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Sample records for swedish national diabetes

  1. Does patient education facilitate diabetic patients' possibilities to reach national treatment targets? A national survey in Swedish primary healthcare.

    Science.gov (United States)

    Adolfsson, Eva Thors; Smide, Bibbi; Rosenblad, Andreas; Wikblad, Karin

    2009-01-01

    To describe how patient education is arranged in Swedish primary healthcare (PHC) and to assess whether the type of patient education and individual goal setting have an impact on diabetic patients' possibilities of reaching national treatment targets. A Swedish national survey. Swedish PHC. Data from 485 primary healthcare centres (PHCCs) and 91,637 diabetic patients reported by the PHCCs to the National Diabetes Register in 2006. Description of how patient education is arranged, HbA(1c), body mass index, cholesterol, blood pressure, and physical activity. Of the PHCCs that reported how they performed the individual counselling, 50% reported checklist-driven counselling and 8% individualized counselling based on patients' needs. A total of 105 PHCCs reported that they arranged group education. Of these, 67% used pre-planned programmes and 9% individualized the programme to the patients' needs. The majority of PHCCs (96%) reported that they set individual goals (HbA(1c), blood pressure, lipids, and lifestyle). A minority of the PHCCs (27%) reported that the patients were involved in the final decision concerning their goals. Individual goal-setting facilitated patients' possibilities of reaching treatment targets. Goal-setting, list size of PHCCs, and personnel resources explained a variance of 2.1-5.7%. Neither individual counselling (checklist-driven or individualized to patients' needs) nor group education had an impact on patients' possibilities of reaching the targets. The current study indicates that improvement is needed in patient education in PHC to facilitate diabetic patients' possibilities of reaching national treatment targets.

  2. Level of physical activity associated with risk of cardiovascular diseases and mortality in patients with type-2 diabetes: report from the Swedish National Diabetes Register.

    Science.gov (United States)

    Zethelius, B; Gudbjörnsdottir, S; Eliasson, B; Eeg-Olofsson, K; Cederholm, J

    2014-02-01

    To estimate risks of coronary heart disease (CHD), cardiovascular disease (CVD), and total mortality with low or higher levels of physical activity (PA) assessed with questionnaire, in an observational study of patients with type-2 diabetes from the Swedish National Diabetes Register. A total of 15,462 patients (60 years), were followed for 5 years from baseline in 2004 until 2009, with 760 CVD events and 427 total mortality events based on 54,344 person-years. Comparing 6963 patients with low baseline PA (never or 1-2 times/week for 30 min) and 8499 patients with higher baseline PA (regular 3 times/week or more), hazard ratios for fatal/nonfatal CHD, fatal/nonfatal CVD, fatal CVD, and total mortality were 1.25 (95% CI 1.05-1.48; p = 0.01), 1.26 (95% CI 1.09-1.45; p = 0.002), 1.69 (95% CI 1.18-2.41; p = 0.004), and 1.48 (95% CI 1.22-1.79; p < 0.001), adjusting for age, sex, diabetes duration, diabetes treatment, and smoking (model 1). Adjusting also for HbA1c, systolic blood pressure, low- and high-density lipoprotein cholesterol, triglycerides, body mass index, and albuminuria (model 2), HRs were 1.19 (95% CI 1.00-1.42; p = 0.049), 1.18 (95% CI 1.02-1.36; p = 0.04), 1.54 (95% CI 1.07-2.22; p = 0.02), and 1.41 (95% CI 1.16-1.72; p < 0.001), respectively. Corresponding results (model 2), comparing 4166 patients having low PA both baseline and at follow up with all other 11,296 patients were 1.68 (95% CI 1.41-2.01), 1.68 (95% CI 1.45-1.96), 2.12 (95% CI 1.48-3.03), and 2.03 (95% CI 1.66-2.48) (all p < 0.001) and compared to 2797 patients with low baseline PA and higher PA at follow up were 2.51 (95% CI 1.87-3.38), 2.54 (95% CI 1.98-3.27), 3.26 (95% CI 1.74-6.10), and 2.91 (95% CI 2.08-4.07) (all p < 0.001). This large observational study of patients with type-2 diabetes showed considerably increased risks for CVD and mortality with low PA.

  3. Ambassadors of the Swedish Nation: National Images in the Teaching of the Swedish Lecturers in Germany 1918-1945

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    Åkerlund, Andreas

    2015-01-01

    This article analyses the teaching of Swedish language lecturers active in Germany during the first half of the twentieth century. It shows the centrality of literature and literary constructions and analyses images of Swedishness and the Swedish nation present in the teaching material of that time in relation to the national image present in…

  4. National Diabetes Education Program

    Science.gov (United States)

    ... Living Tips About WIN NIDDK Information Clearinghouses National Diabetes Education Program Together with more than 200 partners ... type 2 diabetes. Learn more about NDEP . National Diabetes Month You are the center of your diabetes ...

  5. Genetic overlap between type 2 diabetes and depression in Swedish and Danish twin registries

    DEFF Research Database (Denmark)

    Kan, C; Pedersen, Nancy L.; Christensen, K

    2016-01-01

    address is the extent to which the co-occurrence of diabetes and depression is due to correlated genetic and/or environmental risk factors. In this study, we performed structural equation model fitting to population-level data from the Swedish (n=68 606) and Danish (n=95 403) twin registries. The primary......A bidirectional association between type 2 diabetes (T2DM) and depression has been consistently reported. Depression is associated with worse biomedical outcomes and increased mortality. The mechanisms underlying the association of T2DM with depression remain unclear. One possible question we can...... outcomes were clinical diagnosis of T2DM and depression using national hospital discharge registries. The phenotypic correlation between T2DM and depression is modest in both samples. In the Swedish sample, unique environmental effects explain a greater proportion of the covariance in males, whereas...

  6. Genetic overlap between type 2 diabetes and depression in Swedish and Danish twin registries

    DEFF Research Database (Denmark)

    Kan, C; Pedersen, Nancy L.; Christensen, K

    2016-01-01

    A bidirectional association between type 2 diabetes (T2DM) and depression has been consistently reported. Depression is associated with worse biomedical outcomes and increased mortality. The mechanisms underlying the association of T2DM with depression remain unclear. One possible question we can...... address is the extent to which the co-occurrence of diabetes and depression is due to correlated genetic and/or environmental risk factors. In this study, we performed structural equation model fitting to population-level data from the Swedish (n=68 606) and Danish (n=95 403) twin registries. The primary...... outcomes were clinical diagnosis of T2DM and depression using national hospital discharge registries. The phenotypic correlation between T2DM and depression is modest in both samples. In the Swedish sample, unique environmental effects explain a greater proportion of the covariance in males, whereas...

  7. The Swedish national public health policy report 2010.

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    Linell, Anita; Richardson, Matt X; Wamala, Sarah

    2013-02-01

    In 2003, the Swedish Parliament adopted a cross-sectorial national public health policy based on the social determinants of health, with an overarching aim--to create societal conditions that will ensure good health, on equal terms, for the entire population--and eleven objective domains. At that time the policy was globally unique, and serves as guidance for public health practice at the national, regional and local levels. The development of the public health policy and the determinants of health are presented regularly in various reports by the Swedish National Institute of Public Health. This supplement is a condensed version of the 174-page Public Health Policy Report 2010, the second produced since the national policy was adopted in 2003. In order to provide a holistic approach to analysing implemented measures and providing new recommendations within the eleven objective domains of the Swedish national public health policy, we have divided these in three strategic areas. These are: Good Living Conditions, Health-Promoting Living Environments and Living Habits, and Alcohol, Illicit Drugs, Doping, Tobacco and Gambling, each described in the respective introductions for Chapters 3-5. The production of the report was supported by a common analytical model that clarified the societal prerequisites for health in the eleven objective domains. These are factors that can be influenced by political actions in order to create a change. Economic analyses have also been developed to provide a priority basis for political decisions. Analyses of the development of public health determinants were based on data from the National Public Health Survey and data delivered from about 15 various national agencies. Measures that have been implemented between 2004 and 2009 are analysed in details, as the basis for new recommendations for future measures. The introduction describes Swedish public health policy in the new millennium and how it has developed, the role of the Swedish

  8. Chemistry inside an Epistemological Community Box! Discursive Exclusions and Inclusions in Swedish National Tests in Chemistry

    Science.gov (United States)

    Ståhl, Marie; Hussénius, Anita

    2017-01-01

    This study examined the Swedish national tests in chemistry for implicit and explicit values. The chemistry subject is understudied compared to biology and physics and students view chemistry as their least interesting science subject. The Swedish national science assessments aim to support equitable and fair evaluation of students, to concretize…

  9. The Swedish RES national action plan from a forest perspective

    Energy Technology Data Exchange (ETDEWEB)

    Bjoerheden, R. (Uppsala Science Park (Sweden), The Forestry Research Inst. of Sweden), e-mail: rolf.bjorheden@skogforsk.se

    2010-07-01

    The goal set up for Sweden by the EU RES Directive stipulates that Sweden should reach a 49 per cent proportion of renewable energy by 2020. Although this is the highest proportion of energy from RES for any member state in the EU, Sweden has unilaterally decided on a national goal of 50 per cent. Thus, Sweden feels confident that it will be able to comply with the goals. In the current RES mix, forest biomass already plays an important role and there is potential for a substantial increase of forest fuel recovery. But there are a number of outstanding question marks considering follow-up procedures, what fuels that are considered as renewable etc. It is important that the interpretation of current EU regulations is clarified and that they coincide with the current Swedish standpoint. If Nordic forestry is not judged to yield renewable fuel, the EU goals will be much harder to meet. (orig.)

  10. The Swedish strategy and method for development of a national healthcare information architecture.

    Science.gov (United States)

    Rosenälv, Jessica; Lundell, Karl-Henrik

    2012-01-01

    "We need a precise framework of regulations in order to maintain appropriate and structured health care documentation that ensures that the information maintains a sufficient level of quality to be used in treatment, in research and by the actual patient. The users shall be aided by clearly and uniformly defined terms and concepts, and there should be an information structure that clarifies what to document and how to make the information more useful. Most of all, we need to standardize the information, not just the technical systems." (eHälsa - nytta och näring, Riksdag report 2011/12:RFR5, p. 37). In 2010, the Swedish Government adopted the National e-Health - the national strategy for accessible and secure information in healthcare. The strategy is a revision and extension of the previous strategy from 2006, which was used as input for the most recent efforts to develop a national information structure utilizing business-oriented generic models. A national decision on healthcare informatics standards was made by the Swedish County Councils, which decided to follow and use EN/ISO 13606 as a standard for the development of a universally applicable information structure, including archetypes and templates. The overall aim of the Swedish strategy for development of National Healthcare Information Architecture is to achieve high level semantic interoperability for clinical content and clinical contexts. High level semantic interoperability requires consistently structured clinical data and other types of data with coherent traceability to be mapped to reference clinical models. Archetypes that are formal definitions of the clinical and demographic concepts and some administrative data were developed. Each archetype describes the information structure and content of overarching core clinical concepts. Information that is defined in archetypes should be used for different purposes. Generic clinical process model was made concrete and analyzed. For each decision

  11. Impact of the Swedish National Stroke Campaign on stroke awareness.

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    Nordanstig, A; Asplund, K; Norrving, B; Wahlgren, N; Wester, P; Rosengren, L

    2017-10-01

    Time delay from stroke onset to arrival in hospital is an important obstacle to widespread reperfusion therapy. To increase knowledge about stroke, and potentially decrease this delay, a 27-month national public information campaign was carried out in Sweden. To assess the effects of a national stroke campaign in Sweden. The variables used to measure campaign effects were knowledge of the AKUT test [a Swedish equivalent of the FAST (Face-Arm-Speech-Time)] test and intent to call 112 (emergency telephone number) . Telephone interviews were carried out with 1500 randomly selected people in Sweden at eight points in time: before, three times during, immediately after, and nine, 13 and 21 months after the campaign. Before the campaign, 4% could recall the meaning of some or all keywords in the AKUT test, compared with 23% during and directly after the campaign, and 14% 21 months later. Corresponding figures were 15%, 51%, and 50% for those remembering the term AKUT and 65%, 76%, and 73% for intent to call 112 when observing or experiencing stroke symptoms. During the course of the campaign, improvement of stroke knowledge was similar among men and women, but the absolute level of knowledge for both items was higher for women at all time points. The nationwide campaign substantially increased knowledge about the AKUT test and intention to call 112 when experiencing or observing stroke symptoms, but knowledge declined post-intervention. Repeated public information therefore appears essential to sustain knowledge gains. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. How Effective is Swedish Massage on Blood Glucose Level in Children with Diabetes Mellitus?

    Directory of Open Access Journals (Sweden)

    Firoozeh Sajedi

    2011-09-01

    Full Text Available "nThis study was conducted to determine the effect of Swedish massage on blood glucose level in children with diabetes mellitus (DM. It was prospective randomized controlled trial study that conducted on 36 children, 6-12 years old with DM, recruited from a hospital in Qom City, Iran. The children were randomly assigned to intervention and control groups. Swedish massage was performed 15 minutes, 3 times a week, for 3 months in intervention group. The blood glucose levels were evaluated immediately after every session of massage in two groups. The mean ages of children in the intervention (n=18 and control (n=18 groups were 9.05 ± 1.55 and 9.83 ±2.03 years respectively. There was statistically no significant difference in blood glucose levels before intervention between two groups (P=0.586, but the blood glucose levels were lower significantly in intervention group in comparison with control group after intervention (P<0.0001. Addition of Swedish massage to daily routines; exercise, diet and medication regimens, is an effective intervention to reduce blood glucose level in diabetic children.

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

    Science.gov (United States)

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

    2013-06-01

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

  14. Role clarity and role conflict among Swedish diabetes specialist nurses.

    Science.gov (United States)

    Boström, Eva; Hörnsten, Asa; Lundman, Berit; Stenlund, Hans; Isaksson, Ulf

    2013-10-01

    To explore diabetes specialist nurses (DSNs)' perceptions of their role in terms of clarity, conflict and other psychosocial work aspects. A cross-sectional study was conducted among DSNs in a county in northern Sweden. The DSNs answered the Nordic Questionnaire of Psychological and Social Factors at Work (QPS Nordic) about psychosocial aspects of their work. Statistical analysis compared DSNs with a reference group of different health professionals. Correlations between role clarity, role conflict, and other variables were analysed. The DSNs perceived more, and higher, job demands, including quantitative, decision-making and learning demands, but also more positive challenges at work compared with the reference group. Role clarity correlated with experiences of health promotion, perception of mastery, co-worker support, and empowering leadership, while role conflict correlated with quantitative and learning demands. The DSNs perceived high demands but also positive challenges in their work. Their role expectations correlated with several psychosocial work aspects. It is important that DSNs should be presented with positive challenges as meaningful incentives for further role development and enhanced mastery of their work. Copyright © 2013 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  15. Validity of ankylosing spondylitis and undifferentiated spondyloarthritis diagnoses in the Swedish National Patient Register

    DEFF Research Database (Denmark)

    Lindström, U; Exarchou, S; Sigurdardottir, V

    2015-01-01

    OBJECTIVES: Epidemiological studies of spondyloarthritis (SpA), using ICD codes from the Swedish National Patient Register (NPR), offer unique possibilities but hinge upon an understanding of the validity of the codes. The aim of this study was to validate the ICD codes for ankylosing spondylitis...

  16. The Swedish National Defence Research Establishment and the plans for Swedish nuclear weapons; Foersvarets forskningsanstalt och planerna paa svenska kaernvapen

    Energy Technology Data Exchange (ETDEWEB)

    Jonter, Thomas [Uppsala Univ. (Sweden). Dept. of History

    2001-03-01

    This study analyses the Swedish nuclear weapons research since 1945 carried out by the Swedish National Defence Research Establishment (FOA). The most important aspect of this research was dealing with protection in broad terms against nuclear weapons attacks. However, another aspect was also important from early on - to conduct research aiming at a possible production of nuclear weapons. FOA performed an extended research up to 1968, when the Swedish Government signed the Non-Proliferation Treaty (NPT), which meant the end of these production plans. Up to this date, five main investigations about the technical conditions were made, 1948, 1953, 1955, 1957 and 1965, which all together expanded the Swedish know-how to produce a bomb. The Swedish plans to procure nuclear weapons were not an issue in the debate until the mid 50's. The reason for this was simple, prior to 1954 the plans were secretly held within a small group of involved politicians, military and researchers. The change of this procedure did take place when the Swedish Supreme Commander in a public defence report in 1954 favoured a Swedish Nuclear weapons option. In 1958 FOA had reached a technical level that allowed the Parliament to make a decision. Two programs were proposed - the L-programme (the Loading Programme), to be used if the parliament would say yes to a production of nuclear weapons, and the S-programme (the Protection Programme), if the Parliament would say no. The debate on the issue had now created problems for the Social Democratic Government. The Prime Minister, Tage Erlander, who had earlier defended a procurement of nuclear weapons, was now forced to reach a compromise. The compromise was presented to the parliament in a creative manner that meant that only the S-programme would be allowed. The Government argued that the technical level did allow a 'freedom of action' up to at least the beginning of the 60's when Sweden was mature to make a decision on the issue

  17. Institutional profile: the national Swedish academic drug discovery & development platform at SciLifeLab.

    Science.gov (United States)

    Arvidsson, Per I; Sandberg, Kristian; Sakariassen, Kjell S

    2017-06-01

    The Science for Life Laboratory Drug Discovery and Development Platform (SciLifeLab DDD) was established in Stockholm and Uppsala, Sweden, in 2014. It is one of ten platforms of the Swedish national SciLifeLab which support projects run by Swedish academic researchers with large-scale technologies for molecular biosciences with a focus on health and environment. SciLifeLab was created by the coordinated effort of four universities in Stockholm and Uppsala: Stockholm University, Karolinska Institutet, KTH Royal Institute of Technology and Uppsala University, and has recently expanded to other Swedish university locations. The primary goal of the SciLifeLab DDD is to support selected academic discovery and development research projects with tools and resources to discover novel lead therapeutics, either molecules or human antibodies. Intellectual property developed with the help of SciLifeLab DDD is wholly owned by the academic research group. The bulk of SciLifeLab DDD's research and service activities are funded from the Swedish state, with only consumables paid by the academic research group through individual grants.

  18. Mathematical Reasoning Requirements in Swedish National Physics Tests

    Science.gov (United States)

    Johansson, Helena

    2016-01-01

    This paper focuses on one aspect of mathematical competence, namely mathematical reasoning, and how this competency influences students' knowing of physics. This influence was studied by analysing the mathematical reasoning requirements upper secondary students meet when solving tasks in national physics tests. National tests are constructed to…

  19. The carotenoid content in certain plants from Abisko National Park (Swedish Lapland

    Directory of Open Access Journals (Sweden)

    B. Czeczuga

    2015-01-01

    Full Text Available By means of columnar and thin-layer chromatography, the presence of carotenoids in Lichens (2 species, Sphagnaceae (l species, Lycopodiaceae (l species and in 23 species of the higher plants from Abisko National Park (Swedish Lapland was studied. 34 carotenoids were identified and total content ranged from 0.05 mg/g to 0.85 mg/g dry mass.

  20. The National Early Warning Score: Translation, testing and prediction in a Swedish setting.

    Science.gov (United States)

    Spångfors, Martin; Arvidsson, Lisa; Karlsson, Victoria; Samuelson, Karin

    2016-12-01

    The National Early Warning Score - NEWS is a "track and trigger" scale designed to assess in-hospital patients' vital signs and detect clinical deterioration. In this study the NEWS was translated into Swedish and its association with the need of intensive care was investigated. A total of 868 patient charts, recorded by the medical emergency team at a university hospital, containing the parameters needed to calculate the NEWS were audited. The NEWS was translated into Swedish and tested for inter-rater reliability with a perfect agreement (weighted κ=1.0) among the raters. The median score for patients admitted to the ICU were higher than for those who were not (10 vs. 8, pscores for the parameters oxygen saturation and level of consciousness in the NEWS may predict admission to the ICU. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Cognitive ability, lifestyle risk factors, and two-year survival in first myocardial infarction men: A Swedish National Registry study.

    Science.gov (United States)

    Wallert, John; Madison, Guy; Held, Claes; Olsson, Erik

    2017-03-15

    General cognitive ability (CA) is positively associated with later physical and mental health, health literacy, and longevity. We investigated whether CA estimated approximately 30years earlier in young adulthood predicted lifestyle-related risk factors and two-year survival in first myocardial infarction (MI) male patients. Young adulthood CA estimated through psychometric testing at age 18-20years was obtained from the mandatory military conscript registry (INSARK) and linked to national quality registry SWEDEHEART/RIKS-HIA data on smoking, diabetes, hypertension, obesity (BMI>30kg/m2) in 60years or younger Swedish males with first MI. Patients were followed up in the Cause of Death registry. The 5659 complete cases (deceased=106, still alive=5553) were descriptively compared. Crude and adjusted associations were modelled with logistic regression. After multivariable adjustment, one SD increase in CA was associated with a decreased odds ratio of being a current smoker (0.63 [0.59, 0.67], Plifestyle risk factors smoking, diabetes, and obesity, and two-year survival in first MI male patients. CA assessment might benefit risk stratification and possibly aid further tailoring of secondary preventive strategy. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  2. Prevalence and risk factors for the development of diabetes mellitus in Swedish cats

    Directory of Open Access Journals (Sweden)

    Sallander Marie

    2012-10-01

    Full Text Available Abstract Background The prevalence and risk factors for the development of feline diabetes mellitus (FDM in Swedish cats have not previously been reported. The objective of the present pilot study was to indicate prevalence and possible risk factors for FDM in Swedish cats. Twenty diabetic cats from the database at the University Animal Hospital in Uppsala participated in the study, and these were matched with 20 healthy controls on sex and age. A mail-and-telephone questionnaire focusing on diet, activity and obesity was used. Results The prevalence of FDM during the years 2000–2004 based on the results of the hospital records in the present study was 21 per 10,000 cats. The diabetic cats were on average 9 years old when the disease signs were discovered (median, min-max 2–15. Among FDM cases, it was more common to be male (n=17 males vs n=3 females; P≤0.05. Ten out of twenty owners to cases (50% reported their cats to be obese at the time of the diagnosis (median 9 years, min-max 2–15, as compared to five out of twenty (25% controls at the same age. The median BW at the time for diagnosis was 5.5 kg (min-max 2.0-9.0 for cases, and 5.0 kg (min-max 3.0-8.0 kg for controls, respectively. Despite that both cases and controls had the same median age at the time of the study (13 years, min-max 3–18, a significantly higher number of controls were alive at that age (n=16 controls vs 8 cases; P≤0.05. A significantly higher proportion of cases that were obese at the time of the FDM diagnosis were dead at the time of the study compared to the proportion of controls that were obese at a similar age (P≤0.05. The diets given at the time for diagnosis for cases compared to diet of the controls at a similar time were mainly commercial foods, and controls consumed a higher proportion of dry foods compared to cases (medians 79 vs 44% of DM intake/d, respectively; P≤0.05. Cases were less active compared to the controls (2.3 and 3.2 h

  3. Exhibitionistic and voyeuristic behavior in a Swedish national population survey.

    Science.gov (United States)

    Långström, Niklas; Seto, Michael C

    2006-08-01

    We examined the prevalence and correlates of self-reported sexual arousal from exposing one's genitals to a stranger (exhibitionistic behavior) and spying on others having sex (voyeuristic behavior) in a representative national sample. In 1996, 2,450 randomly selected 18-60 year-olds from the general population of Sweden were interviewed in a broad survey of sexuality and health. A total of 76 (3.1%) respondents reported at least one incident of being sexually aroused by exposing their genitals to a stranger and 191 (7.7%) respondents reported at least one incident of being sexually aroused by spying on others having sex. Exhibitionistic and voyeuristic behaviors were examined for possible associations with 9 sociodemographic, 5 health, 4 risk-taking, and 17 sexuality variables. Both paraphilia-like behaviors were positively associated with being male and having more psychological problems, lower satisfaction with life, greater alcohol and drug use, and greater sexual interest and activity in general, including more sexual partners, greater sexual arousability, higher frequency of masturbation, higher frequency of pornography use, and greater likelihood of having had a same-sex sexual partner. Consistent with previous research in clinical samples of men with paraphilias, respondents who reported either exhibitionistic or voyeuristic behavior had substantially greater odds of reporting other atypical sexual behavior (sadomasochistic or cross-dressing behavior). There was evidence both for general and specific associations between sexual fantasies and their corresponding paraphilia-like behaviors. The implications of these findings for research on atypical sexual interests, atypical sexual behavior, and paraphilias are discussed.

  4. Chemistry inside an epistemological community box! Discursive exclusions and inclusions in Swedish National tests in Chemistry

    Science.gov (United States)

    Ståhl, Marie; Hussénius, Anita

    2017-06-01

    This study examined the Swedish national tests in chemistry for implicit and explicit values. The chemistry subject is understudied compared to biology and physics and students view chemistry as their least interesting science subject. The Swedish national science assessments aim to support equitable and fair evaluation of students, to concretize the goals in the chemistry syllabus and to increase student achievement. Discourse and multimodal analyses, based on feminist and critical didactic theories, were used to examine the test's norms and values. The results revealed that the chemistry discourse presented in the tests showed a traditional view of science from the topics discussed (for example, oil and metal), in the way women, men and youth are portrayed, and how their science interests are highlighted or neglected. An elitist view of science emerges from the test, with distinct gender and age biases. Students could interpret these biases as a message that only "the right type" of person may come into the chemistry epistemological community, that is, into this special sociocultural group that harbours a common view about this knowledge. This perspective may have an impact on students' achievement and thereby prevent support for an equitable and fair evaluation. Understanding the underlying evaluative meanings that come with science teaching is a question of democracy since it may affect students' feelings of inclusion or exclusion. The norms and values harboured in the tests will also affect teaching since the teachers are given examples of how the goals in the syllabus can be concretized.

  5. [National and regional prioritisation in Swedish health care: experiences from cardiology].

    Science.gov (United States)

    Carlsson, Jörg

    2012-01-01

    Prioritisation of medical services in Sweden takes place on two different levels. On the national level, the Swedish priority guidelines ascribe priority values ranging from 1 (high priority) to 10 (low priority) to measures (in terms of condition-treatment pairs) of prevention, diagnosis, treatment and rehabilitation of cardiovascular diseases. In addition, this list contains interventions that should be avoided and those that should only be provided as part of clinical research projects. The government then commissions a multi-professional team under the supervision of the National Board of Health and Welfare "Socialstyelsen" with the development of corresponding guidelines. In addition to the scientific evidence, the priority lists incorporate ethical and economical aspects and are based on the so-called ethics platform consisting of human dignity, needs, solidarity and cost-effectiveness. At the other level of prioritisation there are regional projects aiming at the in- and exclusion of medical measures. The Swedish prioritisation process will be described using the example of priority lists in cardiology. (As supplied by publisher). Copyright © 2012. Published by Elsevier GmbH.

  6. The association between cannabis abuse and subsequent schizophrenia: a Swedish national co-relative control study.

    Science.gov (United States)

    Giordano, G N; Ohlsson, H; Sundquist, K; Sundquist, J; Kendler, K S

    2015-01-01

    Although cannabis abuse (CA) is known to be associated with schizophrenia, the causal nature of this association is unclear, with prodromal effects complicating its interpretation. From Swedish national registry databases, we used a co-relative case-control design with full-sibling, half-sibling and first-cousin comparisons, alongside a general Swedish population sample. Using ICD codes, 5456 individuals with an initial diagnosis of schizophrenia (2000-2010) were matched with five schizophrenia-free controls. We further identified first-cousin, half-sibling and full-sibling pairs discordant for CA and statistically extrapolated results for discordant monozygotic (MZ) twins. Within the general Swedish population, CA was strongly associated with later schizophrenia [odds ratio (OR) 10.44, 95% confidence interval (CI) 8.99-12.11]. This association was substantially attenuated both by increasing temporal delays between CA exposure and schizophrenia diagnosis and by controlling for increasing degrees of familial confounding. Extrapolated discordant MZ pairs suggested that fully controlling for confounding familial factors reduced the association between CA and later schizophrenia to more modest levels (ORs of approximately 3.3 and 1.6 with 3- and 7-year temporal delays respectively). Opiate, sedative, cocaine/stimulant and hallucinogen abuse were also strongly associated with subsequent schizophrenia in the general population. After controlling for familial confounding, only cocaine/stimulant exposure remained associated. CA has an appreciable causal impact on future risk for schizophrenia. However, population-based estimates of cannabis-schizophrenia co-morbidity substantially overestimate their causal association. Predictions of the cases of schizophrenia that might be prevented by reduced cannabis consumption based on population associations are therefore likely to be considerably overestimated.

  7. Hospital Admission and Criminality Associated with Substance Misuse in Young Refugees - A Swedish National Cohort Study.

    Science.gov (United States)

    Manhica, Hélio; Gauffin, Karl; Almqvist, Ylva B; Rostila, Mikael; Hjern, Anders

    2016-01-01

    High rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers. Gender stratified Cox regression models were used to estimate the risks of criminal convictions and hospital care associated with substance misuse from national Swedish data for 2005-2012. We focused on 22,992 accompanied and 5,686 unaccompanied refugees who were aged 13-19 years when they settled in Sweden and compared them with 1 million native Swedish youths from the same birth cohort. The risks of criminal conviction associated with substance misuse increased with the length of residency in male refugees, after adjustment for age and domicile. The hazard ratios (HRs) were 5.21 (4.39-6.19) for unaccompanied and 3.85 (3.42-4.18) for accompanied refugees after more than 10 years of residency, compared with the native population. The risks were slightly lower for hospital care, at 2.88 (2.18-3.79) and 2.52(2.01-3.01) respectively. Risks were particularly pronounced for male refugees from the Horn of Africa and Iran. The risks for all male refugees decreased substantially when income was adjusted for. Young female refugees had similar risks to the general population. The risks of criminality and hospital care associated with substance misuse in young male refugees increased with time of residency in Sweden and were associated with a low level of income compared with the native Swedish population. Risks were similar in accompanied and unaccompanied refugees.

  8. 75 FR 67901 - National Diabetes Month, 2010

    Science.gov (United States)

    2010-11-04

    ... diagnosed in young people, is managed by a lifetime of regular medication or insulin treatment. Type 2... their child's obesity later in life. With more Americans becoming affected by diabetes and its... its variations. Obesity is one of the most significant risk factors for Type 2 diabetes. National...

  9. Swedish Projects

    National Research Council Canada - National Science Library

    Borgvall, Jonathan; Lif, Patrik

    2005-01-01

    .... The military research work presented here includes the three military administrations, FOI -- Swedish Defence Research Agency, FMV -- Swedish Defence Materiel Administration, and SNDC -- Swedish...

  10. 78 FR 66613 - National Diabetes Month, 2013

    Science.gov (United States)

    2013-11-05

    ... path to healthier futures. Obese children face an increased risk of adult obesity and all the health... National Diabetes Month. I call upon all Americans, school systems, government agencies, nonprofit...

  11. Digitising the Archaeological Process at the Swedish National Heritage Board: producing, managing and sharing archaeological information

    Directory of Open Access Journals (Sweden)

    Åsa M. Larsson

    2017-03-01

    Full Text Available he Digital Archaeological Process (DAP programme was initiated by the Swedish National Heritage Board in order to create a more seamless process for storing and sharing digital information generated through archaeological surveys and excavations. The programme aims to increase the availability of digital data as well as the quality and usefulness of the information. The Cultural Environment Register is being developed, which will contain and/or link to information about where fieldwork has been done and what was found: archaeological sites, field documentation, finds, as well as the reports and publications. In addition to creating a new system for storing this information, a large amount of old digital projects previously kept by museums and archaeological contractors is being collected to be made publicly available. Our goal is to make heritage management more efficient, and in the process the information will also become more useful to researchers, museums and the general public.

  12. Poor Kids? Economic Resources and Adverse Peer Relations in a Nationally Representative Sample of Swedish Adolescents.

    Science.gov (United States)

    Hjalmarsson, Simon

    2018-01-01

    There is limited knowledge on the impact of economic resources on adverse peer relations during adolescence. This study used a nationally representative sample (n = 4725, 51% girls) of Swedish eighth-grade students (approximately age fourteen) to examine associations between economic resources and adverse peer relations in the form of peer rejection and bullying victimization. Adolescents from households in the lowest within-school household income quintile were found to be rejected by school class peers to a greater extent than more advantaged students, but an association was not found between relative household income and bullying victimization. In contrast, adolescents unable to participate in activities with peers for economic reasons experienced more rejection and were at higher risk of victimization. The results underline the multidimensionality of adverse peer relations and advance our knowledge on how economic resources relate to peer relations in youth.

  13. User-Centred Design and Agile Development: Rebuilding the Swedish National Union Catalogue

    Directory of Open Access Journals (Sweden)

    Henrik Lindström

    2008-12-01

    Full Text Available With a new generation of OPACs emerging that attempt to address longstanding shortcomings, how do we make sure that we do not lose ground again in the future? This article suggests a combination of iterative development and user-centred design as a way to develop systems that will meet the constantly changing expectations of users by providing both functionality and usability. It gives a short introduction to iterative software development and user-centred design. A case study of the development of the new version of LIBRIS (http://libris.kb.se, the Swedish National Union Catalogue, is used as an example of how these methodologies can benefit from each other in practice.

  14. Beliefs about health and illness in Swedish and African-born women with gestational diabetes living in Sweden.

    Science.gov (United States)

    Hjelm, Katarina; Berntorp, Kerstin; Apelqvist, Jan

    2012-05-01

    This paper is a report on a study exploring beliefs about health and illness in women with gestational diabetes born in Sweden and Africa living in Sweden. A further aim is to study the influence of beliefs on self-care and care seeking. Extensive global migration leading to multicultural societies implies challenges to health care. Health/illness beliefs are culturally related and determine health-related behaviour, including self-care, which is crucial in management of gestational diabetes. The risk of developing gestational diabetes is increased in migrants, particularly of African origin, when residing in Western countries. No previous studies, except one, have been found comparing health/illness beliefs in women with gestational diabetes of different origin. Exploratory descriptive study. Semi-structured interviews. Consecutive sample of women diagnosed with gestational diabetes, 13 born in Sweden and 10 born in Africa, from a diabetes clinic in Sweden. Qualitative content analysis of data was applied. Beliefs were mainly related to individual and social factors. Health was described as freedom from disease and being healthy. Swedish women perceived heredity and hormonal changes as causing gestational diabetes, avoided work-related stress, had a healthy lifestyle, worried about the baby's health and development of type 2 diabetes, sought information, used more medications and health care and were on sick-leave more often because of pregnancy-related problems than African women, who did not know the cause of gestational diabetes, had a passive self-care attitude and followed prescriptions, often reported being told by staff that gestational diabetes would disappear after delivery and stated more pregnancy-related problems which they treated with rest or watchful waiting. Health/illness beliefs differed and affected self-care and care seeking. Lower risk awareness in African-born women was related to limited knowledge about the body and gestational diabetes

  15. Biomarkers of food intake and nutrient status are associated with glucose tolerance status and development of type 2 diabetes in older Swedish women

    DEFF Research Database (Denmark)

    Savolainen, Otto; Lind, Mads Vendelbo; Bergström, Göran

    2017-01-01

    multiple dietary biomarkers.Design: Dietary biomarkers were measured in plasma from 64-y-old Swedish women with different GTS [normal glucose tolerance (NGT; n = 190), impaired glucose tolerance (IGT; n = 209), and diabetes (n = 230)]. The same subjects were followed up after 5 y to determine changes...

  16. Ethnic differences in dissatisfaction with sexual life in patients with type 2 diabetes in a Swedish town

    Directory of Open Access Journals (Sweden)

    Taloyan Marina

    2010-09-01

    Full Text Available Abstract Background The first aim of this study was to analyze whether self-reported satisfaction with one's sexual life was associated with ethnicity (Swedish and Assyrian/Syrian in patients with type 2 diabetes. The second was to study whether the association between satisfaction with one's sexual life and ethnicity remained after controlling for possible confounders such as marital status, HbA1c, medication, and presence of other diseases. Methods This cross-sectional, questionnaire-based study was conducted at four primary health care centers in the Swedish town of Södertälje. A total of 354 persons (173 ethnic Assyrians/Syrians and 181 ethnic Swedes participated. Results The total prevalence of self-reported dissatisfaction with one's sexual life in both groups was 49%. No significant ethnic differences were found in the outcome. In the final model, regardless of ethnicity, the odds ratio (OR for self-reported dissatisfaction with one's sexual life in those ≥ 70 years old was 2.52 (95% CI 1.33-4.80. Among those living alone or with children, the OR was more than three times higher than for married or cohabiting individuals (OR = 3.10, 95% CI 1.60-6.00. Those with other diseases had an OR 1.89 times (95% CI 1.10-3.40 higher than those without other diseases. Conclusions The findings demonstrate that almost half of participants were dissatisfied with their sexual life and highlight the importance of sexual life to people with type 2 diabetes. This factor should not be ignored in clinical evaluations. Moreover, the findings demonstrate that it is possible to include questions on sexual life in investigations of patients with type 2 diabetes and even in other health-related, questionnaire studies, despite the sensitivity of the issue of sexuality.

  17. Incidence of acute pulmonary embolism, related comorbidities and survival; analysis of a Swedish national cohort.

    Science.gov (United States)

    Andersson, Therese; Söderberg, Stefan

    2017-06-14

    The aim of the study was to determine the incidence of acute pulmonary embolism (PE) in Sweden and any regional differences. To assess short- and long-term survival analysis after an episode of PE, before and after excluding patients with known malignancies, and to determine the most common comorbidities prior to the PE event. All in-hospital patients, including children, diagnosed with acute PE in 2005 were retrieved from the Swedish National Patient Registry (NPR) and incidence rates were calculated. All registered comorbidities from 1998 until the index events were collected and survival up to 4 years after the event were calculated and compared to matched controls. There were 5793 patients of all ages diagnosed with acute PE in 2005 resulting in a national incidence of 0.6/1000/year. The mean age was 70 years and 52% were women. The most frequent comorbidities were cardiac-, vascular-, infectious- and gastrointestinal diseases, injuries and malignancies. The mortality rates were more than doubled in patients with recent PE compared to that in a matched control group (49.1% vs 21.9%), and the excess mortality remained after exclusion of deaths occurring within one year and after exclusion of patients with any malignancy prior to the event. PE is associated with high age as well as with multiple comorbidities, and with an increased short- and long-term mortality. This study highlights the importance of a proper follow-up after an acute PE.

  18. The Transparency Programme of the Swedish National Council for Nuclear Waste. A Status Report

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Kjell (Karita Research AB, Taeby (Sweden)), E-Mail: kjell.andersson@karita.se

    2009-12-15

    In this paper the activities of the Transparency Programme of the Swedish National Council for Nuclear Waste have been explored. Comparisons have been made with other activities using the same transparency approach and observations made from different reports that deal with the programme or parts of it have been taken into account. Obviously, to make firm conclusions to what extent the aims of the Transparency Programme have been achieved a formal review should be done. It seems evident however that the programme has vitalized the overall dialogue about the Swedish nuclear waste management programme and that the hearings held have raised the awareness about issues that have been dealt with such as value-laden aspects of disposals methods, feasibility of certain alternatives, the need for clarification of how regulatory criteria can be applied and the use of research on governance processes. Stakeholders seem to have appreciated the overall organization and the stretching that took place during the hearings held. For possible future activities, the observations made about the antagonism between certain parties which has existed since a long time ago and the common language and culture need to be taken into account. The core problem, however, is to reach out to the political decision makers at the national level, especially since the time distance between hearings held so far and critical government decisions is at least six years which put a high demand on the reporting system. Taking the experiences from other transparency projects into account, the Council might consider the possibility to establish a reference group with participation from different stakeholders and politicians who could have a role for conveying results to wider groups. One observer has concluded that the reporting from the Transparency Programme should be open in the sense that it should not make conclusions on the issues as such (e.g. if a certain disposal method is to prefer or not). Instead

  19. Binge-eating disorder in the Swedish national registers: Somatic comorbidity.

    Science.gov (United States)

    Thornton, Laura M; Watson, Hunna J; Jangmo, Andreas; Welch, Elisabeth; Wiklund, Camilla; von Hausswolff-Juhlin, Yvonne; Norring, Claes; Herman, Barry K; Larsson, Henrik; Bulik, Cynthia M

    2017-01-01

    To evaluate associations between binge-eating disorder (BED) and somatic illnesses and determine whether medical comorbidities are more common in individuals who present with BED and comorbid obesity. Cases (n = 850) were individuals with a BED diagnosis in the Swedish eating disorders quality registers. Ten community controls were matched to each case on sex, and year, month, and county of birth. Associations of BED status with neurologic, immune, respiratory, gastrointestinal, skin, musculoskeletal, genitourinary, circulatory, and endocrine system diseases were evaluated using conditional logistic regression models. We further examined these associations by adjusting for lifetime psychiatric comorbidity. Amongst individuals with BED, we explored whether comorbid obesity was associated with risk of somatic disorders. BED was associated with most classes of diseases evaluated; strongest associations were with diabetes [odds ratio (95% confidence interval) = 5.7 (3.8; 8.7)] and circulatory systems [1.9 (1.3; 2.7)], likely indexing components of metabolic syndrome. Amongst individuals with BED, those with comorbid obesity were more likely to have a lifetime history of respiratory [1.5 (1.1; 2.1)] and gastrointestinal [2.6 (1.7; 4.1)] diseases than those without comorbid obesity. Increased risk of some somatic disease classes in individuals with BED was not simply due to obesity or other lifetime psychiatric comorbidity. The association of BED with many somatic illnesses highlights the morbidity experienced by individuals with BED. Clinicians treating patients with BED should be vigilant for medical comorbidities. Nonpsychiatric providers may be the first clinical contact for those with BED underscoring the importance of screening in primary care. © 2016 The Authors International Journal of Eating Disorders Published by Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:58-65). © 2016 The Authors International Journal of Eating Disorders Published by Wiley

  20. 76 FR 68617 - National Diabetes Month, 2011

    Science.gov (United States)

    2011-11-04

    .... The increase in Type 2 diabetes among our Nation's children is linked to the rise of childhood obesity. To end the epidemic of childhood obesity within a generation, First Lady Michelle Obama's Let's Move..., school systems, government agencies, nonprofit organizations, health care providers, research...

  1. Neighborhood walkability, deprivation and incidence of type 2 diabetes: a population-based study on 512,061 Swedish adults.

    Science.gov (United States)

    Sundquist, Kristina; Eriksson, Ulf; Mezuk, Briana; Ohlsson, Henrik

    2015-01-01

    Neighborhood walkability has been associated with increased physical activity, but only a few studies have explored the association between walkability and health outcomes related to physical activity, such as type 2 diabetes. The aim of this study was to investigate the association between objectively assessed neighborhood walkability and the 4-year incidence of type 2 diabetes in a sample of 512,061 Swedish adults aged 18 years and older. Neighborhoods were defined by 408 administratively defined geographical areas in the city of Stockholm. We found a negative association between walkability and type 2 diabetes (OR=1.33, 95% CI=1.13-1.55) that remained significant after adjusting for neighborhood deprivation. This association, however, no longer remained statistically significant after adjusting for individual socio-demographic factors. These results were also confirmed using a co-sibling design. Future studies are encouraged to further explore the potential effect of a broader array of the neighborhood built environment on health outcomes related to physical activity. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. The effect of a biological explanation on attitudes towards homosexual persons. A Swedish national sample study.

    Science.gov (United States)

    Landén, Mikael; Innala, Sune

    2002-01-01

    Studies assessing attitudes towards homosexuals have revealed widespread homophobia. The first aim of this study was to assess potential changes in public attitudes after important legislative changes related to homosexuals in Sweden. The second aim was to test whether the attitudes differ: 1) between people who believe in biological vs. people who believe in psychological theories in explanation of homosexuality, 2) between men and women, and 3) between the older and younger age groups. To this end, a questionnaire survey of a representative, randomly selected, national sample of 992 adult Swedish residents was carried out. The response rate was 67%, which is considered high in this context. In conclusion, this study demonstrates a clear-cut change towards more tolerant attitudes towards homosexual men and women compared to earlier studies. The reasons for this change is discussed; among factors of importance are anti-discrimination legislation, increased visibility of homosexual people, and that more people currently regard homosexuality as a biologically determined, natural variant of human sexuality than was the case 10 years ago. In accordance, this study gave further support to the notion that those who believe that homosexuality is caused by biological factors have a less restrictive view on homosexuality than do people who hold a psychological view.

  3. Educational achievement and vocational career in twins - a Swedish national cohort study.

    Science.gov (United States)

    Hjern, Anders; Ekeus, Cecilia; Rasmussen, Finn; Lindblad, Frank

    2012-06-01

    To investigate how being born and raised as a twin is associated with IQ, educational achievement and vocational career. Register study in a national birth cohort, complemented with a siblings study. The study population included 13,368 individuals born and raised as twins and 837,752 singletons, including 3019 siblings of twins, in the Swedish birth cohorts of 1973-1981. Our outcome measures were mean grade points on a five point scale from ninth grade of primary school at 15-16 years, IQ tests on a nine grade point scale from male conscripts at 18-19 years, highest completed education, disability benefits, work income and employment at 27-35 years of age. Twins had slightly better mean grade point averages in ninth grade; +0.08 (95% CI 0.04-0.11) and more often had completed a university education in young adulthood; OR 1.16 (1.02-1.21) compared with singleton siblings, despite male twins having a slightly lower IQ at military conscription compared with male singletons. Employment rates, mean income and disability benefits were similar in twins and singletons. Twins have slightly better educational careers and similar vocational careers compared with those born as singletons. © 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

  4. Childhood socio-economic status, school failure and drug abuse: a Swedish national cohort study.

    Science.gov (United States)

    Gauffin, Karl; Vinnerljung, Bo; Fridell, Mats; Hesse, Morten; Hjern, Anders

    2013-08-01

    To investigate whether socio-economic status (SES) in childhood and school failure at 15 years of age predict illicit drug abuse in youth and young adulthood. Register study in a Swedish national cohort born 1973-88 (n = 1,405,763), followed from age 16 to 20-35 years. Cox regression analyses were used to calculate hazard ratios (HR) for any indication of drug abuse. Our outcomes were hospital admissions, death and criminality associated with illicit drug abuse. Data on socio-demographics, school grades and parental psychosocial problems were collected from censuses (1985 and 1990) and national registers. School failure was defined as having mean school grades from the final year in primary school lower than -1 standard deviation and/or no grades in core subjects. School failure was a strong predictor of illicit drug abuse with an HR of 5.87 (95% CI: 5.76-5.99) after adjustment for age and sex. Childhood SES was associated with illicit drug abuse later in life in a stepwise manner. The lowest stratum had a HR of 2.28 (95% CI: 2.20-2.37) compared with the highest stratum as the reference, when adjusted for other socio-demographic variables. In the fully adjusted model, the effect of SES was greatly attenuated to an HR of 1.23 (95% CI: 1.19-1.28) in the lowest SES category, while the effect of school failure remained high with an HR of 4.22 (95% CI: 4.13-4.31). School failure and childhood socio-economic status predict illicit drug abuse independently in youth and young adults in Sweden. © 2013 Society for the Study of Addiction.

  5. Economic hardships in adulthood and mental health in Sweden. the Swedish National Public Health Survey 2009

    Directory of Open Access Journals (Sweden)

    Ahnquist Johanna

    2011-10-01

    Full Text Available Abstract Background Possible accumulative effects of a combined economic hardship's measure, including both income and non-income related economic hardships measures, on mental health has not been well investigated. The aim of this paper was to investigate; (i independent associations between multiple measures of economic hardships and mental health problems, and (ii associations between a combined economic hardships measure and mental health problems. Methods We analysed data from the 2009 Swedish National Survey of Public Health comprising a randomly selected representative national sample combined with a randomly selected supplementary sample from four county councils and three municipalities consisting of 23,153 men and 28,261 women aged 16-84 years. Mental health problems included; psychological distress (GHQ-12, severe anxiety and use of antidepressant medication. Economic hardship was measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves. Results The results from multivariate adjusted (age, country of birth, educational level, occupational status, employment status, family status and long term illness logistic regression analysis indicate that self-reported current economic difficulties (inability to pay for ordinary bills and lack of cash reserves, were significantly associated with both women's and men's mental health problems (all indicators, while low income was not. In addition, we found a statistically significant graded association between mental health problems and levels of economic hardships. Conclusions The findings indicate that indicators of self-reported current economic difficulties seem to be more strongly associated with poor mental health outcomes than the more conventional measure low income. Furthermore, the likelihood of mental health problems differed significantly in a graded fashion in relation to levels of economic hardships.

  6. Recent Trends in Diabetes Knowledge, Perceptions, and Behaviors: Implications for National Diabetes Education

    Science.gov (United States)

    Piccinino, Linda; Griffey, Susan; Gallivan, Joanne; Lotenberg, Lynne Doner; Tuncer, Diane

    2015-01-01

    Objectives: Examine trends in diabetes-related knowledge, perceptions, and behavior among U.S. adults with and without a diagnosis of diabetes and among subpopulations at risk. Discuss implications for national diabetes education and for the National Diabetes Education Program (NDEP) in particular. Methods: Three population-based NDEP National…

  7. National minorities in history teaching : images of Roma in programs produced by the Swedish Educational Broadcasting Company, 1975-2013

    OpenAIRE

    Indzic Dujso, Aleksandra

    2015-01-01

    In 2000 when Sweden signed the Framework Convention for the Protection of National Minorities the Roma minority became one of the acknowledged national minorities in the country. It meant that the rights of the Roma mi-nority would be safeguarded and the knowledge of its history and culture would be spread. In that context, the Swedish school, with its founded as-signment of democracy, was given an important role. The education was to communicate the multicultural values of the society and to...

  8. Intestinal biospy in children with coeliac disease; a Swedish national study of radiation dose and risk

    Energy Technology Data Exchange (ETDEWEB)

    Persliden, J.; Pettersson, H.B.L. [Linkoeping Univ. (Sweden). Dept. of Radiation Physics; Faelth-Magnusson, K. [University of Linkoeping (Sweden). Faculty of Health Sciences

    1995-12-31

    In paediatric patients, fluoroscopy is used to monitor intestinal biopsies obtained for the diagnosis of coeliac disease. The radiation dose to the child is dependent on the equipment, the sedation of the patient and the experience of the operator. This study presents patient measurements from a national study in Sweden. The cancer excess lifetime mortality risk (CELMR) and the loss of life expectancy (LLE) are calculated for this patient group. TLD measurements were performed by dosemeters at 40 Swedish paediatric departments performing these biopsies. Information was received on sedation techniques, equipment used and fluoroscopy duration. An exponential curve fit was applied to the entrance and exit dose values and this dose distribution was integrated to get the integral dose. From this the mean absorbed dose in the irradiated volume was calculated. The mean and the median of the mean absorbed dose in the irradiated volume to the children was found to be 1.3 mGy (range 0.05-17.5 mGy) and 0.56 mGy respectively. The mean value of the entrance surface dose was 3.0 mGy (range 0.10-27.1 mGy) and the median was 1.4 mGy. The annual collective dose was calculated to 3.3 man Gy, based on 2500 biopsies per year. Variation in doses was found to depend on, e.g. the age of the equipment, focus to patient distance, sedation and operator experience. With this knowledge of doses received by the children in the diagnosis of coeliac disease, CELMR was found to be 0.5 per 25000 biopsies and LLE was 18 years. Recommendations are given on the proper choice of equipment for the reduction of fluoroscopy doses in pediatric radiology. (Author).

  9. Hypertensive disorders in pregnancy and later dementia: a Swedish National Register Study.

    Science.gov (United States)

    Andolf, Ellika G; Sydsjö, Gunilla C M; Bladh, Marie K; Berg, Goran; Sharma, Surendra

    2017-04-01

    Our aim was to investigate the rate of vascular dementia and dementia in women with previous hypertensive disorders in pregnancy, since white matter lesions of the brain and cardiovascular disease are linked both to dementia and hypertensive disorders in pregnancy. Prospective population-based registry study on all women giving birth in Sweden between 1973 and 1975 (284 598). Women with and without hypertensive disorders in pregnancy were identified by means of the Swedish Medical Birth Register and linked to the National Patient Register, where data on somatic disease later in life were obtained. International classification of disease was used. The Cox proportional hazard model was used to calculate hazard ratios for both groups and adjusted for possible confounders. Main outcome measures were in-hospital diagnosis of cardiovascular disease, vascular dementia and dementia. No increased risks were seen for vascular dementia or dementia after any hypertensive disorders in pregnancy. If broken down in specific diagnoses for hypertensive disease in pregnancy, adjusted risks for vascular dementia after hypertension and proteinuria during pregnancy the hazard ratio was 6.27 (95% CI 1.65-27.44). Higher risks for cardiovascular disease were confirmed. Because of the very low absolute risk, the wide confidence interval and risk of misclassification, our results on vascular dementia could be questioned. Considering the pathophysiology of preeclampsia, the findings of brain lesions and the increased risk for cardiovascular disease, the possibly increased risk for all kinds of dementia must be investigated in larger and more well-defined cohorts. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

  10. Alcohol and the risk for latent autoimmune diabetes in adults: results based on Swedish ESTRID study.

    Science.gov (United States)

    Rasouli, Bahareh; Andersson, Tomas; Carlsson, Per-Ola; Dorkhan, Mozhgan; Grill, Valdemar; Groop, Leif; Martinell, Mats; Tuomi, Tiinamaja; Carlsson, Sofia

    2014-11-01

    Moderate alcohol consumption is associated with a reduced risk of type 2 diabetes. Our aim was to investigate whether alcohol consumption is associated with the risk of latent autoimmune diabetes in adults (LADA), an autoimmune form of diabetes with features of type 2 diabetes. A population-based case-control study was carried out to investigate the association of alcohol consumption and the risk of LADA. We used data from the ESTRID case-control study carried out between 2010 and 2013, including 250 incident cases of LADA (glutamic acid decarboxylase antibodies (GADAs) positive) and 764 cases of type 2 diabetes (GADA negative), and 1012 randomly selected controls aged ≥35. Logistic regression was used to estimate the odds ratios (ORs) of diabetes in relation to alcohol intake, adjusted for age, sex, BMI, family history of diabetes, smoking, and education. Alcohol consumption was inversely associated with the risk of type 2 diabetes (OR 0.95, 95% CI 0.92-0.99 for every 5-g increment in daily intake). Similar results were observed for LADA, but stratification by median GADA levels revealed that the results only pertained to LADA with low GADA levels (OR 0.85, 95% CI 0.76-0.94/5 g alcohol per day), whereas no association was observed with LADA having high GADA levels (OR 1.00, 95% CI 0.94-1.06/5 g per day). Every 5-g increment of daily alcohol intake was associated with a 10% increase in GADA levels (P=0.0312), and a 10% reduction in homeostasis model assessment of insulin resistance (P=0.0418). Our findings indicate that alcohol intake may reduce the risk of type 2 diabetes and type 2-like LADA, but has no beneficial effects on diabetes-related autoimmunity. © 2014 The authors.

  11. Increasing Rates of Brain Tumours in the Swedish National Inpatient Register and the Causes of Death Register

    Directory of Open Access Journals (Sweden)

    Lennart Hardell

    2015-04-01

    Full Text Available Radiofrequency emissions in the frequency range 30 kHz–300 GHz were evaluated to be Group 2B, i.e., “possibly”, carcinogenic to humans by the International Agency for Research on Cancer (IARC at WHO in May 2011. The Swedish Cancer Register has not shown increasing incidence of brain tumours in recent years and has been used to dismiss epidemiological evidence on a risk. In this study we used the Swedish National Inpatient Register (IPR and Causes of Death Register (CDR to further study the incidence comparing with the Cancer Register data for the time period 1998–2013 using joinpoint regression analysis. In the IPR we found a joinpoint in 2007 with Annual Percentage Change (APC +4.25%, 95% CI +1.98, +6.57% during 2007–2013 for tumours of unknown type in the brain or CNS. In the CDR joinpoint regression found one joinpoint in 2008 with APC during 2008–2013 +22.60%, 95% CI +9.68, +37.03%. These tumour diagnoses would be based on clinical examination, mainly CT and/or MRI, but without histopathology or cytology. No statistically significant increasing incidence was found in the Swedish Cancer Register during these years. We postulate that a large part of brain tumours of unknown type are never reported to the Cancer Register. Furthermore, the frequency of diagnosis based on autopsy has declined substantially due to a general decline of autopsies in Sweden adding further to missing cases. We conclude that the Swedish Cancer Register is not reliable to be used to dismiss results in epidemiological studies on the use of wireless phones and brain tumour risk.

  12. Childhood Household Dysfunction, Social Inequality and Alcohol Related Illness in Young Adulthood. A Swedish National Cohort Study.

    Science.gov (United States)

    Gauffin, Karl; Hjern, Anders; Vinnerljung, Bo; Björkenstam, Emma

    2016-01-01

    The aim of this paper is to estimate the cumulative effect of childhood household dysfunction (CHD) on alcohol related illness and death later in life and to test the interaction between CHD and socioeconomic background. The study utilised Swedish national registers including data of a Swedish national cohort born 1973-82 (n = 872,912), which was followed from age 18 to 29-40 years. Cox regression analyses were used to calculate hazard ratios (HR) for alcohol related illness or death in young adulthood. The CHD measure consisted of seven indicators: parental alcohol/drug misuse, mental health problems, criminality, death, divorce, social assistance, and child welfare interventions. Childhood socioeconomic position (SEP) was indicated by parental occupational status. Outcomes were alcohol related inpatient hospital care, specialised outpatient care or deaths. Using the highest socioeconomic group without CHD experience as a reference, those in the same socioeconomic group with one indicator of CHD had HRs of 2.1 [95% CI: 1.7-2.5], two CHD indicators 5.6 [4.4-7.1], three or more indicators 9.4 [7.1-12.4] for retrieving inpatient care. Socioeconomic disadvantage further increased the risks-those with low socioeconomic background and three CHD indicators or more had a HR of 12.5 [10.9-14.3]. Testing for interaction suggests that the combined HRs deviates from additivity [Synergy index: 1.6, 95% CI: 1.4-1.9]. The results for outpatient care were similar, but not as pronounced. In conclusion, this Swedish national cohort study shows that childhood household dysfunction is strongly and cumulatively associated to alcohol related illness later in life and that it interacts with socioeconomic disadvantage.

  13. National Standards for Diabetes Self-Management Education

    OpenAIRE

    Funnell, Martha M.; Brown, Tammy L.; Childs, Belinda P.; Haas, Linda B.; Hosey, Gwen M.; Jensen, Brian; Maryniuk, Melinda; Peyrot, Mark; Piette, John D.; Reader, Diane; Siminerio, Linda M.; Weinger, Katie; Weiss, Michael A

    2009-01-01

    Diabetes self-management education (DSME) is a critical element of care for all people with diabetes and is necessary in order to improve patient outcomes. The National Standards for DSME are designed to define quality diabetes self-management education and to assist diabetes educators in a variety of settings to provide evidence-based education. Because of the dynamic nature of health care and diabetes-related research, these Standards are reviewed and revised approximately every 5 years by ...

  14. A clinical study and the national service framework for diabetes.

    Science.gov (United States)

    Barry, Angela; Wilkinson, Isabel; Halford, Victoria; Springett, Kate; McInnes, Alistair

    2004-10-01

    Clinical assessment and management for anyone who has diabetes may be influenced by the development of the National Service Framework (NSF) for Diabetes. Through a case study, this article explains how the NSF for Diabetes and other recent NHS documentation has influenced our approach to managing a type 2 diabetic patient whose feet are categorised as 'high risk'. Some of the potential shortfalls of the NSF for Diabetes are also discussed in this context.

  15. 76 FR 9587 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Science.gov (United States)

    2011-02-18

    ... Diabetes, Endocrinology and Metabolic Diseases, NIDDK, National Institutes of Health. BILLING CODE 4140-01... Diseases Diabetes Mellitus Interagency Coordinating Committee; Notice of Meeting The Diabetes Mellitus... for collaboration. The March 11, 2011, DMICC meeting will discuss ``Diabetes: A1c/Questions/ Diagnosis...

  16. Discrepancies between the electronic medical record, the prescriptions in the Swedish national prescription repository and the current medication reported by patients.

    Science.gov (United States)

    Ekedahl, Anders; Brosius, Helen; Jönsson, Julia; Karlsson, Hanna; Yngvesson, Maria

    2011-11-01

    To study discrepancies between (i) the prescribed current treatment stated by patients with congestive heart failure (CHF) compared with patients with other chronic diseases, (ii) the data in the medication list (ML) in the electronic medical record and (iii) the data in the prescription list (PL) on the prescriptions stored in the national prescription repository in Sweden, to determine current, noncurrent, duplicate and missing prescriptions. At one healthcare centre, a random sample of patients 18 years and older with a diagnosis of CHF, diabetes mellitus (DM) or osteoarthritis (OA) provided written informed consent to participate. Participants were interviewed by telephone on the prescribed current treatment. Of 161 invited patients (61 CHF, 50 DM and 50 OA), 66 patients were included. More than 80% of the patients had at least one discrepancy, a noncurrent, a duplicate or a missing prescription, in the ML and PL. The overall congruence for unique prescriptions on current treatment between the ML and the PL was only 55%. Patients with CHF had overall more discrepancies and patients with DM fewer discrepancies in the ML. Prescriptions for noncurrent treatment, duplicates and missing prescriptions are common in both the ML in the electronic medical record and the list on prescriptions stored in the Swedish National Prescription Repository. Patients with CHF had more discrepancies in the ML. The risk for medication errors in primary care due to incorrect information on prescribed treatment may be substantial. Copyright © 2011 John Wiley & Sons, Ltd.

  17. Swedish emergency department triage and interventions for improved patient flows: a national update.

    Science.gov (United States)

    Farrokhnia, Nasim; Göransson, Katarina E

    2011-12-08

    In Scandinavia, emergency department triage and patient flow processes, are under development. In Sweden, the triage development has resulted in two new triage scales, the Adaptive Process Triage and the Medical Emergency Triage and Treatment System. Both these scales have logistic components, aiming to improve patient flows. The aim of this study was to report the development and current status of emergency department triage and patient flow processes in Sweden. In 2009 and 2010 the Swedish Council on Health Technology Assessment sent out a questionnaire to the ED managers in all (74) Swedish hospital emergency departments. The questionnaire comprised questions about triage and interventions to improve patient flows. Nearly all (97%) EDs in Sweden employed a triage scale in 2010, which was an increase from 2009 (73%). Further, the Medical Emergency Triage and Treatment System was the triage scale most commonly implemented across the country. The implementation of flow-related interventions was not as common, but more than half (59%) of the EDs have implemented or plan to implement nurse requested X-ray. There has been an increase in the use of triage scales in Swedish EDs during the last few years, with acceleration for the past two years. Most EDs have come to use the Medical Emergency Triage and Treatment System, which also indicates regional co-operation. The implementation of different interventions for improved patient flows in EDs most likely is explained by the problem of crowding. Generally, more studies are needed to investigate the economical aspects of these interventions.

  18. Hospital Admission and Criminality Associated with Substance Misuse in Young Refugees – A Swedish National Cohort Study

    Science.gov (United States)

    Manhica, Hélio; Gauffin, Karl; Almqvist, Ylva B.; Rostila, Mikael; Hjern, Anders

    2016-01-01

    Background High rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers. Methods Gender stratified Cox regression models were used to estimate the risks of criminal convictions and hospital care associated with substance misuse from national Swedish data for 2005–2012. We focused on 22,992 accompanied and 5,686 unaccompanied refugees who were aged 13–19 years when they settled in Sweden and compared them with 1 million native Swedish youths from the same birth cohort. Results The risks of criminal conviction associated with substance misuse increased with the length of residency in male refugees, after adjustment for age and domicile. The hazard ratios (HRs) were 5.21 (4.39–6.19) for unaccompanied and 3.85 (3.42–4.18) for accompanied refugees after more than 10 years of residency, compared with the native population. The risks were slightly lower for hospital care, at 2.88 (2.18–3.79) and 2.52(2.01–3.01) respectively. Risks were particularly pronounced for male refugees from the Horn of Africa and Iran. The risks for all male refugees decreased substantially when income was adjusted for. Young female refugees had similar risks to the general population. Conclusion The risks of criminality and hospital care associated with substance misuse in young male refugees increased with time of residency in Sweden and were associated with a low level of income compared with the native Swedish population. Risks were similar in accompanied and unaccompanied refugees. PMID:27902694

  19. National register of diabetes mellitus in Russian Federation.

    Directory of Open Access Journals (Sweden)

    Ivan Ivanovich Dedov

    2015-07-01

    Full Text Available Clinical and epidemiological monitoring of diabetes in Russian Federation (RF is carried out by the National diabetes register, which methodological and organizational reference center is Federal Endocrinology Research Centre. Since 2014 initiated the translation the National diabetes register on online software system in order to increase the effectiveness of the register as a scientific and analytical platform. The article include the analysis of DM prevalence, incidence,DM-related mortality,the prevalence of diabetic complications and analysis of effectiveness of diabetes care (included HbA1c and according to the data of online register.

  20. From National Policy-Making to Global Edu-Business: Swedish Edu-Preneurs on the Move

    Science.gov (United States)

    Rönnberg, Linda

    2017-01-01

    This study explores the movements of some Swedish former education policy-makers that are currently active as commercial edu-business actors with the ambition to expand in the Global Education Industry (GEI). The aim is to map and analyze how a selection of Swedish edu-preneurs affiliated with a particular Swedish school chain enter the GEI and…

  1. Menstrual irregularity and use of oral contraceptives in female adolescent athletes in Swedish National Sports High Schools.

    Science.gov (United States)

    von Rosen, Philip; Heijne, Annette; Frohm, Anna; Fridén, Cecilia

    2017-11-23

    Objective Female adolescent athletes seem to use oral contraceptives (OCs) in the same proportion as the general population. In athletes not using OCs, menstrual irregularity (MI) is reported to be common but there are few studies of MI in adolescent athletes. The aim of the study was to survey menarche, menstrual irregularity and use of OCs in adolescent athletes in the National Sports High Schools in Sweden. A further aim was to study the associations between current sport injury and menstrual irregularity as well as use of OCs. Subjects Two hundred and ninety-eight female adolescent athletes at Swedish National Sports High Schools. Methods A web-based questionnaire containing questions related to menstrual status, contraception and current injury. Results One third (32.6%) of the athletes used OCs and of the remaining athletes 31.8% had MI. The group of athletes with MI had a significantly (p = 0.038; Cohen's d, 0.32) lower BMI and consisted of a significantly (p = 0.043) higher proportion of endurance athletes. OC users were less likely to participate in endurance sports compared to non-OC users (p = 0.024). Current injury was equally distributed in the OC and the non-OC group but athletes with MI had fewer sports injuries compared to eumenorrheic women. Conclusion OCs are frequently used among athletes at Swedish National Sports High Schools. OC users were less likely to participate in endurance sports compared to non-OC users. MI was common and athletes with MI had lower BMI compared to eumenorrheic athletes. Sports injuries were not associated with use of OC and eumenorrheic athletes had a higher proportion of current injury.

  2. TOTALL: high cost of allergic rhinitis-a national Swedish population-based questionnaire study.

    Science.gov (United States)

    Cardell, Lars-Olaf; Olsson, Petter; Andersson, Morgan; Welin, Karl-Olof; Svensson, Johanna; Tennvall, Gunnel Ragnarson; Hellgren, Johan

    2016-02-04

    Allergic rhinitis is a global illness with a well-recognised impact on quality of life and work performance. Comparatively little is known about the extent of its economic impact on society. The TOTALL study estimates the total cost of allergic rhinitis using a sample representing the entire Swedish population of working age. A questionnaire focused on allergic rhinitis was mailed out to a random population of Swedish residents, aged 18-65 years. Health-care contacts, medications, absenteeism (absence from work) and presenteeism (reduced working capacity at work) were assessed, and the direct and indirect costs of allergic rhinitis were calculated. Medication use was evaluated in relation to the ARIA guidelines. In all, 3,501 of 8,001 (44%) answered the questionnaire, and 855 (24%) of these reported allergic rhinitis. The mean annual direct and indirect costs because of allergic rhinitis were €210.3 and €750.8, respectively, resulting in a total cost of €961.1 per individual/year. Presenteeism represented 70% of the total cost. Antihistamines appear to be used in excess in relation to topical steroids, and the use of nasal decongestants was alarmingly high. The total cost of allergic rhinitis in Sweden, with a population of 9.5 million, was estimated at €1.3 billion annually. These unexpectedly high costs could be related to the high prevalence of disease, in combination with the previously often underestimated indirect costs. Improved adherence to guidelines might ease the economic burden on society.

