New electric utility management and control systems : proceedings of conference, held in Boxborough, Massachusetts, May 30-June 1, 1979

"This work was supported by the Center for Energy Policy Research and the Electric Power Systems Engineering Laboratory of the Massachusetts Institute of Technology.

'Join us on our journey': Exploring the experiences of children and young people with type 1 diabetes and their parents

This paper focuses on children and young people with type 1 diabetes and on their parents, and their experiences of diabetes care provision. Nine acute hospitals in the Yorkshire and the Humber region, UK, were recruited to participate in a qualitative research study. Children and young people with type 1 diabetes, aged 6–25, and their parents (approximately 250 participants), took part in talking groups to find out about their experiences of diabetes care provision. Findings show that there are key areas for improvement in the future diabetes care provision for children and young people, including communication and support, schools, structured education and transition. These have important implications for practice and service redesign. This study is thought to be the first of its kind to consult with children, young people and parents to find out about their experiences of type 1 diabetes care provision. The research findings add to the current evidence base by highlighting the disparities in care, the urgent need for change in the way services are delivered and the involvement of service users in this process

Use of the Michigan Neuropathy Screening Instrument as a measure of distal symmetrical peripheral neuropathy in Type 1 diabetes: results from the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications

Aims  The Michigan Neuropathy Screening Instrument (MNSI) is used to assess distal symmetrical peripheral neuropathy in diabetes. It includes two separate assessments: a 15‐item self‐administered questionnaire and a lower extremity examination that includes inspection and assessment of vibratory sensation and ankle reflexes. The purpose of this study was to evaluate the performance of the MNSI in detecting distal symmetrical peripheral neuropathy in patients with Type 1 diabetes and to develop new scoring algorithms. Methods  The MNSI was performed by trained personnel at each of the 28 Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications clinical sites. Neurologic examinations and nerve conduction studies were performed during the same year. Confirmed clinical neuropathy was defined by symptoms and signs of distal symmetrical peripheral neuropathy based on the examination of a neurologist and abnormal nerve conduction findings in ≥ 2 anatomically distinct nerves among the sural, peroneal and median nerves. Results  We studied 1184 subjects with Type 1 diabetes. Mean age was 47 years and duration of diabetes was 26 years. Thirty per cent of participants had confirmed clinical neuropathy, 18% had ≥ 4 and 5% had ≥ 7 abnormal responses on the MNSI questionnaire, and 33% had abnormal scores (≥ 2.5) on the MNSI examination. New scoring algorithms were developed and cut points defined to improve the performance of the MNSI questionnaire, examination and the combination of the two. Conclusions  Altering the cut point to define an abnormal test from ≥ 7 abnormal to ≥ 4 abnormal items improves the performance of the MNSI questionnaire. The MNSI is a simple, non‐invasive and valid measure of distal symmetrical peripheral neuropathy in Type 1 diabetes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/92152/1/j.1464-5491.2012.03644.x.pd

Foodborne illness investigation and control reference manual

The Massachusetts Department of Public Health (MDPH) is placing increased emphasis on foodborne illness investigation, control and prevention. This emphasis is based on the following: the MDPH s Working Group on Foodborne Illness Control (WGFIC), local board of health members and health department staff in Massachusetts who have come together at focus groups and meetings coordinated by the Division of Epidemiology and Immunization and the Food Protection Program, and the CDC s 1994 publication, Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States. These sources point out the need for up-to-date information and increased technical assistance to the local health departments for prevention and control of infectious diseases, including foodborne illness. This reference manual is part of the MDPH s focus on providing more trainings and technical assistance for local boards of health and health department staff. The purpose of the manual is to guide local boards of health and health department staff through foodborne illness investigation and control. It is designed as a comprehensive reference covering both epidemiologic and environmental aspects of a foodborne illness investigation, and emphasizes the practical and necessary features of investigation and control. Contained within the manual are basic information, guidelines, recommendations and regulatory requirements. While this manual is targeted to board of health members and health department staff, other health professionals can also use the information to facilitate understanding of how local boards of health and health department staff operate, and how they themselves play a role in foodborne illness investigation and control.managing editor, Allison Hackbarth.A publication of the Massachusetts Department of Public Health, Working Group on Foodborne Illness Control.September 1997.The development of this manual has been made possible by the CDC, National Center for Infectious Diseases and the Massachusetts Department of Public Health's Working Group on Foodborne Illness Control (WGFIC). This working group is comprised of members of three divisions involved in the investigation of foodborne illness, each in a separate bureau in the Department of Public Health. They are: the Food Protection Program (Center for Environmental Health), the Division of Epidemiology and Immunization (Bureau of Communicable Disease Control), (and the Division of Diagnostic Laboratories (Bureau of Laboratory and Environmental Sciences).The editors wish to acknowledge that this Foodborne Illness Investigation and Control Reference Manual was made possible by the CDC, National Center for Infectious Diseases, Epidemiology and Laboratory Capacity in Infectious Disease Cooperative Agreement