Low carbohydrate meals or a small dose of insulin normalises one-hour blood glucose in a woman with normal glucose tolerance and elevated one-hour postload glucose: A case report

Diabetes is diagnosed by 2-hour BGL ≥ 11.1 mmol/L on OGTT, fasting BGL ≥ 7.0 mmol/L or HbA1C ≥ 6.5%. IFG and IGT are similarly diagnosed by elevated fasting and 2-hour BGLs. Although-hour BGL is routinely measured, results are classified as NGT if fasting and 2-hour levels are normal, irrespective of elevation at 1 hour. It has, however, been shown that 1-hour postload BGL is a strong predictor of future risk for type 2 diabetes and vascular disease, even in those with NGT. Additionally Meisinger et al. identified 1-hour postload glycaemia as a long-term predictor for all-cause mortality in men without diabetes. There is no normal range for 1-hour glucose, but ≥ 8.6 mmol/L has been identified as a cut-off marking increased cardiovascular and diabetes risk. It has been suggested that recognition and management of those with NGT and 1-hour glucose ≥ 8.6mmol/L may reduce incidence of diabetes and vascular events

Omitting follow-up food after initial hypoglycaemic treatment does not increase the likelihood of repeat hypoglycaemia

Introduction: Guidelines for self-treatment of hypoglycaemia specify initial treatment with quick-acting carbohydrate until blood glucose levels normalize and then follow-up with longer-acting carbohydrate. The few studies investigating follow-up show 29–57% omission or undertreatment with follow-up carbohydrate but do not investigate the association of this with repeat hypoglycaemia. This study aimed to develop, validate and administer a questionnaire to delineate this association. The timeframe targeted was 2 h post primary hypoglycaemic event (PPHE), the time influenced by long-acting carbohydrate. Methods: A questionnaire was generated, test–retest reliability assessed, and it was piloted on convenience samples from the target population. The final version was administered to all insulin-treated individuals attending an outpatient diabetes clinic over 4 weeks (169).Results: Questionnaire development: readability (69.6—standard/easy), test–retest reliability (Cohen’s kappa 0.57–0.91) and return rate (72.2%) were all acceptable. Questionnaire data: questionnaires were returned by 122 participants (63 males/59 females). Method of insulin administration was subcutaneous insulin injections (91%) and continuous subcutaneous insulin infusion (CSII) (9%). Repeat hypoglycaemia within 2 h PPHE was reported by 8.2% of respondents. There was no significant difference for age, gender and diabetes duration between those reporting repeat hypoglycaemia and those without. Consumption of follow-up longer-acting carbohydrate was reported by 58.2% of responders with 48% of these using long-acting and 52% medium-acting carbohydrate foods. Method of insulin administration and consumption of follow-up food were significantly associated with repeat hypoglycaemia (P = 0.015, 0.039) but presence or absence of symptoms and duration of action of carbohydrate were not significantly associated (P = 0.103, 0.629). Hierarchical logistic regression analysis showed omission of follow-up food PPHE was not a significant predictor of increased likelihood of repeat hypoglycaemia within 2 h PPHE, irrespective of method of insulin administration (P = 0.085). Conclusion: This study supports guidelines that recommend judicious, rather than routine use of follow-up longer-acting carbohydrate PPHE

Performance Improvement of Ultra Wideband Multiple Access Modulation System using a new Optimal Pulse Shape

Ultra-wideband (UWB) uses very low energy levels to transfer data at very high data rate and bandwidth. An optimal and correct choice of transmission pulse shape is an important criterion in this technology. In this paper, we will present an approach for the generation of an optimal pulse shape with the optimal generation of pulse shape values that can provide effective results when transmitted using multiple access modulation technique over a multipath channel and received by a RAKE type receiver. The bit error analysis of constructed model is also given using Ideal Rake, selective RAKE, and partial RAKE receiver configurations

