spatial perception, and attention. However, recent findings provide evidence that the PPC also encodes information important for making decisions. These findings have initiated a running argument of whether the PPC is critically involved in decision making. To examine this issue, we reversibly inactivated the parietal reach region (PRR), the area of the PPC that is specialized for reaching movements, while two monkeys performed a memory-guided reaching or saccade task. The task included choices between two equally rewarded targets presented simultaneously in opposite visual fields. Free-choice trials were interleaved with instructed trials, in which a single cue presented in the peripheral visual field defined the reach and saccade target unequivocally. We found that PRR inactivation led to a strong reduction of contralesional choices, but only for reaches. On the other hand, saccade choices were not affected by PRR inactivation. Importantly, reaching and saccade movements to single instructed targets remained largely intact. These results cannot be explained as an effector-nonspecific deficit in spatial attention or awareness, since the temporary "lesion" had an impact only on reach choices. Hence, the PPR is a part of a network for reach decisions and not just reach planning. There has been an ongoing debate on whether the posterior parietal cortex (PPC) represents only spatial awareness, perception, and attention or whether it is also involved in decision making for actions. In this study we explore whether the parietal reach region (PRR), the region of the PPC that is specialized for reaches, is involved in the decision process. We inactivated the PRR while two monkeys performed reach and saccade choices between two targets presented simultaneously in both hemifields. We found that inactivation affected only the reach choices, while leaving saccade choices intact

  11. Improving exposure scenario definitions within REACH

    DEFF Research Database (Denmark)

    Lee, Jihyun; Pizzol, Massimo; Thomsen, Marianne

    In recent years, the paradigm of chemical management system has changed from being toxicity oriented and media based to being risk oriented and receptor based. This trend is evident not only regarding environmental quality standards, but also for industrial chemical regulations. Political...... instruments to support a precautionary chemicals management system and to protect receptor’s health have also been increasing. Since 2007, the European Union adopted REACH (the Regulation on Registration, Evaluation, Authorisation and Restriction of Chemicals): REACH makes industry responsible for assessing...... and managing the risks posed by industrial chemicals and providing appropriate safety information to their users (EC, 2007). However, to ensure a high level of protection of human health and the environment, there is a need to consider ‘aggregate exposure’ including background exposures from environment which...

  12. Does workplace health promotion reach shift workers?

    DEFF Research Database (Denmark)

    Nabe-Nielsen, Kirsten; Garde, Anne Helene; Clausen, Thomas

    2015-01-01

    OBJECTIVES: One reason for health disparities between shift and day workers may be that workplace health promotion does not reach shift workers to the same extent as it reaches day workers. This study aimed to investigate the association between shift work and the availability of and participation...... in workplace health promotion. METHODS: We used cross-sectional questionnaire data from a large representative sample of all employed people in Denmark. We obtained information on the availability of and participation in six types of workplace health promotion. We also obtained information on working hours, ie......). RESULTS: In the general working population, fixed evening and fixed night workers, and employees working variable shifts including night work reported a higher availability of health promotion, while employees working variable shifts without night work reported a lower availability of health promotion...

  13. Goal setting with type 2 diabetes: a hermeneutic analysis of the experiences of diabetes educators.

    Science.gov (United States)

    Fleming, Susan E; Boyd, Angela; Ballejos, Miriam; Kynast-Gales, Susan A; Malemute, Charlene L; Armstrong Shultz, Jill; Vandermause, Roxanne K

    2013-01-01

    The purpose of this study was to explicate and interpret common experiences of diabetes educators (DEs) with patient goal setting for patients with type 2 diabetes in diabetes education. Transcripts (n = 10) from semi-structured interviews were analyzed using a hermeneutic phenomenological approach to more deeply explore the accounts of DEs' goal setting with patients with type 2 diabetes. The overarching pattern that emerged was "Striking a Balance," which subsumed 4 subthemes: Applying Theoretical-Practical Principles When Setting Goals, Identifying Idealistic-Realistic Expectations, Creating Patient-Educator-Centered Plans, and Readying-Living With Goal Setting. The pattern, "Striking a Balance," revealed a common meaning of DEs as experiences requiring balance and nuance in goal setting with patients. The results of this study combined with the tenets of the self-determination theory can provide the DEs with real-life exemplars and a theoretical framework to encourage their patients to self-manage, increase intrinsic motivation, and improve adherence related to their lifestyle changes and glycemic control. DEs, as facilitators of change, can implement these changes with flexible and reciprocal activities with their patients. The DEs owned these activities and they are: "building the bond," "sharing the session," "readying for change," "sending them home," and "bringing them back."

  14. Olefins and chemical regulation in Europe: REACH.

    Science.gov (United States)

    Penman, Mike; Banton, Marcy; Erler, Steffen; Moore, Nigel; Semmler, Klaus

    2015-11-05

    REACH (Registration, Evaluation, Authorisation and Restriction of Chemicals) is the European Union's chemical regulation for the management of risk to human health and the environment (European Chemicals Agency, 2006). This regulation entered into force in June 2007 and required manufacturers and importers to register substances produced in annual quantities of 1000 tonnes or more by December 2010, with further deadlines for lower tonnages in 2013 and 2018. Depending on the type of registration, required information included the substance's identification, the hazards of the substance, the potential exposure arising from the manufacture or import, the identified uses of the substance, and the operational conditions and risk management measures applied or recommended to downstream users. Among the content developed to support this information were Derived No-Effect Levels or Derived Minimal Effect Levels (DNELs/DMELs) for human health hazard assessment, Predicted No Effect Concentrations (PNECs) for environmental hazard assessment, and exposure scenarios for exposure and risk assessment. Once registered, substances may undergo evaluation by the European Chemicals Agency (ECHA) or Member State authorities and be subject to requests for additional information or testing as well as additional risk reduction measures. To manage the REACH registration and related activities for the European olefins and aromatics industry, the Lower Olefins and Aromatics REACH Consortium was formed in 2008 with administrative and technical support provided by Penman Consulting. A total of 135 substances are managed by this group including 26 individual chemical registrations (e.g. benzene, 1,3-butadiene) and 13 categories consisting of 5-26 substances. This presentation will describe the content of selected registrations prepared for 2010 in addition to the significant post-2010 activities. Beyond REACH, content of the registrations may also be relevant to other European activities, for

  15. Performance reach in the LHC for 2012

    International Nuclear Information System (INIS)

    Arduini, G.

    2012-01-01

    Based on the 2011 experience and Machine Development study results, the performance reach of the LHC with 25 and 50 ns beams will be addressed for operation at 3.5 and 4 TeV. The possible scrubbing scenarios and potential intensity limitations resulting from vacuum, heating will be taken into account wherever possible. The paper mainly covers the performance of the two high luminosity regions in IR1 and IR5. (author)

  16. INDICATORS FOR DIGITALIZATION OF SUSTAINABLE DEVELOPMENT GOALS IN PEEX PROGRAM

    Directory of Open Access Journals (Sweden)

    Sergey N. Bobylev

    2018-01-01

    Full Text Available This article describes the Pan-Eurasian Experiment (PEEX program and indicators for monitoring of implementation and digitalization of Sustainable Development Goals (SDG inRussia, especially environmental goals. The authors considered the possibility of integration and identification of the methodological approaches of the socio-economic research to environmental sciences. Paper gives insights into the international framework of the United nations, addreses several relevant indicators to be monitored in a Russian perspective and summarizes shortly the status of the monitoring activities and provide an overview on the main tasks for the upcoming years to reach the sustainable development goals established by the United Nations. The tasks to which the Goals divided are considered in detail. The indicators of Russian statistics that can be used to monitor the implementation of these tasks are determined. It is shown, that more detailed regional analysis and new data is needed in order to quantify the feedbackloops.

  17. Índice glicêmico e carga glicêmica de dietas consumidas por indivíduos obesos Glycemic index and glycemic load of diets consumed by obese individuals

    Directory of Open Access Journals (Sweden)

    Helena Alves de Carvalho Sampaio

    2007-12-01

    Full Text Available OBJETIVO: Avaliar o índice glicêmico e a carga glicêmica de dietas de indivíduos obesos. MÉTODOS: Trata-se de estudo retrospectivo, que analisou as fichas clínicas de 80 adultos obesos, acompanhados em um serviço privado localizado em Fortaleza, Ceará. Determinaram-se o índice glicêmico e a carga glicêmica da dieta. Para verificação da associação entre índice glicêmico e carga glicêmica, e dessas variáveis com a ingestão energética diária e com o índice de massa corporal dos indivíduos, utilizou-se o teste de correlação de Pearson. O teste "t" de Student foi utilizado para verificar diferenças entre os dois índices e o sexo. Em ambos os testes adotou-se pOBJECTIVE: To evaluate the glycemic index and glycemic load of diets of obese individuals. METHODS: This is a retrospective study that analyzed the medical records of 80 obese adults attending a private health care service in Fortaleza, Ceará. The glycemic index and load of their diet was determined. The Pearson correlation test was used to verify if there was an association between glycemic index and glycemic load and of these variables with their daily energy intake and body mass index. The Student's "t" test was used to verify the differences between the two indexes and gender. A significance level of p<0.05 was adopted for both tests. RESULTS: Inadequate (moderate or high glycemic index prevailed at breakfast (82.9%, afternoon snack (60.0% and dinner (64.6%. The daily glycemic index was inadequate for 78.7% of the group and predominantly moderate according to the mean found (59.23, however it was less inadequate than the daily glycemic load which was high (143.8 and worse among males. The body mass index of the group, in general and according to gender, was not associated with any of the indices. Daily energy intake was associated only with glycemic load, both generally and taking gender into account. CONCLUSION: The results point toward a higher glycemic load in

  18. Effect of meal glycemic load and caffeine consumption on prolonged monotonous driving performance.

    Science.gov (United States)

    Bragg, Christopher; Desbrow, Ben; Hall, Susan; Irwin, Christopher

    2017-11-01

    Monotonous driving involves low levels of stimulation and high levels of repetition and is essentially an exercise in sustained attention and vigilance. The aim of this study was to determine the effects of consuming a high or low glycemic load meal on prolonged monotonous driving performance. The effect of consuming caffeine with a high glycemic load meal was also examined. Ten healthy, non-diabetic participants (7 males, age 51±7yrs, mean±SD) completed a repeated measures investigation involving 3 experimental trials. On separate occasions, participants were provided one of three treatments prior to undertaking a 90min computer-based simulated drive. The 3 treatment conditions involved consuming: (1) a low glycemic load meal+placebo capsules (LGL), (2) a high glycemic load meal+placebo capsules (HGL) and (3) a high glycemic load meal+caffeine capsules (3mgkg -1 body weight) (CAF). Measures of driving performance included lateral (standard deviation of lane position (SDLP), average lane position (AVLP), total number of lane crossings (LC)) and longitudinal (average speed (AVSP) and standard deviation of speed (SDSP)) vehicle control parameters. Blood glucose levels, plasma caffeine concentrations and subjective ratings of sleepiness, alertness, mood, hunger and simulator sickness were also collected throughout each trial. No difference in either lateral or longitudinal vehicle control parameters or subjective ratings were observed between HGL and LGL treatments. A significant reduction in SDLP (0.36±0.20m vs 0.41±0.19m, p=0.004) and LC (34.4±31.4 vs 56.7±31.5, p=0.018) was observed in the CAF trial compared to the HGL trial. However, no differences in AVLP, AVSP and SDSP or subjective ratings were detected between these two trials (p>0.05). Altering the glycemic load of a breakfast meal had no effect on measures of monotonous driving performance in non-diabetic adults. Individuals planning to undertake a prolonged monotonous drive following consumption of a

  19. Pomegranate juice, but not an extract, confers a lower glycemic response on a high-glycemic index food: randomized, crossover, controlled trials in healthy subjects.

    Science.gov (United States)

    Kerimi, Asimina; Nyambe-Silavwe, Hilda; Gauer, Julia S; Tomás-Barberán, Francisco A; Williamson, Gary

    2017-12-01

    Background: Low-glycemic index diets have demonstrated health benefits associated with a reduced risk of developing type 2 diabetes. Objectives: We tested whether pomegranate polyphenols could lower the glycemic response of a high-glycemic index food when consumed together and the mechanism by which this might occur. Design: We compared the acute effect of a pomegranate juice and a polyphenol-rich extract from pomegranate (supplement) on the bread-derived postprandial blood glucose concentration in 2 randomized, crossover, controlled studies (double-blinded for the supplements), each on 16 healthy volunteers. An additional randomized, crossover, controlled study on 16 volunteers consuming constituent fruit acids in a pH-balanced solution (same pH as pomegranate) and bread was conducted to determine any contributions to postprandial responses caused by acidic beverages. Results: As primary outcome, the incremental area under the curve for bread-derived blood glucose (-33.1% ± 18.1%, P = 0.000005) and peak blood glucose (25.4% ± 19.3%, P = 0.0004) were attenuated by pomegranate juice, compared with a control solution containing the equivalent amount of sugars. In contrast, the pomegranate supplement, or a solution containing the malic and citric acid components of the juice, was ineffective. The pomegranate polyphenol punicalagin was a very effective inhibitor of human α-amylase in vitro, comparable to the drug acarbose. Neither the pomegranate extract nor the individual component polyphenols inhibited 14 C-D-glucose transport across differentiated Caco-2/TC7 cell monolayers, but they inhibited uptake of 14 C-glucose into Xenopus oocytes expressing the human glucose transporter type 2. Further, some of the predicted pomegranate gut microbiota metabolites modulated 14 C-D-glucose and 14 C-deoxy-D-glucose uptake into hepatic HepG2 cells. Conclusions: These data indicate that pomegranate polyphenols, when present in a beverage but not in a supplement, can reduce the

  20. Relations between Classroom Goal Structures and Students' Goal Orientations in Mathematics Classes: When Is a Mastery Goal Structure Adaptive?

    Science.gov (United States)

    Skaalvik, Einar M.; Federici, Roger A.

    2016-01-01

    The purpose of this study was to test possible interactions between mastery and performance goal structures in mathematics classrooms when predicting students' goal orientations. More specifically, we tested if the degree of performance goal structure moderated the associations between mastery goal structure and students' goal orientations.…

  1. [Treatment goals in FACE philosophy].

    Science.gov (United States)

    Martin, Domingo; Maté, Amaia; Zabalegui, Paula; Valenzuela, Jaime

    2017-03-01

    The FACE philosophy is characterized by clearly defined treatment goals: facial esthetics, dental esthetics, periodontal health, functional occlusion, neuromuscular mechanism and joint function. The purpose is to establish ideal occlusion with good facial esthetics and an orthopedic stable joint position. The authors present all the concepts of FACE philosophy and illustrate them through one case report. Taking into account all the FACE philosophy concepts increases diagnostic ability and improves the quality and stability of treatment outcomes. The goal of this philosophy is to harmonize the facial profile, tooth alignment, periodontium, functional occlusion, neuromuscular mechanism and joint function. The evaluation and treatment approach to vertical problems are unique to the philosophy. © EDP Sciences, SFODF, 2017.

  2. Motivational beliefs, values, and goals.

    Science.gov (United States)

    Eccles, Jacquelynne S; Wigfield, Allan

    2002-01-01

    This chapter reviews the recent research on motivation, beliefs, values, and goals, focusing on developmental and educational psychology. The authors divide the chapter into four major sections: theories focused on expectancies for success (self-efficacy theory and control theory), theories focused on task value (theories focused on intrinsic motivation, self-determination, flow, interest, and goals), theories that integrate expectancies and values (attribution theory, the expectancy-value models of Eccles et al., Feather, and Heckhausen, and self-worth theory), and theories integrating motivation and cognition (social cognitive theories of self-regulation and motivation, the work by Winne & Marx, Borkowski et al., Pintrich et al., and theories of motivation and volition). The authors end the chapter with a discussion of how to integrate theories of self-regulation and expectancy-value models of motivation and suggest new directions for future research.

  3. Iterative Goal Refinement for Robotics

    Science.gov (United States)

    2014-06-01

    Researchers have used a variety of ways to represent such constraints (e.g., as a constraint satisfaction problem ( Scala , to appear), in PDDL (Vaquro...lifecycle to recent models of replanning (Talamadupala et al., 2013) and continual planning ( Scala , to appear). We described goal reasoning in...F., & Barreiro, J. (2013). Towards deliberative control in marine robotics. In Marine Robot Autonomy (pp. 91–175). Springer. Scala , E. (to appear

  4. Physics goals of future colliders

    International Nuclear Information System (INIS)

    Kane, G.L.

    1987-01-01

    These lectures describe some of the physics goals that future colliders are designed to achieve. Emphasis is on the SSC, but its capabilities are compared to those of other machines, and set in a context of what will be measured before the SSC is ready. Physics associated with the Higgs sector is examined most thoroughly, with a survey of the opportunities to find evidence of extended gauge theories

  5. Treatment goals of pulmonary hypertension.

    LENUS (Irish Health Repository)

    McLaughlin, Vallerie V

    2013-12-24

    With significant therapeutic advances in the field of pulmonary arterial hypertension, the need to identify clinically relevant treatment goals that correlate with long-term outcome has emerged as 1 of the most critical tasks. Current goals include achieving modified New York Heart Association functional class I or II, 6-min walk distance >380 m, normalization of right ventricular size and function on echocardiograph, a decreasing or normalization of B-type natriuretic peptide (BNP), and hemodynamics with right atrial pressure <8 mm Hg and cardiac index >2.5 mg\\/kg\\/min(2). However, to more effectively prognosticate in the current era of complex treatments, it is becoming clear that the "bar" needs to be set higher, with more robust and clearer delineations aimed at parameters that correlate with long-term outcome; namely, exercise capacity and right heart function. Specifically, tests that accurately and noninvasively determine right ventricular function, such as cardiac magnetic resonance imaging and BNP\\/N-terminal pro-B-type natriuretic peptide, are emerging as promising indicators to serve as baseline predictors and treatment targets. Furthermore, studies focusing on outcomes have shown that no single test can reliably serve as a long-term prognostic marker and that composite treatment goals are more predictive of long-term outcome. It has been proposed that treatment goals be revised to include the following: modified New York Heart Association functional class I or II, 6-min walk distance ≥ 380 to 440 m, cardiopulmonary exercise test-measured peak oxygen consumption >15 ml\\/min\\/kg and ventilatory equivalent for carbon dioxide <45 l\\/min\\/l\\/min, BNP level toward "normal," echocardiograph and\\/or cardiac magnetic resonance imaging demonstrating normal\\/near-normal right ventricular size and function, and hemodynamics showing normalization of right ventricular function with right atrial pressure <8 mm Hg and cardiac index >2.5 to 3.0 l\\/min\\/m(2).

  6. Global end-diastolic volume an emerging preload marker vis-a-vis other markers - Have we reached our goal?

    Directory of Open Access Journals (Sweden)

    P M Kapoor

    2016-01-01

    Full Text Available A reliable estimation of cardiac preload is helpful in the management of severe circulatory dysfunction. The estimation of cardiac preload has evolved from nuclear angiography, pulmonary artery catheterization to echocardiography, and transpulmonary thermodilution (TPTD. Global end-diastolic volume (GEDV is the combined end-diastolic volumes of all the four cardiac chambers. GEDV has been demonstrated to be a reliable preload marker in comparison with traditionally used pulmonary artery catheter-derived pressure preload parameters. Recently, a new TPTD system called EV1000™ has been developed and introduced into the expanding field of advanced hemodynamic monitoring. GEDV has emerged as a better preload marker than its previous conventional counterparts. The advantage of it being measured by minimum invasive methods such as PiCCO™ and newly developed EV1000™ system makes it a promising bedside advanced hemodynamic parameter.

  7. Difficulties in reaching therapeutic goals for hypertension and dysplipidaemia in patients with type 2 diabetes in general practice

    DEFF Research Database (Denmark)

    Knudsen, Søren Tang; Mosbech, Thomas Hammershaimb; Hansen, Birtha Petrea

    2013-01-01

    National guidelines recommend strict control of blood pressure (BP) and plasma low-density lipoprotein cholesterol (LDL) in type 2 diabetes (T2DM), aiming at a BP ≤ 130/80 mmHg and an LDL concentration ≤ 2.5 mmol/l. Angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II-receptor blockers...

  8. How to Reach the Goal of a Sustainable Enterprise--Implementation of Environmental Education and Training in Business.

    Science.gov (United States)

    Lillehagen, Hans Christian

    1998-01-01

    The Sustainable Business Challenge is an Internet-based course designed to make future business leaders aware of environmental and social challenges in business administration. Similar projects are being conducted in Norway, Latin America, Finland, the United States, and the United Kingdom. (SK)

  9. The contribution of goal specificity to goal achievement in collaborative goal setting for the management of asthma.

    Science.gov (United States)

    Smith, Lorraine; Alles, Chehani; Lemay, Kate; Reddel, Helen; Saini, Bandana; Bosnic-Anticevich, Sinthia; Emmerton, Lynne; Stewart, Kay; Burton, Debbie; Krass, Ines; Armour, Carol

    2013-01-01

    Goal setting was investigated as part of an implementation trial of an asthma management service (PAMS) conducted in 96 Australian community pharmacies. Patients and pharmacists identified asthma-related issues of concern to the patient and collaboratively set goals to address these. Although goal setting is commonly integrated into disease state management interventions, the nature of goals, and their contribution to goal attainment and health outcomes are not well understood. To identify and describe: 1) goals set collaboratively between adult patients with asthma and their pharmacist, 2) goal specificity and goal achievement, and 3) describe the relationships between specificity, achievement, asthma control and asthma-related quality of life. Measures of goal specificity, and goal achievement were developed and applied to patient data records. Goals set were thematically analyzed into goal domains. Proportions of goals set, goals achieved and their specificity were calculated. Correlational and regression analyses were undertaken to determine the relationships between goal specificity, goal achievement, asthma control and asthma-related quality of life. Data were drawn from 498 patient records. Findings showed that patients set a wide range and number of asthma-related goals (N = 1787) and the majority (93%) were either achieved or being working toward by the end of the study. Goal achievement was positively associated with specific and moderately specific goals, but not non-specific goals. However, on closer inspection, an inconsistent pattern of relationships emerged as a function of goal domain. Findings also showed that goal setting was associated with end-of-study asthma control but not to asthma-related quality of life. Pharmacists can help patients to set achievable and specific asthma management goals, and these have the potential to directly impact health outcomes such as asthma control. Goal specificity appears to be an important feature in the

  10. Google Hangouts: Leveraging Social Media to Reach the Education Community

    Science.gov (United States)

    Eisenhamer, Bonnie; Summers, Frank; McCallister, Dan; Ryer, Holly

    2015-01-01

    Research shows that educator professional development is most effective when it is sustained and/or when a follow-on component is included to support the learning process. In order to create more comprehensive learning experiences for our workshop participants, the education team at the Space Telescope Science Institute is working collaboratively with scientific staff and other experts to create a follow-on component for our professional development program. The new component utilizes video conferencing platforms, such as Google's Hangouts On Air, to provide educators with content updates and extended learning opportunities in between in-person professional development experiences. The goal is to enhance our professional development program in a cost-effective way while reaching a greater cross-section of educators. Video broadcasts go live on Google+, YouTube, and our website - thus providing access to any user with a web browser. Additionally, the broadcasts are automatically recorded and archived for future viewing on our YouTube channel. This provides educators with anywhere, anytime training that best suits their needs and schedules. This poster will highlight our new Hangouts for educators as well as our cross-departmental efforts to expand the reach of our Hubble Hangouts for the public through a targeted recruitment strategy.

  11. The interaction between dietary and life goals: using goal systems theory to explore healthy diet and life goals.

    Science.gov (United States)

    Turner-McGrievy, Gabrielle M; Wright, Julie A; Migneault, Jeffrey P; Quintiliani, Lisa; Friedman, Robert H

    2014-01-01

    Objective : To examine the types of life and dietary goals individuals report and how these goal domains interact as framed by goal systems theory. Methods : This work is a cross-sectional survey study. Measures included the incidence of common life and dietary goals and how these goals interact with and facilitate each other. Results : The results of a quantitative survey ( n  = 46 participants), which was informed by two focus groups ( n  = 17 participants), showed that participants are trying to achieve several different life (e.g. achieving financial success) and dietary goals (e.g. eating more fruits and vegetables, drinking more water, and losing weight) and that these two types of goals interact to both facilitate and conflict with each other. Having a life goal of exercising was significantly associated with healthy eating goals when compared with other life goals ( p 's goals may be linked and help to facilitate one another. Being in the maintenance phase with the goal of healthy eating was associated with participants feeling like they were more successful in their other non-diet-related health goals ( p  goals can facilitate success in achieving other goals. Conclusions : Life goals can have an impact on a person's ability to achieve and maintain dietary and other health goals. Health educators may help to facilitate long-term behavior change by examining a person's life goals as well as dietary goals.

  12. Riparian Vegetation Mapping Along the Hanford Reach

    International Nuclear Information System (INIS)

    FOGWELL, T.W.

    2003-01-01

    During the biological survey and inventory of the Hanford Site conducted in the mid-1990s (1995 and 1996), preliminary surveys of the riparian vegetation were conducted along the Hanford Reach. These preliminary data were reported to The Nature Conservancy (TNC), but were not included in any TNC reports to DOE or stakeholders. During the latter part of FY2001, PNNL contracted with SEE Botanical, the parties that performed the original surveys in the mid 1990s, to complete the data summaries and mapping associated with the earlier survey data. Those data sets were delivered to PNNL and the riparian mapping by vegetation type for the Hanford Reach is being digitized during the first quarter of FY2002. These mapping efforts provide the information necessary to create subsequent spatial data layers to describe the riparian zone according to plant functional types (trees, shrubs, grasses, sedges, forbs). Quantification of the riparian zone by vegetation types is important to a number of DOE'S priority issues including modeling contaminant transport and uptake in the near-riverine environment and the determination of ecological risk. This work included the identification of vegetative zones along the Reach by changes in dominant plant species covering the shoreline from just to the north of the 300 Area to China Bar near Vernita. Dominant and indicator species included Agropyron dasytachyudA. smithii, Apocynum cannabinum, Aristida longiseta, Artemisia campestris ssp. borealis var scouleriana, Artemisa dracunculus, Artemisia lindleyana, Artemisia tridentata, Bromus tectorum, Chrysothamnus nauseosus, Coreopsis atkinsoniana. Eleocharis palustris, Elymus cinereus, Equisetum hyemale, Eriogonum compositum, Juniperus trichocarpa, Phalaris arundinacea, Poa compressa. Salk exigua, Scirpus acutus, Solidago occidentalis, Sporobolus asper,and Sporobolus cryptandrus. This letter report documents the data received, the processing by PNNL staff, and additional data gathered in FY2002

  13. Long-reach manipulators for decommissioning

    International Nuclear Information System (INIS)

    Webster, D.A.; Challinor, S.F.

