835 research outputs found

    Gender differences in the prevalence of impaired fasting glycaemia and impaired glucose tolerance in Mauritius. Does sex matter?

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    Objective: To examine gender differences in the characteristics and prevalence of various categories of glucose tolerance in a population study in Mauritius.Research design and methods: In 1998, a community-based cross-sectional survey was conducted in Mauritius. Categories of glucose metabolism were determined in 5388 adults, with an oral glucose tolerance test given to those who did not have previously diagnosed diabetes (n = 4036). Other cardiovascular risk factors were assessed among those without known diabetes.Results: For men and women the prevalence of diabetes (22.0 vs. 21.8%, respectively) and the prevalence of coexisting impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) (3.2 vs. 2.9%) were similar. However, men were twice as likely as women to have isolated IFG [5.1% (4.2&ndash;6.0) vs. 2.9% (2.3&ndash;3.5)], despite being younger, thinner and with lower plasma insulin but higher lipids. Conversely, the prevalence of isolated IGT was lower in men [9.0% (7.9&ndash;10.2) vs. 13.9% (12.6&ndash;15.1)]. Among non-diabetic individuals, fasting glucose was higher in men than women, whereas 2-h glucose was higher in women. In people without diabetes, women had significantly higher body mass index, beta cell function (HOMA-B), fasting and 2-h insulin than men and significantly lower waist-hip ratios, waist circumference, insulin sensitivity (HOMA-S) and triglycerides.Conclusion: In Mauritius, the distribution of impaired glucose metabolism differs by sex. The observation that IFG is more prevalent in men and IGT more prevalent in women raises important questions about their underlying aetiology and the ability of the current glucose thresholds to equally identify men and women at high-risk of developing diabetes. IFG should be seen as a complimentary category of abnormal glucose tolerance, rather than a replacement for IGT.<br /

    The remaining hydrocarbon potential of the UK Continental Shelf

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    The United Kingdom Continental Shelf (UKCS) has been a very successful exploration province in the last 38 years, with an average technical success rate of 31% from its 2150 exploration wells. Although the peak of exploration activity on the UKCS occurred during the 1980s and 1990s, there have been 41 technical successes from 82 wells in the last four years, representing an improved recent success rate of 50%. Estimates of undiscovered (yet-to-find) hydrocarbon volumes have been made from a database of prospects compiled over 20 years by the UK Government. This ‘bottom-up’ method provided an estimate of the yet-to-find resources at the end of 2002 of between 3.6 and 22.9 × 109 BOE recoverable. Methodology utilizing an inverse timescale to plot cumulative discovered volumes per year provides minimum estimates of between 4.5 and 9.5 × 109 BOE in place (c. 2.5 to 4.4 × 109 BOE recoverable). Pool size distribution methodology predicts that 11.5 × 109 BOE of in-place (c. 5.8 × 109 BOE recoverable) resources remain to be found on the entire UKCS. Geographically, the UK Central North Sea and Moray Firth area is predicted to contain the largest proportion of undiscovered resources (42%). Thirty-three per cent of the yet-to-find resources are judged to lie within the Atlantic Margin region. Eighty-three per cent of existing UKCS fields and discoveries are located within structural traps. The majority of stratigraphic and combination traps occur in association with syn-rift (Upper Jurassic) and post-rift plays. Many of the major discoveries in these traps were found serendipitously, and there has been relatively little direct exploration for stratigraphic plays. In the UK North Sea, there are few substantial remaining structural traps, except at considerable depth with attendant reservoir quality, high-pressure and high-temperature risks. The future of exploration is believed to lie with the search for subtle stratigraphic traps. Deep-water sandstone stratigraphic plays within the syn- and post-rift sequences offer the greatest potential for substantial new resources

    Health care professionals’ attitudes towards evidence-based medicine in the workers’ compensation setting: a cohort study

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    Abstract Background Problems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers’ compensation system could provide a partial solution, by reducing uncertainty about effective treatment. The aim of this study was to investigate attitudes of health care professionals (HCP) to the potential implementation of an EBM tool in the workers’ compensation setting. Methods The study has a mixed methods design. The quantitative study consisted of an online questionnaire asking about self-reported knowledge, attitudes and behaviour to EBM in general. The qualitative study consisted of interviews about an EBM tool being applied in the workers’ compensation process. Participants were health care practitioners from different clinical specialties. They were recruited through the investigators’ clinical networks and the workers’ compensation government regulator’s website. Results Participants completing the questionnaire (n = 231) indicated they were knowledgeable about the evidence-base in their field, but perceived some difficulties when applying EBM. General practitioners reported having the greatest obstacles to applying EBM. Participants who were interviewed (n = 15) perceived that an EBM tool in the workers’ compensation setting could potentially have some advantages, such as reducing inappropriate treatment, or over-servicing, and providing guidance for clinicians. However, participants expressed substantial concerns that the EBM tool would not adequately reflect the impact of psychosocial factors on recovery. They also highlighted a lack of timeliness in decision making and proper assessment, particularly in pain management. Conclusions Overall, HCP are supportive of EBM, but have strong concerns about implementation of EBM based decision making in the workers’ compensation setting. The participants felt that an EBM tool should not be applied rigidly and should take into account clinical judgement and patient variability and preferences. In general, the treatment approval process in the workers’ compensation insurance system is a sensitive area, in which the interaction between HCP and claims managers can be improved

    Nuclear Level Density and the Determination of Thermonuclear Rates for Astrophysics

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    The prediction of cross sections for nuclei far off stability is crucial in the field of nuclear astrophysics. We discuss the model mostly employed for such calculations: the statistical model (Hauser-Feshbach). Special emphasis is put on the uncertainties arising from nuclear level density descriptions and an improved global description is presented. Furthermore, criteria for the applicability of the statistical model are investigated and a "map" for the applicability of the model to reactions of stable and unstable nuclei with neutral and charged particles is given.Comment: REVTeX paper + 7 B/W figures + 2 color figures; PRC, in press. Also available at http://quasar.physik.unibas.ch/preps.htm
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