  3. The effect of childhood socioeconomic position on alcohol-related disorders later in life: a Swedish national cohort study.

    Science.gov (United States)

    Gauffin, Karl; Hemmingsson, Tomas; Hjern, Anders

    2013-11-01

    Alcohol use is the third most important global-health risk factor and a main contributor to health inequalities. Previous research on social determinants of alcohol-related disorders has delivered inconsistent results. We aimed to investigate whether socioeconomic position (SEP) in childhood predicts alcohol-related disorders in young adulthood in a Swedish national cohort. We studied a register-based national cohort of Swedish citizens born during 1973-1984 (N=948 518) and followed them up to 2009 from age 15. Childhood SEP was defined by a six-category socioeconomic index from the Censuses of 1985 and 1990. HRs of alcohol-related disorders, as indicated by register entries on alcohol-related death and alcohol-related medical care, were analysed in Cox regression models with adjustment for sociodemographic variables and indicators of parental morbidity and criminality. Low childhood SEP was associated with alcohol-related disorders later in life among both men and women in a stepwise manner. Growing up in a household with the lowest SEP was associated with risk for alcohol-related disorders of HR: 2.24 (95% CI 2.08 to 2.42) after adjustment for sociodemographic variables, compared with the highest SEP group. Adjusting the analysis for parental psychosocial problems attenuated the association to HR 1.87 (95% CI 1.73 to 2.01). The study demonstrates that low SEP in childhood predicts alcohol-related disorders in young adulthood. Alcohol abuse needs to be addressed in policies to bridge the gap of health inequalities.

  4. TOTALL: high cost of allergic rhinitis—a national Swedish population-based questionnaire study

    Science.gov (United States)

    Cardell, Lars-Olaf; Olsson, Petter; Andersson, Morgan; Welin, Karl-Olof; Svensson, Johanna; Tennvall, Gunnel Ragnarson; Hellgren, Johan

    2016-01-01

    Allergic rhinitis is a global illness with a well-recognised impact on quality of life and work performance. Comparatively little is known about the extent of its economic impact on society. The TOTALL study estimates the total cost of allergic rhinitis using a sample representing the entire Swedish population of working age. A questionnaire focused on allergic rhinitis was mailed out to a random population of Swedish residents, aged 18–65 years. Health-care contacts, medications, absenteeism (absence from work) and presenteeism (reduced working capacity at work) were assessed, and the direct and indirect costs of allergic rhinitis were calculated. Medication use was evaluated in relation to the ARIA guidelines. In all, 3,501 of 8,001 (44%) answered the questionnaire, and 855 (24%) of these reported allergic rhinitis. The mean annual direct and indirect costs because of allergic rhinitis were €210.3 and €750.8, respectively, resulting in a total cost of €961.1 per individual/year. Presenteeism represented 70% of the total cost. Antihistamines appear to be used in excess in relation to topical steroids, and the use of nasal decongestants was alarmingly high. The total cost of allergic rhinitis in Sweden, with a population of 9.5 million, was estimated at €1.3 billion annually. These unexpectedly high costs could be related to the high prevalence of disease, in combination with the previously often underestimated indirect costs. Improved adherence to guidelines might ease the economic burden on society. PMID:26845513

  5. Cannabis Use as Risk or Protection for Type 2 Diabetes: A Longitudinal Study of 18 000 Swedish Men and Women

    Directory of Open Access Journals (Sweden)

    A. K. Danielsson

    2016-01-01

    Full Text Available Aims. Whether or not cannabis use may increase or decrease the risk of type 2 diabetes is not clear. We analyzed the association between cannabis and subsequent type 2 diabetes and if a potential positive or reverse association persisted after controlling for potential confounders. Methods. In this population-based cohort study, 17,967 Swedish men and women (aged 18–84 years, who answered an extensive questionnaire in 2002 (including questions on cannabis use, were followed up for new cases of type 2 diabetes (n=608 by questionnaire (in 2010 and in health registers during 2003–2011. Odds ratios (ORs with 95% CIs were estimated in a multiple logistic regression analysis. Potential confounders included age, sex, BMI, physical inactivity, smoking, alcohol use, and occupational position. Results. The crude association showed that cannabis users had a reduced risk of type 2 diabetes OR = 0.68 (95% CIs: 0.47–0.99. However, this inverse association attenuated to OR = 0.94 (95% CIs: 0.63–1.39 after adjusting for age. Conclusions. The present study suggests that there is no association between cannabis use and subsequent type 2 diabetes after controlling for age. To make more robust conclusions prospective studies, with longer periods of follow-up and more detailed information about cannabis use, are needed.

  6. Balancing performance-based expectations with a holistic perspective on coaching: a qualitative study of Swedish women?s national football team coaches? practice experiences

    OpenAIRE

    Lindgren, Eva-Carin; Barker-Ruchti, Natalie

    2017-01-01

    ABSTRACT Purpose: The purpose of this study was to explore how an exclusive sample of women?s national football team coaches described how they implement careful coaching while facing social and organizational pressure to win medals. Method: To consider coaches? negotiations, we drew on Noddings? concept of caring. Using an interpretive research paradigm, we conducted in-depth interviews with five Swedish women?s national football team coaches. An abductive approach was used to simultaneously...

  7. Incident diabetes, hypertension and dyslipidemia in a Manitoba First Nation

    Directory of Open Access Journals (Sweden)

    Natalie D. Riediger

    2015-08-01

    Full Text Available Background: Diabetes and diabetes complications are substantially higher among Canadian First Nations populations compared with the general Canadian population. However, incidence data using detailed individual assessments from a population-based cohort have not been undertaken. Objective: We sought to describe incident diabetes, hypertension and dyslipidemia in a population-based cohort from a Manitoba Ojibway First Nation community. Design: Study data were from 2 diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 and 2011/2012. The cohort comprised of respondents to both screening studies (n=171. Health and demographic data were collected using a questionnaire. Fasting blood samples, blood pressure and anthropometric data were also collected objectively. Incident diabetes, hypertension and dyslipidemia were determined. Generalized linear models with Poisson distribution were used to estimate risk of incident diabetes and cardiometabolic conditions according to age and sex. Results: There were 35 (95% CI: 26, 45 new cases of diabetes among 128 participants without diabetes at baseline (27 or 3.3% per year. While participants who were 50 years and older at baseline had a significantly higher risk of incident diabetes at follow-up compared with participants aged 18–29 at baseline (p=0.012, more than half of the incident cases of diabetes occurred among participants aged less than 40 at baseline. There were 28 (95% CI: 20, 37 new cases of dyslipidemia at follow-up among 112 without dyslipidemia at baseline (25%. There were 36 (95% CI: 31, 42 new cases of hypertension among 104 participants without hypertension at baseline (34.6%. Women had half the risk of developing hypertension compared with men (p=0.039. Conclusions: Diabetes incidence is very high, and the number of new cases among those younger than 40 is a concern. Additional public health and primary care efforts are needed to address the

  8. Sickness presenteeism predicts suboptimal self-rated health and sickness absence: a nationally representative study of the Swedish working population.

    Directory of Open Access Journals (Sweden)

    Marina Taloyan

    Full Text Available BACKGROUND: Earlier studies have suggested that sickness presenteeism (SP may be a risk factor for future health problems. The purpose of the present study was to test this in a nationally representative prospective study of Swedish workers. METHODS: Prospective cohort with a representative sample of the Swedish working population surveyed in 2008 and 2010. Odds ratios (OR with 95% confidence intervals (CI were calculated using logistic regression. RESULTS: Those who reported more than 7 days of SP had higher risk of suboptimal SRH compared to those who reported no SP (OR = 5.95; 95% CI 4.98-7.12, also after adjustment for confounders (OR = 1.64; 95% CI 1.30-2.06. Those who reported 1-7 days of SP also had an increased risk before and after adjustments. Inclusion of self-rated physical and psychological work capacity did not attenuate the associations, whereas of emotional exhaustion attenuated the ORs to non-significance for both outcomes, indicating that the health consequences associated with SP are largely related to mental health. CONCLUSION: The results strengthen earlier findings suggesting that SP can be a risk factor for future suboptimal general health and sickness absence, particularly through mental health problems. This indicates that asking about SP could yield important information for employers, occupational health practitioners and GPs, possibly leading to more timely intervention that could decrease the risk of future sickness absence and more serious health problems, especially in the mental domain. Further studies of the possible causal pathways between SP and future health development are also warranted, especially since going to work is often seen as desirable also for those with poor health.

  9. Sickness Presenteeism Predicts Suboptimal Self-Rated Health and Sickness Absence: A Nationally Representative Study of the Swedish Working Population

    Science.gov (United States)

    Taloyan, Marina; Aronsson, Gunnar; Leineweber, Constanze; Magnusson Hanson, Linda; Alexanderson, Kristina; Westerlund, Hugo

    2012-01-01

    Background Earlier studies have suggested that sickness presenteeism (SP) may be a risk factor for future health problems. The purpose of the present study was to test this in a nationally representative prospective study of Swedish workers. Methods Prospective cohort with a representative sample of the Swedish working population surveyed in 2008 and 2010. Odds ratios (OR) with 95% confidence intervals (CI) were calculated using logistic regression. Results Those who reported more than 7 days of SP had higher risk of suboptimal SRH compared to those who reported no SP (OR = 5.95; 95% CI 4.98–7.12), also after adjustment for confounders (OR = 1.64; 95% CI 1.30–2.06). Those who reported 1–7 days of SP also had an increased risk before and after adjustments. Inclusion of self-rated physical and psychological work capacity did not attenuate the associations, whereas of emotional exhaustion attenuated the ORs to non-significance for both outcomes, indicating that the health consequences associated with SP are largely related to mental health. Conclusion The results strengthen earlier findings suggesting that SP can be a risk factor for future suboptimal general health and sickness absence, particularly through mental health problems. This indicates that asking about SP could yield important information for employers, occupational health practitioners and GPs, possibly leading to more timely intervention that could decrease the risk of future sickness absence and more serious health problems, especially in the mental domain. Further studies of the possible causal pathways between SP and future health development are also warranted, especially since going to work is often seen as desirable also for those with poor health. PMID:22984547

  10. Meeting the National Service Framework Standards for Diabetes.

    Science.gov (United States)

    Nazarko, Linda

    2003-11-01

    Diabetes is not simply a disorder of the metabolism but a chronic disease that affects every aspect of a person's body and life and is becoming increasingly common This paper outlines the National Service Framework for Diabetes standards and how they aim to reduce the incidence and the risks of complications of this condition.

  11. Clinical nursing leaders' perceptions of nutrition quality indicators in Swedish stroke wards: a national survey.

    Science.gov (United States)

    Persenius, Mona; Hall-Lord, Marie-Louise; Wilde-Larsson, Bodil; Carlsson, Eva

    2015-09-01

    To describe nursing leaders' perceptions of nutrition quality in Swedish stroke wards. A high risk of undernutrition places great demand on nutritional care in stroke wards. Evidence-based guidelines exist, but healthcare professionals have reported low interest in nutritional care. The Donabedian framework of structure, process and outcome is recommended to monitor and improve nutrition quality. Using a descriptive cross-sectional design, a web-based questionnaire regarding nutritional care quality was delivered to eligible participants. Most clinical nursing leaders reported structure indicators, e.g. access to dieticians. Among process indicators, regular assessment of patients' swallowing was most frequently reported in comprehensive stroke wards compared with other stroke wards. Use of outcomes to monitor nutrition quality was not routine. Wards using standard care plans showed significantly better results. Using the structure, process and outcome framework to examine nutrition quality, quality-improvement needs became visible. To provide high-quality nutrition, all three structure, process and outcome components must be addressed. The use of care pathways, standard care plans, the Senior Alert registry, as well as systematic use of outcome measures could improve nutrition quality. To assist clinical nursing leaders in managing all aspects of quality, structure, process and outcome can be a valuable framework. © 2013 John Wiley & Sons Ltd.

  12. The influence of bereavement on body mass index: results from a national Swedish survey.

    Directory of Open Access Journals (Sweden)

    Aldair J Oliveira

    Full Text Available BACKGROUND: Previous findings suggest that the loss of a family member is associated with health and mortality. The purpose of this study was to investigate the association between bereavement experiences and BMI, and whether there are socio-demographic differences in this association. OBJECTIVE: To investigate the association between bereavement experiences and BMI, and whether there are socio-demographic differences in this association. METHODS: We used cross-sectional data with retrospective questions from the Swedish Level of Living Survey (LNU of 2000, including 5,142 individuals. The bereavement experiences examined in the study include the loss of a sibling, a parent or a spouse, and time since the death of a parent. BMI (kg/m2 was calculated using self-reported measurements of weight and height. The association between bereavement and BMI was evaluated through linear regressions. RESULTS: After controlling for possible confounders, most of the models detected an association between bereavement and BMI. The fully-adjusted model showed that loss of parents was associated with a 0.45 increase in BMI (SE = 0.20. The effect also seemed to be dependent on time since the loss and social class position. CONCLUSIONS: The present study is the first to examine associations between different types of familial losses and BMI. We find an association between the death of a family member and BMI, but it appears to be related to time since the death, type of bereavement experience and social class.

  13. The influence of bereavement on body mass index: results from a national Swedish survey.

    Science.gov (United States)

    Oliveira, Aldair J; Rostila, Mikael; Saarela, Jan; Lopes, Claudia S

    2014-01-01

    Previous findings suggest that the loss of a family member is associated with health and mortality. The purpose of this study was to investigate the association between bereavement experiences and BMI, and whether there are socio-demographic differences in this association. To investigate the association between bereavement experiences and BMI, and whether there are socio-demographic differences in this association. We used cross-sectional data with retrospective questions from the Swedish Level of Living Survey (LNU) of 2000, including 5,142 individuals. The bereavement experiences examined in the study include the loss of a sibling, a parent or a spouse, and time since the death of a parent. BMI (kg/m2) was calculated using self-reported measurements of weight and height. The association between bereavement and BMI was evaluated through linear regressions. After controlling for possible confounders, most of the models detected an association between bereavement and BMI. The fully-adjusted model showed that loss of parents was associated with a 0.45 increase in BMI (SE = 0.20). The effect also seemed to be dependent on time since the loss and social class position. The present study is the first to examine associations between different types of familial losses and BMI. We find an association between the death of a family member and BMI, but it appears to be related to time since the death, type of bereavement experience and social class.

  14. Understanding the Relation between Anorexia Nervosa and Bulimia Nervosa in a Swedish National Twin Sample

    Science.gov (United States)

    Bulik, Cynthia M; Thornton, Laura; Root, Tammy L.; Pisetsky, Emily M.; Lichtenstein, Paul; Pedersen, Nancy L.

    2010-01-01

    Background We present a bivariate twin analysis of anorexia nervosa (AN) and bulimia nervosa (BN) to determine the extent to which shared genetic and environmental factors contribute to liability to these disorders. Method Focusing on females from the Swedish Twin study of Adults: Genes and Environment (STAGE) (N=7000), we calculated heritability estimates for narrow and broad AN and BN and estimated their genetic correlation. Results In the full model, the heritability estimate for narrow AN was (a2 = .57; 95% CI: .00, .81) and for narrow BN (a2 = .62; 95% CI: .08, .70) with the remaining variance accounted for by unique environmental factors. Shared environmental factors estimates were (c2 = .00; 95% CI: .00, .67) for AN and (c2 = .00; 95% CI: .00, .40) for BN. Moderate additive genetic (.46) and unique environmental (.42) correlations between AN and BN were observed. Heritability estimates for broad AN were lower (a2 = .29; 95% CI: .04, .43) than for narrow AN, but estimates for broad BN were similar to narrow BN. The genetic correlation for broad AN and BN was .79 and the unique environmental correlation was .44. Conclusions We highlight the contribution of additive genetic factors to both narrow and broad AN and BN and demonstrate a moderate overlap of both genetic and unique environmental factors that influence the two conditions. Common concurrent and sequential comorbidity of AN and BN can in part be accounted for by shared genetic and environmental influences on liability although independent factors also operative. PMID:19828139

  15. Life cycle assessment of a national policy proposal - the case of a Swedish waste incineration tax.

    Science.gov (United States)

    Björklund, Anna E; Finnveden, Göran

    2007-01-01

    At the core of EU and Swedish waste policy is the so-called waste hierarchy, according to which waste should first be prevented, but should otherwise be treated in the following order of prioritisation: reuse, recycling when environmentally motivated, energy recovery, and last landfilling. Some recent policy decisions in Sweden aim to influence waste management in the direction of the waste hierarchy. In 2001 a governmental commission assessed the economic and environmental impacts of introducing a weight-based tax on waste incineration, the purpose of which would be to encourage waste reduction and increase materials recycling and biological treatment. This paper presents the results of a life cycle assessment (LCA) of the waste incineration tax proposal. It was done in the context of a larger research project concerning the development and testing of a framework for Strategic Environmental Assessment (SEA). The aim of this paper is to assess the life cycle environmental impacts of the waste incineration tax proposal, and to investigate whether there are any possibilities of more optimal design of such a tax. The proposed design of the waste incineration tax results in increased recycling, but only in small environmental improvements. A more elaborate tax design is suggested, in which the tax level would partly be related to the fossil carbon content of the waste.

  16. National Institute of Diabetes and Digestive and Kidney Diseases

    Science.gov (United States)

    ... Us National Institute of Diabetes and Digestive and Kidney Diseases NIDDK conducts and supports research on many ... 17, 2017 | Bethesda, MD Individualizing Treatment for Urinary Incontinence - Evolving Research Questions into Research Plans February 1- ...

  17. Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort.

    Science.gov (United States)

    Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta; Langhoff-Roos, Jens; Damm, Peter; Bech, Bodil H; Vaag, Allan A; Zhang, Cuilin

    2017-05-01

    The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to identify and validate the gestational diabetes mellitus cases in the cohort. We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel evaluated gestational diabetes mellitus status based on results from oral glucose tolerance tests, fasting blood glucose and Hb1c values, as well as diagnoses made by local obstetricians. The audit categorized 783 pregnancies as gestational diabetes mellitus, corresponding to 0.89% of the 87 792 pregnancies for which a pregnancy interview for self-reported diabetes in pregnancy was available. From the randomly selected group the combined information from register and interviews could correctly identify 96% (95% CI 80-99.9%) of all cases in the entire Danish National Birth Cohort population. Positive predictive value, however, was only 59% (56-61%). The combined use of data from register and interview provided a high sensitivity for gestational diabetes mellitus diagnosis. The low positive predictive value, however, suggests that systematic validation by hospital record review is essential not to underestimate the health consequences of gestational diabetes mellitus in future studies. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

  18. Mobile phones, cordless phones and rates of brain tumors in different age groups in the Swedish National Inpatient Register and the Swedish Cancer Register during 1998-2015.

    Directory of Open Access Journals (Sweden)

    Lennart Hardell

    Full Text Available We used the Swedish Inpatient Register (IPR to analyze rates of brain tumors of unknown type (D43 during 1998-2015. Average Annual Percentage Change (AAPC per 100,000 increased with +2.06%, 95% confidence interval (CI +1.27, +2.86% in both genders combined. A joinpoint was found in 2007 with Annual Percentage Change (APC 1998-2007 of +0.16%, 95% CI -0.94, +1.28%, and 2007-2015 of +4.24%, 95% CI +2.87, +5.63%. Highest AAPC was found in the age group 20-39 years. In the Swedish Cancer Register the age-standardized incidence rate per 100,000 increased for brain tumors, ICD-code 193.0, during 1998-2015 with AAPC in men +0.49%, 95% CI +0.05, +0.94%, and in women +0.33%, 95% CI -0.29, +0.45%. The cases with brain tumor of unknown type lack morphological examination. Brain tumor diagnosis was based on cytology/histopathology in 83% for men and in 87% for women in 1980. This frequency increased to 90% in men and 88% in women in 2015. During the same time period CT and MRI imaging techniques were introduced and morphology is not always necessary for diagnosis. If all brain tumors based on clinical diagnosis with CT or MRI had been reported to the Cancer Register the frequency of diagnoses based on cytology/histology would have decreased in the register. The results indicate underreporting of brain tumor cases to the Cancer Register. The real incidence would be higher. Thus, incidence trends based on the Cancer Register should be used with caution. Use of wireless phones should be considered in relation to the change of incidence rates.

  19. Mobile phones, cordless phones and rates of brain tumors in different age groups in the Swedish National Inpatient Register and the Swedish Cancer Register during 1998-2015.

    Science.gov (United States)

    Hardell, Lennart; Carlberg, Michael

    2017-01-01

    We used the Swedish Inpatient Register (IPR) to analyze rates of brain tumors of unknown type (D43) during 1998-2015. Average Annual Percentage Change (AAPC) per 100,000 increased with +2.06%, 95% confidence interval (CI) +1.27, +2.86% in both genders combined. A joinpoint was found in 2007 with Annual Percentage Change (APC) 1998-2007 of +0.16%, 95% CI -0.94, +1.28%, and 2007-2015 of +4.24%, 95% CI +2.87, +5.63%. Highest AAPC was found in the age group 20-39 years. In the Swedish Cancer Register the age-standardized incidence rate per 100,000 increased for brain tumors, ICD-code 193.0, during 1998-2015 with AAPC in men +0.49%, 95% CI +0.05, +0.94%, and in women +0.33%, 95% CI -0.29, +0.45%. The cases with brain tumor of unknown type lack morphological examination. Brain tumor diagnosis was based on cytology/histopathology in 83% for men and in 87% for women in 1980. This frequency increased to 90% in men and 88% in women in 2015. During the same time period CT and MRI imaging techniques were introduced and morphology is not always necessary for diagnosis. If all brain tumors based on clinical diagnosis with CT or MRI had been reported to the Cancer Register the frequency of diagnoses based on cytology/histology would have decreased in the register. The results indicate underreporting of brain tumor cases to the Cancer Register. The real incidence would be higher. Thus, incidence trends based on the Cancer Register should be used with caution. Use of wireless phones should be considered in relation to the change of incidence rates.

  20. Cross-national invariance of dimensions of parental rearing behaviour: comparison of psychometric data of Swedish depressives and healthy subjects with Dutch target ratings on the EMBU.

    Science.gov (United States)

    Arrindell, W A; Perris, C; Perris, H; Eisemann, M; van der Ende, J; von Knorring, L

    1986-03-01

    A psychometric study on Swedish and Dutch samples used the EMBU, a self-report instrument designed to assess memories of parents' rearing behaviour. Of the four primary factors identified previously with Dutch individuals (Rejection, Emotional Warmth, Over-protection, and Favouring Subject), the first three were retrieved in a similar form in the two Swedish groups (depressives and healthy, non-patients). Examination of the metric equivalence of the scales and the strength of the factors for each group indicated that comparisons of patterns and levels between groups from the respective countries on the three factors showing cross-national constancy would be warranted. Scale-level factor analyses of these dimensions produced identical two-factor compositions (CARE and PROTECTION) across national groups which further supported this conclusion.

  1. A European and Swedish perspective on ICT – policies and strategies in education. National and institutional pathways: crossings, blind alleys and uphill slopes

    Directory of Open Access Journals (Sweden)

    Henrik Hansson

    2004-04-01

    Full Text Available This paper aims at answering the following questions: 1. What general goals do politicians in Europe express in national policy documents for the integration of information and communication technology (ICT in their education systems? To develop that theme further we explored the situation in our own country Sweden as a case. 2. What policies and strategies for ICT in education do leaders of Swedish higher education institutions develop? 3. How do Swedish national priorities and academic institutional interests match? The globalisation of education forces different value systems to meet. There is on the national level highly different political values on what kind of education system to prefer – the Scandinavian model and the American model are two extremes. There are also very different values inherent in higher education institutions, the academia, - compared with the values and visions held by the political leaders. These value differences between and within countries are elaborated and discussed. A Swedish, Scandinavian and European perspective is adopted, but a wider international outlook is also given. It is suggested that the value conflicts, often not explicit, understood or recognised, are one of the major inhibitors for systemic change. The direction of change cannot be taken for granted – the driving forces pull in opposing directions. Different visions of the future struggle to be fulfilled.

  2. Diagnosing gestational diabetes mellitus in the Danish National Birth Cohort

    DEFF Research Database (Denmark)

    Olsen, Sjurdur F; Houshmand-Oeregaard, Azedeh; Granström, Charlotta

    2017-01-01

    INTRODUCTION: The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim was to id......INTRODUCTION: The Danish National Birth Cohort (DNBC) contains comprehensive information on diet, lifestyle, constitutional and other major characteristics of women during pregnancy. It provides a unique source for studies on health consequences of gestational diabetes mellitus. Our aim...... was to identify and validate the gestational diabetes mellitus cases in the cohort. MATERIAL AND METHODS: We extracted clinical information from hospital records for 1609 pregnancies included in the Danish National Birth Cohort with a diagnosis of diabetes during or before pregnancy registered in the Danish...... National Patient Register and/or from a Danish National Birth Cohort interview during pregnancy. We further validated the diagnosis of gestational diabetes mellitus in 2126 randomly selected pregnancies from the entire Danish National Birth Cohort. From the individual hospital records, an expert panel...

  3. 77 FR 53208 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-08-31

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... individual intramural programs and projects conducted by the National Institute of Diabetes and Digestive And..., National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health, Building 5...

  4. A Third Wave of European Education Policy: Transnational and National Conceptions of Knowledge in Swedish Curricula

    Science.gov (United States)

    Wahlström, Ninni

    2016-01-01

    The aim of this article is to examine how transnational concepts within educational policies influence national curricula in the reconceptualisation of educational policy into concrete curriculum texts. Based on a critical discourse analysis and the concepts of recontextualisation, convergence and divergence, a third wave of European policy…

  5. Coffee consumption and the risk of latent autoimmune diabetes in adults--results from a Swedish case-control study.

    Science.gov (United States)

    Löfvenborg, J E; Andersson, T; Carlsson, P-O; Dorkhan, M; Groop, L; Martinell, M; Rasouli, B; Storm, P; Tuomi, T; Carlsson, S

    2014-07-01

    Coffee consumption is associated with a reduced risk of Type 2 diabetes. Our aim was to investigate if coffee intake may also reduce the risk of latent autoimmune diabetes in adults, an autoimmune form of diabetes with features of Type 2 diabetes. We used data from a population-based case-control study with incident cases of adult onset (≥ 35 years) diabetes, including 245 cases of latent autoimmune diabetes in adults (glutamic acid decarboxylase antibody positive), 759 cases of Type 2 diabetes (glutamic acid decarboxylase antibody negative), together with 990 control subjects without diabetes, randomly selected from the population. Using questionnaire information on coffee consumption, we estimated the odds ratio of latent autoimmune diabetes in adults and Type 2 diabetes adjusted for age, sex, BMI, smoking, physical activity, alcohol, education and family history of diabetes. Coffee intake was inversely associated with Type 2 diabetes (odds ratio 0.92, 95% CI 0.87-0.98 per cup/day). With regard to latent autoimmune diabetes in adults, the general trend was weak (odds ratio 1.04, 95% CI 0.96-1.13), but stratification by degree of autoimmunity (median glutamic acid decarboxylase antibody levels) suggested that coffee intake may be associated with an increased risk of high glutamic acid decarboxylase antibody latent autoimmune diabetes in adults (odds ratio 1.11, 95% CI 1.00-1.23 per cup/day). Furthermore, for every additional cup of coffee consumed per day, there was a 15.2% (P = 0.0268) increase in glutamic acid decarboxylase antibody levels. Our findings confirm that coffee consumption is associated with a reduced risk of Type 2 diabetes. Interestingly, the findings suggest that coffee may be associated with development of autoimmunity and possibly an increased risk of more Type 1-like latent autoimmune diabetes in adults. © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  6. Trace element concentration in wheat grain: results from the Swedish long-term soil fertility experiments and national monitoring program.

    Science.gov (United States)

    Kirchmann, Holger; Mattsson, Lennart; Eriksson, Jan

    2009-10-01

    Concentrations of trace elements in wheat grain sampled between 1967 and 2003 from the Swedish long-term soil fertility experiments were analyzed using ICP-MS. The long-term effect of inorganic and organic fertilization on trace metal concentrations was investigated including the impact of atmospheric deposition and myccorhiza, whereas other factors such as soil conditions, crop cultivar, etc. are not discussed in this paper. Mean values derived from 10 experimental sites were reported. Significantly declining Pb and Cd concentrations in wheat grain could be explained by lower atmospheric deposition. Mean Se contents in all samples were 0.031 mg kg(-1) grain dry weight. No samples had sufficiently high Se concentrations for human (0.05 mg Se kg(-1)) or animal demand (0.1 mg Se kg(-1)). Concentrations of Co in wheat grain were extremely low, 0.002-0.005 mg Co kg(-1) grain dry weight, and far below the minimum levels required by animals, which applied to all fertilizer treatments. A doubling of Mo concentrations in grain since 1975 resulted in Cu/Mo ratios often below one, which may cause molybdenosis in ruminants. The increase in Mo concentrations in crops correlated with the decline in sulfur deposition. Concentrations of Cu and Fe declined in NPK-fertilized wheat as compared to unfertilized or manure-treated wheat. Very low concentrations of Se and Co and low concentrations of Fe and Cu require attention to counteract risks for deficiencies. The main characteristic of the study is that there are few significant changes over time between different fertilizer treatments, but throughout there are low concentrations of most trace elements in all treatments. In general, good agreement between concentrations in wheat from the long-term fertility experiments and the national monitoring program indicate that values are representative.

  7. Treatment-seeking patients with binge-eating disorder in the Swedish national registers: clinical course and psychiatric comorbidity.

    Science.gov (United States)

    Welch, Elisabeth; Jangmo, Andreas; Thornton, Laura M; Norring, Claes; von Hausswolff-Juhlin, Yvonne; Herman, Barry K; Pawaskar, Manjiri; Larsson, Henrik; Bulik, Cynthia M

    2016-05-26

    We linked extensive longitudinal data from the Swedish national eating disorders quality registers and patient registers to explore clinical characteristics at diagnosis, diagnostic flux, psychiatric comorbidity, and suicide attempts in 850 individuals diagnosed with binge-eating disorder (BED). Cases were all individuals who met criteria for BED in the quality registers (N = 850). We identified 10 controls for each identified case from the Multi-Generation Register matched on sex, and year, month, and county of birth. We evaluated characteristics of individuals with BED at evaluation and explored diagnostic flux across eating disorders presentations between evaluation and one-year follow-up. We applied conditional logistic regression models to assess the association of BED with each comorbid psychiatric disorder and with suicide attempts and explored whether risk for depression and suicide were differentially elevated in individuals with BED with or without comorbid obesity. BED shows considerable diagnostic flux with other eating disorders over time, carries high psychiatric comorbidity burden with other eating disorders (OR 85.8; 95 % CI: 61.6, 119.4), major depressive disorder (OR 7.6; 95 % CI: 6.2, 9.3), bipolar disorder (OR 7.5; 95 % CI: 4.8, 11.9), anxiety disorders (OR 5.2; 95 % CI: 4.2, 6.4), and post-traumatic stress disorder (OR 4.3; 95 % CI: 3.2, 5.7) and is associated with elevated risk for suicide attempts (OR 1.8; 95 % CI: 1.2, 2.7). Depression and suicide attempt risk were elevated in individuals with BED with and without comorbid obesity. Considerable flux occurs across BED and other eating disorder diagnoses. The high psychiatric comorbidity and suicide risk underscore the severity and clinical complexity of BED.

  8. Genetic and family and community environmental effects on drug abuse in adolescence: a Swedish national twin and sibling study.

    Science.gov (United States)

    Kendler, Kenneth S; Maes, Hermine H; Sundquist, Kristina; Ohlsson, Henrik; Sundquist, Jan

    2014-02-01

    Using Swedish nationwide registry data, the authors investigated genetic and environmental risk factors in the etiology of drug abuse by twin sibling modeling. The authors followed up with epidemiological analyses to identify shared environmental influences on drug abuse. Drug abuse was defined using public medical, legal, or pharmacy records. Twin and sibling pairs were obtained from the national twin and genealogical registers. Information about sibling pair residence within the same household, small residential area, or municipality was obtained from Statistics Sweden. The authors predicted concordance for drug abuse by years of co-residence until the older sibling turned 21 and risk for future drug abuse in adolescents living with parental figures as a function of family-level socioeconomic status and neighborhood social deprivation. The best twin sibling fit model predicted substantial heritability for drug abuse in males (55%) and females (73%), with environmental factors shared by siblings operating only in males and accounting for 23% of the variance in liability. For each year of living in the same household, the probability of sibling concordance for drug abuse increased 2%-5%. When not residing in the same household, concordance was predicted from residence in the same small residential area or municipality. Risk for drug abuse was predicted both by family socioeconomic status and neighborhood social deprivation. Controlling for family socioeconomic status, each year of living in a high social deprivation neighborhood increased the risk for drug abuse by 2%. Using objective registry data, the authors found that drug abuse is highly heritable. A substantial proportion of the shared environmental effect on drug abuse comes from community-wide rather than household-level influences. Genetic effects demonstrated in twin studies have led to molecular analyses to elucidate biological pathways. In a parallel manner, environmental effects can be followed up by

  9. National energy policies: Obstructing the reduction of global CO{sub 2} emissions? An analysis of Swedish energy policies for the district heating sector

    Energy Technology Data Exchange (ETDEWEB)

    Difs, Kristina, E-mail: kristina.difs@liu.s [Department of Management and Engineering, Division of Energy Systems, Linkoping University, SE-581 83 Linkoping (Sweden)

    2010-12-15

    The effect of national energy policies on a local Swedish district heating (DH) system has been studied, regarding the profitability of new investments and the potential for climate change mitigation. The DH system has been optimised regarding three investments: biomass-fuelled CHP (bio CHP), natural gas-fuelled combined cycle CHP (NGCC CHP) and biomass-fuelled heat-only boiler (bio HOB) in two scenarios (with or without national taxes and policy instruments). In both scenarios EU's tradable CO{sub 2} emission permits are included. Results from the study show that when national policies are included, the most cost-effective investment option is the bio CHP technology. However, when national taxes and policy instruments are excluded, the DH system containing the NGCC CHP plant has 30% lower system cost than the bio CHP system. Regardless of the scenario and when coal condensing is considered as marginal electricity production, the NGCC CHP has the largest global CO{sub 2} reduction potential, about 300 ktonne CO{sub 2}. However, the CO{sub 2} reduction potential is highly dependent on the marginal electricity production. Demonstrated here is that national policies such as tradable green certificates can, when applied to DH systems, contribute to investments that will not fully utilise the DH systems' potential for global CO{sub 2} emissions reductions. - Research highlights: {yields}Swedish energy policies are promoting biomass fuelled electricity generating technologies over efficient fossil fuel electricity generating technologies. {yields}An efficient fossil fuel technology like the natural gas combine cycle CHP technology with high power-to-heat ratio has potential to reduce the global CO{sub 2} emissions more than a biomass fuelled electricity generating technology. {yields}Swedish energy policies such as tradable green certificates for renewable electricity can, when applied to district heating systems, contribute to investments that will not fully

  10. Emergent programme theories of a national quality register - a longitudinal study in Swedish elderly care.

    Science.gov (United States)

    Nordin, Annika; Andersson Gäre, Boel; Andersson, Ann-Christine

    2017-12-01

    This study aimed to explore programme theories of a national quality register. A programme theory is a bundle of assumptions underpinning how and why an improvement initiative functions. The purpose was to examine and establish programme theories of a national quality register widely used in Sweden: Senior alert. The paper reports on how programme theories among change recipients emerge in relation to the established programme theory of the initiator. A qualitative approach and a longitudinal research design were used. To develop programme theories among change recipients, individual semistructured interviews were conducted. Three sets of interviews were conducted in the period of 2011 to 2013, totalling 22 interviews. In addition, 4 participant observations were made. To develop the initiator's programme theory, an iterative multistage collaboration process between the researchers and the initiator was used. A directed content analysis was used to analyse data. The initiator and change recipients described similar programme logics, but differing programme theories. With time, change recipients' programme theories emerged. Their programme theories converged and became more like the programme theory of the initiator. This study has demonstrated the importance of making both the initiator's and change recipients' programme theories explicit. To learn about conditions for improvement initiatives, comparisons between their programme theories are valuable. Differences in programme theories provide information on how initiators can customize support for their improvement initiatives. Similar programme logics can be underpinned by different programme theories, which can be deceptive. Programme theories emerge over time and need to be understood as dynamic phenomena. © 2017 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd.

  11. 78 FR 55087 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2013-09-09

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and...: National Institute of Diabetes and Digestive and Kidney Diseases Special Emphasis Panel; The NIDDK-KUH...

  12. 78 FR 9401 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2013-02-08

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and..., [email protected] . Name of Committee: National Institute of Diabetes and Digestive and Kidney...

  13. 77 FR 6131 - National Institute of Diabetes and Digestive and Kidney Diseases Notice of Closed Meetings

    Science.gov (United States)

    2012-02-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and..., [email protected] . Name of Committee: National Institute of Diabetes and Digestive and Kidney...

  14. 78 FR 28859 - National Institute of Diabetes and Digestive and Kidney Diseases Notice of Closed Meetings

    Science.gov (United States)

    2013-05-16

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive [email protected] . Name of Committee: National Institute of Diabetes and Digestive and Kidney...

  15. 77 FR 6129 - National Institute of Diabetes and Digestive and Kidney Diseases Notice of Closed Meetings

    Science.gov (United States)

    2012-02-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Committee: National Institute of Diabetes and Digestive and Kidney Diseases Special Emphasis Panel; Novel...

  16. 77 FR 12857 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2012-03-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... of Committee: National Institute of Diabetes and Digestive and Kidney Diseases Special Emphasis Panel...

  17. 78 FR 9063 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Meetings

    Science.gov (United States)

    2013-02-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... . Name of Committee: National Institute of Diabetes and Digestive and Kidney Diseases Initial Review...

  18. 77 FR 47653 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2012-08-09

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and..., (301) 594-8894, [email protected] . Name of Committee: National Institute of Diabetes and Digestive...

  19. 77 FR 52750 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2012-08-30

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... of Committee: National Institute of Diabetes and Digestive and Kidney Diseases Special Emphasis Panel...

  20. 78 FR 50428 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2013-08-19

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and..., [email protected] . Name of Committee: National Institute of Diabetes and Digestive and Kidney...

  1. 78 FR 48456 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2013-08-08

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and..., [email protected] . Name of Committee: National Institute of Diabetes and Digestive and Kidney...

  2. 78 FR 52778 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-08-26

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and....D., Director, Division of Extramural Activities, National Insitute of Diabetes and Digestive and...

  3. 77 FR 38075 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2012-06-26

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and....gov . Name of Committee: National Institute of Diabetes and Digestive and Kidney Diseases Special...

  4. 77 FR 33752 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2012-06-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and....nih.gov . Name of Committee: National Institute of Diabetes and Digestive and Kidney Diseases Special...

  5. Helping patients with diabetes: resources from the National Diabetes Education Program.

    Science.gov (United States)

    Rodgers, Philip T

    2012-01-01

    To familiarize pharmacists with the National Diabetes Education Program (NDEP) and to demonstrate the value of NDEP materials in the care of patients with diabetes. The NDEP website (www.ndep.nih.gov) and PubMed (www.ncbi.nlm.nih.gov/pubmed). NDEP is a collaboration between the National Institutes of Health, Centers for Disease Control and Prevention, and many organization partners. Since 1997, a large number of materials have been created by NDEP using an evidence-based, expert- and patient-reviewed approach to development. Materials are nonbranded and reflect current medical knowledge and practice. Educational materials are available for persons at risk for diabetes, those with diabetes, family members of persons with diabetes, employers, and professionals. The Pharmacy, Podiatry, Optometry, and Dentistry (PPOD) workgroup of NDEP promotes the value of pharmacists and other professionals in diabetes education and management. Resources are available to educate about the value of the PPOD professionals. NDEP provides evidence-based, high-quality educational materials that pharmacists will find useful in the counseling of persons with diabetes.

  6. 78 FR 47326 - Proposed Collection; 60-Day Comment Request: Community Evaluation of the National Diabetes...

    Science.gov (United States)

    2013-08-05

    ... of proven strategies to prevent or delay the onset of diabetes and its complications. The NDEP... effective strategies for preventing type 2 diabetes and complications associated with diabetes; (2) Increase... Evaluation of the National Diabetes Education Program's Diabetes HealthSense Web site Summary: In compliance...

  7. Mechanisms of Copper Corrosion in Aqueous Environments. A report from the Swedish National Council for Nuclear Waste's scientific workshop, on November 16, 2009

    Energy Technology Data Exchange (ETDEWEB)

    2010-07-01

    In 2010 the Swedish Nuclear Fuel and Waste Management Company, SKB, plans to submit its license application for the final repository of spent nuclear fuel. The proposed method is the so-called KBS-3 method and implies placing the spent nuclear fuel in copper canisters, surrounded by a buffer of bentonite clay, at 500 m depth in the bedrock. The site selected by SKB to host the repository is located in the municipality of Oesthammar on the Swedish east coast. The copper canister plays a key role in the design of the repository for spent nuclear fuel in Sweden. The long-term physical and chemical stability of copper in aqueous environments is fundamental for the safety evolution of the proposed disposal concept. However, the corrosion resistance of copper has been questioned by results obtained under anoxic conditions in aqueous solution. These observations caused some head-lines in the Swedish newspapers as well as public and political concerns. Consequently, the Swedish National Council for Nuclear Waste organized a scientific workshop on the issue 'Mechanisms of Copper Corrosion in Aqueous Environments'. The purpose of the workshop was to address the fundamental understanding of the corrosion characteristics of copper regarding oxygen-free environments, and to identify what additional information is needed to assess the validity of the proposed corrosion mechanism and its implication on the containment of spent nuclear fuel in a copper canister. This seminar report is based on the presentations and discussions at the workshop. It also includes written statements by the members of the expert panel

  8. Self-image and suicide in a Swedish national eating disorders clinical register.

    Science.gov (United States)

    Runfola, Cristin D; Thornton, Laura M; Pisetsky, Emily M; Bulik, Cynthia M; Birgegård, Andreas

    2014-04-01

    Using a prospective design, to examine the relation between self-image (assessed using the Structural Analysis of Social Behavior) and suicide attempts/completions in women with anorexia nervosa-restricting type (ANR), anorexia nervosa-binge/purge type (ANBP), bulimia nervosa (BN), binge eating disorder (BED), and eating disorder not otherwise specified (EDNOS); and to assess whether these self-image variables add unique predictive value to suicide when considering other baseline predictors. Women (N=2269) aged 12 to 45 (M=22.1) presenting to specialist eating disorders clinics in Sweden between 2005 and 2009 were identified through the Stepwise Eating Disorders Quality Register. Data on age, body mass index, eating disorder severity (Eating Disorder Examination-Questionnaire scores), psychiatric comorbidity, global assessment of functioning, and self-image were abstracted from Stepwise and included as baseline predictors or covariates. Suicide information (prior attempt and attempt/completion after Stepwise registration) was obtained from the National Patient Register and Cause of Death Register. Prevalence of detected suicide attempts/completions over the study period was 9.2%. Negative self-image variables were associated with prior suicide attempts in ANR and EDNOS and later suicide attempts/completions in women with BN. In a stepwise Cox proportional hazards model, only low self-affirmation predicted time to suicide attempts/completions in women with BN when accounting for age and prior suicide attempt. Assessing self-image might assist with identifying women with BN at elevated risk for suicide. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Negotiating the Nation in History: the Swedish State Approval Scheme for Textbooks and Teaching Aids from 1945 to 1983

    Science.gov (United States)

    Elmersjö, Henrik Åström

    2016-01-01

    This article explores the discussions concerning history textbooks that occurred within the Swedish State Approval Scheme for Textbooks (Statens läroboksnämnd) from 1945 to 1983. By focusing on the negotiation of nationhood and the process of textbook approval as an arena for the renegotiation of ways in which history was taught in schools, the…

  10. Reformation of VET and Demands on Teachers' Subject Knowledge--Swedish Vocational Teachers' Recurrent Participation in a National CPD Initiative

    Science.gov (United States)

    Köpsén, S.; Andersson, P.

    2017-01-01

    This study investigates continuing professional development (CPD) of vocational teachers, with a focus on recurrent participation. Vocational teachers need to be competent as teachers and in relation to their vocational teaching subject. Reformation of Swedish vocational education in order to strengthen the working-life connection imposes demands…

  11. Bread consumption patterns in a Swedish national dietary survey focusing particularly on whole-grain and rye bread

    Directory of Open Access Journals (Sweden)

    Pernilla Sandvik

    2014-09-01

    Full Text Available Background: Bread types with high contents of whole grains and rye are associated with beneficial health effects. Consumer characteristics of different bread consumption patterns are however not well known. Objective: To compare bread consumption patterns among Swedish adults in relation to selected socio-demographic, geographic, and lifestyle-related factors. For selected consumer groups, the further aim is to investigate the intake of whole grains and the context of bread consumption, that is, where and when it is consumed. Design: Secondary analysis was performed on bread consumption data from a national dietary survey (n=1,435. Respondents were segmented into consumer groups according to the type and amount of bread consumed. Multiple logistic regressions were performed to study how selected socio-demographic, geographic, and lifestyle-related factors were associated with the consumer groups. Selected consumption groups were compared in terms of whole-grain intake and consumption context. Consumption in different age groups was analysed more in detail. Results: One-third of the respondents consumed mainly white bread. Socio-demographic, geographic, and healthy-lifestyle-related factors were associated with the bread type consumed. White bread consumption was associated with younger age groups, less education, children in the family, eating less fruit and vegetables, and more candy and snacks; the opposite was seen for mainly whole-grain bread consumers. Older age groups more often reported eating dry crisp bread, whole-grain bread, and whole-grain rye bread with sourdough whereas younger respondents reported eating bread outside the home, something that also mainly white bread eaters did. Low consumers of bread also consumed less whole grain in total. Conclusions: Traditional bread consumption structures were observed, as was a transition among young consumers who more often consumed fast food bread and bread outside the home, as well as

  12. Mortality patterns and risk among older men and women with intellectual disability: a Swedish national retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Nawi Ng

    2017-11-01

    Full Text Available Abstract Background Sweden has closed all institutions and imposed legislation to ensure service and support for individuals with intellectual disability (ID. Understanding mortality among older individuals with ID is essential to inform development of health promotion and disease control strategies. We investigated patterns and risk of mortality among older adults with ID in Sweden. Methods This retrospective cohort study compared older adults aged 55 years and older with ID with a control population. Participants were followed during 2002–2015 or death, and censored if they moved out of Sweden. Individuals with ID were identified from two national registers: one covering all specialist health-care visits (out-patient visits and hospitalisation and the other covering people accessing social/support services. Individuals with ID (n = 15,289 were matched with a control population by sex, birth year, and year of first hospitalisation/out-patient visit/access to LSS services. Cause-of-death data were recorded using International Classification of Diseases, Tenth Revision. Cox proportional hazards regression were conducted to assess if overall and cause-specific mortality rate among individuals with ID was higher than in the Swedish population. Results The overall mortality rate among individuals with ID was 2483 per 100,000 people compared with 810 in the control population. Among those who died, more individuals with ID were younger than 75 years and unmarried. Leading causes of death among individuals with ID were circulatory diseases (34%, respiratory diseases (17% and neoplasms (15%. Leading causes of death in a sub-sample with Down syndrome (DS were respiratory diseases (37%, circulatory diseases (26% and mental/behavioural disorders (11%. Epilepsy and pneumonitis were more common among individuals with ID than controls. Alzheimer’s disease was common in the control population and individuals with DS, but not among those with ID when

  13. Bread consumption patterns in a Swedish national dietary survey focusing particularly on whole-grain and rye bread

    Science.gov (United States)

    Sandvik, Pernilla; Kihlberg, Iwona; Lindroos, Anna Karin; Marklinder, Ingela; Nydahl, Margaretha

    2014-01-01

    Background Bread types with high contents of whole grains and rye are associated with beneficial health effects. Consumer characteristics of different bread consumption patterns are however not well known. Objective To compare bread consumption patterns among Swedish adults in relation to selected socio-demographic, geographic, and lifestyle-related factors. For selected consumer groups, the further aim is to investigate the intake of whole grains and the context of bread consumption, that is, where and when it is consumed. Design Secondary analysis was performed on bread consumption data from a national dietary survey (n=1,435). Respondents were segmented into consumer groups according to the type and amount of bread consumed. Multiple logistic regressions were performed to study how selected socio-demographic, geographic, and lifestyle-related factors were associated with the consumer groups. Selected consumption groups were compared in terms of whole-grain intake and consumption context. Consumption in different age groups was analysed more in detail. Results One-third of the respondents consumed mainly white bread. Socio-demographic, geographic, and healthy-lifestyle-related factors were associated with the bread type consumed. White bread consumption was associated with younger age groups, less education, children in the family, eating less fruit and vegetables, and more candy and snacks; the opposite was seen for mainly whole-grain bread consumers. Older age groups more often reported eating dry crisp bread, whole-grain bread, and whole-grain rye bread with sourdough whereas younger respondents reported eating bread outside the home, something that also mainly white bread eaters did. Low consumers of bread also consumed less whole grain in total. Conclusions Traditional bread consumption structures were observed, as was a transition among young consumers who more often consumed fast food bread and bread outside the home, as well as less rye and whole

  14. 76 FR 25700 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2011-05-05

    ... Diabetes and Digestive and Kidney Diseases Special Emphasis Panel, Periodontitis and Glycemic Control. Date... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and...

  15. 77 FR 40368 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-07-09

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and...

  16. 78 FR 14312 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-03-05

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Domestic Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive...

  17. 78 FR 46358 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2013-07-31

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Institute of Diabetes and Digestive and Kidney Diseases Special Emphasis Panel, Time-Sensitive Obesity...

  18. 77 FR 9676 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2012-02-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Diabetes and Digestive and Kidney Diseases Special Emphasis Panel; Member Conflict Telephone SEP. Date...

  19. 77 FR 9671 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-02-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and.... 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition...

  20. 77 FR 33750 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-06-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition...

  1. 78 FR 70063 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2013-11-22

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... of Diabetes and Digestive and Kidney Diseases Special Emphasis Panel; Time-Sensitive Obesity. Date...

  2. 77 FR 12855 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-03-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases...

  3. Lifestyle and health status in a sample of Swedish women four years after pregnancy: a comparison of women with a history of normal pregnancy and women with a history of gestational diabetes mellitus.

    Science.gov (United States)

    Persson, Margareta; Winkvist, Anna; Mogren, Ingrid

    2015-03-13

    Despite the recommendations to continue the regime of healthy food and physical activity (PA) postpartum for women with previous gestational diabetes mellitus (GDM), the scientific evidence reveals that these recommendations may not be complied to. This study compared lifestyle and health status in women whose pregnancy was complicated by GDM with women who had a normal pregnancy and delivery. The inclusion criteria were women with GDM (ICD-10: O24.4 A and O24.4B) and women with uncomplicated pregnancy and delivery in 2005 (ICD-10: O80.0). A random sample of women fulfilling the criteria (n = 882) were identified from the Swedish Medical Birth Register. A questionnaire was sent by mail to eligible women approximately four years after the pregnancy. A total of 444 women (50.8%) agreed to participate, 111 diagnosed with GDM in their pregnancy and 333 with normal pregnancy/delivery. Women with previous GDM were significantly older, reported higher body weight and less PA before the index pregnancy. No major differences between the groups were noticed regarding lifestyle at the follow-up. Overall, few participants fulfilled the national recommendations of PA and diet. At the follow-up, 19 participants had developed diabetes, all with previous GDM. Women with previous GDM reported significantly poorer self-rated health (SRH), higher level of sick-leave and more often using medication on regular basis. However, a history of GDM or having overt diabetes mellitus showed no association with poorer SRH in the multivariate analysis. Irregular eating habits, no regular PA, overweight/obesity, and regular use of medication were associated with poorer SRH in all participants. Suboptimal levels of PA, and fruit and vegetable consumption were found in a sample of women with a history of GDM as well as for women with normal pregnancy approximately four years after index pregnancy. Women with previous GDM seem to increase their PA after childbirth, but still they perform their PA at

  4. Teenage girls with type 1 diabetes have poorer metabolic control than boys and face more complications in early adulthood

    DEFF Research Database (Denmark)

    Samuelsson, Ulf; Anderzén, Johan; Gudbjörnsdottir, Soffia

    2016-01-01

    AIMS: To compare metabolic control between males and females with type 1 diabetes during adolescence and as young adults, and relate it to microvascular complications. METHODS: Data concerning 4000 adolescents with type 1 diabetes registered in the Swedish paediatric diabetes quality registry......mmol/mol), pcomplications. Improved paediatric diabetes care is of great importance......, and above the age of 18years in the Swedish National Diabetes Registry was used. RESULTS: When dividing HbA1c values in three groups; 9.3% (78mmol/mol), there was a higher proportion of females in the highest group during adolescence. In the group...

  5. Positive predictive values of International Classification of Diseases, 10th revision codes for dermatologic events and hypersensitivity leading to hospitalization or emergency room visit among women with postmenopausal osteoporosis in the Danish and Swedish national patient registries

    Directory of Open Access Journals (Sweden)

    Adelborg K

    2017-03-01

    Full Text Available Kasper Adelborg,1 Lotte Brix Christensen,1 Troels Munch,1 Johnny Kahlert,1 Ylva Trolle Lagerros,2,3 Grethe S Tell,4 Ellen M Apalset,4,5 Fei Xue,6 Vera Ehrenstein1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus N, Denmark; 2Department of Medicine, Clinical Epidemiology Unit, Karolinska Institutet, 3Department of Medicine, Clinic of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden; 4Department of Global Public Health and Primary Care, University of Bergen, 5Department of Rheumatology, Haukeland University Hospital, Bergen, Norway; 6Center for Observational Research, Amgen Inc. Thousand Oaks, CA, USA Background: Clinical epidemiology research studies, including pharmacoepidemiology and pharmacovigilance studies, use routinely collected health data, such as diagnoses recorded in national health and administrative registries, to assess clinical effectiveness and safety of treatments. We estimated positive predictive values (PPVs of International Classification of Diseases, 10th revision (ICD-10 codes for primary diagnoses of dermatologic events and hypersensitivity recorded at hospitalization or emergency room visit in the national patient registries of Denmark and Sweden among women with postmenopausal osteoporosis (PMO. Methods: This validation study included women with PMO identified from the Danish and Swedish national patient registries (2005–2014. Medical charts of the potential cases served as the gold standard for the diagnosis confirmation and were reviewed and adjudicated by physicians. Results: We obtained and reviewed 189 of 221 sampled medical records (86%. The overall PPV was 92.4% (95% confidence interval [CI], 85.1%–96.3% for dermatologic events, while the PPVs for bullous events and erythematous dermatologic events were 52.5% (95% CI, 37.5%–67.1% and 12.5% (95% CI, 2.2%–47.1%, respectively. The PPV was 59.0% (95% CI, 48.3%–69.0% for hypersensitivity; however

  6. The Diabetes National Service Framework--a real opportunity?

    Science.gov (United States)

    Young, Bob

    2004-01-01

    The Diabetes National Service Framework (NSF) represents a new style of this relatively new policy instrument. It sets clear 10-year targets but leaves a large part of implementation decision-making to local teams. It is clear that the central priorities of people with diabetes are therapeutic partnership, expert guidance and integrated service provision. These underpinning themes transcend all of the more specific objectives of the NSF. Realising both the themes and the specific objectives will, in many localities, mean tackling quite challenging transformational programmes. They will probably need to include changed ways of working and information systems development, as well as constructive partnership between primary and secondary care and between many different healthcare disciplines. This may appear a formidable task but having diabetes firmly on the 'must do' healthcare agenda for the first time creates a tremendous opportunity. The way physician specialists in diabetes, the natural local leaders, rise to the challenge will be a key determinant of whether this NSF leads to real improvements in the experience and outcome of care for people with diabetes.

  7. Promoting health after gestational diabetes: a National Diabetes Education Program call to action.

    Science.gov (United States)

    Gabbe, Steven G; Landon, Mark B; Warren-Boulton, Elizabeth; Fradkin, Judith

    2012-01-01

    The National Diabetes Education Program joins the American College of Obstetricians and Gynecologists (the College) to promote opportunities for obstetrician-gynecologists (ob-gyns) and other primary care providers to better meet the long-term health needs of women with prior gestational diabetes mellitus (GDM) and their children. Up to one third of GDM women may have diabetes or prediabetes postpartum, yet only about half of these women are tested postpartum, and about a quarter are tested 6-12 weeks postpartum. Women with GDM face a lifelong increased risk for subsequent diabetes, primarily type 2 diabetes mellitus. Timely testing for prediabetes may provide an opportunity for ob-gyns to prevent or delay the onset of type 2 diabetes mellitus through diet, physical activity, weight management, and pharmacologic intervention. The College and the American Diabetes Association recommend testing women with a history of GDM at 6-12 weeks postpartum. If the postpartum test is normal, retest every 3 years and at the first prenatal visit in a subsequent pregnancy. If prediabetes is diagnosed, test annually. Because children of GDM pregnancies face an increased risk for obesity and type 2 diabetes mellitus, families need support to develop healthy eating and physical activity behaviors. Current criteria indicate that GDM occurs in 2% to 10% of all pregnancies. If new GDM diagnostic criteria are used, the frequency of GDM may increase to about 18% of pregnancies annually. The projected increase in the number of women with GDM and the potential subsequent associated risks underscore the need for proactive long-term primary care treatment of the mother and her children.

  8. Risk equations for the development of worsened glucose status and type 2 diabetes mellitus in a Swedish intervention program.

    Science.gov (United States)

    Neumann, Anne; Norberg, Margareta; Schoffer, Olaf; Norström, Fredrik; Johansson, Ingegerd; Klug, Stefanie J; Lindholm, Lars

    2013-10-26

    Several studies investigated transitions and risk factors from impaired glucose tolerance (IGT) to type 2 diabetes mellitus (T2D). However, there is a lack of information on the probabilities to transit from normal glucose tolerance (NGT) to different pre-diabetic states and from these states to T2D. The objective of our study is to estimate these risk equations and to quantify the influence of single or combined risk factors on these transition probabilities. Individuals who participated in the VIP program twice, having the first examination at ages 30, 40 or 50 years of age between 1990 and 1999 and the second examination 10 years later were included in the analysis. Participants were grouped into five groups: NGT, impaired fasting glucose (IFG), IGT, IFG&IGT or T2D. Fourteen potential risk factors for the development of a worse glucose state (pre-diabetes or T2D) were investigated: sex, age, education, perceived health, triglyceride, blood pressure, BMI, smoking, physical activity, snus, alcohol, nutrition and family history. Analysis was conducted in two steps. Firstly, factor analysis was used to find candidate variables; and secondly, logistic regression was employed to quantify the influence of the candidate variables. Bootstrap estimations validated the models. In total, 29 937 individuals were included in the analysis. Alcohol and perceived health were excluded due to the results of the factor analysis and the logistic regression respectively. Six risk equations indicating different impacts of different risk factors on the transition to a worse glucose state were estimated and validated. The impact of each risk factor depended on the starting or ending pre-diabetes state. High levels of triglyceride, hypertension and high BMI were the strongest risk factors to transit to a worsened glucose state. The equations could be used to identify individuals with increased risk to develop any of the three pre-diabetic states or T2D and to adapt prevention

  9. 77 FR 12860 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-03-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... individual intramural programs and projects conducted by the NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND... and Digestive and Kidney Diseases, National Institutes of Health, Building 10, Room 9N222, Bethesda...

  10. Biomarkers of food intake and nutrient status are associated with glucose tolerance status and development of type 2 diabetes in older Swedish women.

    Science.gov (United States)

    Savolainen, Otto; Lind, Mads Vendelbo; Bergström, Göran; Fagerberg, Björn; Sandberg, Ann-Sofie; Ross, Alastair

    2017-11-01

    Background: Diet is frequently associated with both the development and prevention of type 2 diabetes (T2D), but there is a lack of objective tools for assessing the relation between diet and T2D. Biomarkers of dietary intake are unconfounded by recall and reporting bias, and using multiple dietary biomarkers could help strengthen the link between a healthy diet and the prevention of T2D.Objective: The objective of this study was to explore how diet is related to glucose tolerance status (GTS) and to future development of T2D irrespective of common T2D and cardiovascular disease risk factors by using multiple dietary biomarkers.Design: Dietary biomarkers were measured in plasma from 64-y-old Swedish women with different GTS [normal glucose tolerance (NGT; n = 190), impaired glucose tolerance (IGT; n = 209), and diabetes (n = 230)]. The same subjects were followed up after 5 y to determine changes in glucose tolerance (n = 167 for NGT, n = 174 for IGT, and n = 159 for diabetes). ANCOVA and logistic regression were used to explore baseline data for associations between dietary biomarkers, GTS, and new T2D cases at follow-up (n = 69).Results: Of the 10 dietary biomarkers analyzed, β-alanine (beef) (P-raw raw = 0.003 and 0.011), eicosapentaenoic acid (fish) (P-raw = 0.041), 3-carboxy-4-methyl-5-propyl-2-furanpropanoic acid (CMPF) (fish) (P-raw = 0.002), linoleic acid (P-raw raw = 0.003), and α-tocopherol (margarine and vegetable oil) (P-raw raw = 0.013) and α-tocopherol (OR: 0.71; 95% CI: 0.51, 0.98; P-raw = 0.041) were inversely associated with future T2D development.Conclusions: Several circulating dietary biomarkers were strongly associated with GTS after correction for known T2D risk factors, underlining the role of diet in the development and prevention of T2D. To our knowledge, this study is the first to use multiple dietary biomarkers to investigate the link between diet and disease risk. © 2017 American Society for Nutrition.

  11. Parents' discursive resources: analysis of discourses in Swedish, Danish and Norwegian health care guidelines for children with diabetes type 1.

    Science.gov (United States)

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

    2012-06-01

    The incidence of diabetes type 1 in children, the most common metabolic disorder in childhood, increases worldwide, with highest incidence in Scandinavia. Having diabetes means demands in everyday life, and the outcome of the child's treatment highly depends on parents' engagement and involvement. The aim of this study was to explore and describe discourses in health care guidelines for children with diabetes type 1, in Sweden, Norway and Denmark during 2007-2010, with a focus on how parents were positioned. As method a Foucauldian approach to discourse analysis was applied, and a six-stage model was used to perform the analysis. The findings shows a Medical, a Pedagogic and a Public Health discourse embedded in the hegemonic Expert discourse. The Expert discourse positioned parents as dependent on expert knowledge, as recipients of education, as valuable and responsible for their child's health through practicing medical skills. This positioning may place parents on a continuum from being deprived of their own initiatives to being invited to take an active part and could result in feelings of guilt and uncertainty, but also of security and significance. From this study we conclude that guidelines rooted in the Expert discourse may reduce opportunities for parents' voices to be heard and may overlook their knowledge. By broadening the selection of authors of the guidelines to include patients and all professionals in the team, new discourses could emerge and the parents' voice might be more prominent. © 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.

  12. Obesity and Diabetes as Risk Factors for Severe Plasmodium falciparum Malaria: Results From a Swedish Nationwide Study.

    Science.gov (United States)

    Wyss, Katja; Wångdahl, Andreas; Vesterlund, Maria; Hammar, Ulf; Dashti, Saduddin; Naucler, Pontus; Färnert, Anna

    2017-09-15

    Noncommunicable diseases and obesity are increasing in prevalence globally, also in populations at risk of malaria. We sought to investigate if comorbidity, in terms of chronic diseases and obesity, is associated with severe Plasmodium falciparum malaria. We performed a retrospective observational study in adults (≥18 years of age) diagnosed with malaria in Sweden between January 1995 and May 2015. We identified cases through the surveillance database at the Public Health Agency of Sweden and reviewed clinical data from 18 hospitals. Multivariable logistic regression was used to assess associations between comorbidities and severe malaria. Among 937 adults (median age, 37 years; 66.5% were male), patients with severe malaria had higher prevalence of chronic diseases (28/92 [30.4%]) compared with nonsevere cases (151/845 [17.9%]) (P = .004). Charlson comorbidity score ≥1 was associated with severe malaria (adjusted odds ratio [aOR], 2.63 [95% confidence interval {CI}, 1.45-4.77), as was diabetes among individual diagnoses (aOR, 2.98 [95% CI, 1.25-7.09]). Median body mass index was higher among severe (29.3 kg/m2) than nonsevere cases (24.7 kg/m2) (P Obesity was strongly associated with severe malaria, both independently (aOR, 5.58 [95% CI, 2.03-15.36]) and in combination with an additional metabolic risk factor (hypertension, dyslipidemia, or diabetes) (aOR, 6.54 [95% CI, 1.87-22.88]). The associations were observed among nonimmune travelers as well as immigrants from endemic areas. Comorbidities, specifically obesity and diabetes, are previously unidentified risk factors for severe malaria in adults diagnosed with P. falciparum. Noncommunicable diseases should be considered in the acute management and prevention of malaria.

  13. Swedish electricity market 1996

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-11-01

    The organization of the Swedish electricity market has been in a state of continual change since the electricity market reform was started in the early 1990s. The conditions for the development of the electricity market have changed since the new Electricity Act came into force on 1 January 1996. The purpose of the reform is to introduce greater competition on the electricity market and provide the consumers with greater freedom of choice and, by open trade in electricity, to create the conditions for more efficient pricing. Being the central energy authority, the Swedish National Board for Industrial and Technical Development, NUTEK, was entrusted by the Government with the task of following developments on the Swedish electricity market. The Network Authority, which has the supervisory function for the new electricity market, were entrusted by the Government with the task of following developments on the Swedish electricity market and regularly compiling and reporting current market information. The new electricity market has now been operative for ten months. The Network Authority has submitted to the Government a detailed report entitled `Developments on the electricity market`, dealing with the experience gained from the electricity market reform. The purpose of the publication is to provide the players on the electricity market - the decision makers, the media and the general public - with comprehensive and easily accessible information on the market conditions. The publication includes summaries of information on electricity production and use in recent years, the structure of the electricity market from the perspective of a player, electricity trade in Sweden and in northern Europe, electricity prices in Sweden and other countries, and the impact of the electricity sector on the environment

  14. National energy policies. Obstructing the reduction of global CO{sub 2} emissions? An analysis of Swedish energy policies for the district heating sector

    Energy Technology Data Exchange (ETDEWEB)

    Difs, Kristina [Department of Management and Engineering, Division of Energy Systems, Linkoping University, SE-581 83 Linkoping (Sweden)

    2010-12-15

    The effect of national energy policies on a local Swedish district heating (DH) system has been studied, regarding the profitability of new investments and the potential for climate change mitigation. The DH system has been optimised regarding three investments: biomass-fuelled CHP (bio CHP), natural gas-fuelled combined cycle CHP (NGCC CHP) and biomass-fuelled heat-only boiler (bio HOB) in two scenarios (with or without national taxes and policy instruments). In both scenarios EU's tradable CO{sub 2} emission permits are included. Results from the study show that when national policies are included, the most cost-effective investment option is the bio CHP technology. However, when national taxes and policy instruments are excluded, the DH system containing the NGCC CHP plant has 30% lower system cost than the bio CHP system. Regardless of the scenario and when coal condensing is considered as marginal electricity production, the NGCC CHP has the largest global CO{sub 2} reduction potential, about 300 ktonne CO{sub 2}. However, the CO{sub 2} reduction potential is highly dependent on the marginal electricity production. Demonstrated here is that national policies such as tradable green certificates can, when applied to DH systems, contribute to investments that will not fully utilise the DH systems' potential for global CO{sub 2} emissions reductions. (author)

  15. Applying national survey results for strategic planning and program improvement: the National Diabetes Education Program.