    1993-01-01

    A survey of redundant facilities at Sellafield has identified that in many cases the conventional means of deploying remote handling equipment are not appropriate and that novel means must be employed. However, decommissioning is not a value adding activity and so expensive one off designs must be avoided. The paper will describe BNFL's approach to the synthesis from proprietary parts of a manipulator which can lift 3 te at a horizontal reach of over 5 metres and yet can still perform the dextrous manipulation necessary to remove small items. It will also cover the development of the manipulator control systems and the adaption of commercial handtools to be manipulator friendly. (author)

  14. Luminosity performance reach after LS1

    International Nuclear Information System (INIS)

    Herr, W.

    2012-01-01

    Based on past experience (2010/2011), in particular expected limitations from beam-beam effects, and taking into account the expected beam quality from the LHC injectors, the peak and integrated luminosity at top energy is discussed for different scenarios (e.g. bunch spacing, beta*). In particular it will be shown which are the key parameters to reach the nominal luminosity and it is also shown that peak luminosities two times larger than nominal (or higher) are possible. Possible test in 2012 are discussed

  15. City Reach Code Technical Support Document

    Energy Technology Data Exchange (ETDEWEB)

    Athalye, Rahul A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chen, Yan [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Zhang, Jian [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Liu, Bing [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Frankel, Mark [New Buildings Inst., Portland, OR (United States); Lyles, Mark [New Buildings Inst., Portland, OR (United States)

    2017-10-31

    This report describes and analyzes a set of energy efficiency measures that will save 20% energy over ASHRAE Standard 90.1-2013. The measures will be used to formulate a Reach Code for cities aiming to go beyond national model energy codes. A coalition of U.S. cities together with other stakeholders wanted to facilitate the development of voluntary guidelines and standards that can be implemented in stages at the city level to improve building energy efficiency. The coalition's efforts are being supported by the U.S. Department of Energy via Pacific Northwest National Laboratory (PNNL) and in collaboration with the New Buildings Institute.

  16. In vitro and in vivo assessment of the glycemic index of bakery products: influence of the reformulation of ingredients.

    Science.gov (United States)

    Ferrer-Mairal, A; Peñalva-Lapuente, C; Iglesia, I; Urtasun, L; De Miguel-Etayo, P; Remón, S; Cortés, E; Moreno, L A

    2012-12-01

    To evaluate whether the modification of ingredients of two bakery products, muffins and bread, reduces their glycemic index, by means of in vitro and in vivo procedures. In vitro and in vivo glycemic index were evaluated for two types of bread and two types of muffins including one standard product for each category. For the in vitro determination, kinetics of starch digestion method was used. For the in vivo procedure, postprandial glucose measured as IAUC was obtained in a group of eighteen healthy volunteers (ten did the test with muffins and eight with breads). In in vitro, a reduction in the expected glycemic index regarding the control muffin was achieved with the partial substitution of wheat flour by a mixture of resistant starch, dextrin and lentil flour. In breads, with the partial substitution of wheat flour by a mixture of resistant starch and dextrins, a decrease in the expected glycemic index was also observed. In in vivo, a reduction in GI was also achieved both in muffin and in bread. All the obtained GI was higher in in vitro method. Despite the fact that in vitro overestimate in vivo method, the trend in the reduction in GI seems to be similar in both methods. With the substitution assayed, a reduction in the expected glycemic index and the glycemic index were obtained both in muffins and in breads.

  17. Glycemic Response to Corn Starch Modified with Cyclodextrin Glycosyltransferase and its Relationship to Physical Properties.

    Science.gov (United States)

    Dura, A; Yokoyama, W; Rosell, C M

    2016-09-01

    Corn starch was modified with cyclodextrin glycosyltransferase (CGTase) below the gelatinization temperature. The porous granules with or without CGTase hydrolysis products may be used as an alternative to modified corn starches in foods applications. The amount and type of hydrolysis products were determined, containing mainly β-cyclodextrin (CD), which will influence pasting behavior and glycemic response in mice. Irregular surface and small holes were observed by microscopic analysis and differences in pasting properties were observed in the presence of hydrolysis products. Postprandial blood glucose in mice fed gelatinized enzymatically modified starch peaked earlier than their ungelatinized counterparts. However, in ungelatinized enzymatically modified starches, the presence of β- CD may inhibit the orientation of amylases slowing hydrolysis, which may help to maintain lower blood glucose levels. Significant correlations were found between glycemic curves and viscosity pattern of starches.

  18. Achieving glycemic control in special populations in hospital: perspectives in practice.

    Science.gov (United States)

    Cheng, Alice Y Y

    2014-04-01

    Achieving and maintaining glycemic control in patients with diabetes admitted to hospital is challenging because of the many competing factors of nutrition, pharmacotherapy and other patient-related and systemic factors. For patients receiving enteral or parenteral feeding, eating irregularly or receiving glucocorticoid therapy, the challenges are even greater. The basic principles to follow when managing glycemia in these populations are as follows: 1) Recognition of those at risk for hyperglycemia; 2) frequent bedside glucose monitoring; 3) a proactive approach with routine insulin administration based on the predicted glucose patterns; 4) constant reassessment of the glycemic status and titration of the routine insulin accordingly. Copyright © 2014 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  19. Role of glycemic elements of Cynodon dactylon and Musa paradisiaca in diabetes management.

    Science.gov (United States)

    Rai, Prashant Kumar; Jaiswal, Dolly; Rai, Nilesh K; Pandhija, Shiwani; Rai, A K; Watal, Geeta

    2009-09-01

    The study defined the scientific evaluation of glycemic elements of extracts of Cynodon dactylon and Musa paradisiaca. A dose of 500 mg/kg body weight (bw) of C. dactylon produced maximum falls of 23.2% and 22.8% in blood glucose levels of normoglycemic rats during studies of fasting blood glucose and glucose tolerance, respectively, whereas the same dose of M. paradisiaca produced a rise of 34.9% and 18.4%. In diabetic rats during glucose tolerance tests, a fall of 27.8% and a rise of 17.5% were observed with the same dose of C. dactylon and M. paradisiaca, respectively. Laser-induced breakdown spectroscopy used for detection of glycemic elements present in both the extracts indicated that C. dactylon was rich in magnesium (Mg), whereas M. paradisiaca was rich in potassium (K) and sodium (Na), comparatively, suggesting thereby the defined roles of these elements in diabetes management.

  20. Glycemic Memory as a Pathogenic Basis for Modern Antidiabetic Therapy Algorithm Forming

    Directory of Open Access Journals (Sweden)

    V.V. Poltorak

    2014-04-01

    Full Text Available Prevention/delay of the development of vascular complications remains one of major challenges in treatment of diabetes mellitus. Epidemiological studies have shown lack of efficacy of stable glycemic control in patients with long-existing diabetes. This phenomenon, confirmed in animal models and analyzed at the molecular genetic level, is called metabolic/glycemic memory and associated with epigenetic modifications of gene expression. On the other hand, it has been proven that early intensive intervention in type 1 and 2 diabetes mellitus reduces the risk of micro- and macrovascular complications development and progression, forming the basis for long-term favorable effects that persist beyond normoglycemia. The foregoing justifies change of therapeutic approach in diabetes mellitus since the moment of establishing diagnosis for the early and maximum safely achievement of blood glucose and glycosylated hemoglobin levels close to normal ones.

  1. Hope matters to the glycemic control of adolescents and young adults with type 1 diabetes.

    Science.gov (United States)

    Santos, Fábio R M; Sigulem, Daniel; Areco, Kelsy C N; Gabbay, Monica A L; Dib, Sergio A; Bernardo, Viviane

    2015-05-01

    This study investigated the association of hope and its factors with depression and glycemic control in adolescents and young adults with type 1 diabetes. A total of 113 patients were invited to participate. Significant negative correlations were found between hope and HbA1c and also between hope and depression. Hope showed a significant association with HbA1c and depression in the stepwise regression model. Among the hope factors, "inner positive expectancy" was significantly associated with HbA1c and depression. This study supports that hope matters to glycemic control and depression. Intervention strategies focusing on hope should be further explored. © The Author(s) 2015.

  2. [Association between smoking/smoking cessation and glycemic control in male patients with type 2 diabetes].

    Science.gov (United States)

    Su, J; Qin, Y; Shen, C; Gao, Y; Pan, E C; Pan, X Q; Tao, R; Zhang, Y Q; Wu, M

    2017-11-10

    Objective: To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods: From December 2013 to January 2014, a total of 7 763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results: The prevalence of current smoking was 45.5% in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers ( P smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95 %CI : 0.05%-0.49%) and 0.38% (95 %CI : 0.23%-0.53%), respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers ( P smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion: Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.

  3. Glycemic Control: A Combination of Lifestyle Management and the Use of Drugs

    OpenAIRE

    Standl, Eberhard; Erbach, Michael; Schnell, Oliver

    2012-01-01

    Some 30% of contemporary cardiology patients have coexisting known diabetes, and another 40% have either undiagnosed diabetes or prediabetes. There is still no final conclusive evidence of cardiovascular benefit by good glycemic control in type 2 diabetes, although studies like the United Kingdom Prospective Diabetes Study (UKPDS) and the Prospective Pioglitazone Clinical Trial in Macrovascular Events, and meta-analyses based on these and other randomized controlled trials of blood glucose-lo...

  4. The Relationship Between Perceived Family Climate and Glycemic Control in Type 1 Diabetes Mellitus Adolescent Patients.

    Science.gov (United States)

    Eray, Şafak; Uçar, Halit Necmi; Çetinkaya, Fatma; Eren, Erdal; Vural, Pınar

    2017-09-01

    Type 1 diabetes mellitus (T1DM) is a chronic disease which ranks third in children under age 16 years. Expressed emotion (EE) is a term that indicates a specific family climate including lack of emotional support (LES), irritability, and emotional over-involvement. It is known that the family environment is highly important for glycemic control in diabetic adolescents. In this study, the relationship between perceived EE and glycemic control in adolescents diagnosed with T1DM not accompanied by psychopathology were investigated. The study included 49 adolescents with T1DM and 50 adolescents as a control group. Adolescents with psychopathology and intellectual disability were excluded from the study. Perceived EE was measured by the Shortened Level of Expressed Emotion Scale (SLEES) and blood sugar regulation was assessed by HbA1c levels. The adolescents with T1DM showed a significant difference in perceived EE (p=0.020) and LES (p=0.014) when compared with the control group. When diabetic adolescents were compared among themselves, the diabetic adolescents with poor glycemic control perceived greater EE (p=0.033) and less emotional support (p=0.049). In regression analyses, the predictive power of mother's educational level, the employment status of mothers and the subscale "LES" of SLEES combined to explain HbA1c level was determined to be 37.8%. The strong relationship between perceived EE and glycemic control showed us that perceived EE can hinder treatment compliance without causing psychopathology. For this reason, it is recommended that not only patients with psychopathology, but all diabetic adolescents receive psychosocial support and family interventions.

  5. EFFECTS OF COOKED LENTILS ON GLYCEMIC CONTROL AND BLOOD LIPIDS OF PATIENTS WITH TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    Hamidreza Shams

    2010-12-01

    Full Text Available Abstract    INTRODUCTION: Diabetes control is one of the main conflict issues in diabetes management. Scientists, recently, recommend [increasing low glycemic index (LGI foods in dietary regimen. The effects of cooked lentil as a low glycemic index food on serum blood glucose and lipid profile among type 2 diabetic patients has been investigated in this study.    METHODS: In a randomized cross-over clinical trial which was performed on 30 patients with type II diabetes mellitus, subjects were randomly divided into 2 groups. Group A followed the normal diet and Group B followed normal diet with 50gm cooked lentil and 6gm canula oil substitute of 30gm bread and 20gm cheese. After  6 weeks, groups stopped their diets and put on wash out period for 3 weeks and later the  diets where switched between the them. Diet continued for another 6 weeks. Anthropometric measurements, dietary intakes, serum lipids and glucose levels were determined at the beginning and the end of each test period. Data were analyzed by Food Processor II and SPSS-13.    RESULTS: BMI, LDL_C, HDL_C, TG and serum Fructozamine were not significantly affected by dietary regimens. But Total cholesterol and fasting blood glucose decreased significantly in regimen containing lentil (P<0.05.    CONCLUSION: Consumption of cooked lentil as a LGI food in breakfast led to reduction of FBS and TC and improvement of glycemic control in type 2 diabetic patients.      Keywords: Diabetes Mellitus, Lentil, Lipid profiles, Blood glucose, Glycemic index, Clinical Trial.

  6. Associations of Glycemic Control With Cardiovascular Outcomes Among US Hemodialysis Patients With Diabetes Mellitus.

    Science.gov (United States)

    Rhee, Jinnie J; Zheng, Yuanchao; Montez-Rath, Maria E; Chang, Tara I; Winkelmayer, Wolfgang C

    2017-06-07

    There is a lack of data on the relationship between glycemic control and cardiovascular end points in hemodialysis patients with diabetes mellitus. We included adult Medicare-insured patients with diabetes mellitus who initiated in-center hemodialysis treatment from 2006 to 2008 and survived for >90 days. Quarterly mean time-averaged glycated hemoglobin (HbA 1c ) values were categorized into diabetes mellitus. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  7. IMPACT OF GLYCEMIC CONTROL ON OXIDATIVE STRESS AND ANTIOXIDANT STATUS IN DIABETIC NEUROPATHY

    Directory of Open Access Journals (Sweden)

    Shilpashree

    2015-01-01

    Full Text Available INTRODUCTION: Oxidative stress due to enhanced free - radical generation and/or a decrease in antioxidant defense mechanisms has been implicated in the pathogenesis of diabetic neuropathy. This study was conducted to study the impact of glycemic control on oxidative stress and antioxidant balance in diab etic neuropathy. METHOD S : fifty patients with diabetic neuropathy and fifty age matched healthy controls were included in the study. Glycosylated hemoglobin (HbA1c was estimated to assess the severity of diabetes and the glycemic control. Serum malondiaal dehyde (MDA levels were assessed as a marker of lipid peroxidation and hence oxidative stress. Superoxide Dismutase (SOD levels were assessed for antioxidant status. RESULTS: Significant positive correlation was found between serum MDA levels and hba1c ( r = 0.276, p < 0.0001 in patients with diabetic neuropathy. There was statistically significant reduction in the Glutathione peroxidase levels. Further, SOD levels were inversely correlated with HbA1c (r= - 0.603, p<0.0001 levels. CONCLUSION AND SUMMARY: oxidative stress is greatly increased in patients suffering from diabetic neuropathy and is inversely related to glycemic control. This may be due to depressed antioxidant enzyme levels and may also be responsible for further depletion of antioxidant enzym e GPx. This worsens the oxidative stress and creates a vicious cycle of imbalance of free radical generation and deficit of antioxidant status in these patients which may lead to nervous system damage causing diabetic neuropathy. A good glycemic control is essential for prevention of diabetic neuropathy.

  8. Gastritis in patients undergoing sleeve gastrectomy: Prevalence, ethnic distribution, and impact on glycemic.

    Science.gov (United States)

    Rath-Wolfson, Lea; Varona, Roy; Bubis, Golan; Tatarov, Alexander; Koren, Rumelia; Ram, Edward

    2017-04-01

    Laparoscopic sleeve gastrectomy (LSG) is a therapeutic option in severely obese patients. The aim of this study was to evaluate the presence of Helicobacter pylori (HP) gastritis and non-Helicobacter gastritis in the gastrectomy specimens, and its association to other variables.One hundred six sleeve gastrectomy specimens were examined histopathologically for the presence of gastritis and its relation to other factors like ethnicity, glycemic control, and postoperative complications.Twelve patients had HP gastritis, 39 had non-HP gastritis, and 55 had normal mucosa. There was a statistical difference between the Arab and Jewish Israeli patients in our study. Twenty-eight of the Arab patients had HP gastritis and 48% had non-HP gastritis. In the Jewish population 6% had HP gastritis and 34% had non-HP gastritis. The preoperative glycemic control was worse in the gastritis group with a mean HbA1c of 8.344% while in the normal mucosa group the mean HbA1c was 6.55. After operation the glycemic control reverted to normal in most the diabetic patients. There were few postoperative complications however, they were not related to HP.There is a high incidence of gastritis in obese patients. The incidence of gastritis in the Arab population in our study was higher than that in the Jewish population. The glycemic control before surgery was worse in patients with gastritis than in the normal mucosa group. HP bares no risk for postoperative complications after LSG and does not affect weight loss. However a larger cohort of patients must be studied to arrive at conclusive results.

  9. Safety and Efficacy of D-Tagatose in Glycemic Control in Subjects with Type 2 Diabetes

    OpenAIRE

    Ensor, Mark; Banfield, Amy B.; Smith, Rebecca R.; Williams, Jarrod; Lodder, Robert A.

    2014-01-01

    The primary objectives of this study were to evaluate the treatment effect of D-tagatose on glycemic control, determined by a statistically significant decrease in hemoglobin A1c (HbA1c), and safety profile of D-tagatose compared to placebo. The secondary objectives were to evaluate the treatment effects on fasting blood glucose, insulin, lipid profiles, changes in BMI, and the proportion of subjects achieving HbA1c targets of

  10. Metformin regulates glycemic homeostasis in patients with type 2 diabetes mellitus as an NO donor

    Directory of Open Access Journals (Sweden)

    Ivan Sergeevich Kuznetsov

    2013-11-01

    Full Text Available Aim. To evaluate the influence of metformin on nitric oxide bioavailability in patients with type 2 diabetes mellitus (T2DM regarding glycemic homeostasis, and to investigate a correlation between metformin dosage and NO levels in vivo. Materials and Methods. Two groups ? primary and control ? were assembled for the clinical section of this study. Patients with newly diagnosed T2DM on metformin therapy were included to the primary group, while drug-naive T2DM patients were enrolled as control subjects. Glycemic parameters and NO bioavailability was tested in both groups prior to and after the follow-up period. Experimental section was dedicated to the elucidation of potential dose-dependent effects of metformin on NO bioavailability. Mice were intraperitoneally infused with metformin at 0.5; 1.1; 5.6 mg per subject. Tissue detection of NO was performed with diethyldithiocarbamate (DETC iron complexes to form mononitrosyl iron compounds (MIC with paramagnetic properties. Control rodents were intraperitoneally infused with metformin without spin trapping. Results. We found nitrite and methaemoglobin (a marker for NO bioavailability to increase in parallel along with glycemic compensation in the primary but not control group. In vivo rodent models showed linear correlation between accumulation of DETC/MIC and dose of metformin, as well as formation of dinitrosyl iron complexes, known as endogenous NO transporters. Conclusion. Our data suggests that metformin benefits glycemic homeostasis in T2DM as an NO donor via formation of dinitrosyl iron complexes.

  11. Association among individual deprivation, glycemic control, and diabetes complications: the EPICES score.

    Science.gov (United States)

    Bihan, Hélène; Laurent, Silvana; Sass, Catherine; Nguyen, Gérard; Huot, Caroline; Moulin, Jean Jacques; Guegen, René; Le Toumelin, Philippe; Le Clésiau, Hervé; La Rosa, Emilio; Reach, Gérard; Cohen, Régis

    2005-11-01

    Previous studies have related poor glycemic control and/or some diabetes complications to low socioeconomic status. Some aspects of socioeconomic status have not been assessed in these studies. In the present study, we used an individual index of deprivation, the Evaluation de la Précarité et des Inégalités de santé dans les Centres d'Examens de Santé (Evaluation of Precarity and Inequalities in Health Examination Centers [EPICES]) score, to determine the relationship among glycemic control, diabetes complications, and individual conditions of deprivation. We conducted a cross-sectional prevalence study in 135 consecutive diabetic patients (age 59.41 +/- 13.2 years [mean +/- SD]) admitted in the hospitalization unit of a French endocrine department. Individual deprivation was assessed by the EPICES score, calculated from 11 socioeconomic questions. Glycemic control, lipid levels, blood pressure, retinopathy, neuropathy, and nephropathy were assessed. HbA(1c) level was significantly correlated with the EPICES score (r = 0.366, P < 0.001). The more deprived patients were more likely than the less deprived patients to have poor glycemic control (beta = 1.984 [SE 0.477], P < 0.001), neuropathy (odds ratio 2.39 [95% CI 1.05-5.43], P = 0.037), retinopathy (3.66 [1.39-9.64], P = 0.009), and being less often admitted for 1-day hospitalization (0.32 [0.14-0.74], P = 0.008). No significant relationship was observed with either nephropathy or cardiovascular risk factors. Deprivation status is associated with poor metabolic control and more frequent microvascular complications, i.e., retinopathy and neuropathy. The medical and economic burden of deprived patients is high.

  12. Factors Related to the Glycemic Control in Lithuanian Adolescents with Type 1 Diabetes Mellitus

    OpenAIRE

    Kassem, Salem

    2017-01-01

    1) Adolescent female patients with type 1 diabetes mellitus have better glycemic control and higher levels of diabetes distress than male patients. 2) Parents of adolescents using insulin pumps experience higher diabetes distress than parents of adolescents using multiple daily injections. 3) No differences in diabetes-related factors, emotional state, diabetes-related distress (in adolescent patients and in their primary care-givers) and social factors in groups of adolescent patients ...

  13. Seasonal variations in glycemic control of type 2 diabetes in Korean women.

    Science.gov (United States)

    Ryu, Ohk-Hyun; Lee, Sungwha; Yoo, Hyung Joon; Choi, Moon-Gi

    2014-06-01

    Seasonal variations in lifestyle, such as food intake and physical activity, have been reported. Glycemic control in type 2 diabetes mellitus (T2DM) may be affected by such changes. We investigated seasonal variations in glycemic control, food intake, and physical activity in type 2 diabetic patients. This prospective observational study included 37 Korean female patients who had food intake (kcal/day), HbA1c, and anthropometry every 3 months (August, November, February, May, and August in the Northern Hemisphere) over 1 year. When anti-diabetic drugs were changed, we analyzed the data just before the changes. The mean HbA1c levels (%) of August and November in 2008, and February, May, and August in 2009 were 7.0 ± 0.1, 6.9 ± 0.1, 7.2 ± 0.2, 7.4 ± 0.2, and 7.2 ± 0.2, respectively (P = 0.018). The change of HbA1c was nearly 0.5 % for the 1-year period. From August to May of the following year, there were also seasonal variations in food intake (1,872 ± 143, 1,739 ± 97, 1,673 ± 86, 1,561 ± 132, respectively; P = 0.013), and total physical activity [7.7 (3.7-14.6), 6.3 (2.8-10.4), 5.1 (2.7-12.6), and 11.2 (4.7-20.5), respectively; P = 0.048]. However, the seasonal variations of HbA1c and total physical activity became non-significant when farmers were excluded. These data suggested that glycemic control, total physical activity, and food intake varied seasonally in Korean T2DM patients. These seasonal variations should be considered in education for glycemic control.

  14. Association of reduced zinc status with poor glycemic control in individuals with type 2 diabetes mellitus.

    Science.gov (United States)

    Bandeira, Verônica da Silva; Pires, Liliane Viana; Hashimoto, Leila Leiko; Alencar, Luciane Luca de; Almondes, Kaluce Gonçalves Sousa; Lottenberg, Simão Augusto; Cozzolino, Silvia Maria Franciscato

    2017-12-01

    This study evaluated the relationship between the zinc-related nutritional status and glycemic and insulinemic markers in individuals with type 2 diabetes mellitus (T2DM). A total of 82 individuals with T2DM aged between 29 and 59 years were evaluated. The concentration of zinc in the plasma, erythrocytes, and urine was determined by the flame atomic absorption spectrometry method. Dietary intake was assessed using a 3-day 24-h recall. In addition, concentrations of serum glucose, glycated hemoglobin percentage, total cholesterol and fractions, triglycerides, and serum insulin were determined. The insulin resistance index (HOMA-IR) and β-cell function (HOMA- β) were calculated. The markers of zinc status (plasma: 83.3±11.9μg/dL, erythrocytes: 30.1±4.6μg/g Hb, urine: 899.1±622.4μg Zn/24h, and dietary: 9.9±0.8mg/day) were classified in tertiles and compared to insulinemic and glycemic markers. The results showed that lower zinc concentrations in plasma and erythrocytes, as well as its high urinary excretion, were associated with higher percentages of glycated hemoglobin, reflecting a worse glycemic control in individuals with T2DM (pzinc levels and glycated hemoglobin percentage (r=-0.325, p=0.003), and a positive correlation between urinary zinc excretion and glycemia (r=0.269, p=0.016), glycated hemoglobin percentage (r=0.318, p=0.004) and HOMA-IR (r=0.289, p=0.009). According to our study results, conclude that T2DM individuals with reduced zinc status exhibited poor glycemic control. Copyright © 2017 Elsevier GmbH. All rights reserved.

