Validating self-report of diabetes use by participants in the 45 and up study: A record linkage study

Background: Prevalence studies usually depend on self-report of disease status in survey data or administrative data collections and may over- or under-estimate disease prevalence. The establishment of a linked data collection provided an opportunity to explore the accuracy and completeness of capture of information about diabetes in survey and administrative data collections. Methods. Baseline questionnaire data at recruitment to the 45 and Up Study was obtained for 266,848 adults aged 45 years and over sampled from New South Wales, Australia in 2006-2009, and linked to administrative data about hospitalisation from the Admitted Patient Data Collection (APDC) for 2000-2009, claims for medical services (MBS) and pharmaceuticals (PBS) from Medicare Australia data for 2004-2009. Diabetes status was determined from response to a question 'Has a doctor EVER told you that you have diabetes' (n = 23,981) and augmented by examination of free text fields about diagnosis (n = 119) or use of insulin (n = 58). These data were used to identify the sub-group with type 1 diabetes. We explored the agreement between self-report of diabetes, identification of diabetes diagnostic codes in APDC data, claims for glycosylated haemoglobin (HbA1c) in MBS data, and claims for dispensed medication (oral hyperglycaemic agents and insulin) in PBS data. Results: Most participants with diabetes were identified in APDC data if admitted to hospital (79.3%), in MBS data with at least one claim for HbA1c testing (84.7%; 73.4% if 2 tests claimed) or in PBS data through claim for diabetes medication (71.4%). Using these alternate data collections as an imperfect 'gold standard' we calculated sensitivities of 83.7% for APDC, 63.9% (80.5% for two tests) for MBS, and 96.6% for PBS data and specificities of 97.7%, 98.4% and 97.1% respectively. The lower sensitivity for HbA1c may reflect the use of this test to screen for diabetes suggesting that it is less useful in identifying people with diabetes without additional information. Kappa values were 0.80, 0.70 and 0.80 for APDC, MBS and PBS respectively reflecting the large population sample under consideration. Compared to APDC, there was poor agreement about identifying type 1 diabetes status. Conclusions: Self-report of diagnosis augmented with free text data indicating diabetes as a chronic condition and/or use of insulin among medications used was able to identify participants with diabetes with high sensitivity and specificity compared to available administrative data collections. © 2013 Comino et al.; licensee BioMed Central Ltd

A Conceptual Model for Planning and Management of Areas of Public Space and Meeting in Colombia

A refined investigation of new trends in urban analysis assuming a sustainable design of Areas of Public Space and Meeting (APSM) is a fundamental response to the challenges of inclusive and efficient cities. Even though the APSM are districts regarded as urban structuring systems, there is a lack of territorial planning instruments and conceptual models aimed at explaining their long-term dynamics. Based on these premises, we developed a conceptual model that articulates relevant variables of interest for the planning and management of APSM. The construction of the model includes the review and analysis of the literature and the validation process based on a consultation with a panel of experts on the subject. Our findings demonstrate that the existing research does not address the APSM issue adequately, and the methodologies proposed so far do not lead to accurate and comprehensive analyses of urban complexity in light of sustainability targets. There are only isolated, disjointed, and partial approaches to variables of interest, making it difficult to carry out holistic studies. Our technical and scientific proposal offers a framework for an exhaustive evaluation of these areas. The model has been structured according to the assumptions of urban sustainability and can be applied to diverse urban environments in South America

Impact of diabetes on hospital admission and length of stay among a general population aged 45 year or more: A record linkage study

© 2015 Comino et al. Background: The increased prevalence of diabetes and its significant impact on use of health care services, particularly hospitals, is a concern for health planners. This paper explores the risk factors for all-cause hospitalisation and the excess risk due to diabetes in a large sample of older Australians. Methods: The study population was 263,482 participants in the 45 and Up Study. The data assessed were linked records of hospital admissions in the 12 months following completion of a baseline questionnaire. All cause and ambulatory care sensitive admission rates and length of stay were examined. The associations between demographic characteristics, socioeconomic status, lifestyle factors, and health and wellbeing and risk of hospitalisation were explored using zero inflated Poisson (ZIP) regression models adjusting for age and gender. The ratios of adjusted relative rates and 95% confidence intervals were calculated to determine the excess risk due to diabetes. Results: Prevalence of diabetes was 9.0% (n = 23,779). Age adjusted admission rates for all-cause hospitalisation were 631.3 and 454.8 per 1,000 participant years and the mean length of stay was 8.2 and 7.1 days respectively for participants with and without diabetes. In people with and without diabetes, the risk of hospitalisation was associated with age, gender, household income, smoking, BMI, physical activity, and health and wellbeing. However, the increased risk of hospitalisation was attenuated for participants with diabetes who were older, obese, or had hypertension or hyperlipidaemia and enhanced for those participants with diabetes who were male, on low income, current smokers or who had anxiety or depression. Conclusions: This study is one of the few studies published to explore the impact of diabetes on hospitalisation in a large non-clinical population, the 45 and Up Study. The attenuation of risk associated with some factors is likely to be due to correlation between diabetes and factors such as age and obesity. The increased risk in association with other factors such as gender and low income in participants with diabetes is likely to be due to their synergistic influence on health status and the way services are accessed

Soil degradation and socioeconomic systems’ complexity: Uncovering the latent nexus