Validity and reliability of the safety climate measurement in Malaysia

Organizations started giving attention to organizational and management impact on safety performance particularly the function of safety climate.Inconsistency concerning the appropriate elements that should be in safety climate scale has called for an assessment of the safety climate construct.The purpose of this study was to develop a measure of attitudes and perceptions of safety that are related to safety climate in the workplace.The Safety Climate Assessment Scale(SCAS) was administered to 372 employees ranging from physician to support staff.Analysis of data was done using statistical analysis from the SPSS version twelve. Safety experts reviewed the content validity of the safety climate measurement. Construct validity was analyzed by the exploratory factor analysis, and concurrent validity was examined by correlations.Cronbach’s alpha was used to measure internal consistency reliability.The results revealed acceptable internal consistency reliability, content validity, construct validity and concurrent validity for the SCAS. The SCAS scores had acceptable overall internal consistency reliability (r = .950). The correlation analysis indicated that scores on the 10 dimension scales of safety climate were moderately dependable

Obesity as Assessed by Body Adiposity Index and Multivariable Cardiovascular Disease Risk

To assess the role of body adiposity index (BAI) in predicting cardiovascular disease (CVD) and coronary heart disease (CHD) mortality, in comparison with body mass index (BMI), waist circumference (WC), and the waist circumference to hip circumference ratio (WHR). This study was a prospective 15 year mortality follow-up of 4175 Australian males, free of heart disease, diabetes and stroke. The Framingham Risk Scores (FRS) for CHD and CVD death were calculated at baseline for all subjects. Multivariable logistic regression was used to assess the effects of the measures of obesity on CVD and CHD mortality, before adjustment and after adjustment for FRS. The predictive ability of BAI, though present in the unadjusted analyses, was generally not significant after adjustment for age and FRS for both CVD and CHD mortality. BMI behaved similarly to BAI in that its predictive ability was generally not significant after adjustments. Both WC and WHR were significant predictors of CVD and CHD mortality and remained significant after adjustment for covariates. BAI appeared to be of potential interest as a measure of % body fat and of obesity, but was ineffective in predicting CVD and CHD

Occupational safety and health management in Malaysia: An overview

In today’s economy, globalization has shown tremendous impact on companies. Global competition increases safety and health risks and companies incurred additional cost on safety. To meet the challenges posed by these changes, revamping safety and health practices through strategies to improve performance is critical so as to motivate workforce in creating a safe and healthy environment that lead to decrease work-related accidents and ill-health in the workplace. Although work-related accidents and ill-health are preventable, there is a need for collaboration at the international, regional, national and enterprise levels to accomplish this mission with a positive commitment amongst all concerned. Due to that fact, companies need to focus on continual improvement of their performance in order to survive in the marketplace. One of the mean to encourage employers to achieve a higher standard of safety and health in the workplace is through effective occupational safety and health management

Assessing employees perception on health and safety management in public hospitals

This article examined the perception of employees regarding the management of Occupational Health and Safety (OHS) in public hospital in Malaysia.418 employees from three state hospitals in the northern region of Malaysia participated in this study and that gave a response rate of 43.15%. Data was collected using a set of questionnaires which consists of variables including safety satisfaction and feedback, safety communication, role of supervisor, work pressure, training and competence, management commitment, safety involvement, safety objectives, safety reporting, and leadership style.Data analysis was done using descriptive statistics, t-test, one-way ANOVA, Pearson correlation and multiple regressions.Findings showed that employees perceived safety reporting as the most important dimension and work pressure as the least important component in the OHS practices in their workplaces.Empirical evidence indicated that there was no significant difference in safety satisfaction and feedback between male and female workers but there was a significant difference among these employees in safety involvement.In addition, results also showed that there was a significant difference in safety satisfaction faced by job position like nurse but there was no significant difference between employees with job tenure comprise of less than 1 year, 2 to 15 years, and 16 years and above.Findings suggested that there was a significant positive correlation between safety satisfaction and feedback and safety communication, safety involvement, training and competence, safety reporting, work pressure, safety objectives, management commitment, role of supervisors, and leadership style.Regression analysis revealed approximately 54.5% (R2 = 0.545) of variance in safety satisfaction and feedback, that was simultaneously explained by five independent variables including safety involvement, safety reporting, work pressure, management commitment, and safety objectives