  15. Can donated media placements reach intended audiences?

    Science.gov (United States)

    Cooper, Crystale Purvis; Gelb, Cynthia A; Chu, Jennifer; Polonec, Lindsey

    2013-09-01

    Donated media placements for public service announcements (PSAs) can be difficult to secure, and may not always reach intended audiences. Strategies used by the Centers for Disease Control and Prevention's (CDC) Screen for Life: National Colorectal Cancer Action Campaign (SFL) to obtain donated media placements include producing a diverse mix of high-quality PSAs, co-branding with state and tribal health agencies, securing celebrity involvement, monitoring media trends to identify new distribution opportunities, and strategically timing the release of PSAs. To investigate open-ended recall of PSAs promoting colorectal cancer screening, CDC conducted 12 focus groups in three U.S. cities with men and women either nearing age 50 years, when screening is recommended to begin, or aged 50-75 years who were not in compliance with screening guidelines. In most focus groups, multiple participants recalled exposure to PSAs promoting colorectal cancer screening, and most of these individuals reported having seen SFL PSAs on television, in transit stations, or on the sides of public buses. Some participants reported exposure to SFL PSAs without prompting from the moderator, as they explained how they learned about the disease. Several participants reported learning key campaign messages from PSAs, including that colorectal cancer screening should begin at age 50 years and screening can find polyps so they can be removed before becoming cancerous. Donated media placements can reach and educate mass audiences, including millions of U.S. adults who have not been screened appropriately for colorectal cancer.

  16. Efficacy of REACH Forgiveness across cultures.

    Science.gov (United States)

    Lin, Yin; Worthington, Everett L; Griffin, Brandon J; Greer, Chelsea L; Opare-Henaku, Annabella; Lavelock, Caroline R; Hook, Joshua N; Ho, Man Yee; Muller, Holly

    2014-09-01

    This study investigates the efficacy of the 6-hour REACH Forgiveness intervention among culturally diverse undergraduates. Female undergraduates (N = 102) and foreign extraction (46.2%) and domestic (43.8%) students in the United States were randomly assigned to immediate treatment or waitlist conditions. Treatment efficacy and the effect of culture on treatment response were assessed using measures of emotional and decisional forgiveness across 3 time periods. Students in the treatment condition reported greater improvement in emotional forgiveness, but not decisional forgiveness, relative to those in the waitlist condition. Gains were maintained at a 1-week follow-up. Although culture did not moderate the effect of treatment, a main effect of culture on emotional forgiveness and marginally significant interaction effect of culture on decisional forgiveness were found. The REACH Forgiveness intervention was efficacious for college students from different cultural backgrounds when conducted in the United States. However, some evidence may warrant development of culturally adapted forgiveness interventions. © 2014 Wiley Periodicals, Inc.

  17. On the path to reach the SDG targets: Decreasing maternal and ...

    African Journals Online (AJOL)

    2018-03-03

    Mar 3, 2018 ... (SA) did not reach the Millennium Development Goals targets for maternal and child health ... with an emphasis on interventions to ensure greater survival rates, ... are underpinned by a range of action areas: country leadership; financing for health; health system resilience; individual potential; community ...

  18. Starch digestibility and predicted glycemic index in the bread fortified with pomelo (Citrus maxima) fruit segments.

    Science.gov (United States)

    Reshmi, S K; Sudha, M L; Shashirekha, M N

    2017-12-15

    The aim of this study was to evaluate the starch digestibility and predicted glycemic index in breads incorporated with pomelo fruit (Citrus maxima) segments. Volume of the white and brown breads supplemented with pomelo fresh segments increased, while the crumb firmness decreased. Bread with 20% fresh and 5% dry pomelo segments were sensorily acceptable. Bioactive components such as phenolics, flavonoids, naringin and carotenoids were retained to a greater extent in bread containing dry pomelo segments. The pomelo incorporated bread had higher levels of resistant starch fractions (3.87-10.96%) with low predicted glycemic index (62.97-53.13%), despite their higher total starch (69.87-75.47%) content compared to control bread. Thus pomelo segments in the product formulations lowered the glycemic index probably by inhibiting carbohydrate hydrolyzing enzyme activity which could be attributed to naringin. Hence fortified bread prepared from pomelo fruit segment is recommended to gain nutritional value and to decrease the risk of diabetes. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Leukocyte peroxidase and leptin: an associated link of glycemic tolerance and bronchial asthma?

    Directory of Open Access Journals (Sweden)

    Parco S

    2010-05-01

    Full Text Available Sergio ParcoImmunopathology Unit, Laboratory of the Department of Medicine, Children’s Hospital, IRCCS Burlo Garofolo, Trieste, ItalyAbstract: Recent observations suggest the presence of an interaction between leptin and the inflammatory system during bronchial asthma. Although there is evidence of a positive association between asthma and obesity in adults and children, little is yet known about the role of serum leptin, as a potential mediator for bronchial epithelial homeostasis, and intraleukocyte myeloperoxidase (MPO, a hemoprotein with a molecular weight of 140 kDa, expression of the inflammatory system, in asthmatic children. Glycemic tolerance is an important pathogenetic element in developing type 2 mellitus diabetes and a confirmed predictor of incident asthma-like symptoms in adults. This work is aimed at assessing a possible correlation between basal leukocyte myeloperoxidase levels, basal leptin and insulin-glycemic tolerance in obese children. Thirty obese children aged between 7 and 15 years were examined. The analyzed data showed a normal response to the insulinemic stimulus in children of both sexes whose basal leptin and MPO values, expressed as MPO intracellular index, werewithin the normal range.Keywords: leptin, myeloperoxidase, glycemic tolerance, asthma

  20. Hemorheological and Glycemic Parameters and HDL Cholesterol for the Prediction of Cardiovascular Events

    International Nuclear Information System (INIS)

    Cho, Sung Woo; Kim, Byung Gyu; Kim, Byung Ok; Byun, Young Sup; Goh, Choong Won; Rhee, Kun Joo; Kwon, Hyuck Moon; Lee, Byoung Kwon

    2016-01-01

    Hemorheological and glycemic parameters and high density lipoprotein (HDL) cholesterol are used as biomarkers of atherosclerosis and thrombosis. To investigate the association and clinical relevance of erythrocyte sedimentation rate (ESR), fibrinogen, fasting glucose, glycated hemoglobin (HbA1c), and HDL cholesterol in the prediction of major adverse cardiovascular events (MACE) and coronary heart disease (CHD) in an outpatient population. 708 stable patients who visited the outpatient department were enrolled and followed for a mean period of 28.5 months. Patients were divided into two groups, patients without MACE and patients with MACE, which included cardiac death, acute myocardial infarction, newly diagnosed CHD, and cerebral vascular accident. We compared hemorheological and glycemic parameters and lipid profiles between the groups. Patients with MACE had significantly higher ESR, fibrinogen, fasting glucose, and HbA1c, while lower HDL cholesterol compared with patients without MACE. High ESR and fibrinogen and low HDL cholesterol significantly increased the risk of MACE in multivariate regression analysis. In patients with MACE, high fibrinogen and HbA1c levels increased the risk of multivessel CHD. Furthermore, ESR and fibrinogen were significantly positively correlated with HbA1c and negatively correlated with HDL cholesterol, however not correlated with fasting glucose. Hemorheological abnormalities, poor glycemic control, and low HDL cholesterol are correlated with each other and could serve as simple and useful surrogate markers and predictors for MACE and CHD in outpatients

  1. Hemorheological and Glycemic Parameters and HDL Cholesterol for the Prediction of Cardiovascular Events

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sung Woo [Division of Cardiology - Department of Internal Medicine - Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Division of Cardiology - Department of Medicine - Samsung Medical Center, Seoul (Korea, Republic of); Kim, Byung Gyu; Kim, Byung Ok; Byun, Young Sup; Goh, Choong Won; Rhee, Kun Joo [Division of Cardiology - Department of Internal Medicine - Sanggye Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Kwon, Hyuck Moon; Lee, Byoung Kwon, E-mail: cardiobk@yuhs.ac [Division of Cardiology - Department of Internal Medicine - Gangnam Severance Hospital - Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-01-15

    Hemorheological and glycemic parameters and high density lipoprotein (HDL) cholesterol are used as biomarkers of atherosclerosis and thrombosis. To investigate the association and clinical relevance of erythrocyte sedimentation rate (ESR), fibrinogen, fasting glucose, glycated hemoglobin (HbA1c), and HDL cholesterol in the prediction of major adverse cardiovascular events (MACE) and coronary heart disease (CHD) in an outpatient population. 708 stable patients who visited the outpatient department were enrolled and followed for a mean period of 28.5 months. Patients were divided into two groups, patients without MACE and patients with MACE, which included cardiac death, acute myocardial infarction, newly diagnosed CHD, and cerebral vascular accident. We compared hemorheological and glycemic parameters and lipid profiles between the groups. Patients with MACE had significantly higher ESR, fibrinogen, fasting glucose, and HbA1c, while lower HDL cholesterol compared with patients without MACE. High ESR and fibrinogen and low HDL cholesterol significantly increased the risk of MACE in multivariate regression analysis. In patients with MACE, high fibrinogen and HbA1c levels increased the risk of multivessel CHD. Furthermore, ESR and fibrinogen were significantly positively correlated with HbA1c and negatively correlated with HDL cholesterol, however not correlated with fasting glucose. Hemorheological abnormalities, poor glycemic control, and low HDL cholesterol are correlated with each other and could serve as simple and useful surrogate markers and predictors for MACE and CHD in outpatients.

  2. In vitro colonic fermentation and glycemic response of different kinds of unripe banana flour.

    Science.gov (United States)

    Menezes, Elizabete Wenzel; Dan, Milana C T; Cardenette, Giselli H L; Goñi, Isabel; Bello-Pérez, Luis Arturo; Lajolo, Franco M

    2010-12-01

    This work aimed to study the in vitro colonic fermentation profile of unavailable carbohydrates of two different kinds of unripe banana flour and to evaluate their postprandial glycemic responses. The unripe banana mass (UBM), obtained from the cooked pulp of unripe bananas (Musa acuminata, Nanicão variety), and the unripe banana starch (UBS), obtained from isolated starch of unripe banana, plantain type (Musa paradisiaca) in natura, were studied. The fermentability of the flours was evaluated by different parameters, using rat inoculum, as well as the glycemic response produced after the ingestion by healthy volunteers. The flours presented high concentration of unavailable carbohydrates, which varied in the content of resistant starch, dietary fiber and indigestible fraction (IF). The in vitro colonic fermentation of the flours was high, 98% for the UBS and 75% for the UBM when expressed by the total amount of SCFA such as acetate, butyrate and propionate in relation to lactulose. The increase in the area under the glycemic curve after ingestion of the flours was 90% lower for the UBS and 40% lower for the UBM than the increase produced after bread intake. These characteristics highlight the potential of UBM and UBS as functional ingredients. However, in vivo studies are necessary in order to evaluate the possible benefit effects of the fermentation on intestinal health.

  3. Association between Responsible Pet Ownership and Glycemic Control in Youths with Type 1 Diabetes.

    Directory of Open Access Journals (Sweden)

    Louise Maranda

    Full Text Available Type 1 diabetes mellitus (T1DM a chronic characterized by an absolute insulin deficiency requires conscientious patient self-management to maintain glucose control within a normal range. Family cohesion and adaptability, positive coping strategies, social support and adequate self-regulatory behavior are found to favorably influence glycemic control. Our hypothesis was that the responsible care of a companion animal is associated with these positive attributes and correlated with the successful management of a chronic illness such as type 1 diabetes. We recruited 223 youths between 9 and 19 years of age from the Pediatric Diabetes clinic at the University of Massachusetts Medical School, reviewed the status of their glycemic control (using three consecutive A1c values and asked them questions about the presence of a pet at home, and their level of involvement with its care. Multivariate analyses show that children who care actively for one or more pets at home are 2.5 times more likely to have control over their glycemic levels than children who do not care for a pet, adjusting for duration of disease, socio-economic status, age and self-management [1.1 to 5.8], pWald = 0.032. A separate model involving the care of a petdog only yielded comparable results (ORa = 2.6 [1.1 to 5.9], pWald = 0.023.

  4. The effect of ginger (Zingiber officinale) on glycemic markers in patients with type 2 diabetes.

    Science.gov (United States)

    Shidfar, Farzad; Rajab, Asadollah; Rahideh, Tayebeh; Khandouzi, Nafiseh; Hosseini, Sharieh; Shidfar, Shahrzad

    2015-06-01

    Ginger (Zingiber officinale) is one of the functional foods which contains biological compounds including gingerol, shogaol, paradol and zingerone. Ginger has been proposed to have anti-cancer, anti-thrombotic, anti-inflammatory, anti-arthritic, hypolipidemic and analgesic properties. Here, we report the effect of ginger supplementation on glycemic indices in Iranian patients with type 2 diabetes. A double-blind, placebo-controlled, randomized clinical trial was conducted on 20-60 -year-old patients with type 2 diabetes who did not receive insulin. Participants in the intervention and control groups were received 3 g of powdered ginger or placebo (lactose) (in capsules) daily for 3 months. Glycemic indices, total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), serum paraoxonase, dietary intake and physical activity were measured at the beginning and end of the study, and after 12 h fasting. Comparison of the indices after 3 months showed that the differences between the ginger and placebo groups were statistically significant as follows: serum glucose (-19.41 ± 18.83 vs. 1.63 ± 4.28 mg/dL, p ginger improved glycemic indices, TAC and PON-1 activity in patients with type 2 diabetes.

  5. Polyphenol content and glycemic load of pasta enriched with Faba bean flour

    Directory of Open Access Journals (Sweden)

    Imma Turco

    2016-05-01

    Full Text Available Background: Legumes contain elevated levels of health functional components. The objective of the present paper was to evaluate the nutritional properties and the post-prandial glycaemic responses of pasta obtained using 35% Vicia Faba (VF bean flour, which is an important source of fiber and phytochemical compounds. Results: Protein and fiber content were higher in VF pasta compared with durum wheat semolina (DWS pasta. The total phenol content in VF pasta was about two fold higher compared to that of DWS pasta. A higher total flavonoid content, higher antioxidant activity against peroxyl radicals evaluated by oxygen radical absorbance capacity (ORAC assay was also observed in VF pasta. The comparison of post-prandial increase of glucose after VF intake or DWS demonstrated significant differences and VF pasta exhibited a lower glycemic index value, a lower glycemic load and higher glycemic profile compared with DWS pasta. Conclusion: The results suggest that enrichment with 35% Vicia faba bean has potential health benefits and that VF flour can be used as an ingredient to prepare added-value products.

  6. The glycemic index: methodological aspects related to the interpretation of health effects and to regulatory labeling.

    Science.gov (United States)

    Aziz, Alfred

    2009-01-01

    The glycemic index (GI) is an experimental system that classifies carbohydrates (CHO) and CHO-containing foods according to their blood glucose-raising potential. It is based on the glycemic response following the ingestion of a test food containing a defined amount of available CHO relative to that of an equi-carbohydrate portion of either white bread or glucose. The concept has been extended to mixed meals and whole diets where the GI of the meal/diet is expressed as the weighted average of the GI of each food, based on the percentage of the total mealldiet CHO provided by each food. Over the last few decades, a substantial number of epidemiological and interventional studies have reported beneficial associationsleffects of lower GI diets across a wide spectrum of pathophysiological conditions, including diabetes, cardiovascular disease, obesity, and certain forms of cancer. This has prompted proponents of the GI to recommend its use for dietary planning and labeling purposes. However, the currently recommended GI methodology is not well standardized and has several flaws, which brings into question the strength of evidence attributed to the health effects of low-GI diets. This review focuses exclusively on the methodological aspects of the GI, how they might impact the interpretation of data related to the purported health benefits of low GI diets, and the considerations for the use of the GI in food labeling. In addition, alternative systems for classifying the glycemic effects of CHO-containing foods are briefly discussed.

  7. Glycemic control and periodontal disease in type 2 diabetes mellitus patients: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Vaibhav Tandon

    2015-01-01

    Full Text Available Introduction: Diabetes mellitus (DM is a chronic, noncommunicable disease with concomitant oral manifestations that impact on dental care. Aim: To determine the correlation between glycemic control and periodontitis among 35-45 years aged patients with DM type 2 (DM2. Materials and Methods: A convenient sample of 40 subjects aged 35-45 years with DM2 on oral medication were recruited for the study. Glycosylated, hemoglobin(HbA1c, probing pocket depth (PPD, gingival index (GI, plaque index (PI, and the relevant drug history were recorded. The data were analyzed using unpaired student t-test to compare the means of PPD, GI, PI between different HbA1c levels, gender, and duration of drug, and the Pearson correlation was used to find correlation between HbA1c and PPD, GI, PI, duration of drug. Results: With the increase in HbA1c values there was a significant rise in PPD, PI scores, and GI scores (P < 0.001. Diabetic males had a higher PPD, PI, and GI score as compared to females. With the increase in duration of the drug, there was an increase in PPD, which was found to be statistically nonsignificant. Conclusion: Patients are having poor glycemic level had more severe periodontitis as compared to patients having a fair glycemic level.

  8. From reaching every district to reaching every community: analysis and response to the challenge of equity in immunization in Cambodia

    Science.gov (United States)

    Chan Soeung, Sann; Grundy, John; Duncan, Richard; Thor, Rasoka; Bilous, Julian B

    2013-01-01

    Background An international review of the Cambodian Expanded Programme on Immunization (EPI) in 2010 and other data show that despite immunization coverage increases and vaccine preventable diseases incidence reductions, inequities in access to immunization services exist. Utilizing immunization and health systems literature, analysis of global health databases and the EPI review findings, this paper examines the characteristics of immunization access and outcome inequities, and describes proposed longer-term strategic and operational responses to these problems. Findings The national programme has evolved from earlier central and provincial level planning to strengthening routine immunization coverage through the District level ‘Reaching Every District Strategy’. However, despite remarkable improvements, the review found over 20% of children surveyed were not fully immunized, primarily from communities where inequities of both access and impact persist. These inequities relate mainly to socio-economic exposures including wealth and education level, population mobility and ethnicity. To address these problems, a shift in strategic and operational response is proposed that will include (a) a re-focus of planning on facility level to detect disadvantaged communities, (b) establishment of monitoring systems to provide detailed information on community access and utilization, (c) development of communication strategies and health networks that enable providers to adjust service delivery according to the needs of vulnerable populations, and (d) securing financial, management and political commitment for ‘reaching every community’. Conclusions For Cambodia to achieve its immunization equity objectives and disease reduction goals, a shift of emphasis to health centre and community is needed. This approach will maximize the benefits of new vaccine introduction in the coming ‘Decade of Vaccines’, plus potentially extend the reach of other life-saving maternal

  9. Dynamics of multiple-goal pursuit.

    Science.gov (United States)

    Louro, Maria J; Pieters, Rik; Zeelenberg, Marcel

    2007-08-01

    The authors propose and test a model of multiple-goal pursuit that specifies how individuals allocate effort among multiple goals over time. The model predicts that whether individuals decide to step up effort, coast, abandon the current goal, or switch to pursue another goal is determined jointly by the emotions that flow from prior goal progress and the proximity to future goal attainment, and proximally determined by changes in expectancies about goal attainment. Results from a longitudinal diary study and 2 experiments show that positive and negative goal-related emotions can have diametrically opposing effects on goal-directed behavior, depending on the individual's proximity to goal attainment. The findings resolve contrasting predictions about the influence of positive and negative emotions in volitional behavior, critically amend the goal gradient hypothesis, and provide new insights into the dynamics and determinants of multiple-goal pursuit.

  10. Riparian Vegetation Mapping Along the Hanford Reach

    Energy Technology Data Exchange (ETDEWEB)

    FOGWELL, T.W.

    2003-07-11

    During the biological survey and inventory of the Hanford Site conducted in the mid-1990s (1995 and 1996), preliminary surveys of the riparian vegetation were conducted along the Hanford Reach. These preliminary data were reported to The Nature Conservancy (TNC), but were not included in any TNC reports to DOE or stakeholders. During the latter part of FY2001, PNNL contracted with SEE Botanical, the parties that performed the original surveys in the mid 1990s, to complete the data summaries and mapping associated with the earlier survey data. Those data sets were delivered to PNNL and the riparian mapping by vegetation type for the Hanford Reach is being digitized during the first quarter of FY2002. These mapping efforts provide the information necessary to create subsequent spatial data layers to describe the riparian zone according to plant functional types (trees, shrubs, grasses, sedges, forbs). Quantification of the riparian zone by vegetation types is important to a number of DOE'S priority issues including modeling contaminant transport and uptake in the near-riverine environment and the determination of ecological risk. This work included the identification of vegetative zones along the Reach by changes in dominant plant species covering the shoreline from just to the north of the 300 Area to China Bar near Vernita. Dominant and indicator species included Agropyron dasytachyudA. smithii, Apocynum cannabinum, Aristida longiseta, Artemisia campestris ssp. borealis var scouleriana, Artemisa dracunculus, Artemisia lindleyana, Artemisia tridentata, Bromus tectorum, Chrysothamnus nauseosus, Coreopsis atkinsoniana. Eleocharis palustris, Elymus cinereus, Equisetum hyemale, Eriogonum compositum, Juniperus trichocarpa, Phalaris arundinacea, Poa compressa. Salk exigua, Scirpus acutus, Solidago occidentalis, Sporobolus asper,and Sporobolus cryptandrus. This letter report documents the data received, the processing by PNNL staff, and additional data gathered in FY

  11. Short-term use of continuous glucose monitoring system adds to glycemic control in young type 1 diabetes mellitus patients in the long run: A clinical trial

    Directory of Open Access Journals (Sweden)

    Bukara-Radujković Gordana

    2011-01-01

    Full Text Available Background/Aim. Balancing strict glycemic control with setting realistic goals for each individual child and family can optimize growth, ensure normal pubertal development and emotional maturation, and control long term complications in children with type 1 diabetes (T1DM. The aim of this study was to evaluate the efficacy of short-term continuous glucose monitoring system (CGMS application in improvement of glycemic control in pediatric type 1 diabetes mellitus (T1DM patients. Methods. A total of 80 pediatric T1DM patients were randomly assigned into the experimental and the control group. The experimental group wore CGMS sensor for 72 hours at the beginning of the study. Self-monitored blood glucose (SMBG levels and hemoglobin A1c (HbA1c levels were obtained for both groups at baseline, and at 3 and 6 months. Results. There was a significant improvement in HbA1c (p < 0.001, in both the experimental and the control group, without a significant difference between the groups. Nevertheless, after 6 months the improvement of mean glycemia was noticed only in the experimental group. This finding was accompanied with a decrease in the number of hyperglycemic events and no increase in the number of hypoglycemic events in the experimental group. Conclusions. The results suggest that the CGMS can be considered as a valuable tool in treating pediatric T1DM patients, however further research is needed to more accurately estimate to what extent, if any, it outperforms intensive self-monitoring of blood glucose.

  12. Reductions in glycemic and lipid profiles in hypertensive patients undergoing the Brazilian Dietary Approach to Break Hypertension: a randomized clinical trial.

    Science.gov (United States)

    Lima, Sílvia T R M; Souza, Bárbara S N; França, Ana K T; Salgado, João V; Salgado-Filho, Natalino; Sichieri, Rosely

    2014-08-01

    Hypertensive patients often have an unfavorable lipid and glucose profile. The main goal of dietary treatment for these patients is to achieve adequate control of blood pressure and reducing cardiovascular morbidity and mortality. The aim of this study was to evaluate whether the Brazilian Dietary Approach to Break Hypertension (BRADA) based on Dietary Approaches to Stop Hypertension but with both low sodium and glycemic index foods could reduce lipid and glycemic profiles in hypertensive patients who were seeing primary health care providers in a low-income region of Brazil. A randomized study of 206 individuals were followed up for the duration of 6 months. The experimental group received orientation and planned monthly menus from the BRADA diet. In the control group, counseling was based on standard care and mainly focused on salt intake reduction. Differences in all biochemical parameters were compared at the baseline and at the 6-month follow-up period. The mean age was 60.1 (±12.9) years old, and 156 subjects (119 females) completed the study. An intention-to-treat analysis showed that both groups reduced fasting plasma glucose, glycated hemoglobin, total cholesterol, and low-density lipoprotein cholesterol concentrations; however, statistically significant between-group differences were found for these parameters. The mean difference in fasting glucose was -7.0 (P < .01), -0.2 for HbA1c (P < .01), -28.6 for TC (P < .01), and -23.8 for LDL-c (P < .01) for the experimental group compared with the control group. This study showed the efficacy of the BRADA diet to treat hypertension on biochemical parameters tested in a primary health care service setting. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Reach and get capability in a computing environment

    Science.gov (United States)

    Bouchard, Ann M [Albuquerque, NM; Osbourn, Gordon C [Albuquerque, NM

    2012-06-05

    A reach and get technique includes invoking a reach command from a reach location within a computing environment. A user can then navigate to an object within the computing environment and invoke a get command on the object. In response to invoking the get command, the computing environment is automatically navigated back to the reach location and the object copied into the reach location.

  14. Unified communication to reach vulnerable mothers.

    Science.gov (United States)

    Tezcan, B; Von Rege, I; Henkson, H; Oteng-Ntim, E

    2011-01-01

    The feasibility of using a mobile text to reach vulnerable patient groups was assessed in this study. A total of 121 pregnant or postnatal women were randomly asked to complete a questionnaire. The questionnaire was given to them in the antenatal clinic, postnatal ward, antenatal ward or in the day assessment unit at St Thomas' Hospital, London. The forms were collected and analysed using an Excel database. The results of this survey show that mobile technology is readily available for 97% of the obstetric population. In mothers from vulnerable groups and in mothers from deprived areas, 61% possessed 3rd generation mobile technology. The majority of mothers surveyed wanted their care supplemented by the use of their mobile phones.

