Delivering Diabetes Care in the Philippines and Vietnam: Policy and Practice Issues

The aim of this study is the comparison of 2 studies looking at the barriers to access of diabetes care and medicines in the Philippines and Vietnam. These studies used the Rapid Assessment Protocol for Insulin Access. Diabetes care is provided in specialized facilities and appropriate referral systems are lacking. In Vietnam, no problems were reported with regard to diagnostic tools, whereas this was a concern in the public sector in the Philippines. Both countries had high prices for medicines in comparison to international standards. Availability of medicines was better in Vietnam than in the Philippines, especially with regard to insulin. This affected adherence as did a lack of patient education. As countries aim to provide health care to the majority of their populations through universal coverage, the challenge of diabetes cannot be neglected. Trying to achieve universal coverage in parallel to decentralization, national and local governments need adapted guidance for this

Assessing health systems for type 1 diabetes in sub-Saharan Africa: developing a 'Rapid Assessment Protocol for Insulin Access'

BACKGROUND: In order to improve the health of people with Type 1 diabetes in developing countries, a clear analysis of the constraints to insulin access and diabetes care is needed. We developed a Rapid Assessment Protocol for Insulin Access, comprising a series of questionnaires as well as a protocol for the gathering of other data through site visits, discussions, and document reviews. METHODS: The Rapid Assessment Protocol for Insulin Access draws on the principles of Rapid Assessment Protocols which have been developed and implemented in several different areas. This protocol was adapted through a thorough literature review on diabetes, chronic condition management and medicine supply in developing countries. A visit to three countries in sub-Saharan Africa and meetings with different experts in the field of diabetes helped refine the questionnaires. Following the development of the questionnaires these were tested with various people familiar with diabetes and/or healthcare in developing countries. The Protocol was piloted in Mozambique then refined and had two further iterations in Zambia and Mali. Translations of questionnaires were made into local languages when necessary, with back translation to ensure precision. RESULTS: In each country the protocol was implemented in 3 areas – the capital city, a large urban centre and a predominantly rural area and their respective surroundings. Interviews were carried out by local teams trained on how to use the tool. Data was then collected and entered into a database for analysis. CONCLUSION: The Rapid Assessment Protocol for Insulin Access was developed to provide a situational analysis of Type 1 diabetes, in order to make recommendations to the national Ministries of Health and Diabetes Associations. It provided valuable information on patients' access to insulin, syringes, monitoring and care. It was thus able to sketch a picture of the health care system with regards to its ability to care for people with diabetes. In all countries where this tool was used the involvement of local stakeholders resulted in the process acting as a catalyst in bringing diabetes to the attention of the health authorities

Pseudorabies in the Dog and Cat

Pseudorabies, also called Aujesky\u27s Disease, Mad Itch, and Infectious Bulbar Paralysis, is a viral disease which primarily affects pigs. It occurs in a wide variety of domestic and wild animals and birds, but not in apes, reptiles, or insects. The natural viral reservoir is swine, in which it produces high mortality in suckling pigs, relatively low mortality in older pigs, and may produce carriers showing few or no symptoms

Information Theoretic Estimation of Clone Overlap Probabilities

This technical report describes preliminary research investigating the relationship between information theory and Bayes\u27 theory for estimation of the probability of clone overlap for the use in DNA restriction mapping. A number of languages (along with information theoretic metrics) capable of describing a hypothesized overlap are presented. For each language, the MML criterion is applied to the encoded overlaps of a pair of clones to search for that overlap which is most probable. The objective is to order the pair\u27s encoded overlaps, based on the MML criterion, from the most to the least probable. This ordering is compared to the ordering suggestion by the Bayesian probabilistic approach

Long-range memory model of trading activity and volatility

Earlier we proposed the stochastic point process model, which reproduces a variety of self-affine time series exhibiting power spectral density S(f) scaling as power of the frequency f and derived a stochastic differential equation with the same long range memory properties. Here we present a stochastic differential equation as a dynamical model of the observed memory in the financial time series. The continuous stochastic process reproduces the statistical properties of the trading activity and serves as a background model for the modeling waiting time, return and volatility. Empirically observed statistical properties: exponents of the power-law probability distributions and power spectral density of the long-range memory financial variables are reproduced with the same values of few model parameters.Comment: 12 pages, 5 figure

Implications of long tails in the distribution of mutant effects

Long-tailed distributions possess an in nite variance, yet a nite sample that is drawn from such a distribution has a nite variance. In this work we consider a model of a population subject to mutation, selection and drift. We investigate the implications of a long-tailed distribution of mutant allelic e¤ects on the distribution of genotypic e¤ects in a model with a continuum of allelic e¤ects. While the analysis is confined to asexual populations, it does also have implications for sexual populations. We obtain analytical results for a selectively neutral population as well as one subject to selection. We supplement these analytical results with numerical simulations, to take into account genetic drift. We nd that a long-tailed distribution of mutant e¤ects may a¤ect both the equilibrium and the evolutionary adaptive behaviour of a population

Prevalence of Salmonella in Swine and Pork: A Farm to Consumer Study

Fecal, tissue, and environmental cultures and serological tests were performed on 100 swine on a multi–site farrow to finish production facility. Salmonella of 10 types were identified in the swine herd and environment but none were recovered from rodents or flies caught in the production units. At slaughter, 52% (24 of 46) of swine were serologically positive for Salmonella antibodies, while 9% (4 of 46) were positive by culture. Although clinical salmonellosis was not detected in the study herd, multiple serotypes of Salmonella were causing endemic infections in the study herd

Searching Data: A Review of Observational Data Retrieval Practices in Selected Disciplines

A cross-disciplinary examination of the user behaviours involved in seeking and evaluating data is surprisingly absent from the research data discussion. This review explores the data retrieval literature to identify commonalities in how users search for and evaluate observational research data. Two analytical frameworks rooted in information retrieval and science technology studies are used to identify key similarities in practices as a first step toward developing a model describing data retrieval

Biomechanical Performance of Variable and Fixed Angle Locked Volar Plates for the Dorsally Comminuted Distal Radius

Background The ideal treatment strategy for the dorsally comminuted distal radius fracture continues to evolve. Newer plate designs allow for variable axis screw placement while maintaining the advantages of locked technology. The purpose of this study is to compare the biomechanical properties of one variable axis plate with two traditional locked constructs. Methods Simulated fractures were created via a distal 1 cm dorsal wedge osteotomy in radius bone analogs. The analogs were of low stiffness and rigidity to create a worst-case strength condition for the subject radius plates. This fracture-gap model was fixated using one of three different locked volar distal radius plates: a variable axis plate (Stryker VariAx) or fixed axis (DePuy DVR, Smith & Nephew Peri-Loc) designs. The constructs were then tested at physiologic loading levels in axial compression and bending (dorsal and volar) modes. Construct stiffness was assessed by fracture gap motion during the different loading conditions. As a within-study control, intact bone analogs were similarly tested. Results All plated constructs were significantly less stiff than the intact control bone models in all loading modes (p\u3c0.040). Amongst the plated constructs, the VariAx was stiffest axially (p=0.032) and the Peri-Loc was stiffest in bending (p\u3c0.024). Conclusion In this analog bone fracture gap model, the variable axis locking technology was stiffer in axial compression than other plates, though less stiff in bending