    Science.gov (United States)

    Griffey, Susan; Piccinino, Linda; Gallivan, Joanne; Lotenberg, Lynne Doner; Tuncer, Diane

    2015-02-01

    Since the 1970s, the federal government has spearheaded major national education programs to reduce the burden of chronic diseases in the United States. These prevention and disease management programs communicate critical information to the public, those affected by the disease, and health care providers. The National Diabetes Education Program (NDEP), the leading federal program on diabetes sponsored by the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), uses primary and secondary quantitative data and qualitative audience research to guide program planning and evaluation. Since 2006, the NDEP has filled the gaps in existing quantitative data sources by conducting its own population-based survey, the NDEP National Diabetes Survey (NNDS). The NNDS is conducted every 2–3 years and tracks changes in knowledge, attitudes and practice indicators in key target audiences. This article describes how the NDEP has used the NNDS as a key component of its evaluation framework and how it applies the survey results for strategic planning and program improvement. The NDEP's use of the NNDS illustrates how a program evaluation framework that includes periodic population-based surveys can serve as an evaluation model for similar national health education programs.

  16. A European and Swedish perspective on ICT – policies and strategies in education. National and institutional pathways: crossings, blind alleys and uphill slopes

    Directory of Open Access Journals (Sweden)

    Henrik Hansson

    2004-04-01

    The globalisation of education forces different value systems to meet. There is on the national level highly different political values on what kind of education system to prefer – the Scandinavian model and the American model are two extremes. There are also very different values inherent in higher education institutions, the academia, - compared with the values and visions held by the political leaders. These value differences between and within countries are elaborated and discussed. A Swedish, Scandinavian and European perspective is adopted, but a wider international outlook is also given. It is suggested that the value conflicts, often not explicit, understood or recognised, are one of the major inhibitors for systemic change. The direction of change cannot be taken for granted – the driving forces pull in opposing directions. Different visions of the future struggle to be fulfilled.

  17. 78 FR 22273 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-04-15

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and...

  18. 77 FR 33751 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-06-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and...

  19. 77 FR 9670 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-02-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases...

  20. 78 FR 58325 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2013-09-23

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Digestive and Kidney Diseases Special Emphasis Panel, Regulatory Mechanisms in Intestinal Motility (P01...

  1. 77 FR 2076 - National Institute of Diabetes and Digestive and Kidney Diseases Notice of Closed Meetings

    Science.gov (United States)

    2012-01-13

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... Digestive and Kidney Diseases Special Emphasis Panel; Artificial Pancreas Review. Date: February 22-23, 2012...

  2. 78 FR 50427 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-08-19

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and..., Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases...

  3. 77 FR 35415 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-06-13

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and..., Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases...

  4. 77 FR 6130 - National Institute of Diabetes and Digestive and Kidney Diseases Notice of Closed Meeting

    Science.gov (United States)

    2012-02-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and... and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases...

  5. 78 FR 5467 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-01-25

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... unwarranted invasion of personal privacy. Name of Committee: National Institute of Diabetes and Digestive and...; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology...

  6. 75 FR 39548 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2010-07-09

    ... Kidney Diseases Special Emphasis Panel; Autoimmune Microbiome in Diabetes Ancillary Studies. Date: July... Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney...

  7. 76 FR 14676 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2011-03-17

    ... Diabetes and Digestive and Kidney Diseases Special Emphasis Panel; Cognitive Function in Chronic Diseases... Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National...

  8. Family environment and the malleability of cognitive ability: a Swedish national home-reared and adopted-away cosibling control study.

    Science.gov (United States)

    Kendler, Kenneth S; Turkheimer, Eric; Ohlsson, Henrik; Sundquist, Jan; Sundquist, Kristina

    2015-04-14

    Cognitive ability strongly aggregates in families, and prior twin and adoption studies have suggested that this is the result of both genetic and environmental factors. In this study, we used a powerful design--home-reared and adopted-away cosibling controls--to investigate the role of the rearing environment in cognitive ability. We identified, from a complete national Swedish sample of male-male siblings, 436 full-sibships in which at least one member was reared by one or more biological parents and the other by adoptive parents. IQ was measured at age 18-20 as part of the Swedish military service conscription examination. Parental educational level was rated on a 5-point scale. Controlling for clustering of offspring within biological families, the adopted siblings had an IQ 4.41 (SE = 0.75) points higher than their nonadopted siblings. Each additional unit of rearing parental education was associated with 1.71 (SE = 0.44) units of IQ. We replicated these results in 2,341 male-male half-sibships, in which, controlling for clustering within families, adoption was associated with a gain of IQ of 3.18 (SE = 0.34) points. Each additional unit of rearing parental education was associated with 1.94 (SE = 0.18) IQ units. Using full- and half-sibling sets matched for genetic background, we found replicated evidence that (i) rearing environment affects IQ measured in late adolescence, and (ii) a portion of the IQ of adopted siblings could be explained by the educational level of their adoptive parents.

  9. Cohort profile: The Swedish National Register of Urinary Bladder Cancer (SNRUBC) and the Bladder Cancer Data Base Sweden (BladderBaSe).

    Science.gov (United States)

    Häggström, Christel; Liedberg, Fredrik; Hagberg, Oskar; Aljabery, Firas; Ströck, Viveka; Hosseini, Abolfazl; Gårdmark, Truls; Sherif, Amir; Malmström, Per-Uno; Garmo, Hans; Jahnson, Staffan; Holmberg, Lars

    2017-09-27

    To monitor the quality of bladder cancer care, the Swedish National Register of Urinary Bladder Cancer (SNRUBC) was initiated in 1997. During 2015, in order to study trends in incidence, effects of treatment and survival of men and women with bladder cancer, we linked the SNRUBC to other national healthcare and demographic registers and constructed the Bladder Cancer Data Base Sweden (BladderBaSe). The SNRUBC is a nationwide register with detailed information on 97% of bladder cancer cases in Sweden as compared with the Swedish Cancer Register. Participants in the SNRUBC have registered data on tumour characteristics at diagnosis, and for 98% of these treatment data have been captured. From 2009, the SNRUBC holds data on 88% of eligible participants for follow-up 5 years after diagnosis of non-muscle invasive bladder cancer, and from 2011, data on surgery details and complications for 85% of participants treated with radical cystectomy. The BladderBaSe includes all data in the SNRUBC from 1997 to 2014, and additional covariates and follow-up data from linked national register sources on comorbidity, socioeconomic factors, detailed information on readmissions and treatment side effects, and causes of death. Studies based on data in the SNRUBC have shown inequalities in survival and treatment indication by gender, regions and hospital volume. The BladderBaSe includes 38 658 participants registered in SNRUBC with bladder cancer diagnosed from 1 January 1997 to 31 December 2014. The BladderBaSe initiators are currently in collaboration with researchers from the SNRUBC investigating different aspects of bladder cancer survival. The SNRUBC and the BladderBaSe project are open for collaborations with national and international research teams. Collaborators can submit proposals for studies and study files can be uploaded to servers for remote access and analysis. For more information, please contact the corresponding author. © Article author(s) (or their employer

  10. 76 FR 72425 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2011-11-23

    ...: National Institute of Diabetes and Digestive and Kidney Diseases Special Emphasis Panel; Hemodialysis and Markers of Heart Failure. Date: December 5, 2011. Time: 2 p.m. to 3 p.m. Agenda: To review and evaluate... National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings Pursuant to...

  11. 78 FR 36203 - National Institute of Diabetes and Digestive and Kidney Diseases; Amended Notice of Meeting

    Science.gov (United States)

    2013-06-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... Institute of Diabetes and Digestive and Kidney Diseases Special Emphasis Panel, July 01, 2013, 01:00 p.m. to...

  12. Balancing performance-based expectations with a holistic perspective on coaching: a qualitative study of Swedish women's national football team coaches' practice experiences.

    Science.gov (United States)

    Lindgren, Eva-Carin; Barker-Ruchti, Natalie

    2017-12-01

    The purpose of this study was to explore how an exclusive sample of women's national football team coaches described how they implement careful coaching while facing social and organizational pressure to win medals. To consider coaches' negotiations, we drew on Noddings' concept of caring. Using an interpretive research paradigm, we conducted in-depth interviews with five Swedish women's national football team coaches. An abductive approach was used to simultaneously process the theoretical framework of "ethics of care" and the empirical data. The coaches unanimously adopted a holistic perspective to coaching. The coaching strategies they described included promoting players' development, well-being, and sustainable elite performance; listening to the players' voices and engaging in dialogue; and creating a positive environment and promoting fair play. These findings demonstrate that the women coaches, despite performance pressure, adopt caring coaching in the form of Noddings' pedagogical modelling, dialogue, and confirmation strategies, and provide an example of how coaches can adopt caring, holistic, and athlete-centred coaching while working at the highest level of competitive sport and achieving competitive success.

  13. Balancing performance-based expectations with a holistic perspective on coaching: a qualitative study of Swedish women’s national football team coaches’ practice experiences

    Science.gov (United States)

    Lindgren, Eva-Carin; Barker-Ruchti, Natalie

    2017-01-01

    ABSTRACT Purpose: The purpose of this study was to explore how an exclusive sample of women’s national football team coaches described how they implement careful coaching while facing social and organizational pressure to win medals. Method: To consider coaches’ negotiations, we drew on Noddings’ concept of caring. Using an interpretive research paradigm, we conducted in-depth interviews with five Swedish women’s national football team coaches. An abductive approach was used to simultaneously process the theoretical framework of “ethics of care” and the empirical data. Results: The coaches unanimously adopted a holistic perspective to coaching. The coaching strategies they described included promoting players’ development, well-being, and sustainable elite performance; listening to the players’ voices and engaging in dialogue; and creating a positive environment and promoting fair play. Conclusions: These findings demonstrate that the women coaches, despite performance pressure, adopt caring coaching in the form of Noddings’ pedagogical modelling, dialogue, and confirmation strategies, and provide an example of how coaches can adopt caring, holistic, and athlete-centred coaching while working at the highest level of competitive sport and achieving competitive success. PMID:28812449

  14. National Library of Norway's new database of 22 manuscript maps concerning the Swedish King Charles XII's campaign in Norway in 1716 and 1718

    Directory of Open Access Journals (Sweden)

    Benedicte Gamborg Brisa

    2003-03-01

    Full Text Available The National Library of Norway is planning to digitise approximately 1,500 manuscript maps. Two years ago we started working on a pilot project, and for this purpose we chose 22 maps small enough to be photographed in one piece. We made slides 6 x 7 cm in size, converted the slides into PhotoCDs and used four different resolutions on JPEG-files. To avoid large file sizes, we had to divide the version with the biggest resolution into four pieces. The preliminary work was done in Photoshop, the database on the web is made in Oracle. You can click on the map to zoom. Norwegians and probably Swedes during the Great Northern War drew the 22 maps when the Swedish King Charles XII in 1716 and 1718 unsuccessfully attempted to conquer Norway. The database is now accessible on the National Library of Norway's web site. The database is in Norwegian, but we are working on an English version as well. The maps are searchable on different topics, countries, counties, geographical names, shelfmarks or a combination of these. We are planning to expand the database to other manuscript maps later. This is the reason why it is possible to search for obvious subjects as Charles XII and the Great Northern War.

  15. Diabetic nephropathy and its risk factors in a society with a type 2 diabetes epidemic: a Saudi National Diabetes Registry-based study.

    Directory of Open Access Journals (Sweden)

    Khalid Al-Rubeaan

    Full Text Available AIMS: The prevalence of diabetic nephropathy and its risk factors have not been studied in a society known to have diabetes epidemic like Saudi Arabia. Using a large data base registry will provide a better understanding and accurate assessment of this chronic complication and its related risk factors. METHODOLOGY: A total of 54,670 patients with type 2 diabetes aged ≥ 25 years were selected from the Saudi National Diabetes Registry (SNDR and analyzed for the presence of diabetic nephropathy. The American Diabetes Association (ADA criterion was used to identify cases with microalbuminuria, macroalbuminuria and end stage renal disease (ESRD for prevalence estimation and risk factor assessment. RESULTS: The overall prevalence of diabetic nephropathy was 10.8%, divided into 1.2% microalbuminuria, 8.1%macroalbuninuria and 1.5% ESRD. Age and diabetes duration as important risk factors have a strong impact on the prevalence of diabetic nephropathy, ranging from 3.7% in patients aged 25-44 years and a duration of >5 years, to 21.8% in patients ≥ 65 years with a diabetes duration of ≥ 15 years. Diabetes duration, retinopathy, neuropathy, hypertension, age >45 years, hyperlipidemia, male gender, smoking, and chronologically, poor glycemic control has a significantly high risk for diabetic nephropathy. CONCLUSION: The prevalence of diabetic nephropathy is underestimated as a result of a shortage of screening programs. Risk factors related to diabetic nephropathy in this society are similar to other societies. There is thus an urgent need for screening and prevention programs for diabetic nephropathy among the Saudi population.

  16. IQ and schizophrenia in a Swedish national sample: their causal relationship and the interaction of IQ with genetic risk.

    Science.gov (United States)

    Kendler, Kenneth S; Ohlsson, Henrik; Sundquist, Jan; Sundquist, Kristina

    2015-03-01

    The authors sought to clarify the relationship between IQ and subsequent risk for schizophrenia. IQ was assessed at ages 18-20 in 1,204,983 Swedish males born between 1951 and 1975. Schizophrenia was assessed by hospital diagnosis through 2010. Cox proportional hazards models were used to investigate future risk for schizophrenia in individuals as a function of their IQ score, and then stratified models using pairs of relatives were used to adjust for familial cluster. Finally, regression models were used to examine the interaction between IQ and genetic liability on risk for schizophrenia. IQ had a monotonic relationship with schizophrenia risk across the IQ range, with a mean increase in risk of 3.8% per 1-point decrease in IQ; this association was stronger in the lower than the higher IQ range. Co-relative control analyses showed a similar association between IQ and schizophrenia in the general population and in cousin, half-sibling, and full-sibling pairs. A robust interaction was seen between genetic liability to schizophrenia and IQ in predicting schizophrenia risk. Genetic susceptibility for schizophrenia had a much stronger impact on risk of illness for those with low than high intelligence. The IQ-genetic liability interaction arose largely from IQ differences between close relatives. IQ assessed in late adolescence is a robust risk factor for subsequent onset of schizophrenia. This association is not the result of a declining IQ associated with insidious onset. In this large, representative sample, we found no evidence for a link between genius and schizophrenia. Co-relative control analyses showed that the association between lower IQ and schizophrenia is not the result of shared familial risk factors and may be causal. The strongest effect was seen with IQ differences within families. High intelligence substantially attenuates the impact of genetic liability on the risk for schizophrenia.

  17. Exposure to Gestational Diabetes Mellitus: Impact on the Development of Early-Onset Type 2 Diabetes in Canadian First Nations and Non-First Nations Offspring.

    Science.gov (United States)

    Sellers, Elizabeth A C; Dean, Heather J; Shafer, Leigh Anne; Martens, Patricia J; Phillips-Beck, Wanda; Heaman, Maureen; Prior, Heather J; Dart, Allison B; McGavock, Jonathan; Morris, Margaret; Torshizi, Ali A; Ludwig, Sora; Shen, Garry X

    2016-12-01

    Type 2 diabetes is increasing in children worldwide, with Canadian First Nations (FN) children disproportionally affected. The prevalence of gestational diabetes mellitus (GDM) also is increasing. The objective of this study was to evaluate the impact of GDM exposure in utero and FN status on the subsequent risk of type 2 diabetes in offspring in the first 30 years of life. In this population-based historical prospective cohort study, we used administrative databases linked to a clinical database to explore the independent association and interaction between GDM and FN status on the subsequent development of type 2 diabetes in offspring. Among 321,008 births with a median follow-up of 15.1 years, both maternal GDM and FN status were independently associated with subsequent risk of type 2 diabetes in offspring in the first 30 years of life (hazard ratio 3.03 [95% CI 2.44-3.76; P diabetes risk was observed. FN status had a stronger impact on the development of type 2 diabetes in offspring than GDM. GDM is an important modifiable risk factor for type 2 diabetes, and its prevention may reduce the prevalence of subsequent type 2 diabetes in offspring. This study adds unique and rigorous evidence to the global public health debate about the impact of GDM on the long-term health of offspring. © 2016 by the American Diabetes Association.

  18. Revision surgery in anterior cruciate ligament reconstruction: a cohort study of 17,682 patients from the Swedish National Knee Ligament Register.

    Science.gov (United States)

    Desai, Neel; Andernord, Daniel; Sundemo, David; Alentorn-Geli, Eduard; Musahl, Volker; Fu, Freddie; Forssblad, Magnus; Samuelsson, Kristian

    2017-05-01

    To investigate the association between surgical variables and the risk of revision surgery after ACL reconstruction in the Swedish National Knee Ligament Register. This cohort study was based on data from the Swedish National Knee Ligament Register. Patients who underwent primary single-bundle ACL reconstruction with hamstring tendon were included. Follow-up started with primary ACL reconstruction and ended with ACL revision surgery or on 31 December, 2014, whichever occurred first. Details on surgical technique were collected using an online questionnaire. All group comparisons were made in relation to an "anatomic" reference group, comprised of essential AARSC items, defined as utilization of accessory medial portal drilling, anatomic tunnel placement, visualization of insertion sites and pertinent landmarks. Study end-point was revision surgery. A total of 108 surgeons (61.7%) replied to the questionnaire. A total of 17,682 patients were included [n = 10,013 males (56.6%) and 7669 females (43.4%)]. The overall revision rate was 3.1%. Older age as well as cartilage injury evident at index surgery was associated with a decreased risk of revision surgery. The group using transtibial drilling and non-anatomic bone tunnel placement was associated with a lower risk of revision surgery [HR 0.694 (95% CI 0.490-0.984); P = 0.041] compared with the anatomic reference group. The anatomic reference group showed no difference in risk of revision surgery compared with the transtibial drilling groups with partial anatomic [HR 0.759 (95% CI 0.548-1.051), n.s.] and anatomic tunnel placement [HR 0.944 (95% CI 0.718-1.241), n.s.]. The anatomic reference group showed a decreased risk of revision surgery compared with the transportal drilling group with anatomic placement [HR 1.310 (95% CI 1.047-1.640); P = 0.018]. Non-anatomic bone tunnel placement via transtibial drilling resulted in the lowest risk of revision surgery after ACL reconstruction. The risk of revision surgery

  19. Development of the diabetes typology model for discerning Type 2 diabetes mellitus with national survey data.

    Directory of Open Access Journals (Sweden)

    Anna Bellatorre

    Full Text Available To classify individuals with diabetes mellitus (DM into DM subtypes using population-based studies.Population-based survey.Individuals participated in 2003-2004, 2005-2006, or 2009-2010 the National Health and Nutrition Examination Survey (NHANES, and 2010 Coronary Artery Risk Development in Young Adults (CARDIA survey (research materials obtained from the National Heart, Lung, and Blood Institute Biologic Specimen and Data Repository Information Coordinating Center.3084, 3040 and 3318 US adults from the 2003-2004, 2005-2006 and 2009-2010 NHANES samples respectively, and 5,115 US adults in the CARDIA cohort.We proposed the Diabetes Typology Model (DTM through the use of six composite measures based on the Homeostatic Model Assessment (HOMA-IR, HOMA-%β, high HOMA-%S, insulin and glucose levels, and body mass index and conducted latent class analyses to empirically classify individuals into different classes.Three empirical latent classes consistently emerged across studies (entropy = 0.81-0.998. These three classes were likely Type 1 DM, likely Type 2 DM, and atypical DM. The classification has high sensitivity (75.5%, specificity (83.3%, and positive predictive value (97.4% when validated against C-peptide level. Correlates of Type 2 DM were significantly associated with model-identified Type 2 DM. Compared to regression analysis on known correlates of Type 2 DM using all diabetes cases as outcomes, using DTM to remove likely Type 1 DM and atypical DM cases results in a 2.5-5.3% r-square improvement in the regression analysis, as well as model fits as indicated by significant improvement in -2 log likelihood (p<0.01. Lastly, model-defined likely Type 2 DM was significantly associated with known correlates of Type 2 DM (e.g., age, waist circumference, which provide additional validation of the DTM-defined classes.Our Diabetes Typology Model reflects a promising first step toward discerning likely DM types from population-based data. This novel

  20. Cognitive ability in late adolescence and disability pension in middle age: follow-up of a national cohort of Swedish males.

    Directory of Open Access Journals (Sweden)

    Alma Sörberg

    Full Text Available Low cognitive ability in late adolescence has previously been shown to be associated with disability pension (DP in young adulthood. However, most DP's are granted later in working life, and the mechanisms of the association are not fully understood. We aimed to investigate the association between cognitive ability in late adolescence and DP at ages 40-59, and investigate the role of individual and socioeconomic factors. Information on cognitive ability, health status, personality aspects and health behaviours at age 18-20 was obtained from the 1969-70 conscription cohort, comprising 49,321 Swedish men. Data on DP's 1991-2008 was obtained from the Longitudinal Database of Education, Income and Employment. Information on socioeconomic and work-related factors in childhood and adulthood was obtained from national sociodemographic databases. Hazard ratios for DP during follow-up were estimated by Cox proportional hazards models. We found a graded relationship between cognitive ability in late adolescence and DP in middle age. One step decrease on the nine-point stanine scale of cognitive ability was associated with a crude hazard ratio of 1.26 (95% CI 1.24-1.27. Socioeconomic and work-related circumstances in adulthood explained much of the association, but factors measured already in late adolescence also showed importance. The findings suggest an accumulation of risks over the life course. Although attenuated, the graded relationship remained after adjusting for all factors.

  1. Associations between dental anxiety, sense of coherence, oral health-related quality of life and health behavior--a national Swedish cross-sectional survey.

    Science.gov (United States)

    Carlsson, Viktor; Hakeberg, Magnus; Wide Boman, Ulla

    2015-09-02

    Dental anxiety (DA) is a common condition associated with avoidance of dental care and subsequent health-related and psychosocial outcomes, in what has been described as the vicious circle of DA. Also, recent studies have found an association between the psychosocial concept of sense of coherence (SOC) and DA. More studies are needed to verify the relationship between DA and SOC, especially using population-based samples. There is also a need for studies including factors related to the vicious circle of DA, such as oral health-related quality of life (OHRQoL), in order to further establish the correlates of DA in the general population. Therefore, the aim of this study was to investigate the relationship between DA and SOC, OHRQoL and health-related behaviour in the general Swedish population. The survey included a randomly selected sample of the adult Swedish population (N = 3500, age 19 - 96 years.). Data was collected by means of telephone interviews. Dental anxiety was measured with a single question. The SOC measure consisted of three questions conceptualising the dimensions of the SOC: comprehensibility, manageability and meaningfulness. The data collection also included the five-item version of the Oral Health Impact Profile (OHIP-5), as a measure of OHRQoL, as well as questions on oral health-related behaviour and socioeconomic status. Statistical analyses were made with descriptive statistics and inference testing using Chi-square, t--test and logistic regression. High DA was associated with low OHRQoL, irregular dental care and smoking. There was a statistically significant relationship between the SOC and DA in the bivariate, but not in the multivariate, analyses. Dental anxiety was not associated with oral health-related behaviour or socioeconomic status. This cross-sectional national survey gives support to the significant associations between high dental anxiety, avoidance of dental care and health-related outcomes, which may further reinforce the

  2. Organizational Readiness for Change (ORC) test used in the implementation of assessment instruments and treatment methods in a Swedish National study.

    Science.gov (United States)

    Billsten, Johan; Fridell, Mats; Holmberg, Robert; Ivarsson, Andréas

    2018-01-01

    Organizational climate and related factors are associated with outcome and are as such of vital interest for healthcare organizations. Organizational Readiness for Change (ORC) is the questionnaire used in the present study to assess the influence of organizational factors on implementation success. The respondents were employed in one of 203 Swedish municipalities within social work and psychiatric substance/abuse treatment services. They took part in a nationwide implementation project organized by the Swedish Association of Local Authorities and Regions (SALAR), commissioned by the Swedish National Board of Health and Welfare. The aims were: (a) to identify classes (clusters) of employees with different ORC profiles on the basis of data collected in 2011 and (b) to investigate ORC profiles which predicted the use of assessment instruments, therapy methods and collaborative activities in 2011 and 2013. The evaluation study applied a naturalistic design with registration of outcome at consecutive assessments. The participants were contacted via official e-mail addresses in their respective healthcare units and were encouraged by their officials to participate on a voluntary basis. Descriptive statistics were obtained using SPSS version 23. A latent profile analysis (LPA) using Mplus 7.3 was performed with a robust maximum likelihood estimator (MLR) to identify subgroups (clusters) based on the 18 ORC indexes. A total of 2402 employees responded to the survey, of whom 1794 (74.7%) completed the ORC scores. Descriptive analysis indicated that the respondents were a homogenous group of employees, where women (72.0%) formed the majority. Cronbach's alpha for the 18 ORC indexes ranged from α=0.67 to α=0.78. A principal component analysis yielded a four-factor solution explaining 62% of the variance in total ORC scores. The factors were: motivational readiness (α=0.64), institutional resources (α=0.52), staff attributes (α=0.76), and organizational climate (α=0

  3. Change in depressive symptoms over higher education and professional establishment - a longitudinal investigation in a national cohort of Swedish nursing students.

    Science.gov (United States)

    Christensson, Anna; Runeson, Bo; Dickman, Paul W; Vaez, Marjan

    2010-06-15

    There are indications of a high prevalence of psychological distress among students in higher education and also that distress increases over the course of study. However, not all studies on student distress controlled for sociodemographic differences and few followed development of distress over an extended period through professional establishment. We investigated if there is an independent effect of time in education and the first two years in the profession on depressive symptoms and mapped change over the period in a national cohort of students. Data came from LANE, a nation-wide longitudinal panel survey of Swedish nursing students (N = 1700) who responded to annual questionnaires over five years from 2002 to 2007. Depressive symptoms were measured by the Major Depression Inventory and change over time analysed in a linear mixed effects model for repeated measures. There was a significant change in level of depressive symptoms over time: an increase from the first to later years in education and a decrease to levels similar to baseline after graduation and a year in the profession. The change in symptoms remained significant after adjustment for sociodemographic factors (p education and professional establishment on depressive symptoms. We think heightened distress over education abates as the graduate accommodates to the profession. Nevertheless, within education, the differences in depressive symptoms associated to demographic factors can help identify student groups more vulnerable to distress. Also, as individual differences in distress seem to persist over time, perhaps students highly distressed in the beginning of education can be helped by awareness among educators of the elevated levels of distress in late education.

  4. 77 FR 20646 - National Institute of Diabetes and Digestive and Kidney Diseases: Notice of Closed Meeting

    Science.gov (United States)

    2012-04-05

    ..., Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS) Dated: March 28... Kidney Diseases Special Emphasis Panel; Translational Research in Diabetes and Obesity. Date: May 17...

  5. Parents' views of including young boys in the Swedish national school-based HPV vaccination programme : a qualitative study

    OpenAIRE

    Gottvall, Maria; Stenhammar, Christina; Grandahl, Maria

    2017-01-01

    Objective: To explore parents' views of extending the human papillomavirus (HPV) vaccination programme to also include boys. Design: Explorative qualitative design using individual, face-to-face, interviews and inductive thematic analysis. Setting: 11 strategically chosen municipalities in central Sweden. Participants: Parents (n= 42) who were offered HPV vaccination for their 11-12 years old daughter in the national school-based vaccination programme. Results: The key themes were: equality f...

  6. 78 FR 67372 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-11-12

    ... Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney...

  7. 78 FR 26641 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-05-07

    ... Domestic Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National...

  8. 77 FR 71430 - National Institute of Diabetes and Digestive and Kidney Diseases Notice of Closed Meeting

    Science.gov (United States)

    2012-11-30

    ... Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health...

  9. 78 FR 75358 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-12-11

    ... Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS...

  10. Diabetes - resources

    Science.gov (United States)

    Resources - diabetes ... The following sites provide further information on diabetes: American Diabetes Association -- www.diabetes.org Juvenile Diabetes Research Foundation International -- www.jdrf.org National Center for Chronic Disease Prevention and Health Promotion -- ...

  11. Implementation of national palliative care guidelines in Swedish acute care hospitals: A qualitative content analysis of stakeholders' perceptions.

    Science.gov (United States)

    Lind, S; Wallin, L; Brytting, T; Fürst, C J; Sandberg, J

    2017-11-01

    In high-income countries a large proportion of all deaths occur in hospitals. A common way to translate knowledge into clinical practice is developing guidelines for different levels of health care organisations. During 2012, national clinical guidelines for palliative care were published in Sweden. Later, guidance for palliative care was issued by the National Board of Health and Welfare. The aim of this study was two-fold: to investigate perceptions regarding these guidelines and identify obstacles and opportunities for implementation of them in acute care hospitals. Interviews were conducted with local politicians, chief medical officers and health professionals at acute care hospitals. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. The results showed little knowledge of the two documents at all levels of the health care organisation. Palliative care was primarily described as end of life care and only few of the participants talked about the opportunity to integrate palliative care early in a disease trajectory. The environment and culture at hospitals, characterised by quick decisions and actions, were perceived as obstacles to implementation. Health professionals' expressed need for palliative care training is an opportunity for implementation of clinical guidelines. There is a need for further implementation of palliative care in hospitals. One option for further research is to evaluate implementation strategies tailored to acute care. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. High quality cord blood banking is feasible with delayed clamping practices. The eight-year experience and current status of the national Swedish Cord Blood Bank.

    Science.gov (United States)

    Frändberg, Sofia; Waldner, Berit; Konar, Jan; Rydberg, Lennart; Fasth, Anders; Holgersson, Jan

    2016-09-01

    The National Swedish Cord Blood Bank (NS-CBB) is altruistic and publicly funded. Herein we describe the status of the bank and the impact of delayed versus early clamping on cell number and volume. Cord Blood Units (CBUs) were collected at two University Hospitals in Sweden. Collected volume and nucleated cell content (TNC) were investigated in 146 consecutive Cord Blood (CB) collections sampled during the first quarter of 2012 and in 162 consecutive CB collections done in the first quarter of 2013, before and after clamping practices were changed from immediate to late (60 s) clamping. NS-CBB now holds close to 5000 units whereof 30 % are from non-Caucasian or mixed origins. Delayed clamping had no major effect on collection efficiency. The volume collected was slightly reduced (mean difference, 8.1 ml; 95 % CI, 1.3-15.0 ml; p = 0.02), while cell recovery was not (p = 0.1). The proportion of CBUs that met initial total TNC banking criteria was 60 % using a TNC threshold of 12.5 × 10(8), and 47 % using a threshold of 15 × 10(8) for the early clamping group and 52 and 37 % in the late clamping group. Following implementation of delayed clamping practices at NS-CBB; close to 40 % of the collections in the late clamping group still met the high TNC banking threshold and were eligible for banking, implicating that that cord blood banking is feasible with delayed clamping practices.

  13. Health-related quality of life in children with surgery for CHD: a study from the Swedish National Registry for Congenital Heart Disease.

    Science.gov (United States)

    Svensson, Birgitta; Idvall, Ewa; Nilsson, Fredrik; Liuba, Petru

    2017-03-01

    As survival of children with CHD needing surgery has improved significantly, the need for follow-up in terms of health-related quality of life has become increasingly important. In this study, we sought to describe health-related quality of life in children with CHD in relation to cardiac surgery. A retrospective Swedish National Registry for Congenital Heart Disease survey measured using DISABKIDS chronic generic measure-short version included 337 children (age 9-17 years; 39% girls). The majority (n=319, 95%) of children had a biventricular heart, whereas the remaining had a univentricular heart. Cardiac surgery was performed in 197 (58%) children. Health-related quality of life was expressed as total score (100 highest) and given as medians and 10-90th percentiles. The overall total score was 95 (88-100). Children with a biventricular heart who had undergone three or more surgeries (n=31; 9%) had the lowest total score of 81 (61-97; pChildren with two or more surgeries and those with univentricular heart were classified in NYHA II more frequently than children with one or no cardiac surgery (p=0.005 and Children with three or more surgeries and those with univentricular heart needed more help at school (pchildren with other chronic diseases, children with CHD had a high total score except for children with three or more surgeries who had comparable total scores with children with other chronic diseases. Children with three or more cardiac surgeries and those with a univentricular heart appear to have lower health-related quality of life, cognitive ability, and NYHA classification.

  14. Parents' views of including young boys in the Swedish national school-based HPV vaccination programme: a qualitative study.

    Science.gov (United States)

    Gottvall, Maria; Stenhammar, Christina; Grandahl, Maria

    2017-02-28

    To explore parents' views of extending the human papillomavirus (HPV) vaccination programme to also include boys. Explorative qualitative design using individual, face-to-face, interviews and inductive thematic analysis. 11 strategically chosen municipalities in central Sweden. Parents (n=42) who were offered HPV vaccination for their 11-12 years old daughter in the national school-based vaccination programme. The key themes were: equality from a public health perspective and perception of risk for disease. Parents expressed low knowledge and awareness about the health benefits of male HPV vaccination, and they perceived low risk for boys to get HPV. Some parents could not see any reason for vaccinating boys. However, many parents preferred gender-neutral vaccination, and some of the parents who had not accepted HPV vaccination for their daughter expressed that they would be willing to accept vaccination for their son, if it was offered. It was evident that there was both trust and distrust in authorities' decision to only vaccinate girls. Parents expressed a preference for increased sexual and reproductive health promotion such as more information about condom use. Some parents shared that it was more important to vaccinate girls than boys since they believed girls face a higher risk of deadly diseases associated with HPV, but some also believed girls might be more vulnerable to side effects of the vaccine. A vaccine offered only to girls may cause parents to be hesitant to vaccinate, while also including boys in the national vaccination programme might improve parents' trust in the vaccine. More information about the health benefits of HPV vaccination for males is necessary to increase HPV vaccination among boys. This may eventually lead to increased HPV vaccine coverage among both girls and boys. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. National Diabetes Plans: can they support changes in health care systems to strengthen diabetes prevention and care?

    Science.gov (United States)

    Zaletel, Jelka; Piletic, Milivoj; Lindström, Jaana; Icks, Andrea; Rothe, Ulrike; Sørensen, Monica; Maggini, Marina

    2015-01-01

    Healthcare systems do not fit well with the "modern" patient, who has a right to autonomy and self-determination. The services that are designed and delivered in policy contexts are not prone to encourage innovation. National Diabetes Plans, defined as "any formal strategy for improving diabetes policy, services and outcomes that encompass structured and integrated or linked activities which are planned and co-ordinated nationally and conducted at the national, regional, and local level", may hold a great potential not only to improve prevention and care for type 2 diabetes, but also for transforming healthcare delivery. Today, changes to adapt healthcare delivery tend to be implemented within existing provider structures, with limited understanding of specific context, structures, processes and potential for change. National Diabetes Plan can be a diagnostic tool for barriers, can be a driver for planning the change, and can help develop capacities and competences that are needed to strengthen healthcare systems to better address health promotion and chronic diseases.

  16. National Diabetes Plans: can they support changes in health care systems to strengthen diabetes prevention and care?

    Directory of Open Access Journals (Sweden)

    Jelka Zaletel

    2015-09-01

    Full Text Available Healthcare systems do not fit well with the "modern" patient, who has a right to autonomy and self-determination. The services that are designed and delivered in policy contexts are not prone to encourage innovation. National Diabetes Plans, defined as "any formal strategy for improving diabetes policy, services and outcomes that encompass structured and integrated or linked activities which are planned and co-ordinated nationally and conducted at the national, regional, and local level", may hold a great potential not only to improve prevention and care for type 2 diabetes, but also for transforming healthcare delivery. Today, changes to adapt healthcare delivery tend to be implemented within existing provider structures, with limited understanding of specific context, structures, processes and potential for change. National Diabetes Plan can be a diagnostic tool for barriers, can be a driver for planning the change, and can help develop capacities and competences that are needed to strengthen healthcare systems to better address health promotion and chronic diseases.

  17. National recommendations: Psychosocial management of diabetes in India

    Science.gov (United States)

    Kalra, Sanjay; Sridhar, G. R.; Balhara, Yatan Pal Singh; Sahay, Rakesh Kumar; Bantwal, Ganapathy; Baruah, Manash P.; John, Mathew; Unnikrishnan, Ambika Gopalkrishnan; Madhu, K.; Verma, Komal; Sreedevi, Aswathy; Shukla, Rishi; Prasanna Kumar, K. M.

    2013-01-01

    Although several evidence-based guidelines for managing diabetes are available, few, if any, focus on the psychosocial aspects of this challenging condition. It is increasingly evident that psychosocial treatment is integral to a holistic approach of managing diabetes; it forms the key to realizing appropriate biomedical outcomes. Dearth of attention is as much due to lack of awareness as due to lack of guidelines. This lacuna results in diversity among the standards of clinical practice, which, in India, is also due to the size and complexity of psychosocial care itself. This article aims to highlight evidence- and experience-based Indian guidelines for the psychosocial management of diabetes. A systemic literature was conducted for peer-reviewed studies and publications covering psychosocial aspects in diabetes. Recommendations are classified into three domains: General, psychological and social, and graded by the weight they should have in clinical practice and by the degree of support from the literature. Ninety-four recommendations of varying strength are made to help professionals identify the psychosocial interventions needed to support patients and their families and explore their role in devising support strategies. They also aid in developing core skills needed for effective diabetes management. These recommendations provide practical guidelines to fulfill unmet needs in diabetes management, and help achieve a qualitative improvement in the way physicians manage patients. The guidelines, while maintaining an India-specific character, have global relevance, which is bound to grow as the diabetes pandemic throws up new challenges. PMID:23869293

  18. National patterns and correlates of complementary and alternative medicine use in adults with diabetes.

    Science.gov (United States)

    Garrow, Donald; Egede, Leonard E

    2006-11-01

    The aim of this study was to determine national patterns and correlates of complementary and alternative medicine (CAM) use among adults with diabetes. The authors compared CAM use in 2474 adults with and 28,625 adults without diabetes who participated in the most comprehensive national survey on CAM use (2002 National Health Interview Survey). Eight CAM use categories were created, including dietary, herbal, chiropractic, yoga, relaxation, vitamin, prayer, and other (acupuncture, Ayurveda, biofeedback, chelation, energy healing or Reiki therapy, hypnosis, massage, naturopathy, and homeopathy). An overall CAM use category also was created that excluded vitamins and prayer. Patterns of use were compared with chi-square and independent correlates of CAM use with multiple logistic regression controlling for relevant covariates. STATA was used for analysis to account for the complex survey design. Prevalence of overall use of CAM did not differ significantly by diabetes status (47.6 versus 47.9%, p = 0.81). Diabetes was not an independent predictor of overall use of CAM (OR 0.93, 95% confidence interval [CI] 0.83, 1.05). However, persons with diabetes were more likely to use prayer (OR 1.19, 95% CI 1.05, 1.36), but less likely to use herbs (OR 0.86, 95% CI 0.75, 0.99), yoga (OR 0.56, 95% CI 0.43, 0.72), or vitamins (OR 0.82, 95% CI 0.72, 0.93) than people without diabetes after controlling for relevant covariates. Independent correlates of overall use of CAM differed by age, income, employment, comorbidity, and health status between people with and without diabetes. This study found that there has been a dramatic increase in overall use of CAM in adults with diabetes; diabetes was not an independent predictor of overall use of CAM; and people with diabetes were more likely to use prayer, but less likely to use herbs, yoga, or vitamins compared to persons without diabetes.

  19. The Swedish Model

    DEFF Research Database (Denmark)

    Kokko, Ari

    2012-01-01

    The main characteristics of ‘the Swedish model’ are arguably related to the country's knowledge-intensive industry and its advanced welfare state. The purpose of this chapter is to discuss the historical development of these two features of the Swedish economy. The first part looks at industrial...

  20. Type 2 Diabetes Mellitus and Kidney Cancer Risk: A Retrospective Cohort Analysis of the National Health Insurance.

    Science.gov (United States)

    Tseng, Chin-Hsiao

    2015-01-01

    To evaluate the association between incidence of any kidney cancer and type 2 diabetes mellitus. A random sample of 1,000,000 subjects covered by the National Health Insurance was recruited. A total of 998728 people (115655 diabetes and 883073 non-diabetes) without kidney cancer at recruitment were followed from 2003 to 2005. The cumulative incidence of kidney cancer from 2003 to 2005 in diabetic patients and non-diabetic people in all ages and in age kidney cancer with regards to diabetes status and diabetes duration (as a continuous variable or categorized into subgroups of non-diabetes, diabetes duration kidney cancer in the diabetic patients and the non-diabetic people was 166.9 and 33.1 per 100,000 person-years, respectively. The incidence increased with regards to increasing age in both the diabetic patients and the non-diabetic people, but a higher risk of kidney cancer for the diabetic patients compared to the non-diabetic people was consistently observed in different age groups. After multivariable adjustment, the odds ratio for diabetic patients versus non-diabetic people was 1.7 (95% confidence interval: 1.3-2.1, Pkidney cancer. Additionally, living in metropolitan Taipei region might also be associated with a higher risk of kidney cancer in the non-diabetic people, indicating a potential link between kidney cancer and some factors related to urbanization. Patients with type 2 diabetes mellitus have a significantly higher risk of kidney cancer.

  1. Chronic Liver Disease-Associated Hospitalizations Among Adults with Diabetes, National Inpatient Sample, 2001–2012

    Science.gov (United States)

    Mehal, Jason M.; Schillie, Sarah F.; Holman, Robert C.; Haberling, Dana; Murphy, Trudy

    2015-01-01

    Objective Many people with diabetes have a variety of diabetes-related complications. Among the variety of conditions associated with diabetes, however, liver diseases are less well recognized. As such, we aimed to describe chronic liver disease (CLD)-associated hospitalization rates among U.S. adults with diabetes from 2001–2012. Methods We used a nationally representative database of hospitalizations, the National Inpatient Sample, to determine CLD-associated hospitalization rates among U.S. adults aged ≥18 years with and without diabetes, from 2001–2012. Hospitalizations listing an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code for CLD on the discharge record were selected for analysis and were further classified by diabetes status based on concurrent presence of a diabetes ICD-9-CM code. We calculated average annual age-adjusted hospitalization rates and 95% confidence intervals (CIs), and conducted a test for trend. Results For 2001–2012, the total age-adjusted CLD-associated hospitalization rate among adults with diabetes (1,680.9 per 100,000 population; 95% CI 1,577.2, 1,784.6) was approximately four times the rate of adults without diabetes (424.2 per 100,000 population; 95% CI 413.4, 435.1). Total age-adjusted hospitalization rates of adults with and without diabetes increased 59% and 48%, respectively, from 2001–2002 to 2011–2012 (pHepatitis C- and chronic hepatitis and cirrhosis-associated hospitalizations comprised the largest proportion of total CLD-associated hospitalizations among adults with and without diabetes. Conclusion Providers should be aware of the potential existence of CLD among adults with diabetes and counsel patients on preventive methods to avoid progressive liver damage. PMID:26556941

  2. Achievement of Weight Loss and Other Requirements of the Diabetes Prevention and Recognition Program: A National Diabetes Prevention Program Network Based on Nationally Certified Diabetes Self-management Education Programs.

    Science.gov (United States)

    DiBenedetto, Joanna Craver; Blum, Natalie M; O'Brian, Catherine A; Kolb, Leslie E; Lipman, Ruth D

    2016-12-01

    The purpose of this report is (1) to describe the use of the American Association of Diabetes Educators' (AADE's) model of implementation of the National Diabetes Prevention Program through nationally certified diabetes self-management education (DSME) programs and (2) to report the aggregated program outcomes as defined by the Diabetes Prevention and Recognition Program standards of the Centers for Disease Control and Prevention (CDC). In 2012, the AADE worked with the CDC to select 30 certified DSME programs for National Diabetes Prevention Program delivery. For the following 3 years, the AADE continued to work with 25 of the 30 original programs. Results for all CDC recognition standards have been collected from these 25 programs and analyzed as aggregated data over the course of 36 months. At the end of the full-year program, average percentage body weight loss for participants across all 25 programs exceeded the CDC's minimum requirement of 5% weight loss. All programs on average met the CDC requirements for program attendance. Increasing access to the National Diabetes Prevention Program, through an array of networks, including certified DSME programs, will better ensure that people are able to engage in an effective approach to reducing their risk of diabetes. © 2016 The Author(s).

  3. Triparental families: a new genetic-epidemiological design applied to drug abuse, alcohol use disorders, and criminal behavior in a Swedish national sample.

    Science.gov (United States)

    Kendler, Kenneth S; Ohlsson, Henrik; Sundquist, Jan; Sundquist, Kristina

    2015-06-01

    The authors sought to clarify the sources of parent-offspring resemblance for drug abuse, alcohol use disorders, and criminal behavior, using a novel genetic-epidemiological design. Using national registries, the authors identified rates of drug abuse, alcohol use disorders, and criminal behavior in 41,360 Swedish individuals born between 1960 and 1990 and raised in triparental families comprising a biological mother who reared them, a "not-lived-with" biological father, and a stepfather. When each syndrome was examined individually, hazard rates for drug abuse in offspring of parents with drug abuse were highest for mothers (2.80, 95% CI=2.23-3.38), intermediate for not-lived-with fathers (2.45, 95% CI=2.14-2.79), and lowest for stepfathers (1.99, 95% CI=1.55-2.56). The same pattern was seen for alcohol use disorders (2.23, 95% CI=1.93-2.58; 1.84, 95% CI=1.69-2.00; and 1.27, 95% CI=1.12-1.43) and criminal behavior (1.55, 95% CI=1.44-1.66; 1.46, 95% CI=1.40-1.52; and 1.30, 95% CI=1.23-1.37). When all three syndromes were examined together, specificity of cross-generational transmission was highest for mothers, intermediate for not-lived-with fathers, and lowest for stepfathers. Analyses of intact families and other not-lived-with parents and stepparents showed similar cross-generation transmission for these syndromes in mothers and fathers, supporting the representativeness of results from triparental families. A major strength of the triparental design is its inclusion, within a single family, of parents who provide, to a first approximation, their offspring with genes plus rearing, genes only, and rearing only. For drug abuse, alcohol use disorders, and criminal behavior, the results of this study suggest that parent-offspring transmission involves both genetic and environmental processes, with genetic factors being somewhat more important. These results should be interpreted in the context of the strengths and limitations of national registry data.

  4. Diabetes, glucose metabolism, and glaucoma: the 2005-2008 National Health and Nutrition Examination Survey.

    Directory of Open Access Journals (Sweden)

    Di Zhao

    Full Text Available BACKGROUND: Diabetes may affect vascular autoregulation of the retina and optic nerve and may be associated with an increased risk of glaucoma,but the association of prediabetes, insulin resistance, markers of glucose metabolismwith glaucoma has not beenevaluated in general population samples. OBJECTIVE: To examine the relation between diabetes, pre-diabetes, metabolic syndrome and its components and the levels of fasting glucose, HbA1c and HOMA-IR with the prevalence of glaucoma in the general U.S. population. METHODS: Cross-sectional study of 3,299 adult men and women from the 2005-2008 National Health and NutritionExamination Survey (NHANES. The presence of diabetes, prediabetes, the metabolic syndrome and its individual components and biomarkers of glucose metabolisms were based on standardized questionnaire and physical exam data and laboratory tests. The history of glaucoma was assessed through questionnaire during the home interview. RESULTS: Diabetes was strongly associated with prevalent glaucoma.In fully adjusted models, the odds ratiofor glaucoma comparing participants with diabetes with participants in the reference group with neither pre-diabetes nor diabetes was 2.12 (95% CI: 1.23, 3.67. The corresponding odd ratio comparing participants with pre-diabetes to those in the reference group was 1.01 (95% CI: 0.57, 1.82. Patients with 5 or more years of diabetes duration hadan OR for glaucoma of 3.90 (95% CI: 1.63, 9.32 compared with patients with <5 years of diabetes duration. We also found a hockey-stick shaped associations between biomarkers of glucose metabolisms and the prevalence of glaucoma. CONCLUSIONS: Diabetes was associated with higher risk of glaucoma. Participants without diabetes but at the higher levels of fasting glucose, fasting insulin, HbA1c and HOMA-IR spectrum may also be at greater risk of glaucoma.

  5. Addressing the gaps in diabetes care in first nations communities with the reorganizing the approach to diabetes through the application of registries (RADAR): the project protocol

    OpenAIRE

    Eurich, Dean T.; Majumdar, Sumit R; Wozniak, Lisa A.; Soprovich, Allison; Meneen, Kari; Johnson, Jeffrey A.; Samanani, Salim

    2017-01-01

    Background Type-2 diabetes rates in First Nations communities are 3-5 times higher than the general Canadian population, resulting in a high burden of disease, complications and comorbidity. Limited community nursing capacity, isolated environments and a lack of electronic health records (EHR)/registries lead to a reactive, disorganized approach to diabetes care for many First Nations people. The Reorganizing the Approach to Diabetes through the Application of Registries (RADAR) project was d...

  6. Prevalence and Determinants of Diabetic Nephropathy in Korea: Korea National Health and Nutrition Examination Survey

    Directory of Open Access Journals (Sweden)

    Jae Hee Ahn

    2014-04-01

    Full Text Available BackgroundDiabetic nephropathy is a leading cause of end stage renal disease and is associated with an increased risk of cardiovascular mortality. It manifests as albuminuria or impaired glomerular filtration rate (GFR, and the prevalence of diabetic nephropathy varies with ethnicity. The prevalence of diabetic nephropathy and its determinants in Korean adults have not previously been studied at the national level. This cross-sectional study was undertaken to ascertain the prevalence and determinants of albuminuria and chronic kidney disease (CKD in Korean patients with diabetes.MethodsThe Korea National Health and Nutrition Examination Survey (KNHANES V, conducted in 2011, was used to define albuminuria (n=4,652, and the dataset of KNHANES IV-V (2008-2011 was used to define CKD (n=21,521. Selected samples were weighted to represent the entire civilian population in Korea. Albuminuria was defined as a spot urine albumin/creatinine ratio >30 mg/g. CKD was defined as a GFR <60 mL/min/1.73 m2.ResultsAmong subjects with diabetes, 26.7% had albuminuria, and 8.6% had CKD. Diabetes was associated with an approximate 2.5-fold increased risk of albuminuria, with virtually no difference between new-onset and previously diagnosed diabetes. Only systolic blood pressure was significantly associated with albuminuria, and old age, high serum triglyceride levels, and previous cardiovascular disease (CVD were related with CKD in subjects with diabetes.ConclusionKorean subjects with diabetes had a higher prevalence of albuminuria and CKD than those without diabetes. Blood pressure was associated with albuminuria, and age, triglyceride level, and previous CVD were independent determinants of CKD in subjects with diabetes.

  7. Swedish Government Minister at CERN

    CERN Multimedia

    2008-01-01

    The Swedish Minister for Higher Education and Research recently visited CERN. The Swedish Minister was greeted by Swedish scientists working at CERN. Signing of the Swedish Computing Memorandum of Understanding. Pär Omling, Director-General of the Swedish Research Council (left), and Jos Engelen, CERN’s Chief Scientific Officer. Lars Leijonborg, the Swedish Minister for Higher Education and Research, was welcomed to CERN by Director-General Robert Aymar on 10 March. After an introduction to the Laboratory’s activities, the Minister was given guided tours of the control room, the ATLAS surface hall and experiment cavern and the adjoining LHC tunnel. Mr Leijonborg was then greeted by Swedish scientists and given an overview of the Swedish research programme at CERN. Five Swedish university groups are taking part in LHC research. Swedish universities are notably involved in the manufacture of parts for the sub-detectors of AT...

  8. 76 FR 12125 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2011-03-04

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... Kidney Diseases Special Emphasis Panel; GenitoUrinary Development Molecular Anatomy Project (GUDMAP) Date...

  9. 76 FR 14672 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2011-03-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Diabetes and Digestive and Kidney... Kidney Diseases Special Emphasis Panel; PAR09-247 Ancillary Clinical Studies: Nephropathy and Urinary Incontinence. Date: April 4, 2011. Time: 1 p.m. to 4:30 p.m. Agenda: To review and evaluate grant applications...

  10. Does First Nations ancestry modify the association between gestational diabetes and subsequent diabetes: a historical prospective cohort study among women in Manitoba, Canada.

    Science.gov (United States)

    Shen, G X; Shafer, L A; Martens, P J; Sellers, E; Torshizi, A A; Ludwig, S; Phillips-Beck, W; Heaman, M; Prior, H J; McGavock, J; Morris, M; Dart, A B; Campbell, R; Dean, H J

    2016-09-01

    Over the past 30 years, the prevalence of diabetes has steadily increased among Canadians, and is particularly evident among First Nations (FN) women. The interplay between FN ancestry, gestational diabetes and the development of subsequent diabetes among mothers remains unclear. After excluding known pre-existing diabetes, we explored whether FN ancestry may modify the association between gestational diabetes and post-partum diabetes among women in Manitoba (1981-2011) via a historical prospective cohort database study. We analysed administrative data in the Population Health Research Data Repository using Kaplan-Meier survival analysis and Cox proportional hazards regression. Gestational diabetes was diagnosed in 11 906 of 404 736 deliveries (2.9%), 6.7% of FN and 2.2% of non-FN pregnant women (P women than among non-FN women (P women with gestational diabetes within the follow-up period. The hazard ratio of gestational diabetes for post-partum diabetes was 10.6 among non-FN women and 5.4 among FN women. Other factors associated with a higher risk of diabetes included lower family income among FN and non-FN women and rural/remote residences among FN women. Among non-FN women, urban residence was associated with a higher risk of diabetes. Gestational diabetes increases post-partum diabetes in FN and non-FN women. FN women had substantially more gestational diabetes or post-partum diabetes than non-FN women, partially due to socio-economic and environmental barriers. Reductions in gestational diabetes and socio-economic inequalities are required to prevent diabetes in women, particularly in FN population. © 2015 Diabetes UK.

  11. Living in two homes-a Swedish national survey of wellbeing in 12 and 15 year olds with joint physical custody

    Science.gov (United States)

    2013-01-01

    Background The practice of joint physical custody, where children spend equal time in each parent’s home after they separate, is increasing in many countries. It is particularly common in Sweden, where this custody arrangement applies to 30 per cent of children with separated parents. The aim of this study was to examine children’s health-related quality of life after parental separation, by comparing children living with both parents in nuclear families to those living in joint physical custody and other forms of domestic arrangements. Methods Data from a national Swedish classroom study of 164,580 children aged 12 and 15-years-old were analysed by two-level linear regression modelling. Z-scores were used to equalise scales for ten dimensions of wellbeing from the KIDSCREEN-52 and the KIDSCREEN-10 Index and analysed for children in joint physical custody in comparison with children living in nuclear families and mostly or only with one parent. Results Living in a nuclear family was positively associated with almost all aspects of wellbeing in comparison to children with separated parents. Children in joint physical custody experienced more positive outcomes, in terms of subjective wellbeing, family life and peer relations, than children living mostly or only with one parent. For the 12-year-olds, beta coefficients for moods and emotions ranged from −0.20 to −0.33 and peer relations from −0.11 to −0.20 for children in joint physical custody and living mostly or only with one parent. The corresponding estimates for the 15-year-olds varied from −0.08 to −0.28 and from −0.03 to −0.13 on these subscales. The 15-year-olds in joint physical custody were more likely than the 12-year-olds to report similar wellbeing levels on most outcomes to the children in nuclear families. Conclusions Children who spent equal time living with both parents after a separation reported better wellbeing than children in predominantly single parent care. This was

  12. Living in two homes-a Swedish national survey of wellbeing in 12 and 15 year olds with joint physical custody.

    Science.gov (United States)

    Bergström, Malin; Modin, Bitte; Fransson, Emma; Rajmil, Luis; Berlin, Marie; Gustafsson, Per A; Hjern, Anders

    2013-09-22

    The practice of joint physical custody, where children spend equal time in each parent's home after they separate, is increasing in many countries. It is particularly common in Sweden, where this custody arrangement applies to 30 per cent of children with separated parents. The aim of this study was to examine children's health-related quality of life after parental separation, by comparing children living with both parents in nuclear families to those living in joint physical custody and other forms of domestic arrangements. Data from a national Swedish classroom study of 164,580 children aged 12 and 15-years-old were analysed by two-level linear regression modelling. Z-scores were used to equalise scales for ten dimensions of wellbeing from the KIDSCREEN-52 and the KIDSCREEN-10 Index and analysed for children in joint physical custody in comparison with children living in nuclear families and mostly or only with one parent. Living in a nuclear family was positively associated with almost all aspects of wellbeing in comparison to children with separated parents. Children in joint physical custody experienced more positive outcomes, in terms of subjective wellbeing, family life and peer relations, than children living mostly or only with one parent. For the 12-year-olds, beta coefficients for moods and emotions ranged from -0.20 to -0.33 and peer relations from -0.11 to -0.20 for children in joint physical custody and living mostly or only with one parent. The corresponding estimates for the 15-year-olds varied from -0.08 to -0.28 and from -0.03 to -0.13 on these subscales. The 15-year-olds in joint physical custody were more likely than the 12-year-olds to report similar wellbeing levels on most outcomes to the children in nuclear families. Children who spent equal time living with both parents after a separation reported better wellbeing than children in predominantly single parent care. This was particularly true for the 15-year-olds, while the reported

  13. National guidelines for the management of Diabetes Mellitus: A ...

    African Journals Online (AJOL)

    Since 1994, the emphasis in the provision of health services in South Africa has shifted from hospital-based care to a community-based comprehensive primary health care system, especially important in the management of chronic diseases, such as Diabetes Mellitus (DM). The incidence of DM is rapidly increasing on a ...

  14. A high mean-HbA1c value 3-15 months after diagnosis of type 1 diabetes in childhood is related to metabolic control, macroalbuminuria, and retinopathy in early adulthood--a pilot study using two nation-wide population based quality registries.

    Science.gov (United States)

    Samuelsson, Ulf; Steineck, Isabelle; Gubbjornsdottir, Soffia

    2014-05-01

    Intensive treatment of patients with type 1 diabetes delays the onset of long-term complications. On the basis of the information from two nation-wide quality registers, we investigated to which extent HbA1c values 3-15 months after diagnosis in childhood are related to metabolic control, albuminuria, and retinopathy in early adulthood. In Sweden, physicians register all children and adolescents with type 1 diabetes mellitus in the Swedish Pediatric Quality Registry. After 18 yr of age, people with diabetes are followed by the Swedish National Diabetes Register. We identified 1543 children and adolescents with a mean age of 13.9 yr at diagnosis and a mean duration of type 1 diabetes mellitus of 7.1 yr. Children and adolescents with poor metabolic control (mean HbA1c ≥ 70 mmol/mol (8.6 %)) adjacent to diagnosis had a significantly higher mean HbA1c value years later as adults than did patients with a good metabolic control [metabolic group. Patients with a high mean HbA1c 3-15 months after diagnosis had significantly more often macroalbuminuria and retinopathy in early adulthood. Metabolic control adjacent to the diagnosis of type 1 diabetes in childhood or adolescence can predict metabolic control in early adulthood. It is therefore very important that pediatric diabetes teams identify key factors for successful early metabolic control. Actively using quality registries may be one such factor. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Selection of essential medicines for diabetes in low and middle income countries : a survey of 32 national essential medicines lists

    NARCIS (Netherlands)

    Taghipour Bazargani, Y.; de Boer, Anthonius; Leufkens, Hubert G M; Mantel-Teeuwisse, Aukje K

    2014-01-01

    AIM: Diabetes is a growing burden especially in low and middle income countries (LMICs). Inadequate access to diabetes care is of particular concern and selection of appropriate diabetes medicines on national essential medicines lists (NEMLs) is a first step in achieving adequate access. This

  16. Are Cryptocurrencies the Future of Money? : Whether a Transition to Cryptocurrency, as National Currency of Sweden, Would be Possible and What it Would Imply for the Swedish Society

    OpenAIRE

    Gartz, Madeleine; Linderbrandt, Ida

    2017-01-01

    The underlying technology of cryptocurrencies is a broadly discussed subject. In Sweden, a growing interest for digital assets and payment methods can be observed. The fact that this coincides with an increasing acceptance for cryptocurrencies creates interesting possibilities. Some claim that cryptocurrency could be the future mean of payment. The objective of this report is therefore to examine whether a cryptocurrency could replace the Swedish krona, and what such a transition would imply ...

  17. Prevalence of Chronic Complications in Korean Patients with Type 2 Diabetes Mellitus Based on the Korean National Diabetes Program

    Directory of Open Access Journals (Sweden)

    Sang Youl Rhee

    2011-10-01

    Full Text Available BackgroundThe Korean National Diabetes Program (KNDP cohort study is performing an ongoing large-scale prospective multicenter investigation to discover the pathogenesis of type 2 diabetes in Korean patients. This study was performed to examine the prevalence of chronic complications in patients with type 2 diabetes among those registered in the KNDP cohort within the past 4 years.MethodsThis study was performed between June 2006 and September 2009 at 13 university hospitals and included 4,265 KNDP cohort participants. Among the participants, the crude prevalence of microvascular and macrovascular diseases of those checked for diabetes-related complications was determined, and the adjusted standard prevalence and standardization of the general population prevalence ratio (SPR was estimated based on the 2005 Korean National Health and Nutrition Examination Survey (KNHANES population demographics.ResultsAmong the KNDP registrants, 43.2% had hypertension, 34.8% had dyslipidemia, 10.8% had macrovascular disease, and 16.7% had microvascular disease. The SPR of the KNDP registrants was significantly higher than that of the KNHANES subjects after adjusting for demographics in the KNHANES 2005 population. However, with the exception of cardiovascular disease in females, the standardized prevalence for the most complicated items in the survey was significantly higher than that in the KNHANES subjects.ConclusionThe prevalence of macrovascular disease and peripheral vascular disease were significantly higher in Korean patients with type 2 diabetes than in the normal population. However, no significant difference was noted in the prevalence of cardiovascular disease in females.

  18. The National Diabetes Education Program at 20 Years: Lessons Learned and Plans for the Future.

    Science.gov (United States)

    Siminerio, Linda M; Albright, Ann; Fradkin, Judith; Gallivan, Joanne; McDivitt, Jude; Rodríguez, Betsy; Tuncer, Diane; Wong, Faye

    2018-02-01

    The National Diabetes Education Program (NDEP) was established to translate findings from diabetes research studies into clinical and public health practice. Over 20 years, NDEP has built a program with partnership engagement that includes science-based resources for multiple population and stakeholder audiences. Throughout its history, NDEP has developed strategies and messages based on communication research and relied on established behavior change models from health education, communication, and social marketing. The program's success in continuing to engage diverse partners after 20 years has led to time-proven and high-quality resources that have been sustained. Today, NDEP maintains a national repository of diabetes education tools and resources that are high quality, science- and audience-based, culturally and linguistically appropriate, and available free of charge to a wide variety of audiences. This review looks back and describes NDEP's evolution in transforming and communicating diabetes management and type 2 diabetes prevention strategies through partnerships, campaigns, educational resources, and tools and identifies future opportunities and plans. © 2018 by the American Diabetes Association.

  19. Barrier Factors to the Completion of Diabetes Education in Korean Diabetic Adult Patients: Korea National Health and Nutrition Examination Surveys 2007-2012.

    Science.gov (United States)

    Kim, Hee-Tae; Lee, Kiheon; Jung, Se Young; Oh, Seung-Min; Jeong, Su-Min; Choi, Yoon-Jung

    2015-09-01

    Diabetes is a disease with high social burdens and is expected to increase gradually. A long-term management is essential for the treatment of diabetes, requiring patient self-cares. Diabetes education is important for such self-cares, but it does not sufficiently take place. In addition, little studies have been conducted on the barriers to the completion of diabetes education. This study, thus, aimed to analyze the factors related to the completion of diabetes education and investigate its barriers. Of 50,405 respondents to the fourth and fifth Korea National Health and Nutrition Examination Survey, a total of 3,820 were selected for the analysis, excluding those aged 29 or younger and those with missing values. The completion of diabetes education was set as a dependent variable and an analysis was made on the factors that affect the dependent variable. A multivariable logistic regression was employed for the analysis. Lower educational level was associated with less diabetes education, and the degree of diabetes education was lower in the group with male, the group that didn't have a family history or was not aware of a family history, the group that was not currently aware of diabetes and the group without a spouse. There was no difference in the completion of diabetes education by underlying diseases, family income level, age, residing area, economic activity status, insurance coverage, smoking, and drinking. Diabetes education is of importance for the treatment and management of diabetes. Currently, however, diabetes education is not sufficiently carried out in Korea. The completion rate of diabetes education was low in male, patients without or not knowing a family history, patients who were not currently aware of their diabetes, patients without a spouse, and patients with low educational level. Therefore, encouraging these patients to take the education will be a more effective approach to increase the completion rate of diabetes education.

  20. 2017 National Standards for Diabetes Self-Management Education and Support.

    Science.gov (United States)

    Beck, Joni; Greenwood, Deborah A; Blanton, Lori; Bollinger, Sandra T; Butcher, Marcene K; Condon, Jo Ellen; Cypress, Marjorie; Faulkner, Priscilla; Fischl, Amy Hess; Francis, Theresa; Kolb, Leslie E; Lavin-Tompkins, Jodi M; MacLeod, Janice; Maryniuk, Melinda; Mensing, Carolé; Orzeck, Eric A; Pope, David D; Pulizzi, Jodi L; Reed, Ardis A; Rhinehart, Andrew S; Siminerio, Linda; Wang, Jing

    2017-10-01

    Purpose The purpose of this study is to review the literature for Diabetes Self-Management Education and Support (DSMES) to ensure the National Standards for DSMES (Standards) align with current evidence-based practices and utilization trends. Methods The 10 Standards were divided among 20 interdisciplinary workgroup members. Members searched the current research for diabetes education and support, behavioral health, clinical, health care environment, technical, reimbursement, and business practice for the strongest evidence that guided the Standards revision. Results Diabetes Self-Management Education and Support facilitates the knowledge, skills, and ability necessary for diabetes self-care as well as activities that assist a person in implementing and sustaining the behaviors needed to manage their condition on an ongoing basis. The evidence indicates that health care providers and people affected by diabetes are embracing technology, and this is having a positive impact of DSMES access, utilization, and outcomes. Conclusion Quality DSMES continues to be a critical element of care for all people with diabetes. The DSMES services must be individualized and guided by the concerns, preferences, and needs of the person affected by diabetes. Even with the abundance of evidence supporting the benefits of DSMES, it continues to be underutilized, but as with other health care services, technology is changing the way DSMES is delivered and utilized with positive outcomes.

  1. Quantification of diabetes comorbidity risks across life using nation-wide big claims data.

    Directory of Open Access Journals (Sweden)

    Peter Klimek

    2015-04-01

    Full Text Available Despite substantial progress in the study of diabetes, important questions remain about its comorbidities and clinical heterogeneity. To explore these issues, we develop a framework allowing for the first time to quantify nation-wide risks and their age- and sex-dependence for each diabetic comorbidity, and whether the association may be consequential or causal, in a sample of almost two million patients. This study is equivalent to nearly 40,000 single clinical measurements. We confirm the highly controversial relation of increased risk for Parkinson's disease in diabetics, using a 10 times larger cohort than previous studies on this relation. Detection of type 1 diabetes leads detection of depressions, whereas there is a strong comorbidity relation between type 2 diabetes and schizophrenia, suggesting similar pathogenic or medication-related mechanisms. We find significant sex differences in the progression of, for instance, sleep disorders and congestive heart failure in diabetic patients. Hypertension is a highly sex-sensitive comorbidity with females being at lower risk during fertile age, but at higher risk otherwise. These results may be useful to improve screening practices in the general population. Clinical management of diabetes must address age- and sex-dependence of multiple comorbid conditions.

  2. Personality correlates of type 1 diabetes in a national representative sample

    Directory of Open Access Journals (Sweden)

    Iva Čukić

    2016-04-01

    Full Text Available We examined cross-sectional relationships between personality traits and type 1 diabetes. The sample (n=8490 was taken from the 1982-84 wave of the National Health and Nutrition Examination Survey Epidemiological Follow-up Study. We fit three logistic regression models to test whether neuroticism, extraversion, openness, or the Type A behavior pattern were associated with type 1 diabetes. Model 1 included sex, age, race/ethnicity and all four personality traits. Model 2 added depressive symptoms. Model 3 added body mass index, hypertension, and cigarette smoking status. Results regarding personality traits were consistent across all three models: higher neuroticism was associated with 39% higher chance of having type 1 diabetes per standard deviation increase and openness was associated with 26% decrease in that chance per standard deviation increase. Extraversion, and Type A personality were not associated with type 1 diabetes in our models.

  3. 77 FR 14027 - National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Mellitus Interagency...