  15. Validity of an Interactive Functional Reach Test.

    Science.gov (United States)

    Galen, Sujay S; Pardo, Vicky; Wyatt, Douglas; Diamond, Andrew; Brodith, Victor; Pavlov, Alex

    2015-08-01

    Videogaming platforms such as the Microsoft (Redmond, WA) Kinect(®) are increasingly being used in rehabilitation to improve balance performance and mobility. These gaming platforms do not have built-in clinical measures that offer clinically meaningful data. We have now developed software that will enable the Kinect sensor to assess a patient's balance using an interactive functional reach test (I-FRT). The aim of the study was to test the concurrent validity of the I-FRT and to establish the feasibility of implementing the I-FRT in a clinical setting. The concurrent validity of the I-FRT was tested among 20 healthy adults (mean age, 25.8±3.4 years; 14 women). The Functional Reach Test (FRT) was measured simultaneously by both the Kinect sensor using the I-FRT software and the Optotrak Certus(®) 3D motion-capture system (Northern Digital Inc., Waterloo, ON, Canada). The feasibility of implementing the I-FRT in a clinical setting was assessed by performing the I-FRT in 10 participants with mild balance impairments recruited from the outpatient physical therapy clinic (mean age, 55.8±13.5 years; four women) and obtaining their feedback using a NASA Task Load Index (NASA-TLX) questionnaire. There was moderate to good agreement between FRT measures made by the two measurement systems. The greatest agreement between the two measurement system was found with the Kinect sensor placed at a distance of 2.5 m [intraclass correlation coefficient (2,k)=0.786; PNASA/TLX questionnaire. FRT measures made using the Kinect sensor I-FRT software provides a valid clinical measure that can be used with the gaming platforms.

  16. Goals? What goals? Europeans to hear more about the world's millennium development goals

    International Nuclear Information System (INIS)

    Bianchi, S.

    2005-01-01

    The European Union (EU) is quickly becoming the front-runner of development aid to regions in Africa and other developing countries. However, over three-quarters of EU citizens are unaware of development efforts being made on the part of the Union to Third World countries, according to a public opinion poll released by Eurobarometer. In light of the low awareness of the EU's development agenda and the United Nations's Millennium Development Goals, the EU Humanitarian Aid and Development Commission has employed a campaign to raise the level of awareness among the EU's 460 million citizens

  17. Goal motives and multiple-goal striving in sport and academia: A person-centered investigation of goal motives and inter-goal relations.

    Science.gov (United States)

    Healy, Laura C; Ntoumanis, Nikos; Duda, Joan L

    2016-12-01

    This investigation extended the goal striving literature by examining motives for two goals being pursued simultaneously. Grounded in self-determination theory, we examined how student-athletes' motives for their sporting and academic goals were associated with inter-goal facilitation and interference. Cross-sectional survey. UK university student-athletes (n=204) identified their most important sporting and academic goals. They then rated their extrinsic, introjected, identified and intrinsic motives for these goals and completed questionnaires assessing inter-goal facilitation and interference. Using a person-centered approach via latent profile analysis, we identified three distinct profiles of goal motives. Auxiliary analyses showed that the profile with high identified motives for both goals reported greater inter-goal facilitation. Extending the previous literature, the findings demonstrate the benefits of autonomous motives when simultaneously pursing goals in sport and academia. Copyright © 2016. Published by Elsevier Ltd.

  18. COMBINATION OF GOALS STRATEGY REGION

    Directory of Open Access Journals (Sweden)

    Denys Yu. Lapigin

    2015-01-01

    Full Text Available Currently the tools to identify strategicallyimportant objectives of regional development is not enough to build a developmentperspective, relying on something special,what distinguishes each region from therest. The article discusses approaches to the formation of the regional developmentstrategy, which is based on goals set by the results of the analysis of the main factors inthe development of the region. The study is based on the methodology of systems theoryand methods of strategic management. The most important results should include tools tobuild the tree of strategic objectives resultingfrom the implementation of the algorithm forconstructing planes of analysis and development of the region. The results can be used to develop a strategy for the developmentof socio-economic systems of various typesand forms.

  19. The goal of ape pointing.

    Science.gov (United States)

    Halina, Marta; Liebal, Katja; Tomasello, Michael

    2018-01-01

    Captive great apes regularly use pointing gestures in their interactions with humans. However, the precise function of this gesture is unknown. One possibility is that apes use pointing primarily to direct attention (as in "please look at that"); another is that they point mainly as an action request (such as "can you give that to me?"). We investigated these two possibilities here by examining how the looking behavior of recipients affects pointing in chimpanzees (Pan troglodytes) and bonobos (Pan paniscus). Upon pointing to food, subjects were faced with a recipient who either looked at the indicated object (successful-look) or failed to look at the indicated object (failed-look). We predicted that, if apes point primarily to direct attention, subjects would spend more time pointing in the failed-look condition because the goal of their gesture had not been met. Alternatively, we expected that, if apes point primarily to request an object, subjects would not differ in their pointing behavior between the successful-look and failed-look conditions because these conditions differed only in the looking behavior of the recipient. We found that subjects did differ in their pointing behavior across the successful-look and failed-look conditions, but contrary to our prediction subjects spent more time pointing in the successful-look condition. These results suggest that apes are sensitive to the attentional states of gestural recipients, but their adjustments are aimed at multiple goals. We also found a greater number of individuals with a strong right-hand than left-hand preference for pointing.

  20. The relevance of goal-orientation for motivation in high versus low proneness to negative symptoms.

    Science.gov (United States)

    Schlier, Björn; Engel, Maike; Fladung, Anne-Katharina; Fritzsche, Anja; Lincoln, Tania M

    2017-06-01

    The psychological mechanisms of why individuals with negative symptoms fail to initiate and perform goal-directed behavior are not well understood. Drawing on the reward-sensitivity and expectancy-value theories, we investigate whether negative symptom-like experiences (NSLE) are associated with generating less approach goals (aimed at reaching a positive outcome) and more avoidance goals (aimed at avoiding a negative outcome) and whether this type of goal-orientation explains motivational deficits (i.e., perceiving goals as less feasible and important and being less committed to them). Based on the continuum model of negative symptoms, we identified two parallelized extreme groups with high and low levels of NSLE (n = 37, respectively) in an ad-hoc online-sample of healthy individuals (N = 262) using the Community Assessment of Psychic Experiences. In an online study, these participants were instructed to generate approach and avoidance goals and to rate each goal in terms of feasibility, importance and goal-commitment. Participants with low levels of NSLE generated more approach than avoidance goals. Participants with high levels of NSLE showed no such difference due to increased numbers of avoidance goals. Furthermore, avoidance goal-orientation predicted reduced subjective feasibility and importance of goals and less goal-commitment. Results are based on a healthy sample rather than people with psychosis. No longitudinal or behavioral data for goal-striving was collected. People with NSLE generate more avoidance goals than controls. This is dysfunctional because it correlates with feeling less committed to reach one's goals. Optimizing goal-setting could be a promising starting-point for psychological interventions aimed at reducing negative symptoms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. A Shared Decision-Making Approach to Telemedicine: Engaging Rural Patients in Glycemic Management

    Directory of Open Access Journals (Sweden)

    Michelle L. Griffith

    2016-11-01

    Full Text Available Telemedicine can connect specialist health care providers with patients in remote and underserved areas. It is especially relevant in diabetes care, where a proliferation of treatment options has added further complexity to the care of an already complex, highly prevalent disease. Recent developments in health reform encourage delivery systems to use team-based models and engage patients in shared decision-making (SDM, where patients and providers together make health care decisions that are tailored to the specific characteristics and values of the patient. The goal of this project was to design, integrate, and evaluate a team-based, SDM approach delivered to patients with diabetes in a rural community, building upon the previously established telemedicine for reach, education, access, and treatment (TREAT model. Patients in this feasibility study demonstrated improvement in hemoglobin A1c values, and reported better understanding of diabetes. Providers reported the SDM aids increased cohesion among team members (including patients and facilitated patient education and behavioral goal setting. This project demonstrated that SDM could be integrated into the workflow of a telemedicine team visit with good provider and patient satisfaction.

  2. Glycemic index, glycemic load and glycemic response

    DEFF Research Database (Denmark)

    Augustin, Livia S A; Kendall, Cyril W C; Jenkins, David J A

    2015-01-01

    BACKGROUND AND AIMS: The positive and negative health effects of dietary carbohydrates are of interest to both researchers and consumers. METHODS: International experts on carbohydrate research held a scientific summit in Stresa, Italy, in June 2013 to discuss controversies surrounding the utilit...

  3. Goal-setting in clinical medicine.

    Science.gov (United States)

    Bradley, E H; Bogardus, S T; Tinetti, M E; Inouye, S K

    1999-07-01

    The process of setting goals for medical care in the context of chronic disease has received little attention in the medical literature, despite the importance of goal-setting in the achievement of desired outcomes. Using qualitative research methods, this paper develops a theory of goal-setting in the care of patients with dementia. The theory posits several propositions. First, goals are generated from embedded values but are distinct from values. Goals vary based on specific circumstances and alternatives whereas values are person-specific and relatively stable in the face of changing circumstances. Second, goals are hierarchical in nature, with complex mappings between general and specific goals. Third, there are a number of factors that modify the goal-setting process, by affecting the generation of goals from values or the translation of general goals to specific goals. Modifying factors related to individuals include their degree of risk-taking, perceived self-efficacy, and acceptance of the disease. Disease factors that modify the goal-setting process include the urgency and irreversibility of the medical condition. Pertinent characteristics of the patient-family-clinician interaction include the level of participation, control, and trust among patients, family members, and clinicians. The research suggests that the goal-setting process in clinical medicine is complex, and the potential for disagreements regarding goals substantial. The nature of the goal-setting process suggests that explicit discussion of goals for care may be necessary to promote effective patient-family-clinician communication and adequate care planning.

  4. ESO telbib: Linking In and Reaching Out

    Science.gov (United States)

    Grothkopf, U.; Meakins, S.

    2015-04-01

    Measuring an observatory's research output is an integral part of its science operations. Like many other observatories, ESO tracks scholarly papers that use observational data from ESO facilities and uses state-of-the-art tools to create, maintain, and further develop the Telescope Bibliography database (telbib). While telbib started out as a stand-alone tool mostly used to compile lists of papers, it has by now developed into a multi-faceted, interlinked system. The core of the telbib database is links between scientific papers and observational data generated by the La Silla Paranal Observatory residing in the ESO archive. This functionality has also been deployed for ALMA data. In addition, telbib reaches out to several other systems, including ESO press releases, the NASA ADS Abstract Service, databases at the CDS Strasbourg, and impact scores at Altmetric.com. We illustrate these features to show how the interconnected telbib system enhances the content of the database as well as the user experience.

  5. Using New Media to Reach Broad Audiences

    Science.gov (United States)

    Gay, P. L.

    2008-06-01

    The International Year of Astronomy New Media Working Group (IYA NMWG) has a singular mission: To flood the Internet with ways to learn about astronomy, interact with astronomers and astronomy content, and socially network with astronomy. Within each of these areas, we seek to build lasting programs and partnerships that will continue beyond 2009. Our weapon of choice is New Media. It is often easiest to define New Media by what it is not. Television, radio, print and their online redistribution of content are not New Media. Many forms of New Media start as user provided content and content infrastructures that answer that individual's creative whim in a way that is adopted by a broader audience. Classic examples include Blogs and Podcasts. This media is typically distributed through content specific websites and RSS feeds, which allow syndication. RSS aggregators (iTunes has audio and video aggregation abilities) allow subscribers to have content delivered to their computers automatically when they connect to the Internet. RSS technology is also being used in such creative ways as allowing automatically updating Google-maps that show the location of someone with an intelligent GPS system, and in sharing 100 word microblogs from anyone (Twitters) through a single feed. In this poster, we outline how the IYA NMWG plans to use New Media to reach target primary audiences of astronomy enthusiasts, image lovers, and amateur astronomers, as well as secondary audiences, including: science fiction fans, online gamers, and skeptics.

  6. Media perspective - new opportunities for reaching audiences

    Science.gov (United States)

    Haswell, Katy

    2007-08-01

    The world of media is experiencing a period of extreme and rapid change with the rise of internet television and the download generation. Many young people no longer watch standard TV. Instead, they go on-line, talking to friends and downloading pictures, videos, music clips to put on their own websites and watch/ listen to on their laptops and mobile phones. Gone are the days when TV controllers determined what you watched and when you watched it. Now the buzzword is IPTV, Internet Protocol Television, with companies such as JOOST offering hundreds of channels on a wide range of subjects, all of which you can choose to watch when and where you wish, on your high-def widescreen with stereo surround sound at home or on your mobile phone on the train. This media revolution is changing the way organisations get their message out. And it is encouraging companies such as advertising agencies to be creative about new ways of accessing audiences. The good news is that we have fresh opportunities to reach young people through internet-based media and material downloaded through tools such as games machines, as well as through the traditional media. And it is important for Europlanet to make the most of these new and exciting developments.

  7. Has Athletic Performance Reached its Peak?

    Science.gov (United States)

    Berthelot, Geoffroy; Sedeaud, Adrien; Marck, Adrien; Antero-Jacquemin, Juliana; Schipman, Julien; Saulière, Guillaume; Marc, Andy; Desgorces, François-Denis; Toussaint, Jean-François

    2015-09-01

    Limits to athletic performance have long been a topic of myth and debate. However, sport performance appears to have reached a state of stagnation in recent years, suggesting that the physical capabilities of humans and other athletic species, such as greyhounds and thoroughbreds, cannot progress indefinitely. Although the ultimate capabilities may be predictable, the exact path for the absolute maximal performance values remains difficult to assess and relies on technical innovations, sport regulation, and other parameters that depend on current societal and economic conditions. The aim of this literature review was to assess the possible plateau of top physical capabilities in various events and detail the historical backgrounds and sociocultural, anthropometrical, and physiological factors influencing the progress and regression of athletic performance. Time series of performances in Olympic disciplines, such as track and field and swimming events, from 1896 to 2012 reveal a major decrease in performance development. Such a saturation effect is simultaneous in greyhound, thoroughbred, and frog performances. The genetic condition, exhaustion of phenotypic pools, economic context, and the depletion of optimal morphological traits contribute to the observed limitation of physical capabilities. Present conditions prevailing, we approach absolute physical limits and endure a continued period of world record scarcity. Optional scenarios for further improvements will mostly depend on sport technology and modification competition rules.

  8. LEP Dismantling Reaches Half-Way Stage

    CERN Multimedia

    2001-01-01

    LEP's last superconducting module leaves its home port... Just seven months into the operation, LEP dismantling is forging ahead. Two of the eight arcs which form the tunnel have already been emptied and the last of the accelerator's radiofrequency (RF) cavities has just been raised to the surface. The 160 people working on LEP dismantling have reason to feel pleased with their progress. All of the accelerator's 72 superconducting RF modules have already been brought to the surface, with the last one being extracted on 2nd May. This represents an important step in the dismantling process, as head of the project, John Poole, explains. 'This was the most delicate part of the project, because the modules are very big and they could only come out at one place', he says. The shaft at point 1.8 through which the RF cavity modules pass is 18 metres in diameter, while each module is 11.5 metres long. Some modules had to travel more than 10 kilometres to reach the shaft. ... is lifted up the PM 1.8 shaft, after a m...

  9. Important ATLAS Forward Calorimeter Milestone Reached

    CERN Document Server

    Loch, P.

    The ATLAS Forward Calorimeter working group has reached an important milestone in the production of their detectors. The mechanical assembly of the first electromagnetic module (FCal1C) has been completed at the University of Arizona on February 25, 2002, only ten days after the originally scheduled date. The photo shows the University of Arizona FCal group in the clean room, together with the assembled FCal1C module. The module consists of a stack of 18 round copper plates, each about one inch thick. Each plate is about 90 cm in diameter, and has 12260 precision-drilled holes in it, to accommodate the tube/rod electrode assembly. The machining of the plates, which was done at the Science Technology Center (STC) at Carleton University, Ottawa, Canada, required high precision to allow for easy insertion of the electrode copper tube. The plates have been carefully cleaned at the University of Arizona, to remove any machining residue and metal flakes. This process alone took about eleven weeks. Exactly 122...

  10. Flexion synergy overshadows flexor spasticity during reaching in chronic moderate to severe hemiparetic stroke.

    Science.gov (United States)

    Ellis, Michael D; Schut, Ingrid; Dewald, Julius P A

    2017-07-01

    Pharmaceutical intervention targets arm flexor spasticity with an often-unsuccessful goal of improving function. Flexion synergy is a related motor impairment that may be inadvertently neglected. Here, flexor spasticity and flexion synergy are disentangled to determine their contributions to reaching dysfunction. Twenty-six individuals participated. A robotic device systematically modulated shoulder abduction loading during ballistic reaching. Elbow muscle electromyography data were partitioned into windows delineated by elbow joint velocity allowing for the separation of synergy- and spasticity-related activation. Reaching velocity decreased with abduction loading (psynergy increased with abduction loading (psynergy is the predominant contributor to reaching dysfunction while flexor spasticity appears only relevant during unnaturally occurring passively supported movement. Interventions targeting flexion synergy should be leveraged in future stroke recovery trials. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  11. Illegitimacy Improves Goal Pursuit in Powerless Individuals

    OpenAIRE

    Willis , Guillermo B.; Guinote , Ana; Rodríguez-Bailón , Rosa

    2009-01-01

    Abstract The effects of power legitimacy on self-regulation during goal pursuit were examined. Study 1 focused on goal-setting and goal-striving. Specifically, it examined how much time legitimate and illegitimate powerless individuals needed to set goals, and how many means they generated to pursue these goals. Study 2 examined persistence in the face of difficulties. Consistently across these studies illegitimacy improved self-regulation in powerless individuals. Illegitimate pow...

  12. Glycemic index and glycemic load in relation to changes in body weight, body fat distribution, and body composition in adult Danes 1-3

    DEFF Research Database (Denmark)

    Hare-Bruun, Helle; Flint, Anne; L. Heitmann, Berit

    2006-01-01

    born in 1922, 1932, 1942, or 1952. A baseline health examination and a dietary history interview were carried out in 1987 and 1988; a follow-up health examination was performed in 1993 and 1994. Results: Positive associations between GI and changes in bodyweight (¿BW), percentage body fat (%BF......), and waist circumference (¿WC) were observed in women after adjustment for covariates.Significant GI X sex X physical activity interactions for ABSTRACTBackground: A diet with a high glycemic index (GI) and glycemicload (GL) may promote overconsumption of energy and increase therisk of weight gain...... of the Monitoring Trendsand Determinants in Cardiovascular Disease study. The subsamplecomprised 185 men and 191 women born in 1922, 1932, 1942, or1952. A baseline health examination and a dietary history interviewwere carried out in 1987 and 1988; a follow-up health examinationwas performed in 1993 and 1994...

  13. The prevalence and determinants of poor glycemic control among adults with type 2 diabetes mellitus in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Alzaheb RA

    2018-01-01

    Full Text Available Riyadh A Alzaheb,1 Abdullah H Altemani2 1Department of Clinical Nutrition, Faculty of Applied Medical Sciences, 2Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk, Tabuk, Saudi Arabia Background: Although the prevalence of type 2 diabetes mellitus (T2DM is rising sharply in Saudi Arabia, data on glycemic control, crucial to reducing diabetes mellitus complications, remain scarce. This study therefore investigated glycemic control status and the factors influencing poor glycemic control among adult T2DM patients in Saudi Arabia.Methods: This cross-sectional study examined 423 T2DM patients at a diabetic center in Tabuk, Saudi Arabia between September 2016 and July 2017. Glycemic levels were measured via fasting blood glucose (FBG levels, and “poor glycemic control” was defined as FBG >130 mg/dL. Poor glycemic control’s risk factors were identified using a logistic regression.Results: In the sample, 74.9% of the patients had poor blood glycemic control. Logistic regression revealed that T2DM patients had an increased chance of poorly controlled diabetes if they had family histories of diabetes (adjusted odds ratio [AOR] =7.38, 95% CI 4.09–13.31, longer diabetic durations (AOR =2.33, 95% CI 1.14–4.78 for 5–10 years and AOR =5.19, 95% CI 2.50–10.69 for >10 years, insufficient physical exercise (AOR =19.02, 95% CI 6.23–58.06, or were overweight (AOR =3.79, 95% CI 2.00–7.18, or obese (AOR =5.35, 95% CI 2.72–12.59.Conclusion: A high proportion of the sampled patients had poor glycemic control, therefore, health care professionals should manage the associated risk factors to limit disease complications and improve the health of patients with diabetes. Keywords: type 2 diabetes, glycemic control, Saudi Arabia

  14. Planning of the Extended Reach well Dieksand 2; Planung der Extended Reach Bohrung Dieksand 2

    Energy Technology Data Exchange (ETDEWEB)

    Frank, U.; Berners, H. [RWE-DEA AG, Hamburg (Germany). Drilling Team Mittelplate und Dieksand; Hadow, A.; Klop, G.; Sickinger, W. [Wintershall AG Erdoelwerke, Barnstdorf (Germany); Sudron, K.

    1998-12-31

    The Mittelplate oil field is located 7 km offshore the town of Friedrichskoog. Reserves are estimated at 30 million tonnes of oil. At a production rate of 2,500 t/d, it will last about 33 years. The transport capacity of the offshore platform is limited, so that attempts were made to enhance production by constructing the extended reach borehole Dieksand 2. Details are presented. (orig.) [Deutsch] Das Erdoelfeld Mittelplate liegt am suedlichen Rand des Nationalparks Schleswig Holsteinisches Wattenmeer, ca. 7000 m westlich der Ortschaft Friedrichskoog. Die gewinnbaren Reserven betragen ca. 30 Millionen t Oel. Bei einer Foerderkapazitaet von 2.500 t/Tag betraegt die Foerderdauer ca. 33 Jahre. Aufgrund der begrenzten Transportkapazitaeten von der Insel, laesst sich durch zusaetzliche Bohrungen von der kuenstlichen Insel Mittelplate keine entscheidende Erhoehung der Foerderkapazitaet erzielen. Ab Sommer 1996 wurde erstmals die Moeglichkeit der Lagerstaettenerschliessung von Land untersucht. Ein im Mai 1997 in Hamburg etabliertes Drilling Team wurde mit der Aufgabe betraut, die Extended Reach Bohrung Dieksand 2 zu planen und abzuteufen. Die Planungsphasen fuer die Extended Reach Bohrung Dieksand 2 wurden aufgezeigt. Die fuer den Erfolg einer Extended Reach Bohrung wichtigen Planungsparameter wurden erlaeutert. Es wurden Wege gezeigt, wie bei diesem Projekt technische und geologische Risiken in der Planung mit beruecksichtigt und nach Beginn der Bohrung weiter bearbeitet werden koennen. (orig.)

  15. Adaptive mixed reality rehabilitation improves quality of reaching movements more than traditional reaching therapy following stroke.

    Science.gov (United States)

    Duff, Margaret; Chen, Yinpeng; Cheng, Long; Liu, Sheng-Min; Blake, Paul; Wolf, Steven L; Rikakis, Thanassis

    2013-05-01

    Adaptive mixed reality rehabilitation (AMRR) is a novel integration of motion capture technology and high-level media computing that provides precise kinematic measurements and engaging multimodal feedback for self-assessment during a therapeutic task. We describe the first proof-of-concept study to compare outcomes of AMRR and traditional upper-extremity physical therapy. Two groups of participants with chronic stroke received either a month of AMRR therapy (n = 11) or matched dosing of traditional repetitive task therapy (n = 10). Participants were right handed, between 35 and 85 years old, and could independently reach to and at least partially grasp an object in front of them. Upper-extremity clinical scale scores and kinematic performances were measured before and after treatment. Both groups showed increased function after therapy, demonstrated by statistically significant improvements in Wolf Motor Function Test and upper-extremity Fugl-Meyer Assessment (FMA) scores, with the traditional therapy group improving significantly more on the FMA. However, only participants who received AMRR therapy showed a consistent improvement in kinematic measurements, both for the trained task of reaching to grasp a cone and the untrained task of reaching to push a lighted button. AMRR may be useful in improving both functionality and the kinematics of reaching. Further study is needed to determine if AMRR therapy induces long-term changes in movement quality that foster better functional recovery.

  16. The effect of consumption of low-glycemic-index and low-glycemic-load desserts on anthropometric parameters and inflammatory markers in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Argiana, Vasiliki; Kanellos, Panagiotis Τ; Makrilakis, Konstantinos; Eleftheriadou, Ioanna; Tsitsinakis, Georgios; Kokkinos, Alexander; Perrea, Despina; Tentolouris, Nikolaos

    2015-10-01

    The aim of the present study was to examine the effects of consumption of desserts with low glycemic index (GI) and low glycemic load (GL), as part of a balanced hypo-caloric diet, on anthropometric and biochemical parameters in patients with type 2 diabetes mellitus (T2DM). A total of 61 subjects with T2DM were randomly assigned to the intervention (n = 30) or to the control group (n = 31). Both groups followed the same hypo-caloric (-500 kcal) diet for 12 weeks. Consumption of four portions of low-GI/low-GL desserts/week was included in the diet in the intervention group while one portion of a favorite usual sweet/week was allowed to be consumed in the control group. Thirty subjects in the control and 28 subjects in the intervention group completed the trial. Body weight, body mass index, and waist circumference were reduced significantly in both groups. Arterial blood pressure, fasting blood glucose, glycosylated hemoglobin, insulin, and γ-GT were reduced significantly only in the intervention group; however, there were no significant differences between the two groups at endpoint. C-reactive protein was reduced in the intervention, and HDL cholesterol was also reduced in the control group; the reductions were significantly different at the end of the trial. No significant changes were observed in the other plasma lipids, uric acid, leptin, adiponectin, and interleukin-6 in either study group. Consumption of desserts with low GI/GL in a balanced hypo-caloric diet has a positive impact on anthropometric and metabolic parameters of patients with T2DM.

  17. Dietary glycemic load and glycemic index and risk of coronary heart disease and stroke in Dutch men and women: the EPIC-MORGEN study.

