Diabetes care and service access among elderly Vietnamese with type 2 diabetes

BACKGROUND: Vietnamese patients are disproportionately represented in type 2 diabetes mellitus statistics and also incur high rates of diabetes complications. This situation is compounded by limited access to health care. The aim of this project was to gain a deeper understanding of the difficulties Vietnamese patients experience when accessing services and managing their type 2 diabetes mellitus, and to identify factors that are important in promoting health service use. METHODS: Three focus groups with 15 Vietnamese participants with type 2 diabetes mellitus, 60 to >70 years of age, were conducted in Vietnamese. Open-ended questions were used and focussed on experiences of living with diabetes and access to healthcare services in the Inner Northwest Melbourne region. Audio recordings were transcribed and then translated into English. Data were analysed using a thematic analysis framework. RESULTS: Findings indicate four main themes, which together provide some insight into the experiences of living with diabetes and accessing ongoing care and support, for elderly Vietnamese with type 2 diabetes. Themes included: (1) the value of being healthy; (2) controlling diabetes; (3) staying healthy; and (4) improving services and information access. CONCLUSIONS: Participants in this study were encouraged to adhere to diabetes self-management principles, based largely on a fear of medical complications. Important aspects of healthcare access were identified as; being treated with respect, having their questions answered and having access to interpreters and information in Vietnamese. Attention to these details is likely to lead to improved access to healthcare services and ultimately to improve glycemic control and overall health status for this community

Interannual sea-air CO2 flux variability from an observation-driven ocean mixed-layer scheme

Interannual anomalies in the sea–air carbon dioxide (CO2) exchange have been estimated from surface-ocean CO2 partial pressure measurements. Available data are sufficient to constrain these anomalies in large parts of the tropical and North Pacific and in the North Atlantic, in some areas covering the period from the mid 1980s to 2011. Global interannual variability is estimated as about 0.31 Pg Cyr−1 (temporal standard deviation 1993–2008). The tropical Pacific accounts for a large fraction of this global variability, closely tied to El Niño–Southern Oscillation (ENSO). Anomalies occur more than 6 months later in the east than in the west. The estimated amplitude and ENSO response are roughly consistent with independent information from atmospheric oxygen data. This both supports the variability estimated from surface-ocean carbon data and demonstrates the potential of the atmospheric oxygen signal to constrain ocean biogeochemical processes. The ocean variability estimated from surface-ocean carbon data can be used to improve land CO2 flux estimates from atmospheric inversions

Volatile aldehydes in libraries and archives

Volatile aldehydes are produced during degradation of paper-based materials. This may result in their accumulation in archival and library repositories. However, no systematic study has been performed so far. In the frame of this study, passive sampling was carried out at ten locations in four libraries and archives. Despite the very variable sampling locations, no major differences were found, although air-filtered repositories were found to have lower concentrations while a non-ventilated newspaper repository exhibited the highest concentrations of volatile aldehydes (formaldehyde, acetaldehyde, furfural and hexanal). Five employees in one institution were also provided with personal passive samplers to investigate employees’ exposure to volatile aldehydes. All values were lower than the presently valid exposure limits. The concentration of volatile aldehydes, acetic acid, and volatile organic compounds (VOCs) in general was also compared with that of outdoor-generated pollutants. It was evident that inside the repository and particularly inside archival boxes, the concentration of VOCs and acetic acid was much higher than the concentration of outdoor-generated pollutants, which are otherwise more routinely studied in connection with heritage materials. This indicates that further work on the pro-degradative effect of VOCs on heritage materials is necessary and that monitoring of VOCs in heritage institutions should become more widespread

A lunar occultation and direct imaging survey of multiplicity in the Ophiuchus and Taurus star-forming regions

We present an IR lunar occultation and direct imaging search for companions in the Ophiuchus star-forming region and update a similar search of the Taurus region. The search is sensitive to companions in the angular separation range 0.005-10 sec. In Ophiuchus, we surveyed 35 young star targets; this sample contains at least 10 binaries, two triples, and one quadruple. Ten of the companion stars are newly discovered. In Taurus, the survey now includes 47 systems among which there are at least 22 binaries and four triples. Only two companion stars are newly identified because there is strong overlap with prior work. All the triples and quadruple are hierarchical. The observed binary frequency in Ophiuchus, in the 3-1400 AU range of separations, is at least 1.1 +/- 0.3 that of the nearby solar-like stars. This value is a lower bound because we make no corrections for incompleteness. In Taurus, in the same range of separations, the observed binary frequency is at least 1.6 +/- 0.3 that of the nearby solar-like stars. This value extends Ghez et al.'s (1993) and Leinert's et al.'s (1993) determination of an excess binary frequency to 3 AU separation. We used the weak-line T Tauri star/T Tauri star (WT/TT) type and the K-L color index to distinguish between systems with and without inner disks. We find no convincing difference in the binary frequency or distribution of separations of the systems with and without inner disks. The 1.3 mm continuum emission of the single systems exceeds that of the multiples suggesting that their extensive outer disks are more massive. The specific angular momenta of the binaries overlap those of molecular cloud cores measured by Goodman et al. (1993)

Pre‑operative pain sensitivity : a prediction of post‑operative outcome in the obstetric population

Context: Experimental assessments can determine pain threshold and tolerance, which mirror sensitivity to pain. This, in turn, influences the post‑operative experience. Aims: The study intended to evaluate whether the pre‑operative pressure and electrical pain tests can predict pain and opioid requirement following cesarean delivery. Settings and Design: Research was conducted on females scheduled for cesarean section at a tertiary care hospital of the state. Twenty women were enrolled, after obtaining written informed consent. Materials and Methods: Pain assessment was performed on the eve of cesarean sections using three devices: PainMatcher® determined electrical pain threshold while the algometers PainTest™ FPN100 (manual) and PainTest™ FPX 25 (digital) evaluated pressure pain threshold and tolerance. Post‑operative pain relief included intravenous morphine administered by patient‑controlled analgesia, diclofenac (100 mg, every 12 h, rectally, enforced) and paracetamol (1000 mg, every 4‑6 h, orally, on patient request). Pain scores were reported on numerical rating scales at specified time intervals. Statistical Analysis Used: Correlational and regression statistics were computed using IBM SPSS Statistics 21 software (IBM Corporation, USA). Results: A significant correlation was observed between morphine requirement and: (1) electrical pain threshold (r = –0.45, P = 0.025), (2) pressure pain threshold (r = –0.41 P = 0.036) and (3) pressure pain tolerance (r = –0.44, P = 0.026) measured by the digital algometer. The parsimonious regression model for morphine requirement consisted of electrical pain threshold (r2 = 0.20, P = 0.049). The dose of morphine consumed within 48 h of surgery decreases by 0.9 mg for every unit increment in electrical pain threshold. Conclusions: The predictive power of pain sensitivity assessments, particularly electrical pain threshold, may portend post‑cesarean outcomes, including opioid requirements.peer-reviewe