    Science.gov (United States)

    2012-03-08

    .... at the Neuroscience Building, Room C, 6001 Executive Boulevard, Rockville, MD 20852. The meeting is... to learn about and discuss current and future diabetes programs in DMICC member organizations and to... days in advance of the meeting. Interested individuals and representatives or organizations should...

  4. [Realistic possibilities of using data sources in quality assessment of care of patients with diabetes in the Czech Republic: National Diabetes Information System].

    Science.gov (United States)

    Kvapil, Milan

    2015-11-01

    Diabetes mellitus is a serious health and economic problem of our time. Therapy is primarily perceived as prevention of the late complications of diabetes. Most pharmacoeconomic analyses state that the cost associated with the therapy of diabetes mellitus is largely spent on the therapy of its complications. The project of the National Diabetes Information System is based on the essential principle of automated collection of data which is available in digital form in the Czech Republic and which describes the quality and quantity of the care provided for patients with diabetes mellitus and its results. Benefits of the posited National Diabetes Information System embrace minimizing of selective loss of data, a comprehensive view of epidemiology, therapy and its results, possibility of following trends, inclusion of costs related to hospitalization and social benefits. Risks involve correct interpretation and a possible system error. If we succeeded in implementing such system in the Czech Republic, it would be the first fully automatic information system on such a comprehensive scale worldwide. The data describing the incidence and prevalence of diabetes mellitus, therapy structure, direct healthcare costs and induced costs of social payments is in the largest part available in digital form. This creates a basis for the foundation of the National Diabetes Information System which will allow for continuous quality assessment of care for patients with diabetes mellitus, including the related pharmacoeconomic and social impacts.

  5. Dietary Patterns and Type 2 Diabetes Mellitus in a First Nations Community.

    Science.gov (United States)

    Reeds, Jacqueline; Mansuri, Sudaba; Mamakeesick, Mary; Harris, Stewart B; Zinman, Bernard; Gittelsohn, Joel; Wolever, Thomas M S; Connelly, Phillip W; Hanley, Anthony

    2016-08-01

    Type 2 diabetes mellitus is a growing concern worldwide, particularly in Indigenous communities, which have undergone a marked nutrition transition characterized by reduced intakes of traditional foods and increased intakes of market foods. Few studies have assessed the relationships between differing dietary patterns and risk for type 2 diabetes in Indigenous communities in Canada. The objective of the study was to characterize dietary patterns using factor analysis (FA) and to relate these patterns to the incidence of type 2 diabetes after 10 years of follow up in a First Nations community in Ontario, Canada. We conducted a prospective analysis of 492 participants in the SLHDP who did not have diabetes at baseline (1993 to 1995) and were followed for 10 years. A food-frequency questionnaire was administered, and FA was used to identify patterns of food consumption. Multivariate logistic regression analyses determined associations of food patterns with incident type 2 diabetes, adjusting for sociodemographic and lifestyle confounders. At follow up, 86 participants had developed incident type 2 diabetes. FA revealed 3 prominent dietary patterns: Balanced Market Foods, Beef and Processed Foods and Traditional Foods. After adjustment for age, sex, waist circumference, interleukin-6 and adiponectin, the Beef and Processed Foods pattern was associated with increased risk for incident type 2 diabetes (OR=1.38; 95% CI 1.02, 1.86). In contrast, the Balanced Market Foods and Traditional Foods Patterns were not significantly associated with type 2 diabetes. Dietary interventions should encourage reduced consumption of unhealthful market foods, in combination with improvements in local food environments so as to increase access to healthful foods and reduce food insecurity in Indigenous communities. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  6. 76 FR 78286 - National Institute of Diabetes and Digestive and Kidney Diseases Notice of Closed Meeting

    Science.gov (United States)

    2011-12-16

    ....847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS) Dated... Kidney Diseases Special Emphasis Panel, PAR09-247: Ancillary Studies to the ongoing Clincal Research...

  7. 77 FR 66076 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-11-01

    ... Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes... Kidney Diseases Special Emphasis Panel; PAR-11-350 Research Using Biosamples from Selected Type 1...

  8. 77 FR 64816 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2012-10-23

    ... Program Evaluation. Date: December 17, 2012. Time: 11:00 a.m. to 2:00 p.m. Agenda: To review and evaluate... Domestic Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National...

  9. National study of the prevalence of gestational diabetes mellitus among Danish women from 2004 to 2012

    DEFF Research Database (Denmark)

    Jeppesen, Charlotte; Maindal, Helle T; Kristensen, Jette K

    2017-01-01

    AIMS: The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. We studied the prevalence of GDM from 2004 to 2012 in Danish women aged 15-49 years using registries with records of the diagnosis of GDM at delivery. METHODS: We conducted a national register-based study of 12...

  10. Trends in diabetic retinopathy and related medical practices among type 2 diabetes patients: Results from the National Insurance Service Survey 2006-2013.

    Science.gov (United States)

    Song, Su Jeong; Han, Kyungdo; Choi, Kyung Seek; Ko, Seung-Hyun; Rhee, Eun-Jung; Park, Cheol-Young; Park, Joong-Yeol; Lee, Ki-Up; Ko, Kyung-Soo

    2018-01-01

    The present study aimed to analyze the temporal changes in the prevalence, screening rate, visual impairments and treatment patterns of diabetic retinopathy in the Korean population over 8 years. This was a retrospective population-based study of Korean national health insurance beneficiaries aged 30 years or older with type 2 diabetes, obtained from the Korean National Health Insurance Claims database from 2006 to 2013 (n = 1,655,495 in 2006 and 2,720,777 in 2013). The annual prevalence rates of diabetes, diabetic retinopathy, dilated fundus examinations, visual impairment, laser treatment and vitrectomy, as determined based on diagnostic and treatment codes, were analyzed. There was a steady increase in the prevalence of diabetic retinopathy, from 14.3% in 2006 to 15.9% in 2013. However, the incidence of new diabetic retinopathy cases decreased from 6.7/100 person-years in 2006 to 5.6 in 2013. Approximately 98% of patients underwent at least one dilated fundus examination during the follow-up period. The prevalence of diabetic retinopathy peaked in the 60-69 years age group. The prevalence of diabetic retinopathy was higher in female than in male diabetes patients. The proportion of patients who underwent an annual dilated fundus examination improved from 24.3% in 2006 to 30.0% in 2013. Among patients with diabetic retinopathy, constant decreases in the proportions of those who received laser treatment (11.4% in 2006 to 6.9% in 2013) and who underwent vitrectomy (2.4% in 2006 to 1.7% in 2013) were noted. Additionally, a decreasing trend in the prevalence of visual impairment was noted among the patients with diabetic retinopathy, from 2% (4,820/237,267) in 2006 to 0.08% (3,572/431,964) in 2013. Although there was a rapid increase in the prevalence of diabetes in the Korean population in the past decade, the prevalence of diabetic retinopathy remained stable during the study period. However, just three out of 10 patients with diabetes underwent regular annual

  11. The Swedish Academy Dictionary Project

    African Journals Online (AJOL)

    rbr

    (bo.wendt@svenskaakademien.se), Dictionary Staff of the Swedish Academy,. Lund, Sweden. Abstract: The Swedish Academy Dictionary is one of the world's largest dictionary projects. Work on it was started in 1884 and it will be completed by 2017. The dictionary describes the writ- ten standard language of Swedish from ...

  12. Food Insecurity is Associated with Diabetes Mellitus: Results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999–2002

    National Research Council Canada - National Science Library

    Seligman, Hilary K; Bindman, Andrew B; Vittinghoff, Eric; Kanaya, Alka M; Kushel, Margot B

    2007-01-01

    ... diabetes.To evaluate whether there is an independent association between food insecurity and diabetes.Cross-sectional analysis of the nationally representative, population-based National Health and Nutrition Examination Survey (1999–2002 waves...

  13. Prevalence of type 2 diabetes mellitus (T2DM) in the adult Russian population (NATION study).

    Science.gov (United States)

    Dedov, Ivan; Shestakova, Marina; Benedetti, Massimo Massi; Simon, Dominique; Pakhomov, Iakov; Galstyan, Gagik

    2016-05-01

    To estimate type 2 diabetes mellitus (T2DM) prevalence in Russian adults. NATION is a national, epidemiological, cross-sectional study, conducted in Russia. In adults (aged 20-79 years), recruitment was stratified by age, sex, geographic region and settlement type to obtain a representative sample. Recruitment was in public areas with high numbers of people. T2DM was diagnosed by glycated haemoglobin A1c (HbA1c) levels (diabetes: HbA1c ≥6.5% [≥48mmol/mol]; pre-diabetes: HbA1c ≥5.7 to 26,620 subjects were available. Overall, 5.4% were diagnosed with T2DM (previously diagnosed: 2.5%; previously undiagnosed: 2.9%); 19.3% were pre-diabetic. T2DM prevalence increased with age (up to 70 years) and was higher among females than males (6.1% vs. 4.7%, pdiabetes and T2DM tended to increase with increasing body mass index. T2DM prevalence was higher in rural versus urban populations (6.7% vs. 5.0%, pdiabetes, T2DM prevalence was 5.4%, and 54% of subjects with diabetes were previously undiagnosed. These results may help to develop a new T2DM predictive, preventative and management programme in Russia. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  14. Factors associated with self-reported diabetes according to the 2013 National Health Survey.

    Science.gov (United States)

    Malta, Deborah Carvalho; Bernal, Regina Tomie Ivata; Iser, Betine Pinto Moehlecke; Szwarcwald, Célia Landmann; Duncan, Bruce Bartholow; Schmidt, Maria Inês

    2017-06-01

    To analyze the factors associated with self-reported diabetes among adult participants of the National Health Survey (PNS). Cross-sectional study using data of the PNS carried out in 2013, from interviews with adults (≥ 18 years) of 64,348 Brazilian households. The prevalence of self-reported diabetes, assessed by the question "Has a doctor ever told you that you have diabetes?," was related to sociodemographic characteristics, lifestyle, self-reported chronic disease, and self-evaluation of the health condition. Prevalence ratios were adjusted according to age, sex, and schooling by Poisson regression with robust variance. The diagnosis of diabetes was reported by 6.2% of respondents. Its crude prevalence was higher in women (7.0% vs. 5.4%), and among older adults, reaching 19.8% in the elderly. Black adults who received less schooling showed higher prevalence. Among those classified as obese, 11.8% reported having diabetes. Ex-smokers, those insufficiently active and those who consume alcohol abusively reported diabetes more often. Differences were not verified in eating habits among adults who reported, or did not, diabetes. A relation between diabetes and hypertension was found. After adjustment according to age, schooling and sex, diabetes was shown to be associated with higher age, lower schooling, past smoking, overweight and obesity, and hypertension, as well as with a self-declared poor state of health, indicating a pattern of risk factors common to many chronic non-communicable diseases and the association of the disease with morbidity. Analisar os fatores associados ao diabetes autorreferido entre adultos entrevistados na Pesquisa Nacional de Saúde (PNS). Estudo transversal utilizando dados da PNS realizada em 2013, a partir de entrevistas com adultos (≥ 18 anos) de 64.348 domicílios brasileiros. A prevalência de diabetes autorreferido, avaliada pela pergunta "Algum médico já lhe disse que o sr(a) tem diabetes?", foi relacionada a caracter

  15. Current national patterns of comorbid diabetes among acute ischemic stroke patients.

    Science.gov (United States)

    Towfighi, Amytis; Markovic, Daniela; Ovbiagele, Bruce

    2012-01-01

    Type 2 diabetes rates in the general population have risen with the growing obesity epidemic. Knowledge of temporal patterns and factors associated with comorbid diabetes among stroke patients may enable health practitioners and policy makers to develop interventions aimed at reducing diabetes rates, which may consequently lead to declines in stroke incidence and improvements in stroke outcomes. Using the Nationwide Inpatient Sample (NIS), a nationally representative data set of US hospital admissions, we assessed trends in the proportion of acute ischemic stroke (AIS) patients with comorbid diabetes from 1997 to 2006. Independent factors associated with comorbid diabetes were evaluated using multivariable logistic regression. Over the study period, the absolute number of AIS hospitalizations declined by 17% (from 489,766 in 1997 to 408,378 in 2006); however, the absolute number of AIS hospitalizations with comorbid type 2 diabetes rose by 27% [from 97,577 (20%) in 1997 to 124,244 (30%) in 2006, p targets for mitigating this trend. Copyright © 2012 S. Karger AG, Basel.

  16. Ecological aspects of historical and contemporary Swedish and Danish mortality

    DEFF Research Database (Denmark)

    Hansen, Hans Oluf

    2014-01-01

    preventive and curative measures introduced in the second half of the twentieth century? Hansen (2013) proposed a multivariate hazard model aiming at separating ecological factors in terms of endogenous biological from exogenous effects in human mortality. He explored some of its analytic potentials...... the early 1960s to now. This has been a blow to the national pride. Is the better contemporary Swedish life expectancy associated with selection spurred by different timing of the modern Swedish and Danish long term decline of mortality? Or could it be rooted in more expedient Swedish behavior and better...

  17. THE DIABETES EPIDEMIC IN CHINA: AN INTEGRATED REVIEW OF NATIONAL SURVEYS

    Science.gov (United States)

    Shen, Xiuhua; Vaidya, Anand; Wu, Shoulin; Gao, Xiang

    2017-01-01

    Objective To review trends in the prevalence and incidence of diabetes mellitus (DM) and related risk factors in China. Methods We searched the literature using PubMed, China Knowledge Resource Integrated Database, and China Wanfang Digital Database for large epidemiologic studies and national surveys. Results During the past 30 years (1980–2010), 7 national diabetes mellitus surveys were conducted in China mainland, indicating that the prevalence of DM has increased 17-fold, from 0.67 to 11.6% of the population. The prevalence of impaired glucose regulation (IGR, including impaired fasting glucose and impaired glucose tolerance) also increased, from 2.09 in 1994 to 27.2% in 2010. There was no national representative study of the incidence of diabetes to date; the reported incidence of type 2 diabetes during past 25 years in several cohort studies varied (2.7 to 15.8 per 1,000 person-years). Potential risk factors which could have contributed to the increasing prevalence and incidence of DM and IGR in the Chinese population include social and economic development, urbanization, dietary pattern, and Westernized lifestyle. Further, genetic studies have suggested that unique inheritable risk factors in the Chinese population may increase the risk for DM when compared to Caucasians. Conclusion DM and IGR have become epidemic in China. Public health strategies should focus on modifying lifestyle and dietary factors, particularly among those with a susceptible genetic background. PMID:27295015

  18. Long-term incidence of female-specific cancer after bariatric surgery or usual care in the Swedish Obese Subjects Study.

    Science.gov (United States)

    Anveden, Åsa; Taube, Magdalena; Peltonen, Markku; Jacobson, Peter; Andersson-Assarsson, Johanna C; Sjöholm, Kajsa; Svensson, Per-Arne; Carlsson, Lena M S

    2017-05-01

    To examine the long-term effects of bariatric surgery on female-specific cancer in women with obesity. The prospective, matched Swedish Obese Subjects (SOS) study was designed to examine outcomes after bariatric surgery. This study includes 1420 women from the SOS cohort that underwent bariatric surgery and 1447 contemporaneously matched controls who received conventional obesity treatment. Age was 37-60years and BMI was ≥38kg/m2. Information on cancer events was obtained from the Swedish National Cancer Registry. Median follow-up time was 18.1years (interquartile range 14.8-20.9years, maximum 26years). This study is registered with ClinicalTrials.gov, NCT01479452. Bariatric surgery was associated with reduced risk of overall cancer (hazard ratio=0.71; 95% CI 0.59-0.85; pbariatric surgery was associated with reduced risk of endometrial cancer (hazard ratio=0.56: 95% CI 0.35-0.89; p=0.014). In this long-term study, bariatric surgery was associated with reduced risk of female-specific cancer, especially in women with hyperinsulinemia at baseline. This project was supported by grants from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number R01DK105948 (the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health), the Swedish Research Council K2013-99X-22279-01, K2013-54X-11285-19, Sahlgrenska University Hospital ALF research grant and Swedish Diabetes Foundation. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Doctrinal Imbalance: A Study of Swedish Army Doctrine

    Science.gov (United States)

    2014-06-13

    patience with endless grammar and spelling corrections. Furthermore, Dr. Sterrett also involved his wife, military historian Dr. Corinne Mahaffey, and his...provocative statement of the Swedish supreme commander. The Swedish Army teaches that doctrine derives from a balance between resources, national...it comes to writing a new doctrine, but none of them evaluates doctrine against a specific scenario using the actual forces the doctrine is supposed

  20. Prevalence of footrot in Swedish slaughter lambs

    Directory of Open Access Journals (Sweden)

    Nyman Ann-Kristin J

    2011-04-01

    Full Text Available Abstract Background Footrot is a world-wide contagious disease in sheep and goats. It is an infection of the epidermis of the interdigital skin, and the germinal layers of the horn tissue of the feet. The first case of footrot in Swedish sheep was diagnosed in 2004. Due to difficulties in distinguishing benign footrot from early cases of virulent footrot and because there is no possibility for virulence testing of strains of Dichelobacter nodosus in Sweden, the diagnosis is based of the presence or absence of clinical signs of footrot in sheep flocks. Ever since the first diagnosed case the Swedish Animal Health Service has worked intensively to stop the spread of infection and control the disease at flock level. However, to continue this work effectively it is important to have knowledge about the distribution of the disease both nationally and regionally. Therefore, the aims of this study were to estimate the prevalence of footrot in Swedish lambs at abattoirs and to assess the geographical distribution of the disease. Methods A prevalence study on footrot in Swedish lambs was performed by visual examination of 2000 feet from 500 lambs submitted from six slaughter houses. Each foot was scored according to a 0 to 5 scoring system, where feet with score ≥2 were defined as having footrot. Moreover, samples from feet with footrot were examined for Dichelobacter nodosus by culture and PCR. Results The prevalence of footrot at the individual sheep level was 5.8%, and Dichelobacter nodosus was found by culture and PCR in 83% and 97% of the samples from feet with footrot, respectively. Some minor differences in geographical distribution of footrot were found in this study. Conclusions In a national context, the findings indicate that footrot is fairly common in Swedish slaughter lambs, and should be regarded seriously.

  1. Sweden's second national report under the Joint Convention on the safety of spent fuel management and on the safety of radioactive waste management. Swedish implementation of the obligations of the Joint Convention

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-12-01

    Article 32 of the Joint Convention calls for a self-assessment by each Contracting Party regarding compliance with the obligations of the Convention. Sweden's self-assessment has demonstrated compliance with all the obligations of the Convention, as shown in detail in sections B to K of this report. Having taken a very active part in the creation of the Joint Convention, Sweden wishes to emphasise the incentive character of the Convention. In Sweden's opinion, the Convention implies a commitment to continuous improvement of safety whenever operating experience, safety research or technical development indicates that there is room for such improvement. Continuous learning from experience and a proactive approach to safety are in fact corner stones of the current Swedish nuclear and radiation safety work, both for the industry and the regulatory bodies. Therefore, Sweden has found it important that its National Report highlights strong features in national practices, as well as areas in which improvements are justified. Implementation of such improvements should then be followed up in the National Reports to subsequent Review Meetings. The major events in the Swedish nuclear programme since the first report to the Convention was issued are: - The general safety regulations of SKI have been revised and issued as SKIFS 2004:1. - A commission of inquiry has been carried out in order to review and suggest improvements to the financing system. - The second unit of the twin nuclear power plant unit at Barsebaeck (Barsebaeck 2) was permanently shut down 31 May 2005. The first unit (Barsebaeck 1) was closed in 1999. - The research reactors R2 and R2-0 at the Studsvik site were permanently shut down 16 June 2005. - The Swedish Nuclear Fuel and Waste Management Co. (SKB) has announced its decision to take over operation of the interim storage facility for spent nuclear fuel (Clab). The operation of Clab is currently contracted out to OKG, who operates the three

  2. Health care among adults with self-reported diabetes mellitus in Brazil, National Health Survey, 2013.

    Science.gov (United States)

    Malta, Deborah Carvalho; Iser, Betine Pinto Moehlecke; Chueiri, Patricia Sampaio; Stopa, Sheila Rizzato; Szwarcwald, Celia Landmann; Schmidt, Maria Inês; Duncan, Bruce Bartholow

    2015-12-01

    To describe the care measurements provided to patients with self-reported diabetes mellitus in Brazil. Data from the Brazilian National Health Survey (2013) were used. This is a cross-sectional population-based study in which the subjects with self-reported diabetes mellitus answered questions concerning their use of health services and access to medicine. The prevalence of self-reported diabetes mellitus was 6.2%, while 11.5% of the population had never undergone a glucose testing. From the adults with diabetes mellitus, 80.2% had taken medications two weeks before the interview, 57.4% used the Popular Pharmacy Program, 73.2% received medical care, and 47.1% were cared for in the Health Basic Units. In 65.2%, the physician who cared for them in the last appointment was the same from previous ones, 95.3% of the patients were able to perform the required complementary examinations, and 83.3% could go to the appointments with a specialist. About 35.6 and 29.1% of the subjects with diabetes mellitus reported feet and eyes examination, respectively. About 13.4% declared previous hospitalization owing to diabetes or any complications, and 7.0% mentioned limitations in their daily activities owing to the disease. In general, women and the elderly people, those with higher education levels, white, and those living in the south and southeastern regions showed a higher prevalence of the disease and greater access to services, medicine, and appointments. The care reported by patients with diabetes, which is essential to maintain their quality of life and prevent serious outcomes, seemed, in most cases, to be adequate.

  3. Physical activity, glycemic control, and diabetic peripheral neuropathy: a national sample.

    Science.gov (United States)

    Loprinzi, Paul D; Hager, Kathy K; Ramulu, Pradeep Y

    2014-01-01

    To determine if physical activity and/or blood glycohemoglobin (HbA1c) are associated with the prevalence of peripheral neuropathy (PN) in a representative population of diabetics. Three hundred thirty-nine diabetic participants (40-85 yrs) taking part in 2003-2004 National Health and Nutrition Examination Survey were studied. Participants were defined as having peripheral neuropathy if examination determined ≥1 insensate area in either foot. Moderate-to-vigorous physical activity (MVPA) was objectively-measured using accelerometry. After adjustments, MVPA was not significantly associated with PN (OR=1.16; 95% CI: 0.48-2.78), nor was HbA1c (OR=0.55; 95% CI: 0.28-1.04). However, there was evidence of statistical interaction (OR=0.24; 95% CI: 0.06-0.87) between MVPA and HbA1c status, showing that diabetics engaging in higher levels of MVPA and having normal HgbA1c levels were less likely to have PN than what would be expected based on the individual effects of MVPA and HbA1c alone. Although MVPA was not directly associated with PN, these findings suggest that proper physical activity, coupled with good glycemic control, is associated with less neuropathy. Future longitudinal studies are required to evaluate whether physical activity and improved glycemic control may help prevent or slow the progression of diabetic end-organ damage, particularly diabetic neuropathy. © 2013.

  4. Acculturation and the Prevalence of Diabetes in US Latino Adults, National Health and Nutrition Examination Survey 2007–2010

    OpenAIRE

    O’Brien, Matthew J.; Alos, Victor A.; Davey, Adam; Bueno, Angeli; Whitaker, Robert C.

    2014-01-01

    Introduction US Latinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes. Acculturation may increase the risk of diabetes among all Latinos, but this hypothesis has not been studied in a nationally representative sample. The objective of this study was to test the hypothesis that acculturation was associated with an increased risk of diabetes in such a sample. Methods We conducted a cross-sectional analysis includin...

  5. Prevalence of eye pathology in a group of diabetic patients at National District Hospital Outpatient Department in Bloemfontein, South Africa

    Directory of Open Access Journals (Sweden)

    Joleen P. Cairncross

    2017-01-01

    Full Text Available Background: Diabetic retinopathy is the third most common cause of blindness after cataracts and glaucoma in South Africa. Primary healthcare interventions providing eye care services play an important role in preventing complications.Aim: To determine the prevalence of eye pathology in a group of diabetic patients at National District Hospital by screening for diabetes-associated ocular pathology.Setting: Outpatients Department run by Department of Family Medicine at National District Hospital in Bloemfontein from June to July 2014.Methods: Interviews were used to collect information regarding diabetic patients’ history of diabetes mellitus and if and when previous diabetic retinopathy screening was performed. Visual acuity was assessed, intra-ocular pressure measured and a non-mydriatic digital fundus camera used to screen for retinal pathology.Results: During the last year, only 4.5% of patients had their vision checked with a Snellen chart, and 16.5% were examined with an ophthalmoscope. Since diagnosis of diabetes, only 15.5% of patients were referred to an ophthalmologist. Patient referral was needed for 87 (42.9% cases for refractive disorders, 37 (18.2% for suspected glaucoma, 30 (14.8% for cataracts, and 22 (10.8% for diabetic retinopathy.Conclusion: This study confirms that glaucoma, cataracts and diabetic retinopathy are prevalent eye conditions among diabetic patients. Offering eye screening at primary healthcare level may contribute to early detection of eye pathology and timeous referral for sight-saving treatment.

  6. Adherence to anti-diabetic drugs among patients with Type 2 diabetes mellitus at Muhimbili National Hospital, Dar es Salaam, Tanzania- A cross-sectional study.

    Science.gov (United States)

    Rwegerera, Godfrey Mutashambara

    2014-01-01

    Adherence to diabetes mellitus treatment regimens among Type 2 diabetes patients in Tanzania has not been well documented. This study sought to assess adherence to antidiabetic drugs and associated factors among patients with Type 2 diabetes mellitus. A cross-sectional study was conducted among type 2 diabetes mellitus patients who were attending the Diabetic clinic of Muhimbili National hospital between May 2009 and February 2010. Assement of adherence to antidiabetic medications was based on patients' self-reported recall of skipped days without taking medications, over the past one week and three months. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS Inc. Chicago, Illinois version 16). The crude and adjusted odds ratio (COR/ AOR) and 95% Confidence Interval (CI) were performed to determine factors associated with anti-diabetic medications adherence and a p-value of 0.05 or less was considered statistically significant. Adherence rates to antidiabetic drugs were found to be 60.2% and 71.2% at one week and three months respectively. High cost of medication was significantly associated with anti-diabetic non-adherence. Adherence to anti-diabetic drugs significantly increased with an increase in number of non-diabetic medications. Adherence to antidiabetic drugs was found to be suboptimal. Patients with other medical conditions in addition to diabetes mellitus are more likely to adhere to anti-diabetic medications. There is a need for the responsible authorities to set policies that subsidize cost of anti-diabetic drugs to improve adherence and reduce associated complications.

  7. Addressing the gaps in diabetes care in first nations communities with the reorganizing the approach to diabetes through the application of registries (RADAR): the project protocol.

    Science.gov (United States)

    Eurich, Dean T; Majumdar, Sumit R; Wozniak, Lisa A; Soprovich, Allison; Meneen, Kari; Johnson, Jeffrey A; Samanani, Salim

    2017-02-06

    Type-2 diabetes rates in First Nations communities are 3-5 times higher than the general Canadian population, resulting in a high burden of disease, complications and comorbidity. Limited community nursing capacity, isolated environments and a lack of electronic health records (EHR)/registries lead to a reactive, disorganized approach to diabetes care for many First Nations people. The Reorganizing the Approach to Diabetes through the Application of Registries (RADAR) project was developed in alignments with federal calls for innovative, culturally relevant, community-specific programs for people with type-2 diabetes developed and delivered in partnership with target communities. RADAR applies both an integrated diabetes EHR/registry system (CARE platform) and centralized care coordinator (CC) service that will support local healthcare. The CC will work with local healthcare workers to support patient and community health needs (using the CARE platform) and build capacity in best practices for type-2 diabetes management. A modified stepped wedge controlled trial design will be used to evaluate the model. During the baseline phase, the CC will work with local healthcare workers to identify patients with type-2 diabetes and register them into the CARE platform, but not make any management recommendations. During the intervention phase, the CC will work with local healthcare workers to proactively manage patients with type-2 diabetes, including monitoring and recall of patients, relaying clinical information and coordinating care, facilitated through the shared use of the CARE platform. The RE-AIM framework will provide a comprehensive assessment of the model. The primary outcome measure will be a 10% improvement in any one of A1c, BP, or cholesterol over the baseline values. Secondary endpoints will address other diabetes care indicators including: the proportion of clinical measures completed in accordance with guidelines (e.g., foot and eye examination, receipt of

  8. Physical activity in outpatients with type 2 diabetes in a national hospital of Peru

    OpenAIRE

    Manzaneda, Ana Josefina; Facultad de Medicina. Universidad Peruana Cayetano Heredia. Lima, Perú.; Lazo-Porras, María; Facultad de Medicina. Universidad Peruana Cayetano Heredia. Lima, Perú.; Málaga, Germán; Facultad de Medicina. Universidad Peruana Cayetano Heredia. Lima, Perú. Hospital Nacional Cayetano Heredia. Lima, Perú.

    2015-01-01

    In order to determine the level of physical activity performed by outpatients with type 2 diabetes seen at a NationalHospital in Lima, Peru, we surveyed 120 patients with the International Physical Activity Questionnaire (IPAQ). 66% werewomen, the mean age was 61.6 years, and 70% had poor glycemic control. 20% of the patients qualified as inactive,68% as minimally active, and 12% had adequate physical activity. No relationship between physical activity, durationof disease, glycemic control, a...

  9. Bangladesh national guidelines on the management of tuberculosis and diabetes mellitus co-morbidity (summary).

    Science.gov (United States)

    Hossain, Mohammad Delwar; Ahmed, Jamal Uddin; Rahim, Muhammad Abdur; Musa, A K M; Latif, Zafar Ahmed

    2016-01-01

    Tuberculosis (TB) and diabetes mellitus (DM) have synergetic relationship. People with diabetes are 2-3 times at higher risk of getting active TB disease. On the other hand, TB or anti-TB treatment may cause glucose intolerance. The dual disease of DM and TB is more likely to be associated with atypical disease presentation, higher probability of treatment failure and complications. In most of the health-care delivery systems of the world, DM and TB are managed separately by two vertical health-care delivery programs in spite of clear interaction between the two diseases. Thus, there should be a uniform management service for TB-DM co-morbidity. Realizing this situation, Bangladesh Diabetic Samity (BADAS), a nonprofit, nongovernment organization for the management of diabetes in Bangladesh, with the patronization of TB CARE II Project funded by U.S. Agency for International Development (USAID), launched a project in 2013 titled BADAS-USAID TB Care II, Bangladesh with the goal of "Integrated approach to increase access to TB services for diabetic patients." One of the project objective and activity was to develop a national guideline for the management of TB-DM comorbidity. Thus, under the guidance of National Tuberculosis Control Program, of the Directorate General of Health Services, Government of the People's Republic of Bangladesh and World Health Organization (WHO), this guideline was developed in 2014. It is based on the existing "National Guidelines and Operational Manual for TB Control" (5 th edition) and guidelines for management of DM as per WHO and International Diabetes Federations. Along with that, expert opinions from public health experts and clinicians and "Medline"-searched literature were used to develop the guidelines. These guidelines illustrate the atypical presentation of the TB-DM co-morbidity, recommendations for screening, treatment, and follow-up of these patients and also recommendations in case of management of TB in patients with kidney

  10. Serum magnesium level is associated with type 2 diabetes in women with a history of gestational diabetes mellitus: the Korea National Diabetes Program study.

    Science.gov (United States)

    Yang, Sae Jeong; Hwang, Soon Young; Baik, Sei Hyun; Lee, Kwan Woo; Nam, Moon Suk; Park, Yong Soo; Woo, Jeong Taek; Kim, Young Seol; Park, Sunmin; Park, So-Young; Yim, Chang Hoon; Yoon, Hyun Koo; Kim, Sung-Hoon

    2014-01-01

    Gestational diabetes mellitus (GDM) is a strong predictor of postpartum prediabetes and transition to overt type 2 diabetes (T2DM). Although many reports indicate that low magnesium is correlated with deteriorated glucose tolerance, the association between postpartum serum magnesium level and the risk for T2DM in women with a history of GDM has not been evaluated. We analyzed postpartum serum magnesium levels and development of prediabetes and T2DM in women with prior GDM according to American Diabetes Association (ADA) criteria using the Korean National Diabetes Program (KNDP) GDM cohort. During a mean follow-up of 15.6 ± 2.0 months after screening, 116 women were divided into three groups according to glucose tolerance status. Ultimately, eight patients (6.9%) were diagnosed with T2DM, 59 patients (50.9%) with prediabetes, and 49 patients (42.2%) with normal glucose tolerance (NGT) after follow-up. The T2DM group had the lowest serum magnesium level (0.65 [0.63-0.68] mM/L) in the postpartum period, but there was no significant difference between the prediabetes group (0.70 [0.65-0.70] mM/L) and the NGT group (0.70 [0.65-0.70] mM/L) (P=0.073) Multiple logistic regression analysis showed that postpartum HOMA-IR was a significant predictor of both prediabetes and T2DM. Moreover, we found that postpartum serum magnesium level was also a possible predictor for T2DM development. Serum magnesium level in the postpartum period may be a possible predictor for T2DM development in women with a history of GDM.

  11. Self-reported frequency of sex as self-injury (SASI) in a national study of Swedish adolescents and association to sociodemographic factors, sexual behaviors, abuse and mental health.

    Science.gov (United States)

    Fredlund, Cecilia; Svedin, Carl Göran; Priebe, Gisela; Jonsson, Linda; Wadsby, Marie

    2017-01-01

    Sex as self-injury has become a concept in Swedish society; however it is a largely unexplored area of research, not yet conceptualized and far from accepted in the research field. The use of sex as a way of affect regulation is known in the literature and has, in interviews with young women who sell sex, been compared to direct self-injury, such as cutting or burning the skin. The aim of this study was to investigate the self-reported frequency of sex as self-injury and the association to sociodemographic factors, sexual orientation, voluntary sexual experiences, sexual risk-taking behaviors, sexual, physical and mental abuse, trauma symptoms, healthcare for psychiatric disorders and non-suicidal self-injury. A representative national sample of 5750 students in the 3rd year of Swedish high school, with a mean age of 18 years was included in the study. The study was questionnaire-based and the response rate was 59.7%. Mostly descriptive statistics were used and a final logistic regression model was made. Sex as self-injury was reported by 100 (3.2%) of the girls and 20 (.8%) of the boys. Few correlations to sociodemographic factors were noted, but the group was burdened with more experiences of sexual, physical and emotional abuse. Non-heterosexual orientation, trauma symptoms, non-suicidal self-injury and healthcare for suicide attempts, depression and eating disorders were common. Sex used as self-injury seems to be highly associated with earlier traumas such as sexual abuse and poor mental health. It is a behavior that needs to be conceptualized in order to provide proper help and support to a highly vulnerable group of adolescents.

  12. 78 FR 76849 - National Institute of Diabetes and Digestive and Kidney and Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-12-19

    ..., Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS) Dated: November 6...

  13. Salmonella in Swedish cattle

    OpenAIRE

    Ågren, Estelle

    2017-01-01

    In Sweden, all herds detected with salmonella are put under restrictions and measures aiming at eradication are required. The purpose of these studies was to provide a basis for decisions on how surveillance and control of salmonella in Swedish cattle can be made more cost-efficient. Results from a bulk milk screening were used to investigate seroprevalence of salmonella and to study associations between salmonella status and geographical location, local animal density, number of test pos...

  14. Swedish Family Policy.

    Science.gov (United States)

    Herrstrom, Staffan

    1986-01-01

    Family policy remains one of the leading issues of Swedish domestic politics. All parties are agreed that families with children must be given a better deal in the wake of the economic crisis. But how is this to be done and how quickly can it be achieved? Is the expansion of day nursery facilities to be speeded up, or are parents to be given a…

  15. Association of Sleep Duration with Stroke in Diabetic Patients: Analysis of the National Health Interview Survey.

    Science.gov (United States)

    Akinseye, Oluwaseun A; Ojike, Nwakile I; Akinseye, Leah I; Dhandapany, Perundurai S; Pandi-Perumal, Seithikurippu R

    2016-03-01

    Habitual sleep duration is increasingly being recognized as an important risk factor for stroke. We sought to describe the association between sleep duration and stroke in a cohort of individuals with diabetes. Data from the National Health Interview Survey for the years 2004-2013 were used. Only those answering "yes" to the question "Have you EVER been told by a doctor or other health professional that you have diabetes or sugar diabetes?" were included in the analysis. Sleep duration was categorized as short (≤6 hours), normal (7-8 hours), or long (≥9 hours). Self-reported diagnosis of stroke was the main outcome of interest. A total number of 26,364 self-reported diabetic individuals provided data for analysis. Stroke was reported in 9.1% of short sleepers, 16.1% of long sleepers, and 8.3% of normative sleepers (P sleep and stroke became nonsignificant after multivariate adjustment (OR = 1.15, 95% CI: .95-1.40, P = .16) except in white participants. The association between long sleep duration and stroke persisted (OR = 1.46, 95% CI: 1.16-1.84, P = .01), especially in males (OR = 1.62, 95% CI: 1.14-2.28) and in white participants (OR = 1.97, 95% CI: 1.47-2.65). In diabetic patients, abnormal sleep duration was associated with increased risk of stroke, and this association varied among different sex and ethnic groups. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  16. Prevalence of diabetes and impaired fasting glucose in Costa Rica: Costa Rican National Cardiovascular Risk Factors Survey, 2010.

    Science.gov (United States)

    Wong-McClure, Roy; Gregg, Edward W; Barcelo, Alberto; Sanabria-Lopez, Laura; Lee, Kahye; Abarca-Gomez, Leandra; Cervantes-Loaiza, Marvin; Luman, Elizabeth T

    2016-09-01

    The projected rising prevalence of diabetes and impaired fasting glucose (IFG) in developing countries warrants careful monitoring. The aim of this study was to present the results of the Costa Rican National Cardiovascular Risk Factors Surveillance System, which provides the first national estimates of diabetes and IFG prevalence among adults in Costa Rica. A cross-sectional survey of 3653 non-institutionalized adults aged ≥20 years (87.8% response rate) following the World Health Organization STEPwise approach was built on a probabilistic sample of the non-institutionalized population during 2010. Known diabetes was defined as self-reported diagnosis, the use of insulin, or hypoglycemic oral treatment as consequence of diabetes during at least the previous 2 weeks before the survey. Unknown diabetes was defined no self-reported diabetes but with venous blood concentrations of fasting glucose >125 mg/dL determined by laboratory testing. Impaired fasting glucose was defined as fasting glucose between 100 and 125 mg/dL among those without diabetes. The prevalence of diabetes and IFG prevalence was estimated according gender, body mass index (BMI), waist circumference (WC), educational level, and physical activity level. Overall diabetes prevalence was 10.8% (9.5% known and 1.3% unknown diabetes) and IFG prevalence was 16.5%. The prevalence of known diabetes was higher among women >65 years compared with men of the same age group. Both known and unknown diabetes were significantly associated with higher BMI, increased WC, and low education level (P = 0.01). The prevalence of diabetes and IFG in Costa Rica is comparable to that in developed countries and indicates an urgent need for effective preventive interventions. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  17. Diabetes MILES – The Netherlands: rationale, design and sample characteristics of a national survey examining the psychosocial aspects of living with diabetes in Dutch adults

    Directory of Open Access Journals (Sweden)

    Nefs Giesje

    2012-10-01

    Full Text Available Abstract Background As the number of people with diabetes is increasing rapidly worldwide, a more thorough understanding of the psychosocial aspects of living with this condition has become an important health care priority. While our knowledge has grown substantially over the past two decades with respect to the physical, emotional and social difficulties that people with diabetes may encounter, many important issues remain to be elucidated. Under the umbrella of the Diabetes MILES (Management and Impact for Long-term Empowerment and Success Study International Collaborative, Diabetes MILES – The Netherlands aims to examine how Dutch adults with diabetes manage their condition and how it affects their lives. Topics of special interest in Diabetes MILES - The Netherlands include subtypes of depression, Type D personality, mindfulness, sleep and sexual functioning. Methods/design Diabetes MILES – The Netherlands was designed as a national online observational study among adults with diabetes. In addition to a main set of self-report measures, the survey consisted of five complementary modules to which participants were allocated randomly. From September to October 2011, a total of 3,960 individuals with diabetes (40% type 1, 53% type 2 completed the battery of questionnaires covering a broad range of topics, including general health, self-management, emotional well-being and contact with health care providers. People with self-reported type 1 diabetes (specifically those on insulin pump therapy were over-represented, as were those using insulin among respondents with self-reported type 2 diabetes. People from ethnic minorities were under-represented. The sex distribution was fairly equal in the total sample, participants spanned a broad age range (19–90 years, and diabetes duration ranged from recent diagnosis to living with the condition for over fifty years. Discussion The Diabetes MILES Study enables detailed investigation of the

  18. Diabetes MILES – The Netherlands: rationale, design and sample characteristics of a national survey examining the psychosocial aspects of living with diabetes in Dutch adults

    Science.gov (United States)

    2012-01-01

    Background As the number of people with diabetes is increasing rapidly worldwide, a more thorough understanding of the psychosocial aspects of living with this condition has become an important health care priority. While our knowledge has grown substantially over the past two decades with respect to the physical, emotional and social difficulties that people with diabetes may encounter, many important issues remain to be elucidated. Under the umbrella of the Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Study International Collaborative, Diabetes MILES – The Netherlands aims to examine how Dutch adults with diabetes manage their condition and how it affects their lives. Topics of special interest in Diabetes MILES - The Netherlands include subtypes of depression, Type D personality, mindfulness, sleep and sexual functioning. Methods/design Diabetes MILES – The Netherlands was designed as a national online observational study among adults with diabetes. In addition to a main set of self-report measures, the survey consisted of five complementary modules to which participants were allocated randomly. From September to October 2011, a total of 3,960 individuals with diabetes (40% type 1, 53% type 2) completed the battery of questionnaires covering a broad range of topics, including general health, self-management, emotional well-being and contact with health care providers. People with self-reported type 1 diabetes (specifically those on insulin pump therapy) were over-represented, as were those using insulin among respondents with self-reported type 2 diabetes. People from ethnic minorities were under-represented. The sex distribution was fairly equal in the total sample, participants spanned a broad age range (19–90 years), and diabetes duration ranged from recent diagnosis to living with the condition for over fifty years. Discussion The Diabetes MILES Study enables detailed investigation of the psychosocial aspects of living

  19. Factors associated with fecal incontinence in a nationally representative sample of diabetic women.

    Science.gov (United States)

    De La Luz Nieto, Maria; Wu, Jennifer M; Matthews, Catherine; Whitehead, William E; Markland, Alayne D

    2015-10-01

    Fecal incontinence (FI) is a debilitating condition that significantly affects quality of life, and has been associated with multiple risk factors. Our goal was to assess the prevalence of FI among diabetic women and evaluate factors associated with FI in this population. The National Health and Nutrition Examination Survey (NHANES) from 2005 to 2010 was used to evaluate women with diabetes mellitus and FI. FI was defined as involuntary loss of mucus, liquid, or solid stool at least monthly. Severity was evaluated using the Fecal Incontinence Severity Index. Potential risk factors associated with FI were explored with weighted chi-squared statistics. Variables associated with FI in multivariable logistic regression analysis are reported with odds ratios (OR) and 95 % confidence intervals (95 % CI). Among 7,039 women, 13.6 % were diabetic, and 18.1 % of diabetic women reported FI compared to 8.4 % in the overall NHANES population (p diabetic women, FI was associated with advancing age (OR 1.3, 95 % CI 1.1 - 1.5), depression (OR 2.0 95 % CI 0.9 - 4.5), poorer health status (OR 1.9, 95 % CI 1.2 - 3.1), urinary incontinence (OR 3.5, 95 % CI 2.1 - 5.9) and bowel movement frequency of ≥21/week (OR 4.9, 95 % CI 2.3 - 10.6) in a multivariable logistic regression model adjusted for race, education level, BMI, comorbidities, prior hysterectomy, and stool consistency. FI affects one in five diabetic women and is strongly associated with high bowel movement frequency, a possible important modifiable factor that should be investigated further in prospective studies.

  20. Deliveries among teenage women – with emphasis on incidence and mode of delivery: a Swedish national survey from 1973 to 2010

    Science.gov (United States)

    2013-01-01

    Background Since the 1970-ies Sweden has actively developed strategies in social care, education and health care in order to counteract the negative consequences of adolescent parenthood. The aims of this study are to determine the annual incidence of singleton delivery among adolescents 1973–2010 and analyse obstetric and neonatal outcomes. Methods A retrospective cohort study, using data from the Swedish Medical Birth Register was conducted. All singleton deliveries in Sweden between 1973 and 2010 were included. Totally 1,941,940 women had 3,761,576 deliveries during the period. Analyses of obstetric and neonatal outcome were restricted to 1992–2010. Adolescents were subdivided into three groups: teenage births decreased significantly from 7.7 to 1.6%. Teenagers were more likely to deliver normally vaginally (aOR 1.70 (95%CI 1.64-1.75), less likely to have Caesarean section (aOR 0.61 (95%CI 0.58-0.64), and had a greater risk of delivering prematurely ( 1000 ml and perineal rupture were significantly lower among teenagers. Although the rate with Apgar score teenager’s neonates showed less fetal distress and meconium aspiration. Conclusion Adolescent births have steadily decreased in Sweden. Adolescents were more likely to be delivered vaginally than the adult women. The risks for obstetric maternal complications for adolescents were lower than for adult women except for the risk of prematurity. PMID:24207112

  1. The Pre-National Period’s Swedish Documents as a Source for the Study of the Russian Anthroponymy of Karelia

    Directory of Open Access Journals (Sweden)

    Irina A. Kyurshunova

    2016-12-01

    Full Text Available The article deals with the late 16th — early 17th centuries Swedish documents that reflect the anthroponymic system of Kexholm County, one of the territories ceded to Sweden by the Treaty of Stolbovo in 1617. This led to the formation of a unique onomasticon which combined Christian names of different religions and ethnic groups. The author analyses Russian anthroponymic units as documented in the above sources and conclude that they all have features proper to the Russian system of personal naming of that period: non-calendar personal names are preserved; calendar names are few in number and display a great variation of forms; russianised names have grammatical properties that distinguish them from corresponding West European Christian names; patronyms derived from those names are formed according to Russian patronymic patterns; naming formulas may vary, however, the binomial pattern ‘personal (calendar, most often modified, or non-calendar name + patronym’ prevails. The studied documents contain a considerable number of nicknames made up following Russian patterns and onomasiological models of naming. The author shows that all these features were widespread on the former Russian territories and in some neighbouring areas. Also, Russian onomasticon had a strong impact on the non-Slavic onomasticon which manifested itself in the emergence of modified Russian names and trinomial patterns of personal naming.

  2. Level of implementation of guidelines on screening and diagnosis of gestational diabetes: A national survey.

    Science.gov (United States)

    Pintaudi, Basilio; Fresa, Raffaella; Dalfrà, Mariagrazia; Marcone, Teresa; Dodesini, Alessandro Roberto; Napoli, Angela; Bonomo, Matteo

    2016-03-01

    To describe the degree of diffusion and acceptance of national guideline on screening and diagnosis of gestational diabetes (GDM) among Italian diabetes centers and to detect possible areas for benchmarking. In 2013 the Italian Diabetes in Pregnancy Study Group structured a national survey, focused on GDM screening and diagnostic procedures, that was administered to diabetologists. Overall, 122 diabetologists of 122 different diabetes centers (21.7% territorial, 78.3% hospital/University) completed the questionnaire. All respondents declared to execute a 75 g-oral glucose tolerance test (OGTT) as diagnostic test. Almost one in five centers preferred a universal screening procedure, the others executing a selective risk factors-based screening. In patients at high risk for GDM the OGTT was performed at 16-18 weeks' gestation in 84.0% of the cases; only 6.5% of respondents preferred to execute it as soon as possible; and 9.5% used to wait until 24-28 weeks' gestation. In the case of fasting plasma glucose (FPG) ≥ 5.1 mmol/l (92 mg/dl), two third of respondents used to proceed with the execution of the complete diagnostic OGTT, the others considering sufficient the FPG value for the diagnosis. Good level of reception of national recommendations was documented. The diagnostic procedure was generally accepted and applied. Some criticisms were specifically linked to the choice of universal or risk factor-based screening procedure, and to the right time for executing the OGTT in women at high risk. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. Diabetes

    OpenAIRE

    Smith, Paul

    2003-01-01

    Derbyshire general practitioner Stuart Bootle has had diabetes for 20 years. He speaks to Paul Smith, who has type 1 diabetes himself, about the trials and tribulations of being on the receiving end of NHS care

  4. Ascertainment of Outpatient Visits by Patients with Diabetes: The National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS)

    Science.gov (United States)

    Asao, Keiko; McEwen, Laura N.; Lee, Joyce M.; Herman, William H.

    2015-01-01

    Aims To estimate and evaluate the sensitivity and specificity of providers’ diagnosis codes and medication lists to identify outpatient visits by patients with diabetes. Methods We used data from the 2006 to 2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. We assessed the sensitivity and specificity of providers’ diagnoses and medication lists to identify patients with diabetes, using the checkbox for diabetes as the gold standard. We then examined differences in sensitivity by patients’ characteristics using multivariate logistic regression models. Results The checkbox identified 12,647 outpatient visits by adults with diabetes among the 70,352 visits used for this analysis. The sensitivity and specificity of providers’ diagnoses or listed diabetes medications were 72.3% (95% CI: 70.8% to 73.8%) and 99.2% (99.1% to 99.4%), respectively. Diabetic patients ≥75 years pf age, women, non-Hispanics, and those with private insurance or Medicare were more likely to be missed by providers’ diagnoses and medication lists. Diabetic patients who had more diagnosis codes and medications recorded, had glucose or hemoglobin A1c measured, or made office- rather than hospital-outpatient visits were less likely to be missed. Conclusions Providers’ diagnosis codes and medication lists fail to identify approximately one quarter of outpatient visits by patients with diabetes. PMID:25891975

  5. Ascertainment of outpatient visits by patients with diabetes: The National Ambulatory Medical Care Survey (NAMCS) and the National Hospital Ambulatory Medical Care Survey (NHAMCS).

    Science.gov (United States)

    Asao, Keiko; McEwen, Laura N; Lee, Joyce M; Herman, William H

    2015-07-01

    To estimate and evaluate the sensitivity and specificity of providers' diagnosis codes and medication lists to identify outpatient visits by patients with diabetes. We used data from the 2006 to 2010 National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey. We assessed the sensitivity and specificity of providers' diagnoses and medication lists to identify patients with diabetes, using the checkbox for diabetes as the gold standard. We then examined differences in sensitivity by patients' characteristics using multivariate logistic regression models. The checkbox identified 12,647 outpatient visits by adults with diabetes among the 70,352 visits used for this analysis. The sensitivity and specificity of providers' diagnoses or listed diabetes medications were 72.3% (95% CI: 70.8% to 73.8%) and 99.2% (99.1% to 99.4%), respectively. Diabetic patients ≥75 years of age, women, non-Hispanics, and those with private insurance or Medicare were more likely to be missed by providers' diagnoses and medication lists. Diabetic patients who had more diagnosis codes and medications recorded, had glucose or hemoglobin A1c measured, or made office- rather than hospital-outpatient visits were less likely to be missed. Providers' diagnosis codes and medication lists fail to identify approximately one quarter of outpatient visits by patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Studies in Swedish Energy Opinion

    Energy Technology Data Exchange (ETDEWEB)

    Holmberg, Soeren; Hedberg, Per

    2012-07-01

    the 1970s, energy production was politicized big time in the industrialized world. The birth of the environmental movement, the oil crises in 1973 - 74 and the beginning conflict surrounding civilian nuclear power, put energy issues center stage on the political agenda. Energy policies - especially related to the development of nuclear power - came to dominate election campaigns, like in Sweden in 1976 or be the subject of referendums, like in Austria in 1978 or in Sweden in 1980. Critical voices toward the peaceful use of nuclear power - having started in America before being exported to Europe - gained real strength and public support all over the Western world by the nuclear accident at the Three Mile Island plant in Harrisburg, Pennsylvania in 1979. The energy genie was out of the bottle and out to stay. Fueled by the nuclear meltdowns in Chernobyl in 1986 and in Fukushima in 2011 and supplemented by conflicts over how to reduce the use of oil and coal, how to sensibly exploit the waste gas reserves, and how to develop renewable energy sources based on sun, wind and waves – have made all kinds of energy issues the focal point of political contentions ever since the early 1970s. In Sweden, as in many other countries, energy policies - often with nuclear power in the center - have been one of the most fought-over policy areas during the last thirty-forty years. And the contentious character of energy policies is not limited to the elite level of politics - to politicians, to media pundits or to lobbyists. It is also manifest among ordinary citizens. Energy issues - nuclear power and wind power in particular - are highly polarizing among voters as well. Given this historic background, starting in the 1970s, it was rather natural that energy questions - featuring most prominently questions related to nuclear power - would be important parts of the voter surveys performed by the Swedish National Elections Studies (SNES) at the Univ. of Gothenburg. The first book

  7. Healthcare costs associated with progressive diabetic retinopathy among National Health Insurance enrollees in Taiwan, 2000-2004

    Directory of Open Access Journals (Sweden)

    Tsai Ming-Tsu

    2010-05-01

    Full Text Available Abstract Background Diabetic retinopathy is one of the most common microvascular complications of diabetes and one of the major causes of adult visual impairment in national surveys in Taiwan. This study aimed to identify the healthcare costs of Taiwan's National Health Insurance program on behalf of diabetic patients with stable or progressive retinopathy. Methods A retrospective cohort study was conducted with 4,988 medication-using diabetic retinopathy subjects ≥ 40 years of age under National Health Insurance Program coverage between 2000 and 2004. Study cohort subjects were recorded as having diabetic retinopathy according to ICD-9-CM codes. States of diabetic retinopathy were strategically divided into stable and progressive categories according to subjects' conditions at follow-up in 2004. Expenditures were calculated and compared for the years 2000 and 2004. Results During the 4-year follow-up (2000 through 2004, 4,116 subjects (82.5% of 4,988 diabetic subjects were in the stable category, and 872 (17.5% were in the progressive category. Average costs of those in the normal category increased by US $48 from US $1921 in 2000 to US $1969 in 2004 (p = 0.594, whereas costs for those progressing from normal to non-proliferative diabetic retinopathy (NPDR or proliferative diabetic retinopathy (PDR increased by US $1760, from US $1566 in 2000 to US $3326 in 2004 (p Conclusions This large-scale longitudinal study provides evidence that increased healthcare costs are associated with progressive diabetic retinopathy among diabetic NHI enrollees in Taiwan.

  8. Diabetes Risk and Disease Management in Later Life: A National Longitudinal Study of the Role of Marital Quality.

    Science.gov (United States)

    Liu, Hui; Waite, Linda; Shen, Shannon

    2016-11-01

    We assess the association between marital quality and both the risk of developing diabetes and the management of diabetes after its onset in later life. We use data from the first two waves of the National Social Life, Health, and Aging Project to estimate regression models with lagged dependent variables. The sample includes 1,228 married respondents, among whom 389 were diabetic. Those with either a reported diagnosis or with HbA1c ≥ 6.5% are identified diabetic. We categorize diabetic respondents into three groups: controlled, undiagnosed, and uncontrolled diabetes. We conduct factor analysis to construct positive and negative marital quality scales. For women, an increase in positive marital quality between Waves 1 and 2 is related to a lower risk of being diabetic at Wave 2, net of diabetes status at Wave 1; surprisingly, for men, an increase in negative marital quality between Waves 1 and 2 is related to both a lower risk of being diabetic at Wave 2 and a higher chance of controlling diabetes at Wave 2 after its onset. Our results challenge the traditional assumption that negative marital quality is always detrimental to health and encourage family scholars to distinguish different sources and types of negative marital quality. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Effect of Marriage on Risk for Onset of Alcohol Use Disorder: A Longitudinal and Co-Relative Analysis in a Swedish National Sample.

    Science.gov (United States)

    Kendler, Kenneth S; Lönn, Sara Larsson; Salvatore, Jessica; Sundquist, Jan; Sundquist, Kristina

    2016-09-01

    The authors sought to clarify the relationship between marriage and risk for alcohol use disorder. The association between marital status and risk for first registration for alcohol use disorder in medical, criminal, and pharmacy registries was assessed in a population-based Swedish cohort (N=3,220,628) using longitudinal time-dependent survival and co-relative designs. First marriage was associated with a substantial decline in risk for onset of alcohol use disorder in men (hazard ratio=0.41, 95% CI=0.40-0.42) and women (hazard ratio=0.27, 95% CI=0.26-0.28). This association was slightly stronger when the spouse had no lifetime alcohol use disorder, while marriage to a spouse with lifetime alcohol use disorder increased risk for subsequent alcohol use disorder registration in both men (hazard ratio=1.29, 95% CI=1.16-1.43) and women (hazard ratio=1.18, 95% CI=1.06-1.30). In both sexes, the protective effect of marriage was significantly stronger in those with than those without a family history of alcohol use disorder. In both men and women, the associations between marriage and risk for alcohol use disorder in cousins, half siblings, full siblings, and monozygotic twins discordant for marital status were as strong as that seen in the general population. First marriage to a spouse with no lifetime alcohol use disorder is associated with a large reduction in risk for alcohol use disorder. This association cannot be explained by standard covariates or, as indicated by co-relative analyses, familial genetic or shared environmental confounders. These results are consistent with the hypothesis that the psychological and social aspects of marriage, and in particular health-monitoring spousal interactions, strongly protect against the development of alcohol use disorder. The protective effects of marriage on risk for alcohol use disorder are increased in those at high familial risk for alcoholism.

  10. Influence of BMI on short-term surgical outcome after colorectal cancer surgery: a study based on the Swedish national quality registry.

    Science.gov (United States)

    Hede, Per; Sörensson, Marina Åkerblom; Polleryd, Per; Persson, Kamilla; Hallgren, Thomas

    2015-09-01

    It is well known that an increased body mass index (BMI) is associated with cancer development. Results from studies on colorectal cancer (CRC) treatment outcome and BMI are however conflicting. Our hypothesis was that a high as well as a low BMI will have negative effects on short-term outcome after CRC surgery. Data from the Swedish Colorectal Cancer Registry from 2007 to 2012 was analyzed. A total of 24,587 patients operated on for CRC were included in the study and divided into one of five categories for BMI. Operative bleeding, operating time, surgical complications, and 30-day mortality were compared between groups. Operative bleeding as well as operating time was significantly increased when comparing normal-weight patients to overweight (p < 0.001). 15.1% of normal-weight patients suffered from postoperative surgical complications. This was significantly increased with each BMI step but did not affect the 30-day mortality. However, underweight patients, on the other hand, had fewer complications (13.3%) but an increased 30-day mortality. Longer operating times and increased perioperative bleeding may be explanatory factors behind increased postoperative complication rates for CRC patients with higher BMI. In underweight patients, advanced disease may be a reason for a higher 30-day mortality. To improve outcome, specific precautions are suggested when operating on under- as well as overweight CRC patients. We also suggest that the registry introduces a better marker than BMI for central visceral fat-the link between obesity and cancer development. Further studies are needed to analyze the findings in detail and to study long-term effects.

  11. Role of environmental chemicals in diabetes and obesity: a National Toxicology Program workshop review.

    Science.gov (United States)

    Thayer, Kristina A; Heindel, Jerrold J; Bucher, John R; Gallo, Michael A

    2012-06-01

    There has been increasing interest in the concept that exposures to environmental chemicals may be contributing factors to the epidemics of diabetes and obesity. On 11-13 January 2011, the National Institute of Environmental Health Sciences (NIEHS) Division of the National Toxicology Program (NTP) organized a workshop to evaluate the current state of the science on these topics of increasing public health concern. The main objective of the workshop was to develop recommendations for a research agenda after completing a critical analysis of the literature for humans and experimental animals exposed to certain environmental chemicals. The environmental exposures considered at the workshop were arsenic, persistent organic pollutants, maternal smoking/nicotine, organotins, phthalates, bisphenol A, and pesticides. High-throughput screening data from Toxicology in the 21st Century (Tox21) were also considered as a way to evaluate potential cellular pathways and generate -hypotheses for testing which and how certain chemicals might perturb biological processes related to diabetes and obesity. Overall, the review of the existing literature identified linkages between several of the environmental exposures and type 2 diabetes. There was also support for the "developmental obesogen" hypothesis, which suggests that chemical exposures may increase the risk of obesity by altering the differentiation of adipocytes or the development of neural circuits that regulate feeding behavior. The effects may be most apparent when the developmental exposure is combined with consumption of a high-calorie, high-carbohydrate, or high-fat diet later in life. Research on environmental chemical exposures and type 1 diabetes was very limited. This lack of research was considered a critical data gap. In this workshop review, we outline the major themes that emerged from the workshop and discuss activities that NIEHS/NTP is undertaking to address research recommendations. This review also serves as

  12. Environmental Management at Swedish Universities

    Science.gov (United States)

    Arvidsson, Karin

    2004-01-01

    Since 1996, all Swedish public authorities, which includes most universities, have been made responsible for contributing to the sustainable development of the society. Swedish universities are thus required to submit annual environmental reports about their policies, structures and actions. This study provides a review of the activities that…

  13. Entrepreneurial Learning in Swedish Preschools: Possibilities for and Constraints on Children's Active Participation

    Science.gov (United States)

    Insulander, Eva; Ehrlin, Anna; Sandberg, Anette

    2015-01-01

    The website of the Swedish National Agency for Education states that preschools are to promote entrepreneurial learning. Many Swedish preschools, therefore, have started to work consciously with entrepreneurial learning as a way of fostering pupils' creativity and ability to make their own decisions. This article investigates whether and how…

  14. Acculturation and the Prevalence of Diabetes in US Latino Adults, National Health and Nutrition Examination Survey 2007–2010

    Science.gov (United States)

    Alos, Victor A.; Davey, Adam; Bueno, Angeli; Whitaker, Robert C.

    2014-01-01

    Introduction US Latinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes. Acculturation may increase the risk of diabetes among all Latinos, but this hypothesis has not been studied in a nationally representative sample. The objective of this study was to test the hypothesis that acculturation was associated with an increased risk of diabetes in such a sample. Methods We conducted a cross-sectional analysis including 3,165 Latino participants in the 2007–2010 National Health and Nutrition Examination Survey. Participants with doctor-diagnosed diabetes and participants without diagnosed diabetes who had glycated hemoglobin (HbA1C) values of 6.5% or higher were classified as having diabetes. An acculturation score, ranging from 0 (lowest) to 3 (highest), was calculated by giving 1 point for each of 3 characteristics: being born in the United States, speaking predominantly English, and living in the United States for 20 years or more. Logistic regression was used to determine the association between acculturation and diabetes. Results The prevalence of diabetes among Latinos in our sample was 12.4%. After adjusting for sociodemographic factors, the likelihood of diabetes (95% confidence interval [CI]) increased with level of acculturation— 1.71 (95% CI, 1.31–2.23), 1.63 (95% CI, 1.11–2.39), and 2.05 (95% CI, 1.27–3.29) for scores of 1, 2, and 3, respectively. This association persisted after further adjustment for body mass index (BMI), total dietary calories, and physical inactivity. Conclusion Acculturation was associated with a higher risk of diabetes among US Latinos, and this risk was only partly explained by BMI and weight-related behaviors. Future research should examine the bio-behavioral mechanisms that underlie the relationship between acculturation and diabetes in Latinos. PMID:25299982

  15. Acculturation and the prevalence of diabetes in US Latino Adults, National Health and Nutrition Examination Survey 2007-2010.

    Science.gov (United States)

    O'Brien, Matthew J; Alos, Victor A; Davey, Adam; Bueno, Angeli; Whitaker, Robert C

    2014-10-09

    US Latinos are growing at the fastest rate of any racial/ethnic group in the United States and have the highest lifetime risk of diabetes. Acculturation may increase the risk of diabetes among all Latinos, but this hypothesis has not been studied in a nationally representative sample. The objective of this study was to test the hypothesis that acculturation was associated with an increased risk of diabetes in such a sample. We conducted a cross-sectional analysis including 3,165 Latino participants in the 2007-2010 National Health and Nutrition Examination Survey. Participants with doctor-diagnosed diabetes and participants without diagnosed diabetes who had glycated hemoglobin (HbA1C) values of 6.5% or higher were classified as having diabetes. An acculturation score, ranging from 0 (lowest) to 3 (highest), was calculated by giving 1 point for each of 3 characteristics: being born in the United States, speaking predominantly English, and living in the United States for 20 years or more. Logistic regression was used to determine the association between acculturation and diabetes. The prevalence of diabetes among Latinos in our sample was 12.4%. After adjusting for sociodemographic factors, the likelihood of diabetes (95% confidence interval [CI]) increased with level of acculturation- 1.71 (95% CI, 1.31-2.23), 1.63 (95% CI, 1.11-2.39), and 2.05 (95% CI, 1.27-3.29) for scores of 1, 2, and 3, respectively. This association persisted after further adjustment for body mass index (BMI), total dietary calories, and physical inactivity. Acculturation was associated with a higher risk of diabetes among US Latinos, and this risk was only partly explained by BMI and weight-related behaviors. Future research should examine the bio-behavioral mechanisms that underlie the relationship between acculturation and diabetes in Latinos.

  16. The Association between Working Memory and Educational Attainment as Measured in Different Mathematical Subtopics in the Swedish National Assessment: Primary Education

    Science.gov (United States)

    Nyroos, Mikaela; Wiklund-Hornqvist, Carola

    2012-01-01

    The aim of this study was to examine the relationship between working memory capacity and mathematical performance measured by the national curriculum assessment in third-grade children (n = 40). The national tests concerned six subareas within mathematics. One-way ANOVA, two-tailed Pearson correlation and multiple regression analyses were…

  17. Patient safety as perceived by Swedish leaders.

    Science.gov (United States)

    Härenstam, Karin Pukk; Elg, Mattias; Svensson, Carina; Brommels, Mats; Ovretveit, John

    2009-01-01

    The purpose of this paper is to survey Swedish healthcare leaders' patient safety awareness, the priority they give to safety issues and their views on suitable safety management strategies. A total 623 leaders of a sample of 1,129 responded to a mail questionnaire (55 percent response rate). Descriptive statistics of the responses are presented as frequency distributions across respondent subgroups. Means were tested for similarity by a repetitive one-way ANOVA procedure. Homogeneous response groups were sought by hierarchical cluster analysis. Swedish healthcare leaders show relatively high safety awareness and how their organizations prioritize safety management. There is a marked polarization between leaders; half feel that the system works reasonably well, and that adequate funds are available to improve or maintain services. The other half thinks the system needs major change and calls for additional funding. A majority sees system errors as the main cause for adverse events; a substantial minority find human errors to be more important. Two-thirds were willing to make safety performance information on organizations and specialties public, one third was restrictive. Survey instruments used to explore leaders' patient safety views have not yet been rigorously tested against psychometric criteria. One hospital type was slightly over-represented and three regions somewhat under-represented in the respondent groups. This is the first systematic attempt to explore the views of Swedish healthcare leaders on patient safety. It provides input to a national strategy to improve patient safety.