    Directory of Open Access Journals (Sweden)

    Koert N J Burger

    Full Text Available BACKGROUND: The associations of glycemic load (GL and glycemic index (GI with the risk of cardiovascular diseases (CVD are not well-established, particularly in men, and may be modified by gender. OBJECTIVE: To assess whether high dietary GL and GI increase the risk of CVD in men and women. METHODS: A large prospective cohort study (EPIC-MORGEN was conducted within the general Dutch population among 8,855 men and 10,753 women, aged 21-64 years at baseline (1993-1997 and free of diabetes and CVD. Dietary intake was assessed with a validated food-frequency questionnaire and GI and GL were calculated using Foster-Powell's international table of GI. Information on morbidity and mortality was obtained through linkage with national registries. Cox proportional hazards analysis was performed to estimate hazard ratios (HRs for incident coronary heart disease (CHD and stroke, while adjusting for age, CVD risk factors, and dietary factors. RESULTS: During a mean follow-up of 11.9 years, 581 CHD cases and 120 stroke cases occurred among men, and 300 CHD cases and 109 stroke cases occurred among women. In men, GL was associated with an increased CHD risk (adjusted HR per SD increase, 1.17 [95% CI, 1.02-1.35], while no significant association was found in women (1.09 [0.89-1.33]. GI was not associated with CHD risk in both genders, while it was associated with increased stroke risk in men (1.27 [1.02-1.58] but not in women (0.96 [0.75-1.22]. Similarly, total carbohydrate intake and starch intake were associated with a higher CHD risk in men (1.23 [1.04-1.46]; and 1.24 [1.07-1.45], but not in women. CONCLUSION: Among men, high GL and GI, and high carbohydrate and starch intake, were associated with increased risk of CVD.

  18. Goal-based dictator game

    Science.gov (United States)

    Zaibidi, Nerda Zura; Ibrahim, Adyda; Abidin, Norhaslinda Zainal

    2014-12-01

    A considerable number of studies have been conducted to study fairness issues using two-player game. Dictator Game is one of the two-player games that receive much attention. In this paper, we develop an evolutionary approach to the Dictator Game by using Goal programming to build a model of human decision-making for cooperation. The model is formulated based on the theories of cognitive neuroscience that is capable in capturing a more realistic fairness concerns between players in the games. We show that fairness will evolve by taking into account players' aspirations and preferences explicitly in terms of profit and fairness concerns. The model is then simulated to investigate any possible effective strategy for people in economics to deal with fairness coalition. Parallels are drawn between the approach and concepts of human decision making from the field of cognitive neuroscience and psychology. The proposed model is also able to help decision makers to plan or enhance the effective strategies for business purposes.

  19. Can coronal hole spicules reach coronal temperatures?

    Science.gov (United States)

    Madjarska, M. S.; Vanninathan, K.; Doyle, J. G.

    2011-08-01

    Aims: The present study aims to provide observational evidence of whether coronal hole spicules reach coronal temperatures. Methods: We combine multi-instrument co-observations obtained with the SUMER/SoHO and with the EIS/SOT/XRT/Hinode. Results: The analysed three large spicules were found to be comprised of numerous thin spicules that rise, rotate, and descend simultaneously forming a bush-like feature. Their rotation resembles the untwisting of a large flux rope. They show velocities ranging from 50 to 250 kms-1. We clearly associated the red- and blue-shifted emissions in transition region lines not only with rotating but also with rising and descending plasmas. Our main result is that these spicules although very large and dynamic, are not present in the spectral lines formed at temperatures above 300 000 K. Conclusions: In this paper we present the analysis of three Ca ii H large spicules that are composed of numerous dynamic thin spicules but appear as macrospicules in lower resolution EUV images. We found no coronal counterpart of these and smaller spicules. We believe that the identification of phenomena that have very different origins as macrospicules is due to the interpretation of the transition region emission, and especially the He ii emission, wherein both chromospheric large spicules and coronal X-ray jets are present. We suggest that the recent observation of spicules in the coronal AIA/SDO 171 Å and 211 Å channels probably comes from the existence of transition region emission there. Movie is available in electronic form at http://www.aanda.org

  20. When Does the Warmest Water Reach Greenland?

    Science.gov (United States)

    Grist, J. P.; Josey, S. A.; Boehme, L.; Meredith, M. P.; Laidre, K. L.; Heide-Jørgensen, M. P.; Kovacs, K. M.; Lydersen, C.; Davidson, F. J. M.; Stenson, G. B.; Hammill, M. O.; Marsh, R.; Coward, A.

    2016-02-01

    The warmest water reaching the east and west coast of Greenland is found between 200 and 600 m, in the warm Atlantic Water Layer (WL). Temperature changes within the WL have been highlighted as a possible cause of accelerated melting of tidewater glaciers and therefore are an important consideration for understanding global sea level rise. However, a limited number of winter observations of the WL have prohibited determining its seasonal variability. To address this, temperature data from Argo profiling floats, a range of sources within the World Ocean Database, and unprecedented coverage from marine-mammal borne sensors have been analyzed for the period 2002-2011. A significant seasonal range in temperature ( 1-2°C) is found in the warm layer, in contrast to most of the surrounding ocean. The magnitude of the seasonal cycle is thus comparable with the 1990s warming that was associated with an increased melt rate in a marine terminating glacier of West Greenland. The phase of the seasonal cycle exhibits considerable spatial variability; with high-resolution ocean model trajectory analysis suggesting it is determined by the time taken for waters to be advected from the subduction site in the Irminger Basin. For western Greenland, the annual temperature maximum occurs near or after the turn of the calendar year. This is significant because a recent study suggested that it is in the non-summer months when fjord-shelf exchanges allow the WL to most strongly influence glacier melt rate. However this is also the time of the year when the WL is least well observed. It is therefore clear that year-round subsurface temperature measurements are still required for a complete description of the WL seasonality, and in particular to ensure that the ice-melting potential of the WL is not underestimated.

  1. Blood glucose monitoring and glycemic control in adolescents with type 1 diabetes: meter downloads versus self-report.

    Science.gov (United States)

    Guilfoyle, Shanna M; Crimmins, Nancy A; Hood, Korey K

    2011-09-01

    Reported frequencies of blood glucose monitoring (BGM) by both adolescents and their caregivers serve as adherence proxies when meter downloads are not available. Yet, correlates of reported BGM frequencies and their predictive utility are understudied. To identify sociodemographic, psychological, and disease-specific correlates of reported BGM frequencies in adolescents with type 1 diabetes and to explore the predictive utility of BGM indices on glycemic control. Study participants included caregivers and adolescents with type 1 diabetes (N=143, 13-18 yr) receiving diabetes treatment at a tertiary care setting. At the initial visit, adolescents and caregivers reported on daily BGM frequencies. A sub-sample provided meter downloads. Adolescents also completed a depression inventory. Three months later, adolescents provided blood sampling for A1c assessment. Multivariate general linear modeling identified that older adolescent age and more depressive symptoms were associated with reports of less frequent BGM. Two stepwise multivariate regression models examined the predictive utility of BGM indices (i.e., adolescent-reported BGM, caregiver-reported BGM, meter download) on glycemic control. Caregiver-reported BGM frequency predicted glycemic control in the absence of meter download data (pmeter download data were the most robust predictor of glycemic control (pMeter downloads have the most robust association with glycemic control when contextual variables are considered. Caregiver-reported BGM frequencies can serve as reliable substitutes in the absence of meter download, but they may not be as reliable in adolescents with depressive symptoms. © 2011 John Wiley & Sons A/S.

  2. THE LONG REACH OF EDUCATION: EARLY RETIREMENT.

    Science.gov (United States)

    Venti, Steven; Wise, David A

    2015-12-01

    The goal of this paper is to draw attention to the long lasting effect of education on economic outcomes. We use the relationship between education and two routes to early retirement - the receipt of Social Security Disability Insurance (DI) and the early claiming of Social Security retirement benefits - to illustrate the long-lasting influence of education. We find that for both men and women with less than a high school degree the median DI participation rate is 6.6 times the participation rate for those with a college degree or more. Similarly, men and women with less than a high school education are over 25 percentage points more likely to claim Social Security benefits early than those with a college degree or more. We focus on four critical "pathways" through which education may indirectly influence early retirement - health, employment, earnings, and the accumulation of assets. We find that for women health is the dominant pathway through which education influences DI participation. For men, the health, earnings, and wealth pathways are of roughly equal magnitude. For both men and women the principal channel through which education influences early Social Security claiming decisions is the earnings pathway. We also consider the direct effect of education that does not operate through these pathways. The direct effect of education is much greater for early claiming of Social Security benefits than for DI participation, accounting for 72 percent of the effect of education for men and 67 percent for women. For women the direct effect of education on DI participation is not statistically significant, suggesting that the total effect may be through the four pathways.

  3. Reaching the global target to reduce stunting: an investment framework.

    Science.gov (United States)

    Shekar, Meera; Kakietek, Jakub; D'Alimonte, Mary R; Rogers, Hilary E; Eberwein, Julia Dayton; Akuoku, Jon Kweku; Pereira, Audrey; Soe-Lin, Shan; Hecht, Robert

    2017-06-01

    Childhood stunting, being short for one's age, has life-long consequences for health, human capital and economic growth. Being stunted in early childhood is associated with slower cognitive development, reduced schooling attainment and adult incomes decreased by 5-53%. The World Health Assembly has endorsed global nutrition targets including one to reduce the number of stunted children under five by 40% by 2025. The target has been included in the Sustainable Development Goals (SDG target 2.2). This paper estimates the cost of achieving this target and develops scenarios for generating the necessary financing. We focus on a key intervention package for stunting (KIPS) with strong evidence of effectiveness. Annual scale-up costs for the period of 2016-25 were estimated for a sample of 37 high burden countries and extrapolated to all low and middle income countries. The Lives Saved Tool was used to model the impact of the scale-up on stunting prevalence. We analysed data on KIPS budget allocations and expenditure by governments, donors and households to derive a global baseline financing estimate. We modelled two financing scenarios, a 'business as usual', which extends the current trends in domestic and international financing for nutrition through 2025, and another that proposes increases in financing from all sources under a set of burden-sharing rules. The 10-year financial need to scale up KIPS is US$49.5 billion. Under 'business as usual', this financial need is not met and the global stunting target is not reached. To reach the target, current financing will have to increase from US$2.6 billion to US$7.4 billion a year on average. Reaching the stunting target is feasible but will require large coordinated investments in KIPS and a supportive enabling environment. The example of HIV scale-up over 2001-11 is instructive in identifying the factors that could drive such a global response to childhood stunting. © The Author 2017. Published by Oxford University

  4. Goal conflicts, attainment of new goals, and well-being among managers.

    Science.gov (United States)

    Kehr, Hugo M

    2003-07-01

    Researchers widely understand that conflicts among goals inhibit the attainment of these goals. However, this notion comes close to tautological reasoning. To avert this problem, this study examined whether preexisting goal conflict also inhibits success in newly set goals. Using the context of management training, in which managers collectively set new goals, the study variables were assessed at 3 testing periods covering 5 months. Results indicate that goal conflicts that persevere over time were associated with inhibited attainment of new goals but not with decreased subjective well-being (SWB). Goal attainment, however, was positively related to SWB. Interactions of residual changes in goal conflict and goal attainment were associated with positive affect.

  5. Scientific goals of SCHOOLS & QUAKES

    Science.gov (United States)

    Brückl, Ewald; Köberl, Christian; Lenhardt, Wolfgang; Mertl, Stefan; Rafeiner-Magor, Walter; Stark, Angelika; Stickler, Gerald; Weber, Robert

    2015-04-01

    In many countries around the world seismometers are used in schools to broaden the knowledge in seismology in a vivid way and to take part in the observation of the current worldwide seismic activity. SCHOOLS & QUAKES is a project within the Sparkling Science program (http://www.sparklingscience.at), which not only pursues the given educational goals but also integrates scholars in seismological research permitting their own contributions. Research within SCHOOLS & QUAKES concentrates on the seismic activity of the Mürz Valley - Semmering - Vienna Basin transfer fault system in Austria because of its relatively high earthquake hazard and risk. The detection of low magnitude local earthquakes (magnitude ≤ 2), precise location of hypocenters, determination of the focal mechanisms, and correlation of hypocenters with active geological structures are the main scientific goals in this project. Furthermore, the long term build-up of tectonic stress, slip deficit and aseismic slip, and the maximum credible earthquake in this area are issues to be addressed. The scientific efforts of SCHOOLS & QUAKES build on the work of the Seismological Service of Austria at the Zentralanstalt für Meteorologie und Geodynamik (ZAMG), and benefit from the findings on the lithospheric structure of the Eastern Alps gained by the CELEBRATION 2000 and ALP 2002 projects. Regional Vp and Vs-models were derived from this data covering the SCHOOLS & QUAKES target area. Within the ALPAACT project (Seismological and geodetic monitoring of ALpine-PAnnonian ACtive Tectonics) the seismic network of the target area was densified by 7 broadband und 2 short period stations. Relocations based on a 3D-velocity model and the densified seismic network yielded substantially higher spatial resolution of seismically active structures. A new method based on waveform stacking (GRA, 16, EGU2014-5722) allowed for focal mechanism solutions of low magnitude (Ml ~2.5) events. Data from 22 GNSS stations have been

  6. Reaching remote areas in Latin America.

    Science.gov (United States)

    Jaimes, R

    1994-01-01

    Poor communities in remote and inaccessible areas tend to not only be cut off from family planning education and services, but they are also deprived of basic primary health care services. Efforts to bring family planning to such communities and populations should therefore be linked with other services. The author presents three examples of programs to bring effective family planning services to remote communities in Central and South America. Outside of the municipal center in the Tuxtlas region of Mexico, education and health levels are low and people live according to ancient customs. Ten years ago with the help of MEXFAM, the IPPF affiliate in Mexico, two social promoters established themselves in the town of Catemaco to develop a community program of family planning and health care offering education and prevention to improve the quality of people's lives. Through their health brigades taking health services to towns without an established health center, the program has influenced an estimated 100,000 people in 50 villages and towns. The program also has a clinic. In Guatemala, the Family Welfare Association (APROFAM) gave bicycles to 240 volunteer health care workers to facilitate their outreach work in rural areas. APROFAM since 1988 has operated an integrated program to treat intestinal parasites and promote family planning in San Lucas de Toliman, an Indian town close to Lake Atitlan. Providing health care to more than 10,000 people, the volunteer staff has covered the entire department of Solola, reaching each family in the area. Field educators travel on motorcycles through the rural areas of Guatemala coordinating with the health volunteers the distribution of contraceptives at the community level. The Integrated Project's Clinic was founded in 1992 and currently carries out pregnancy and Pap tests, as well as general lab tests. Finally, Puna is an island in the middle of the Gulf of Guayaquil, Ecuador. Women on the island typically have 10

  7. Pro-Social Goals in Achievement Situations: Amity Goal Orientation Enhances the Positive Effects of Mastery Goal Orientation.

    Science.gov (United States)

    Levontin, Liat; Bardi, Anat

    2018-04-01

    Research has neglected the utility of pro-social goals within achievement situations. In this article, four studies demonstrate that amity goal orientation, promoting mutual success of oneself together with others, enhances the utility of mastery goal orientation. We demonstrate this in longitudinally predicting performance (Studies 1 and 2) and in maintaining motivation after a disappointing performance (Studies 3 and 4). The studies demonstrate the same interaction effect in academic and in work achievement contexts. Specifically, whereas amity goal orientation did not predict achievement on its own, it enhanced the positive effect of mastery goal orientation. Together, these studies establish the importance of amity goal orientation while also advancing our understanding of the effects of other achievement goal orientations. We suggest future directions in examining the utility of amity goals in other contexts.

  8. Get a taste of your goals: promoting motive-goal congruence through affect-focus goal fantasy.

    Science.gov (United States)

    Job, Veronika; Brandstätter, Veronika

    2009-10-01

    Studies show that motive-goal congruence is an important predictor of well-being (Baumann, Kaschel, & Kuhl, 2005; Brunstein, Schultheiss, & Grässmann, 1998). However, little is known about the factors that promote congruence between implicit motives and goals. Relying on McClelland's (1985) concept of implicit motives and the theory of fantasy realization (Oettingen, 1999), we postulated that goal fantasies focusing on motive-specific affective incentives promote motive-congruent goal setting. This hypothesis was tested in 3 experimental studies. In Study 1 (n=46) and Study 2 (n=48), participants were asked to select goals in a hypothetical scenario. In Study 3 (n=179), they rated their commitment to personal goals for their actual life situation. The results of all 3 studies supported our hypothesis that participants who focus on motive-specific affective incentives in their goal fantasies set their goals in line with their corresponding implicit motive dispositions.

  9. A Journey to Improved Inpatient Glycemic Control by Redesigning Meal Delivery and Insulin Administration.

    Science.gov (United States)

    Engle, Martha; Ferguson, Allison; Fields, Willa

    2016-01-01

    The purpose of this quality improvement project was to redesign a hospital meal delivery process in order to shorten the time between blood glucose monitoring and corresponding insulin administration and improve glycemic control. This process change redesigned the workflow of the dietary and nursing departments. Modifications included nursing, rather than dietary, delivering meal trays to patients receiving insulin. Dietary marked the appropriate meal trays and phoned each unit prior to arrival on the unit. The process change was trialed on 2 acute care units prior to implementation hospital wide. Elapsed time between blood glucose monitoring and insulin administration was analyzed before and after process change as well as evaluation of glucometrics: percentage of patients with blood glucose between 70 and 180 mg/dL (percent perfect), blood glucose greater than 300 mg/dL (extreme hyperglycemia), and blood glucose less than 70 mg/dL (hypoglycemia). Percent perfect glucose results improved from 45% to 53%, extreme hyperglycemia (blood glucose >300 mg/dL) fell from 11.7% to 5%. Hypoglycemia demonstrated a downward trend line, demonstrating that with improving glycemic control hypoglycemia rates did not increase. Percentage of patients receiving meal insulin within 30 minutes of blood glucose check increased from 35% to 73%. In the hospital, numerous obstacles were present that interfered with on-time meal insulin delivery. Establishing a meal delivery process with the nurse performing the premeal blood glucose check, delivering the meal, and administering the insulin improves overall blood glucose control. Nurse-led process improvement of blood glucose monitoring, meal tray delivery, and insulin administration does lead to improved glycemic control for the inpatient population.

  10. Starch digestibility and predicted glycemic index of fried sweet potato cultivars

    Directory of Open Access Journals (Sweden)

    Amaka Odenigbo

    2012-07-01

    Full Text Available Background: Sweet potato (Ipomoea batatas L. is a very rich source of starch. There is increased interest in starch digestibility and the prevention and management of metabolic diseases.Objective: The aim of this study was to evaluate the levels of starch fractions and predicted glycemic index of different cultivars of sweet potato. Material and Method: French fries produced from five cultivars of sweet potato (‘Ginseng Red’, ‘Beauregard’, ‘White Travis’, ‘Georgia Jet clone #2010’ and ‘Georgia Jet’ were used. The level of total starch (TS, resistant starch (RS, digestible starch (DS, and starch digestion index starch digestion index in the samples were evaluated. In vitro starch hydrolysis at 30, 90, and 120 min were determined enzymatically for calculation of rapidly digestible starch (RDS, predicted glycemic index (pGI and slowly digestible starch (SDS respectively. Results: The RS content in all samples had an inversely significant correlation with pGI (-0.52; P<0.05 while RDS had positive and significant influence on both pGI (r=0.55; P<0.05 and SDI (r= 0.94; P<0.01. ‘White Travis’ and ‘Ginseng Red’ had higher levels of beneficial starch fractions (RS and SDS with low pGI and starch digestion Index (SDI, despite their higher TS content. Generally, all the cultivars had products with low to moderate GI values. Conclusion: The glycemic index of these food products highlights the health promoting characteristics of sweet potato cultivars.

  11. Frozen desserts and glycemic response in well-controlled NIDDM patients.

    Science.gov (United States)

    Bukar, J; Mezitis, N H; Saitas, V; Pi-Sunyer, F X

    1990-04-01

    Fructose is known to elicit a lower glycemic response than sucrose, and high-fructose desserts have been recommended for a diabetic diet. We compared a cholesterol-free tofu-based frozen dessert (TFD) containing high-fructose corn syrups with a dairy-based sucrose-sweetened ice cream (IC). Six male and six female non-insulin-dependent diabetic patients (mean age 51 yr, mean ideal body weight 143%, fasting blood glucose less than 160 mg/dl) with well-controlled diabetes and managed on oral hypoglycemic agents were studied. Subjects underwent three trials. In the first trial they ingested 50 g glucose, and in the next two trials they ingested 50-g carbohydrate equivalents of either TFD or IC in random sequence. Venous blood was drawn at intervals during the 3-h trials for glucose and insulin determinations. Fasting plasma glucose was not statistically different between IC and TFD trials (130 vs. 121 mg/dl). Peak glucose responses were at 120 min in both trials (190 mg/dl for IC and 222 mg/dl for TFD), with those for TFD being significantly higher (P less than 0.01). Mean glucose area and glycemic index for TFD were significantly greater than for IC (P less than 0.01 and P less than 0.03, respectively). There was no significant difference between mean insulin areas. In summary, the TFD, which contains soybean curd and high-fructose corn syrup, might have been expected to produce more satisfactory postprandial blood glucose levels than IC, which contains sucrose, yet a higher glycemic response was elicited. This is related to the substantial amount of total glucose in this "fructose" dessert.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Evaluation of the glycemic indices of three commonly eaten mixed meals in Okada, Edo State.

    Science.gov (United States)

    Omage, Kingsley; Omage, Sylvia O

    2018-01-01

    People do not generally eat single or individual meals; rather they eat mixed meals, consisting of two or more individual meals. These mixed meals usually have glycemic indices which differ from that of the individual food type. This study was aimed at evaluating the glycemic indices of three commonly consumed mixed meals eaten in Okada; rice and beans (test food 1), rice and plantain (test food 2), beans and plantain (test food 3). Two hundred and forty healthy subjects aged between 18 and 30 participated in this study. They were randomized into three groups of eighty persons each, and fed with the standard food (50 g glucose) on day one and one of the test foods on day two, after an overnight fast. Blood samples were taken at 0, 30, 60, 90, and 120 min after the food had been eaten. The results showed that the Glycemic Index (GI) values for the test foods were high: 86.60 (test food 1), 89.74 (test food 2), 86.93(test food 3). The incremental increase in blood glucose was monitored and calculated for each food and when compared with that of the standard food (glucose), there was significant differences ( p   .05). The results from this study indicated that the GI of the mixed meals was affected by the constituent nutrient and the response is also affected by the proportion of each nutrient. Our findings show that the selected test foods (mixed meals) consumed in Okada have high GI values.

  13. Metabolic changes after a hypocaloric, low-glycemic-index diet in obese children.

    Science.gov (United States)

    Parillo, M; Licenziati, M R; Vacca, M; De Marco, D; Iannuzzi, A

    2012-07-01

    A low glycemic index (LGI) diet has been proposed as a treatment for obesity in adults; few studies have evaluated LGI diets in obese children. The purpose of the study was to compare the effects of two diets, with similar energy intakes, but different glycemic indexes in a pediatric outpatient setting. A parallel- group, randomized controlled trial was conducted, and 22 obese outpatient children with a body mass index (BMI) Z-score >2 (11 females and 11 males, BMI 28.9±2.9 kg/m²) were included in the study. Patients were randomly allocated to a hypocaloric LGI (GI:60), or to a hypocaloric high glycemic index (HGI) diet (GI:90). The LGI and HGI diets were almost equivalent for macronutrient composition. Anthropometric and biochemical parameters were measured at baseline and after 6 months. In both groups there were significant decreases in BMI, BMI Z-score, blood pressure, and high-sensitivity C-reactive protein. Only LGI diets produced a significant decrease in waist circumference and homeostasis model assessment. Analysis of variance demonstrated that the BMI Z-score decrease from baseline values was significantly greater after the LGI diet than after the HGI diet [-0.20 (95% confidence interval (CI) -0.29 to -0.10) vs -0.34 (95%CI -0.43 to -0.24)], mean difference between groups -0.14 (95%CI -0.27 to -0.01), pdiet (phypocaloric LGI diet has beneficial metabolic effects in comparison to a hypocaloric HGI diet in obese children.

  14. Glycemic Effects of Rebaudioside A and Erythritol in People with Glucose Intolerance

    Directory of Open Access Journals (Sweden)

    Dong Hee Shin

    2016-06-01

    Full Text Available BackgroundRebaudioside A and erythritol are nonnutritive sweeteners. There have been several studies of their glycemic effects, but the outcomes remain controversial. The purpose of this study was to evaluate the glycemic effects of rebaudioside A and erythritol as a sweetener in people with glucose intolerance.MethodsThis trial evaluated the glycemic effect after 2 weeks of consumption of rebaudioside A and erythritol as sweeteners in a pre-diabetic population. The patients were evaluated for fructosamine, fasting plasma glucose, C-peptide, insulin, and 2-hour plasma glucose before and after consumption of sweetener. The primary outcome was a change in fructosamine levels from the baseline to the end of treatment. Secondary outcomes were the changes in levels of fasting plasma glucose and 2-hour plasma glucose.ResultsFrom the baseline to the end of experiment, the changes in fructosamine levels after consumption of rebaudioside A and erythritol, did not differ significantly (244.00±19.57 vs. 241.68±23.39 µmol/L, P=0.366. The change in levels from the baseline to end of the study for rebaudioside A and erythritol were fasting plasma glucose (102.56±10.72 vs. 101.32±9.20 mg/dL, 2-hour plasma glucose (154.92±54.53 vs. 141.92±42.22 mg/dL, insulin (7.56±4.29 vs. 7.20±5.12 IU/mL, and C-peptide (2.92±1.61 vs. 2.73±1.31 ng/mL, respectively, and also did not differ significantly (P>0.05 for all.ConclusionOur study suggests that consumption of rebaudioside A and erythritol does not alter the glucose homeostasis in people with glucose intolerance.

  15. Gestational diabetes mellitus: glycemic control during pregnancy and neonatal outcomes of twin and singleton pregnancies.

