Depression in patients with Type 2 Diabetes in Maltese primary care

Background: Type 2 diabetes and depression are two common chronic conditions affecting the Maltese population with significant and costly effects on health. Multiple studies have demonstrated a higher prevalence of depression in diabetic patients and a link with uncontrolled diabetes; however, despite this, depression is still not considered as important to chronic conditions in terms of the effects it has on health. -- Objectives: This study was conducted to estimate the prevalence of depression in type 2 diabetic patients in primary care and to study their associated risk factors. -- Method: A quantitative, cross-sectional, retrospective, descriptive study was performed among 400 participants with type 2 diabetes attending diabetes clinics within the public health centres in Malta. Patients completed a self-administered questionnaire to quantify depressive symptoms and to study patient and disease characteristics. Convenience sampling was used to collect the data. -- Results: Data analysis showed that the prevalence of depression is around 29.7% among type 2 diabetic patients. Younger diabetics, women, lower educational levels, unemployment, obesity, a family history of depression and uncontrolled diabetes were found to be associated with a higher risk of developing depressive symptoms. -- Conclusions: Screening for depression in type 2 diabetic patients is important due to the high prevalence and significant impact on health. Appropriate management can significantly improve the outcome of both conditions and consequently improve both health and quality of life.peer-reviewe

The Effects of Childhood Social Support and Family Resiliency on Mental Health in Adulthood

The effect of social support on the overall health and quality of life in adulthood has been well documented particularly in chronic disease populations. Very few studies examined the relationships between childhood social support, family resiliency and mental health in adulthood in the community and among disadvantaged minority populations. We examined the role of social support and family resilience during childhood on subsequent mental health-related quality of life (HRQoL) in adulthood among racial/ethnic minorities. A needs assessment survey which was designed to explore health determinants and quality of life indicators using a community-based participatory research (CBPR) approach in a low-income community in Tampa was analyzed. Participants were predominantly low-income non-Hispanic black and Hispanic population (n=187). The outcome mental HRQoL was measured using the validated Centers for Disease Control and Prevention’s (CDC) “Healthy Days Measure” instrument. We utilized sequential multivariable logistic regression models to examine the independent effects of childhood social support and family resiliency on mental HRQoL in adulthood. Approximately 12.3% of study participants reported poor mental HRQoL (i.e. ≥14 unhealthy days due to mental health). Childhood social support and family resiliency were significant predictors of mental HRQoL in adulthood, after controlling for sociodemographic characteristics. Sleep and composite health issues in adulthood were also associated with mental HRQoL. Our analyses highlight an opportunity to promote mental health through support of interventions that improve positive family relationships and reduce the burden of chronic health issues among non-Hispanic black and Hispanic children

Personal and family correlates to happiness amongst Italian children and pre-adolescents

This study examines how family functioning, the parent-child relationship and personal factors are related to happiness in 1549 children aged 7 to 14 years old (53% females) in Italy. Children and pre-adolescents completed a set of questionnaires on self-rated happiness, self-concept and loneliness. At least one of their parents filled in questionnaires on family functioning, attachment and their child’s happiness level. No gender differences were found in the direct measure of happiness, but younger participants were happier than older participants, according to both the children’s and parents’ evaluations. Happiness is influenced by positive self-concept, self-esteem and low levels of satisfaction but family functioning does not seem to play a major role. The clinical and social implications of the study are discussed.peer-reviewe

A recipe for myositis : nuclear factor κB and nuclear factor of activated T-cells transcription factor pathways spiced up by cytokines

Nuclear factor κB (NF-κB) is a well-known pro-inflammatory transcription factor that regulates the expression of the tissue’s immune-active components, which include cytokines, chemokines and adhesion molecules. In addition, the versatile nuclear factor of activated T-cells (NFAT) family of transcription factors plays a crucial role in the development and function of the immune system, integrating calcium signaling with other signaling pathways. NF-κB and NFAT share many structural and functional characteristics and likely regulate gene expression through shared enhancer elements. This review describes recent research data that has led to new insights into the involvement of NFκB- and NFAT-mediated pathways in the different idiopathic inflammatory myopathies. The general activation of NF-κB p65 in blood vessel endothelium, seems to flag down inflammatory cells that subsequently accumulate mostly at perimysial sites in dermatomyositis. The joint activation of p65 and NFAT5 in myofibers specifically at perifascicular areas reflects the characteristic tissue damage pattern observed in that particular subgroup of patients. In immune cells actively invading nonnecrotic muscle fibers in polymyositis and sporadic inclusion body myositis on the other hand, p65 activation is an important aspect of their cytotoxic and chemoattactant properties. In addition, both transcription factor families are generally upregulated in regenerating muscle fibers as components of the differentiation process. It can be concluded that the two transcription factor families function in close relationship with each other, representing two-edged swords for muscle disease: on the one hand promoting cell growth and regeneration, while on the other hand actively participating in inflammatory cell damage. In this respect, cytokines function as important go-betweens at the crossroads of the pathways. Beyond NF-κB and NFAT, many fascinating winding roads relevant to inflammatory myopathy disease management still lie ready for the exploring

Off the Beaten Path: Let's Replace Term-Based Retrieval with k-NN Search

Retrieval pipelines commonly rely on a term-based search to obtain candidate records, which are subsequently re-ranked. Some candidates are missed by this approach, e.g., due to a vocabulary mismatch. We address this issue by replacing the term-based search with a generic k-NN retrieval algorithm, where a similarity function can take into account subtle term associations. While an exact brute-force k-NN search using this similarity function is slow, we demonstrate that an approximate algorithm can be nearly two orders of magnitude faster at the expense of only a small loss in accuracy. A retrieval pipeline using an approximate k-NN search can be more effective and efficient than the term-based pipeline. This opens up new possibilities for designing effective retrieval pipelines. Our software (including data-generating code) and derivative data based on the Stack Overflow collection is available online

Abstract State Machines 1988-1998: Commented ASM Bibliography

An annotated bibliography of papers which deal with or use Abstract State Machines (ASMs), as of January 1998.Comment: Also maintained as a BibTeX file at http://www.eecs.umich.edu/gasm