  18. Prevalence and correlates of diabetes mellitus in Malawi: population-based national NCD STEPS survey.

    Science.gov (United States)

    Msyamboza, Kelias Phiri; Mvula, Chimwemwe J; Kathyola, Damson

    2014-05-12

    Previously considered as a disease of the affluent, west or urban people and not of public health importance, diabetes mellitus is increasingly becoming a significant cause of morbidity and mortality in sub-Saharan Africa. However, population-based data to inform prevention, treatment and control are lacking. Using the WHO STEPwise approach to chronic disease risk factor surveillance, a population-based, nationwide cross-sectional survey was conducted between July and September 2009 on participants aged 25-64 years. A multi-stage cluster sample design and weighting were used to produce a national representative data for that age range. Detailed findings on the magnitude of diabetes mellitus and impaired fasting blood glucose are presented in this paper. Fasting blood glucose measurement was conducted on 3056 participants (70.2% females, 87.9% from rural areas). The age- sex standardised population-based mean fasting blood glucose was 4.3 mmol/L (95% CI 4.1-4.4 mmol/L) with no significant differences by age, sex and location (urban/rural). The overall prevalence of impaired fasting blood glucose was 4.2% (95% CI 3.0%-5.4%). Prevalence of impaired blood glucose was higher in men than in women, 5.7% (95% CI 3.9%-7.5%) vs 2.7% (95% CI 1.6%- 3.8%), p prevalence of raised fasting blood glucose or currently on medication for diabetes was 5.6% (95% CI 2.6%- 8.5%). Although the prevalence of diabetes was higher in men than women, 6.5% (95% CI 2.6%-10.3%) vs 4.7% (95% CI 2.4%-7.0%), in rural than urban, 5.4% (95% CI 2.4%-8.4%) vs 4.4% (95% CI 2.8%-5.9%) and in males in rural than males in urban, 6.9% (95% CI 2.8%-11.0%) vs 3.2% (95% CI 0.1%-6.3%), the differences were not statistically significant, p > 0.05. Compared to previous estimates, prevalence of diabetes increased from prevalence of impaired fasting blood glucose and diabetes mellitus call for the implementation of primary healthcare approaches such as the WHO package for essential non-communicable diseases

  19. Acculturation and diabetes among Hispanics: evidence from the 1999-2002 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Mainous, Arch G; Majeed, Azeem; Koopman, Richelle J; Baker, Richard; Everett, Charles J; Tilley, Barbara C; Diaz, Vanessa A

    2006-01-01

    Hispanic individuals in the United States have a greater prevalence of diabetes mellitus than non-Hispanic white individuals; however, it is unclear whether Hispanics' risk of diabetes differs based on their level of acculturation. The purpose of our research was to examine acculturation among Hispanic Americans with respect to prevalence and control of diabetes. We conducted an analysis of the National Health and Nutrition Examination Survey (NHANES), 1999-2002, a nationally representative sample of the noninstitutionalized U.S. population. We evaluated data on Hispanic adults (> or = 18 years of age, unweighted n=2,696), analyzing diagnosed diabetes, glycemic blood pressure and lipid control, and diabetes complications according to acculturation as measured by language and birth outside the United States. Hispanics with low acculturation were more likely to be without a routine place for health care, have no health insurance, and have low levels of education. In adjusted analyses, individuals with low acculturation, measured by language, were more likely to have diabetes (odds ratio [OR] 1.90, 95% confidence interval [CI] 1.02, 3.54). Among individuals with diagnosed diabetes, no significant association was yielded between acculturation and diabetes control. However, individuals with low language acculturation were more likely to have the diabetes complication of peripheral neuropathy (OR 4.01, 95% CI 1.40, 11.48). Acculturation as measured through language is associated with diabetes and complications among Hispanics even after controlling for a variety of demographic characteristics including health insurance and education. The findings suggest that even within a "single" minority ethnic group, there are differences in disease prevalence and complications and access to health care.

  20. Cardiovascular Diseases and Life Expectancy in Adults With Type 2 Diabetes: A Korean National Sample Cohort Study.

    Science.gov (United States)

    Kang, Yu Mi; Cho, Yun Kyung; Lee, Seung Eun; Park, Joong-Yeol; Lee, Woo Je; Kim, Ye-Jee; Jung, Chang Hee

    2017-09-01

    Although type 2 diabetes is a strong risk factor for cardiovascular disease and mortality, information on its association with mortality and life expectancy according to cardiovascular comorbidities is limited, especially in Asia. Thus, this study assessed mortality and reductions in life expectancy associated with cardiometabolic multimorbidity. A total of 569,831 participants older than 30 years from Korean National Health Insurance Service-National Sample Cohort were enrolled between 2002 and 2006 and followed for a median of 12.0 years. They were categorized into five mutually exclusive groups according to baseline disease status, as follows: none (reference group); diabetes only; diabetes and stroke; diabetes and myocardial infarction (MI); and diabetes, stroke, and MI. Mortality rates and hazard ratios (HRs), reductions of life expectancy, and age-specific contributions to life expectancy were calculated by constructing life tables. The mortality rates per 1000 person-years were 6.85, 19.86, 67.17, 66.34, and 115.52 in the reference, diabetes only; diabetes and stroke; diabetes and MI; and diabetes, stroke, and MI groups, respectively. The corresponding HRs for all-cause mortality were 1.70 [95% confidence interval (CI), 1.66 to 1.75], 3.66 (95% CI, 3.32 to 4.03), 3.56 (95% CI, 3.06 to 4.14), and 4.79 (95% CI, 3.05 to 7.50) compared with the reference group. The estimated reductions in life expectancy were greater at younger ages and markedly increased with more cardiometabolic comorbidities. Young Asians with type 2 diabetes, especially those with cardiovascular comorbidity, did not live as long than their nondiabetic equivalents. Thus, these individuals require special attention to prevent further reductions in life expectancy.

  1. Estimating cardiovascular risk in patients with type 2 diabetes: a national multicenter study in Brazil

    Directory of Open Access Journals (Sweden)

    Gomes Marilia B

    2009-10-01

    Full Text Available Abstract According to Brazilian National Data Survey diabetes is the fifth cause for hospitalization and is one of the ten major causes of mortality in this country. Aims to stratify the estimated cardiovascular risk (eCVR in a population of type 2 diabetics (T2DM according to the Framingham prediction equations as well as to determine the association between eCVR with metabolic and clinical control of the disease. Methods From 2000 to 2001 a cross-sectional multicenter study was conducted in 13 public out-patients diabetes/endocrinology clinics from 8 Brazilian cities. The 10-year risk of developing coronary heart disease (CHD was estimated by the prediction equations described by Wilson et al (Circulation 1998. LDL equations were preferably used; when patients missed LDL data we used total cholesterol equations instead. Results Data from 1382 patients (59.0% female were analyzed. Median and inter-quartile range (IQ of age and duration of diabetes were 57.4 (51-65 and 8.8 (3-13 years, respectively without differences according to the gender. Forty-two percent of these patients were overweight and 35.4% were obese (the prevalence of higher BMI and obesity in this T2DM group was significantly higher in women than in men; p 20% in 738 (53.4%, intermediate in 202 (14.6% and low in 442 (32% patients. Men [25.1(15.4-37.3] showed a higher eCVR than women [18.8 (12.4-27.9 p

  2. Annual effective dose due to residential radon progeny in Sweden: Evaluations based on current risk projections models and on risk estimates from a nation-wide Swedish epidemiological study

    Energy Technology Data Exchange (ETDEWEB)

    Doi, M. [National Inst. of Radiological Sciences, Chiba (Japan); Lagarde, F. [Karolinska Inst., Stockholm (Sweden). Inst. of Environmental Medicine; Falk, R.; Swedjemark, G.A. [Swedish Radiation Protection Inst., Stockholm (Sweden)

    1996-12-01

    Effective dose per unit radon progeny exposure to Swedish population in 1992 is estimated by the risk projection model based on the Swedish epidemiological study of radon and lung cancer. The resulting values range from 1.29 - 3.00 mSv/WLM and 2.58 - 5.99 mSv/WLM, respectively. Assuming a radon concentration of 100 Bq/m{sup 3}, an equilibrium factor of 0.4 and an occupancy factor of 0.6 in Swedish houses, the annual effective dose for the Swedish population is estimated to be 0.43 - 1.98 mSv/year, which should be compared to the value of 1.9 mSv/year, according to the UNSCEAR 1993 report. 27 refs, tabs, figs.

  3. New national Biobank of The Danish Center for Strategic Research on Type 2 Diabetes (DD2)

    Science.gov (United States)

    Christensen, Henry; Nielsen, Jens Steen; Sørensen, Karina Meden; Melbye, Mads; Brandslund, Ivan

    2012-01-01

    Long-term storage of biological samples from patients has become increasingly important in studies of disease control and treatment. The first nationwide Danish diabetes project, ie, The Danish Center for Strategic Research in Type II Diabetes (DD2), aims to improve treatment and the long-term outcome of patients with newly diagnosed type 2 diabetes (T2D). The DD2 project includes establishment of a biobank with samples from 50,000 patients with newly diagnosed T2D. This paper describes how blood and urine samples from 10,000 patients per year are collected, handled, and stored. The biobank includes whole blood, DNA, and plasma and urine samples, all frozen at −80°C. Sampling tubes have been standardized and are sent to hospital outpatient clinics and general practitioners where samples are taken, handled, aliquoted, and returned by mail overnight in standardized cryostorage tubes. When received at the biobank, samples are frozen without further treatment. From each patient, 24 cryostorage tubes are stored. Each tube is labeled with a barcode that links the data to other information available in a clinical databank registry. When patients are enrolled in DD2, a questionnaire is filled out and a quality monitoring system ensures that patients, samples, and questionnaires can be linked together at all times. The biobank is located at Vejle Hospital and the Danish National Biobank at Statens Serum Institut. As of the end of March 2012, samples from 1186 patients have been stored, and currently samples from 8–10 patients arrive per day. We have established the first national biobank in Denmark where blood, DNA, and plasma and urine samples from patients with newly diagnosed T2D are systematically collected and stored. This biobank enables sophisticated analysis of genetic variation and response to treatment, as well as disease marker studies that better classify disease status, progression, and complications. PMID:23071400

  4. [Association between diabetes mellitus and cardiovascular disease in Chilean adults: analysis of the National Health Survey 2009-2010].

    Science.gov (United States)

    Arteaga, Antonio; Maiz, Alberto; Rigotti, Attilio; Cortés, Víctor

    2014-02-01

    Diabetes mellitus (DM) is a recognized atherosclerotic cardiovascular disease (ACVD) risk factor. This association has yet to be quantified in the Chilean population. To compare the frequency of ACVD between diabetic and non-diabetic Chilean subjects. Data was extracted from the Chile National Health Survey (ENS) performed in 2009-2010. DM diagnosis was made with fasting glucose. ACVD (coronary, cerebral and peripheral vascular disease) was established by self-report. Major cardiovascular risk factors were identified by clinical and laboratory assessment. A total of 5,416 adults (2,200 men and 3,216 women) were surveyed in ENS 2009-2010. Of these, 508 were diabetic and 375 reported ACVD. ACVD frequency was 16.1% and 6.1% in diabetic and non-diabetic subjects, respectively. In diabetic men, the frequency of ACVD steadily increased with age, from 5.1% to 22.1%. In diabetic women, the highest frequency of ACVD (17.4%) was found in ages ranging from 45 to 54 years. In people younger than 54 years, the odds ratio for ACVD in diabetic compared to non-diabetic subjects, was 3.59 in men (χ2 = 4.03 p < 0.03) and 5.26 in women (χ2 = 7.7 p < 0.007). Cardiovascular risk factors and metabolic syndrome were significantly more common in diabetic subjects with reported ACVD. DM is associated with an increased frequency of ACVD and cardiovascular risk factors in Chilean adults. In line with international reports, our findings suggest that DM is also a cardiovascular risk factor in Chile, particularly relevant for women.

  5. Swedish nuclear waste efforts

    Energy Technology Data Exchange (ETDEWEB)

    Rydberg, J.

    1981-09-01

    After the introduction of a law prohibiting the start-up of any new nuclear power plant until the utility had shown that the waste produced by the plant could be taken care of in an absolutely safe way, the Swedish nuclear utilities in December 1976 embarked on the Nuclear Fuel Safety Project, which in November 1977 presented a first report, Handling of Spent Nuclear Fuel and Final Storage of Vitrified Waste (KBS-I), and in November 1978 a second report, Handling and Final Storage of Unreprocessed Spent Nuclear Fuel (KBS II). These summary reports were supported by 120 technical reports prepared by 450 experts. The project engaged 70 private and governmental institutions at a total cost of US $15 million. The KBS-I and KBS-II reports are summarized in this document, as are also continued waste research efforts carried out by KBS, SKBF, PRAV, ASEA and other Swedish organizations. The KBS reports describe all steps (except reprocessing) in handling chain from removal from a reactor of spent fuel elements until their radioactive waste products are finally disposed of, in canisters, in an underground granite depository. The KBS concept relies on engineered multibarrier systems in combination with final storage in thoroughly investigated stable geologic formations. This report also briefly describes other activities carried out by the nuclear industry, namely, the construction of a central storage facility for spent fuel elements (to be in operation by 1985), a repository for reactor waste (to be in operation by 1988), and an intermediate storage facility for vitrified high-level waste (to be in operation by 1990). The R and D activities are updated to September 1981.

  6. Diabetes

    DEFF Research Database (Denmark)

    Damm, Peter; Mathiesen, Elisabeth R

    2015-01-01

    For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women with gestat......For >30 years, insulin has been the drug of choice for the medical treatment of gestational diabetes mellitus. However, the use of oral hypoglycaemic agents has increased during the past 1–2 decades, so a recent comparison of treatment with glibenclamide, metformin or insulin in women...... with gestational diabetes mellitus is highly relevant....

  7. Attack rates of dengue fever in Swedish travellers.

    Science.gov (United States)

    Rocklöv, Joacim; Lohr, Wolfgang; Hjertqvist, Marika; Wilder-Smith, Annelies

    2014-06-01

    Dengue is endemic in many countries visited by Swedish travellers. We aimed to determine the attack rate of dengue in Swedish travellers and analyse the trends over time and the geographical variation. We obtained the following data from the Swedish Institute for Communicable Disease Control for the y 1995-2010: number of Swedish residents with confirmed dengue, the country and year of infection. We also obtained registers on the Swedish annual air traveller arrivals to dengue endemic areas from the United Nations World Tourist Organization for the time period. We estimated attack rates with 95% confidence intervals (CI). In total, 925 Swedish travellers with confirmed dengue were reported. We found an increasing trend over time for most destinations. The majority of the dengue cases were acquired in Thailand (492 out of 925 travellers; 53%), with an attack rate of 13.6 (95% CI 12.7, 14.4) per 100,000 travellers. However, the 2 highest attack rates per 100,000 travellers were found for Sri Lanka (45.3, 95% CI 34.3, 56.4) and Bangladesh (42.6, 95% CI 23.8, 61.5). Information on attack rates in travellers is more helpful in guiding travel medicine practitioners than reports of absolute numbers, as the latter reflect travel preferences rather than the true risk. Although the majority of dengue infections in Swedish travellers were acquired in Thailand, the attack rates for dengue in travellers to Sri Lanka and Bangladesh were much higher. These data aid in refining information on the risk of dengue in travellers.

  8. Strategic analysis of Swedish agriculture

    OpenAIRE

    Fogelfors, Håkan; Wivstad, Maria; Eckersten, Henrik; Holstein, Fredrik; Johansson, Susanne; Verwijst, Theo

    2009-01-01

    This strategic analysis of Swedish agriculture – production systems and agricultural landscapes in a time of change – focuses on climate change, future availability of natural resources and economic regulation in a global food market. The background to the project was that the Faculty of Natural Resources and Agriculture of the Swedish University of Agricultural Sciences identified an urgent need to explore the implications and opportunities of coming changes for agricultural production syste...

  9. Diabetes

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — These datasets provide de-identified insurance data for diabetes. The data is provided by three managed care organizations in Allegheny County (Gateway Health Plan,...

  10. Prevalence, correlates and management of type 2 diabetes mellitus in Lebanon: findings from a national population-based study.

    Science.gov (United States)

    Costanian, Christy; Bennett, Kathleen; Hwalla, Nahla; Assaad, Shafika; Sibai, Abla M

    2014-09-01

    This study aims to examine the prevalence, associated risk factors and complications of diabetes, as well management and preventive care in Lebanon, a small, middle-income country of the Mediterranean region. Using a comprehensive multi-dimensional questionnaire, a cross-sectional national survey of 2195 Lebanese adults aged ≥25 years was conducted based on the WHO STEPwise guidelines. The outcome variable, diabetes, was self-reported. Measures for diabetes management included frequency of blood glucose testing and regular eye and foot exams. Macrovascular and microvascular complications were also recorded. The prevalence of type 2 diabetes was 8.5% (95%CI=7.3-9.7). Factors associated with an increased risk of having diabetes were: being divorced or widowed (OR=2.56; 95%CI=1.07-5.42) compared to single, being obese (OR=1.50, 95%CI=1.00-2.57), and having a family history of diabetes (OR=3.40;95%CI=2.48-5.19). Vigorous physical activity significantly decreased the odds of diabetes (OR=0.42; 95%CI=0.24-0.72). Diabetes management and self-care goals were as follows: 82% were not measuring their blood sugar via dextro on a daily basis, 64.2% did not have a foot exam within the past year, and 52.4% did not obtain the recommended yearly eye exam. The most common complications included heart disease (27.8%) and retinopathy (16.6%). Prevalence of diabetes in Lebanon was comparable to that found in the West, yet remained lower than estimates in other resource-rich neighboring countries. Adherence to management and self-care measures was sub-optimal resulting in high complication rates. Contextual factors play a role in increasing diabetes risk. Population-based interventions to enhance and promote self-management behaviors are essential to improve complication rates. Copyright © 2014. Published by Elsevier Ireland Ltd.

  11. Care of vision and ocular health in diabetic members of a national diabetes organization: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jervell Jak

    2008-07-01

    Full Text Available Abstract Background Regular examination and early treatment of diabetic retinopathy can prevent visual loss. The aim of the study was to describe the care of vision and ocular health in people with diabetes in Norway. Methods A cross-sectional questionnaire survey of a random sample (n = 1,887 of the Norwegian Diabetic Associations' (NDA members was carried out in 2005. Questions were asked about care of vision and ocular health, history of ocular disease and visual symptoms, general medical history and diabetes management. The study was approved by the Regional Committee for Medical Research Ethics. Results The response rate was 74%. Forty-four questionnaires with incomplete data regarding gender, age or type of diabetes were excluded, leaving 1352 cases (52% females for analysis. 451 (33% had type 1 and 901 (67% had type 2 diabetes, the mean duration of diabetes was respectively, 22 (sd ± 14 and 10 (sd ± 9 years. In all 1,052 (78% had their eyes examined according to guidelines and 1,169 (87% confirmed to have received information about regular eye examinations. One in two recalled to have received such information from their general practitioner. To have received information about the importance of eye examinations (PR 3.1, 95% CI 2.4 to 4.0, and diabetes duration > 10 years (PR 1.2, 95% CI 1.2 to 1.3, were independently associated with reporting regular eye examinations. A history of diabetic retinopathy was reported by 178 (13% responders, of which 101 (57% reported a history of laser treatment. Responders who had regular eye examinations reported more frequently a history of diabetic retinopathy (19% vs. 5%, p Conclusion Eight out of ten diabetic members of the NDA had their eyes examined according to current guidelines and the majority was well informed about the risk of vision loss due to diabetes. The results indicate that the reported history of diabetic retinopathy likely underestimates the prevalence of retinopathy.

  12. The perception of aquaculture on the Swedish West Coast

    DEFF Research Database (Denmark)

    Thomas, Jean-Baptiste E.; Nordström, Leif Jonas; Risén, Emma

    2017-01-01

    Efforts are on the way on the Swedish West Coast to develop the capacity for cultivation of marine resources, notably of kelps. Given that this is a region of great natural and national heritage, public opposition to marine developments has been identified as a possible risk factor. This survey...

  13. Patterns of Authority in Swedish Higher Education and Research.

    Science.gov (United States)

    Andren, Carl-Gustaf

    1983-01-01

    The current structure of governance and decision making in Swedish higher education and the effects of recent national reform on perceived and actual autonomy at the central, regional, and local levels are discussed. An initial desire for more decentralized decision making has turned to increasing demand for more guidance by central organizations.…

  14. Peripheral arterial disease among adult diabetic patients attending a large outpatient diabetic clinic at a national referral hospital in Uganda: a descriptive cross sectional study.

    Directory of Open Access Journals (Sweden)

    Raymond Mbayo Mwebaze

    Full Text Available BACKGROUND: Peripheral arterial disease (PAD is one of the recognised diabetic macro vascular complications. It is a marker of generalised systemic atherosclerosis and is closely associated with symptomatic coronary and cerebrovascular disease, hence significant morbidity and mortality. Among African adult diabetic populations, screening and diagnosis of PAD is frequently suboptimal. The aim of this study was to determine the prevalence and associated clinical factors of PAD in adult ambulatory diabetic patients attending the outpatient diabetic clinic of Mulago national referral and teaching hospital, Kampala Uganda. METHODS: In this descriptive cross sectional study, 146 ambulatory adult diabetic patients were studied. Information about their socio-demographic and clinical characteristics, fasting lipid profile status, blood pressure, glycated haemoglobin (HbA1c levels and presence of albuminuria was collected using a pre tested questionnaire. Measurement of ankle brachial index (ABI to assess for PAD, defined as a ratio less than 0.9 was performed using a portable 5-10 MHz Doppler device. Clinical factors associated with PAD were determined by comparing specific selected characteristics in patients with PAD and those without. RESULTS: The mean age/standard deviation of the study participants was 53.9/12.4 years with a male predominance (75, 51.4%. PAD was prevalent in 57 (39% study participants. Of these, 34 (59.6% had symptomatic PAD. The noted clinical factors associated with PAD in this study population were presence of symptoms of intermittent claudication and microalbuminuria. CONCLUSIONS: This study documents a high prevalence of PAD among adult ambulatory Ugandan diabetic patients. Aggressive screening for PAD using ABI measurement in adult diabetic patients should be emphasised in Uganda especially in the presence of symptoms of intermittent claudication and microalbuminuria.

  15. Sandy Lake Health and Diabetes Project: A community-based intervention targeting type 2 diabetes and its risk factors in a First Nations community

    Directory of Open Access Journals (Sweden)

    Kara Elizabeth Kakekagumick

    2013-11-01

    Full Text Available The Sandy Lake Health and Diabetes Project (SLHDP was initiated in 1991 as a partnership between Sandy Lake First Nation and researchers interested in addressing the high rates of type 2 diabetes mellitus (T2DM in the community. Following the expressed wishes of the community, the SLHDP has encompassed a variety of community-wide interventions and activities including: community surveys to document T2DM prevalence and risk factors, the Northern Store program aimed at increasing the availability and knowledge of healthy food options, a home visit program for the prevention and management of T2DM, a local diabetes radio show, a school diabetes curriculum for grades 3 and 4, a community-wide walking trail to encourage increased physical activity, youth diabetes summer camps, and a variety of community events focusing on nutrition and physical activity. Over the twenty-two year existence of the SLHDP, the community has taken ownership of the program and activities have evolved in alignment with community needs and priorities. This paper discusses the history, implementation, evaluation and outcomes of the SLHDP and describes its sustainability. The SLHDP is a model of culturally appropriate participatory research that is iterative, with reciprocal capacity building for both key community stakeholders and academic partners.

  16. Diabetes Management and Education in Older Adults: The Development of a National Consensus of Key Research Priorities.

    Science.gov (United States)

    Sherifali, Diana; Meneilly, Graydon

    2016-02-01

    Diabetes in older adults is increasing in its prevalence and complexity. To date, little research has been done to inform current diabetes management, including education and support, in older adults in Canada. The objective of this interactive national workshop was to develop key research priorities for future research related to diabetes in older adults. Workshop participants comprised interprofessional healthcare providers, decision makers and policy makers from across Canada. Approximately 30 individuals attended an interactive 2-day meeting that included expert presentations and group consensus building using an electronic meeting system as well as nominal group techniques. The results of the 2-day meeting found more than 50 ideas that were summarized into 5 overall themes, with 14 subquestions, reflecting areas such as 1) identifying relevant outcomes for patients, providers and decision makers; 2) diabetes prevention; 3) the impact of diabetes on older adults and informal caregivers; 4) risk assessment tools and 5) effective models of care across a variety of healthcare settings. To date, this workshop is the first of its kind and follows suit with other international working groups and associations. The research priorities developed through consensus from this workshop set forward a research agenda for diabetes in older adults in Canada. Copyright © 2015 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

  17. Challenges to the provision of diabetes care in first nations communities: results from a national survey of healthcare providers in Canada

    Directory of Open Access Journals (Sweden)

    Macaulay Ann C

    2011-10-01

    Full Text Available Abstract Background Aboriginal peoples globally, and First Nations peoples in Canada particularly, suffer from high rates of type 2 diabetes and related complications compared with the general population. Research into the unique barriers faced by healthcare providers working in on-reserve First Nations communities is essential for developing effective quality improvement strategies. Methods In Phase I of this two-phased study, semi-structured interviews and focus groups were held with 24 healthcare providers in the Sioux Lookout Zone in north-western Ontario. A follow-up survey was conducted in Phase II as part of a larger project, the Canadian First Nations Diabetes Clinical Management and Epidemiologic (CIRCLE study. The survey was completed with 244 healthcare providers in 19 First Nations communities in 7 Canadian provinces, representing three isolation levels (isolated, semi-isolated, non-isolated. Interviews, focus groups and survey questions all related to barriers to providing optimal diabetes care in First Nations communities. Results the key factors emerging from interviews and focus group discussions were at the patient, provider, and systemic level. Survey results indicated that, across three isolation levels, healthcare providers' perceived patient factors as having the largest impact on diabetes care. However, physicians and nurses were more likely to rank patient factors as having a large impact on care than community health representatives (CHRs and physicians were significantly less likely to rank patient-provider communication as having a large impact than CHRs. Conclusions Addressing patient factors was considered the highest impact strategy for improving diabetes care. While this may reflect "patient blaming," it also suggests that self-management strategies may be well-suited for this context. Program planning should focus on training programs for CHRs, who provide a unique link between patients and clinical services

  18. Deregulation and internationalisation - impact on the Swedish nuclear industry

    Energy Technology Data Exchange (ETDEWEB)

    Haukeland, Sverre R. [Swedish Nuclear Society, Vattenfall Research and Development, 162 89 Stockholm (Sweden)

    2010-07-01

    The deregulation of the Swedish electricity market in 1996 was well known in advance, and the nuclear power plants in Sweden, as well as their main suppliers, made early preparations for a this new situation. In a study - performed by the author at Malardalen University in Sweden - it is concluded that the electricity industry, including the nuclear power plants, was fundamentally transformed in conjunction with market liberalisation. Two large foreign companies, E-on and Fortum, entered the Swedish market and became part-owners of the nuclear plants. After deregulation, the electricity market in Sweden is dominated by these two companies and the large national company Vattenfall. Similarly, Vattenfall has recently grown into an international energy company, acquiring generation capacity in Northern Europe outside of Sweden, including nuclear power plants in Germany. Restructuring of the nuclear industry on the supplier side started in the 1980's, when the Swedish company ASEA and BBC of Switzerland merged to become ABB. Several years later the Swedish nuclear plant supplier ABB-Atom became part of Westinghouse Electric Company, today owned by Toshiba. The Swedish experience thus confirms an international trend of mergers and consolidation in the nuclear industry. (authors)

  19. Women and Diabetes

    Medline Plus

    Full Text Available ... you need depends on your health and the type of diabetes you have. Use these resources to ... from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression ...

  20. Contemporary risk of hip fracture in type 1 and type 2 diabetes: a national registry study from Scotland.

    Science.gov (United States)

    Hothersall, Eleanor J; Livingstone, Shona J; Looker, Helen C; Ahmed, S Faisal; Cleland, Steve; Leese, Graham P; Lindsay, Robert S; McKnight, John; Pearson, Donald; Philip, Sam; Wild, Sarah H; Colhoun, Helen M

    2014-01-01

    The purpose of this study was to compare contemporary risk of hip fracture in type 1 and type 2 diabetes with the nondiabetic population. Using a national diabetes database, we identified those with type 1 and type 2 diabetes who were aged 20 to 84 years and alive anytime from January 1, 2005 to December 31, 2007. All hospitalized events for hip fracture in 2005 to 2007 for diabetes patients were linked and compared with general population counts. Age- and calendar-year-adjusted incidence rate ratios were calculated by diabetes type and sex. One hundred five hip fractures occurred in 21,033 people (59,585 person-years) with type 1 diabetes; 1421 in 180,841 people (462,120 person-years) with type 2 diabetes; and 11,733 hip fractures over 10,980,599 person-years in the nondiabetic population (3.66 million people). Those with type 1 diabetes had substantially elevated risks of hip fracture compared with the general population incidence risk ratio (IRR) of 3.28 (95% confidence interval [CI] 2.52-4.26) in men and 3.54 (CI 2.75-4.57) in women. The IRR was greater at younger ages, but absolute risk difference was greatest at older ages. In type 2 diabetes, there was no elevation in risk among men (IRR 0.97 [CI 0.92-1.02]) and the increase in risk in women was small (IRR 1.05 [CI 1.01-1.10]). There remains a substantial elevation relative risk of hip fracture in people with type 1 diabetes, but the relative risk is much lower than in earlier studies. In contrast, there is currently little elevation in overall hip fracture risk with type 2 diabetes, but this may mask elevations in risk in particular subgroups of type 2 diabetes patients with different body mass indexes, diabetes duration, or drug exposure. © 2014 American Society for Bone and Mineral Research.

  1. Factors contributing to the differences in work related injury rates between Danish and Swedish construction workers

    DEFF Research Database (Denmark)

    Spangenberg, S.; Baarts, C.; Dyreborg, J.

    2002-01-01

    of injury risk factors at group and individual level for Danish and Swedish workers. LTI-rates and injury risk factors were compared for Danish and Swedish workers during the construction of the combined rail and road link across the 16-km wide sound, Oresund, between Denmark and Sweden. The comparison......Comparison of Danish and Swedish national occupational injury statistics shows that the reported LTI-rate, or number of reported lost-time injuries per million working hours, for Danish construction workers is significantly higher than the reported LTI-rate for Swedish construction workers...... showed that the LTI-rate of the Danish construction workers was approximately fourfold the LTI-rate of the Swedish construction workers. Factors at the micro-level (group and individual level) e.g. differences in education and experience, training and learning, and attitude were important...

  2. Application of a national administrative case definition for the identification of pre-existing diabetes mellitus in pregnancy.

    Science.gov (United States)

    Allen, V M; Dodds, L; Spencer, A; Cummings, E A; MacDonald, N; Kephart, G

    2012-06-01

    Accurate ascertainment of pregnant women with pre-existing diabetes allows for the comprehensive surveillance of maternal and neonatal outcomes associated with this chronic disease. To determine the accuracy of case definitions for pre-existing diabetes mellitus when applied to a pregnant population, a cohort of women who were pregnant in Nova Scotia, Canada, between 1991 and 2003 was obtained from a population-based provincial perinatal database, the Nova Scotia Atlee Perinatal Database (NSAPD). Person-level data from administrative databases using hospital discharge abstract data and outpatient physician services data were linked to this cohort. Various algorithms for defining diabetes mellitus from the administrative data, including the algorithm suggested by the National Diabetes Surveillance System (NDSS), were compared to a reference standard definition from the NSAPD. Validation of the NDSS case definition applied to this pregnant population demonstrated a sensitivity of 87% and a positive predictive value (PPV) of 66.4%. Use of ICD-9 and ICD-10 diagnostic codes among hospitalizations with diabetes mellitus in pregnancy showed important increases in sensitivity and PPV, especially for those pregnancies delivered in tertiary centres. In this population, pregnancy-related administrative data from the hospitalization database alone appear to be a more accurate data source for identifying pre-existing diabetes than applying the NDSS case definition, particularly when pregnant women are delivered in a tertiary hospital. Although the NDSS definition of diabetes performs reasonably well compared to a reference standard definition of diabetes, using this definition for evaluating maternal and perinatal outcomes associated with diabetes in pregnancy will result in a certain degree of misclassification and, therefore, biased estimates of outcomes.

  3. Swedish encapsulation station review

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, Sven Olof; Brunzell, P.; Heibel, R.; McCarthy, J.; Pennington, C.; Rusch, C.; Varley, G. [NAC International, Zuerich (Switzerland)

    1998-06-01

    In the Encapsulation Station (ES) Review performed by NAC International, a number of different areas have been studied. The main objectives with the review have been to: Perform an independent review of the cost estimates for the ES presented in SKB`s document `Plan 1996`. This has been made through comparisons between the ES and BNFL`s Waste Encapsulation Plant (WEP) at Sellafield as well as with the CLAB facility. Review the location of the ES (at the CLAB site or at the final repository) and its interaction with other parts of the Swedish system for spent fuel management. Review the logistics and plant capacity of the ES. Identify important safety aspects of the ES as a basis for future licensing activities. Based on NAC International`s experience of casks for transport and storage of spent fuel, review the basic design of the copper/steel canister and the transport cask. This review insides design, manufacturing, handling and licensing aspects. Perform an overall comparison between the ES project and the CLAB project with the objective to identify major project risks and discuss their mitigation 19 refs, 9 figs, 35 tabs

  4. Swedish vineyards: a utopia?

    Directory of Open Access Journals (Sweden)

    Mårtensson A

    2013-07-01

    Full Text Available Anna Mårtensson,1 Thord Karlsson,2 Jan-Gunnar Gustafsson31Department of Soil and Environment, 2Department of Economics, Swedish University of Agricultural Sciences, Uppsala, Sweden; 3Bio Evaluation AB, Uppsala, SwedenAbstract: As there is an increasing interest for setting up vineyards and wineries in Sweden, a cost analysis is becoming necessary. In this study, we assessed the potential for wine production in Sweden. The estimated annual costs varied from €15.1/per L for production of 1800 L wine per ha to €41.9 for 525 L per ha. For an annual production of 1800 L per ha potentially achieved in an established vineyard, the capital requirement is €730,000. It would take 6 years for the investment to be paid off if the wine was sold for €37.5 per L. The high production costs mean that the only viable option for success is to orientate production towards the exclusive upper segment.Keywords: cold climate conditions, wine production costs, wine quality

  5. 77 FR 38072 - Submission for OMB Review; Comment Request; The National Diabetes Education Program Survey of the...

    Science.gov (United States)

    2012-06-26

    ..., private, and nontraditional partners, and use of national, state, and local media, traditional and social media, and other relevant channels; and (4) conducting and supporting the evaluation of NDEP resources... diabetes and their families and the public. Frequency of Response: One occasion. Affected Public...

  6. Diabetes Attitudes, Wishes and Needs second study (DAWN2™) : Cross-national benchmarking of diabetes-related psychosocial outcomes for people with diabetes

    NARCIS (Netherlands)

    Nicolucci, A.; Kovacs Burns, K.; Holt, R.I.G.; Comaschi, M.; Hermanns, N.; Ishii, H.; Kokoszka, A.; Pouwer, F.; Skovlund, S.E.; Stuckey, H.; Tarkun, I.; Vallis, M.; Wens, J.; Peyrot, M.

    2013-01-01

    Aims The second Diabetes Attitudes, Wishes and Needs (DAWN2) study aimed to assess psychosocial outcomes in people with diabetes across countries for benchmarking. Methods Surveys included new and adapted questions from validated questionnaires that assess health-related quality of life,

  7. Mortality in Swedish patients with Hirschsprung disease.

    Science.gov (United States)

    Löf Granström, Anna; Wester, Tomas

    2017-11-01

    Hirschsprung disease (HSCR) has previously been associated with increased mortality. The aim of this study was to assess mortality in patients with Hirschsprung disease in a population-based cohort. This was a nationwide, population-based cohort study. The study exposure was HSCR and the study outcome was death. The cohort included all individuals with HSCR registered in the Swedish National Patient Register between 1964 and 2013 and ten age- and sex-matched controls per patient, randomly selected from the Population Register. Mortality and cause of death were assessed using the Swedish National Causes of Death Register. The cohort comprised 739 individuals with HSCR (565 male) and 7390 controls (5650 male). Median age of the cohort was 19 years (range 2-49). Twenty-two (3.0%) individuals with HSCR had died at median age 2.5 years (range 0-35) compared to 49 (0.7%) controls at median age 20 years (0-44), p < 0.001. Hazard ratio for death in HSCR patients compared to healthy controls was 4.77 (confidence interval (CI) 95% 2.87-7.91), and when adjusted for Down syndrome, the hazard ratio was 3.6 (CI 95% 2.04-6.37). The mortality rate in the HSCR cohort was 3%, which was higher than in controls also when data were adjusted for Down syndrome.

  8. Respiratory Tract Infection and Risk of Hospitalization in Children with Congenital Heart Defects During Season and Off-Season: A Swedish National Study.

    Science.gov (United States)

    Granbom, Elin; Fernlund, Eva; Sunnegårdh, Jan; Lundell, Bo; Naumburg, Estelle

    2016-08-01

    Respiratory tract infections (RTI) are common among young children, and congenital heart defect (CHD) is a risk factor for severe illness and hospitalization. This study aims to assess the relative risk of hospitalization due to RTI in winter and summer seasons for different types of CHD. All children born in Sweden and under the age of two, in 2006-2011, were included. Heart defects were grouped according to type. Hospitalization rates for respiratory syncytial virus (RSV) infection and RTI in general were retrieved from the national inpatient registry. The relative risk of hospitalization was calculated by comparing each subgroup to other types of CHD and otherwise healthy children. The relative risk of hospitalization was increased for all CHD subgroups, and there was a greater increase in risk in summer for the most severe CHD. This included RSV infection, as well as RTI in general. The risk of hospitalization due to RTI is greater for CHD children. Prophylactic treatment with palivizumab, given to prevent severe RSV illness, is only recommended during winter. We argue that information to healthcare staff and parents should include how the risk of severe infectious respiratory tract illnesses, RSV and others, is present all year round for children with CHD.

  9. The association between self-reported lack of sleep, low vitality and impaired glucose tolerance: a Swedish cross-sectional study

    National Research Council Canada - National Science Library

    Andersson, Susanne; Ekman, Inger; Friberg, Febe; Bøg-Hansen, Erik; Lindblad, Ulf

    2013-01-01

    ... of developing type 2 diabetes, impaired glucose tolerance and insulin resistance (IR). This study explore how self-reported lack of sleep and low vitality, are associated with IGT in a representative Swedish population...

  10. The Swedish Energy Market 2005

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-10-01

    The Swedish Energy Market, 2005 is an annual publication that presents information and statistics on the network based energy markets in Sweden, i.e. the markets for electricity, natural gas and district heating. It also provides an overview of the issues that have arisen on these markets during the second half of 2004 and the first half of 2005. Considerable work is being carried out in the EU on creating a single market for electricity and natural gas. This publication therefore describes expansion of the Swedish market towards a Nordic and a European market. The publication normally includes a theme chapter, describing some event of particular interest for the Swedish energy market during the year. This year, the theme chapter is devoted to the Storm Gudrun, which struck the south of the country at the beginning of January, and its effects on electricity supply throughout the country. The chapter is based on the report submitted to the Government by the Energy Markets Inspectorate in the spring of 2005, and also includes a summary of the Inspectorate's proposals for measures to improve the security of electricity transmission. Energy in Sweden, which is another of the Swedish Energy Agency's annual publications, provides information and statistics on the development of the entire Swedish energy system.

  11. Health and safety strategy in Swedish agriculture.

    Science.gov (United States)

    Lundqvist, Peter; Svennefelt, Catharina Alwall

    2012-01-01

    In Sweden there is a joint focus on injury prevention in agriculture and this is coordinated through the Swedish Committee on Working Environment (LAMK). LAMK is a network working for a good, healthy and safe working environment in Swedish agriculture from the view of the enterprise with the humans in focus. It is a committee consisting of representatives of authorities, institutions, companies, research & education institutions and organisations referring to the green sector. Examples of on-going initiatives & partners are presented which are included in this mission against injuries in agriculture. It involves the Swedish Work Environment Authority,, the Federation of Swedish Farmers (LRF), the Swedish Institute of Agricultural and Environmental Engineering, Swedish University of Agricultural Sciences (SLU, the Federation of Swedish Forestry and Agricultural Employers (SLA) and the Swedish Municipal Worker's Union.

  12. Is the Swedish FRAX model appropriate for Swedish immigrants?

    Science.gov (United States)

    Johansson, H; Odén, A; Lorentzon, M; McCloskey, E; Kanis, J A; Harvey, N C; Karlsson, M K; Mellström, D

    2015-11-01

    The incidence of hip fracture in Sweden is substantially lower in immigrants than in the population born in Sweden. Thus, the use of a FRAX® model in immigrants overestimates the risk of fracture, and the use of country of origin-specific models may be more appropriate. Age-specific fracture and mortality rates vary between countries so that FRAX tools are country-specific. In the case of immigrants, it is not known whether the model for the original or the new country is most appropriate. The aim of this study was to compare the incidence of hip fractures in foreign-born and Swedish-born individuals residing in Sweden. We studied the incidence of hip fracture in all men and women aged 50 years or more in Sweden between 1987 and 2002. The population comprised 2.8 million Swedish-born and 270,000 foreign-born individuals. Incident hip fractures occurred in 239,842 Swedish-born and 12,563 foreign-born individuals. The hip fracture incidence rose with age for both groups and was higher for women than men amongst both Swedish-born and foreign-born individuals. The hip fracture incidence for the Swedish-born cohort was approximately twice that of immigrants. For example, at the age of 70 years, the annual hip fracture incidence (per 100,000) was 450 (95 % CI 446-454) for a Swedish-born woman and 239 (95 % CI 223-257) for a foreign-born woman at the time of immigration. The hip fracture incidence rose slowly with time from immigration (0.6 % per annum, 95 % CI 0.5-0.8 %) but remained significantly lower than for Swedish-born individuals even after 40 years of residence. The incidence of hip fracture in Sweden is substantially lower in immigrants than in the population native to Sweden. Although there was a small rise in age- and sex-specific incidence after immigration, the incidence remained markedly lower than that observed in Swedish-born individuals. Thus, the use of a FRAX model for Sweden will overestimate the risk of fracture for foreign-born individuals living

  13. The Swedish Armed Forces Operational Challenges for Command and Control

    Science.gov (United States)

    2010-02-01

    Contracted Expeditionary Force Challenge - transforming the Manning system Swe Lead nation for EU NBG 11 + NBG 14 HEADQUARTERS SWEDISH ARMED...Sweden – Advanced parts of the SwAF, for example data-links within the Air Force since 1970-ies – Defence-, IT- and Telecomm industry...Information Management Portal (SHAREPOINT) Exercise Management System (EXONAUT) National simulation systems (TYR, JCATS, GESI, TCT) Air & Combat

  14. Are self-report of disability pension and long-term sickness absence accurate? Comparisons of self-reported interview data with national register data in a Swedish twin cohort

    Directory of Open Access Journals (Sweden)

    Lichtenstein Paul

    2010-12-01

    Full Text Available Abstract Background Self-reported disability pension (DP and sickness absence are commonly used in epidemiological and other studies as a measure of exposure or even as an outcome. The aims were (1 to compare such self-reports with national register information in order to evaluate the validity of self-reported DP and sickness absence, and (2 to estimate the concordance of reporting behaviour in different twin zygosity groups, also by sex. Methods All Swedish twins born 1933-1958 who participated in the Screening Across the Lifespan Twin study (SALT 1998-2003, were included (31,122 individuals. The self-reported DP and long-term sickness absence (LTSA at the time of interview was compared to the corresponding register information retrieved from the National Social Insurance Agency by calculating the proportions of agreements, kappa, sensitivity, specificity, concordance rates, and chi-square test, to evaluate construct validity. Results The proportions of overall agreement were 96% and specificity 99% for both DP and LTSA, while the sensitivity was 70% for DP and 45% for LTSA. Kappa estimates were 0.76 for DP, and 0.58 for LTSA. The proportions of positive agreement were 64% for DP and 42% for LTSA. No difference in response style was found between zygosity groups among complete twin pairs for DP and LTSA. Results were similar for women and men and across age. Kappa estimates for DP differed somewhat depending on years of education, 0.68 (college/university vs. 0.77 (less than 13 years in school but not for LTSA. Conclusions Self-reported DP data may be very useful in studies when register information is not available, however, register data is preferred especially for LTSA. The same degree of twin similarity was found for truthful self-report of DP and LTSA in both monozygotic and dizygotic twin pairs. Thus, the response style was not influenced by genetic factors. One consequence of this would be that when estimating the relative importance of

  15. Large increase in the prevalence of self-reported diabetes based on a nationally representative survey in Hungary.

    Science.gov (United States)

    Domján, Beatrix A; Ferencz, Viktória; Tänczer, Tímea; Szili-Janicsek, Zsófia; Barkai, László; Hidvégi, Tibor; Jermendy, György; Kempler, Péter; Winkler, Gábor; Gerő, László; Tabák, Adam G

    2017-04-01

    To estimate and compare the prevalence of self-reported diabetes based on nationally representative surveys of the Hungarian adult population in 2002 (published data - Hungarostudy) and a survey in 2012. A cross-sectional computer-assisted telephone interview survey on a stratified representative sample of community-dwelling adults (n=1000) in 2012. To describe self-reported diabetes prevalence and its temporal changes generalized linear models were used and results were compared to figures from Hungarostudy. Age standardized prevalence of self-reported type 2 diabetes was 11.7% (95%CI 10.0-13.8%) without gender or rural-urban differences in 2012. People with self-reported diabetes were older than controls (mean [SE]: 63.9 [0.9] vs. 45.9 [0.3] years, p<0.0001). The prevalence of diabetes sharply increased after 40 years of age and peaked at age 70 (27.7% [2.5], p age*age <0.0001). The prevalence of self-reported diabetes increased by 89% (OR 1.89, 95%CI 1.53-2.32) from 6.2 to 11.7% between the two surveys with the most pronounced increase in the age group 55-64 years (from 11.6 to 24.4%). We reported an alarming increase in the prevalence of self-reported type 2 diabetes in the last decade that mostly affects working age people. If this trend continues, a major public health crisis in Hungary can be envisaged. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  16. Prevalence and management of diabetes and metabolic risk factors in Thai adults: the Thai National Health Examination Survey IV, 2009.

    Science.gov (United States)

    Aekplakorn, Wichai; Chariyalertsak, Suwat; Kessomboon, Pattapong; Sangthong, Rassamee; Inthawong, Rungkarn; Putwatana, Panwadee; Taneepanichskul, Surasak

    2011-09-01

    To determine the prevalence of impaired fasting glucose (IFG) and undiagnosed and diagnosed diabetes in Thai adults in 2009 and examine the extent of changes in proportions of diagnosis, treatment, and control for blood glucose, high blood pressure, and high total cholesterol between 2004 and 2009. Data from the multistage cross-sectional National Health Examination Survey (NHES) IV of 18,629 Thai adults aged ≥20 years conducted in 2009 were used to analyze and compare with the data from NHES III in 2004. The prevalence of IFG and diabetes was 10.6 and 7.5%, respectively. Of all diabetes diagnoses, 35.4% were not previously diagnosed, and the proportion was higher in men than in women (47.3 vs. 23.4%, P < 0.05). Compared with those in year 2004, the proportions of individuals with diabetes and concomitant hypertension did not significantly decrease in 2009 in both sexes, but the proportions of women with diabetes who were abdominally obese or had high total cholesterol (≥5.2 mmol/L) significantly increased in 2009 by 18.0 and 23.5%, respectively (all P < 0.01). The rates of treatment and control of blood glucose, high blood pressure, and high total cholesterol were favorably improved in 2009. However, in substantial proportions of individuals with diabetes these concomitants were still controlled suboptimally. The prevalence of diabetes and IFG remained high in Thai adults. Improvement in detection and control of diabetes and associated metabolic risk factors, particularly obesity and high serum cholesterol, are necessary.

  17. Assessing the Burden of Diabetes Mellitus in Emergency Departments in the United States: The National Hospital Ambulatory Medical Care Survey (NHAMCS)

    Science.gov (United States)

    Asao, Keiko; Kaminski, James; McEwen, Laura N.; Wu, Xiejian; Lee, Joyce M.; Herman, William H.

    2014-01-01

    Objective To evaluate the performance of three alternative methods to identify diabetes in patients visiting Emergency Departments (EDs), and to describe the characteristics of patients with diabetes who are not identified when the alternative methods are used. Research Design and Methods We used data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) 2009 and 2010. We assessed the sensitivity and specificity of using providers’ diagnoses and diabetes medications (both excluding and including biguanides) to identify diabetes compared to using the checkbox for diabetes as the gold standard. We examined the characteristics of patients whose diabetes was missed using multivariate Poisson regression models. Results The checkbox identified 5,567 ED visits by adult patients with diabetes. Compared to the checkbox, the sensitivity was 12.5% for providers’ diagnoses alone, 20.5% for providers’ diagnoses and diabetes medications excluding biguanides, and 21.5% for providers’ diagnoses and diabetes medications including biguanides. The specificity of all three of the alternative methods was >99%. Older patients were more likely to have diabetes not identified. Patients with self-payment, those who had glucose measured or received IV fluids in the ED, and those with more diagnosis codes and medications, were more likely to have diabetes identified. Conclusions NHAMCS's providers’ diagnosis codes and medication lists do not identify the majority of patients with diabetes visiting EDs. The newly introduced checkbox is helpful in measuring ED resource utilization by patients with diabetes. PMID:24680472

  18. Bonjour tristesse in Swedish suburbia

    DEFF Research Database (Denmark)

    Andersson, Jonas E

    2013-01-01

    the country. Global news media paralleled the Swedish situation with previous incidents in Paris in 2007, Athens in 2008 and London in 2011. Foreign offices, among others the American, British, Danish, and Norwegian ones, advised their citizens not to travel to Sweden: the Swedish welfare model...... and a high unemployment rate. The young generation experienced a Bonjour Tristesse! existence going in and out of unemployment. An existing dismay with architecture and physical planning of suburbia surfaced: The plausible responsibility of the body of architects was debated, since many esteemed profiles...... of the Swedish functionalist architecture had been involved in its realisation. One representative of the profession stated the need for upgrading the existing architecture to new user needs, while another one emphasised that the real group of inhabitants in suburbia is often not the group of users envisioned...

  19. Obstetric Thromboprophylaxis: The Swedish Guidelines

    Directory of Open Access Journals (Sweden)

    Pelle G. Lindqvist

    2011-01-01

    Full Text Available Obstetric thromboprophylaxis is difficult. Since 10 years Swedish obstetricians have used a combined risk estimation model and recommendations concerning to whom, at what dose, when, and for how long thromboprophylaxis is to be administrated based on a weighted risk score. In this paper we describe the background and validation of the Swedish guidelines for obstetric thromboprophylaxis in women with moderate-high risk of VTE, that is, at similar or higher risk as the antepartum risk among women with history of thrombosis. The risk score is based on major risk factors (i.e., 5-fold increased risk of thromboembolism. We present data on the efficacy of the model, the cost-effectiveness, and the lifestyle advice that is given. We believe that the Swedish guidelines for obstetric thromboprophylaxis aid clinicians in providing women at increased risk of VTE with effective and appropriate thromboprophylaxis, thus avoiding both over- and under-treatment.

  20. Study On The Prevalence Of Various Forms Of Cancer In Diabetic Patients Hospitalized In The National Institute Of Diabetes, Nutrition And Metabolic Diseases “Prof. N.C. Paulescu”

    Directory of Open Access Journals (Sweden)

    Popescu-Vâlceanu Horaţiu-Cristian

    2015-06-01

    Full Text Available Background and aims: Epidemiological evidence suggests that people with diabetes have a significantly increased risk of developing various cancers. The aim of the study was to assess the frequency of various cancers in diabetic patients admitted in the National Institute of Diabetes Nutrition and Metabolic Diseases “Prof. N.C. Paulescu” between 01.01.2011 and 01.09.2014.

  1. School Principals' Perceptions of "Basic Values" in the Swedish Compulsory School System in Regard to Bronfenbrenner's Ecological Systems Theory

    Science.gov (United States)

    Drakenberg, Margareth; Malmgren, Therese Vincenti

    2013-01-01

    The purpose of this study is to compare how Swedish school principals understand basic values that are important in fulfilling the Swedish national curriculum, Curriculum 1994 (a new curriculum, Curriculum 2011, which came into operation in autumn 2011, has only minor differences compared to the common text in Curriculum 1994), considering…

  2. National study of the prevalence of gestational diabetes mellitus among Danish women from 2004 to 2012.

    Science.gov (United States)

    Jeppesen, Charlotte; Maindal, Helle T; Kristensen, Jette K; Ovesen, Per G; Witte, Daniel R

    2017-12-01

    The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. We studied the prevalence of GDM from 2004 to 2012 in Danish women aged 15-49 years using registries with records of the diagnosis of GDM at delivery. We conducted a national register-based study of 12,538 women with a diagnosis of GDM during a pregnancy leading to a live birth in the period 2004-2012. The diagnosis of GDM was taken from the National Patient Registry and combined with the total number of births at the national level from Statistics Denmark. Prevalence estimates were reported as crude and age-standardized using Danish and international data for women aged 15-49 years. A total of 566,083 live births was registered in Denmark from 2004 to 2012. The age-standardized prevalence of GDM increased from 1.7% (1095/63,465) of the total births in 2004 to 2.9% (1721/56,894) of the total births in 2012. During the period 2004-2012, the age-stratified prevalence increased from 1.1 to 1.8% among women aged 15-24 years, from 1.5 to 2.6% among women aged 25-34 years and from 2.9 to 4.7% among women aged 35-49 years. The prevalence was higher among immigrants and their descendants than in native Danish women (4.06 and 2.09% in 2007 vs. 4.51 and 2.72% in 2012, respectively). The prevalence of GDM in Denmark has increased across all age groups. Although the prevalence is low on a global scale, attention should be paid to this development by preventive health services.

  3. Diabetes MILES--Australia (management and impact for long-term empowerment and success: methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults

    Directory of Open Access Journals (Sweden)

    Speight Jane

    2012-02-01

    Full Text Available Abstract Background Successful management of diabetes requires attention to the behavioural, psychological and social aspects of this progressive condition. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success Study is an international collaborative. Diabetes MILES--Australia, the first Diabetes MILES initiative to be undertaken, was a national survey of adults living with type 1 or type 2 diabetes in Australia. The aim of this study was to gather data that will provide insights into how Australians manage their diabetes, the support they receive and the impact of diabetes on their lives, as well as to use the data to validate new diabetes outcome measures. Methods/design The survey was designed to include a core set of self-report measures, as well as modules specific to diabetes type or management regimens. Other measures or items were included in only half of the surveys. Cognitive debriefing interviews with 20 participants ensured the survey content was relevant and easily understood. In July 2011, the survey was posted to 15,000 adults (aged 18-70 years with type 1 or type 2 diabetes selected randomly from the National Diabetes Services Scheme (NDSS database. An online version of the survey was advertised nationally. A total of 3,338 eligible Australians took part; most (70.4% completed the postal survey. Respondents of both diabetes types and genders, and of all ages, were adequately represented in both the postal and online survey sub-samples. More people with type 2 diabetes than type 1 diabetes took part in Diabetes MILES--Australia (58.8% versus 41.2%. Most respondents spoke English as their main language, were married/in a de facto relationship, had at least a high school education, were occupied in paid work, had an annual household income > $AUS40,000, and lived in metropolitan areas. Discussion A potential limitation of the study is the under-representation of respondents from culturally and

  4. The Swedish Perception of European Security in the Light of the Crisis in Ukraine

    Directory of Open Access Journals (Sweden)

    Kobierecka Anna

    2016-12-01

    Full Text Available The events in Ukraine, the annexation of Crimea, and the Russian attitude towards Ukraine show an evident change in European relations. The escalation of conflict between Russia and Ukraine however does not affect only those two countries, but also those in the nearest vicinity. Especially in Scandinavian and Nordic countries change in social ambience can be observed. The aim of this article is essentially to analyze Swedish reaction to the Ukrainian Crisis, the change in Swedish attitude towards international security systems, especially NATO, and Swedish perception of its national safety.

  5. The Parametrisation of Legal Terminology Concerning Child Maintenance Support in the Swedish and Polish Legal Systems

    Directory of Open Access Journals (Sweden)

    Hadryan Milena

    2017-03-01

    Full Text Available This paper deals with translating legal terminology concerning child maintenance from Polish to Swedish. The analysis covers selected terms regulated in the Polish civil law and their possible Swedish equivalents. The method used is based on the parameterisation of legal terms, which allows the specification of terms by selected parameters, which are understood as mutually exclusive properties. The parameterised equivalents are analysed in the context of various types of recipients. This provides the basis for the choice of appropriate translation strategies. The author also discusses pragmatic equivalents featured in Rikstermbanken, the Swedish national terminological database, and those used in practice.

  6. Ten years of the national genetic diabetes nurse network: a model for the translation of genetic information into clinical care.

    Science.gov (United States)

    Shepherd, M; Colclough, K; Ellard, S; Hattersley, A T

    2014-04-01

    Increasing technological advances have resulted in the recognition of a range of genetic conditions not traditionally seen by clinical genetics teams. This has implications for the education of other healthcare professionals who may have insufficient knowledge to identify or support families with these conditions. The national genetic diabetes nurse (GDN) project, which trains diabetes specialist nurses (DSNs), was started in 2002 to increase awareness of monogenic diabetes among healthcare professionals across the UK. This paper describes the development and evaluation of the first 10 years of this project, indicating that GDNs have increased diagnostic referral rates and supported local families through diagnosis and treatment changes across the UK. The GDN project has proved an effective, innovative means of disseminating new genetic information from a centre of excellence and is suggested as a model for the successful and rapid dissemination of genetic information into routine clinical care in other conditions.

  7. Life expectancy of type 1 diabetic patients during 1997-2010: a national Australian registry-based cohort study.

    Science.gov (United States)

    Huo, Lili; Harding, Jessica L; Peeters, Anna; Shaw, Jonathan E; Magliano, Dianna J

    2016-06-01

    There is limited information about the impact of type 1 diabetes on life expectancy in a contemporary population. We examined the life expectancy of type 1 diabetic patients and explored the contribution of mortality at different ages and of different causes of death to years of life lost (YLL) compared with the general population. We derived mortality rates of Australians with type 1 diabetes listed on the National Diabetes Services Scheme (NDSS) between 1997 and 2010 (n = 85,547) by linking the NDSS to the National Death Index. The Chiang method was used to estimate life expectancy and Arriaga's method was used to estimate the contributions of age-specific and cause-specific mortality to the YLL. A total of 5,981 deaths were identified during the 902,136 person-years of follow up. Type 1 diabetic patients had an estimated life expectancy at birth of 68.6 years (95% CI 68.1, 69.1), which was 12.2 years (95% CI 11.8, 12.7) less than that in the general population. The improvement in life expectancy at birth in 2004-2010 compared with 1997-2003 was similar for both type 1 diabetic patients (men, 1.9 years [95% CI 0.4, 3.3]; women, 1.5 years [95% CI 0.0, 3.2]) and the general population (men, 2.2 years; women, 1.4 years). Deaths at age life expectancy at birth of 12.2 years compared with the general population.

  8. Increased odds of patient-reported success at 2 years after anterior cruciate ligament reconstruction in patients without cartilage lesions: a cohort study from the Swedish National Knee Ligament Register.

    Science.gov (United States)

    Hamrin Senorski, Eric; Alentorn-Geli, Eduard; Musahl, Volker; Fu, Freddie; Krupic, Ferid; Desai, Neel; Westin, Olof; Samuelsson, Kristian

    2017-06-07

    To investigate whether the surgical technique of single-bundle anterior cruciate ligament (ACL) reconstruction, the visualization of anatomic surgical factors and the presence or absence of concomitant injuries at primary ACL reconstruction are able to predict patient-reported success and failure. The hypothesis of this study was that anatomic single-bundle surgical procedures would be predictive of patient-reported success. This cohort study was based on data from the Swedish National Knee Ligament Register during the period of 1 January 2005 through 31 December 2014. Patients who underwent primary single-bundle ACL reconstruction with hamstring tendons were included. Details on surgical technique were collected using an online questionnaire comprising essential anatomic anterior cruciate ligament reconstruction scoring checklist items, defined as the utilization of accessory medial portal drilling, anatomic tunnel placement, the visualization of insertion sites and pertinent landmarks. A univariate logistic regression model adjusted for age and gender was used to determine predictors of patient-reported success and failure, i.e. 20th and 80th percentile, respectively, in the Knee injury and Osteoarthritis Outcome Score (KOOS), 2 years after ACL reconstruction. In the 6889 included patients, the surgical technique used for single-bundle ACL reconstruction did not predict the predefined patient-reported success or patient-reported failure in the KOOS4. Patient-reported success was predicted by the absence of concomitant injury to the meniscus (OR = 0.81 [95% CI, 0.72-0.92], p = 0.001) and articular cartilage (OR = 0.70 [95% CI, 0.61-0.81], p techniques used in primary single-bundle ACL reconstruction did not predict the KOOS 2 years after the reconstruction. However, the absence of concomitant injuries at index surgery predicted patient-reported success in the KOOS. The results provide further evidence that concomitant injuries at ACL reconstruction affect

  9. No differences in subjective knee function between surgical techniques of anterior cruciate ligament reconstruction at 2-year follow-up: a cohort study from the Swedish National Knee Ligament Register.

    Science.gov (United States)

    Hamrin Senorski, Eric; Sundemo, David; Murawski, Christopher D; Alentorn-Geli, Eduard; Musahl, Volker; Fu, Freddie; Desai, Neel; Stålman, Anders; Samuelsson, Kristian

    2017-12-01

    The purpose of this study was to investigate how different techniques of single-bundle anterior cruciate ligament (ACL) reconstruction affect subjective knee function via the Knee injury and Osteoarthritis Outcome Score (KOOS) evaluation 2 years after surgery. It was hypothesized that the surgical techniques of single-bundle ACL reconstruction would result in equivalent results with respect to subjective knee function 2 years after surgery. This cohort study was based on data from the Swedish National Knee Ligament Register during the 10-year period of 1 January 2005 through 31 December 2014. Patients who underwent primary single-bundle ACL reconstruction with hamstrings tendon autograft were included. Details on surgical technique were collected using a web-based questionnaire comprised of essential AARSC items, including utilization of accessory medial portal drilling, anatomic tunnel placement, and visualization of insertion sites and landmarks. A repeated measures ANOVA and an additional linear mixed model analysis were used to investigate the effect of surgical technique on the KOOS4 from the pre-operative period to 2-year follow-up. A total of 13,636 patients who had undergone single-bundle ACL reconstruction comprised the study group for this analysis. A repeated measures ANOVA determined that mean subjective knee function differed between the pre-operative time period and at 2-year follow-up (p technique or gender. Additionally, the linear mixed model adjusted for age at reconstruction, gender, and concomitant injuries showed no difference between surgical techniques in KOOS4 improvement from baseline to 2-year follow-up. However, KOOS4 improved significantly in patients for all surgical techniques of single-bundle ACL reconstruction (p techniques of primary single-bundle ACL reconstruction did not demonstrate differences in the improvement in baseline subjective knee function as measured with the KOOS4 during the first 2 years after surgery. However

  10. Family Consumer Behaviors, Adolescent Prediabetes and Diabetes in the National Health and Nutrition Examination Survey (2007-2010).

    Science.gov (United States)

    Nagarajan, Sairaman; Khokhar, Aditi; Holmes, Danielle Sweetnam; Chandwani, Sheenu

    2017-01-01

    Prediabetes or diabetes (characterized by hemoglobin A1c [HbA1c] levels ≥ 5.7 gm%) has been associated with numerous long-term complications. Family consumer behaviors are important risk factors that lead to impaired glucose tolerance or diabetes. However, few studies have studied the association between the family consumer environment and prediabetes and diabetes in adolescents. The aim of this study was to examine the association between family consumer behaviors (healthy food availability and supermarket spending) and adolescent prediabetes and diabetes (ClinicalTrials.gov identifier #NCT03136289.) Methods: Data from a nationwide survey conducted by the Centers for Disease Control and Prevention (National Health and Nutrition Examination Survey [NHANES] 2007-2010 data) were used for these analyses. Adolescents aged 12-19 years were selected for this study. Bivariate analyses and logistic regression models assessed the relationship between family consumer behaviors and the prevalence of adolescent prediabetes and diabetes. Multivariable models adjusted for age, gender, ethnicity, physical activity, education, income, and household size. A total of 2520 adolescents were eligible for this study. Adolescents with healthier household food availability had negative odds (odds ratio [OR] = 0.74, 95% confidence interval [CI], 0.55-1.00), as did higher log supermarket spending (OR = 0.69; 95% CI, 0.57-0.85). Interaction models demonstrated that adolescent females had more negative odds of prediabetes/diabetes for both healthier food availability (OR = 0.79, 95% CI, 0.39-1.29) and for greater log supermarket spending (OR = 0.69, 95% CI, 0.57-0.85). This study shows that both healthy food availability and an increase in supermarket spending were associated with a decreased adjusted prevalence of prediabetes and diabetes in adolescents, with a greater effect in females. These results suggest the need for policy and dietary interventions targeting the consumer

  11. Exposure to DDT and diabetic nephropathy among Mexican Americans in the 1999-2004 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Everett, Charles J; Thompson, Olivia M; Dismuke, Clara E

    2017-03-01

    Concentrations of the pesticide DDT (dichlorodiphenyltrichloroethane) and its metabolite DDE (dichlorodiphenyldichloroethylene), in the blood of Mexican Americans, were evaluated to determine their relationships with diabetes and diabetic nephropathy. The data were derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2004 (unweighted N = 1,411, population estimate = 13,760,609). The sample included teens, 12-19 years old, which accounted for 19.8% of the data. The time of the study overlapped the banning of DDT in Mexico in the year 2000, and those participants born in Mexico were exposed to DDT before they immigrated to the US. We sought to better understand the relationship of DDT with diabetes in a race/ethnicity group prone to develop diabetes and exposed to DDT. In this study, nephropathy was defined as urinary albumin to creatinine ratio >30 mg/g, representing microalbuminuria and macroalbuminuria, and total diabetes was defined as diagnosed and undiagnosed diabetes (glycohemoglobin, A1c ≥ 6.5%). The proportion with the isomer p,p'-DDT >0.086 ng/g (above the maximum limit of detection) was 13.3% for Mexican Americans born in the US, and 36.9% for those born in Mexico. Levels of p,p'-DDT >0.086 ng/g were associated with total diabetes with nephropathy (odds ratio = 4.42, 95% CI 2.23-8.76), and with total diabetes without nephropathy (odds ratio = 2.02, 95% CI 1.19-3.44). The third quartile of p,p'-DDE (2.99-7.67 ng/g) and the fourth quartile of p,p'-DDE (≥7.68 ng/g) were associated with diabetic nephropathy and had odds ratios of 5.32 (95% CI 1.05-26.87) and 14.95 (95% CI 2.96-75.48) compared to less than the median, respectively, whereas p,p'-DDE was not associated with total diabetes without nephropathy. The findings of this study differ from those of a prior investigation of the general adult US population in that there were more associations found with the Mexican Americans sample. Published by Elsevier Ltd.

  12. Prevalence and unmet need for diabetes care across the care continuum in a national sample of South African adults: Evidence from the SANHANES-1, 2011-2012.

    Directory of Open Access Journals (Sweden)

    Andrew Stokes

    Full Text Available South Africa faces an epidemic of chronic non-communicable diseases (NCDs, yet national surveillance is limited due to the lack of recent data. We used data from the first comprehensive national survey on NCDs-the South African National Health and Nutrition Examination Survey (SANHANES-1 (2011-2012-to evaluate the prevalence of and health system response to diabetes through a diabetes care cascade. We defined diabetes as a Hemoglobin A1c equal to or above 6.5% or currently on treatment for diabetes. We constructed a diabetes care cascade by categorizing the population with diabetes into those who were unscreened, screened but undiagnosed, diagnosed but untreated, treated but uncontrolled, and treated and controlled. We then used multivariable logistic regression models to explore factors associated with diagnosed and undiagnosed diabetes. The age-standardized prevalence of diabetes in South Africans aged 15+ was 10.1%. Prevalence rates were higher among the non-white population and among women. Among individuals with diabetes, a total of 45.4% were unscreened, 14.7% were screened but undiagnosed, 2.3% were diagnosed but untreated, 18.1% were treated but uncontrolled, and 19.4% were treated and controlled, suggesting that 80.6% of the diabetic population had unmet need for care. The diabetes care cascade revealed significant losses from lack of screening, between screening and diagnosis, and between treatment and control. These results point to significant unmet need for diabetes care in South Africa. Additionally, this analysis provides a benchmark for evaluating efforts to manage the rising burden of diabetes in South Africa.

  13. Towards critical literacy: A national test and prescribed classroom preparations

    National Research Council Canada - National Science Library

    Ekvall, Ulla

    2013-01-01

    This study focuses, from a bilingual perspective, on how a Swedish national test is intended to promote critical literacy and language development in line with related aims in syllabuses for Swedish...