    Science.gov (United States)

    Guillén-Sacoto, María Augusta; Barquiel, Beatriz; Hillman, Natalia; Burgos, María Ángeles; Herranz, Lucrecia

    2018-04-20

    To assess the impact of glycemic control in gestational on neonatal weight and metabolic complications of twin and singleton pregnancies. An observational, retrospective study to monitor 120 twin and 240 singleton pregnancies in women with GDM. Maternal glycemic parameters during pregnancy (oral glucose tolerance test results, treatment, insulinization rate, mean HbA1c in the third trimester), and neonatal complications and weight were recorded. A higher infant birth weight ratio (IBWR 1.02±0.12 vs. 0.88±0.12, P<.001) and a lower rate of newborns small for gestational age (severe SGA 2.5% vs. 8.3%, P=.012) were seen after singleton pregnancies as compared to twin pregnancies. The rates of newborns large for gestational age (LGA 12.6% vs. 12.5%, P=.989); macrosomic (6.7% vs. 7.5%, P=.777); or small for gestational age (SGA 6.7% vs. 10.8%, P=.175) were similar in both groups. Neonates from twin pregnancies had a higher risk of hypoglycemia (adjusted OR 4.71; 1.38-16.07, P=.013) and polycythemia (adjusted OR 10.05; 1.82-55.42, P=0.008). A linear relationship was seen between third trimester HbA1c levels and IBWR in singleton (r=.199, P=.003), but not in twin pregnancies (r=0.049, P=0.610). Risk of severe SGA, hypoglycemia, and polycythemia was significantly higher in twin pregnancies of women with GDM. Neonatal weight outcomes and metabolic complications in twin pregnancies of women with GDM were not related to glycemic control. Moreover, in our study population, fasting glucose at diagnosis and mean HbA1c in the third trimester showed a linear relationship with higher birth weights in singleton, but not in twin pregnancies. Copyright © 2018 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Intensive gestational glycemic management and childhood obesity: a systematic review and meta-analysis.

    Science.gov (United States)

    Guillemette, L; Durksen, A; Rabbani, R; Zarychanski, R; Abou-Setta, A M; Duhamel, T A; McGavock, J M; Wicklow, B

    2017-07-01

    Hyperglycemia in pregnancy is associated with increased risk of offspring childhood obesity. Treatment reduces macrosomia; however, it is unclear if this effect translates into a reduced risk of childhood obesity. We performed a systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy and safety of intensive glycemic management in pregnancy in preventing childhood obesity. We searched MEDLINE, EMBASE, CENTRAL and ClinicalTrials.gov up to February 2016 and conference abstracts from 2010 to 2015. Two reviewers independently identified randomized controlled trials evaluating intensive glycemic management interventions for hyperglycemia in pregnancy and included four of the 383 citations initially identified. Two reviewers independently extracted study data and evaluated internal validity of the studies using the Cochrane Collaboration's Risk of Bias tool. Data were pooled using random-effects models. Statistical heterogeneity was quantified using the I 2 test. The primary outcome was age- and sex-adjusted childhood obesity. Secondary outcomes included childhood weight and waist circumference and maternal hypoglycemia during the trial (safety outcome). The four eligible trials (n=767 children) similarly used lifestyle and insulin to manage gestational hyperglycemia, but only two measured offspring obesity and waist circumference and could be pooled for these outcomes. We found no association between intensive gestational glucose management and childhood obesity at 7-10 years of age (relative risk 0.89, 95% confidence interval (CI) 0.65 to 1.22; two trials; n=568 children). Waist circumference also did not differ between treatment and control arms (mean difference, -2.68 cm; 95% CI, -8.17 to 2.81 cm; two trials; n=568 children). Intensive gestational glycemic management is not associated with reduced childhood obesity in offspring, but randomized data is scarce. Long-term follow-up of trials should be prioritized and comprehensive

  17. A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

    Directory of Open Access Journals (Sweden)

    Itandehui Castro-Quezada

    Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

  18. The relationship between breakfast skipping, chronotype, and glycemic control in type 2 diabetes.

    Science.gov (United States)

    Reutrakul, Sirimon; Hood, Megan M; Crowley, Stephanie J; Morgan, Mary K; Teodori, Marsha; Knutson, Kristen L

    2014-02-01

    Breakfast skipping is associated with obesity and an increased risk of type 2 diabetes. Later chronotypes, individuals who have a preference for later bed and wake times, often skip breakfast. The aim of the study was to explore the relationships among breakfast skipping, chronotype, and glycemic control in type 2 diabetes patients. We collected sleep timing and 24-h dietary recall from 194 non-shift-working type 2 diabetes patients who were being followed in outpatient clinics. Mid-sleep time on free days (MSF) was used as an indicator of chronotype. Hemoglobin A1C (HbA1C) values were obtained from medical records. Hierarchical linear regression analyses controlling for demographic, sleep, and dietary variables were computed to determine whether breakfast skipping was associated with HbA1C. Additional regression analyses were performed to test if this association was mediated by chronotype. There were 22 participants (11.3%) who self-reported missing breakfast. Breakfast skippers had significantly higher HbA1C levels, higher body mass indices (BMI), and later MSF than breakfast eaters. Breakfast skipping was significantly associated with higher HbA1C values (B = 0.108, p = 0.01), even after adjusting for age, sex, race, BMI, number of diabetes complications, insulin use, depressive symptoms, perceived sleep debt, and percentage of daily caloric intake at dinner. The relationship between breakfast skipping and HbA1C was partially mediated by chronotype. In summary, breakfast skipping is associated with a later chronotype. Later chronotype and breakfast skipping both contribute to poorer glycemic control, as indicated by higher HbA1C levels. Future studies are needed to confirm these findings and determine whether behavioral interventions targeting breakfast eating or sleep timing may improve glycemic control in patients with type 2 diabetes.

  19. Estimating the reliability of glycemic index values and potential sources of methodological and biological variability.

    Science.gov (United States)

    Matthan, Nirupa R; Ausman, Lynne M; Meng, Huicui; Tighiouart, Hocine; Lichtenstein, Alice H

    2016-10-01

    The utility of glycemic index (GI) values for chronic disease risk management remains controversial. Although absolute GI value determinations for individual foods have been shown to vary significantly in individuals with diabetes, there is a dearth of data on the reliability of GI value determinations and potential sources of variability among healthy adults. We examined the intra- and inter-individual variability in glycemic response to a single food challenge and methodologic and biological factors that potentially mediate this response. The GI value for white bread was determined by using standardized methodology in 63 volunteers free from chronic disease and recruited to differ by sex, age (18-85 y), and body mass index [BMI (in kg/m 2 ): 20-35]. Volunteers randomly underwent 3 sets of food challenges involving glucose (reference) and white bread (test food), both providing 50 g available carbohydrates. Serum glucose and insulin were monitored for 5 h postingestion, and GI values were calculated by using different area under the curve (AUC) methods. Biochemical variables were measured by using standard assays and body composition by dual-energy X-ray absorptiometry. The mean ± SD GI value for white bread was 62 ± 15 when calculated by using the recommended method. Mean intra- and interindividual CVs were 20% and 25%, respectively. Increasing sample size, replication of reference and test foods, and length of blood sampling, as well as AUC calculation method, did not improve the CVs. Among the biological factors assessed, insulin index and glycated hemoglobin values explained 15% and 16% of the variability in mean GI value for white bread, respectively. These data indicate that there is substantial variability in individual responses to GI value determinations, demonstrating that it is unlikely to be a good approach to guiding food choices. Additionally, even in healthy individuals, glycemic status significantly contributes to the variability in GI value

  20. Short-term effects of a low glycemic index carob-containing snack on energy intake, satiety, and glycemic response in normal-weight, healthy adults: Results from two randomized trials.

    Science.gov (United States)

    Papakonstantinou, Emilia; Orfanakos, Nickolaos; Farajian, Paul; Kapetanakou, Anastasia E; Makariti, Ifigenia P; Grivokostopoulos, Nikolaos; Ha, Marie-Ann; Skandamis, Panagiotis N

    2017-10-01

    The potential positive health effects of carob-containing snacks are largely unknown. Therefore, the aims of these studies were to determine the glycemic index (GI) of a carob snack compared with chocolate cookie containing equal amounts of available carbohydrates and to compare the effects of a carob versus chocolate cookie preload consumed as snack before a meal on (a) short-term satiety response measured by subsequent ad libitum meal intake, (b) subjective satiety as assessed by visual analog scales and (c) postprandial glycemic response. Ten healthy, normal-weight volunteers participated in GI investigation. Then, 50 healthy, normal-weight individuals consumed, crossover, in random order, the preloads as snack, with 1-wk washout period. Ad libitum meal (lunch and dessert) was offered. Capillary blood glucose samples were collected at baseline, 2 h after breakfast, just before preload consumption, 2 h after preload, 3 h after preload, just before meal (lunch and dessert), 1 h after meal, and 2 h after meal consumption. The carob snack was a low GI food, whereas the chocolate cookie was a high GI food (40 versus 78, respectively, on glucose scale). Consumption of the carob preload decreased the glycemic response to a following meal and to the individual's feelings of hunger, desire to eat, preoccupation with food, and thirst between snack and meal, as assessed with the use of visual analog scales. Subsequently, participants consumed less amounts of food (g) and had lower total energy intake at mealtimes. The carob snack led to increased satiety, lower energy intake at meal, and decreased postmeal glycemic response possibly due to its low GI value. Identifying foods that promote satiety and decrease glycemic response without increasing the overall energy intake may offer advantages to body weight and glycemic control. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Turning goals into results: the power of catalytic mechanisms.

    Science.gov (United States)

    Collins, J

    1999-01-01

    Most executives have a big, hairy, audacious goal. They write vision statements, formalize procedures, and develop complicated incentive programs--all in pursuit of that goal. In other words, with the best of intentions, they install layers of stultifying bureaucracy. But it doesn't have to be that way. In this article, Jim Collins introduces the catalytic mechanism, a simple yet powerful managerial tool that helps translate lofty aspirations into concrete reality. Catalytic mechanisms are the crucial link between objectives and performance; they are a galvanizing, nonbureaucratic means to turn one into the other. What's the difference between catalytic mechanisms and most traditional managerial controls? Catalytic mechanisms share five characteristics. First, they produce desired results in unpredictable ways. Second, they distribute power for the benefit of the overall system, often to the discomfort of those who traditionally hold power. Third, catalytic mechanisms have teeth. Fourth, they eject "viruses"--those people who don't share the company's core values. Finally, they produce an ongoing effect. Catalytic mechanisms are just as effective for reaching individual goals as they are for corporate ones. To illustrate how catalytic mechanisms work, the author draws on examples of individuals and organizations that have relied on such mechanisms to achieve their goals. The same catalytic mechanism that works in one organization, however, will not necessarily work in another. Catalytic mechanisms must be tailored to specific goals and situations. To help readers get started, the author offers some general principles that support the process of building catalytic mechanisms effectively.

  2. Muscle synergy extraction during arm reaching movements at different speeds.

    Science.gov (United States)

    Sabzevari, Vahid Reza; Jafari, Amir Homayoun; Boostani, Reza

    2017-01-01

    Muscle synergy is the activation of a group of muscles that contribute to a particular movement. The goal of the present study is to examine the hypothesis that human reaching movements at different speeds share similar muscle synergies and to investigate the kinesiology basis and innervation of muscles. Electromyographic activity from six muscles of the upper limb and shoulder girdle were recorded during three movements at different speeds, i.e. slow, moderate and fast. The effect of window length on the RMS signal of the EMG was analyzed and then EMG envelope signals were decomposed using non-negative matrix factorization. For each of the ten subjects, three synergies were extracted which accounted for at least 99% of the VAF. For each movement, the muscle synergies and muscle activation coefficients of all participants were clustered in to three partitions. Investigation showed a high similarity and dependency of cluster members due to the cosine similarity and mutual information in muscle synergy clustering. For further verification, the EMG envelope signals for all subjects were reconstructed. The results indicated a lower reconstruction error using the center of the muscle synergy clusters in comparison with the average of the activation coefficients, which confirms the current research's hypothesis.

  3. Self-regulation through Goal Setting

    DEFF Research Database (Denmark)

    Koch, Alexander; Nafziger, Julia

    2011-01-01

    Goals are an important motivator. But little is known about why and how people set them. We address this issue in a model based on two stylized facts. i) Goals serve as reference points for performance. ii) Present-biased preferences create self-control problems. We show the power and limits...... of self-regulation through goals. Goals increase an individual's motivation - but only up to a certain point. And they are painful self-disciplining devices. Greater self-control problems may result in tougher goals; but for a severe present bias goals either lack motivating force, or are too painful...

  4. Exercise training in older patients with systolic heart failure: Adherence, exercise capacity, inflammation and glycemic control

    DEFF Research Database (Denmark)

    Prescott, Eva; Hjardem-Hansen, Rasmus; Dela, Flemming

    2009-01-01

    markers of glycemic control (glucose, insulin, glycerol, free fatty acids, HbA1c), inflammation and endothelial function (hsCRP, orosomucoid, interleukin 6, TNF-alpha, urine-orosomucoid and -albumin/creatinin), lipid metabolism, NT-proBNP or other regulatory hormones (cortisol, epinephrine and IGF-1......). There were no changes in quality of life. Conclusions. The effect of exercise training in these older CHF-patients was not as impressive as reported in younger and more selected patients. More studies on the efficiency of exercise training that reflect the age- and co-morbidity of the majority of CHF...

  5. Serum glycated albumin as a new glycemic marker in pediatric diabetes

    Directory of Open Access Journals (Sweden)

    Ji Woo Lee

    2013-12-01

    Full Text Available PurposeSerum glycated albumin (GA has been recently used as another glycemic marker that reflects shorter term glycemic control than glycated hemoglobin (HbA1c. Insulin secretory function and glycemic fluctuation might be correlated with the ratio of GA to HbA1c (GA/HbA1c in diabetic adult patients. This study investigated the association of GA and GA/HbA1c ratio with the levels of fasting C-peptide, fasting plasma glucose in type 1 and type 2 pediatric diabetes.MethodsTotal 50 cases from 42 patients were included. The subjects were classified into type 1 diabetes mellitus (T1DM (n=30 and type 2 diabetes mellitus (T2DM (n=20 group. The associations among HbA1c, GA, and GA/HbA1c ratio were examined. The relationship between the three glycemic indices and fasting glucose, fasting C-peptide were analyzed.ResultsMean values of GA, the GA/HbA1c ratio were significantly higher in T1DM than T2DM. GA (r=0.532, P=0.001, HbA1c (r=0.519, P=0.002 and the GA/HbA1c ratio (r=0.409, P=0.016 were correlated with the fasting plasma glucose. Fasting C-peptide level arranged 4.22±3.22 ng/mL in T2DM, which was significantly above the values in T1DM (0.26±0.49 ng/mL. There were no significant correlation between HbA1c and fasting C-peptide level. However, GA and the GA/HbA1c ratio exhibited inverse correlations with fasting C-peptide level (r=-0.214, P=0.002; r=-0.516, P<0.001.ConclusionGA seems to more accurately reflects fasting plasma glucose level than HbA1c. GA, GA/HbA1c ratio appear to reflect insulin secretory function.

  6. Glycemic control strategies and the occurrence of surgical site infection: a systematic review.

    Science.gov (United States)

    Domingos, Caroline Maria Herrero; Iida, Luciana Inaba Senyer; Poveda, Vanessa de Brito

    2016-01-01

    To analyze the evidence available in the scientific literature regarding the relationship between the glycemic control strategies used and the occurrence of surgical site infection in adult patients undergoing surgery. This is a systematic review performed through search on the databases of CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews and EMBASE. Eight randomized controlled trials were selected. Despite the diversity of tested interventions, studies agree that glycemic control is essential to reduce rates of surgical site infection, and should be maintained between 80 and 120 mg/dL during the perioperative period. Compared to other strategies, insulin continuous infusion during surgery was the most tested and seems to get better results in reducing rates of surgical site infection and achieving success in glycemic control. Tight glycemic control during the perioperative period benefits the recovery of surgical patients, and the role of the nursing team is key for the successful implementation of the measure. Analisar as evidências disponíveis na literatura científica sobre a relação entre as estratégias de controle glicêmico efetuadas e a ocorrência de infecção do sítio cirúrgico em pacientes adultos submetidos à cirurgia. Trata-se de revisão sistemática, por meio das bases de dados CINAHL, MEDLINE, LILACS, Cochrane Database of Systematic Reviews e EMBASE. Foram selecionados oito ensaios clínicos randomizados. Apesar da diversidade de intervenções testadas, os estudos concordam que o controle glicêmico é essencial para a redução das taxas de infecção do sítio cirúrgico e deve ser mantido entre 80 e 120 mg/dL durante o perioperatório. A infusão contínua de insulina no transoperatório foi a mais testada e parece obter melhores resultados na redução das taxas de infecção do sítio cirúrgico e sucesso no controle glicêmico comparada às demais estratégias. O controle glicêmico rigoroso durante o perioperat

  7. The Influence of Glycemic Index on Cognitive Functioning: A Systematic Review of the Evidence1

    OpenAIRE

    Philippou, Elena; Constantinou, Marios

    2014-01-01

    The impact of the rate of carbohydrate absorption, as measured by the carbohydrate’s glycemic index (GI) on cognitive performance, is not clear. The aim of this review was to systematically assess the relevant research studies. A systematic review of English-language articles using Medline, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and PsycARTICLES (up to July 2012) using the search terms “glyc(a)emic index” or “glycaemic load” combined with “cognitive function” or “co...

  8. Glycemic indices of five varieties of dates in healthy and diabetic subjects

    Directory of Open Access Journals (Sweden)

    Gariballa Salah

    2011-05-01

    Full Text Available Abstract Background This study was designed to determine the glycemic indices of five commonly used varieties of dates in healthy subjects and their effects on postprandial glucose excursions in individuals with type 2 diabetes mellitus. Methods Composition analysis was carried out for five types of dates (Tamer stage. The weights of the flesh of the dates equivalent to 50 g of available carbohydrates were calculated. The study subjects were thirteen healthy volunteers with a mean (± SD age of 40.2 ± 6.7 years and ten participants with type 2 diabetes mellitus (controlled on lifestyle measures and/or metformin with a mean HbA1c (± SD of 6.6 ± (0.7% and a mean age (± SD of 40.8 ± 5.7 years. Each subject was tested on eight separate days with 50 g of glucose (on 3 occasions and 50 g equivalent of available carbohydrates from the 5 varieties of date (each on one occasion. Capillary glucose was measured in the healthy subjects at 0, 15, 30, 45, 60, 90 and 120 min and for the diabetics at 0, 30, 60, 90, 120, 150 and 180 min. The glycemic indices were determined as ratios of the incremental areas under the response curves for the dates compared to glucose. Statistical analyses were performed using the Mann-Whitney U test and repeated measures analysis of variance. Results Mean glycemic indices ± SEM of the dates for the healthy individuals were 54.0 ± 6.1, 53.5 ± 8.6, 46.3 ± 7.1, 49.1 ± 3.6 and 55.1 ± 7.7 for Fara'd, Lulu, Bo ma'an, Dabbas and Khalas, respectively. Corresponding values for those with type 2 diabetes were very similar (46.1 ± 6.2, 43.8 ± 7.7, 51.8 ± 6.9, 50.2 ± 3.9 and 53.0 ± 6.0. There were no statistically significant differences in the GIs between the control and the diabetic groups for the five types of dates, nor were there statistically significant differences among the dates' GIs (df = 4, F = 0.365, p = 0.83. Conclusion The results show low glycemic indices for the five types of dates included in the study and

  9. Glycemic Control by Exercise and Urtica Dioica Supplements in Men With Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Dabagh

    2016-01-01

    Full Text Available Background Type 2 diabetes is a metabolic disease in which hyperglycemia is a major symptom, and is associated with numerous vascular and non-vascular complications. People with diabetes use medicinal treatment to exert glycemic control, as well as exercise training and herbal remedies, such as urtica dioica (UD. Objectives This study aimed to compare the effects of 8 weeks of aerobic training and UD supplementation alone, and in combination, on glycemic control in men with type 2 diabetes mellitus (T2DM. Patients and Methods This semi-experimental study was conducted in 2014, in the city of Dezful, Iran. A total of 40 males (aged 30 - 50 years with T2DM were selected and randomly divided into one of four groups in equal numbers (n = 10: 1 - aerobic training (Ae, 2 - UD supplements (UD, 3 - a combination of aerobic training and UD supplements (Ae + UD, and 4 - a control group. Blood samples were taken 24 hours before and 48 hours after the intervention period, following 10 - 12 hours of fasting. A t-test and analysis of variance was used to analyze the changes in the measured parameters, and P ≤ 0.05 was considered statistically significant. Results A significant decrease in fasting blood sugar (FBS was observed in the Ae group (-9.50 ± 6.96 mg/dl; P = 0.002, the UD group (-7.60 ± 6.04 mg/dL; P = 0.001, and the Ae + UD group (-18.30 ± 6.63 mg/dL; P < 0.001 after 8 weeks. There was a significant difference in FBS between the three intervention groups and the control group. In addition, a significant difference in FBS (P < 0.05 was shown between the UD and Ae + UD groups. Conclusions The findings confirmed the positive influence of UD supplements and aerobic training on glycemic control in males with T2DM. When aerobic training was combined with a UD supplement, a greater degree of glycemic control was observed.

  10. Accuracy of Continuous Glucose Monitoring Measurements in Normo-Glycemic Individuals

    DEFF Research Database (Denmark)

    Akintola, Abimbola A; Noordam, Raymond; Jansen, Steffy W

    2015-01-01

    a 24-hour period. Validity of CGM-derived individual glucose measurements, calculated measures of glycemia over daytime (09:00h-23:00h) and nighttime (23:00h-09:00h), and calculated measures of glycemic variability (e.g. 24h standard deviation [SD]) were assessed by Pearson correlation coefficients......, mean absolute relative difference (MARD) and paired t-tests. RESULTS: The median correlation coefficient between CGM and venous glucose measurements per participant was 0.68 (interquartile range: 0.40-0.78), and the MARD was 17.6% (SD = 17%). Compared with venous sampling, the calculated measure...

  11. The combination of colesevelam with sitagliptin enhances glycemic control in diabetic ZDF rat model

    DEFF Research Database (Denmark)

    Shang, Quan; Liu, Matthew K; Saumoy, Monica

    2012-01-01

    . In the present study, we tested whether adding sitagliptin (Januvia) (SIT), which prolongs bioactive GLP-1 half life, to COL would further enhance glycemic control. Male Zucker diabetic fatty (ZDF) rats were assigned to four groups: diabetic model without treatment (the model), the model treated with 2% COL or 0...... to levels similar to the model. Histological examination of the pancreatic ß-cell islets showed that islet sizes were larger, proliferation enhanced, and cell apoptosis reduced in the COL+SIT but not the SIT alone group compared with the model. We hypothesize that the combination of COL with SIT extends...

  12. The Influence of Diabetes, Glycemic Control, and Diabetes-Related Comorbidities on Pulmonary Tuberculosis

    Science.gov (United States)

    Chiang, Chen Yuan; Bai, Kuan Jen; Lin, Hsien Ho; Chien, Shun Tien; Lee, Jen Jyh; Enarson, Donald A.; Lee, Ting-I; Yu, Ming-Chih

    2015-01-01

    Background To assess the influence of diabetes mellitus (DM), glycemic control, and diabetes-related comorbidities on manifestations and outcome of treatment of pulmonary tuberculosis (TB). Methodology/Principal Findings Culture positive pulmonary TB patients notified to health authorities in three hospitals in Taiwan from 2005–2010 were investigated. Glycemic control was assessed by glycated haemoglobin A1C (HbA1C) and diabetic patients were categorized into 3 groups: HbA1C9%. 1,473 (705 with DM and 768 without DM) patients were enrolled. Of the 705 diabetic patients, 82 (11.6%) had pretreatment HbA1C9%, and 195 (27.7%) had no information of HbA1C. The proportions of patients with any symptom, cough, hemoptysis, tiredness and weight loss were all highest in diabetic patients with HbA1C>9%. In multivariate analysis adjusted for age, sex, smoking, and drug resistance, diabetic patients with HbA1C>9% (adjOR 3.55, 95% CI 2.40–5.25) and HbA1C 7–9% (adjOR 1.62, 95% CI 1.07–2.44) were significantly more likely to be smear positive as compared with non-diabetic patients, but not those with HbA1C<7% (adjOR 1.16, 95% CI 0.70–1.92). The influence of DM on outcome of TB treatment was not proportionately related to HbA1C, but mainly mediated through diabetes-related comorbidities. Patients with diabetes-related comorbidities had an increased risk of unfavorable outcome (adjOR 3.38, 95% CI 2.19–5.22, p<0.001) and one year mortality (adjOR 2.80, 95% CI 1.89–4.16). However, diabetes was not associated with amplification of resistance to isoniazid (p = 0.363) or to rifampicin (p = 0.344). Conclusions/Significance Poor glycemic control is associated with poor TB treatment outcome and improved glycemic control may reduce the influence of diabetes on TB. PMID:25822974

  13. Glycemic variability in patients with Wolfram syndrome is lower than in type 1 diabetes.

    Science.gov (United States)

    Zmyslowska, A; Fendler, W; Szadkowska, A; Borowiec, M; Mysliwiec, M; Baranowska-Jazwiecka, A; Buraczewska, M; Fulmanska-Anders, M; Mianowska, B; Pietrzak, I; Rzeznik, D; Mlynarski, W

    2015-12-01

    Wolfram syndrome (WFS) is diagnosed as coexistence of diabetes mellitus and optic atrophy, where pancreatic beta cell destruction is associated with neurodegeneration. Typically, WFS necessitates insulin treatment similar to type 1 diabetes (T1D), but the mechanism of beta cell mass reduction leading to hyperglycemia is different. The aim of the study was to assess glycemic variability using the continuous glucose monitoring (CGM) system in seven pediatric patients with genetically confirmed WFS and compare the results with data obtained from 21 propensity score-matched patients with T1D. The "GlyCulator" application was used for the calculation of glycemic variability indices. CGM recordings showed similarities in glycemic variability among WFS patients, but differing from those of the T1D group. Coefficient of variation (%CV), CONGA4h, and GONGA6h were significantly (p < 0.05) lower in WFS patients (28.08 ± 7.37, 54.96 ± 11.92, and 55.99 ± 10.58) than in T1D patients (37.87 ± 14.24, 74.12 ± 28.74, p = 0.02, and 80.26 ± 35.05, respectively). In WFS patients, the percentage of values above 126 mg/dL was 69.79 (52.08-77.43), whereas in patients with T1D, the percentage was significantly lower-47.22 (35.07-62.85, p = 0.018). Curiously, a tendency toward a lower percentage of measurements below 70 mg/dL was noted in the WFS group [0 (0-7.29)] in comparison with the T1D group [6.25 (0-18.06), p = 0.122]. WFS patients had a significantly higher C-peptide level (0.31 ± 0.2 ng/mL) than T1D patients (0.04 ± 0.04 ng/mL; p = 0.006). Patients with WFS show smaller glycemic variability than individuals with T1D, and this may be associated with persistent residual insulin secretion.