Understanding Soil Degradation Processes (SDPs) is a fundamental issue for humankind. Soil degradation involves complex processes that are influenced by a multifaceted ensemble of socioeconomic and ecological factors at vastly different spatial scales. Desertification risk (the ultimate outcome of soil degradation, seen as an irreversible process of natural resource destruction) and socioeconomic trends have been recently analyzed assuming “resilience thinking” as an appropriate interpretative paradigm. In a purely socioeconomic dimension, resilience is defined as the ability of a local system to react to external signals and to promote future development. This ability is intrinsically bonded with the socio-ecological dynamics characteristic of environmentally homogeneous districts. However, an evaluation of the relationship between SDPs and socioeconomic resilience in local systems is missing in mainstream literature. Our commentary formulates an exploratory framework for the assessment of soil degradation, intended as a dynamic process of natural resource depletion, and the level of socioeconomic resilience in local systems. Such a framework is intended to provide a suitable background to sustainability science and regional policies at the base of truly resilient local systems

Population trends and urbanization. Simulating density effects using a local regression approach

7siopenDensity-dependent population growth regulates long-term urban expansion and shapes distinctive socioeconomic trends. Despite a marked heterogeneity in the spatial distribution of the resident population, Mediterranean European countries are considered more homogeneous than countries in other European regions as far as settlement structure and processes of metropolitan growth are concerned. However, rising socioeconomic inequalities among Southern European regions reflect latent demographic and territorial transformations that require further investigation. An integrated assessment of the spatio-temporal distribution of resident populations in more than 1000 municipalities (1961-2011) was carried out in this study to characterize density-dependent processes of metropolitan growth in Greece. Using geographically weighted regressions, the results of our study identified distinctive local relationships between population density and growth rates over time. Our results demonstrate that demographic growth rates were non-linearly correlated with other variables, such as population density, with positive and negative impacts during the first (1961-1971) and the last (2001-2011) observation decade, respectively. These findings outline a progressive shift over time from density-dependent processes of population growth, reflecting a rapid development of large metropolitan regions (Athens, Thessaloniki) in the 1960s, to density-dependent processes more evident in medium-sized cities and accessible rural regions in the 2000s. Density-independent processes of population growth have been detected in the intermediate study period (1971-2001). This work finally discusses how a long-term analysis of demographic growth, testing for density-dependent mechanisms, may clarify the intrinsic role of population concentration and dispersion in different phases of the metropolitan cycle in Mediterranean Europe.openPolinesi G.; Recchioni M.C.; Turco R.; Salvati L.; Rontos K.; Rodrigo-Comino J.; Benassi F.Polinesi, G.; Recchioni, M. C.; Turco, R.; Salvati, L.; Rontos, K.; Rodrigo-Comino, J.; Benassi, F

Identification of a new R3 MYB type repressor and functional characterization of the members of the MBW transcriptional complex involved in anthocyanin biosynthesis in eggplant (S. Melongena L.)

Here we focus on the highly conserved MYB-bHLH-WD repeat (MBW) transcriptional complex model in eggplant, which is pivotal in the transcriptional regulation of the anthocyanin biosynthetic pathway. Through a genome-wide approach performed on the recently released Eggplant Genome (cv. 67/3) previously identified, and reconfirmed by us, members belonging to the MBW complex (SmelANT1, SmelAN2, SmelJAF13, SmelAN1) were functionally characterized. Furthermore, a regulatory R3 MYB type repressor (SmelMYBL1), never reported before, was identified and characterized as well. Through a qPCR approach, we revealed specific transcriptional patterns of candidate genes in different plant tissue/organs at two stages of fruit development. Two strategies were adopted for investigating the interactions of bHLH partners (SmelAN1, SmelJAF13) with MYB counterparts (SmelANT1, SmelAN2 and SmelMYBL1): Yeast Two Hybrid (Y2H) and Bimolecular Fluorescent Complementation (BiFC) in A. thaliana mesophylls protoplast. Agro-infiltration experiments highlighted that N. benthamiana leaves transiently expressing SmelANT1 and SmelAN2 showed an anthocyanin-pigmented phenotype, while their co-expression with SmelMYBL1 prevented anthocyanin accumulation. Our results suggest that SmelMYBL1 may inhibits the MBW complex via the competition with MYB activators for bHLH binding site, although this hypothesis requires further elucidation

Grafting vigour is associated with DNA de-methylation in eggplant.

In horticulture, grafting is a popular technique used to combine positive traits from two different plants. This is achieved by joining the plant top part (scion) onto a rootstock which contains the stem and roots. Rootstocks can provide resistance to stress and increase plant production, but despite their wide use, the biological mechanisms driving rootstock-induced alterations of the scion phenotype remain largely unknown. Given that epigenetics plays a relevant role during distance signalling in plants, we studied the genome-wide DNA methylation changes induced in eggplant (Solanum melongena) scion using two interspecific rootstocks to increase vigour. We found that vigour was associated with a change in scion gene expression and a genome-wide hypomethylation in the CHH context. Interestingly, this hypomethylation correlated with the downregulation of younger and potentially more active long terminal repeat retrotransposable elements (LTR-TEs), suggesting that graft-induced epigenetic modifications are associated with both physiological and molecular phenotypes in grafted plants. Our results indicate that the enhanced vigour induced by heterografting in eggplant is associated with epigenetic modifications, as also observed in some heterotic hybrids