  14. Algae consumption and risk of type 2 diabetes: Korean National Health and Nutrition Examination Survey in 2005.

    Science.gov (United States)

    Lee, Hyeon Ju; Kim, Hyeon Chang; Vitek, Libor; Nam, Chung Mo

    2010-01-01

    The purpose of this study is to examine the relationship between dietary algae (seaweed) consumption and the risk of Type 2 diabetes mellitus in the Korean population. We analyzed data from the Korean National Health and Nutrition Examination Survey in 2005, a nationally representative survey. The study participants included 3,405 males and females aged 20-65 y. Participants were classified into four groups according to the quartiles of total algae consumption frequencies. Proportional odds models were used to assess the relationship between algae consumption and the risk of having diabetes or prediabetes, after adjustment for age, family history of diabetes, education, smoking, alcohol consumption, physical activity, body mass index, waist circumference, triglycerides, total energy intake and food group intakes. The frequency of algae consumption was positively correlated to the consumption of legumes, fruits, fish, and dairy products in both genders (palgae consumption compared to the lowest quartile. Our results suggest that dietary algae consumption may decrease the risk of diabetes mellitus in Korean men. A well-designed prospective study is needed to confirm this association.

  15. Stakeholder involvement in Swedish nuclear waste management

    Energy Technology Data Exchange (ETDEWEB)

    Elam, Mark; Sundqvist, Goeran [Goeteborg Univ. (Sweden). Section for Science and Technology Studies

    2006-09-15

    This report concerning Swedish nuclear waste management has been produced as part of a cross national research project: CARL - A Social Science Research Project into the Effects of Stakeholder involvement on Decision-Making in Radioactive Waste Management. Besides Sweden, the participating countries are Belgium, Canada, Finland, Slovenia and United Kingdom. A social science research team, working for three years, is in the first phase conducting research in their own countries in order to produce 6 country reports. During the next years the focus will shift to comparisons of stakeholder involvement practices in the participating countries. The report addresses current practices of Swedish nuclear waste management and their historical development. The main focus is on past, current and emerging patterns of stakeholder involvement in the siting of a deep repository for the final disposal of Sweden's spent nuclear fuel. The general questions attended to in the report are: Who are the main stakeholders, and how have they emerged and gained recognition as such? What are the issues currently subject to stakeholder involvement and how have these been decided upon? How is stakeholder involvement organized locally and nationally and how has this changed over time? How has stakeholder involvement gained acceptance as an activity of value in the siting of major waste facilities? The report have attempted to show the development of stakeholder involvement in the siting of a final repository for Sweden's spent nuclear fuel as resembling something other than a straightforward linear process of improvement and refinement. Stakeholder involvement has developed, over the past 15 years or so, into something more like a patchwork of different shapes and forms. Some of the forces that may well contribute to the further elaboration of the patchwork of stakeholder involvement have been pointed out, contingently modifying once more its overall colour and orientation. Questions

  16. The associations between nationality, fertility history and diabetes-related mortality: a retrospective cohort study in the Brussels-Capital Region (2001-2005).

    Science.gov (United States)

    Vandenheede, Hadewijch; Deboosere, Patrick; Gadeyne, Sylvie; De Spiegelaere, Myriam

    2012-03-01

    The relationship between women's parity and diabetes mortality has been investigated in several studies, with mixed results. This study aims to establish if parity and age at first birth are associated with diabetes-related mortality and if these factors contribute to variations in diabetes-related mortality among women with different nationalities. Data of the 2001 census are linked to registration records of all deaths and emigrations (period 2001-2005). The study population comprises all female inhabitants of the Brussels-Capital Region aged 45-74 of either Belgian or North African nationality (n = 108 296). Age-standardized mortality rates (direct standardization) and mortality rate ratios (Poisson's regression) are computed. Both parity and age at first birth are associated with diabetes-related mortality. Highest risks of dying from diabetes are observed among grandmultiparous women and teenage mothers. Differences in diabetes-related mortality according to nationality are observed. Age-standardized diabetes mortality rates are higher in North African [ASMR = 417.4/100,000; 95% confidence interval (CI) 227.2-607.7] than in Belgian women (ASMR = 184.0/100,000; 95% CI 157.3-210.8). Taking parity, age at first birth and education into account, these differences largely disappear. Reproductive factors are associated with diabetes-related mortality and play an important part in the higher diabetes-related mortality of North African compared with Belgian women.

  17. Evaluation of family history as a risk factor and screening tool for detecting undiagnosed diabetes in a nationally representative survey population.

    Science.gov (United States)

    Hariri, Susan; Yoon, Paula W; Moonesinghe, Ramal; Valdez, Rodolfo; Khoury, Muin J

    2006-12-01

    We examined the utility of a three-level familial risk stratification system as a screening tool for diabetes in a nationally representative sample of the U.S. adult population. National Health and Nutrition Examination Survey data were used to assess the prevalence and distribution of familial risk for diabetes, the association between three levels of familial risk and undiagnosed diabetes, and the use of familial risk as a screening tool for diabetes, alone and in combination with body mass index and age. The prevalence of undiagnosed diabetes was 3% and increased with increasing familial risk (average = 2%, moderate = 4%, high = 10%). High familial risk was significantly associated with undiagnosed diabetes (adjusted odds ratio = 4.6; 95% confidence interval: 1.9-11.3). The use of a three-tiered familial risk stratification for diabetes screening yielded higher specificity (94%) and positive predictive value (9.9%) for high familial risk than body mass index > or = 25 (specificity = 38%, positive predictive value = 4.2%). High familial risk and body mass index > or = 25 combined had higher specificity (97%) and positive predictive value (13.4%); the addition of age > or = 45 years further improved positive predictive value (21.0%) without reducing specificity. There was a strong and proportional association between familial risk and undiagnosed diabetes, suggesting that a three-tiered assessment of familial diabetes risk may increase the effectiveness of diabetes screening.

  18. Educational disparities in quality of diabetes care in a universal health insurance system: evidence from the 2005 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Do, Young Kyung; Eggleston, Karen N

    2011-08-01

    To investigate educational disparities in the care process and health outcomes among patients with diabetes in the context of South Korea's universal health insurance system. Bivariate and multiple regression analyses of data from a cross-sectional health survey. A nationally representative and population-based survey, the 2005 Korea National Health and Nutrition Examination Survey. Respondents aged 40 or older who self-reported prior diagnosis with diabetes (n= 1418). Seven measures of the care process and health outcomes, namely (i) receiving medical treatment for diabetes, (ii) ever received diabetes education, (iii) received dilated eye examination in the past year, (iv) received microalbuminuria test in the past year, (v) having activity limitation due to diabetes, (vi) poor self-rated health and (vii) self-rated health on a visual analog scale. Except for receiving medical care for diabetes, overall process quality was low, with only 25% having ever received diabetes education, 39% having received a dilated eye examination in the past year and 51% having received a microalbuminuria test in the past year. Lower education level was associated with both poorer care processes and poorer health outcomes, whereas lower income level was only associated with poorer health outcomes. While South Korea's universal health insurance system may have succeeded in substantially reducing financial barriers related to diabetes care, the quality of diabetes care is low overall and varies by education level. System-level quality improvement efforts are required to address the weaknesses of the health system, thereby mitigating educational disparities in diabetes care quality.

  19. Age and kidney function are the primary correlates of fasting plasma total homocysteine levels in non-diabetic and diabetic adults. Results from the 1999–2002 National Health and Nutrition Examination Survey

    Directory of Open Access Journals (Sweden)

    Li Sierra M

    2005-05-01

    Full Text Available Abstract Background Plasma total homocysteine (tHcy is commonly elevated in persons with diabetes. This may be due to effects of insulin and/or glucose and/or metabolic control on the metabolism or plasma levels of tHcy. This study examined the effects of fasting plasma glucose status on fasting tHcy levels among adults without diabetes, and diabetes per se among adults with a self-report history of diabetes. Methods Analysis of data on adults (≥ 20y who had fasted at least 8 hours, from the National Health and Nutrition Examination Survey (1999–2000 and 2001–2002. Subjects with no self-report history of diabetes were grouped according to fasting plasma glucose status as normal (n = 2,244, impaired (≥ 100 n = 1,108, or a provisional diagnosis of diabetes (≥ 126 mg/dL = DFG, n = 133. Subjects with a self-report history of diabetes (n = 275 were examined separately. Results Fasting tHcy was higher (Ps r = 0.38 to 0.44 and r = -0.35 to -0.46, respectively and diabetic subjects (r = 0.41 and r = -0.46, respectively (Ps 1c were weaker (but still significant correlates of tHcy in non-diabetic and diabetic subjects. Fasting glucose status was not a significant independent predictor of fasting tHcy levels in non-diabetic subjects, and HbA1c was not a significant independent predictor of tHcy in diabetic subjects (Ps > 0.05. Conclusion Fasting tHcy levels are elevated among non-diabetic adults with elevated fasting glucose levels, compared to persons with normal fasting glucose levels, and among diabetic adults. However, elevations in fasting tHcy appear to be mediated primarily by age and kidney function, and not by measures of glucose metabolism.

  20. Disease severity is associated with the use of complementary medicine to treat or manage type-2 diabetes: data from the 2002 and 2007 National Health Interview Survey

    Directory of Open Access Journals (Sweden)

    Nahin Richard L

    2012-10-01

    Full Text Available Abstract Background The overall prevalence of complementary medicine (CM use among adults in the United States with diabetes has been examined both in representative national samples and in more restricted populations. However, none of these earlier studies attempted to identify predictors of CM use to treat diabetes among the populations sampled, nor looked for a relationship between CM use and diabetes severity. Methods Combining data from the 2002 and 2007 National Health Interview Survey (NHIS, we constructed a nationally representative sample of 3,978 U.S. adults aged ≥18 years with self-reported diabetes. Both the 2002 and 2007 NHIS contained extensive questions on the use of CM. We used logistic regression to examine the association between diabetes severity and overall CM use, as well as the use of specific categories of CM. Results In adults with type-2 diabetes, 30.9% used CM for any reason, but only 3.4% used CM to treat or manage their type-2 diabetes versus 7.1% of those with type-1 diabetes. Among those using CM to treat/manage their type-2 diabetes, 77% used both CM and conventional prescription medicine for their diabetes. The most prevalent types of CM therapies used were diet-based interventions (35.19%, S.E. 5.11 and non-vitamin/non-mineral dietary supplements (33.74%, S.E. 5.07. After controlling for sociodemographic factors, we found that, based on a count of measures of diabetes severity, persons with the most severe diabetes had nearly twice the odds of using CM as those with less severe disease (OR=1.9, 95%CI 1.2-3.01. Persons who had diabetes 10 years or more (OR=1.66, 95%CI 1.04-3.66 and those that had a functional limitation resulting from their diabetes (OR=1.74, 95%CI 1.09-2.8 had greater odds of using CM than those not reporting these measures. No significant associations were observed between overall CM use and other individual measures of diabetes severity: use of diabetic medications, weak or failing kidneys

  1. Dyslipidemia and associated factors among diabetic patients attending Durame General Hospital in Southern Nations, Nationalities, and People’s Region

    Directory of Open Access Journals (Sweden)

    Bekele S

    2017-06-01

    Full Text Available Shiferaw Bekele, Tagesech Yohannes, Abdurehman Eshete Mohammed Department of Medical Laboratory Sciences, College of Health Sciences, Jimma University, Jimma, Ethiopia Background: Diabetes mellitus is a group of metabolic disorders that are caused by deficiency in insulin secretion or the decreased ability of insulin to act effectively on target tissues, particularly muscle, liver, and fat. As a result of insulin resistance in the target tissues, particularly in the adipocytes, free fatty acid flux is increased, leading to increased lipid synthesis in hepatocytes, which is responsible for diabetic dyslipidemia.Objective: The objective of this study was to determine the prevalence and associated factors of dyslipidemia among diabetic patients in Durame General Hospital in Kembata Tembaro zone.Methods: A cross-sectional study was conducted from September 2015 to April 2016. In total, 224 subjects were involved in the study by using convenient sampling techniques. Face-to-face interview–administered questionnaire was used to collect sociodemographic data and other possible clinical data associated with the prevalence of dyslipidemia. Fasting venous blood specimens were collected to assess serum lipid profiles. Blood pressure (BP, weight, height, and waist circumference were measured.Results: The prevalence of dyslipidemia was 65.6%. Individual lipid abnormality of elevated LDL-C, TC, TG, and reduced HDL-C were identified in 43.8%, 23.7%, 40.6%, and 41.9% of study subjects, respectively. The prevalence of dyslipidemia was significantly associated with high BP, high body mass index, aging, and longer duration of diabetes mellitus. Conclusion: High prevalence of dyslipidemia was found among diabetic patients in the study area. Therefore, a compressive mechanism is required to screen, treat, and prevent dyslipidemia. Keywords: diabetes, lipid profile, Jimma, Ethiopia

  2. The economic burden of diabetes to French national health insurance: a new cost-of-illness method based on a combined medicalized and incremental approach.

    Science.gov (United States)

    de Lagasnerie, Grégoire; Aguadé, Anne-Sophie; Denis, Pierre; Fagot-Campagna, Anne; Gastaldi-Menager, Christelle

    2017-02-11

    A better understanding of the economic burden of diabetes constitutes a major public health challenge in order to design new ways to curb diabetes health care expenditure. The aim of this study was to develop a new cost-of-illness method in order to assess the specific and nonspecific costs of diabetes from a public payer perspective. Using medical and administrative data from the major French national health insurance system covering about 59 million individuals in 2012, we identified people with diabetes and then estimated the economic burden of diabetes. Various methods were used: (a) global cost of patients with diabetes, (b) cost of treatment directly related to diabetes (i.e., 'medicalized approach'), (c) incremental regression-based approach, (d) incremental matched-control approach, and (e) a novel combination of the 'medicalized approach' and the 'incremental matched-control' approach. We identified 3 million individuals with diabetes (5% of the population). The total expenditure of this population amounted to €19 billion, representing 15% of total expenditure reimbursed to the entire population. Of the total expenditure, €10 billion (52%) was considered to be attributable to diabetes care: €2.3 billion (23% of €10 billion) was directly attributable, and €7.7 billion was attributable to additional reimbursed expenditure indirectly related to diabetes (77%). Inpatient care represented the major part of the expenditure attributable to diabetes care (22%) together with drugs (20%) and medical auxiliaries (15%). Antidiabetic drugs represented an expenditure of about €1.1 billion, accounting for 49% of all diabetes-specific expenditure. This study shows the economic impact of the assumption concerning definition of costs on evaluation of the economic burden of diabetes. The proposed new cost-of-illness method provides specific insight for policy-makers to enhance diabetes management and assess the opportunity costs of diabetes complications

  3. Dietary Sodium Intake in People with Diabetes in Korea: The Korean National Health and Nutrition Examination Survey for 2008 to 2010

    Directory of Open Access Journals (Sweden)

    Myung Shin Kang

    2016-06-01

    Full Text Available BackgroundDiabetics are likely to receive advice from their physicians concerning lifestyle changes. To understand how much sodium is consumed by diabetics in Korea, we compared the average daily sodium intake between diabetics and non-diabetics after controlling for confounding factors.MethodsWe obtained the sodium intake data for 13,957 individuals who participated in the Korean National Health and Nutrition Examination Survey (KNHANES, 2008 to 2010, which consisted of a health interview and behavioral and nutritional surveys. The KNHANES uses a stratified, multistage, probability-sampling design, and weighting adjustments were conducted to represent the entire population.ResultsOur analysis revealed that, overall, diabetics tended to have lower sodium intake (4,910.2 mg than healthy individuals (5,188.2 mg. However, both diabetic and healthy individuals reported higher sodium intake than is recommended by the World Health Organization (WHO. Stratified subgroup analyses revealed that the sodium intake (4,314.2 mg among newly diagnosed diabetics was higher among women when compared to patients with known diabetes (3,812.5 mg, P=0.035. Female diabetics with cardiovascular disease had lower average sodium intake compared to those without cardiovascular disease after adjusting for sex, age, body mass index, and total energy intake (P=0.058. Sodium intake among male diabetics with hypercholesterolemia (P=0.011 and female diabetics with hypertriglyceridemia (P=0.067 tended to be higher than that among those who without dyslipidemia.ConclusionThe average sodium intake of diabetics in Korea was higher than the WHO recommends. Sodium intake in newly diagnosed diabetics was significantly higher than that in non-diabetics and previously diagnosed diabetics among females. Prospective studies are needed to identify the exact sodium intake.

  4. 77 FR 29676 - National Institute of Diabetes and Digestive and Kidney Disorders; Notice of Closed Meetings

    Science.gov (United States)

    2012-05-18

    ... Diabetes and Digestive and Kidney Disorders; Notice of Closed Meetings Pursuant to section 10(d) of the... requests for preclinical development resources for potential new therapeutics for type 1 diabetes. The... contract resources for development of the potential therapeutic to improve the treatment or prevent the...

  5. 3 CFR 8447 - Proclamation 8447 of October 30, 2009. National Diabetes Month, 2009

    Science.gov (United States)

    2010-01-01

    .... While no cure exists, medical advancements are continually producing new, more effective treatments to... the most prevalent form of diabetes, and usually affects individuals age 40 and older, and those who... obesity in our country. Preventive care is the simplest way to avoid diabetes and its complications. A...

  6. Insufficient rest or sleep and its relation to cardiovascular disease, diabetes and obesity in a national, multiethnic sample.

    Science.gov (United States)

    Shankar, Anoop; Syamala, Shirmila; Kalidindi, Sita

    2010-11-30

    A new question on insufficient rest/sleep was included in the 2008 Behavioral Risk Factor Surveillance System (BRFSS) for the 50 states, District of Columbia, and three US territories. No previous study, however, has examined perceived insufficient rest/sleep in relation to cardiovascular disease (CVD) or diabetes mellitus. We examined the association between self-reported insufficient rest/sleep and CVD, diabetes, and obesity in a contemporary sample of US adults. Multiethnic, nationally representative, cross-sectional survey (2008 BRFSS) participants were >20 years of age (n=372, 144, 50% women). Self-reported insufficient rest/sleep in the previous month was categorized into four groups: zero, 1-13, 14-29, and 30 days. There were five outcomes: 1) any CVD, 2) coronary heart disease (CHD), 3) stroke, 4) diabetes mellitus, and 5) obesity (body mass index≥30 kg/m2). We employed multivariable logistic regression to calculate odds ratio (OR), (95% confidence interval (CI), of increasing categories of insufficient rest/sleep, taking zero days of insufficient rest/sleep as the referent category. Insufficient rest/sleep was found to be associated with 1) any CVD, 2) CHD, 3) stroke, 4) diabetes mellitus, and 5) obesity, in separate analyses. Compared to those reporting zero days of insufficient sleep (referent), the OR (95% CI) associated with all 30 days of insufficient sleep was 1.67 (1.55-1.79) for any cardiovascular disease, 1.69(1.56-1.83) for CHD, 1.51(1.36-1.68) for stroke, 1.31(1.21-1.41) for diabetes, and 1.51 (1.43-1.59) for obesity. In a multiethnic sample of US adults, perceived insufficient rest/sleep was found to be independently associated with CHD, stroke, diabetes mellitus and obesity.

  7. Effects of exercise on glycemic control in type 2 diabetes mellitus in Koreans: the fifth Korea National Health and Nutrition Examination Survey (KNHANES V)

    OpenAIRE

    Park, Ji-Hye; Lee, Young-Eun

    2015-01-01

    [Purpose] The aim of this study was to investigate the effect of exercise on glycemic control using data from fifth Korea National Health and Nutrition Examination Survey and to provide appropriate exercise guidelines for patients with type 2 diabetes mellitus in Korea. [Subjects and Methods] We selected 1,328 patients from the fifth Korea National Health and Nutrition Examination Survey database who had type 2 diabetes and ranged in age from 30 to 90?years. Statistical analyses included ?2 t...

  8. Patient and provider perceptions of care for diabetes: results of the cross-national DAWN Study

    DEFF Research Database (Denmark)

    Peyrol, Mark; Rubin, Richard R.; Lauritzen, Torsten

    2006-01-01

    , Europe and North America. Participants were randomly selected adults with type 1 or type 2 diabetes (n=5,104), and randomly selected diabetes-care providers, including primary-care physicians (n=2,070), diabetes specialist physicians (n=635) and nurses (n=1,122). Multivariate analysis was used to examine....... Patients reported moderate levels of collaboration among providers, and providers indicated that several specialist disciplines were not readily available to them. Patients reported high levels of collaboration with providers in their own care. Provider endorsement of primary prevention strategies for type......Aims/hypothesis We assessed country-level and individual-level patterns in patient and provider perceptions of diabetes care. Methods The study used a cross-sectional design with face-to-face or telephone interviews of diabetic patients and healthcare providers in 13 countries from Asia, Australia...

  9. Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): a prospective, 5-year, Swedish nationwide study.

    Science.gov (United States)

    Olbers, Torsten; Beamish, Andrew J; Gronowitz, Eva; Flodmark, Carl-Erik; Dahlgren, Jovanna; Bruze, Gustaf; Ekbom, Kerstin; Friberg, Peter; Göthberg, Gunnar; Järvholm, Kajsa; Karlsson, Jan; Mårild, Staffan; Neovius, Martin; Peltonen, Markku; Marcus, Claude

    2017-03-01

    cardiovascular risk factors in adolescent surgical patients showed improvement over 5 years and compared favourably with those in adolescent controls. 20 (25%) of 81 adolescent surgical patients underwent additional abdominal surgery for complications of surgery or rapid weight loss and 58 (72%) showed some type of nutritional deficiency; health-care consumption (hospital attendances and admissions) was higher in adolescent surgical patients compared with adolescent controls. 20 (25%) of 81 adolescent controls underwent bariatric surgery during the 5-year follow-up. Adolescents with severe obesity undergoing Roux-en-Y gastric bypass had substantial weight loss over 5 years, alongside improvements in comorbidities and risk factors. However, gastric bypass was associated with additional surgical interventions and nutritional deficiencies. Conventional non-surgical treatment was associated with weight gain and a quarter of patients had bariatric surgery within 5 years. Swedish Research Council; Swedish Governmental Agency for Innovation Systems; National Board of Health and Welfare; Swedish Heart and Lung Foundation; Swedish Childhood Diabetes Foundation; Swedish Order of Freemasons Children's Foundation; Stockholm County Council; Västra Götaland Region; Mrs Mary von Sydow Foundation; Stiftelsen Göteborgs Barnhus; Stiftelsen Allmänna Barnhuset; and the US National Institute of Diabetes, Digestive, and Kidney Diseases (National Institutes of Health). Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Novel approach to systematic random sampling in population surveys: Lessons from the United Arab Emirates National Diabetes Study (UAEDIAB).

    Science.gov (United States)

    Sulaiman, Nabil; Albadawi, Salah; Abusnana, Salah; Fikri, Mahmoud; Madani, Abdulrazzag; Mairghani, Maisoon; Alawadi, Fatheya; Zimmet, Paul; Shaw, Jonathan

    2015-09-01

    The prevalence of diabetes has risen rapidly in the Middle East, particularly in the Gulf Region. However, some prevalence estimates have not fully accounted for large migrant worker populations and have focused on minority indigenous populations. The objectives of the UAE National Diabetes and Lifestyle Study are to: (i) define the prevalence of, and risk factors for, T2DM; (ii) describe the distribution and determinants of T2DM risk factors; (iii) study health knowledge, attitudes, and (iv) identify gene-environment interactions; and (v) develop baseline data for evaluation of future intervention programs. Given the high burden of diabetes in the region and the absence of accurate data on non-UAE nationals in the UAE, a representative sample of the non-UAE nationals was essential. We used an innovative methodology in which non-UAE nationals were sampled when attending the mandatory biannual health check that is required for visa renewal. Such an approach could also be used in other countries in the region. Complete data were available for 2719 eligible non-UAE nationals (25.9% Arabs, 70.7% Asian non-Arabs, 1.1% African non-Arabs, and 2.3% Westerners). Most were men service and sales, and unskilled occupations. Most (37.4%) had completed high school and 4.1% had a postgraduate degree. This novel methodology could provide insights for epidemiological studies in the UAE and other Gulf States, particularly for expatriates. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  11. Health Care Utilization and Expenditures of Patients with Diabetes Comorbid with Depression Disorder: A National Population-Based Cohort Study.

    Science.gov (United States)

    Huang, Chun-Jen; Hsieh, Hui-Min; Chiu, Herng-Chia; Wang, Peng-Wei; Lee, Mei-Hsuan; Li, Chih-Yi; Lin, Ching-Hua

    2017-11-01

    The study investigated to compare health care utilization and expenditures between diabetic patients with and without depression in Taiwan. Health care utilization and expenditure among diabetic patients with and without depression disorder during 2000 and 2004 were examined using Taiwan's population-based National Health Insurance claims database. Health care utilization included outpatient visits and the use of inpatient services, and health expenditures were outpatient, inpatient, and total medical expenditures. Moreover, general estimation equation models were used for analyzing the factors associated with outpatient visits and expenditures. Multiple logistic regression analysis was applied for identifying the factors associated with hospitalization. The average annual outpatient visits and annual total medical expenditures in the study period were 44.23-52.20; NT$87,496-133,077 and 30.75-32.92; NT$64,411-80,955 for diabetic patients with and without depression. After adjustment for covariates, our results revealed that gender and complication were associated with out-patient visits. Moreover, the time factor was associated with the total medical expenditure, and residential urbanization and complication factors were associated with hospitalization. Health care utilization and expenditures for diabetic patients with depression were significantly higher than those without depression. Sex, complications, time, and urbanization are the factors associated with health care utilization and expenditures.

  12. Endoparasites in some Swedish Amphibians

    DEFF Research Database (Denmark)

    Cedhagen, Tomas

    1988-01-01

    A study was made of the endoparasites in specimens of Rana arvalis and R. temporaria collected on two occasions from a locality of southern Sweden. Some frogs were investigated directly after capture while other frogs were kept hibernating and the composition of the parasites as well as the behav...... not previously been reported from Sweden. The late Prof. O. Nybelin's unpublished records of parasites found in Swedish amphibians are also given....

  13. Swedish minister rebuilds scientists' trust

    CERN Multimedia

    Sylwan, P

    1999-01-01

    Thomas Ostros, Sweden's new science minister is aiming to improve links with the science community, severely strained during the tenure of Carl Tham. Significantly, he confirmed that he will not be making any further changes to the managment of the Swedish Foundation for Strategic Research. He also announced a 5 per cent increase in government funding for science which will be used to strengthen basic research and education (1 page).

  14. Women and Diabetes

    Medline Plus

    Full Text Available ... Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression in ... Advisory Committees Regulatory Information Safety Emergency ... News & Events Training & Continuing Education Inspections & Compliance Federal, ...

  15. Women and Diabetes

    Medline Plus

    Full Text Available ... Women's Health Publications Women's Health Information on Twitter Information from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression in Older Women ...

  16. Women and Diabetes

    Medline Plus

    Full Text Available ... from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression ... Emergency Preparedness International Programs News & Events Training & Continuing Education Inspections & Compliance Federal, State & Local Officials Consumers Health ...

  17. Women and Diabetes

    Medline Plus

    Full Text Available ... on WebMD Order Free Women's Health Publications Women's Health Information on Twitter Information from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression ...

  18. Women and Diabetes

    Medline Plus

    Full Text Available ... from Other Government Agencies and Offices National Diabetes Education Program Diabetes Information on MedlinePlus Diabetes and Depression in ... Advisory Committees Regulatory Information Safety Emergency Preparedness ... Inspections & Compliance Federal, State & Local Officials Consumers Health ...

  19. New Swedish environmental and sustainable education research

    Directory of Open Access Journals (Sweden)

    Johan Öhman

    2011-01-01

    Full Text Available This special issue of Education & Democracy presents examples froma new generation of Swedish research on environmental and sustainability education and thereby complement the picture of the current Swedish environmental and sustainability education research outlined in the recent Danish-Swedish special issue of Environmental EducationResearch (Vol 16, No 1 and the anthology Democracy and Values inEducation for Sustainable Development – Contributions from Swedish Research (Öhman 2008. All the contributors to this issue are associatedwith the Graduate School in Education and Sustainable Development (GRESD, either as PhD students or as supervisors.

  20. National trends in anti-diabetic treatment in Taiwan, 2000–2009

    Directory of Open Access Journals (Sweden)

    Chia-Hsuin Chang

    2012-11-01

    Conclusion: We found an increasing complexity of anti-diabetic therapy during the past decade in Taiwan. Further studies are needed to evaluate whether this treatment pattern will lead to improved clinical outcomes in terms of cost-effectiveness.

  1. 78 FR 72684 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-12-03

    ... Federal Domestic Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research...

  2. 78 FR 78373 - National Institute of Diabetes and Digestive and Kidney Diseases Notice of Closed Meeting

    Science.gov (United States)

    2013-12-26

    ... Federal Domestic Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research...

  3. 78 FR 72683 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-12-03

    ... Federal Domestic Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research...

  4. 75 FR 41870 - Proposed Collection; Comment Request; National Institute of Diabetes and Digestive and Kidney...

    Science.gov (United States)

    2010-07-19

    ..., health care professionals, patients, family and friends of patients. The annual reporting burden is as... Diabetes and Digestive and Kidney Diseases Information Clearinghouses Customer Satisfaction Survey SUMMARY... Clearinghouses Customer Satisfaction Survey. Type of Information Requested: Reinstatement, with change, of a...

  5. 76 FR 60057 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2011-09-28

    ... Kidney Diseases Special Emphasis Panel, Cognitive Function in Chronic Disease Ancillary Studies. Date..., Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849...

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

    Science.gov (United States)

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

    2017-06-01

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

  7. Diabetes, hypertension and mobility among Brazilian older adults: findings from the Brazilian National Household Sample Survey (1998, 2003 and 2008).

    Science.gov (United States)

    Nascimento, Clarissa de Matos; Mambrini, Juliana Vaz de Melo; de Oliveira, Cesar Messias; Giacomin, Karla Cristina; Peixoto, Sérgio Viana

    2015-06-27

    The rapid population ageing has been accompanied by a growing number of older adults experiencing chronic conditions, especially diabetes and hypertension, which are conditions associated to the decline in physical functioning. The aim of this study was to investigate changes in the strength of the association between mobility and two chronic conditions (hypertension and diabetes) in a large representative sample of Brazilian older adults over a ten year period. The data came from the Brazilian National Household Sample Survey (PNAD) of 1998, 2003 and 2008. The sample comprised 28,943 participants aged 60 years and older investigated in 1998, 35,042 in 2003 and 41,269 in 2008, totalling 105,254 older adults. The dependent variable was the physical mobility index (PMI) constructed based on the Item Response Theory (IRT) using five physical mobility indicators. The chronic conditions were self-reported and the confounders included: age, sex, schooling, ethnicity, family income, household composition, other co-morbidities and use of health services. The association between physical mobility (three different groups) and chronic conditions (hypertension and diabetes) was performed using multinomial logistic regression. Over the ten year period the prevalence of hypertension increased from 44 % (1998), 49 % (2003) to 53 % (2008) (p hypertension and diabetes over the ten year period, the decrease in strength of the association with physical mobility during the first period could be explained by improvements in health services and treatment of older adults. Special attention should be given to the treatment and management of diabetes in order to avoid declines in physical mobility levels.

  8. Benchmarking by HbA1c in a national diabetes quality register--does measurement bias matter?

    Science.gov (United States)

    Carlsen, Siri; Thue, Geir; Cooper, John Graham; Røraas, Thomas; Gøransson, Lasse Gunnar; Løvaas, Karianne; Sandberg, Sverre

    2015-08-01

    Bias in HbA1c measurement could give a wrong impression of the standard of care when benchmarking diabetes care. The aim of this study was to evaluate how measurement bias in HbA1c results may influence the benchmarking process performed by a national diabetes register. Using data from 2012 from the Norwegian Diabetes Register for Adults, we included HbA1c results from 3584 patients with type 1 diabetes attending 13 hospital clinics, and 1366 patients with type 2 diabetes attending 18 GP offices. Correction factors for HbA1c were obtained by comparing the results of the hospital laboratories'/GP offices' external quality assurance scheme with the target value from a reference method. Compared with the uncorrected yearly median HbA1c values for hospital clinics and GP offices, EQA corrected HbA1c values were within ±0.2% (2 mmol/mol) for all but one hospital clinic whose value was reduced by 0.4% (4 mmol/mol). Three hospital clinics reduced the proportion of patients with poor glycemic control, one by 9% and two by 4%. For most participants in our study, correcting for measurement bias had little effect on the yearly median HbA1c value or the percentage of patients achieving glycemic goals. However, at three hospital clinics correcting for measurement bias had an important effect on HbA1c benchmarking results especially with regard to percentages of patients achieving glycemic targets. The analytical quality of HbA1c should be taken into account when comparing benchmarking results.

  9. Adherence to diabetes care processes at general practices in the National Capital Region-Delhi, India

    Directory of Open Access Journals (Sweden)

    Roopa Shivashankar

    2016-01-01

    Full Text Available Aim: To assess the level of adherence to diabetes care processes, and associated clinic and patient factors at general practices in Delhi, India. Methods: We interviewed physicians (n = 23 and patients with diabetes (n = 406, and reviewed patient charts at general practices (government = 5; private = 18. We examined diabetes care processes, specifically measurement of weight, blood pressure (BP, glycated hemoglobin (HbA1c, lipids, electrocardiogram, dilated eye, and a foot examination in the last one year. We analyzed clinic and patient factors associated with a number of care processes achieved using multilevel Poisson regression model. Results: The average number of clinic visits per patient was 8.8/year (standard deviation = 5.7, and physicians had access to patient's previous records in only 19.7% of patients. Dilated eye exam, foot exam, and electrocardiogram were completed in 7.4%, 15.1%, and 29.1% of patients, respectively. An estimated 51.7%, 88.4%, and 28.1% had ≥1 measurement of HbA1c, BP, and lipids, respectively. Private clinics, physician access to patient's previous records, use of nonphysicians, patient education, and the presence of diabetes complication were positively associated with a number of care processes in the multivariable model. Conclusion: Adherence to diabetes care processes was suboptimal. Encouraging implementation of quality improvement strategies like Chronic Care Model elements at general practices may improve diabetes care.

  10. Self-reported frequency of sex as self-injury (SASI) in a national study of Swedish adolescents and association to sociodemographic factors, sexual behaviors, abuse and mental health

    OpenAIRE

    Fredlund, Cecilia; Svedin, Carl Göran; Priebe, Gisela; Jonsson, Linda; Wadsby, Marie

    2017-01-01

    Background Sex as self-injury has become a concept in Swedish society; however it is a largely unexplored area of research, not yet conceptualized and far from accepted in the research field. The use of sex as a way of affect regulation is known in the literature and has, in interviews with young women who sell sex, been compared to direct self-injury, such as cutting or burning the skin. The aim of this study was to investigate the self-reported frequency of sex as self-injury and the associ...

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

    Science.gov (United States)

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

    2016-10-01

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

  12. Relationship of serum bisphenol A with diabetes in the Thai population, National Health Examination Survey IV, 2009.

    Science.gov (United States)

    Aekplakorn, Wichai; Chailurkit, La-Or; Ongphiphadhanakul, Boonsong

    2015-03-01

    Epidemiological studies of the association between bisphenol A (BPA) exposure and diabetes have been inconsistent. The present study determined serum BPA concentrations in the Thai population and their association with hyperglycemia and diabetes. In all, 2581 serum samples from the Thai National Health Examination Survey (2009) were used to determine BPA levels. Impaired fasting glucose (IFG) was defined as fasting plasma glucose ≥100 and <126 mg/dL. Diabetes was defined as a history of a physician's diagnosis or fasting plasma glucose ≥126 mg/dL. Multinomial logistic regression was used to examine the association of serum BPA with IFG and diabetes. Of 2581 samples tested, BPA was detected in 2135 samples (weighted percentage 78.1%), with a geometric mean concentration of 0.34 ng/mL BPA. Serum BPA levels were significantly higher among those with diabetes or IFG compared with normoglycemic individuals (0.52 and 0.38 vs 0.33 ng/mL, respectively; P < 0.001). After adjusting for potential confounders, compared with the first quartile (≤0.071 ng/mL), the overall adjusted odds ratios (OR) of serum BPA concentration in the third and fourth quartiles (0.319-0.745 and ≥0.746 ng/mL, respectively) for IFG were 1.72 (95% confidence interval [CI] 1.19, 2.49) and 1.23 (95% CI 0.80, 1.89), respectively; for diabetes, the adjusted OR were 1.88 (95% CI 1.18, 2.99) and 1.83 (95% CI 1.12, 2.95), respectively, with a slightly stronger association among men than in women. Serum BPA concentrations were not associated with IFG, but were positively associated with diabetes in the Thai population. Further prospective studies are needed to confirm the relationship. © 2014 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  13. Diabetes and Pregnancy: Gestational Diabetes

    Centers for Disease Control (CDC) Podcasts

    2007-11-14

    Gestational diabetes happens in a woman who develops diabetes during pregnancy. This podcast discusses its potential effects and action steps to avoid complications.  Created: 11/14/2007 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Diabetes Translation (DDT) and National Center on Birth Defects and Developmental Disabilities (NCBDDD), Prevention Research Branch.   Date Released: 11/27/2007.

  14. The perception of aquaculture on the Swedish West Coast.

    Science.gov (United States)

    Thomas, Jean-Baptiste E; Nordström, Jonas; Risén, Emma; Malmström, Maria E; Gröndahl, Fredrik

    2017-09-22

    Efforts are on the way on the Swedish West Coast to develop the capacity for cultivation of marine resources, notably of kelps. Given that this is a region of great natural and national heritage, public opposition to marine developments has been identified as a possible risk factor. This survey thus sought to shed light on awareness levels, perceptions of different types of aquaculture and on reactions to a scenario depicting future aquaculture developments on the West Coast. When asked about their general opinions of aquaculture, respondents tended to be favourable though a majority chose neutral responses. On the whole, respondents were favourable to the depicted scenario. Finally, it was found that the high-awareness group tended to be more supportive than the low or medium-awareness groups, hinting at the benefits of increasing awareness to reduce public aversion and to support a sustainable development of aquaculture on the Swedish West Coast.

  15. Nurses Contribution to Swedish eHealth Strategy.

    Science.gov (United States)

    Törnvall, Eva

    2012-01-01

    In 2005 the Swedish government identified the need of common development of information and communication technology in health and social care. The purpose of this paper is to describe nurses' contribution to the establishment of a national cooperation concerning eHealth development in health and social care. The Swedish strategy of eHealth have six actions areas eServices for accessibility and empowerment, Usable and accessible information (for staff), Knowledge management, innovation and learning, Creating a common technical infrastructure, Creating a common information structure and Bringing laws and regulations into line with extended use of ICT. Nurses are involved in all action areas and emphasize the empowerment and safety of the patient and account of ethical values. Patients' possibility to take part of the information and adding information in their own patient health record, nurses' education and safe IT support in medication are areas that need further development.

  16. How to Prevent Diabetes: MedlinePlus Health Topic

    Science.gov (United States)

    ... Game Plan to Prevent Type 2 Diabetes (National Diabetes Education Program) - PDF Clinical Trials ClinicalTrials.gov: Preventing Diabetes Type 2 (National Institutes of Health) Journal Articles ...

  17. Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009.

    Science.gov (United States)

    Chuck, Kumban Walter; Hwang, Minji; Choi, Kui Son; Suh, Mina; Jun, Jae Kwan; Park, Boyoung

    2017-01-01

    To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, pgastric cancer; 60.5 vs. 71.5%, pcancer; and 49.1 vs. 59.6%, pcancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, pcancer (38.8 vs. 44.6%, pcancer (35.1 vs. 51.2%, pscreening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9). The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

  18. Swedish Opinion on Nuclear Power 1986 - 2011

    Energy Technology Data Exchange (ETDEWEB)

    Holmberg, Soeren

    2012-11-01

    This report contains the Swedish opinion on Nuclear Power and European Attitudes on Nuclear Power. It also includes European Attitudes Towards the Future of Three Energy Sources; Nuclear Energy, Wind Power and Solar Power - with a focus on the Swedish opinion. Results from measurements done by the SOM Inst. are presented.

  19. Is spoken Danish less intelligible than Swedish?

    NARCIS (Netherlands)

    Gooskens, Charlotte; van Heuven, Vincent J.; van Bezooijen, Renee; Pacilly, Jos J. A.

    2010-01-01

    The most straightforward way to explain why Danes understand spoken Swedish relatively better than Swedes understand spoken Danish would be that spoken Danish is intrinsically a more difficult language to understand than spoken Swedish. We discuss circumstantial evidence suggesting that Danish is

  20. Cadmium exposure in the Swedish environment

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-03-01

    This report gives a thorough description of cadmium in the Swedish environment. It comprises three parts: Cadmium in Sweden - environmental risks;, Cadmium in goods - contribution to environmental exposure;, and Cadmium in fertilizers, soil, crops and foods - the Swedish situation. Separate abstracts have been prepared for all three parts

  1. New national Biobank of The Danish Center for Strategic Research on Type 2 Diabetes (DD2)

    DEFF Research Database (Denmark)

    Christensen, Henry; Nielsen, Jens Steen; Sørensen, Karina Meden

    2012-01-01

    Long-term storage of biological samples from patients has become increasingly important in studies of disease control and treatment. The first nationwide Danish diabetes project, ie, The Danish Center for Strategic Research in Type II Diabetes (DD2), aims to improve treatment and the long......-term outcome of patients with newly diagnosed type 2 diabetes (T2D). The DD2 project includes establishment of a biobank with samples from 50,000 patients with newly diagnosed T2D. This paper describes how blood and urine samples from 10,000 patients per year are collected, handled, and stored. The biobank...... received at the biobank, samples are frozen without further treatment. From each patient, 24 cryostorage tubes are stored. Each tube is labeled with a barcode that links the data to other information available in a clinical databank registry. When patients are enrolled in DD2, a questionnaire is filled out...

  2. The extent and determinants of diabetes and cardiovascular disease comorbidity in South Africa – results from the South African National Health and Nutrition Examination Survey (SANHANES-1

    Directory of Open Access Journals (Sweden)

    Chipo Mutyambizi

    2017-09-01

    Full Text Available Abstract Background Diabetes is a major health problem and cause of death worldwide. It is predicted that the prevalence of diabetes will increase from 415 million in 2015 to 642 million in 2040. However, the burden of diabetes in low- and middle-income countries is not clearly understood, particularly its interaction with other chronic illnesses. This study investigates the self-reported prevalence of and factors associated with diabetes and cardiovascular comorbidity in South Africa. Methods Data used in this study are from the 2012 South African National Health and Nutrition Examination Survey; a nationally representative cross-sectional household survey (N = 25,532. Diabetes and cardiovascular disease comorbidity was defined as the coexistence of diabetes plus one or more cardiovascular diseases reported at the time of the survey. This study makes use of multinomial logistic regression models to analyse the relationship between diabetes - cardiovascular disease comorbidity and several predictors including race, income, socio-economic status and obesity. Results According to the survey data we analysed, 5% of South Africans aged 15 and above had self-reported diabetes in 2011–2012. Among those with self-reported diabetes, 73% had at least one additional cardiovascular chronic illness. Diabetes and its cardiovascular disease comorbidity was more prevalent in Africans (66%, females (66%, those who lived in urban areas (75%, had secondary education (44% and were unemployed (62%. Factors strongly associated with diabetes - cardiovascular disease comorbidity were older age (Odds ratio [OR] 1.09; 95% Confidence Interval [CI] 1.06–1.12, high household income (0.27; 0.10–0.76 versus low income, moderate (0.33; 0.11–0.96 and good self-rated health (0.24; 0.08–0.68 versus bad self-rated health, occasional (0.29; 0.10–0.88 and regular smokers (0.25; 0.12–0.53 versus non-smokers and physical activity (0.15; 0.03–0.68 versus no physical

  3. Teenage girls with type 1 diabetes have poorer metabolic control than boys and face more complications in early adulthood.

    Science.gov (United States)

    Samuelsson, Ulf; Anderzén, Johan; Gudbjörnsdottir, Soffia; Steineck, Isabelle; Åkesson, Karin; Hanberger, Lena

    2016-07-01

    To compare metabolic control between males and females with type 1 diabetes during adolescence and as young adults, and relate it to microvascular complications. Data concerning 4000 adolescents with type 1 diabetes registered in the Swedish paediatric diabetes quality registry, and above the age of 18years in the Swedish National Diabetes Registry was used. When dividing HbA1c values in three groups; 9.3% (78mmol/mol), there was a higher proportion of females in the highest group during adolescence. In the group with the highest HbA1c values during adolescence and as adults, 51.7% were females, expected value 46.2%; in the group with low HbA1c values in both registries, 34.2% were females, pcontrol was found in adolescent females, and they had a higher frequency of microvascular complications. Improved paediatric diabetes care is of great importance for increasing the likelihood of lower mortality and morbidity later in life. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Total pancreatectomy with islet autotransplantation: summary of a National Institute of Diabetes and Digestive and Kidney diseases workshop.

    Science.gov (United States)

    Bellin, Melena D; Gelrud, Andres; Arreaza-Rubin, Guillermo; Dunn, Ty B; Humar, Abhinav; Morgan, Katherine A; Naziruddin, Bashoo; Rastellini, Cristiana; Rickels, Michael R; Schwarzenberg, Sarah J; Andersen, Dana K

    2014-11-01

    A workshop sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases focused on research gaps and opportunities in total pancreatectomy with islet autotransplantation (TPIAT) for the management of chronic pancreatitis (CP). The session was held on July 23, 2014, and structured into 5 sessions: (1) patient selection, indications, and timing; (2) technical aspects of TPIAT; (3) improving success of islet autotransplantation; (4) improving outcomes after total pancreatectomy; and (5) registry considerations for TPIAT. The current state of knowledge was reviewed; knowledge gaps and research needs were specifically highlighted. Common themes included the need to identify which patients best benefit from and when to intervene with TPIAT, current limitations of the surgical procedure, diabetes remission and the potential for improvement, opportunities to better address pain remission, gastrointestinal complications in this population, and unique features of children with CP considered for TPIAT. The need for a multicenter patient registry that specifically addresses the complexities of CP and total pancreatectomy outcomes as well as postsurgical diabetes outcomes was repeatedly emphasized.

  5. [Diabetes mellitus in an adult population of the IMSS (Mexican Institute of Social Security). Results of the National Health Survey 2000].

    Science.gov (United States)

    Vázquez-Martínez, José Luis; Gómez-Dantés, Héctor; Fernández-Cantón, Sonia

    2006-01-01

    To describe the prevalence and control of diabetes in the adult population served by the Instituto Mexicano del Seguro Social according to data from the National Health Survey 2000 (ENSA-2000). The data for adults from the National Health Survey 2000 was used to estimate and describe the prevalence of diabetes in the population that belongs to the social security system in Mexico. Criteria used to define diabetes mellitus were the medical diagnosis of the disease (MDDM) and the glucose measurement from capillary blood (>126 mg/dL fasting sample and 200 mg/dL in casual blood sample). If diabetes was confirmed only through blood sample, the diabetes case was define as survey finding (SF). Prevalences were estimated for both groups, while means and medians were estimated for the four possible combination groups (SF+, MDDM+, SF+, MDDM-, SF-, MDDM+, SF-, MDDM-). Sampling results were adjusted for population estimates according to the methods established in the ENSA-2000. Diabetes is described according to age, sex, education level, geographic region, background of diabetes in the family, body mass index (BMI), abdominal perimeter. A logistic regression method was used to estimate potential associations with different risk factors. Overall prevalence was 8.7%; for MDDM, it was 7.1%, and for SF, only 1.5%. Glycemia was highest in SF+ and MDDM-, median 292 mg/dL and in MDDM+ but SF-, median 289 mg/dL. Major risk factors were background of diabetes in both parents, abdominal obesity, low educational level age (coef. = 0.5943 per decade) and BMI (coef. = 0.0133). Diabetes in social security population is higher than in the rest of the population, while genetic background, age, educational level, high BMI and abdominal perimeter have important influences in diabetes prevalence in this population. Glucose control is suboptimal even in patients under medical supervision.

  6. The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research

    OpenAIRE

    Ludvigsson, Jonas F; Otterblad-Olausson, Petra; Pettersson, Birgitta U.; Ekbom, Anders

    2009-01-01

    Swedish health care and national health registers are dependent on the presence of a unique identifier. This paper describes the Swedish personal identity number (PIN) and explores ethical issues of its use in medical research. A ten-digit-PIN is maintained by the National Tax Board for all individuals that have resided in Sweden since 1947. Until January 2008, an estimated 75,638 individuals have changed PIN. The most common reasons for change of PIN are incorrect recording of date of birth ...

  7. Prevalence of Metabolic Syndrome among Korean Adolescents According to the National Cholesterol Education Program, Adult Treatment Panel III and International Diabetes Federation

    OpenAIRE

    Seonho Kim; Wi-Young So

    2016-01-01

    In both adults and children, metabolic syndrome (MetS) has been attributed to risk factors for type 2 diabetes and cardiovascular disease such as insulin resistance, abdominal obesity, hypertension, and dyslipidemia. This descriptive study aimed to compare the prevalence of MetS and diagnostic components according to the National Cholesterol Education Program, Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) in 2330 Korean adolescents (10–18 years), using d...

  8. Racial and ethnic differences in diabetes mellitus among people with and without psychiatric disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.

    Science.gov (United States)

    Cabassa, Leopoldo J; Blanco, Carlos; Lopez-Castroman, Jorge; Lin, Keng-Han; Lui, Shang-Min; Lewis-Fernández, Roberto

    2011-01-01

    This study examined racial/ethnic differences in the prevalence of diabetes mellitus in a nationally representative sample of adults with and without common psychiatric disorders. Data were drawn from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (N=34,653). Logistic regression models adjusting for sociodemographic variables and diabetes risk factors were used to examine racial/ethnic differences in 12-month prevalence rates of diabetes by psychiatric status. Among people without psychiatric disorders, African Americans, Hispanics and American Indians/Alaska Natives, but not Asians/Pacific Islanders, had significantly higher rates of diabetes than non-Hispanic whites even after adjusting for sociodemographic variables and diabetes risk factors. In the presence of psychiatric disorders, these health disparities persisted for African Americans and Hispanics, but not for American Indians/Alaska Natives. No significant interactions between race/ethnicity and psychiatric disorders in the odds of diabetes were found across any group. Policies and services that support culturally appropriate prevention and treatment strategies are needed to reduce racial/ethnic disparities in diabetes among people with and without psychiatric disabilities. Copyright © 2011 Elsevier Inc. All rights reserved.

  9. The Danish national type 2 diabetes cohort – the DD2 study

    Directory of Open Access Journals (Sweden)

    Sørensen HT

    2012-09-01

    Full Text Available Henrik Toft Sørensen,1 Søren Friborg,2 Jørgen Rungby,3 Jens Sandahl Christensen,4 Allan Vaag,5 Henning Beck-Nielsen61Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, 2Department of Endocrinology M, Odense University Hospital, Odense, Denmark, 3Department of Pharmacology, University of Aarhus, Aarhus, 4Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, 5Department of Endocrinology, Rigshospitalet and Copenhagen University, 6Diabetes Research Centre, Department of Endocrinology, Odense University Hospital, Odense, DenmarkType 2 diabetes is a pandemic and an enormous public health problem. This supplemental issue of Clinical Epidemiology describes the rationale, design, and implementation of the establishment of a large cohort of all Danes with type 2 diabetes (the DD2 study and of a biobank to bridge the scientific disciplines of epidemiology, clinical medicine, genetics, epigenetics, and pharmacology. This will most likely result in great benefits for the application of evidence-based medicine to the care of, and improved outcomes for, Danish type 2 diabetes patients.

  10. 77 FR 34396 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-06-11

    ... Federal Domestic Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research... Kidney Diseases Special Emphasis Panel;; Digestive Diseases Research Core Centers. Date: July 23, 2012...

  11. Women do not fare worse than men after lumbar fusion surgery: Two-year follow-up results from 4,780 prospectively collected patients in the Swedish National Spine Register with lumbar degenerative disc disease and chronic low back pain.

    Science.gov (United States)

    Triebel, Jan; Snellman, Greta; Sandén, Bengt; Strömqvist, Fredrik; Robinson, Yohan

    2017-05-01

    Proper patient selection is of utmost importance in the surgical treatment of degenerative disc disease (DDD) with chronic low back pain (CLBP). Among other factors, gender was previously found to influence lumbar fusion surgery outcome. This study investigates whether gender affects clinical outcome after lumbar fusion. This is a national registry cohort study. Between 2001 and 2011, 2,251 men and 2,521 women were followed prospectively within the Swedish National Spine Register (SWESPINE) after lumbar fusion surgery for DDD and CLBP. Patient-reported outcome measures (PROMs), visual analog scale (VAS) for leg and back pain, Oswestry Disability Index (ODI), quality of life (QoL) parameter EQ5D, and labor status and pain medication were collected preoperatively, 1 and 2 years after surgery. Gender differences of baseline data and PROM improvement from baseline were analyzed. The effect of gender on clinically important improvement of PROM was determined in a multivariate logistic regression model. Furthermore, gender-related differences in return-to-work were investigated. Preoperatively, women had worse leg pain (pback pain (p=.002), lower QoL (ppain, function, and QoL (all ppain (odds ratio [OR]=1.39, 95% confidence interval [CI]: 1.19-1.61, pback pain (OR=1.20,95% CI:1.03-1.40, p=.02) as well as ODI (OR=1.24, 95% CI:1.05-1.47, p=.01), but improved at a slower pace in leg pain (pback pain (p=.009), and disability (p=.008). No gender differences were found in QoL and return to work at 2 years postoperatively. Swedish women do not have worse results than men after spinal fusion surgery. Female patients present with worse pain and function preoperatively, but improve more than men do after surgery. Copyright © 2016 The Author(s). Published by Elsevier Inc. All rights reserved.

  12. First trimester coffee and tea intake and risk of gestational diabetes mellitus: a study within a national birth cohort.

    Science.gov (United States)

    Hinkle, S N; Laughon, S K; Catov, J M; Olsen, J; Bech, B H

    2015-02-01

    Coffee and tea consumption is associated with a decreased type 2 diabetes risk in non-pregnant adults. We examined the relation between first trimester coffee and tea consumption and gestational diabetes mellitus (GDM) risk. Population-based cohort study. Denmark 1996-2002. Non-diabetic women with singleton pregnancies in the Danish National Birth Cohort (n = 71,239). Estimated adjusted relative risks (RR) and 95% confidence intervals (95%CI) for the association between first trimester coffee and tea or estimated total caffeine and GDM. GDM ascertained from the National Hospital Discharge Register or maternal interview. Coffee or tea intake was reported in 81.2% (n = 57,882) and 1.3% (n = 912) of pregnancies were complicated by GDM. Among non-consumers, 1.5% of pregnancies were complicated by GDM. Among coffee drinkers, GDM was highest among women who drank ≥8 cups/day (1.8%) with no significant difference across intake levels (P = 0.10). Among tea drinkers, there was no difference in GDM across intake levels (1.2%; P = 0.98). After adjustment for age, socio-occupational status, parity, pre-pregnancy body mass index, smoking, and cola, there was suggestion of a protective, but non-significant association with increasing coffee (RR ≥8 versus 0 cups/day = 0.89 [95%CI 0.64-1.25]) and tea (RR ≥8 versus 0 cups/day = 0.77 [95%CI 0.55-1.08]). Results were similar by smoking status, except a non-significant 1.45-fold increased risk with ≥8 coffee cups/day for non-smokers. There was a non-significant reduced GDM risk with increasing total caffeine. Our results suggest that moderate first trimester coffee and tea intake were not associated with GDM increased risk and possibly may have a protective effect. © 2014 Royal College of Obstetricians and Gynaecologists.

  13. Adherence to diabetic eye examination guidelines in Australia: the National Eye Health Survey.

    Science.gov (United States)

    Foreman, Joshua; Keel, Stuart; Xie, Jing; Van Wijngaarden, Peter; Taylor, Hugh R; Dirani, Mohamed

    2017-05-15

    To determine adherence to NHMRC eye examination guidelines for Indigenous and non-Indigenous Australian people with diabetes. Cross-sectional survey using multistage, random cluster sampling. Thirty randomly selected geographic sites in the five mainland Australian states and the Northern Territory, stratified by remoteness. 1738 Indigenous Australians aged 40-92 years and 3098 non-Indigenous Australians aged 50-98 years were recruited and examined between March 2015 and April 2016 according to a standardised protocol that included a questionnaire (administered by an interviewer) and a series of standard eye tests. Adherence rates to NHMRC eye examination guidelines; factors influencing adherence. Adherence to screening recommendations was significantly greater among non-Indigenous Australians (biennial screening; 77.5%) than Indigenous Australians (annual screening; 52.7%; P < 0.001). Greater adherence by non-Indigenous Australians was associated with longer duration of diabetes (adjusted odds ratio [aOR], 1.19 per 5 years; P = 0.018), while increasing age was associated with poorer adherence in non-Indigenous Australians (aOR, 0.70 per decade; P = 0.011). For Indigenous Australians, residing in inner regional areas (aOR, 1.66; P = 0.007) and being male (aOR, 1.46; P = 0.018) were significant factors positively associated with adherence. More than three-quarters of non-Indigenous Australians with diabetes and more than half of Indigenous Australians with diabetes adhere to the NHMRC eye examination guidelines. The discrepancy between the adherence rates may point to gaps in the provision or uptake of screening services in Indigenous communities, or a lack of awareness of the guidelines. A carefully integrated diabetic retinopathy screening service is needed, particularly in remote areas, to improve adherence rates.

  14. Women Are Diagnosed with Type 2 Diabetes at Higher Body Mass Indices and Older Ages than Men: Korea National Health and Nutrition Examination Survey 2007-2010

    Directory of Open Access Journals (Sweden)

    Su Kyoung Kwon

    2014-02-01

    Full Text Available BackgroundMany epidemiologic studies have shown that women with type 2 diabetes have an increased risk of developing cardiovascular disease compared with men with diabetes. The aim of this study is to elucidate whether disparities of adiposity, age and insulin resistance (IR at the time of diabetes diagnosis exist between women and men in the adult Korean population.MethodsData from The Korea National Health and Nutrition Examination Survey, performed in Korea from 2007 to 2010, were used. In the survey, anthropometric data and blood samples were obtained during a fasting state. IR and β-cell function were calculated using the homeostasis model assessment (HOMA-IR and HOMA-β, respectvely.ResultsThe mean age of diabetes diagnosis was 58.5 years in women and was 55.1 years in men (P=0.015. The mean body mass index (BMI of newly diagnosed diabetes subjects was 26.1 kg/m2 in women and 25.0 kg/m2 in men (P=0.001. The BMI was inversely related to age in both genders, and the higher BMI in women than men was consistent throughout all age groups divided by decade. The HOMA-IR in women with diabetes is higher than in men with diabetes (7.25±0.77 vs. 5.20±0.32; P=0.012.ConclusionKorean adult women are diagnosed with type 2 diabetes at higher BMI and older age than men and are more insulin-resistant at the time of diabetes diagnosis. This may help explain why women with diabetes have an increased risk of developing cardiovascular disease after the diagnosis of diabetes, compared to men.

  15. The Effect of National Service on Metabolic Control, Weight Status and Incidence of Acute Diabetes Complications in Young Adults with Type 1 Diabetes.

    Science.gov (United States)

    Brener, Avivit; Mel, Eran; Shalitin, Shlomit; Lazar, Liora; de Vries, Liat; Tenenbaum, Ariel; Oron, Tal; Farfel, Alon; Phillip, Moshe; Lebenthal, Yael

    2016-07-01

    Patients with type 1 diabetes (T1D) are exempt from conscript military service, but some volunteer for national service. To evaluate the effect of national service (military or civil) on metabolic control and incidence of acute diabetes complications in young adults with T1D. Clinical and laboratory data of 145 T1D patients were retrieved from medical records. The cohort comprised 76 patients volunteering for national service and 69 non-volunteers. Outcome measures were HbA1c, body mass index-standard deviation scores (BMI-SDS), insulin dosage, and occurrence of severe hypoglycemia or diabetic ketoacidosis (DKA). Metabolic control was similar in volunteers and non-volunteers: mean HbA1c at various time points was: 7.83 ± 1.52% vs. 8.07% ± 1.63 one year before enlistment age, 7.89 ± 1.36% vs. 7.93 ± 1.42% at enlistment age, 7.81 ± 1.28% vs. 8.00 ± 1.22% one year thereafter, 7.68 ± 0.88% vs. 7.82 ± 1.33% two years thereafter, and 7.62 ± 0.80% vs. 7.79 ± 1.19% three years thereafter. There were no significant changes in HbA1c from baseline throughout follow-up. BMI and insulin requirements were similar and remained unchanged in volunteers and controls: mean BMI-SDS one year before enlistment age was 0.23 ± 0.83 vs. 0.29 ± 0.95, at enlistment age 0.19 ± 0.87 vs. 0.25 ± 0.98, one year thereafter 0.25 ± 0.82 vs. 0.20 ± 0.96, two years thereafter 0.10 ± 0.86 vs. 0.15 ± 0.94, and three years thereafter 0.20 ± 0.87 vs. 0.16 ± 0.96. Mean insulin dose in U/kg/day one year before enlistment age was 0.90 ± 0.23 vs. 0.90 ± 0.37, at enlistment age 0.90 ± 0.28 vs. 0.93 ± 0.33, one year thereafter 0.86 ± 0.24 vs. 0.95 ± 0.33, two years thereafter 0.86 ± 0.21 vs. 0.86 ± 0.29, and three years thereafter 0.87 ± 0.23 vs. 0.86 ± 0.28. There were no episodes of severe hypoglycemia or DKA in either group. Our data indicate that during voluntary national service young adults with T1D maintain metabolic control similar to that of non-volunteers.

  16. Diabetes miles youth Australia : Methods and sample characteristics of a national survey of the psychological aspects of living with type 1 diabetes in Australian youth and their parents

    NARCIS (Netherlands)

    Hagger, V.; Trawley, S.; Hendrieckx, C.; Browne, J.L.; Cameron, F.; Pouwer, F.; Skinner, T.; Speight, J.

    2016-01-01

    Background Type 1 diabetes is a complex and demanding condition, which places a substantial behavioural and psychological burden on young people and their families. Around one-third of adolescents with type 1 diabetes need mental health support. Parents of a child with type 1 diabetes are also at

  17. An international comparison study indicated physicians' habits in reporting diabetes in part I of death certificate affected reported national diabetes mortality.

    Science.gov (United States)

    Lu, Tsung-Hsueh; Walker, Sue; Johansson, Lars Age; Huang, Chien-Ning

    2005-11-01

    Physicians may find it confusing to decide whether to report diagnoses in part I or part II of the death certificate. The aim of this study was to contrast differences in diabetes mortality through a comparison of physicians' habits in reporting diabetes in part I of death certification among Taiwan, Australia, and Sweden. A cross-sectional, intercountry comparison study. We calculated the proportion of deaths with mention of diabetes in which diabetes was reported in part I of the death certificate and the proportion of deaths with mention of diabetes in which diabetes was selected as underlying cause of death. We found that half of the differences in reported diabetes mortality among Taiwan, Australia, and Sweden were due to differences in reporting deaths with mention of diabetes anywhere on the certificate, and half due to differences in proportion of deaths with mention of diabetes in which diabetes was reported in part I of the death certificate. Differences in the reporting of diabetes in part I of the death certificate among physicians in Taiwan, Australia, and Sweden was one of the factors that affected differing reported diabetes mortality in Taiwan, Australia, and Sweden.

  18. Informing the development of a national diabetes register in Ireland: a literature review of the impact of patient registration on diabetes care

    Directory of Open Access Journals (Sweden)

    Monica O'Mullane

    2010-09-01

    Conclusions This review suggested that registers are generally assumed to be an essential element of quality improvement interventions rather than an optional addition. A diabetes register is central to the development of a comprehensive diabetes management system in primary care, which can lead to improvements in the processes and outcomes of diabetes care.

  19. Diabetes Attitudes, Wishes and Needs second study (DAWN2™) : Cross-national benchmarking indicators for family members living with people with diabetes

    NARCIS (Netherlands)

    Kovacs Burns, K.; Nicolucci, A.; Holt, R.I.G.; Willaing, I.; Hermanns, N.; Kalra, S.; Wens, J.; Pouwer, F.; Skovlund, S.E.; Peyrot, M.

    2013-01-01

    Aims The second Diabetes Attitudes, Wishes and Needs (DAWN2) study examined the experiences of family members of people with diabetes for benchmarking and identifying unmet needs or areas for improvement to assist family members and those with diabetes to effectively self-manage. Methods In total,

  20. Operating experience from Swedish nuclear power plants 2004

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-07-01

    2004 was somewhat of a record year for the Swedish nuclear power stations. No serious faults occurred, and production exceeded previous record outputs. Total output from the eleven nuclear power units during the year amounted to 75 TWh, which is the largest amount of power ever produced by nuclear power in Sweden. Corresponding figures for earlier years are 59 TWh (2003), 65 TWh (2002) and 69 TWh (2001). An important reason for this excellent result was the very high energy availability. Forsmark 1, for example, exceeded 97 % availability, while Forsmark 2 just reached 97 %. For all the Swedish nuclear power stations as a whole, availability in 2004 amounted to 91 %. In addition to the connection between production and energy availability, there is also a connection with safety. During the year, safety in the Swedish power stations has been high, not only in absolute terms but also in an international perspective. One measure of safety is to be found in the number of accidents, incidents, anomalies or deviations reported to the IAEA on a scale known as the International Nuclear Event Scale (INES). Sweden has undertaken to report all events in accordance with this international system. Three reports were submitted by the Swedish Nuclear Power Inspectorate, which is responsible for national reporting, during the year. None of them had any significance for reactor safety: all were categorised as incidents or minor deviations from the regulations. Summarising, 2004 has been an excellent year for nuclear power safety, which is also reflected by the record electricity production during the year.

  1. 77 FR 14405 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2012-03-09

    ... Dysfunction After Spinal Cord Injury. Date: June 13, 2012. Time: 1 p.m. to 3:30 p.m. Agenda: To review and... Interdisciplinary Team Science in NIDDK Research Areas. Date: March 30, 2012. Time: 11:30 a.m. to 1 p.m. Agenda: To... Domestic Assistance Program Nos. 93.847, Diabetes, Endocrinology and Metabolic Research; 93.848, Digestive...

  2. Gender Integration and the Swedish Armed Forces

    DEFF Research Database (Denmark)

    Gustafsson, Daniel Marcus Sunil

    This paper discusses different gender aspects of the Swedish Armed Forces with specific references to sexual harassment and prostitution. By using the concept of Hegemonic Masculinity, sexual harassment of the women in the Swedish Armed Forces is explained in terms of a need of the men within...... the organisation to reinforce the notion of women as inferior and subordinate to men, whereby the external hegemony is believed to be restored. Likewise, male Swedish peacekeepers’ demand for prostitution during international peacekeeping missions is explained in terms of a need to confirm manhood and as homo...

  3. Prevalence, awareness, treatment and control of hypertension in adults with diagnosed diabetes: the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV).

    Science.gov (United States)

    Lee, H-S; Lee, S-S; Hwang, I-Y; Park, Y-J; Yoon, S-H; Han, K; Son, J-W; Ko, S-H; Park, Y G; Yim, H W; Lee, W-C; Park, Y-M

    2013-06-01

    We evaluated the prevalence, awareness, treatment and control of hypertension in Korean adults with diagnosed diabetes using nationally representative data. Among subjects aged ≥30 years who participated in the Fourth Korea National Health and Nutrition Examination Survey in 2007 and 2008, a total of 745 subjects (336 men and 409 women) with a previous diagnosis of diabetes mellitus were analyzed. The prevalence of hypertension in adults with diagnosed diabetes was 55.5%. The rates of awareness, treatment and control were 88.0, 94.2, and 30.8%, respectively. Compared with the general population, the prevalence of hypertension in adults with diagnosed diabetes was higher in all age groups in both genders. Factors independently associated with a high prevalence of hypertension included being male, increasing age, single, <9 years of education, the presence of chronic kidney disease risk, hypercholesterolemia (≥240 mg dl(-1)) and high body mass index (≥25 kg m(-2)). Regular medical screening was positively associated with hypertension control, whereas a high triglyceride level (≥150 mg dl(-1)) was inversely associated. A high prevalence and a low control rate of hypertension in adults with diagnosed diabetes suggest that stringent efforts are needed to control blood pressure in diabetic patients.