  14. Correlation between glycemic variability and gastroesophageal reflux in adolescentswith type 1 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    I L Alimova

    2013-03-01

    Full Text Available Aims. To estimate an impact of glycemic variability on the development of gastroesophageal reflux disease (GERD in adolescents with type 1 diabetes mellitus (T1DM. Materials and methods. We enrolled 33 patients with T1DM aged from 12 to 17 years. 24-h pH-monitoring was performed with ?Gas- troskan 24? system (Istok-Sistema, Fryazino; 24-h continuous glucose monitoring utilized CGMS MMT-7310 (Medtronic Minimed, USA with subsequent night-time analysis. Results. As compared to stable night-time glycemia controls (SD 2.0 mmol/L showed longer period of esophageal acidification (17% [2?58]; p

  15. Whole grains, bran, and germ in relation to homocysteine and markers of glycemic control, lipids, and inflammation 1

    DEFF Research Database (Denmark)

    Jensen, Majken K; Koh-Banerjee, Pauline; Franz, Mary

    2006-01-01

    BACKGROUND: Intake of whole grains is inversely associated with risk of diabetes and ischemic heart disease in observational studies. The lower risk associated with high whole-grain intakes may be mediated through improvements in glycemic control, lipid profiles, or reduced inflammation. OBJECTIV...... in this population. CONCLUSION: The results suggest a lower risk of diabetes and heart disease in persons who consume diets high in whole grains.......BACKGROUND: Intake of whole grains is inversely associated with risk of diabetes and ischemic heart disease in observational studies. The lower risk associated with high whole-grain intakes may be mediated through improvements in glycemic control, lipid profiles, or reduced inflammation. OBJECTIVE......-reactive protein, fibrinogen, and interleukin 6). DESIGN: This was a cross-sectional study of the relations of whole grains, bran, and germ intakes with homocysteine and markers of glycemic control, lipids, and inflammation in 938 healthy men and women. RESULTS: Whole-grain intake was inversely associated...

  16. Distinct lipid profiles predict improved glycemic control in obese, nondiabetic patients after a low-caloric diet intervention

    DEFF Research Database (Denmark)

    Valsesia, Armand; Saris, Wim Hm; Astrup, Arne

    2016-01-01

    BACKGROUND: An aim of weight loss is to reduce the risk of type 2 diabetes (T2D) in obese subjects. However, the relation with long-term glycemic improvement remains unknown. OBJECTIVE: We evaluated the changes in lipid composition during weight loss and their association with long-term glycemic...... improvement. DESIGN: We investigated the plasma lipidome of 383 obese, nondiabetic patients within a randomized, controlled dietary intervention in 8 European countries at baseline, after an 8-wk low-caloric diet (LCD) (800-1000 kcal/d), and after 6 mo of weight maintenance. RESULTS: After weight loss......: In this study, we report a lipid signature of LCD success (for weight and glycemic outcome) in obese, nondiabetic patients. Lipid changes during an 8-wk LCD allowed us to predict insulin-resistant patients after 6 mo of weight maintenance. The determination of the lipid composition during an LCD enables...

  17. Mother-father informant discrepancies regarding diabetes management: associations with diabetes-specific family conflict and glycemic control.

    Science.gov (United States)

    Sood, Erica D; Pendley, Jennifer Shroff; Delamater, Alan M; Rohan, Jennifer M; Pulgaron, Elizabeth R; Drotar, Dennis

    2012-09-01

    To examine the relationship of mother-father informant discrepancies regarding diabetes management to diabetes-specific family conflict and glycemic control. One hundred thirty-six mothers and fathers of youth with Type 1 diabetes reported on the youth's diabetes management, diabetes-specific family conflict, and amount of paternal involvement in diabetes care. Glycosylated hemoglobin A1c (HbA1c) was used to measure glycemic control. As hypothesized, mother-father discrepancies regarding diabetes management were positively associated with frequency of diabetes-specific family conflict. Contrary to hypotheses, mother-father discrepancies regarding diabetes management predicted poorer glycemic control for youth with less involved fathers only. Results highlight the importance of caregivers being consistent about pediatric illness management and support the idea that informant discrepancies represent an important window into the functioning of the family system. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  18. Functional reach and lateral reach tests adapted for aquatic physical therapy

    Directory of Open Access Journals (Sweden)

    Ana Angélica Ribeiro de Lima

    Full Text Available Abstract Introduction: Functional reach (FR and lateral reach (LR tests are widely used in scientific research and clinical practice. Assessment tools are useful in assessing subjects with greater accuracy and are usually adapted according to the limitations of each condition. Objective: To adapt FR and LR tests for use in an aquatic environment and assess the performance of healthy young adults. Methods: We collected anthropometric data and information on whether the participant exercised regularly or not. The FR and LR tests were adapted for use in an aquatic environment and administered to 47 healthy subjects aged 20-30 years. Each test was repeated three times. Results: Forty-one females and six males were assessed. The mean FR test score for men was 24.06 cm, whereas the mean value for right lateral reach (RLR was 10.94 cm and for left lateral reach (LLR was 9.78 cm. For females, the mean FR score was 17.57 cm, while the mean values for RLR was 8.84cm and for LLR was 7.76 cm. Men performed better in the FR (p < 0.001 and RLR tests than women (p = 0.037. Individuals who exercised regularly showed no differences in performance level when compared with their counterparts. Conclusion: The FR and LR tests were adapted for use in an aquatic environment. Males performed better on the FR and RLR tests, when compared to females. There was no correlation between the FR and LR tests and weight, height, Body Mass Index (BMI, foot length or length of the dominant upper limb.

  19. A low-glycemic index diet and exercise intervention reduces TNF(alpha) in isolated mononuclear cells of older, obese adults

    DEFF Research Database (Denmark)

    Kelly, Karen R; Haus, Jacob M; Solomon, Thomas

    2011-01-01

    Low-glycemic index diets and exercise independently improve glucose tolerance and reduce diabetes risk. However, the combined effect of a low-glycemic index diet and exercise on inflammation and glucose metabolism is not known. Therefore, we randomized 28 insulin-resistant adults (age: 66 ± 1 y; ...

  20. Blood profile of proteins and steroid hormones predicts weight change after weight loss with interactions of dietary protein level and glycemic index

    DEFF Research Database (Denmark)

    Wang, Ping; Holst, Claus; Andersen, Malene R

    2011-01-01

    Weight regain after weight loss is common. In the Diogenes dietary intervention study, high protein and low glycemic index (GI) diet improved weight maintenance.......Weight regain after weight loss is common. In the Diogenes dietary intervention study, high protein and low glycemic index (GI) diet improved weight maintenance....

  1. IAEA Patient Protection Effort Reaches Key Milestone

    International Nuclear Information System (INIS)

    2012-01-01

    scans when it can be avoided. An increasing number of infants and children are also getting repeated CT scans. In most cases, the medical benefits still outweigh the harm, but there is growing concern about unjustified CT scans with increased cumulative doses to patients that could be detrimental. The IAEA held its first Smart Card development meeting in 2009. Additional sessions in 2010 and 2012 led to the final draft of the Joint Position Statement, which outlines a number of major goals: 1. Supporting accountability for patient safety; 2. Strengthening of the process of justification (e.g. information available at the point-of-care for the referring practitioner); 3. Supporting optimization (e.g. use of diagnostic reference levels (DRLs)); 4. Providing information for assessment of radiation risks; and 5. Establishing a tool for use in research and epidemiology. (IAEA)

  2. Glycemic Response to Black Beans and Chickpeas as Part of a Rice Meal: A Randomized Cross-Over Trial.

    Science.gov (United States)

    Winham, Donna M; Hutchins, Andrea M; Thompson, Sharon V

    2017-10-04

    Legumes, such as black beans ( Phaseolus vulgaris L.) and chickpeas ( Cicer arietinum L.), have a low glycemic index, and may reduce the glycemic load of meals in which they are included. Although the low glycemic response of beans consumed alone has been documented, few studies have examined the glycemic response to traditional food combinations such as black beans and rice or chickpeas and rice. This randomized cross-over study examined the glycemic and insulinemic impact of 50 grams of available carbohydrate from three test meals: plain white rice (control), black beans with rice, and chickpeas with rice among healthy adult women ( n = 12, 18-65 years). Treatments were consumed on different mornings, a minimum of 7 days apart. Blood samples were collected at time 0 (fasting), and at 30, 60, 90, and 120 min postprandial, and were subsequently analyzed for glucose and insulin concentrations. Glucose response based on the incremental area under the curve showed a significant difference by treatment ( p = 0.027). Changes in blood glucose concentrations were significantly different for the black bean meal and the chickpea meal in comparison to rice alone at 60 min ( p = 0.026 and p = 0.024), 90 min ( p = 0.001 and p = 0.012) and 120 min post prandial ( p = 0.024; black bean meal). Findings indicate that combinations of black beans and chickpeas with white rice improve glycemic response, providing evidence that has promising implications for dietary guidance to reduce postprandial glucose and related health risks through traditional food patterns.

  3. The Fallacy of Average: How Using HbA1c Alone to Assess Glycemic Control Can Be Misleading.

    Science.gov (United States)

    Beck, Roy W; Connor, Crystal G; Mullen, Deborah M; Wesley, David M; Bergenstal, Richard M

    2017-08-01

    HbA 1c is a v aluable metric for comparing treatment groups in a randomized trial, for assessing glycemic trends in a population over time, or for cross-sectional comparisons of glycemic control in different populations. However, what is not widely appreciated is that HbA 1c may not be a good indicator of an individual patient's glycemic control because of the wide range of mean glucose concentrations and glucose profiles that can be associated with a given HbA 1c level. To illustrate this point, we plotted mean glucose measured with continuous glucose monitoring (CGM) versus central laboratory-measured HbA 1c in 387 participants in three randomized trials, showing that not infrequently HbA 1c may underestimate or overestimate mean glucose, sometimes substantially. Thus, if HbA 1c is to be used to assess glycemic control, it is imperative to know the patient's actual mean glucose to understand how well HbA 1c is an indicator of the patient's glycemic control. With knowledge of the mean glucose, an estimated HbA 1c (eA1C) can be calculated with the formula provided in this article to compare with the measured HbA 1c . Estimating glycemic control from HbA 1c alone is in essence applying a population average to an individual, which can be misleading. Thus, a patient's CGM glucose profile has considerable value for optimizing his or her diabetes management. In this era of personalized, precision medicine, there are few better examples with respect to the fallacy of applying a population average to a specific patient rather than using specific information about the patient to determine the optimal approach to treatment. © 2017 by the American Diabetes Association.

  4. The Relation Between Goals and Autobiographical Memory

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Rasmussen, Anne Scharling; Berntsen, Dorthe

    facilitate recall of goal congruent autobiographical memories which supports the idea of autobiographical memory facilitating goal attainment. Further, no differences between involuntary and voluntary memories with regard to frequency or characteristics of goal related content were found. Yet memories...... related to goals were rated as more central to the person's identity, life story and expectations for the future than non-goal related memories, irrespective of mode of recall. Interestingly, depression and PTSD symptoms correlated positively with the proportion of goal related memories, thereby......The present study examines involuntary (spontaneously retrieved) versus voluntary (deliberately retrieved) autobiographical memories in relation to earlier registered goals measured by the Personal Concern Inventory (Cox & Klinger, 2000). We found that the important and not yet planned goals...

  5. Growth goals, maturity, and well-being.

    Science.gov (United States)

    Bauer, Jack J; McAdams, Dan P

    2004-01-01

    In 2 studies (125 college students and 51 adults), 2 forms of growth goals (exploratory and intrinsic) were compared with 2 forms of personality development (social-cognitive maturity and social-emotional well-being). Participants whose narratives of major life goals emphasized conceptual exploration were especially likely to have high levels of maturity (measured as ego development; J. Loevinger, 1976), whereas those whose goals emphasized intrinsic interests (K. M. Sheldon & T. Kasser, 1995) were especially likely to have high levels of well-being. Participants who had coherent hierarchies of growth goals on the levels of major life goals and everyday goals were especially likely to have high levels of personality development. Finally, growth goals accounted for some relationships between age and personality development. Growth goals are discussed in terms of intentional self-development and specific developmental paths. (c) 2003 APA

  6. Do Cinnamon Supplements Have a Role in Glycemic Control in Type 2 Diabetes – A Narrative Review?

    OpenAIRE

    Costello, Rebecca B.; Dwyer, Johanna T.; Saldanha, Leila; Bailey, Regan L.; Merkel, Joyce; Wambogo, Edwina

    2016-01-01

    Cinnamon (Cinnamomum sp.) has been suggested to help patients with type 2 diabetes mellitus (T2DM) achieve better glycemic control although conclusions from meta-analyses are mixed. To evaluate whether the use of cinnamon dietary supplements by adults with T2DM had clinically meaningful effects on glycemic control, as measured by changes in fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c), a comprehensive PubMed literature search was performed. Eleven RCTs were identified meeting our in...

  7. Stability and Change in Social Goals as Related to Goal Structures and Engagement in School

    Science.gov (United States)

    Madjar, Nir

    2017-01-01

    The current studies explored (a) the extended external validity of social-goal-orientation framework; (b) the mediating role of social goals between classroom goal structures and students' engagement; and (c) whether changes in social goals can be explained by classroom goal structures and engagement. Study 1 was cross-sectional (N = 317), and…

  8. The actual goals of geoethics

    Science.gov (United States)

    Nemec, Vaclav

    2014-05-01

    The most actual goals of geoethics have been formulated as results of the International Conference on Geoethics (October 2013) held at the geoethics birth-place Pribram (Czech Republic): In the sphere of education and public enlightenment an appropriate needed minimum know how of Earth sciences should be intensively promoted together with cultivating ethical way of thinking and acting for the sustainable well-being of the society. The actual activities of the Intergovernmental Panel of Climate Changes are not sustainable with the existing knowledge of the Earth sciences (as presented in the results of the 33rd and 34th International Geological Congresses). This knowledge should be incorporated into any further work of the IPCC. In the sphere of legislation in a large international co-operation following steps are needed: - to re-formulate the term of a "false alarm" and its legal consequences, - to demand very consequently the needed evaluation of existing risks, - to solve problems of rights of individuals and minorities in cases of the optimum use of mineral resources and of the optimum protection of the local population against emergency dangers and disasters; common good (well-being) must be considered as the priority when solving ethical dilemmas. The precaution principle should be applied in any decision making process. Earth scientists presenting their expert opinions are not exempted from civil, administrative or even criminal liabilities. Details must be established by national law and jurisprudence. The well known case of the L'Aquila earthquake (2009) should serve as a serious warning because of the proven misuse of geoethics for protecting top Italian seismologists responsible and sentenced for their inadequate superficial behaviour causing lot of human victims. Another recent scandal with the Himalayan fossil fraud will be also documented. A support is needed for any effort to analyze and to disclose the problems of the deformation of the contemporary

  9. Control to goal of cardiometabolic risk factors among Nigerians living with type 2 diabetes mellitus.

    Science.gov (United States)

    Okafor, C I; Ofoegbu, E N

    2012-01-01

    Cardiovascular risk factors contribute to morbidity and mortality among diabetic patients. National and international guidelines on management of diabetes therefore emphasize control to goals of blood glucose, blood pressure, dyslipidemia, and obesity so as to minimize the development of complications and enhance the patients' quality of life. To evaluate the status of control to goals of cardiometabolic risk factors among the diabetic patients attending the Diabetes clinic of University of Nigeria Teaching Hospital, Enugu. A survey of 233 type 2 diabetic patients recruited from the Diabetes clinic of our hospital was carried out. Standard procedures as described in the WHO STEP instrument were used to determine the waist circumference, weight, height, and systolic and diastolic blood pressure. Fasting blood glucose and lipid profiles were also assessed. Therapeutic goals used to define risk or poor control were values adopted by expert groups such as American diabetes association (ADA), National cholesterol education program (NCEP), American association of clinical endocrinologist (AACE) and International diabetes federation (IDF). There were 98 males and 135 females with mean (SD) duration of diabetes mellitus (DM) of 6.7 (6.3) years. Suboptimal glycemic, blood pressure control and dyslipidemia were observed in 65.7%, 51.9%, 97.1% of the subjects respectively while 60.1% of the subjects were found to be overweight/obese. Comparing the mean indices of risk factors with the recommended therapeutic goals, status of control was optimal for HDL-cholesterol, waist circumference and triglycerides. All the other risk factors were suboptimal. Control to goals of cardiovascular risk factors is poor among the patients. There is the need to identify and tackle the possible contributing factors so as to reduce the morbidity and mortality in these patients.

  10. National Education Goals: Can We Afford Them?

    Science.gov (United States)

    Guthrie, James W.

    Financial estimates for achieving the six national education goals proposed at the Charlottesville Education Summit are provided in this paper. Specific objectives under each goal, as outlined by the National Goals Panel, are assessed. A conclusion is that although the cost estimates have involved huge assumptions and sometimes wide variations,…

  11. The selfish goal meets the selfish gene.

    Science.gov (United States)

    Neuberg, Steven L; Schaller, Mark

    2014-04-01

    The connection between selfish genes and selfish goals is not merely metaphorical. Many goals that shape contemporary cognition and behavior are psychological products of evolutionarily fundamental motivational systems and thus are phenotypic manifestations of genes. An evolutionary perspective can add depth and nuance to our understanding of "selfish goals" and their implications for human cognition and behavior.

  12. From Desires, Obligations and Norms to Goals

    NARCIS (Netherlands)

    Dignum, F.P.M.; Kinny, D.; Sonenberg, L.

    2002-01-01

    Traditional models of agents based on Beliefs, Desires and Intentions usually only include either desires or goals. Therefore the process whereby goals arise from desires is given scant attention. In this paper we argue that the inclusion of both desires and goals in the same model can be

  13. Goal Expectations as Predictors of Retirement Intentions

    Science.gov (United States)

    Brougham, Ruby R.; Walsh, David A.

    2005-01-01

    The current study explored the contribution of personal goals to retirement decisions. A SMARTER methodology (to assess multiattribute utility) and taxonomy of human goals were used to investigate the relationship between older workers' personal goals and their retirement intentions. Two hundred and fifty-one employees of a large university,…

  14. ORGANIZATIONAL GOALS--A SYSTEMS APPROACH.

    Science.gov (United States)

    OHM, ROBERT E.

    CONTEMPORARY SYSTEMS THEORISTS HAVE PROVIDED A HELPFUL VIEW OF THE WAY GOAL-STRUCTURE MAY SHAPE ADMINISTRATIVE BEHAVIOR IN EDUCATIONAL ORGANIZATIONS. THE "TRADITIONALIST" VIEW ASSIGNED ORGANIZATIONAL GOALS THE FUNCTIONS OF FORECASTING AND PLANNING. THE "EMERGING MODEL" VIEWED GOALS AS UNDEFINED ELEMENTS REQUIRING LITTLE SYSTEMATIC TREATMENT IN A…

  15. Self-regulation through Goal Setting

    DEFF Research Database (Denmark)

    Koch, Alexander; Nafziger, Julia

    self-control problems. We show how goals permit self-regulation, but also that they are painful self-disciplining devices. Greater self-control problems therefore lead to stronger self-regulation through goals only up to a certain point. For severely present-biased preferences, the required goal...... for self-regulation is too painful and the individual rather gives up....

  16. Cookery demonstrations in GOAL supported clinics

    African Journals Online (AJOL)

    stunting are high, and various micronutrient deficiencies, including those of ... the household are the underlying causes seen in GOAL- assisted areas. ... feeding. Thus, the nutrition cookery demonstration activity has come to play an important role in mother and child health activities in GOAL-supported clinics and GOAL's.

  17. Effect of dietary glycemic index on food intake, adiposity, and fasting plasma ghrelin levels in animals.

    Science.gov (United States)

    Sculati, M; Rossi, F; Cena, H; Roggi, C

    2010-04-01

    An increase in lipid storage as a consequence of feeding animals with high-glycemic index (GI) diets has been observed by many authors. Ghrelin is one of the most important orexigenic hormones, and curiously, its fasting plasma levels are decreased in human obesity. As ghrelin secretion is affected by insulin concentration, we hypothesized that carbohydrates with different glycemic responses might influence fasting plasma ghrelin levels. Twenty rats were divided into two groups and fed ad libitum a low-GI or a high-GI diet for 21 days. In rats fed a high- vs low-GI diet we observed: increased food intake (18.9+/-0.6 vs 16.4+/-2.0 g/day; pfasting ghrelin levels (41.1+/-10.7 vs 59.5+/-9.8 pg/ml; p=0.05). Ghrelin appeared to be downregulated in rats fed a high-GI diet; this observation could be related to the higher food intake and fat mass observed in these rats and to the effects of insulin response on ghrelin levels.

  18. Evaluation of finger millet incorporated noodles for nutritive value and glycemic index.

    Science.gov (United States)

    Shukla, Kamini; Srivastava, Sarita

    2014-03-01

    The present study was undertaken to develop finger millet incorporated noodles for diabetic patients. Finger millet variety VL-149 was taken. The finger millet flour and refined wheat flour (RWF) were evaluated for nutrient composition. The finger millet flour (FMF) was blended in various proportions (30 to 50%) in refined wheat flour and used for the preparation of noodles. Control consisted of RWF noodles. Sensory quality and nutrient composition of finger millet noodles was evaluated. The 30% finger millet incorporated noodles were selected best on the basis of sensory evaluation. Noodles in that proportion along with control were evaluated for glycemic response. Nutrient composition of noodles showed that 50% finger millet incorporated noodles contained highest amount of crude fat (1.15%), total ash (1.40%), crude fiber (1.28%), carbohydrate (78.54%), physiological energy (351.36 kcal), insoluble dietary fiber (5.45%), soluble dietary fiber (3.71%), iron (5.58%) and calcium (88.39%), respectively. However, control RWF noodles contained highest amount of starch (63.02%), amylose (8.72%) and amylopectin (54.29%). The glycemic index (GI) of 30% finger millet incorporated noodles (best selected by sensory evaluation) was observed significantly lower (45.13) than control noodles (62.59). It was found that finger millet flour incorporated noodles were found nutritious and showed hypoglycemic effect.

  19. Glycemic control, compliance, and satisfaction for diabetic gravidas in centering group care.

    Science.gov (United States)

    Parikh, Laura I; Jelin, Angie C; Iqbal, Sara N; Belna, Sarah L; Fries, Melissa H; Patel, Misbah; Desale, Sameer; Ramsey, Patrick S

    2017-05-01

    To determine if diabetic gravidas enrolled in Centering® group care have improved glycemic control compared to those attending standard prenatal care. To compare compliance and patient satisfaction between the groups. We conducted a prospective cohort study of diabetics enrolled in centering group care from October 2013 to December 2015. Glycemic control, compliance and patient satisfaction (five-point Likert scale) were evaluated. Student's t-test, Chi-Square and mixed effects model were used to compare outcomes. We compared 20 patients in centering to 28 standard prenatal care controls. Mean fasting blood sugar was lower with centering group care (91.0 versus 105.5 mg/dL, p =0.017). There was no difference in change in fasting blood sugar over time between the two groups (p = 0.458). The percentage of time patients brought their blood glucose logs did not differ between the centering group and standard prenatal care (70.7 versus 73.9%, p = 0.973). Women in centering group care had better patient satisfaction scores for "ability to be seen by a physician" (5 versus 4, p = 0.041) and "time in waiting room" (5 versus 4, p =0.001). Fasting blood sugar was lower for patients in centering group care. Change in blood sugar over time did not differ between groups. Diabetic gravidas enrolled in centering group care report improved patient satisfaction.

  20. In vitro starch hydrolysis and estimated glycemic index of tef porridge and injera.

    Science.gov (United States)

    Shumoy, Habtu; Raes, Katleen

    2017-08-15

    The aim of this study was to investigate the in vitro starch digestibility of injera and porridge from seven tef varieties and to estimate their glycemic index. The total starch, free glucose, apparent amylose, resistant, slowly digestible and rapidly digestible starches of the varieties ranged between 66 and 76, 1.8 and 2.4g/100g flour dry matter (DM), 29 and 31%, 17 and 68, 19 and 53, 12 and 30g/100g starch DM, respectively. After processing into injera and porridge, the rapidly digestible starch content increased by 60-85% and 3-69%, respectively. The estimated glycemic index of porridge and injera of the varieties ranged 79-99 and 94-137 when estimated based on model of Goni et al. (1997) whereas from 69 to 100 and 94 to 161, respectively based on Granfeldtet al. (1992). Tef porridge and injera samples studied here can be classified as medium- high GI foods, not to be considered as a proper food ingredient for diabetic people and patients in weight gain control. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Moderate glycemic control safe in critically ill adult burn patients: A 15 year cohort study.

