Primary health care for Aboriginal Australian women in remote communities after a pregnancy with hyperglycaemia

Background: Hyperglycaemia in pregnancy contributes to adverse outcomes for women and their children. The postpartum period is an opportune time to support women to reduce cardiometabolic and diabetes risk in subsequent pregnancies. Aims: To identify strengths and gaps in current care for Aboriginal women after a pregnancy complicated by hyperglycaemia. Methods: A retrospective review of the 12 month postpartum care provided by primary health centres in remote Australia in 2013-2014 identified 195 women who experienced hyperglycaemia in pregnancy (gestational diabetes (GDM) (n = 147), type 2 diabetes (T2D) (n = 39), and unclear diabetes status (n = 9)). RESULTS: Only 80 women (54%) with GDM had postpartum glycaemic checks. Of these, 32 women were diagnosed with prediabetes (n = 24) or diabetes (n = 8). Compared to women with GDM, women with T2D were more likely to have their weight measured (75% vs. 52%, p <0.01), and smoking status documented as "discussed" (65% vs. 34%, p < 0.01). Most women (97%) accessed the health centre at least once in the 12 month postpartum period but, during these visits, only 52% of women had service provision, either structured or opportunistic, related to diabetes. Conclusion: High rates of dysglycaemia among women screened for T2D after GDM in the 12 month postpartum period highlight the need for increased screening and early intervention to prevent the development of T2D and its complications. Whilst a clear strength was high postpartum attendance, many women did not attend health services for diabetes screening or management.Anna Wood, Diana MacKay, Dana Fitzsimmons, Ruth Derkenne, Renae Kirkham, Jacqueline A. Boyle, Christine Connors, Cherie Whitbread, Alison Welsh, Alex Brown, Jonathan E. Shaw, and Louise Maple-Brow

The MAGPI Survey: impact of environment on the total internal mass distribution of galaxies in the last 5 Gyr

We investigate the impact of environment on the internal mass distribution of galaxies using the Middle Ages Galaxy Properties with Integral field spectroscopy (MAGPI) survey. We use 2D resolved stellar kinematics to construct Jeans dynamical models for galaxies at mean redshift z ∼ 0.3, corresponding to a lookback time of 3–4 Gyr. The internal mass distribution for each galaxy is parametrized by the combined mass density slope γ (baryons + dark matter), which is the logarithmic change of density with radius. We use a MAGPI sample of 28 galaxies from low-to-mid density environments and compare to density slopes derived from galaxies in the high density Frontier Fields clusters in the redshift range 0.29 < z < 0.55, corresponding to a lookback time of ∼5 Gyr. We find a median density slope of γ = −2.22 ± 0.05 for the MAGPI sample, which is significantly steeper than the Frontier Fields median slope (γ = −2.00 ± 0.04), implying the cluster galaxies are less centrally concentrated in their mass distribution than MAGPI galaxies. We also compare to the distribution of density slopes from galaxies in ATLAS3D at z ∼ 0, because the sample probes a similar environmental range as MAGPI. The ATLAS3D median total slope is γ = −2.25 ± 0.02, consistent with the MAGPI median. Our results indicate environment plays a role in the internal mass distribution of galaxies, with no evolution of the slope in the last 3–4 Gyr. These results are in agreement with the predictions of cosmological simulations

The MAGPI Survey -- science goals, design, observing strategy, early results and theoretical framework

© The Author(s), 2021. Published by Cambridge University Press on behalf of the Astronomical Society of Australia. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1017/pasa.2021.25We present an overview of the Middle Ages Galaxy Properties with Integral Field Spectroscopy (MAGPI) survey, a Large Program on ESO/VLT. MAGPI is designed to study the physical drivers of galaxy transformation at a lookback time of 3-4 Gyr, during which the dynamical, morphological, and chemical properties of galaxies are predicted to evolve significantly. The survey uses new medium-deep adaptive optics aided MUSE observations of fields selected from the GAMA survey, providing a wealth of publicly available ancillary multi-wavelength data. With these data, MAGPI will map the kinematic and chemical properties of stars and ionised gas for a sample of 60 massive (> 7 x 10^10 M_Sun) central galaxies at 0.25 < zPeer reviewe

Cardiac autonomic dysfunction in diabetic children.

OBJECTIVE: Adults with type 1 diabetes may have abnormal alterations in heart rate variability (HRV) due to cardiac autonomic neuropathy. This prospective study was performed to determine whether HRV can be used to detect subclinical autonomic neuropathy in diabetic children. RESEARCH DESIGN AND METHODS: We examined five time domain and three frequency domain HRV indices determined from 24-h Holter recordings in 73 diabetic children and adolescents aged 3-18 years (mean 12.1 years) with a mean duration of diabetes of 55 months. The measures were compared with normal ranges. Z scores were established for each parameter and were compared with classic risk factors of other diabetic complications. RESULTS: Most HRV indices were significantly depressed in children aged > or = 11 years, and the levels of HRV abnormalities were significantly correlated with long-term metabolic control (mean GHb for 4 years) in that age-group. In younger patients, HRV indices were within the normal range and were not correlated with the level of metabolic control. Illness duration and microalbuminuria but not short-term metabolic control (most recent GHb) were also independently predictive of HRV abnormalities. CONCLUSIONS: These results suggest that early puberty is a critical period for the development of diabetic cardiac autonomic dysfunction. Therefore, all type 1 diabetic patients should be screened for this complication by HRV analysis beginning at the first stage of puberty regardless of illness duration, microalbuminuria, and level of metabolic control

Data accuracy, consistency and completeness of the national Swiss cystic fibrosis patient registry: Lessons from an ECFSPR data quality project.

Good data quality is essential when rare disease registries are used as a data source for pharmacovigilance studies. This study investigated data quality of the Swiss cystic fibrosis (CF) registry in the frame of a European Cystic Fibrosis Society Patient Registry (ECFSPR) project aiming to implement measures to increase data reliability for registry-based research. All 20 pediatric and adult Swiss CF centers participated in a data quality audit between 2018 and 2020, and in a re-audit in 2022. Accuracy, consistency and completeness of variables and definitions were evaluated, and missing source data and informed consents (ICs) were assessed. The first audit included 601 out of 997 Swiss people with CF (60.3 %). Data quality, as defined by data correctness ≥95 %, was high for most of the variables. Inconsistencies of specific variables were observed because of an incorrect application of the variable definition. The proportion of missing data was low with &lt;5 % for almost all variables. A considerable number of missing source data occurred for CFTR variants. Availability of ICs varied largely between centers (10 centers had &gt;5 % of missing documents). After providing feedback to the centers, availability of genetic source data and ICs improved. Data audits demonstrated an overall good data quality in the Swiss CF registry. Specific measures such as support of the participating sites, training of data managers and centralized data collection should be implemented in rare disease registries to optimize data quality and provide robust data for registry-based scientific research