  4. Workplace Incivility in a Swedish Context

    Directory of Open Access Journals (Sweden)

    Eva Torkelson

    2016-06-01

    Full Text Available The present study investigated workplace incivility in a Swedish context. The first aim was to assess how common the phenomenon is and the second was to study which groups (gender, age, ethnicity, and power position are most targeted by workplace incivility and are more prone to act in an uncivil way. Additionally, the relationships between experienced and witnessed incivility and wellbeing as well as instigated incivility were investigated. An online survey was administered by SIFO (the national public opinion poll agency. The collected data consist of a stratified sample whose composition is identical to the working population in Sweden (N = 3001. The results show that almost three quarters of the respondents had been the target of coworker incivility and 52% of supervisor incivility at least one to two times in the past year. Of the respondents, 75% had witnessed coworkers and 58% witnessed a supervisor treating others in an uncivil way. Furthermore, 66% had instigated uncivil acts toward others. The results also show that female and younger employees are slightly more targeted by incivility from coworkers and younger employees and supervisors are slightly more prone to instigate incivility. Moreover, it was found that that experienced incivility was the strongest predictor of low well-being and that witnessed incivility was the strongest predictor of instigated incivility.

  5. Epidemiology and outcomes of hypoglycemia in patients with advanced diabetic kidney disease on dialysis: A national cohort study.

    Directory of Open Access Journals (Sweden)

    Yeh-Wen Chu

    Full Text Available Patients with advanced diabetic kidney disease (DKD behave differently to diabetic patients without kidney disease. We aimed to investigate the associations of hypoglycemia and outcomes after initiation of dialysis in patients with advanced DKD on dialysis.Using National Health Insurance Research Database, 20,845 advanced DKD patients beginning long-term dialysis between 2002 and 2006 were enrolled. We investigated the incidence of severe hypoglycemia episodes before initiation of dialysis. Patients were followed from date of first dialysis to death, end of dialysis, or 2008. Main outcomes measured were all-cause mortality, myocardial infarction (MI, and subsequent severe hypoglycemic episodes after dialysis.19.18% patients had at least one hypoglycemia episode during 1-year period before initiation of dialysis. Advanced DKD patients with higher adapted Diabetes Complications Severity Index (aDCSI scores were associated with more frequent hypoglycemia (P for trend < 0.001. Mortality and subsequent severe hypoglycemia after dialysis both increased with number of hypoglycemic episodes. Compared to those who had no hypoglycemic episodes, those who had one had a 15% higher risk of death and a 2.3-fold higher risk of subsequent severe hypoglycemia. Those with two or more episodes had a 19% higher risk of death and a 3.9-fold higher risk of subsequent severe hypoglycemia. However, previous severe hypoglycemia was not correlated with risk of MI after dialysis.The rate of severe hypoglycemia was high in advanced DKD patients. Patients with higher aDCSI scores tended to have more hypoglycemic episodes. Hypoglycemic episodes were associated with subsequent hypoglycemia and mortality after initiation of dialysis. We studied the associations and further study is needed to establish cause. In addition, more attention is needed for hypoglycemia prevention in advanced DKD patients, especially for those at risk patients.

  6. Ferride geochemistry of Swedish precambrian iron ores

    Science.gov (United States)

    Loberg, B. E. H.; Horndahl, A.-K.

    1983-10-01

    Chemical analysis for major and trace elements have been performed on 30 Swedish Precambrian iron ores and on some from Iran and Chile. The Swedish ores consist of apatite iron ores, quartz-banded iron ores, skarn and limestone iron ores from the two main ore districts of Sweden, the Bergslagen and the Norrbotten province. Some Swedish titaniferous iron ores were also included in the investigation. The trace element data show that the Swedish ores can be subdivided into two major groups: 1. orthomagmatic and exhalative, 2. sedimentary. Within group 1 the titaniferous iron ores are distinguished by their high Ti-contents. From the ferride contents of the Kiruna apatite iron ores, the ores are considered to be mobilization products of skarn iron ores from the Norbotten province.

  7. 77 FR 52042 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2012-08-28

    ... Kidney Diseases Special Emphasis Panel; Health Promotion ] Among Racial and Ethnic Minority-PA10-236...: National Institutes of Health, Two Democracy Plaza, 6707 Democracy Boulevard, Bethesda, MD 20892..., DEA, NIDDK, National Institutes of Health, Room 749, 6707 Democracy Boulevard, Bethesda, MD 20892-5452...

  8. Diabetic nephropathy research in China: Data analysis and review from the National Natural Science Foundation of China.

    Science.gov (United States)

    Wan, Qiang; Xu, Yanying; Dong, Erdan

    2015-05-01

    As the largest funding agency of natural science of China, the National Natural Science Foundation of China (NSFC) has made great efforts in promoting the development of diabetic nephropathy (DN) research in recent years. The aim of the current study is to summarize the diabetic nephropathy research in China by analyzing NSFC-funded projects. Data on all projects in the DN field funded by NSFC from 1986 to 2013 were collected. The funding tendency, funding areas, and hotspots in the DN field, and major research institutions, were analyzed. As one output of this support, outstanding research groups in China, and their representative studies, are also highlighted. From 1986 to 2013, the NSFC has funded a total of 248 projects in the DN field, with a total funding amount of 91.5 million RMB (US$14.9 million). A rapid increase could be seen in the past 5 years, with an average annual 30% increase in projects numbers and a 52% increase in funding amount. All fields in DN research have been covered by the NSFC, including etiology, pathophysiology, diagnostics, and therapeutics. Along with increased funding of the DN research, there has been a growth in the papers published in Science Citation Index journals by Chinese scholars. In the past decade, the funding scale and funding budget have increased dramatically. Benefiting from this, DN research in China has also made considerable progression. © 2015 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  9. Prevalence of overweight and obesity in United Arab Emirates Expatriates: the UAE National Diabetes and Lifestyle Study

    Directory of Open Access Journals (Sweden)

    Nabil Sulaiman

    2017-11-01

    Full Text Available Abstract Objective To describe current prevalence of obesity and related non-communicable diseases (NCDs in expatriates living in the United Arab Emirates (UAE. Methods We used data from the cross-sectional UAE National Diabetes and Lifestyle Study (UAEDIAB, which surveyed adult expatriates living in the UAE for at least 4 years. We report crude prevalence of overweight and obesity, indicated by gender and ethnicity-specific body mass index (BMI, waist circumference (WC and waist-to-hip ratio (WHR cut-offs, by lifestyle and biomedical characteristics, as well as age and sex-adjusted odds ratios. Results Out of a total of 3064 recruited expatriates (response rate 68%, 2724 had completed all stages of the UAEDIAB study. Expatriates were; 81% men, mean age 38 years (range 18–80, 71% South East Asians, and 36% university graduates. In this sample, the prevalence of overweight and obesity, by BMI, were 43.0 and 32.3%, respectively. 52.4 and 56.5% of participants were at a substantially increased risk according to WC and WHR, respectively. The prevalence of diabetes, hypertension and hypercholesterolemia were 15.5, 31.8, and 51.7%, respectively, with the prevalence of each being higher in those with obesity. Conclusion Prevalence of obesity and associated NCDs are extremely high in UAE expatriates. Without comprehensive prevention and management, levels of disease will continue to increase and productivity will fall.

  10. Russian National Consensus Statement on gestational diabetes: diagnostics, treatment and postnatal care

    Directory of Open Access Journals (Sweden)

    Ivan Ivanovich Dedov

    2012-12-01

    Full Text Available Current document presents the expert consensus of Russian Association of Endocrinologists and Russian Society of Obstetrician- Gynecologists on diagnostic criteria of gestational diabetes and other glycemic disorders of pregnancy. The consensus is based on analysis of HAPO (Hyperglycemia and Adverse Pregnancy Outcomes Study - a major multinational study, that included more than 23000 patients. Project of current consensus was repeatedly discussed during meetings of the research group and publicly addressed at 6th Pan-Russian Congress of Endocrinology with international participation «Modern Endocrine Technologies», as well as Pan-Russian Educational Interscience Conference «Complicated Pregnancy and Preterm Birth».

  11. Association between family history of diabetes and cardiovascular disease and lifestyle risk factors in the United States population: The 2009-2012 National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Akhuemonkhan, Eboselume; Lazo, Mariana

    2017-03-01

    Family history is a well-known risk factor for diabetes and cardiovascular disease (CVD) and modification of lifestyle risk factors can significantly lessen such risk. Our aim was to assess the association between family history of diabetes and/or CVD and lifestyle behaviors and risk factors (smoking, low physical activity, excessive dietary sodium and cholesterol intake and obesity) in a nationally representative sample of U.S. adults. We conducted a cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) 2009-2012. Family history, lifestyle behaviors and risk factors were defined using self-reported and physical examination data. The study sample included 10,988 participants with a mean age of 47years. Among the U.S. adult population, 29.5%, 5.7% and 6.5% had a family history of diabetes, CVD and both diseases respectively. Compared to participants with no family history, participants with a family history of diabetes, CVD and both diabetes and CVD were more likely to be current smokers (OR=1.18[95% CI, 1.03-1.35], OR=1.68[95% CI, 1.31-2.17] and OR=1.71[95% CI, 1.30-2.26] respectively). Participants with a family history of diabetes (OR=1.42[95% CI, 1.26-1.61]) and both diabetes and CVD were more likely to be overweight/obese (OR=2.06[95% CI, 1.57-2.69]). There was no association between family history and dietary factors or physical activity. In the U.S., there is a high prevalence of modifiable risk factors among persons with a family history of diabetes and/or CVD. Healthcare providers have a significant role to play in targeting these individuals for lifestyle changes. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Association of diabetes, comorbidities, and A1C with functional disability in older adults: results from the National Health and Nutrition Examination Survey (NHANES), 1999-2006.

    Science.gov (United States)

    Kalyani, Rita Rastogi; Saudek, Christopher D; Brancati, Frederick L; Selvin, Elizabeth

    2010-05-01

    To examine the relationship of diabetes and functional disability in older adults and the possible mediating roles of comorbidities and A1C. We analyzed data from a nationally representative sample of 6,097 participants aged >or=60 years in the National Health and Nutrition Examination Survey, 1999-2006. Diabetes was defined by self-report. Disability was defined as difficulty performing a physical task. We evaluated disability by grouping 19 physical tasks into five functional groups: lower-extremity mobility (LEM), general physical activities (GPA), activities of daily living (ADL), instrumental activities of daily living (IADL), and leisure and social activities (LSA). Older U.S. adults with diabetes had the greatest disability in GPA (prevalence 73.6% [95% CI 70.2-76.9]), followed by LEM (52.2% [48.5-55.9]), IADL (43.6% [40.1-47.2]), ADL (37.2% [33.1-41.3]), and LSA groups (33.8% [30.8-36.9]). Diabetes was associated with two to three times increased odds of disability across functional groups (all P or=8%) together explained up to 85% of the excess odds of disability associated with diabetes, whereas poor glycemic control alone explained only approximately 10% of the excess odds. Adjustment for comorbidities, A1C, and diabetes duration fully attenuated the associations of diabetes with disability in all functional groups (all P > 0.05). Older adults with diabetes have a high prevalence of disabilities with variable associations attributable to comorbidities and A1C. Aggressive management of cardiovascular risk factors and obesity may significantly reduce the burden of disability in this population.

  13. Relationship between abuse and neglect in childhood and diabetes in adulthood: differential effects by sex, national longitudinal study of adolescent health.

    Science.gov (United States)

    Duncan, Alexis E; Auslander, Wendy F; Bucholz, Kathleen K; Hudson, Darrell L; Stein, Richard I; White, Neil H

    2015-05-07

    Few studies have investigated links between child abuse and neglect and diabetes mellitus in nationally representative samples, and none have explored the role of obesity in the relationship. We sought to determine whether child abuse and neglect were associated with diabetes and if so, whether obesity mediated this relationship in a population-representative sample of young adults. We used data from 14,493 participants aged 24 to 34 years from Wave IV of the National Longitudinal Study of Adolescent Health to study associations between self-reported child abuse (sexual, physical, or emotional abuse) and neglect as children and diabetes or prediabetes in young adulthood. We conducted sex-stratified logistic regression analyses to evaluate associations in models before and after the addition of body mass index (BMI) as a covariate. Although the prevalence of diabetes was similar for men and women (7.0% vs 6.7%), men were more likely than women to have prediabetes (36.3% vs 24.6%; omnibus P recurrent sexual abuse (≥3 lifetime incidents) was significantly associated with diabetes (OR, 3.66; 95% CI, 1.31-10.24), but not with prediabetes. There was no evidence of mediation by BMI. No forms of child abuse or neglect were associated with diabetes or prediabetes among women. Recurrent sexual abuse is robustly associated with diabetes in young adult men, independently of other forms of child abuse or neglect and BMI. Future research should explore other potential mechanisms for this association to identify avenues for prevention of diabetes among men who have experienced sexual abuse.

  14. United Kingdom National Ophthalmology Database Study: Diabetic Retinopathy; Report 1: prevalence of centre-involving diabetic macular oedema and other grades of maculopathy and retinopathy in hospital eye services

    Science.gov (United States)

    Keenan, T D L; Johnston, R L; Donachie, P H J; Sparrow, J M; Stratton, I M; Scanlon, P

    2013-01-01

    Aims To report estimates of the prevalence of diabetic retinopathy (DR) and maculopathy grades for a large cohort of patients managed by the UK hospital eye service (HES). Methods Anonymised data were extracted from 30 UK NHS hospital trusts using a single ophthalmic electronic medical record (EMR) for the period from April 2000 to November 2010 to create the National Ophthalmology Database (NOD). From 2007, the EMR facilitated capture of a nationally agreed-upon standardised data set (DR Structured Assessment) relating to the presence or absence of clinical signs of DR and maculopathy. An algorithm in the software automatically calculated the Early Treatment of Diabetic Retinopathy Study grades of retinopathy and maculopathy. Results Between 2007 and 2010, 307 538 patients had data on the NOD, with 76 127 (24.8%) patients having been recorded as having diabetes. The proportion of patients with diabetes who had a structured assessment increased from 50.7% (2007) to 86.8% (2010). In each NHS year, 12.6–20.6% of eyes with structured assessments had no DR; 59.6–67.3% had non-proliferative DR; and 18.3–20.9% had active or regressed proliferative DR. Clinically significant macular oedema was present in 15.8–18.1% of eyes, and in 8.7–10.0% of eyes, this involved the central macula. Conclusion This study provides contemporary estimates of the prevalence of retinopathy and maculopathy grades in a large cohort of patients with diabetes managed by the UK HES. Centre-involving diabetic macular oedema, potentially amenable to anti-VEGF therapy, is present in the eyes of almost 10% of these patients. This information is useful for clinicians, health-care economists, and commissioners involved in planning and delivering diabetic eye services. PMID:24051410

  15. Type 2 diabetes mellitus unawareness, prevalence, trends and risk factors: National Health and Nutrition Examination Survey (NHANES) 1999-2010.

    Science.gov (United States)

    Zhang, Nana; Yang, Xin; Zhu, Xiaolin; Zhao, Bin; Huang, Tianyi; Ji, Qiuhe

    2017-04-01

    Objectives To determine whether the associations with key risk factors in patients with diagnosed and undiagnosed type 2 diabetes mellitus (T2DM) are different using data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2010. Methods The study analysed the prevalence and association with risk factors of undiagnosed and diagnosed T2DM using a regression model and a multinomial logistic regression model. Data from the NHANES 1999-2010 were used for the analyses. Results The study analysed data from 10 570 individuals. The overall prevalence of diagnosed and undiagnosed T2DM increased significantly from 1999 to 2010. The prevalence of undiagnosed T2DM was significantly higher in non-Hispanic whites, in individuals physical activity levels. Conclusion The overall T2DM prevalence increased between 1999 and 2010, particularly for undiagnosed T2DM in patients that were formerly classified as low risk.

  16. Global Flows in Local Language Planning: Articulating Parallel Language Use in Swedish University Policies

    Science.gov (United States)

    Hult, Francis M.; Källkvist, Marie

    2016-01-01

    In this paper, the language policies of three Swedish universities are examined as instances of language planning in local contexts. Although Sweden has the national Language Act of 2009 (SFS 2009:600) as well as a general Higher Education Ordinance (SFS 1993:100; SFS 2014:1096), language planning for higher education is left to the purview of…

  17. Thinking and Caring about Indigenous Peoples' Human Rights: Swedish Students Writing History beyond Scholarly Debate

    Science.gov (United States)

    Nygren, Thomas

    2016-01-01

    According to national and international guidelines, schools should promote historical thinking and foster moral values. Scholars have debated, but not analysed in depth in practice, whether history education can and should hold a normative dimension. This study analyses current human rights education in two Swedish senior high school groups, in…

  18. Swedish PE Teachers' Understandings of Legitimate Movement in a Criterion-Referenced Grading System

    Science.gov (United States)

    Svennberg, Lena

    2017-01-01

    Background: Physical Education (PE) has been associated with a multi-activity model in which movement is related to sport discourses and sport techniques. However, as in many international contexts, the Swedish national PE syllabus calls for a wider and more inclusive concept of movement. Complex movement adapted to different settings is valued,…

  19. Teaching of Chemical Bonding: A Study of Swedish and South African Students' Conceptions of Bonding

    Science.gov (United States)

    Nimmermark, Anders; Ohrstrom, Lars; Mårtensson, Jerker; Davidowitz, Bette

    2016-01-01

    Almost 700 Swedish and South African students from the upper secondary school and first-term chemistry university level responded to our survey on concepts of chemical bonding. The national secondary school curricula and most common textbooks for both countries were also surveyed and compared for their content on chemical bonding. Notable…

  20. Racial and Ethnic Heterogeneity in Self-Reported Diabetes Prevalence Trends Across Hispanic Subgroups, National Health Interview Survey, 1997–2012

    Science.gov (United States)

    Mincey, Krista D.; Ackermann, Nicole; Milam, Laurel; Goodman, Melody S.; Colditz, Graham A.

    2016-01-01

    Introduction We examined racial/ethnic heterogeneity in self-reported diabetes prevalence over 15 years. Methods We used National Health Interview Survey data for 1997 through 2012 on 452,845 adults aged 18 years or older. Annual self-reported diabetes prevalence was estimated by race/ethnicity and education. We tested for trends over time by education and race/ethnicity. We also analyzed racial/ethnic and education trends in average annual prevalence. Results During the 15 years studied, diabetes prevalence differed significantly by race/ethnicity (P < .001) and by Hispanic subgroup (P < .001). Among participants with less than a high school education, the 5-year trend in diabetes prevalence was highest among Cubans and Cuban Americans (β5YR = 4.8, P = .002), Puerto Ricans (β5YR = 2.2, P = .06), non-Hispanic blacks (β5YR = 2.2, P < .001), and non-Hispanic whites (β5YR = 2.1, P < .001). Among participants with more than a high school education, non-Hispanic blacks had the highest average annual prevalence (5.5%) and Puerto Ricans had the highest 5-year trend in annual diabetes prevalence (β5YR = 2.6, P = .001). Conclusions In this representative sample of US adults, results show ethnic variations in diabetes prevalence. The prevalence of diabetes is higher among Hispanics than among non-Hispanic whites, unevenly distributed across Hispanic subgroups, and more pronounced over time and by education. Findings support disaggregation of data for racial/ethnic populations in the United States to monitor trends in diabetes disparities and the use of targeted, culturally appropriate interventions to prevent diabetes. PMID:26796518

  1. Use of the National Diabetes Data Group and the Carpenter-Coustan criteria for assessing gestational diabetes mellitus and risk of adverse pregnancy outcome.

    Science.gov (United States)

    Lu, Mei-Chun; Huang, Song-Shan; Yan, Yuan-Horng; Wang, Panchalli

    2016-08-17

    The influence of different diagnostic thresholds for gestational diabetes mellitus (GDM) on pregnancy outcomes is not fully understood. Degrees of glucose intolerance according to the Carpenter-Coustan (CC) criteria were less severe than the National Diabetes Data Group (NDDG) criteria for GDM. Recent studies have shown inconsistent results regarding the risk of adverse pregnancy outcomes between the NDDG and CC criteria. Therefore, the objective of this study was to investigate whether pregnant women who met only the CC criteria but not the NDDG criteria and those who met the NDDG criteria had increased risks of adverse pregnancy outcomes compared to a negative screening group. A total of 11,486 Taiwanese pregnancies were enrolled in a retrospective cohort study. The study subjects were classified as follows: (1) negative screening group: women with negative 50-g glucose challenge test (GCT) results, (2) false-positive screening group: women with positive GCT results and negative 100-g OGTT results according to both CC and NDDG criteria, (3) CC-only-GDM group: women with positive GCT results plus GDM diagnosis meeting the CC but not the NDDG criteria, and (4) NDDG-GDM group: women diagnosed with GDM using the NDDG criteria. Multiple mixed effects logistic regression analysis was used to examine the relationships between the groups and pregnancy outcomes. There were 9002 (78.4 %), 1776 (15.5 %), 251 (2.2 %), and 457 (4.0 %) study pregnancies in the 4 groups. Compared with the negative screening group, the maternal outcomes were not different within groups except for gestational hypertension/preeclampsia. For neonatal outcomes, the CC-only-GDM group had significantly greater risks of macrosomia, low birth weight, and admission to a neonatal intensive care unit [adjusted odds ratio (aOR), (95 % confidence interval, CI): 2.73 (1.18-6.31), 1.64 (1.01-2.64), and 1.61 (1.05-2.46), respectively]. The NDDG-GDM group also showed significantly greater risks, and the

  2. 78 FR 6122 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2013-01-29

    ... Kidney Diseases Special Emphasis Panel, Renal Transport Program Projects. Date: February 25, 2013. Time... Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health...

  3. 78 FR 10623 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-02-14

    ..., Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS) Dated: February 7, 2013. David Clary...

  4. 77 FR 66855 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2012-11-07

    ..., Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS) Dated: November 1, 2012. David Clary...

  5. 78 FR 7793 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-02-04

    ..., Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS) Dated: January 29, 2013. David Clary...

  6. Physical and meteorological data collected from current meters and other instruments from Swedish Lightships from 1860 to 1989 (NODC Accession 0113242)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Lightships were placed along the Swedish coast to lead the Mariners from 1844 to 1972. From 1860 routine measurements of meteorological and oceanographic...

  7. Depression among people with type 2 diabetes mellitus, US National Health and Nutrition Examination Survey (NHANES), 2005-2012.

    Science.gov (United States)

    Wang, Yiting; Lopez, Janice M S; Bolge, Susan C; Zhu, Vivienne J; Stang, Paul E

    2016-04-05

    Depression in people with diabetes can result in increased risk for diabetes-related complications. The prevalence of depression has been estimated to be 17.6 % in people with type 2 diabetes mellitus (T2DM), based on studies published between 1980 and 2005. There is a lack of more recent estimates of depression prevalence among the US general T2DM population. The present study used the US National Health and Nutrition Examination Survey (NHANES) 2005-2012 data to provide an updated, population-based estimate for the prevalence of depression in people with T2DM. NHANES is a cross-sectional survey of a nationally representative sample of the civilian, non-institutionalized US population. Starting from 2005, the Patient Health Questionnaire (PHQ-9) was included to measure signs and symptoms of depression. We defined PHQ-9 total scores ≥ 10 as clinically relevant depression (CRD), and ≥ 15 as clinically significant depression (CSD). Self-reported current antidepressant use was also combined to estimate overall burden of depression. Predictors of CRD and CSD were investigated using survey logistic regression models. A total of 2182 participants with T2DM were identified. The overall prevalence of CRD and CSD among people with T2DM is 10.6 % (95 % confidence interval (CI) 8.9-12.2 %), and 4.2 % (95 % CI 3.4-5.1 %), respectively. The combined burden of depressive symptoms and antidepressants may be as high as 25.4 % (95 % CI 23.0-27.9 %). Significant predictors of CRD include age (younger than 65), sex (women), income (lower than 130 % of poverty level), education (below college), smoking (current or former smoker), body mass index (≥30 kg/m(2)), sleep problems, hospitalization in the past year, and total cholesterol (≥200 mg/dl). Significant predictors of CSD also include physical activity (below guideline) and cardiovascular diseases. The prevalence of CRD and CSD among people with T2DM in the US may be lower than in earlier studies, however, the burden of

  8. Brand-Name Prescription Drug Use Among Diabetes Patients in the VA and Medicare Part D: A National Comparison

    Science.gov (United States)

    Gellad, Walid F.; Donohue, Julie M.; Zhao, Xinhua; Mor, Maria K.; Thorpe, Carolyn T.; Smith, Jeremy; Good, Chester B.; Fine, Michael J.; Morden, Nancy E.

    2013-01-01

    Background Medicare Part D and the Department of Veterans Affairs (VA) use different approaches to manage prescription drug benefits, with implications for spending. Medicare relies on private plans with distinct formularies, whereas VA administers its own benefit using a national formulary. Objective To compare overall and regional rates of brand-name drug use among older adults with diabetes in Medicare and VA. Design Retrospective cohort Setting Medicare and VA Patients National sample in 2008 of 1,061,095 Part D beneficiaries and 510,485 Veterans age 65+ with diabetes. Measurements Percent of patients on oral hypoglycemics, statins, and angiotensin-converting-enzyme inhibitors/angiotensin-receptor-blockers who filled brand-name drugs and percent of patients on long-acting insulin who filled analogues. We compared sociodemographic and health-status adjusted hospital referral region (HRR) brand-name use to examine local practice patterns, and calculated changes in spending if each system’s brand-name use mirrored the other. Results Brand-name use in Medicare was 2–3 times that of VA: 35.3% vs. 12.7% for oral hypoglycemics, 50.7% vs. 18.2% for statins, 42.5% vs. 20.8% for angiotensin-converting-enzyme inhibitors/angiotensin-receptor-blockers, and 75.1% vs. 27.0% for insulin analogues. Adjusted HRR brand-name statin use ranged (5th to 95th percentile) from 41.0%–58.3% in Medicare and 6.2%–38.2% in VA. For each drug group, the HRR at the 95th percentile in VA had lower brand-name use than the 5th percentile HRR in Medicare. Medicare spending in this population would have been $1.4 billion less if brand-name use matched the VA for these medications. Limitation This analysis cannot fully describe the factors underlying differences in brand-name use. Conclusions Medicare beneficiaries with diabetes use 2–3 times more brand-name drugs than a comparable group within VA, at substantial excess cost. Primary Funding Sources VA; NIH; RWJF PMID:23752663

  9. Determinants and consequences of insulin initiation for type 2 diabetes in France: analysis of the National Health and Wellness Survey

    Directory of Open Access Journals (Sweden)

    Reach G

    2013-10-01

    Full Text Available Gérard Reach,1 Véronique Le Pautremat,2 Shaloo Gupta31Department of Endocrinology, Diabetes, and Metabolic Diseases, Avicenne Hospital APHP, and EA 3412, CRNH-IdF, Paris 13 University, Sorbonnne Paris Cité, Bobigny, France; 2Kantar Health, Paris, France; 3Kantar Health, Princeton, NJ, USABackground: The aim of the study was to identify the intrinsic patient characteristics and extrinsic environmental factors predicting prescription and use and, more specifically, early initiation (up to 5 years of disease duration of insulin for type 2 diabetes in France. A secondary objective was to evaluate the impact of insulin therapy on mental and physical quality of life and patient adherence.Methods: The data used in this study were derived from the 2008, 2010, and 2011 France National Health and Wellness Survey. This survey is an annual, cross-sectional, self-administered, Internet-based questionnaire among a nationwide representative sample of adults (aged 18 years or older. Of the total of 45,958 persons recruited in France, 1,933 respondents (deduped were identified as diagnosed with type 2 diabetes. All unique respondents from the three waves, currently using insulin or oral bitherapy or tritherapy at the time of assessment, were included in this analysis.Results: Early (versus late initiation of insulin therapy was 9.9 times more likely to be prescribed by an endocrinologist or diabetologist than by a primary care physician (P < 0.0001. Younger age at diagnosis and current smoking habits were significant predictors of early (versus late insulin initiation (odds ratio [OR] 1.031, 95% confidence interval [CI] 1.005–1.059, P = 0.0196, and OR 2.537, 95% CI 1.165–5.524, P = 0.0191, respectively. Patients with a yearly income ≥€50,000 were less likely to be put on insulin early (P = 0.0399. A link between insulin prescription and complications was shown only in univariate analysis. Mental quality of life was lower in patients on early (versus

  10. Comparison of clinical outcomes in diabetic and non-diabetic burns patients in a national burns referral centre in southeast Asia: A 3-year retrospective review.

    Science.gov (United States)

    Low, Zhao-Kai; Ng, Wai-Yee; Fook-Chong, Stephanie; Tan, Bien-Keem; Chong, Si-Jack; Hwee, Jolie; Tay, Sook-Muay

    2017-03-01

    Diabetic burns patients may be at risk of worse clinical outcomes. This study aims to further investigate the impact of diabetes mellitus on clinical outcomes in burns patients in Singapore. A 3-year retrospective review was performed at the Singapore General Hospital Burns Centre (2011-2013). Pure inhalational burns were excluded. Diabetic (N=53) and non-diabetic (N=533) patients were compared, and the impact of diabetes on clinical outcomes, adjusting for confounders, was investigated using multivariate logistic regression. The diabetic group had a significantly higher incidence of wound infection and severe renal impairment, as well as a longer length of stay, higher number of operations and higher rate of unplanned readmission. ICU admission was significantly associated with hyperglycaemia (OR 5.44 [2.61-11.35], p<0.001) and a higher total body surface area of burn (OR per 1% TBSA 1.07 [1.05-1.09], p<0.001). Unplanned readmission was significantly associated with wound infection (OR 4.29 [1.70-10.83], p=0.002), and mortality associated with a higher TBSA (OR per 1% TBSA 1.1 [1.07-1.14], p<0.001). After adjusting for confounders, diabetes mellitus was not significantly associated with unplanned readmission or mortality. Diabetic burns patients have an increased risk of worse clinical outcomes, including wound infections, renal impairment and longer length of stay. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  11. Monitoring of Individual Needs in Diabetes (MIND)-2 Follow-up data from the cross-national Diabetes Attitudes, Wishes, and Needs (DAWN) MIND study

    NARCIS (Netherlands)

    Snoek, F.J.; Kersch, N.Y.A.; Eldrup, E.; Harman-Boehm, I.; Hermanns, N.; Kokoszka, A.; Matthews, D.R.; McGuire, B.E.; Pibernik-Okanovic, M.; Singer, J.; de Wit, M.; Skovlund, S.E.

    2012-01-01

    OBJECTIVE - To test the effects of implementing computer-assisted Monitoring of Individual Needs in Diabetes (MIND) in routine diabetes care on psychological status and glycemic control, identify predictors of poor psychological outcomes, and evaluate care providers' experiences. RESEARCH DESIGN AND

  12. Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009

    Directory of Open Access Journals (Sweden)

    Kumban Walter Chuck

    2017-08-01

    Full Text Available OBJECTIVES To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. METHODS Data from the Korea National Health and Nutrition Examination Survey (2007-2009 were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. RESULTS Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer. Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001, breast cancer (38.8 vs. 44.6%, p<0.001, and cervical cancer (35.1 vs. 51.2%, p<0.001. In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9, and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9. CONCLUSIONS The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

  13. Increased risk of metabolic disorders in healthy young adults with family history of diabetes: from the Korea National Health and Nutrition Survey.

    Science.gov (United States)

    Moon, Joon Ho; Roh, Eun; Oh, Tae Jung; Kim, Kyoung Min; Moon, Jae Hoon; Lim, Soo; Jang, Hak Chul; Choi, Sung Hee

    2017-01-01

    We assessed the impact of a family history of diabetes on type 2 diabetes, metabolic syndrome, and behavioral traits in young Korean adults. Subjects aged 25-44 years were included, and the presence of a family history of diabetes was obtained by a self-reported questionnaire (the Korea National Health and Nutrition Survey 2010). We compared the prevalence of type 2 diabetes and metabolic syndrome, and other metabolic parameters, including blood pressure and lipid profile. Of 2059 participants, those with a family history of diabetes involving first-degree relatives (n = 489, 23.7%) had a significantly higher prevalence of impaired fasting glucose (14.3 vs. 11.7%) and type 2 diabetes (6.7 vs. 1.8%), compared to those without a family history (P < 0.001). The prevalence of metabolic syndrome (21.3 vs. 12.1%, P < 0.001) and its components (except for high-density lipoprotein cholesterol) were greater in subjects with a family history of diabetes. Among subjects exhibiting normal glucose tolerance (n = 1704), those with a family history of diabetes had higher fasting glucose (89.0 vs. 87.8 mg/dL, P < 0.001) and triglyceride (100.5 vs. 89.0 mg/dL, P < 0.001), and lower beta cell function by the homeostasis model assessment (HOMA-β; 134.2 vs. 137.5, P = 0.020). The obesity indices (body mass index, waist circumference, and triglyceride) were significantly correlated with those of both parents (P < 0.01 for all variables). Risk-reducing behavior, including regular exercise (18.2 vs. 19.7%, P = 0.469) and calorie intake (2174.8 vs. 2149.1 kcal/day, P = 0.636), did not markedly differ according to a family history of diabetes. Young adults with a family history of diabetes had an increased risk of type 2 diabetes and metabolic syndrome, even though they currently exhibited a normal glycemic profile. Proactive lifestyle consultation is requested especially among healthy young population with a family history of diabetes.

  14. Analysis using national databases reveals a positive association between dietary polyunsaturated fatty acids with TV watching and diabetes in European females.

    Science.gov (United States)

    Pither, Jason; Botta, Amy; Maity, Chittaranjan; Ghosh, Sanjoy

    2017-01-01

    In recent years, dietary polyunsaturated fatty acids (PUFA) have increased in parallel to sedentary behavior and diabetes across the world. To test any putative association between dietary PUFA and sedentary behavior or diabetes in females, we obtained country-specific, cross-sectional data on sedentary activity and diabetes prevalence from European Cardiovascular Statistics 2012. Age and gender-specific, nutritional data from each country were obtained from nutritional surveys as well. Socioeconomic (GDP), physical environment (urbanization index) and climatic confounders were accounted for each country. Upon analysis, we found a strong, positive association between sedentary lifestyle in 11-yr old girls (> = 2 hours of TV/ weekday) and dietary PUFA across 21 European countries. Further, a weak association of dietary PUFA and a strong relationship of per-capita GDP was established with elevated fasting blood glucose [(> = 7.0 mmol/L; or on medication] among 25+ year old adult females across 23 countries in Europe. In summary, we present novel ecological evidence that dietary PUFA is strongly associated with sedentary behavior among pre-teen girls and weakly associated with diabetes among adult women across Europe. In the latter group, per-capita GDP was a significant predictor for diabetes as well. Therefore, we recommend that prospective randomized controlled trials (RCTs) be implemented to evaluate if ubiquitous presence of dietary PUFA and low socioeconomic status are possible confounders when intervening to treat/prevent sedentary lifestyle or diabetes in female subjects in Western nations.

  15. Alcohol consumption and the risk of type 2 diabetes mellitus: effect modification by hypercholesterolemia: the Third Korea National Health and Nutrition Examination Survey (2005).

    Science.gov (United States)

    Jang, Hyeongap; Jang, Won-Mo; Park, Jong-Heon; Oh, Juhwan; Oh, Mu-Kyung; Hwang, Soo-Hee; Kim, Yong-Ik; Lee, Jin-Seok

    2012-01-01

    While the protective nature of moderate alcohol consumption against diabetes mellitus is well known, inconsistent findings continue to be reported. The possibility of different mixes of effect modifiers has been raised as a reason for those inconsistent findings. Our study aim was to examine potential effect modifiers that can change the effect of alcohol consumption on type 2 diabetes. From data in the third Korea National Health and Nutrition Examination Survey, 3,982 individuals over the age of 30 years who had not been diagnosed with diabetes were selected for inclusion in the study population. Breslow and Day's test and the Wald test between hypercholesterolemia and alcohol consumption in a multiple logistic regression model were used to assess effect modification. Odds ratios for diabetes stratified by alcohol consumption strata and assessed using Breslow and Day's tests for homogeneity indicated that hypercholesterolemia was not a significant confounding factor (p=0.01). However, the Wald test for interaction terms, which is a conservative method of effect modification, was significant (p=0.03). The results indicate that moderate alcohol consumption is not necessarily protective for type 2 diabetes mellitus, if a person has hypercholesterolemia. People who have hypercholesterolemia should be aware of the risk associated with alcohol consumption, a risk that contrasts with the reported protective effect of moderate alcohol consumption on diabetes.

  16. Analysis using national databases reveals a positive association between dietary polyunsaturated fatty acids with TV watching and diabetes in European females.

    Directory of Open Access Journals (Sweden)

    Jason Pither

    Full Text Available In recent years, dietary polyunsaturated fatty acids (PUFA have increased in parallel to sedentary behavior and diabetes across the world. To test any putative association between dietary PUFA and sedentary behavior or diabetes in females, we obtained country-specific, cross-sectional data on sedentary activity and diabetes prevalence from European Cardiovascular Statistics 2012. Age and gender-specific, nutritional data from each country were obtained from nutritional surveys as well. Socioeconomic (GDP, physical environment (urbanization index and climatic confounders were accounted for each country. Upon analysis, we found a strong, positive association between sedentary lifestyle in 11-yr old girls (> = 2 hours of TV/ weekday and dietary PUFA across 21 European countries. Further, a weak association of dietary PUFA and a strong relationship of per-capita GDP was established with elevated fasting blood glucose [(> = 7.0 mmol/L; or on medication] among 25+ year old adult females across 23 countries in Europe. In summary, we present novel ecological evidence that dietary PUFA is strongly associated with sedentary behavior among pre-teen girls and weakly associated with diabetes among adult women across Europe. In the latter group, per-capita GDP was a significant predictor for diabetes as well. Therefore, we recommend that prospective randomized controlled trials (RCTs be implemented to evaluate if ubiquitous presence of dietary PUFA and low socioeconomic status are possible confounders when intervening to treat/prevent sedentary lifestyle or diabetes in female subjects in Western nations.

  17. Quality of Diabetes Care: The Challenges of an Increasing Epidemic in Mexico. Results from Two National Health Surveys (2006 and 2012.

    Directory of Open Access Journals (Sweden)

    Sergio Flores-Hernández

    Full Text Available The quality of diabetes care remains suboptimal according to numerous studies assessing the achievement of quality indicators for diabetes care in various healthcare settings. We report about global and specific quality indicators for diabetes care and their association to glycemic control at the population level in two national health surveys in Mexico.We conducted a cross-sectional analysis of the 2006 and 2012 National Health Surveys in Mexico. We examined quality of care for 2,965 and 4,483 adults (≥ 20 years with diagnosed type 2 diabetes using fourteen simple and two composite indicators derived from self-reported information. In a subsample for both surveys, glycated hemoglobin (HbA1c was measured at the time of the interview. We obtained survey weight-adjusted estimators using multiple regression models (logistic and linear with combined data files, including survey year as covariate to assess change.Global quality of care in 2012 was 40.8%, with a relative improvement of 11.7% between 2006 and 2012. Detections of cardiovascular disease risk factors (dyslipidemia and hypertension were the indicators with the highest improvement, while non-pharmaceutical treatment and diabetic foot exams showed minor changes. We found a significant association between the quality of the process of diabetes care and glycemic control (OR 2.53, 95% CI 1.63-3.94. Age more than 65 years old, the type of health subsystem, gender (males, and high socio-economic status were also significantly associated to glycemic control.Quality diabetes care and glycemic control improved and are significantly associated. However, according to international standards, the current situation remains suboptimal. A more holistic approach is needed, with an emphasis on improving quality in outpatient care.

  18. Predictors of work disability after start of anti-TNF therapy in a national cohort of Swedish patients with rheumatoid arthritis: does early anti-TNF therapy bring patients back to work?

    Science.gov (United States)

    Olofsson, T; Petersson, I F; Eriksson, J K; Englund, M; Nilsson, J A; Geborek, P; Jacobsson, L T H; Askling, J; Neovius, M

    2017-07-01

    To examine predictors of work ability gain and loss after anti-tumour necrosis factor (TNF) start, respectively, in working-age patients with rheumatoid arthritis (RA) with a special focus on disease duration. Patients with RA, aged 19-62 years, starting their first TNF inhibitor 2006-2009 with full work ability (0 sick leave/disability pension days during 3 months before bio-start; n=1048) or no work ability (90 days; n=753) were identified in the Swedish biologics register (Anti-Rheumatic Treatment In Sweden, ARTIS) and sick leave/disability pension days retrieved from the Social Insurance Agency. Outcome was defined as work ability gain ≥50% for patients without work ability at bio-start and work ability loss ≥50% for patients with full work ability, and survival analyses conducted. Baseline predictors including disease duration, age, sex, education level, employment, Health Assessment Questionnaire, Disease Activity Score 28 and relevant comorbidities were estimated using Cox regression. During 3 years after anti-TNF start, the probability of regaining work ability for totally work-disabled patients was 35% for those with disease duration start, disease duration did not predict work ability loss. Baseline disability pension was also a strong predictor of work ability gain after treatment start. A substantial proportion of work-disabled patients with RA who start anti-TNF therapy regain work ability. Those initiating treatment within 5 years of symptom onset have a more than doubled 3-year probability of regaining work ability compared with later treatment starts. This effect seems largely due to the impact of disease duration on disability pension status. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  19. Swedish health care in perspective.

    Science.gov (United States)

    Anderson, O W

    1992-01-01

    The evolution and current problems of the Swedish health services are placed in an international comparative perspective with other industrially developed democratic states as to cost control, distribution of facilities and personnel, management of waiting lists for services, and differences in use of services. All of these countries are experiencing the same aforementioned problems differing mainly in degree. It is suggested that Sweden as well as other countries needs to reconceptualize the meaning of equality of access relative to the apparent emergence of private insurance as waiting lists grow for quality of life procedures such as lens and hip replacement. A concept of a basic service for everybody and so-called luxury service for those who wish to buy it needs to be faced in political debate. It is clear that government is unable to finance and supply the range of demand of a consumption good represented by a modern medicine. In so far as Sweden has been regarded as a model it appears that no country is a model anymore. The complexities of a modern health service has overwhelmed all countries and can be regarded as a sublime loss of innocence.

  20. The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research.

    Science.gov (United States)

    Ludvigsson, Jonas F; Otterblad-Olausson, Petra; Pettersson, Birgitta U; Ekbom, Anders

    2009-01-01

    Swedish health care and national health registers are dependent on the presence of a unique identifier. This paper describes the Swedish personal identity number (PIN) and explores ethical issues of its use in medical research. A ten-digit-PIN is maintained by the National Tax Board for all individuals that have resided in Sweden since 1947. Until January 2008, an estimated 75,638 individuals have changed PIN. The most common reasons for change of PIN are incorrect recording of date of birth or sex among immigrants or newborns. Although uncommon, change of sex always leads to change of PIN since the PIN is sex-specific. The most common reasons for re-use of PIN (n = 15,887), is when immigrants are assigned a PIN that has previously been assigned to someone else. This is sometimes necessary since there is a shortage of certain PIN combinations referring to dates of birth in the 1950s and 1960s. Several ethical issues can be raised pro and con the use of PIN in medical research. The Swedish PIN is a useful tool for linkages between medical registers and allows for virtually 100% coverage of the Swedish health care system. We suggest that matching of registers through PIN and matching of national health registers without the explicit approval of the individual patient is to the benefit for both the individual patient and for society.

  1. Physical inactivity among adults with diabetes mellitus and depressive symptoms: results from two independent national health surveys.

    Science.gov (United States)

    Geulayov, Galit; Goral, Aviva; Muhsen, Khitam; Lipsitz, Joshua; Gross, Raz

    2010-01-01

    To examine the association between depressive symptoms and physical inactivity in community samples of patients with diabetes mellitus (DM). Two representative samples of Israeli adults (age ≥21 years) were analyzed: The First Israeli National Health Interview Survey (INHIS-1) (n=9509) and the Israel National Health Survey (INHS) (n=4859). Information was obtained about past-month depressive symptoms, physician-diagnosed DM and physical activity. Multiple logistic regression models were used to examine the association between level of depressive symptoms and physical inactivity among individuals with DM, adjusting for potential confounders. Prevalence of DM ranged from 7.2% (INHIS-1) to 8.7% (INHS). In both samples, physical inactivity was significantly more prevalent among persons with significant depressive symptoms, compared to those without depressive symptoms [INHIS-1: 67.0% vs. 50.6%; adjusted odds ratio (AOR): 1.57; 95% confidence interval (95% CI), 1.05-2.35, P=.03; INHS: 71.4% vs. 43.9%; AOR: 2.67; 95% CI, 1.67-4.27, Passociated with a higher likelihood of physical inactivity in persons with DM. Body mass index of patients reporting no regular physical activity was elevated compared to persons who were physically active. This finding supports the view that identification and management of depression should be part of interventions designed to improve self care behaviors in patients with DM. Copyright © 2010 Elsevier Inc. All rights reserved.

  2. 77 FR 3783 - Collection; Comment Request: Revision of the National Diabetes Education Program Comprehensive...

    Science.gov (United States)

    2012-01-25

    ... use of national, state, and local media, traditional and social media, and other relevant channels....25 hours per response for the eligible respondent interview. Respondents/Affected Entities: Adult...: Written comments and/or suggestions from the public and affected agencies are invited on one or more of...

  3. 78 FR 77475 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-12-23

    ..., Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS). Dated: December 17, 2013. David... Kidney Diseases Special Emphasis Panel; Time-Sensitive Obesity Research. Date: January 29, 2014. Time: 3...

  4. 78 FR 14806 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-03-07

    ..., Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS) Dated: March 1, 2013. David Clary... Kidney Diseases Special Emphasis Panel: Translational Research. Date: April 22, 2013. Time: 11:00 a.m. to...

  5. 78 FR 60293 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meeting

    Science.gov (United States)

    2013-10-01

    ..., Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS) Dated: September 25, 2013. David... Kidney Diseases Special Emphasis Panel; Time-Sensitive Obesity Research. Date: October 28, 2013. Time: 11...

  6. 78 FR 56904 - National Institute of Diabetes and Digestive and Kidney Diseases; Notice of Closed Meetings

    Science.gov (United States)

    2013-09-16

    ... and Kidney Diseases Special Emphasis Panel; DDK-D Member Conflict of Interest SEP. Date: November 1..., Endocrinology and Metabolic Research; 93.848, Digestive Diseases and Nutrition Research; 93.849, Kidney Diseases, Urology and Hematology Research, National Institutes of Health, HHS) Dated: September 10, 2013. David...

  7. Swedish Seafarers' Commitment to Work in Times of Flagging out

    Directory of Open Access Journals (Sweden)

    C. Hult

    2014-03-01

    Full Text Available This study takes its departure in the difficulties to recruit and retain qualified senior seafarers in the Swedish shipping sector. The study focus is on seafarers' motivation at work for the specific shipping company (organizational commitment, and seafarers' motivation towards their occupation (occupational commitment, in times of flagging out. It was hypothesized that the youngest seafarers and the oldest may be most sensitive to foreign registration of ships. Statistical analyses were employed, using a survey material of 1,309 Swedish seafarers randomly collected in 2010 from a national register of seafarers. The results of the analyses show that flagging-out imposes a significant decline in organizational commitment for all seafarers. This decline is related to the perception of the social composition of crew. In addition, the oldest seafarers (age 55+ demonstrate diminished occupational commitment under a foreign flag. This decline is related to the degree of satisfaction with the social security structure. Occupational commitment among the youngest seafarers (age 19-30 is not affected by the nationality of flag. However, this type of commitment is decreasing by the time served on the same ship. This effect is partly related to a decline in satisfaction with the work content. In the concluding discussion, the findings are discussed in more details and recommendations are put forward.

  8. Survival rates and worker compensation expenses in a national cohort of Mexican workers with permanent occupational disability caused by diabetes

    Directory of Open Access Journals (Sweden)

    Iván de Jesús Ascencio-Montiel

    2016-09-01

    Full Text Available Abstract Background Permanent occupational disability is one of the most severe consequences of diabetes that impedes the performance of usual working activities among economically active individuals. Survival rates and worker compensation expenses have not previously been examined among Mexican workers. We aimed to describe the worker compensation expenses derived from pension payments and also to examine the survival rates and characteristics associated with all-cause mortality, in a cohort of 34,014 Mexican workers with permanent occupational disability caused by diabetes during the years 2000–2013 at the Mexican Institute of Social Security. Methods A cross-sectional analysis study was conducted using national administrative records data from the entire country, regarding permanent occupational disability medical certification, pension payment and vital status. Survival rates were estimated using the Kaplan–Meier method. Multivariate Cox proportional hazard model was used to estimate adjusted hazard ratios (HR and 95 % confidence intervals (95 % CI in order to assess the cohort characteristics and all-cause mortality risk. Total expenses derived from pension payments for the period were accounted for in U.S. dollars (USD, 2013. Results There were 12,917 deaths in 142,725.1 person-years. Median survival time was 7.26 years. After multivariate adjusted analysis, males (HR, 1.39; 95 % CI, 1.29–1.50, agricultural, forestry, and fishery workers (HR, 1.41; 95 % CI, 1.15–1.73 and renal complications (HR, 3.49; 95 % CI, 3.18–3.83 had the highest association with all-cause mortality. The all-period expenses derived from pension payments amounted to $777.78 million USD (2013, and showed a sustained increment: from $58.28 million USD in 2000 to $111.62 million USD in 2013 (percentage increase of 91.5 %. Conclusions Mexican workers with permanent occupational disability caused by diabetes had a median survival of 7.26 years, and those

  9. The impact of new national guidelines on screening for gestational diabetes mellitus.

    LENUS (Irish Health Repository)

    Ali, F M

    2013-02-01

    Gestational diabetes mellitus (GDM) has important maternal and fetal implications. In 2010, the Health Service Executive published guidelines on GDM. We examined the impact of the new guidelines in a large maternity unit. In January 2011, the hospital replaced the 100 g Oral Glucose Tolerance Test (OGTT) with the new 75 g OGTT. We compared the first 6 months of 2011 with the first 6 months of 2010. The new guidelines were associated with a 22% increase in women screened from 1375 in 2010 to 1679 in 2011 (p < 0.001). Of the women screened, the number diagnosed with GDM increased from 10.1% (n=139) to 13.2% (n=221) (p<0.001).The combination of increased screening and a more sensitive OGTT resulted in the number of women diagnosed with GDM increasing 59% from 139 to 221 (p = 0.02).This large increase has important resource implications but, if clinical outcomes are improved, there should be a decrease in long-term costs.

  10. Screening and management of gestational diabetes mellitus in Scottish obstetric units: a national survey.

    Science.gov (United States)

    Stirrat, Laura I; Denison, Fiona C; Love, Corinne D B; Lindsay, Robert S; Reynolds, Rebecca M

    2015-02-01

    The last study of screening practices for gestational diabetes (GDM) in the UK concluded that a lack of consensus about screening was due to a lack of clinical guidelines. We aimed to determine current practices in Scotland since new guidelines recommended that diagnosis should be made at a lower level of hyperglycaemia. An online questionnaire designed to investigate the screening and management of GDM was distributed to all maternity units in Scotland managing women with GDM (n = 15) for completion by relevant clinical team members. The response rate was 100%. Considerable variation in clinical practice existed between units. Thirteen units (86.7%) had adopted the lower glucose tolerance values for diagnosis of GDM (fasting ≥5.1 mmol/L; 2-h ≥8.5 mmol/L) recommended by the Scottish Intercollegiate Guidelines Network in 2010. Available data from units using this guideline (n = 3) revealed a significant increase in the percentage of women diagnosed with GDM between 2010 and 2012 (2010: 1.28%, 2012: 2.54%; p management of GDM in Scotland. If a similar increase in the prevalence of GDM is experienced across Scotland, there will be major implications for health care provision and resource allocation. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. Maternal and neonatal outcomes in pregnancies complicated by gestational diabetes. a nation-wide study.

    Science.gov (United States)

    Ovesen, Per Glud; Jensen, Dorte Møller; Damm, Peter; Rasmussen, Steen; Kesmodel, Ulrik Schiøler

    2015-01-01

    To estimate the association between gestational diabetes mellitus (GDM) and adverse pregnancy and neonatal outcomes in Denmark. A population-based cohort study including all singleton pregnancies in Denmark from 2004 to 2010 (n = 403 092). Maternal complications during pregnancy and delivery and fetal complications were classified according to the International Classification of Diseases 10th Revision. The final study population consisted of 398 623 women. Of these, 9014 (2.3%) had GDM. Data were adjusted for maternal age, parity, smoking, gestational age, birth weight, BMI, gender of the fetus and calendar year. The risk of preeclampsia, caesarean section (both planned and emergency) and shoulder dystocia was increased in women with GDM. In the unadjusted analysis, the risk of thrombosis was increased by a factor 2 in the GDM patients, but in the adjusted analysis this association disappeared. Post-partum hemorrhage was similar in the two groups. The GDM women had an increased risk of giving birth to a macrosomic neonate although the unadjusted analysis did not show any difference between the two groups. Low Apgar score was increased in the GDM, but this association disappeared in the adjusted analysis. Stillbirth was comparable in the two groups. Women with GDM still have increased incidence of obstetric and neonatal complications, which could imply that treatment of women with GDM should be tightened.

  12. Community governance of the Kahnawake Schools Diabetes Prevention Project, Kahnawake Territory, Mohawk Nation, Canada.

    Science.gov (United States)

    Cargo, Margaret; Lévesque, Lucie; Macaulay, Ann C; McComber, Alex; Desrosiers, Serge; Delormier, Treena; Potvin, Louise

    2003-09-01

    Health promotion emphasizes the importance of community ownership in the governance of community-based programmes, yet little research has been conducted in this area. This study examined perceptions of community ownership among project partners taking responsibility for decision-making related to the Kahnawake Schools Diabetes Prevention Project (KSDPP). Project partners were surveyed cross-sectionally at 18 months (T1) and 60 months (T2) into the project. The perceived influence of each project partner was assessed at T1 and T2 for three domains: (i) KSDPP activities; (ii) KSDPP operations; and (iii) Community Advisory Board (CAB) activities. Project staff were perceived to have the greatest influence on KSDPP activities, KSDPP operations and CAB activities at both T1 and T2. High mean scores of perceived influence for CAB members and community researchers, however, suggests that project decision-making was a shared responsibility among multiple community partners. Although academic researcher influence was consistently low, they were satisfied with their level of influence. This was unlike community affiliates, who were less satisfied with their lower level of influence. In keeping with Kanien'kehaka (Mohawk) culture, the findings suggest a participatory democracy or shared decision-making as the primary mode of governance of KSDPP.

  13. Governance of Swedish school mathematics — where and how did it happen? A study of different modes of governance in Swedish school mathematics, 1910-1980

    Directory of Open Access Journals (Sweden)

    Johan Prytz

    2017-07-01

    Full Text Available The aim of this paper is to revise a standard narrative about governance of the Swedish school system in the period of 1910-1908. According to this narrative, the Swedish school system was centralized during this period. However, this narrative does not fit the history of Swedish mathematics education (years 1-9. The research questions are: where in the school system was change initiated and how was change enforced? On the basis of studies of syllabi, textbooks, teaching literature, teacher journals and reports from investigations and development projects, different modes of governance of school mathematics are identified. The main results are that textbook producers rather than national syllabi and exams were drivers of change in the period 1910-1960. Moreover, the centralized attempts to change school mathematics, prepared in the 1960s, were soon abandoned in the early 1970s. Thus, centralized governance of Swedish school mathematics, with the ambition to achieve change, was something that took effect relatively late and during a very short period of time.

  14. Type 1 Diabetes in Parents and Risk of Attention Deficit Hyperactivity Disorder in Offspring: A Population-Based Study in Sweden.

    Science.gov (United States)

    Ji, Jianguang; Chen, Tianhui; Sundquist, Jan; Sundquist, Kristina

    2018-01-26

    To explore whether a family history of type 1 diabetes (T1D) is associated with an increased incidence of attention deficit hyperactivity disorder (ADHD) in offspring. Individuals with T1D were identified from the nationwide Swedish National Hospital Discharge Register and Swedish Outpatient Register in Sweden and were linked to the Swedish Multi-Generation Register to identify their offspring. Cox regression was used to calculate the hazard ratio (HR) of ADHD in offspring of patients with T1D compared with the general population. A total of 15,615 individuals were born after their parents were diagnosed with T1D. After a set of confounding factors was controlled for, offspring of T1D patients had a significantly increased risk of ADHD with a HR of 1.29 (95%CI 1.15-1.42). Maternal T1D was associated with an enhanced risk of ADHD (HR 1.35 [95%CI 1.18-1.55]) compared with paternal T1D (HR 1.20 [95%CI 1.03-1.41]), but the difference was not statistically significant. In this retrospective cohort study, we found that a parental history of T1D was associated with a 29% increased risk of being diagnosed with ADHD. However, the underlying mechanisms need to be explored in future studies. © 2018 by the American Diabetes Association.

  15. Diabetes mellitus en adultos mexicanos: resultados de la Encuesta Nacional de Salud 2000 Diabetes mellitus in Mexican adults: results from the 2000 National Health Survey

    Directory of Open Access Journals (Sweden)

    Gustavo Olaiz-Fernández

    2007-01-01

    xico. Su efecto se magnifica al afectar con mayor frecuencia a grupos de población cuyos factores sociales o económicos limitan su acceso al tratamiento. Los datos informados son útiles para la institución de programas de escrutinio y prevención. Los resultados confirman que la diabetes debe ser motivo de investigación en familiares de primer grado e individuos que tengan uno o más de los componentes del síndrome metabólico (hipertensión, dislipidemia, obesidad y microalbuminuria.OBJECTIVE: To show the prevalence of diabetes mellitus (DM and its associated factors in adults, using data derived from the 2000 National Health Survey (NHS. MATERIAL AND METHODS: The 2000 NHS was conducted between November 1999 and June 2000. An adult questionnaire was administered to 45 294 subjects 20 years of age and older. Capillary glucose levels, weight, height and blood pressure were obtained. Individual weighted factors were considered in the statistical analysis, as was the survey's complex sampling design to obtain variances using SUDAAN 7.5.6. RESULTS: The national prevalence of DM in adults ages 20 years and older was 7.5% (95% CI: 7.1-7.9. The prevalence was 7.8% in women and 7.2% in men. It was higher according to age: 2.3% in adults 40 years or younger and 21.2% in those older than 60 years of age. In the urban population, prevalence was 8.1% and in the rural population it was 6.5%. The disease was more frequent in the northern region of the country (8.4% and in the Mexico City metropolitan area (8.1%. DM was more frequent in the population with the least amount of schooling (9.9%, the lowest income (8.1%, high blood pressure (13.7%, hypercholesterolemia (23.3% microalbuminuria (15.5% and renal disease (12.3%. Using multivariate logistic regression, stratified by gender, variables associated with DM were identified: age, little schooling, family history of DM, high blood pressure, renal disease or hypercholesterolemia in both genders. Abdominal obesity was associated

  16. National Cholesterol Education Program Adult Treatment Panel III versus International Diabetic Federation Definition of Metabolic Syndrome, which one is associated with Diabetes Mellitus and Coronary Artery Disease?

    OpenAIRE

    Abbas Rezaianzadeh; Seyedeh-Mahdieh Namayandeh; Seyed-Mahmood Sadr

    2012-01-01

    Background: A cluster of risk factors for cardiovascular diseases and type 2 diabetes mellitus, which occur together more often than by chance alone, have been known as the metabolic syndrome. Various definitions have been proposed by different organizations over the past decade. This study was designed to evaluate a new definition of the metabolic syndrome for the prediction of diabetes mellitus among the Iranian population. Methods: This study was carried out in an urban population, aged...

  17. National Cholesterol Education Program Adult Treatment Panel III Versus International Diabetic Federation Definition of Metabolic Syndrome, Which One is Associated with Diabetes Mellitus and Coronary Artery Disease?

    Science.gov (United States)

    Rezaianzadeh, Abbas; Namayandeh, Seyedeh-Mahdieh; Sadr, Seyed-Mahmood

    2012-08-01

    A cluster of risk factors for cardiovascular diseases and type 2 diabetes mellitus, which occur together more often than by chance alone, have been known as the metabolic syndrome. Various definitions have been proposed by different organizations over the past decade. This study was designed to evaluate a new definition of the metabolic syndrome for the prediction of diabetes mellitus among the Iranian population. This study was carried out in an urban population, aged 20 to 74 years, from Yazd, a city in the center of Iran. The study is a part of the phase I of Yazd Healthy Heart Program, that is, a community-based intervention study for the prevention of cardiovascular disease. The significance level has been defined as PAdult Treatment Panel III (NCEP ATP III) criteria was 21.3 ± .017%, and by International Diabetes Federation (IDF) criteria it was 30.16 ± .02%. The multivariate analysis showed that the most important relevant factors of diabetes mellitus were: Increased age and metabolic syndrome by both definitions of NCEP and IDF criteria, and also, the most important relevant factors of stable angina were: Increased age, male sex, and metabolic syndrome by only IDF definitions, but the NCEP definition of the metabolic syndrome cannot predict diabetes mellitus independent of age and sex. This study showed that increased age and metabolic syndrome are the most important relevant factors for diabetes mellitus, especially by using the IDF criteria for definition of the metabolic syndrome.

  18. Dietary fiber intake is inversely associated with stroke incidence in healthy Swedish adults.

    Science.gov (United States)

    Larsson, Susanna C; Wolk, Alicja

    2014-12-01

    Prospective studies of dietary fiber intake in relation to stroke risk have reported inconsistent results. This study assessed the association between intake of total fiber and fiber sources and stroke incidence in healthy Swedish adults. The analysis was based on 69,677 participants (aged 45-83 y) from the Swedish Mammography Cohort and the Cohort of Swedish Men who were free from cancer, cardiovascular disease, and diabetes at baseline (1 January 1998). Diet was assessed with a food-frequency questionnaire. Cases of stroke were ascertained through linkage to the Swedish Inpatient Register and the Swedish Cause of Death Register. Cox proportional hazards regression model was used to calculate RRs, adjusted for potential confounders. During 10.3 y of follow-up, 3680 incident stroke cases, including 2722 cerebral infarctions, 363 intracerebral hemorrhages, 160 subarachnoid hemorrhages, and 435 unspecified strokes, were ascertained. High intakes of total fiber and fiber from fruits and vegetables but not from cereals were inversely associated with risk of stroke. After adjustment for other risk factors for stroke, the multivariable RRs of total stroke for the highest vs. lowest quintile of intake were 0.90 (95% CI: 0.81, 0.99) for total fiber, 0.85 (95% CI: 0.77, 0.95) for fruit fiber, 0.90 (95% CI: 0.82, 1.00) for vegetable fiber, and 0.94 (95% CI: 0.84, 1.04) for cereal fiber. These findings indicate that intake of dietary fiber, especially fruit and vegetable fibers, is inversely associated with risk of stroke. © 2014 American Society for Nutrition.

  19. Compensation in Swedish infrastructure projects and suggestions on policy improvements

    Directory of Open Access Journals (Sweden)

    Jesper Persson

    2015-07-01

    Full Text Available Environmental compensation includes a range of activities intended to counterbalance such negative impacts of development projects that remain in the environment after all preventive and corrective measures have been fully implemented. Sweden, being a member state of the European Union (EU, must implement environmental compensation under EU directives such as the Habitat Directive. However, like in other countries, implementation is not yet widespread in Sweden, and new practices and guidelines remain to be developed both nationally and at European level. This need is all the more urgent considering that the European Commission estimates that, within the EU, about 100,000 hectares of land is converted from its natural state each year. The aim of this paper is to describe current environmental-compensation practices in Swedish road and railway projects and to discuss issues of vital importance to the development of compensation policy, such as what to compensate for, how much, and how. A national inventory was performed, for the first time in Sweden, to identify compensation measures in road and railway projects. Data were collected from a national mailing list including 141 officials at county administrative boards (CABs, internal e-mail correspondence within the Swedish Transport Administration and databases of court decisions. The inventory focused on compensation measures ordered by virtue of the Swedish Environmental Code. In addition, two case studies were carried out to investigate the planning of compensation measures. The results showed that CABs and courts rarely order compensation in infrastructure projects, even though this is possible under Swedish law. Between 1999 and 2012, 37 cases (i.e. permits issued were found for which compensation was ordered. Of these cases, 76% concerned compensation for encroachments on minor habitats such as small ponds and cairns. No CAB ordered compensation for non-protected areas. Compensation ratios

  20. Tensions in Stakeholder Relations for a Swedish Football Club

    DEFF Research Database (Denmark)

    Junghagen, Sven

    2016-01-01

    Swedish football is an industry not yet being as commercial as the big leagues and is regulated in terms of ownership of clubs. This implies a need for management of stakeholder relations for a Swedish football club. This paper identifies important stakeholders in Swedish football and discusses...

  1. Working on an historical dictionary: the Swedish academy dictionary ...

    African Journals Online (AJOL)

    Working on an historical dictionary: the Swedish academy dictionary project. P Stille, B-O Wendt. Abstract. The Swedish Academy Dictionary is one of the world's largest dictionary projects. Work on it was started in 1884 and it will be completed by 2017. The dictionary describes the written standard language of Swedish ...

  2. Food insecurity is associated with diabetes mellitus: results from the National Health Examination and Nutrition Examination Survey (NHANES) 1999-2002.

    Science.gov (United States)

    Seligman, Hilary K; Bindman, Andrew B; Vittinghoff, Eric; Kanaya, Alka M; Kushel, Margot B

    2007-07-01

    Food insecurity refers to limited or uncertain access to food resulting from inadequate financial resources. There is a clear association between food insecurity and obesity among women, but little is known about the relationship between food insecurity and type 2 diabetes. To evaluate whether there is an independent association between food insecurity and diabetes. Cross-sectional analysis of the nationally representative, population-based National Health and Nutrition Examination Survey (1999-2002 waves). Four thousand four hundred twenty-three adults > 20 years of age with household incomes poverty level. We categorized respondents as food secure, mildly food insecure, or severely food insecure using a well-validated food insecurity scale. Diabetes was determined by self-report or a fasting serum glucose > or = 126 mg/dl. Diabetes prevalence in the food secure, mildly food insecure, and severely food insecure categories was 11.7%, 10.0%, and 16.1%. After adjusting for sociodemographic factors and physical activity level, participants with severe food insecurity were more likely to have diabetes than those without food insecurity (adjusted odds ratio [AOR] 2.1, 95% CI 1.1-4.0, p = .02). This association persisted after further adjusting for body mass index (AOR 2.2, 95% CI 1.2-3.9, p = .01). Food insecurity may act as a risk factor for diabetes. Among adults with food insecurity, increased consumption of inexpensive food alternatives, which are often calorically dense and nutritionally poor, may play a role in this relationship. Future work should address how primary care clinicians can most effectively assist patients with food insecurity to make healthy dietary changes.

  3. Swedish strategies for health and safety in agriculture: a coordinated multiagency approach.

    Science.gov (United States)

    Lundqvist, Peter; Alwall Svennefelt, Catharina

    2014-01-01

    Occupational injuries are a major problem in agriculture world-wide. Sweden is developing a national approach to scoordinate different stakeholders with the common goal of reducing injuries in the agricultural sector. The Swedish strategy involves important factors, such as: 1) Collaboration between all stakeholders involved in health and safety in agriculture, 2) A national programme on injury prevention, 3) Coordination of actions and 4) Knowledge, attitude and behaviour in focus. This approach is being coordinated through the Swedish Committee on Working Environment (LAMK), a network acting to achieve a good, healthy and safe working environment in Swedish agriculture. The Committee consists of representatives of authorities, institutions, companies, research and education institutions and organisations working in the green sector. The Swedish model will be evaluated as a whole concept on its effect on the frequency of injuries in the agricultural industry in the beginning of 2014. Promising results has been shown in evaluations of minor parts. This coordinated approach has been applied in others countries (United States and New Zealand) as well and seems like an efficient way of using limited resources to achieve higher impact on a specific problems such as occupational injuries in agriculture.

  4. Association of Periodontitis With Urinary Albumin Excretion in Korean Adults With Diabetes: The 2012 Korea National Health and Nutrition Examination Survey.

