Assessment of depression and diabetes distress in type 2 diabetes mellitus patients in a tertiary care hospital of South India

Background: Depression is one of the many complications seen among diabetics. Depression leads to lack of self-care by the diabetic and endangers the therapeutic compliance, accounting for a derangement in metabolic control which in turn causes further diabetic complications and may even result in hospitalization. This leads to an increase in depressive symptoms and thus the vicious cycle continues.Methods: It is a Descriptive, cross sectional study conducted in the Medicine outpatient department. Depression was assessed by Hamilton depression rating scale. Diabetic distress was assessed by diabetic distress scale.Results: Out of the 250 study participants, 142 (56.8%) were found to be suffering from depression and 6 (2.4%) were found to have diabetes distress. The magnitude of depression was similar in both male and female. Depression was high among illiterates, unemployed (70%), single, separated individuals and patients with complications of diabetes. There was no significant association between religion and low economic status with depression. Treatment modalities, complications of diabetes, sociodemographic factors like age, sex, occupation, education, marital status, religion and socio-economic status had no significant correlation with diabetic distress. But there was a statistically significant association between diabetic distress and co-morbid conditions. 95.8% with depression had no distress and this association was found to be statistically significant (0.038).Conclusions: The magnitude of depression and distress is much high among diabetics. Early detection, counselling and treatment are required for all diabetics, especially those who have additional risk factors for the development of depression

Paisatges funeraris i diversitat a Anglaterra i a Gal·les: l'establiment d'una agenda = Deathscapes and diversity in England and Wales: setting an agenda

Aquest article se centra en una dimensió poc discutida, però important, de les experiències dels migrants i les minories a Anglaterra i Gal·les: els cementiris i crematoris de què disposen. Basat en una àmplia investigació amb comunitats locals i proveïdors de serveis en quatre ciutats casos d’estudi, aquest article ex-plora les diverses necessitats funeràries culturals i religioses a Anglaterra i Gal·les, els reptes que hi estan associats i les formes en què tant les comunitats com els proveïdors de serveis (p. ex.: planifica-dors i directors funeraris) hi responen. Destaquen vuit temes clau: i)l’oferta de cementiris; ii)l’oferta de crematoris; iii)l’oferta desigual per diferents grups migrants i minoritaris; iv)la diversitat en la diversitat; v)els canvis de patrons de repatriació;vi)el foment del diàleg;vii)la comprensió entre professionals icomunitats, i viii)la planificació dels cementiris com aespais de trobada.Este artículo se centra en una dimensión poco discutida pero importante de las experiencias de los migrantes y las mi-norías en Inglaterra y Gales: los cemen-terios y crematorios de que disponen. Basándose en una amplia investigación con comunidades locales y proveedores de servicios en cuatro ciudades casos de estudio, este artículo explora las diver-sas necesidades funerarias culturales y religiosas en Inglaterra y Gales, los retos asociados a estas y las formas en que tanto las comunidades como los provee-dores de servicios (p. ej.: planificadores y directores funerarios) responden a ellos. Destacan ocho temas clave: i)la oferta de cementerios; ii)la oferta de crematorios; iii)la oferta desigual por diferentes grupos migrantes y minoritarios; iv)la diversidad en la diversidad;v)los cambios de patrones de repatri-ación; vi)el fomento del diálogo;vii)la comprensión entre profesionalesy comunidades, y viii)la planificación de los cementerios como espacios de encuentro.This paper focuses on a little discussed but important dimension of migrant and minority experiences in England and Wales: cemetery and crematoria provi-sion. Based on extensive research with local communities and service providers in four case study towns, this paper explores the varied cultural and religious funerary needs in England and Wales, the associated challenges and the ways in which both communities and service providers (e.g. cemetery managers, town planners and funeral directors) respond to them. It highlights seven key themes, namely:i)cemetery provision;ii)crematorium provision;iii)unequal provision across migrantand minority groups;iv)diversity within diversity;v)changing patterns of repatriation; vi)fostering dialogue;vii)understanding between profession-als and communities; and viii)planning for cemeteries as spacesof encounter. / Este artículo se centra en una dimensión poco discutida pero importante de las experiencias de los migrantes y las mi-norías en Inglaterra y Gales: los cemen-terios y crematorios de que disponen. Basándose en una amplia investigación con comunidades locales y proveedores de servicios en cuatro ciudades casos de estudio, este artículo explora las diver-sas necesidades funerarias culturales y religiosas en Inglaterra y Gales, los retos asociados a estas y las formas en que tanto las comunidades como los provee-dores de servicios (p. ej.: planificadores y directores funerarios) responden a ellos. Destacan ocho temas clave: i)la oferta de cementerios; ii)la oferta de crematorios; iii)la oferta desigual por diferentes grupos migrantes y minoritarios; iv)la diversidad en la diversidad;v)los cambios de patrones de repatri-ación; vi)el fomento del diálogo;vii)la comprensión entre profesionalesy comunidades, y viii)la planificación de los cementerios como espacios de encuentro. / This paper focuses on a little discussed but important dimension of migrant and minority experiences in England and Wales: cemetery and crematoria provi-sion. Based on extensive research with local communities and service providers in four case study towns, this paper explores the varied cultural and religious funerary needs in England and Wales, the associated challenges and the ways in which both communities and service providers (e.g. cemetery managers, town planners and funeral directors) respond to them. It highlights seven key themes, namely:i)cemetery provision;ii)crematorium provision;iii)unequal provision across migrantand minority groups;iv)diversity within diversity;v)changing patterns of repatriation; vi)fostering dialogue;vii)understanding between profession-als and communities; and viii)planning for cemeteries as spacesof encounter