    Science.gov (United States)

    Stoecklin, Patricia; Delodder, Frederik; Pantet, Olivier; Berger, Mette M

    2016-02-01

    Hyperglycemia is a metabolic alteration in major burn patients associated with complications. The study aimed at evaluating the safety of general ICU glucose control protocols applied in major burns receiving prolonged ICU treatment. 15 year retrospective analysis of consecutive, adult burn patients admitted to a single specialized centre. death or length of stay burned surface (TBSA), severity scores, infections, ICU stay, outcome. Metabolic variables: total energy, carbohydrate and insulin delivery/24h, arterial blood glucose and CRP values. Analysis of 4 periods: 1, before protocol; 2, tight doctor driven; 3, tight nurse driven; 4, moderate nurse driven. 229 patients, aged 45 ± 20 years (mean ± SD), burned 32 ± 20% TBSA were analyzed. SAPSII was 35 ± 13. TBSA, Ryan and ABSI remained stable. Inhalation injury increased. A total of 28,690 blood glucose samples were analyzed: the median value remained unchanged with a narrower distribution over time. After the protocol initiation, the normoglycemic values increased from 34.7% to 65.9%, with a reduction of hypoglycaemic events (no extreme hypoglycemia in period 4). Severe hyperglycemia persisted throughout with a decrease in period 4 (9.25% in period 4). Energy and glucose deliveries decreased in periods 3 and 4 (pprotocol improved the glycemic control in adult burn patients, reducing glucose variability. Moderate glycemic control in burns was safe specifically related to hypoglycemia, reducing the incidence of hypoglycaemic events compared to the period before. Hyperglycemia persisted at a lower level. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  2. Carbohydrate intake and glycemic index affect substrate oxidation during a controlled weight cycle in healthy men.

    Science.gov (United States)

    Kahlhöfer, J; Lagerpusch, M; Enderle, J; Eggeling, B; Braun, W; Pape, D; Müller, M J; Bosy-Westphal, A

    2014-09-01

    Because both, glycemic index (GI) and carbohydrate content of the diet increase insulin levels and could thus impair fat oxidation, we hypothesized that refeeding a low GI, moderate-carbohydrate diet facilitates weight maintenance. Healthy men (n=32, age 26.0±3.9 years; BMI 23.4±2.0 kg/m(2)) followed 1 week of controlled overfeeding, 3 weeks of caloric restriction and 2 weeks of hypercaloric refeeding (+50, -50 and +50% energy requirement) with low vs high GI (41 vs 74) and moderate vs high CHO intake (50% vs 65% energy). We measured adaptation of fasting macronutrient oxidation and the capacity to supress fat oxidation during an oral glucose tolerance test. Changes in fat mass were measured by quantitative magnetic resonance. During overfeeding, participants gained 1.9±1.2 kg body weight, followed by a weight loss of -6.3±0.6 kg and weight regain of 2.8±1.0 kg. Subjects with 65% CHO gained more body weight compared with 50% CHO diet (Pfat oxidation when compared with a low-GI diet (Pfat oxidation was associated with regain in fat mass (r=0.43, Pcarbohydrate content affect substrate oxidation and thus the regain in body weight in healthy men. These results argue in favor of a lower glycemic load diet for weight maintenance after weight loss.

  3. Effect of Ramadan fasting on glycemic control in patients with Type 2 diabetes.

    Science.gov (United States)

    Norouzy, A; Mohajeri, S M R; Shakeri, S; Yari, F; Sabery, M; Philippou, E; Varasteh, A-R; Nematy, M

    2012-09-01

    Although Muslim patients with Type 2 diabetes may be exempt from fasting during Ramadan for medical reasons, a high proportion of them fast. To investigate the association between Ramadan fasting and glycemic control in patients with Type 2 diabetes. A prospective cohort clinical trial was designed. Eighty-eight patients with Type 2 diabetes (45 male, 43 female, age 51±10 yr) who opted to fast for at least 10 days during the month of Ramadan were recruited. Fasting blood samples were taken at the beginning and end of Ramadan, and 1 month after Ramadan, to assess fasting blood glucose (FBG), fasting insulin, full blood count, glycated hemoglobin (HbA(1c)) and fasting lipid profile. Insulin resistance was estimated using the homeostatic model assessment. Anthropometrics and blood pressure were also measured. There was a significant deterioration in FBG and HbA(1c) (p=0.002 and p≤0.001, respectively) and significant improvements in HDL and LDL cholesterol and body mass index after Ramadan (pRamadan (9.4±2% at the end of Ramadan vs 8.4±2.5% 1 month after Ramadan; pRamadan deteriorated the glycemic control in Type 2 diabetes patients. This was more evident in patients using oral hypoglycemic medication than diet- controlled patients. However, Ramadan fasting had small positive effects on lipid profile and body weight.

  4. Endocrinology Telehealth Consultation Improved Glycemic Control Similar to Face-to-Face Visits in Veterans.

    Science.gov (United States)

    Liu, Winnie; Saxon, David R; McNair, Bryan; Sanagorski, Rebecca; Rasouli, Neda

    2016-09-01

    Rates of diabetes for veterans who receive health care through the Veterans Health Administration are higher than rates in the general population. Furthermore, many veterans live in rural locations, far from Veterans Affairs (VA) hospitals, thus limiting their ability to readily seek face-to-face endocrinology care for diabetes. Telehealth (TH) technologies present an opportunity to improve access to specialty diabetes care for such patients; however, there is a lack of evidence regarding the ability of TH to improve glycemic control in comparison to traditional face-to-face consultations. This was a retrospective cohort study of all new endocrinology diabetes consultations at the Denver VA Medical Center over a 1-year period. A total of 189 patients were included in the analysis. In all, 85 patients had received face-to-face (FTF) endocrinology consultation for diabetes and 104 patients had received TH consultation. Subjects were mostly males (94.7%) and the mean age was 62.8 ± 10.1 years old. HbA1c improved from 9.76% (9.40% to 10.11%) to 8.55% (8.20% to 8.91%) (P Endocrinology TH consultations improved short-term glycemic control as effectively as traditional FTF visits in a veteran population with diabetes. © 2016 Diabetes Technology Society.

  5. The Consumption of Bicarbonate-Rich Mineral Water Improves Glycemic Control

    Directory of Open Access Journals (Sweden)

    Shinnosuke Murakami

    2015-01-01

    Full Text Available Hot spring water and natural mineral water have been therapeutically used to prevent or improve various diseases. Specifically, consumption of bicarbonate-rich mineral water (BMW has been reported to prevent or improve type 2 diabetes (T2D in humans. However, the molecular mechanisms of the beneficial effects behind mineral water consumption remain unclear. To elucidate the molecular level effects of BMW consumption on glycemic control, blood metabolome analysis and fecal microbiome analysis were applied to the BMW consumption test. During the study, 19 healthy volunteers drank 500 mL of commercially available tap water (TW or BMW daily. TW consumption periods and BMW consumption periods lasted for a week each and this cycle was repeated twice. Biochemical tests indicated that serum glycoalbumin levels, one of the indexes of glycemic controls, decreased significantly after BMW consumption. Metabolome analysis of blood samples revealed that 19 metabolites including glycolysis-related metabolites and 3 amino acids were significantly different between TW and BMW consumption periods. Additionally, microbiome analysis demonstrated that composition of lean-inducible bacteria was increased after BMW consumption. Our results suggested that consumption of BMW has the possible potential to prevent and/or improve T2D through the alterations of host metabolism and gut microbiota composition.

  6. Relationship between depression and glycemic control among patients with type 2 diabetes in Medan

    Science.gov (United States)

    Amelia, R.; Yunanda, Y.

    2018-03-01

    Depression is a mental problem whichifnot handled properly will cause uncontrolled diabetes that affects the quality of life and increase the risk of complications. This study aimed to determine the relationship between depressionwith glycemic control among patients with type 2 Diabetes in Amplas Primary Health Care (PHC) Medan. The study design was a cross-sectional analytic approach. The study population was patients with Type 2 diabetes that is in the region Amplas PHC with a sample of 100 people with consecutive sampling method. We collected data by interviewing and blood analysis. Adapted CES-D questionnaire assessed the depression status. AFull Automatic Spectrophotometer Colorimeter method measured the Blood Sugar Level (BSL),and a Modified HPLC with Doronad affinity measured the HbA1c in avenous blood sample. We used Chi-square test and SPP to analyze and process the data. The results showed 57 (57%) subjects had depression, based on BSL as many as 69 subjects (69%) were not well-controlled diabetes, HbA1c levels showed that 79 subjects (79%) were uncontrolled diabetes. Chi-Square test found a significant relationship between the incidence of depression with glycemic control in diabetic patients in the Amplas PHC (p <0.05).

  7. Diet, Inflammation, and Glycemic Control in Type 2 Diabetes: An Integrative Review of the Literature

    Directory of Open Access Journals (Sweden)

    Sarah Y. Nowlin

    2012-01-01

    Full Text Available Type 2 diabetes (T2D is a growing national health problem affecting 35% of adults ≥20 years of age in the United States. Recently, diabetes has been categorized as an inflammatory disease, sharing many of the adverse outcomes as those reported from cardiovascular disease. Medical nutrition therapy is recommended for the treatment of diabetes; however, these recommendations have not been updated to target the inflammatory component, which can be affected by diet and lifestyle. To assess the current state of evidence for which dietary programs contain the most anti-inflammatory and glycemic control properties for patients with T2D, we conducted an integrative review of the literature. A comprehensive search of the PubMed, CINAHL, Scopus, and Web of Science databases from January 2000 to May 2012 yielded 786 articles. The final 16 studies met the selection criteria including randomized control trials, quasiexperimental, or cross-sectional studies that compared varying diets and measured inflammatory markers. The Mediterranean and DASH diets along with several low-fat diets were associated with lower inflammatory markers. The Mediterranean diet demonstrated the most clinically significant reduction in glycosylated hemoglobin (HbA1c. Information on best dietary guidelines for inflammation and glycemic control in individuals with T2D is lacking. Continued research is warranted.

  8. Bread Affects Clinical Parameters and Induces Gut Microbiome-Associated Personal Glycemic Responses.

    Science.gov (United States)

    Korem, Tal; Zeevi, David; Zmora, Niv; Weissbrod, Omer; Bar, Noam; Lotan-Pompan, Maya; Avnit-Sagi, Tali; Kosower, Noa; Malka, Gal; Rein, Michal; Suez, Jotham; Goldberg, Ben Z; Weinberger, Adina; Levy, Avraham A; Elinav, Eran; Segal, Eran

    2017-06-06

    Bread is consumed daily by billions of people, yet evidence regarding its clinical effects is contradicting. Here, we performed a randomized crossover trial of two 1-week-long dietary interventions comprising consumption of either traditionally made sourdough-leavened whole-grain bread or industrially made white bread. We found no significant differential effects of bread type on multiple clinical parameters. The gut microbiota composition remained person specific throughout this trial and was generally resilient to the intervention. We demonstrate statistically significant interpersonal variability in the glycemic response to different bread types, suggesting that the lack of phenotypic difference between the bread types stems from a person-specific effect. We further show that the type of bread that induces the lower glycemic response in each person can be predicted based solely on microbiome data prior to the intervention. Together, we present marked personalization in both bread metabolism and the gut microbiome, suggesting that understanding dietary effects requires integration of person-specific factors. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Trends in Drug Utilization, Glycemic Control, and Rates of Severe Hypoglycemia, 2006-2013.

    Science.gov (United States)

    Lipska, Kasia J; Yao, Xiaoxi; Herrin, Jeph; McCoy, Rozalina G; Ross, Joseph S; Steinman, Michael A; Inzucchi, Silvio E; Gill, Thomas M; Krumholz, Harlan M; Shah, Nilay D

    2017-04-01

    To examine temporal trends in utilization of glucose-lowering medications, glycemic control, and rate of severe hypoglycemia among patients with type 2 diabetes (T2DM). Using claims data from 1.66 million privately insured and Medicare Advantage patients with T2DM from 2006 to 2013, we estimated the annual 1 ) age- and sex-standardized proportion of patients who filled each class of agents; 2 ) age-, sex-, race-, and region-standardized proportion with hemoglobin A 1c (HbA 1c ) use increased for metformin (from 47.6 to 53.5%), dipeptidyl peptidase 4 inhibitors (0.5 to 14.9%), and insulin (17.1 to 23.0%) but declined for sulfonylureas (38.8 to 30.8%) and thiazolidinediones (28.5 to 5.6%; all P use of glucose-lowering drugs has changed dramatically among patients with T2DM. Overall glycemic control has not improved and remains poor among nearly a quarter of the youngest patients. The overall rate of severe hypoglycemia remains largely unchanged. © 2017 by the American Diabetes Association.

  10. Evidence-based Critical Evaluation of Glycemic Potential of Cynodon dactylon

    Science.gov (United States)

    Singh, Santosh Kumar; Rai, Prashant Kumar; Jaiswal, Dolly

    2008-01-01

    The present study is an extension of our previous work carried out on Cynodon dactylon. This study deals with the critical evaluation of glycemic potential of ethanolic extract of defatted C. dactylon. The doses of 250, 500 and 750 mg kg−1 bw of the extract were administered orally to normal as well as Streptozotocin-induced diabetic rats to study its glycemic potential. The effect of repeated oral administration of the same doses of ethanolic extract was also studied on serum lipid profile of severely diabetic (SD) rats. The dose of 500 mg kg−1 bw was identified as the most effective dose as it lowered the blood glucose levels of normal by 42.12% and of diabetic by 43.42% during fasting blood glucose (FBG) and glucose tolerance test respectively. The SD rats were also treated daily with this identified dose of 500 mg kg−1 bw for 2 weeks and a significant reduction of 56.34% was observed in FBG level. Total cholesterol, low density lipoprotein and triglyceride levels were also decreased by 32.94, 64.06 and 48.46% respectively in SD rats whereas, cardioprotective high density lipoprotein increased by 16.45%. The reduced urine sugar level and increased body weight are additional advantages. These evidences clearly indicate that the ethanolic extract of defatted C. dactylon has high antidiabetic potential along with good hypolipidemic profile. PMID:18955211

  11. THE EFFECT OF GLYCEMIC INDEX ON PLASMA IL-6 IN SUB-MAX EXERCISE

    Directory of Open Access Journals (Sweden)

    S.H. Hasani

    2015-05-01

    Full Text Available Purpose: This study examined the effect of a pre-exercise meal with different glycemic index (GI on plasma IL-6 concentration and glucose metabolism during sub-max exercise (endurance performance run. Material : Ten men completed 1 h running at 70%-75% VO2max on a level treadmill on three occasions. In each trial, one of the three prescribed beverages as meal, i.e. high GI and low GL or placebo was consumed by the subjects 45 min before exercise. Blood samples were collected before, after, 1h and 24h after exercise. Result: Concentration of Plasma IL-6 in LGI group was less than HGI and Pla groups, IL-6 tended to significantly increase after exercise in groups (all P < 0.05, also there was significant difference for plasma IL-6 concentration between placebo and low glycemic groups in after exercise (P=.003 and 1hour after exercise (P=.005 . CK was significantly elevated at all- time points after exercise in 3 groups (all P < 0.05. Concentration of serum CK in LGI group was less than HGI and Pla groups but there not significantly. The consumption of the LGI beverage before exercise could minimize the increasing of plasma IL-6 concentration immediately after exercise and during the 1 h recovery period compared with the HGI beverage and Pla. Conclusion: This result suggested that the LGI beverage consumed as pre-exercise meal could modify the inflammatory response in prolonged exercise.

  12. THE EFFECT OF GLYCEMIC INDEX ON PLASMA IL-6 IN SUB-MAX EXERCISE

    Directory of Open Access Journals (Sweden)

    Hasani S.H.

    2015-04-01

    Full Text Available Purpose: This study examined the effect of a pre-exercise meal with different glycemic index (GI on plasma IL-6 concentration and glucose metabolism during sub-max exercise (endurance performance run. Material : Ten men completed 1 h running at 70%-75% VO2max on a level treadmill on three occasions. In each trial, one of the three prescribed beverages as meal, i.e. high GI and low GL or placebo was consumed by the subjects 45 min before exercise. Blood samples were collected before, after, 1h and 24h after exercise. Result: Concentration of Plasma IL-6 in LGI group was less than HGI and Pla groups, IL-6 tended to significantly increase after exercise in groups (all P < 0.05, also there was significant difference for plasma IL-6 concentration between placebo and low glycemic groups in after exercise (P=.003 and 1hour after exercise (P=.005 . CK was significantly elevated at all- time points after exercise in 3 groups (all P < 0.05. Concentration of serum CK in LGI group was less than HGI and Pla groups but there not significantly. The consumption of the LGI beverage before exercise could minimize the increasing of plasma IL-6 concentration immediately after exercise and during the 1 h recovery period compared with the HGI beverage and Pla. Conclusion: This result suggested that the LGI beverage consumed as pre-exercise meal could modify the inflammatory response in prolonged exercise.

  13. Lowering the glycemic index of white bread using a white bean extract

    Directory of Open Access Journals (Sweden)

    Singh Betsy B

    2009-10-01

    Full Text Available Abstract Background Phase 2® is a dietary supplement derived from the common white kidney bean (Phaseolus vulgaris. Phase 2 has been shown to inhibit alpha-amylase, the complex carbohydrate digesting enzyme, in vitro. The inhibition of alpha-amylase may result in the lowering of the effective Glycemic Index (GI of certain foods. The objective of this study was to determine whether the addition of Phase 2 would lower the GI of a commercially available high glycemic food (white bread. Methods An open-label 6-arm crossover study was conducted with 13 randomized subjects. Standardized GI testing was performed on white bread with and without the addition of Phase 2 in capsule and powder form, each in dosages of 1500 mg, 2000 mg, and 3000 mg. Statistical analysis was performed by one-way ANOVA of all seven treatment groups using unadjusted multiple comparisons (t tests to the white bread control. Results For the capsule formulation, the 1500 mg dose had no effect on the GI and the 2000 mg and 3000 mg capsule doses caused insignificant reductions in GI. For the powder, the 1500 mg and 2000 mg doses caused insignificant reductions in the GI, and the 3000 mg dose had a significant effect (-20.23 or 34.11%, p = 0.023 Conclusion Phase 2 white bean extract appears to be a novel and potentially effective method for reducing the GI of existing foods without modifying their ingredient profile. Trial Registration Trial Registration: ISRCTN50347345

  14. Lowering the glycemic index of white bread using a white bean extract.

    Science.gov (United States)

    Udani, Jay K; Singh, Betsy B; Barrett, Marilyn L; Preuss, Harry G

    2009-10-28

    Phase 2((R)) is a dietary supplement derived from the common white kidney bean (Phaseolus vulgaris). Phase 2 has been shown to inhibit alpha-amylase, the complex carbohydrate digesting enzyme, in vitro. The inhibition of alpha-amylase may result in the lowering of the effective Glycemic Index (GI) of certain foods. The objective of this study was to determine whether the addition of Phase 2 would lower the GI of a commercially available high glycemic food (white bread). An open-label 6-arm crossover study was conducted with 13 randomized subjects. Standardized GI testing was performed on white bread with and without the addition of Phase 2 in capsule and powder form, each in dosages of 1500 mg, 2000 mg, and 3000 mg. Statistical analysis was performed by one-way ANOVA of all seven treatment groups using unadjusted multiple comparisons (t tests) to the white bread control. For the capsule formulation, the 1500 mg dose had no effect on the GI and the 2000 mg and 3000 mg capsule doses caused insignificant reductions in GI. For the powder, the 1500 mg and 2000 mg doses caused insignificant reductions in the GI, and the 3000 mg dose had a significant effect (-20.23 or 34.11%, p = 0.023) Phase 2 white bean extract appears to be a novel and potentially effective method for reducing the GI of existing foods without modifying their ingredient profile. Trial Registration: ISRCTN50347345.

  15. Work-related psychosocial stress and glycemic control among working adults with diabetes mellitus.

    Science.gov (United States)

    Annor, Francis B; Roblin, Douglas W; Okosun, Ike S; Goodman, Michael

    2015-01-01

    To examine the association between glycosylated hemoglobin (HbA1c) and four subscales of work-related psychosocial stress at study baseline and over time. We used survey data from a major HMO located in the Southeastern part of the US on health and healthy behaviors linked with patients' clinical, pharmacy and laboratory records for the period between 2005 and 2009. Study participants (n=537) consisted of working adults aged 25-59 years, diagnosed with diabetes mellitus (DM) but without advanced micro or macrovascular complications at the time of the survey. We estimated the baseline (2005) association between HbA1c and work-related psychosocial stress and their interactions using linear regression analysis. Using individual growth model approach, we estimated the association between HbA1c over time and work-related psychosocial stress. Each of the models controlled for socio-demographic variables, diet and physical activity factor, laboratory factor, physical examinations variables and medication use in a hierarchical fashion. After adjusting for all study covariates, we did not find a significant association between work-related psychosocial stress and glycemic control either at baseline or over time. Among fairly healthy middle aged working adults with DM, work-related psychosocial stress was not directly associated with glycemic control. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  16. THE CONTENT OF MICROELEMENTS IN BLOOD SERUM AND ERYTHROCYTES IN CHILDREN WITH DIABETES MELLITUS TYPE I DEPENDING ON LEVEL OF GLYCEMIC CONTROL.

    Science.gov (United States)

    Gluschenko, N; Vasylyshyn, Kh; Roschupkin, A; Lekishvili, S; Gladchenko, O

    2016-01-01

    The aim of this paper is to investigate the content of chromium, cobalt and nickel in serum and erythrocytes in children with type 1 diabetes mellitus, depending on the level of glycemic control. The study was conducted on 68 children with type 1 diabetes mellitus. The patients were divided into four groups based on glycemic control. Group I was composed of 9 children with optimal level of glycemic control. Group II - 25 children with suboptimal level of glycemic control. Group III - 34 children with a high risk to life level of glycemic control. Group IV (control group) consisted of 30 healthy children. Compensation state of type 1 diabetes was evaluated according to ISPAD (Consensus for the Management of Type 1 Diabetes Mellitus in Children and Adolescens 2000). The content of trace elements in biological agents was determined by atomic absorbtion spectrophotometry method with C-115M1 mass-spectrophotometer, manufactured by «Selmi» enterprise (Ukraine). It is found that there is a decrease in serum concentrations of chromium and erythrocyte content of cobalt in patients with optimal level of glycemic control. The deficiency of chromium is accompanied by the deficiency of cobalt in patients with suboptimal level of glycemic control. The lower levels of cobalt and nickel are recorded simultaneously, but there is theexcess of chromium in the erythrocytes of these patients. Patients, who suffer from 1 type diabetes mellitus and high risk for life level of glycemic control have considerable polideficiency of cobalt, nickel and chromium in serum.The increasing level of chromium was recorded only in the erythrocytes. The level of glycemic control and the duration of 1 type diabetes mellitus are important in the forecasting of the development of chronic diabetic complications. It is found that the duration of 1 type diabetes mellitus influences the levels of cobalt and nickel in serum mostly, while the level of glycemic control influences the chromium content.

  17. Successfully Changing the Landscape of Information Distribution: Extension Food Website Reaches People Locally and Globally

    OpenAIRE

    Alice Henneman; Lisa Franzen-Castle; Kayla Colgrove; Vishal Singh

    2016-01-01

    The goal of the Food website was to develop Internet-based content that was relevant and reached the general public and multiplier groups, such as educators, health professionals, and media outlets. The purpose of this paper was to examine whether a multi-modal approach to information delivery through increases in and changes to content, electronic mailing list creation, and social media posting impacted user access, traffic channels, and referrals from 2010 to 2014. When comparing 2010-2011 ...

  18. Quantitative HTGR safety and forced outage goals

    International Nuclear Information System (INIS)

    Houghton, W.J.; Parme, L.L.; Silady, F.A.

    1985-05-01

    A key step in the successful implementation of the integrated approach is the definition of the overall plant-level goals. To be effective, the goals should provide clear statements of what is to be achieved by the plant. This can be contrasted to the current practice of providing design-prescriptive criteria which implicitly address some higher-level objective but restrict the designer's flexibility. Furthermore, the goals should be quantifiable in such a way that satisfaction of the goal can be measured. In the discussion presented, two such plant-level goals adopted for the HTGR and addressing the impact of unscheduled occurrences are described. 1 fig

  19. Goals of measurement systems for international safeguards

    International Nuclear Information System (INIS)

    de Montmollin, J.M.; Weinstock, E.V.

    1979-01-01

    The safeguards applied by the International Atomic Energy Agency are based on technical performance goals and criteria that have been developed, but not officially adopted by the Agency. The goals derive in part from the external consequences that safeguards are intended to prevent and in some cases on internal considerations of feasibility. To the extent that these goals may not be attainable, as may be the case with large-throughput bulk reprocessing plants, the Agency is placed in a difficult position. In this paper safeguards goals and criteria and their underlying rationales are critically examined. Suggestions for a more rational and workable structure of performance goals are offered

  20. Psychological aspects of glycemic control in young patients with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Oleg Gennad'evich Motovilin

    2010-03-01

    Full Text Available Aim. To elucidate the relationship between glycemic control (assessed by the level of HbA1c and psychological status of the patients. Materials and methods. The study included 115 patients with type 1 diabetes aged 13-27 years. The following tests were used to assess the psychological statusof the patients status (emotional state, social relations, attitude toward disease: State-trait-anxiety Inventory (Spielberger C.D., Hanin Y.L, Center for EpidemiologicStudies Depression Scale (CES-D, Social ajustment scale by A.K. Osnizkiy based on Q-Sort Adjustment Scale developed by R. Dymond andC.R. Rogers (1954, Lusher colour test , Colour attitudes test, A.M. Etkind original technique, method for the assessment of attitude toward disease developedin V.M. Bekhterev Research Psychoneurologic Institute, Sankt-Peterburg. The patients were allocated to 3 groups differing in terms of 33.3% percentile ofHbA1c levels. Results. Patients with good glycemic control (mean HbA1c level 7.4% show the lowest level of social adaptation and emotional well-being. The reason for thisphenomenon is the excessive focus of patient on the disease and narrow scope of interests, which suggest psychological dependence on diabetes. Patients withpoor glycemic control (mean HbA1c level 13.1% also experience emotional discomfort due to increased anxiety. Despite the fact they exhibit a higher degreeof social adaptation than the patients of the above group, the main concern is the low level of communicative autonomy and the feeling of being unable to copewith the disease. Such personal characteristics also create a psychological dependence on diabetes, although of a different type than in the first group of patients.Patients with average glycemic control (mean HbA1c level 9.5% in the sample have the most favorable psychological state in comparison with the other twogroups. Their emotional state and social adaptation are significantly better than in the other two groups. These patients