    Science.gov (United States)

    Han, Kyungdo; Nam, Ga Eun; Kim, Do Hoon; Park, Jun-Beom; Ko, Youngkyung; Roh, Yong Kyun; Cho, Kyung Hwan; Park, Yong Gyu

    2015-10-01

    Albuminuria and periodontitis are both commonly associated with systemic inflammation. However, the association between urinary albumin excretion (UAE) and periodontitis in patients with type 2 diabetes has not been fully investigated. This study aimed to investigate the association between UAE and periodontitis in Korean adults with type 2 diabetes.This study performed a cross-sectional analysis and used hierarchical multivariable logistic regression analysis models. Data from the 2012 Korean National Health and Nutrition Examination Survey were analyzed. A total of 547 patients, with type 2 diabetes without renal impairment, were included in this study. UAE was assessed using the urinary albumin to creatinine ratio (UACR). A community periodontal index greater than or equal to code 3 was used to define periodontitis.The risk of periodontitis tended to increase as UACR increased even after adjustment for potential confounders (P for trend in the odds ratios = 0.05 in model 1; 0.02 in model 2; and 0.01 in model 3). In a subgroup analysis, the prevalence of periodontitis was significantly higher in the patients with albuminuria (UACR >30 mg/g) than in those without albuminuria among patients younger than 65 years (P = 0.03), those with newly diagnosed diabetes (P = 0.04), or those without obesity (P = .04).UAE was positively associated with the risk of periodontitis in Korean adults with type 2 diabetes. In the patients who were younger, were newly diagnosed with diabetes, or had normal body mass index, individuals with albuminuria were more likely to have a higher prevalence of periodontitis. Early identification of periodontitis may be helpful in Korean diabetic adults with increased UAE.

  5. Phonology of a southern Swedish idiolect

    OpenAIRE

    Svantesson, Jan-Olof

    2001-01-01

    In this egocentric article I describe briefly the segmental phonology of my own southern Swedish idiolect. I grew up in Getinge in central Halland, about 20 km north of Halmstad, speaking a regional variant of southern Standard Swedish. Although my dialect has certainly changed somewhat after I moved to Lund in 1964 at the age of 20, I believe that I still retain the basic pronunciation of vowels and consonants from my original dialect. There is one older description of the Getinge dialect by...

  6. Market reforms in Swedish health care

    DEFF Research Database (Denmark)

    Diderichsen, Finn

    1993-01-01

    This report presents the main characteristics of reforms in the Swedish health services, as exemplified by the "Stockholm Model" introduced in 1992 in Stockholm county. The author discusses the motives behind these reforms, the already-evident increases in costs that are occurring, and the effect...... of these reforms on public support for the welfare state.......This report presents the main characteristics of reforms in the Swedish health services, as exemplified by the "Stockholm Model" introduced in 1992 in Stockholm county. The author discusses the motives behind these reforms, the already-evident increases in costs that are occurring, and the effect...

  7. Gestational diabetes mellitus in Greenland: a national study of prevalence and testing efficacy

    Directory of Open Access Journals (Sweden)

    Michael Lynge Pedersen

    2016-08-01

    Full Text Available Background: Within the last 20 years, the prevalence of gestational diabetes mellitus (GDM has been reported to be increasing worldwide in correlation with ethnic and geographic variations. The actual prevalence of GDM throughout all of Greenland remains unknown. Objective: The aim of this study was to estimate the prevalence of GDM among Greenlanders and non-Greenlanders living in Greenland and to estimate the efficacy of testing for GDM. Design: This study was performed as an observational, cross-sectional study including all women with permanent address in Greenland who had given birth to a singleton during 2014. The prevalence of GDM was calculated as the proportion of all pregnant women tested with a 75-g 2-h glucose tolerance test who had a 2-h capillary whole-blood glucose value of 8.5 mmol/l or above. Testing efficacy was calculated as the proportion of women who fulfilled the testing criteria who were actually tested in Greenland in 2014. Results: A total of 794 women (727 Greenlanders and 67 non-Greenlanders were included in the study. The prevalence of GDM among tested women was 3.3% (confidence interval, CI: 0.9–5.6 among Greenlanders and 12.5% (CI: 0–25.7 among non-Greenlanders, corresponding, respectively, to 1.0% (CI: 0.3–1.3 and 4.5% (CI: 0–9.4 of all singleton pregnancies in Greenland in 2014. The overall testing efficacy was 69.0% among all eligible residents of Greenland and 85.1% among eligible residents in the capital city, Nuuk. Conclusion: In conclusion, the prevalence of GDM seems quite low in Greenland. Although diagnostic testing activity has improved within the last 6 years, still around one-third of all pregnant women in all Greenland fulfilling the testing criteria were not tested. Universal testing for GDM may be needed to improve testing of GDM in Greenland.

  8. Speaking with forked tongues - Swedish public administration and the European employment strategy

    Directory of Open Access Journals (Sweden)

    Åsa Casula Vifell

    2009-07-01

    Full Text Available The aim of this paper is to understand how decision making processes within the EU comes to affect the structures for national policy making within the employment field. The paper addresses the question of how the process of writing new employment guidelines for the EES – European employment strategy, has affected the work of the Swedish public administration. Through applying a neo-institutionalist perspective, it contributes to the understanding of effects that the increased embededness of states, often characterized as Europeanization, invoke on national administrations. I argue that the way the process has been managed can be analyzed from an organizational perspective where conflicting demands on the Swedish state has led to a certain organization of the work activities. On the one hand, Swedish representatives have to act according to the norms of the European cooperation in order to be seen as a legitimate actor. On the other hand, EU and European influence on Swedish employment policy is not a legitimate concept at national level. In order to satisfy these two seemingly incompatible demands the organizing principle of decoupling is being used to create space for maneuvering for the administration. However, through participation at EU-level organizational identities are partly transformed which in time leads to a situation where changed practices are not met by changes in formal structures. As a consequence the Swedish representatives are in a manner ‘speaking with forked tongue’ and obscuring the new way in which policy making is conducted thus introducing democratic shortcomings in terms of transparency and accountability.

  9. Diet and exercise among adults with type 2 diabetes: findings from the third national health and nutrition examination survey (NHANES III).

    Science.gov (United States)

    Nelson, Karin M; Reiber, Gayle; Boyko, Edward J

    2002-10-01

    To describe diet and exercise practices from a nationally representative sample of U.S. adults with type 2 diabetes. We analyzed data from 1,480 adults older than 17 years with a self-reported diagnosis of type 2 diabetes in the Third National Health and Nutrition Examination Survey (NHANES III). Fruit and vegetable consumption was obtained from a food frequency questionnaire; the percentages of total calories from fat and saturated fat were obtained from a 24-h food recall. Physical activity was based on self report during the month before the survey. Of individuals with type 2 diabetes, 31% reported no regular physical activity and another 38% reported less than recommended levels of physical activity. Sixty-two percent of respondents ate fewer than five servings of fruits and vegetables per day. Almost two thirds of the respondents consumed >30% of their daily calories from fat and >10% of total calories from saturated fat. Mexican Americans and individuals over the age of 65 years ate a higher number of fruits and vegetables and a lower percentage of total calories from fat. Lower income and increasing age were associated with physical inactivity. Thirty-six percent of the sample were overweight and another 46% were obese. The majority of individuals with type 2 diabetes were overweight, did not engage in recommended levels of physical activity, and did not follow dietary guidelines for fat and fruit and vegetable consumption. Additional measures are needed to encourage regular physical activity and improve dietary habits in this population.

  10. Association of Pulmonary Tuberculosis and Diabetes in Mexico: Analysis of the National Tuberculosis Registry 2000-2012.

    Directory of Open Access Journals (Sweden)

    Guadalupe Delgado-Sánchez

    Full Text Available Tuberculosis (TB remains a public health problem in Mexico while the incidence of diabetes mellitus type 2 (DM has increased rapidly in recent years.To describe the trends of incidence rates of pulmonary TB associated with DM and not associated with DM and to compare the results of treatment outcomes in patients with and without DM.We analysed the National Tuberculosis Registry from 2000 to 2012 including patients with pulmonary TB among individuals older than 20 years of age. The association between DM and treatment failure was analysed using logistic regression, accounting for clustering due to regional distribution.In Mexico from 2000 to 2012, the incidence rates of pulmonary TB associated to DM increased by 82.64%, (p<0.001 in contrast to rates of pulmonary TB rate without DM, which decreased by 26.77%, (p<0.001. Patients with a prior diagnosis of DM had a greater likelihood of failing treatment (adjusted odds ratio, 1.34 (1.11-1.61 p<0.002 compared with patients who did not have DM. There was statistical evidence of interaction between DM and sex. The odds of treatment failure were increased in both sexes.Our data suggest that the growing DM epidemic has an impact on the rates of pulmonary TB. In addition, patients who suffer from both diseases have a greater probability of treatment failure.

  11. Association of Pulmonary Tuberculosis and Diabetes in Mexico: Analysis of the National Tuberculosis Registry 2000–2012

    Science.gov (United States)

    Delgado-Sánchez, Guadalupe; García-García, Lourdes; Castellanos-Joya, Martín; Cruz-Hervert, Pablo; Ferreyra-Reyes, Leticia; Ferreira-Guerrero, Elizabeth; Hernández, Andrés; Ortega-Baeza, Victor Manuel; Montero-Campos, Rogelio; Sulca, José Antonio; Martínez-Olivares, Ma. de Lourdes; Mongua-Rodríguez, Norma; Baez-Saldaña, Renata; González-Roldán, Jesús Felipe; López-Gatell, Hugo; Ponce-de-León, Alfredo; Sifuentes-Osornio, José; Jiménez-Corona, María Eugenia

    2015-01-01

    Background Tuberculosis (TB) remains a public health problem in Mexico while the incidence of diabetes mellitus type 2 (DM) has increased rapidly in recent years. Objective To describe the trends of incidence rates of pulmonary TB associated with DM and not associated with DM and to compare the results of treatment outcomes in patients with and without DM. Materials and Methods We analysed the National Tuberculosis Registry from 2000 to 2012 including patients with pulmonary TB among individuals older than 20 years of age. The association between DM and treatment failure was analysed using logistic regression, accounting for clustering due to regional distribution. Results In Mexico from 2000 to 2012, the incidence rates of pulmonary TB associated to DM increased by 82.64%, (p 4 (1.11–1.61) p <0.002) compared with patients who did not have DM. There was statistical evidence of interaction between DM and sex. The odds of treatment failure were increased in both sexes. Conclusion Our data suggest that the growing DM epidemic has an impact on the rates of pulmonary TB. In addition, patients who suffer from both diseases have a greater probability of treatment failure. PMID:26075393

  12. Cultural Aspects when Implementing Lean Production and Lean Product Development – Experiences from a Swedish Perspective

    Directory of Open Access Journals (Sweden)

    Promporn Wangwacharakul

    2014-07-01

    Full Text Available Lean principles and methods, originating in a Japanese cultural context, have spread to a large number of companies throughout the world. The aim of this case study research is to identify and compare national cultural aspects that influence Lean Production and Lean Product Development implementation in Swedish companies. Data were collected through questionnaires, interviews and an industrial workshop with Swedish Lean practitioners. The study shows that some sub-areas in Lean, such as value definition, control systems, leadership, team development, knowledge management, and strategies, are highly dependent on contextual factors related to human, cultural and organizational aspects. These are related to the national culture and should be considered to a higher extent for successful sustainable implementation of Lean in different cultural contexts. As for implementing Lean in Sweden, national cultural characteristics, such as individualism, autonomy and supportive management style fit well with Lean thinking.

  13. Energy Performance Indicators in the Swedish Building Procurement Process

    Directory of Open Access Journals (Sweden)

    Ingrid Allard

    2017-10-01

    Full Text Available In Sweden, all new buildings need to comply with the National Board of Housing, Building and Planning’s requirement on specific purchased energy (kWh/m2. Accordingly, this indicator is often used to set design criteria in the building procurement process. However, when energy use is measured in finished buildings, the measurements often deviate significantly from the design calculations. The measured specific purchased energy does not necessarily reflect the responsibility of the building contractor, as it is influenced by the building operation, user behavior and climate. Therefore, Swedish building practitioners may prefer other indicators for setting design criteria in the building procurement process. The aim of this study was twofold: (i to understand the Swedish building practitioners’ perspectives and opinions on seven building energy performance indicators (envelope air leakage, U-values for different building parts, average U-value, specific heat loss, heat loss coefficient, specific net energy, and specific purchased energy; and (ii to understand the consequences for the energy performance of multi-family buildings of using the studied indicators to set criteria in the procurement process. The study involved a Delphi approach and simulations of a multi-family case study building. The studied indicators were discussed in terms of how they may meet the needs of the building practitioners when used to set building energy performance criteria in the procurement process.

  14. Experiences of Injuries and Injury Reporting among Swedish Skydivers

    Directory of Open Access Journals (Sweden)

    Mats Jong

    2014-01-01

    Full Text Available The objective was to illuminate the experience of injuries and the process of injury reporting within the Swedish skydiving culture. Data contained narrative interviews that were subsequently analyzed with content analysis. Seventeen respondents (22–44 years were recruited at three skydiving drop zones in Sweden. In the results injury events related to the full phase of a skydive were described. Risk of injury is individually viewed as an integrated element of the recreational activity counterbalanced by its recreational value. The human factor of inadequate judgment such as miscalculation and distraction dominates the descriptions as causes of injuries. Organization and leadership act as facilitators or constrainers for reporting incidents and injuries. On the basis of this study it is interpreted that safety work and incident reporting in Swedish skydiving may be influenced more by local drop zone culture than the national association regulations. Formal and informal hierarchical structures among skydivers seem to decide how skydiving is practiced, rules are enforced, and injuries are reported. We suggest that initial training and continuing education need to be changed from the current top-down to a bottom-up perspective, where the individual skydiver learns to see the positive implications of safety work and injury reporting.

  15. Experiences of Injuries and Injury Reporting among Swedish Skydivers.

    Science.gov (United States)

    Jong, Mats; Westman, Anton; Saveman, Britt-Inger

    2014-01-01

    The objective was to illuminate the experience of injuries and the process of injury reporting within the Swedish skydiving culture. Data contained narrative interviews that were subsequently analyzed with content analysis. Seventeen respondents (22-44 years) were recruited at three skydiving drop zones in Sweden. In the results injury events related to the full phase of a skydive were described. Risk of injury is individually viewed as an integrated element of the recreational activity counterbalanced by its recreational value. The human factor of inadequate judgment such as miscalculation and distraction dominates the descriptions as causes of injuries. Organization and leadership act as facilitators or constrainers for reporting incidents and injuries. On the basis of this study it is interpreted that safety work and incident reporting in Swedish skydiving may be influenced more by local drop zone culture than the national association regulations. Formal and informal hierarchical structures among skydivers seem to decide how skydiving is practiced, rules are enforced, and injuries are reported. We suggest that initial training and continuing education need to be changed from the current top-down to a bottom-up perspective, where the individual skydiver learns to see the positive implications of safety work and injury reporting.

  16. Association between Coffee Consumption and Renal Impairment in Korean Women with and without Diabetes: Analysis of the Fourth Korea National Health and Nutrition Examination Survey in 2008

    OpenAIRE

    Kim, Bo Ha; Park, Yong Soon; Noh, Hye Mi; Sung, Ji Sun; Lee, Jung Kwon

    2013-01-01

    Background Recent studies suggest that coffee consumption has an influence on kidney function. This study investigated the relationship between habitual coffee consumption and renal impairment in Korean women, in consideration of diabetic status. Methods This study involved 2,673 women aged 35 to 84 years who had participated in the Fourth Korea National Health and Nutrition Examination Surveys, conducted in 2008. Habitual coffee consumption was classified into three categories: less than 1 c...

  17. Leisure, Government and Governance: A Swedish Perspective

    Science.gov (United States)

    Lindstrom, Lisbeth

    2011-01-01

    The leisure sector has witnessed a tremendous expansion since 1960. The purpose of this article is to analyse the decisions and goals of Swedish government policy during the period 1962 to 2005. The empirical analysis covers government Propositions and governmental investigations. The fields covered are sports, culture, exercise, tourism and…

  18. Training Entrepreneurship at Universities: A Swedish Case.

    Science.gov (United States)

    Klofsten, Magnus

    2000-01-01

    The Entrepreneurship and New Business Development Program trains Swedish individuals in the startup of technology- or knowledge-based enterprises. Built on the characteristics of entrepreneurial behavior, the program features a holistic outlook, a network of established entrepreneurs, mentoring, a mix of theory and practice, and focus on the…

  19. Exergy use in the Swedish society 1994

    Energy Technology Data Exchange (ETDEWEB)

    Wall, G.

    1997-07-01

    The exergy concept is reviewed as a tool for resource accounting. Conversions of energy and material resources in the Swedish society in 1994 are described in terms of exergy. Necessary concepts and conventions are introduced. Exergy losses in transformations of material resources and in conversions of various forms of energy into heat are described in some detail

  20. SWEDISH CRIME FICTION AS SOCIALLY INVOLVED LITERATURE

    Directory of Open Access Journals (Sweden)

    Monika Samsel-Chojnacka

    2011-01-01

    Full Text Available Swedish crime novel has been transforming for many years to become more socially involved. The ambition of many writers is not only to entertain the readers but also to participating in the social debate, criticizing the political and economical system, focusing on important issues such as violence against women, exploitation of working class by the privileged ruling class, the problems of a modern family and the situation of immigrants. Since the moment when in the mid 60’s two journalists Maj Sjöwall and Per Wahlöö decided to use popular literature to spread social matters many other Swedish writers have decided to follow their way. Some of them are journalists – like Liza Marklund, Börge Hellström and Anders Roslund or Stieg Larsson. Their novels as well as the ones written by Henning Mannkel on Kurt Wallander have become crucial evidence of changes of Swedish society in the past twenty years. Modern Swedish crime fiction illustrates the population in the model fashion that is the reason why it can become one of the interests of the sociology of literature.

  1. Mathematics and Didactic Contract in Swedish Preschools

    Science.gov (United States)

    Delacour, Laurence

    2016-01-01

    The purpose of this article is to study and analyse how a teacher implements an outdoor realistic problem situation for children aged 4-5 in a Swedish preschool. By an "outdoor realistic problem situation", I mean a situation initiated by a teacher in which children come into contact with mathematical concepts and in which the outside…

  2. Diabetes and thyroid cancer risk in the National Institutes of Health-AARP Diet and Health Study.

    Science.gov (United States)

    Aschebrook-Kilfoy, Briseis; Sabra, Mona M; Brenner, Alina; Moore, Steven C; Ron, Elaine; Schatzkin, Arthur; Hollenbeck, Albert; Ward, Mary H

    2011-09-01

    We hypothesized that diabetes may play a role in thyroid cancer risk due to the parallel secular rise in diabetes prevalence and morbidity in the United States, the higher prevalence of thyroid disorders among diabetics compared with the general population, and the potential roles of metabolic syndrome, obesity, and diabetes as precipitating factors in cancer development. We assessed the association between self-reported diabetes and the risk of differentiated thyroid cancer in the NIH-AARP Diet and Health Study, a prospective cohort of 200,556 women and 295,992 men, 50-71 years of age, in 1995-1996. Diabetes status and information on potential confounders was ascertained using a self-administered questionnaire. During an average of 10 years of follow-up, 585 thyroid cancer cases were identified. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for thyroid cancer and thyroid cancer subtypes in men and women according to diabetes status. Nine percent of the total baseline cohort reported a history of diabetes (7% of women, 10% of men). A nonsignificant 25% increase in thyroid cancer risk (HR = 1.25; 95% CI: 0.95-1.64) was associated with diabetes. Among women, the risk was significantly increased (HR = 1.46, 95% CI: 1.01-2.10). The risk was not elevated among men (HR = 1.04, 95% CI: 0.69-1.58). In this cohort, diabetic women with differentiated thyroid cancer were at somewhat higher risk of follicular thyroid cancer (HR = 1.92; 95% CI: 0.86-4.27) than papillary thyroid cancer (HR = 1.25; 95% CI: 0.80-1.97). This study lends support to the hypothesis that diabetes increases the risk of differentiated thyroid cancer.

  3. Early-onset type 2 diabetes in a Mexican survey: results from the National Health and Nutrition Survey 2006 Diabetes tipo 2 de inicio temprano en una encuesta nacional: resultados de la Encuesta Nacional de Salud y Nutrición 2006

    OpenAIRE

    Aída Jiménez-Corona; Rosalba Rojas; Francisco J Gómez-Pérez; Aguilar-Salinas, Carlos A.

    2010-01-01

    OBJECTIVE: To describe the characteristics of patients with type 2 diabetes diagnosed before age 40 (early-onset type 2 diabetes) identified in a nation-wide, population-based study. MATERIALS AND METHODS: The survey was done in Mexico during 2006. Medical history, anthropometric and biochemical measurements were obtained in every subject. RESULTS: Cases diagnosed before (n=181) and after age 40 (n=659) were included. Early-onset type 2 diabetes was present in 13.1% of the previously diagnose...

  4. Higher Prevalence and Awareness, but Lower Control Rate of Hypertension in Patients with Diabetes than General Population: The Fifth Korean National Health and Nutrition Examination Survey in 2011

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    Seung-Hyun Ko

    2014-02-01

    Full Text Available BackgroundWe investigated the prevalence, awareness, treatment, and control rate of hypertension in Korean adults with diabetes using nationally representative data.MethodsUsing data of 5,105 adults from the fifth Korea National Health and Nutrition Examination Survey in 2011 (4,389 nondiabetes mellitus [non-DM], 242 newly diagnosed with DM (new-DM, and 474 previously diagnosed with DM (known-DM, we analyzed the prevalence of hypertension (mean systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive medication and control rate of hypertension (blood pressure [BP] <130/80 mm Hg.ResultsThe prevalence of hypertension in diabetic adults was 54.6% (44.4% in new-DM and 62.6% in known-DM, P<0.0001 and P<0.0001, respectively compared with non-DM adults (26.2%. Compared to non-DM, awareness (85.7%, P<0.001 and treatment (97.0%, P=0.020 rates were higher in known-DM, whereas no differences were found between new-DM and non-DM. Control rate among all hypertensive subjects was lower in new-DM (14.9%, compared to non-DM (35.1%, P<0.001 and known-DM (33.3%, P=0.004. Control rate among treated subjects was also lower in new-DM (25.2%, compared to non-DM (68.4%, P<0.0001 and known-DM (39.9%, P<0.0001.ConclusionHigher prevalence and low control rate of hypertension in adults with diabetes suggest that stringent efforts are needed to control BP in patients with diabetes, particularly in newly diagnosed diabetic patients.

  5. Association of hypertension, diabetes, dyslipidemia, and metabolic syndrome with obesity: findings from the National Health and Nutrition Examination Survey, 1999 to 2004.

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    Nguyen, Ninh T; Magno, Cheryl P; Lane, Karen T; Hinojosa, Marcelo W; Lane, John S

    2008-12-01

    Hypertension, diabetes, and dyslipidemia are common conditions associated with obesity. This study provides current estimates of the prevalence of hypertension, diabetes, dyslipidemia, and metabolic syndrome according to the severity of obesity in men and women participating in the 1999 to 2004 National Health and Nutrition Examination Survey (NHANES). Data from a representative sample of 13,745 US men and women who participated in the NHANES between 1999 and 2004 were reviewed. Overweight and obesity classes 1, 2, and 3 were defined as a body mass index of 25.0 to 29.9, 30.0 to 34.9, 35.0 to 39.9, and> or =40.0 kg/m(2), respectively. Metabolic syndrome was defined according to the 2004 National Heart, Lung and Blood Institute/American Heart Association conference proceedings. With increasing overweight and obesity class, there is an increase in the prevalence of hypertension (18.1% for normal weight to 52.3% for obesity class 3), diabetes (2.4% for normal weight to 14.2% for obesity class 3), dyslipidemia (8.9% for normal weight to 19.0% for obesity class 3), and metabolic syndrome (13.6% for normal weight to 39.2% for obesity class 3). With normal weight individuals as a reference, individuals with obesity class 3 had an adjusted odds ratio of 4.8 (95% CI 3.8 to 5.9) for hypertension, 5.1 (95% CI 3.7 to 7.0) for diabetes, 2.2 (95% CI 1.7 to 2.4) for dyslipidemia, and 2.0 (95% CI 1.4 to 2.8) for metabolic syndrome. The prevalence of hypertension, diabetes, dyslipidemia, and metabolic syndrome substantially increases with increasing body mass index. These findings have important public health implications for the prevention and treatments (surgical and nonsurgical) of obesity.

  6. Higher prevalence and awareness, but lower control rate of hypertension in patients with diabetes than general population: the fifth korean national health and nutrition examination survey in 2011.

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    Ko, Seung-Hyun; Kwon, Hyuk-Sang; Kim, Dae Jung; Kim, Jae Hyeon; Kim, Nan Hee; Kim, Chul Sik; Song, Kee-Ho; Won, Jong Chul; Lim, Soo; Choi, Sung Hee; Han, Kyungdo; Park, Yong-Moon; Cha, Bong-Yun

    2014-02-01

    We investigated the prevalence, awareness, treatment, and control rate of hypertension in Korean adults with diabetes using nationally representative data. Using data of 5,105 adults from the fifth Korea National Health and Nutrition Examination Survey in 2011 (4,389 nondiabetes mellitus [non-DM]), 242 newly diagnosed with DM (new-DM), and 474 previously diagnosed with DM (known-DM), we analyzed the prevalence of hypertension (mean systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive medication) and control rate of hypertension (blood pressure [BP] <130/80 mm Hg). The prevalence of hypertension in diabetic adults was 54.6% (44.4% in new-DM and 62.6% in known-DM, P<0.0001 and P<0.0001, respectively) compared with non-DM adults (26.2%). Compared to non-DM, awareness (85.7%, P<0.001) and treatment (97.0%, P=0.020) rates were higher in known-DM, whereas no differences were found between new-DM and non-DM. Control rate among all hypertensive subjects was lower in new-DM (14.9%), compared to non-DM (35.1%, P<0.001) and known-DM (33.3%, P=0.004). Control rate among treated subjects was also lower in new-DM (25.2%), compared to non-DM (68.4%, P<0.0001) and known-DM (39.9%, P<0.0001). Higher prevalence and low control rate of hypertension in adults with diabetes suggest that stringent efforts are needed to control BP in patients with diabetes, particularly in newly diagnosed diabetic patients.

  7. Swedish attitudes towards persons with mental illness.

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    Högberg, Torbjörn; Magnusson, Annabella; Lützén, Kim; Ewalds-Kvist, Béatrice

    2012-04-01

    Negative and stigmatizing attitudes towards persons with mental illness must be dealt with to facilitate the sufferers' social acceptance. The present study aimed at survey Swedish attitudes towards persons with mental illness related to factors impacting these attitudes. New CAMI-S based on the questionnaire "Community Attitudes to Mental Illness in Sweden" ([CAMI] Taylor & Dear, 1981) was developed with nine behavioral-intention items and thus comprised a total of 29 items. Of 5000 Swedish people, 2391 agreed to complete the questionnaire. Principal component analysis rendered four factors reflecting attitudes towards the mentally ill: Intention to Interact, Fearful and Avoidant, Open-minded and Pro-Integration, as well as Community Mental Health Ideology. The factors were analyzed for trends in attitudes. By MANOVA, the experience of mental illness effects on mind-set towards the sufferers was assessed. By means of logistic regression, demographic factors contributing to positive attitudes towards persons with mental illness residing in the neighborhood were assessed. By New CAMI-S, the Swedish attitudes towards the mentally ill were surveyed and trends in agreement with living next to a person with mental illness were revealed in three out of four factors derived by principal component analysis. Aspects impacting the Swedish attitudes towards persons with mental illness and willingness to have him/her residing in the neighborhood comprised experience of mental illness, female gender, age (31-50 years), born in Scandinavia or outside Europe, only 9 years of compulsory school and accommodation in flat. The New CAMI-S came out as a useful tool to screen Swedish attitudes towards persons with mental illness. Most Swedes were prepared to live next to the mentally ill.

  8. Professional reinventions: Swedish psychologists, 1990-2010.

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    Skagius, Peter; Münger, Ann-Charlotte

    2016-11-01

    Since the early 20th century, the Swedish psychology profession has undergone several changes in its essential tasks, epistemological foundations, and social roles. These changes occurred through an ongoing "tuning" with Swedish society, in which the profession strove to appear relevant to society's concerns and problems as well as enroll others to share the profession's goals and aims. Studying the history of the profession can thus shed light on the changing definitions and contours of the psychology profession itself as well as on the organization of the society in which it acts. This article examines the history of the Swedish psychology profession from 1990 to 2010, through an analysis of the discussions and debates taking place in the Swedish Psychological Association's journal. The analytical framework used draws on work done within actor-network theory and science studies. We argue that the profession's institutional connections, defining tasks, epistemological underpinnings, and social position have changed in major ways during these 2 decades. Overall, as a result of an increasingly felt insecurity, the profession has turned outward and tried to find new ways to legitimize itself to politicians, the media, patients, and customers through means such as a more economized vocabulary and novel forms of empirical research. These changes have led to a more socialized profession, now more closely tuned to other actors in Swedish society, leading to conflicts within the profession over whether this is an opportunity to better control their own destiny or if it will lead to a loss of autonomy. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  9. Early Invasive Strategy and In-Hospital Survival Among Diabetics With Non-ST-Elevation Acute Coronary Syndromes: A Contemporary National Insight.

    Science.gov (United States)

    Mahmoud, Ahmed N; Elgendy, Islam Y; Mansoor, Hend; Wen, Xuerong; Mojadidi, Mohammad K; Bavry, Anthony A; Anderson, R David

    2017-03-18

    There are limited data on the merits of an early invasive strategy in diabetics with non-ST-elevation acute coronary syndrome, with unclear influence of this strategy on survival. The aim of this study was to evaluate the in-hospital survival of diabetics with non-ST-elevation acute coronary syndrome treated with an early invasive strategy compared with an initial conservative strategy. The National Inpatient Sample database, years 2012-2013, was queried for diabetics with a primary diagnosis of non-ST-elevation acute coronary syndrome defined as either non-ST-elevation myocardial infarction or unstable angina (unstable angina). An early invasive strategy was defined as coronary angiography±revascularization within 48 hours of admission. Propensity scores were used to assemble a cohort managed with either an early invasive or initial conservative strategy balanced on >50 baseline characteristics and hospital presentations. Incidence of in-hospital mortality was compared in both groups. In a cohort of 363 500 diabetics with non-ST-elevation acute coronary syndrome, 164 740 (45.3%) were treated with an early invasive strategy. Propensity scoring matched 21 681 diabetics in both arms. Incidence of in-hospital mortality was lower with an early invasive strategy in both the unadjusted (2.0% vs 4.8%; odds ratio [OR], 0.41; 95% CI, 0.39-0.42; Pstrategy may be associated with a lower incidence of in-hospital mortality in patients with diabetes. The benefit of this strategy appears to be superior in patients presenting with non-ST-elevation myocardial infarction compared with unstable angina. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  10. Diabetic macular oedema treated with intravitreal anti-vascular endothelial growth factor - 2-4 years follow-up of visual acuity and retinal thickness in 566 patients following Danish national guidelines

    DEFF Research Database (Denmark)

    Hodzic-Hadzibegovic, Delila; Sander, Birgit Agnes; Monberg, Tine Juul

    2018-01-01

    PURPOSE: To investigate long-term functional and anatomical outcomes, discontinuation patterns, drug switching and rates of nonimprovement in patients treated with ranibizumab pro re nata (PRN) regimen for diabetic macular oedema (DME) according to the Danish national guidelines. METHODS: Retrosp......PURPOSE: To investigate long-term functional and anatomical outcomes, discontinuation patterns, drug switching and rates of nonimprovement in patients treated with ranibizumab pro re nata (PRN) regimen for diabetic macular oedema (DME) according to the Danish national guidelines. METHODS...

  11. Current Indicators of Nutritional Care in Children with Type 1 Diabetes in India: Do we Need a National Nutritional Guideline?

    Science.gov (United States)

    Kalra, Sanjay; Das, Ashok Kumar; Raghupathy, P; Chowdhury, Subhankar; Saboo, Banshi D; Dinakaran, P; Chugh, Shuchy

    2017-01-01

    Nutrition is an important pillar of management in children with type 1 diabetes. Indian food is heavily influenced by region, religion, traditions, seasons, and cultural choices. This survey was done to assess current practices and the need for India specific nutritional guidelines for children with type 1 diabetes. Two 12-item questionnaires were administered to forty health-care professionals across India. The first questionnaire evaluated current clinical practice indicators for nutrition in these children and second assessed practices for counseling a child on dietary habits. There is great heterogeneity across the country with regard to dietary advice offered to children with type 1 diabetes. 97.5% of the respondents feel there is a need for an Indian dietary guideline for children with type 1 diabetes. There is need of India specific nutritional guidelines that should be made considering key variants such as age, region, cultural preference, economic burden and psychosocial beliefs, to offer guidance to diabetes care professionals.

  12. An attempt to appoint a Swedish vice consul to Bucharest (1834-1835

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    Veniamin Ciobanu

    2012-08-01

    Full Text Available The economic development of Sweden at the end of the second decade of the nineteenth century accentuated the interest of the Swedish ruling circles to valorize the new economic potential. A series of measures, as the dissolution of the terrestrial customs between Sweden and Norway in 1825, or the abolition of the protectionist policy in imports, opened the way for the conclusion of certain commercial treaties with other states, such as that with Great Britain in 1826 or with the Ottoman Empire in 1827. Consequently, the commercial fleet, especially the Norwegian one, registered a substantial development. In this context, the Swedish diplomacy continued to pay close attention to Eastern Europe where favorable conditions for the extension of the foreign trade of Sweden and Norway could be found. This space, where the Romanian Principalities were located, had a geostrategic position and economic potential that had to be valorized. In order to achieve this goal, Sweden appointed consuls and vice consuls in the Romanian Principalities. The attempt to appoint a vice consul to Bucharest between 1834 and 1835 circumscribes this effort. The information regarding these demarches came from Swedish diplomatic reports, held in the funds of the National Archives of Sweden (Sveriges Riksarkivet, from Stockholm and offers, among many other details which may serve to broaden the horizon of the research regarding the history of Romanian-Swedish relations in the first half of the nineteenth century, an image of the Lutheran community from the capital of Wallachia.

  13. Clustering and inertia: structural integration of home care in Swedish elderly care

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    Nils Olof Hedman

    2007-09-01

    Full Text Available Purpose: To study the design and distribution of different organizational solutions regarding the responsibility for and provision of home care for elderly in Swedish municipalities. Method: Directors of the social welfare services in all Swedish municipalities received a questionnaire about old-age care organization, especially home care services and related activities. Rate of response was 73% (211/289. Results: Three different organizational models of home care were identified. The models represented different degrees of integration of home care, i.e. health and social aspects of home care were to varying degrees integrated in the same organization. The county councils (i.e. large sub-national political-administrative units tended to contain clusters of municipalities (smaller sub-national units with the same organizational characteristics. Thus, municipalities' home care organization followed a county council pattern. In spite of a general tendency for Swedish municipalities to reorganize their activities, only 1% of them had changed their home care services organization in relation to the county council since the reform. Conclusion: The decentralist intention of the reform—to give actors at the sub-national levels freedom to integrate home care according to varying local circumstances—has resulted in a sub-national inter-organizational network structure at the county council, rather than municipal, level, which is highly inert and difficult to change.

  14. Clustering and inertia: structural integration of home care in Swedish elderly care.

    Science.gov (United States)

    Olof Hedman, Nils; Johansson, Roine; Rosenqvist, Urban

    2007-09-12

    To study the design and distribution of different organizational solutions regarding the responsibility for and provision of home care for elderly in Swedish municipalities. Directors of the social welfare services in all Swedish municipalities received a questionnaire about old-age care organization, especially home care services and related activities. Rate of response was 73% (211/289). Three different organizational models of home care were identified. The models represented different degrees of integration of home care, i.e. health and social aspects of home care were to varying degrees integrated in the same organization. The county councils (i.e. large sub-national political-administrative units) tended to contain clusters of municipalities (smaller sub-national units) with the same organizational characteristics. Thus, municipalities' home care organization followed a county council pattern. In spite of a general tendency for Swedish municipalities to reorganize their activities, only 1% of them had changed their home care services organization in relation to the county council since the reform. The decentralist intention of the reform-to give actors at the sub-national levels freedom to integrate home care according to varying local circumstances-has resulted in a sub-national inter-organizational network structure at the county council, rather than municipal, level, which is highly inert and difficult to change.

  15. The National Cholesterol Education Program - Adult Treatment Panel III, International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes.

    Science.gov (United States)

    Lorenzo, Carlos; Williams, Ken; Hunt, Kelly J; Haffner, Steven M

    2007-01-01

    The clinical value of metabolic syndrome is uncertain. Thus, we examined cardiovascular disease (CVD) and diabetes risk prediction by the National Cholesterol Education Program (NCEP)-Adult Treatment Panel III (ATPIII), International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome. We analyzed the risks associated with metabolic syndrome, the NCEP multiple risk factor categories, and 2-h glucose values in the San Antonio Heart Study (n = 2,559; age range 25-64 years; 7.4 years of follow-up). Both ATPIII metabolic syndrome plus age > or = 45 years (odds ratio 9.25 [95% CI 4.85-17.7]) and multiple (two or more) risk factors plus a 10-year coronary heart disease (CHD) risk of 10-20% (11.9 [6.00-23.6]) had similar CVD risk in men without CHD, as well as CHD risk equivalents. In women counterparts, multiple (two or more) risk factors plus a 10-year CHD risk of 10-20% was infrequent (10 of 1,254). However, either a 10-year CHD risk of 5-20% (7.72 [3.42-17.4]) or ATPIII metabolic syndrome plus age > or = 55 years (4.98 [2.08-12.0]) predicted CVD. ATPIII metabolic syndrome increased the area under the receiver operating characteristic curve of a model containing age, sex, ethnic origin, family history of diabetes, and 2-h and fasting glucose values (0.857 vs. 0.842, P = 0.013). All three metabolic syndrome definitions imparted similar CVD and diabetes risks. Metabolic syndrome is associated with a significant CVD risk, particularly in men aged > or = 45 years and women aged > or = 55 years. The metabolic syndrome predicts diabetes beyond glucose intolerance alone.

  16. Comparison of the prevalence of metabolic syndrome and its association with diabetes and cardiovascular disease in the rural population of Bangladesh using the modified National Cholesterol Education Program Expert Panel Adult Treatment Panel III and International Diabetes Federation definitions.

    Science.gov (United States)

    Bhowmik, Bishwajit; Afsana, Faria; Siddiquee, Tasnima; Munir, Sanjida B; Sheikh, Fareeha; Wright, Erica; Bhuiyan, Farjana R; Ashrafuzzaman, Sheikh Mohammad; Mahtab, Hajera; Azad Khan, Abul Kalam; Hussain, Akhtar

    2015-05-01

    To compare the prevalence of metabolic syndrome (MS) using the modified National Cholesterol Education Program Adult Treatment Plan III (NCEP) and the International Diabetes Federation (IDF) definitions and, using both definitions, determine and compare the association of MS, prediabetes, type 2 diabetes, hypertension (HTN) and cardiovascular disease risk (CVD). A total of 2,293 randomly selected participants (aged ≥20 years) in a rural community in Bangladesh were investigated in a population-based cross-sectional study. Sociodemographic and anthropometric characteristics, blood pressure, blood glucose, and lipid profiles were studied. Age-adjusted data for MS and cardiometabolic risk factors were assessed, and their relationships were examined. The age-adjusted prevalence of MS was 30.7% (males 30.5%; females 30.5%) using the NCEP definition, and 24.5% (males 19.2%, females 27.5%) using the IDF definition. The prevalence of MS using the NCEP definition was also higher in study participants with prediabetes, type 2 diabetes, HTN and CVD risk. The agreement rate between both definitions was 92% (k = 0.80). The NCEP definition had a stronger association with type 2 diabetes and HTN (odds ratio 12.4 vs 5.2; odds ratio 7.0 vs 4.7, respectively) than the IDF definition. However, the odds ratios for prediabetes and CVD risk were not significantly different. The prevalence of MS was higher using the NCEP definition, and was more strongly associated with prediabetes, type 2 diabetes, HTN and CVD in this Bangladeshi population.

  17. Contextualizing Obesity and Diabetes Policy: Exploring a Nested Statistical and Constructivist Approach at the Cross-National and Subnational Government Level in the United States and Brazil

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    Eduardo J. Gómez

    2017-11-01

    Full Text Available Background This article conducts a comparative national and subnational government analysis of the political, economic, and ideational constructivist contextual factors facilitating the adoption of obesity and diabetes policy. Methods We adopt a nested analytical approach to policy analysis, which combines cross-national statistical analysis with subnational case study comparisons to examine theoretical prepositions and discover alternative contextual factors; this was combined with an ideational constructivist approach to policy-making. Results Contrary to the existing literature, we found that with the exception of cross-national statistical differences in access to healthcare infrastructural resources, the growing burden of obesity and diabetes, rising healthcare costs and increased citizens’ knowledge had no predictive affect on the adoption of obesity and diabetes policy. We then turned to a subnational comparative analysis of the states of Mississippi in the United States and Rio Grande do Norte in Brazil to further assess the importance of infrastructural resources, at two units of analysis: the state governments versus rural municipal governments. Qualitative evidence suggests that differences in subnational healthcare infrastructural resources were insufficient for explaining policy reform processes, highlighting instead other potentially important factors, such as state-civil societal relationships and policy diffusion in Mississippi, federal policy intervention in Rio Grande do Norte, and politicians’ social construction of obesity and the resulting differences in policy roles assigned to the central government. Conclusion We conclude by underscoring the complexity of subnational policy responses to obesity and diabetes, the importance of combining resource and constructivist analysis for better understanding the context of policy reform, while underscoring the potential lessons that the United States can learn from Brazil.

  18. Diabetes and onset of natural menopause: results from the European Prospective Investigation into Cancer and Nutrition.

    Science.gov (United States)

    Brand, J S; Onland-Moret, N C; Eijkemans, M J C; Tjønneland, A; Roswall, N; Overvad, K; Fagherazzi, G; Clavel-Chapelon, F; Dossus, L; Lukanova, A; Grote, V; Bergmann, M M; Boeing, H; Trichopoulou, A; Tzivoglou, M; Trichopoulos, D; Grioni, S; Mattiello, A; Masala, G; Tumino, R; Vineis, P; Bueno-de-Mesquita, H B; Weiderpass, E; Redondo, M L; Sánchez, M J; Castaño, J M Huerta; Arriola, L; Ardanaz, E; Duell, E J; Rolandsson, O; Franks, P W; Butt, S; Nilsson, P; Khaw, K T; Wareham, N; Travis, R; Romieu, I; Gunter, M J; Riboli, E; van der Schouw, Y T

    2015-06-01

    Do women who have diabetes before menopause have their menopause at an earlier age compared with women without diabetes? Although there was no overall association between diabetes and age at menopause, our study suggests that early-onset diabetes may accelerate menopause. Today, more women of childbearing age are being diagnosed with diabetes, but little is known about the impact of diabetes on reproductive health. We investigated the impact of diabetes on age at natural menopause (ANM) in 258 898 women from the European Prospective Investigation into Cancer and Nutrition (EPIC), enrolled between 1992 and 2000. Determinant and outcome information was obtained through questionnaires. Time-dependent Cox regression analyses were used to estimate the associations of diabetes and age at diabetes diagnosis with ANM, stratified by center and adjusted for age, smoking, reproductive and diabetes risk factors and with age from birth to menopause or censoring as the underlying time scale. Overall, no association between diabetes and ANM was found (hazard ratio (HR) = 0.94; 95% confidence interval (CI) 0.89-1.01). However, women with diabetes before the age of 20 years had an earlier menopause (10-20 years: HR = 1.43; 95% CI 1.02-2.01, type 1 and type 2 diabetes. Based on the literature, an accelerating effect of early-onset diabetes on ANM might be plausible. A delaying effect of late-onset diabetes on ANM has not been reported before, and is not in agreement with recent studies suggesting the opposite association. The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark); Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Générale de l'Education Nationale, Institut National de la Santé et de la Recherche Médicale (INSERM) (France); German Cancer Aid, German Cancer Research Center (DKFZ) and Federal Ministry of

  19. The incidence and prevalence of diabetes mellitus and related atherosclerotic complications in Korea: a National Health Insurance Database Study.

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    Bo Kyung Koo

    Full Text Available The incidence and prevalence of type 2 diabetes mellitus (T2DM and related macrovascular complications in Korea were estimated using the Health Insurance Review and Assessment (HIRA database from 2007-2011, which covers the claim data of 97.0% of the Korean population.T2DM, coronary artery disease (CAD, cerebrovascular disease (CVD, and peripheral artery disease (PAD were defined according to ICD-10 codes. We used the Healthcare Common Procedure Coding System codes provided by HIRA to identify associated procedures or surgeries. When calculating incidence, we excluded cases with preexisting T2DM within two years before the index year. A Poisson distribution was assumed when calculating 95% confidence intervals for prevalence and incidence rates.The prevalence of T2DM in Korean adults aged 20-89 years was 6.1-6.9% and the annual incidence rates of T2DM ranged from 9.5-9.8/1,000 person-year (PY during the study period. The incidence rates of T2DM in men and women aged 20-49 years showed decreasing patterns from 2009 to 2011 (P<0.001; by contrast, the incidence in subjects aged 70-79 years showed increased patterns from 2009 to 2011 (P<0.001. The incidence rates of CAD and CVD in patients newly diagnosed with T2DM were 18.84/1,000 PY and 11.32/1,000 PY, respectively, in the year of diagnosis. Among newly diagnosed individuals with T2DM who were undergoing treatment for PAD, 14.6% underwent angioplasty for CAD during the same period.Our study measured the national incidences of T2DM, CAD, CVD, and PAD, which are of great concern for public health. We also confirmed the relatively higher risk of CAD and CVD newly detected T2DM patients compared to the general population in Korea.

  20. Relationship between Regional Body Fat Distribution and Diabetes Mellitus: 2008 to 2010 Korean National Health and Nutrition Examination Surveys

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    Soo In Choi

    2017-01-01

    Full Text Available BackgroundThe aim of this study was to investigate the association between regional body fat distribution, especially leg fat mass, and the prevalence of diabetes mellitus (DM in adult populations.MethodsA total of 3,181 men and 3,827 postmenopausal women aged 50 years or older were analyzed based on Korea National Health and Nutrition Examination Surveys (2008 to 2010. Body compositions including muscle mass and regional fat mass were measured using dual-energy X-ray absorptiometry.ResultsThe odds ratios (ORs for DM was higher with increasing truncal fat mass and arm fat mass, while it was lower with increasing leg fat mass. In a partial correlation analysis adjusted for age, leg fat mass was negatively associated with glycosylated hemoglobin in both sexes and fasting glucose in women. Leg fat mass was positively correlated with appendicular skeletal muscle mass and homeostasis model assessment of β cell. In addition, after adjusting for confounding factors, the OR for DM decreased gradually with increasing leg fat mass quartiles in both genders. When we subdivided the participants into four groups based on the median values of leg fat mass and leg muscle mass, higher leg fat mass significantly lowered the risk of DM even though they have smaller leg muscle mass in both genders (P<0.001.ConclusionThe relationship between fat mass and the prevalence of DM is different according to regional body fat distribution. Higher leg fat mass was associated with a lower risk of DM in Korean populations. Maintaining leg fat mass may be important in preventing impaired glucose tolerance.

  1. Association of Urinary Phthalates with Self-Reported Eye Affliction/Retinopathy in Individuals with Diabetes: National Health and Nutrition Examination Survey, 2001–2010

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    Manju Mamtani

    2016-01-01

    Full Text Available Background. An epidemiological association between exposure to phthalates and type 2 diabetes (T2D is known. However, the potential role of environmental phthalates in the complications of T2D is unknown. Methods. Using data from the National Health and Nutrition Examination Survey (NHANES 2001–2010, we studied the association of 12 urinary phthalate metabolites with self-reported eye affliction/retinopathy in 1,004 participants with diabetes. Data from retinal imaging was used to validate this outcome. Independence of the phthalates→T2D association was studied by adjusting for age, sex, race, marital status, educational attainment, poverty income ratio, physical activity, glycated hemoglobin levels, total serum cholesterol, serum high-density lipoprotein cholesterol, serum triglycerides, blood pressure, duration of diabetes, total calorie intake, and obesity. Results. Self-reported eye affliction/retinopathy had 82% accuracy with Cohen’s kappa of 0.31 (p<0.001. Urinary mono-n-octyl phthalate (MOP was independently associated with the likelihood of self-reported eye affliction/retinopathy in subjects with T2D after accounting for all the confounders. This significance of this association was robust to the potential misclassification in cases and controls of retinopathy. Further, a significant dose-response relationship between MOP and self-reported eye affliction/retinopathy was demonstrable. Conclusions. We show a novel epidemiological link between the environment and diabetic complications in NHANES 2001–2010 participants.

  2. Extreme Levels of HbA1c Increase Incident ESRD Risk in Chinese Patients with Type 2 Diabetes: Competing Risk Analysis in National Cohort of Taiwan Diabetes Study.

    Directory of Open Access Journals (Sweden)

    Li-Na Liao

    Full Text Available Whether HbA1c is a predictor of end-stage renal disease (ESRD in type 2 diabetes patients remains unclear. This study evaluated relationship between HbA1c and ESRD in Chinese patients with type 2 diabetes.Patients aged ≥ 30 years who were free of ESRD (n = 51 681 were included from National Diabetes Care Management Program from 2002-2003. Extended Cox proportional hazard model with competing risk of death served to evaluate association between HbA1c level and ESRD.A total of 2613 (5.06% people developed ESRD during a follow-up period of 8.1 years. Overall incidence rate of ESRD was 6.26 per 1000 person-years. Patients with high levels of HbA1c had a high incidence rate of ESRD, from 4.29 for HbA1c of  6.0%-6.9% to 10.33 for HbA1c ≥ 10.0% per 1000 person-years. Patients with HbA1c < 6.0% particularly had a slightly higher ESRD incidence (4.34 per 1000 person-years than those with HbA1c  of 6.0%-6.9%. A J-shaped relationship between HbA1c level and ESRD risk was observed. After adjustment, patients with HbA1c < 6.0% and ≥ 10.0% exhibited an increased risk of ESRD (HR: 1.99, 95% CI: 1.62-2.44; HR: 4.42, 95% CI: 3.80-5.14, respectively compared with those with HbA1c of 6.0%-6.9%.Diabetes care has focused on preventing hyperglycemia, but not hypoglycemia. Our study revealed that HbA1c level ≥ 7.0% was linked with increased ESRD risk in type 2 diabetes patients, and that HbA1c < 6.0% also had the potential to increase ESRD risk. Our study provides epidemiological evidence that appropriate glycemic control is essential for diabetes care to meet HbA1c targets and improve outcomes without increasing the risk to this population. Clinicians need to pay attention to HbA1c results on diabetic nephropathy.

  3. Benign prostatic hyperplasia is a significant risk factor for bladder cancer in diabetic patients: a population-based cohort study using the National Health Insurance in Taiwan

    Directory of Open Access Journals (Sweden)

    Tseng Chin-Hsiao

    2013-01-01

    Full Text Available Abstract Background Diabetic patients have a higher risk of bladder cancer and benign prostatic hyperplasia (BPH. Theoretically, BPH patients may have an increased risk of bladder cancer because residual urine in the bladder surely increases the contact time between urinary excreted carcinogens and the urothelium. However, whether BPH increases bladder cancer risk in patients with type 2 diabetes has not been studied. Methods The reimbursement databases of all Taiwanese diabetic patients under oral anti-diabetic agents or insulin from 1996 to 2009 were retrieved from the National Health Insurance. An entry date was set at 1 January 2006 and a total of 547584 men with type 2 diabetes were followed up for bladder cancer incidence until the end of 2009. Incidences of bladder cancer for BPH by status and by duration were calculated and adjusted hazard ratios (95% confidence intervals were estimated by Cox regression. The effects of diabetes duration and medications used for diabetic control in relation with bladder cancer risk were also evaluated by Cox regression in BPH men. Results The incidences were 258.77 and 69.34 per 100,000 person-years for patients with and without BPH, respectively, adjusted hazard ratio 1.794 (1.572, 2.047. For BPH patients, those who underwent surgical procedures for BPH had a higher incidence than those who did not (355.45 vs. 250.09 per 100,000 person-years, respective adjusted hazard ratios: 2.459 (1.946, 3.109 and 1.709 (1.492, 1.958. The significantly higher risk could be demonstrated for BPH of any duration: respective adjusted hazard ratios 1.750 (1.430, 1.605, 1.844 (1.543, 2.203, 2.011 (1.680, 2.406 and 1.605 (1.341, 1.921 for BPH Conclusions BPH is a significant risk factor for bladder cancer in men with type 2 diabetes. Metformin may protect against bladder cancer in BPH men.

  4. Use of the National Health and Nutrition Examination Survey to calculate the impact of obesity and diabetes on cost and prevalence of urolithiasis in 2030.

    Science.gov (United States)

    Antonelli, Jodi A; Maalouf, Naim M; Pearle, Margaret S; Lotan, Yair

    2014-10-01

    The prevalence of urolithiasis and its risk factors such as obesity and diabetes have increased over time. Determine the future cost and prevalence of kidney stones using current and projected estimates for stones, obesity, diabetes, and population rates. The stone prevalence in 2000 was estimated from the National Health and Nutrition Examination Survey (NHANES) 1988-1994 and 2007-2010. The cost per percentage prevalence of stones in 2000, calculated using Urologic Diseases in America Project data, was used to estimate the annual cost of stones in 2030, adjusting for inflation and increases in population, stone prevalence, obesity and diabetes rates. The primary outcome was prevalence and cost of stones in 2030. The secondary outcomes were the impact of obesity and diabetes on these values, calculated using odds ratios for stones by body mass index and diabetes status. The annual cost of stone disease in 2000, adjusted for inflation to 2014 US dollars, was approximately $2.81 billion. After accounting for increases in population and stone prevalence from 2000, the estimated cost of stones in 2007 in 2014 US dollars was $3.79 billion. Future population growth alone would increase the cost of stone disease by $780 million in 2030. Based on projected estimates for 2030, obesity will independently increase stone prevalence by 0.36%, with an annual cost increase of $157 million. Diabetes will independently increase stone prevalence by 0.72%, associated with a cost increase of $308 million annually by 2030. NHANES data, however, capture patient self-assessment rather than medical diagnosis, which is a potential bias. The rising prevalence of obesity and diabetes, together with population growth, is projected to contribute to dramatic increases in the cost of urolithiasis, with an additional $1.24 billion/yr estimated by 2030. Obesity, diabetes, and population rates will contribute to an estimated $1.24 billion/yr increase in the cost of kidney stones by 2030. Copyright

  5. Sex differences in the association between socio-economic status and type 2 diabetes: data from the 2005 Korean National Health and Nutritional Examination Survey (KNHANES).

    Science.gov (United States)

    Lee, D S; Kim, Y J; Han, H R

    2013-06-01

    While socio-economic status (SES) is considered a key social-environment factor affecting health outcomes, sex differences in the association between SES and the risk of type 2 diabetes remain unclear. The aims of this study were: (1) to identify risk factors associated with type 2 diabetes in a representative sample of Korean adults with a focus on socio-economic determinants; and (2) to examine how the association between SES and type 2 diabetes is affected by sex. Cross-sectional study. This study used data obtained from 3870 Korean adults (age ≥35 years) who participated in the 2005 Korean National Health and Nutritional Examination Survey (KNHANES III). The risk of type 2 diabetes in relation to SES was calculated, after controlling for other risk factors such as medical characteristics (hypertension, family history, body mass index, triglyceride, total cholesterol, high-density lipoprotein cholesterol), lifestyle factors (body mass index, smoking, alcohol intake, exercise) and perceived stress. Odds ratios (ORs) were calculated separately for Korean men and women using multivariate logistic regression. Compared with individuals with ≥13 years of education, those with ≤6 years of education or 7-12 years of education had higher ORs for the risk of type 2 diabetes - 2.10 (95% confidence interval (CI) 1.27-3.48) and 1.62 (95% CI 1.04-2.52), respectively - after adjusting for age, sex, medical characteristics, lifestyle factors and stress level. The OR for women with ≤6 years of education was particularly high (OR 10.16, 95% CI 2.08-49.53), even after adjusting for the study covariates. However, this increasing trend in the OR was not observed for men. SES significantly influences the risk of type 2 diabetes in Korean adults, and there are interactions with sex. Korean women with a low level of education represent a particularly high-risk group for type 2 diabetes. Future interventions should incorporate more targeted diabetes prevention efforts for women

  6. Viagra selfhood: pharmaceutical advertising and the visual formation of Swedish masculinity.

    Science.gov (United States)

    Asberg, Cecilia; Johnson, Ericka

    2009-06-01

    Using material from the Pfizer sponsored website providing health information on erectile dysfunction to potential Swedish Viagra customers (www.potenslinjen.se), this article explores the public image of masculinity in relation to sexual health and the cultural techniques for creating pharmaceutical appeal. We zoom in on the targeted ideal users of Viagra, and the nationalized, racialized and sexualized identities they are assigned. As part of Pfizer's marketing strategy of adjustments to fit the local consumer base, the ways in which Viagra is promoted for the Swedish setting is telling of what concepts of masculinity are so stable and unassailable that they can withstand the association with a drug that is, in essence, an acknowledgement of 'failed' masculinity and 'dysfunctional' sexuality. With comparative national examples, this study presents an interdisciplinary take on the 'glocalized' cultural imaginary of Viagra, and the masculine subject positions it engenders.

  7. "The Feelings Have Come Home to Me." Examining Advertising Films on the Swedish Website of El Sistema

    Science.gov (United States)

    Kuuse, Anna-Karin; Lindgren, Monica; Skåreus, Eva

    2016-01-01

    The purpose of this study is to analyze how the music educational program of El Sistema Sweden is advertised and legitimized through moving images. The films are a major part of the information on the Swedish national website of El Sistema and are supposed to contribute to the picture that the organization and its founders wish to market. The use…

  8. Ethnic Swedish parents' experiences of minority ethnic nurses' cultural competence in Swedish paediatric care.

    Science.gov (United States)

    Tavallali, Azar G; Kabir, Zarina Nahar; Jirwe, Maria

    2014-06-01

    Sweden has a population of a little more than 9.4 million. The rapid growth of immigration in Sweden has resulted in an increased number of minority ethnic patients and minority ethnic nurses in the Swedish healthcare system. This also applies to paediatric care. The purpose of this study was to explore how parents with ethnic Swedish backgrounds experience minority ethnic nurses' cultural competence and the care the nurses provide in a Swedish paediatric care context. This exploratory qualitative study is of 14 parents with an ethnic Swedish background whose child was in a ward at a children's hospital in Stockholm County Council. Data were collected using semi-structured interviews to identify parents' perceptions and experiences of minority ethnic nurses' cultural competence. The interviews were analysed by qualitative content analysis. The analyses of the interviews led to four main categories: influence of nurses' ethnicity; significance of cross-cultural communication; cross-cultural skills; and the importance of nursing education. Nurses' ethnicity did not have much impact on parents' satisfaction with their child's care. The parents attached importance to nurses' language skills and to their adaptation and awareness of Swedish culture. They also attached weight to nurses' professional knowledge and personal attributes. The role of nursing education to increase nurses' cultural awareness was highlighted too. © 2013 Nordic College of Caring Science.

  9. Reregulation of the Swedish pharmacy sector

    DEFF Research Database (Denmark)

    Wisell, Kristin; Winblad, Ulrika; Sporrong, Sofia Kälvemark

    2015-01-01

    In 2009, a reregulation of the Swedish pharmacy sector took place, and a fundamental change in ownership and structure followed. The reregulation provides an opportunity to reveal the politicians' views on pharmacies. The aim of this study was to explore and analyze the political arguments...... for the reregulation of the Swedish pharmacy sector in 2009. The method used was a qualitative content analysis of written political documents regarding the reregulation. The primary rationales for the reregulation were better availability, efficiency, price pressure, and safe usage of medicines. During...... are better equipped to perform public activities. The results point to that the reform was done almost solely in order to introduce private ownership in the pharmacy sector, and was not initiated in order to solve any general problems, or to enhance patient outcomes of medicine use....

  10. Use of Fibrates Monotherapy in People with Diabetes and High Cardiovascular Risk in Primary Care: A French Nationwide Cohort Study Based on National Administrative Databases.

    Directory of Open Access Journals (Sweden)

    Ronan Roussel

    Full Text Available According to guidelines, diabetic patients with high cardiovascular risk should receive a statin. Despite this consensus, fibrate monotherapy is commonly used in this population. We assessed the frequency and clinical consequences of the use of fibrates for primary prevention in patients with diabetes and high cardiovascular risk.Retrospective cohort study based on nationwide data from the medical and administrative databases of French national health insurance systems (07/01/08-12/31/09 with a follow-up of up to 30 months.Lipid-lowering drug-naive diabetic patients initiating fibrate or statin monotherapy were identified. Patients at high cardiovascular risk were then selected: patients with a diagnosis of diabetes and hypertension, and > 50 (men or 60 (women, but with no history of cardiovascular events. The composite endpoint comprised myocardial infarction, stroke, amputation, or death.Of the 31,652 patients enrolled, 4,058 (12.8% received a fibrate. Age- and gender-adjusted annual event rates were 2.42% (fibrates and 2.21% (statins. The proportionality assumption required for the Cox model was not met for the fibrate/statin variable. A multivariate model including all predictors was therefore calculated by dividing data into two time periods, allowing Hazard Ratios to be calculated before (HR 540 of follow-up. Multivariate analyses showed that fibrates were associated with an increased risk for the endpoint after 540 days: HR 540 = 1.73 (1.28-2.32.Fibrate monotherapy is commonly prescribed in diabetic patients with high cardiovascular risk and is associated with poorer outcomes compared to statin therapy.

  11. Hypertension and diabetes prevalence among U.S. Hispanics by country of origin: the National Health Interview Survey 2000-2005.

    Science.gov (United States)

    Pabon-Nau, Lina P; Cohen, Amy; Meigs, James B; Grant, Richard W

    2010-08-01

    Despite their diverse cultural origins, Hispanics in the US are generally studied as a single ethnic group. 1) Assess demographic and disease-related differences among U.S. Hispanics by country of origin, and 2) Examine the mediating roles of socioeconomic status and acculturation on disease prevalence in these subgroups. Using data from the 2000-2005 National Health Interview Survey (NHIS), we compared characteristics of Mexican-Americans with Hispanics originally from: Mexico, Puerto Rico, Central/South America, Cuba, and Dominican Republic (n = 31,240). We stratified the analysis by foreign versus US-born Hispanic subgroups and modeled hypertension and diabetes prevalence, adjusting for demographic and acculturation differences. The six Hispanic subgroups were significantly diverse in all measured variables. Prevalence of hypertension (32%) and diabetes (15%) was highest in foreign-born Puerto Ricans. After adjusting for age, BMI, smoking, socioeconomic status and acculturation in foreign-born Hispanics, Puerto Ricans (OR = 1.76 [95% CI: 1.23, 2.50], p = 0.002) and Dominicans (OR = 1.93 [1.24, 3.00], p = 0.004), had higher prevalence of hypertension relative to Mexican-Americans. Adjusted diabetes prevalence among foreign-born Hispanics was half or less in Cubans (OR = 0.42 [0.25, 0.68] p diabetes prevalence compared to Mexican-Americans in adjusted models. The prevalence of hypertension and diabetes varies significantly among Hispanics by country of origin. Health disparities research should include representation from all Hispanic subgroups.

  12. Association between Coffee Consumption and Renal Impairment in Korean Women with and without Diabetes: Analysis of the Fourth Korea National Health and Nutrition Examination Survey in 2008.

    Science.gov (United States)

    Kim, Bo Ha; Park, Yong Soon; Noh, Hye Mi; Sung, Ji Sun; Lee, Jung Kwon

    2013-07-01

    Recent studies suggest that coffee consumption has an influence on kidney function. This study investigated the relationship between habitual coffee consumption and renal impairment in Korean women, in consideration of diabetic status. This study involved 2,673 women aged 35 to 84 years who had participated in the Fourth Korea National Health and Nutrition Examination Surveys, conducted in 2008. Habitual coffee consumption was classified into three categories: less than 1 cup per day, 1 cup per day, and 2 or more cups per day. Renal function impairment was defined as an estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) by the Modification of Diet in Renal Disease equation. The prevalence of diabetes and renal function impairment was higher in women who drank coffee per day. Compared with drinking coffee per day, the odds ratio (OR) for renal function impairment was significantly lower (OR, 0.59; 95% confidence interval [CI], 0.37 to 0.95; P = 0.03) in those who habitually drank ≥ 2 cups per day after adjusting for multiple confounding factors. When data were stratified according to the presence of diabetes, coffee consumption ≥ 2 cups of coffee per day showed an inverse association with renal function impairment in only diabetic women (OR, 0.14; 95% CI, 0.02 to 0.88; P = 0.04), compared with consumption coffee per day. In a representative sample of Korean women, coffee consumption was significantly associated with a decreased risk of renal impairment especially in middle and elderly-aged diabetic women.

  13. Workplace Incivility in a Swedish Context

    OpenAIRE

    Eva Torkelson; Kristoffer Holm; Martin Bäckström

    2016-01-01

    The present study investigated workplace incivility in a Swedish context. The first aim was to assess how common the phenomenon is and the second was to study which groups (gender, age, ethnicity, and power position) are most targeted by workplace incivility and are more prone to act in an uncivil way. Additionally, the relationships between experienced and witnessed incivility and wellbeing as well as instigated incivility were investigated. An online survey was administered by SIFO (the nat...

  14. Diversity work in a Swedish Municipality

    OpenAIRE

    Risberg, Annette

    2012-01-01

    This paper builds on a case study of diversity work in a Swedish municipality, Malmö. It focuses on certain actors partaking in the diversity work done in the municipality that of a gender and diversity committee and its members – here called diversity ambassadors. I will describe the work of the diversity ambassadors and discuss what impact they could possibly have on the organization. Organizational efforts to change inequalities at the workplace may take different forms. The literature ...

  15. The swedish challenge; Le pari Suedois

    Energy Technology Data Exchange (ETDEWEB)

    Tregouet, R

    2006-07-01

    Sweden decided to be the first country without petroleum for 2020. The author presents the major energy policy axis implemented by the swedish government to delete the part of the produced energy by the petroleum: development of the renewable energies, research programs of the transportation sector concerning the alternative fuels for the motors, energy efficiency and development of the biomass to replace the nuclear energy. (A.L.B.)

  16. Patient safety as perceived by Swedish leaders

    OpenAIRE

    Härenstam, Karin Pukk; Elg, Mattias; Svensson, Carina; Brommels, Mats; Øvretveit, John

    2009-01-01

    Artikkelen beskriver en studie hvor hensikten var å kartlegge svenske helselederes bevissthet knyttet til pasientsikkerhet, deres prioritering av sikkerhetsspørsmål, og deres syn på ledelsesstrategier som er egnet i pasientsikkerhetsarbeid. The purpose of this paper is to survey Swedish healthcare leaders' patient safety awareness, the priority they give to safety issues and their views on suitable safety management strategies. A total 623 leaders of a sample of 1,129 responded to a mail q...

  17. Spirometric reference equations for Swedish adults.

    Science.gov (United States)

    Brisman, Jonas; Kim, Jeong-Lim; Olin, Anna-Carin; Torén, Kjell; Bake, Björn

    2017-11-01

    New spirometric reference equations for Swedish adults are required. Three different older sets of reference equations clinically used in Sweden have various drawbacks and the recently published 'The Global Lung Function 2012 (GLI) equations' have been shown not to be adequate for Swedish normal, healthy non-smokers. We have recently concluded that a piecewise linear model presented by Lubinski and Gólczewski accurately describes the distribution of spirometric variables in a large Swedish random population sample. This piecewise linear model also offers the important advantage of implementing easily physiologically interpretable coefficients. The present study aimed at presenting piecewise linear reference equations for Swedish adults based on a random population sample of 6685 individuals aged 25-75 years. Predicted normal values by the piecewise linear reference equations and lower limit normal (LLN) were compared with the three reference equations frequently used clinically in Sweden and the GLI equations. We found predicted normal values according to the present piecewise linear reference equations close to 100% predicted normal as expected, whereas the other equations either overestimated or underestimated normal subjects. Concerning LLN, the present equations, i.e. 1·645 × RSD, showed the least deviation from the expected 5% and, e.g., the GLI equations systematically identified too few subjects below LLN. We conclude that the present piecewise linear reference equations, based on a relatively large general population sample, ought to be considered for clinical use in Sweden. Application of