First-principles study of orthorhombic CdTiO3 perovskite

In this work we perform an ab-initio study of CdTiO3 perovskite in its orthorhombic phase using FLAPW method. Our calculations help to decide between the different cristallographic structures proposed for this perovskite from X-Ray measurements. We compute the electric field gradient tensor (EFG) at Cd site and obtain excellent agreement with available experimental information from a perturbed angular correlation (PAC) experiment. We study EFG under an isotropic change of volume and show that in this case the widely used "point charge model approximation" to determine EFG works quite well.Comment: 4 pages, 1 figure. Accepted in Physical Review

Families as support and burden: a mixed methods exploration of the extent to which family identification and support predicts reductions in stress among disadvantaged neighbourhood residents

Stronger family relationships predict positive health outcomes: a relationship that is partially due to the range of emotional, practical and informational support that families can provide. Yet not all families possess these resources. A survey study in a disadvantaged community in Nottingham, UK (N=142) demonstrated that family identification positively predicts ability to cope with financial stress, but that this relationship is moderated by whether family support is present or absent. Semi-structured interviews with 10 members of different families from the same community shed further light upon the nature of this relationship: individuals report that they tend to turn to their family rather than friends or community services in times of financial hardship, even though their family are unlikely to be able to support them effectively, and that this is often due to feelings of embarrassment or finance-related stigma. Our findings highlight the complex role that families can play in finance-related issues, as well as the need to encourage individuals to seek financial support from sources which provide effective (rather than emotionally comfortable) assistance

Novel Heparan Sulfate-Binding Peptides for Blocking Herpesvirus Entry

Human cytomegalovirus (HCMV) infection can lead to congenital hearing loss and mental retardation. Upon immune suppression, reactivation of latent HCMV or primary infection increases morbidity in cancer, transplantation, and late stage AIDS patients. Current treatments include nucleoside analogues, which have significant toxicities limiting their usefulness. In this study we screened a panel of synthetic heparin-binding peptides for their ability to prevent CMV infection in vitro. A peptide designated, p5+14 exhibited ~ 90% reduction in murine CMV (MCMV) infection. Because negatively charged, cell-surface heparan sulfate proteoglycans (HSPGs), serve as the attachment receptor during the adsorption phase of the CMV infection cycle, we hypothesized that p5+14 effectively competes for CMV adsorption to the cell surface resulting in the reduction in infection. Positively charged Lys residues were required for peptide binding to cell-surface HSPGs and reducing viral infection. We show that this inhibition was not due to a direct neutralizing effect on the virus itself and that the peptide blocked adsorption of the virus. The peptide also inhibited infection of other herpesviruses: HCMV and herpes simplex virus 1 and 2 in vitro, demonstrating it has broad-spectrum antiviral activity. Therefore, this peptide may offer an adjunct therapy for the treatment of herpes viral infections and other viruses that use HSPGs for entry

Effects of a refugee elective on medical student perceptions

<p>Abstract</p> <p>Background</p> <p>There are growing numbers of refugees throughout the world. Refugee health is a relatively unstudied and rarely taught component of medical education. In response to this need, a Refugee Health Elective was begun. Medical student perceptions toward cultural aspects of medicine and refugee health before and after participation in the elective were measured.</p> <p>Methods</p> <p>Preliminary questionnaires were given to all preclinical students at the academic year commencement with follow-up questionnaires at the refugee elective's conclusion. Both questionnaires examined students' comfort in interacting with patients and familiarity with refugee medical issues, alternative medical practices, and social hindrances to medical care. The preliminary answers served as a control and follow-up questionnaire data were separated into participant/non-participant categories. All preclinical medical students at two Midwestern medical schools were provided the opportunity to participate in the Refugee Health Elective and surveys. The 3 data groups were compared using unadjusted and adjusted analysis techniques with the Kruskall-Wallis, Bonferroni and ANCOVA adjustment. P-values < 0.05 were considered significant.</p> <p>Results</p> <p>408 and 403 students filled out the preliminary and follow-up questionnaires, respectfully, 42 of whom participated in the elective. Students considering themselves minorities or multilingual were more likely to participate. Elective participants were more likely to be able to recognize the medical/mental health issues common to refugees, to feel comfortable interacting with foreign-born patients, and to identify cultural differences in understanding medical/mental health conditions, after adjusting for minority or multilingual status.</p> <p>Conclusion</p> <p>As medical schools integrate a more multicultural curriculum, a Refugee Health Elective for preclinical students can enhance awareness and promote change in attitude toward medical/mental health issues common to refugees. This elective format offers tangible and effective avenues for these topics to be addressed.</p

Challenges of Loss to Follow-up in Tuberculosis Research.

In studies evaluating methods for diagnosing tuberculosis (TB), follow-up to verify the presence or absence of active TB is crucial and high dropout rates may significantly affect the validity of the results. In a study assessing the diagnostic performance of the QuantiFERON®-TB Gold In-Tube test in TB suspect children in Tanzania, factors influencing patient adherence to attend follow-up examinations and reasons for not attending were examined. In 160 children who attended and 102 children who did not attend scheduled 2-month follow-up baseline health characteristics, demographic data and risk factors for not attending follow-up were determined. Qualitative interviews were used to understand patient and caretakers reasons for not returning for scheduled follow-up. Being treated for active tb in the dots program (OR: 4.14; 95% CI:1.99-8.62;p-value<0.001) and receiving money for the bus fare (OR:129; 95% CI 16->100;P-value<0.001) were positive predictors for attending follow-up at 2 months, and 21/85(25%) of children not attending scheduled follow-up had died. Interviews revealed that limited financial resources, i.e. lack of money for transportation and poor communication, were related to non-adherence. Patients lost to follow-up is a potential problem for TB research. Receiving money for transportation to the hospital and communication is crucial for adherence to follow-up conducted at a study facility. Strategies to ensure follow-up should be part of any study protocol

Longitudinal double-spin asymmetry and cross section for inclusive jet production in polarized proton collisions at sqrt(s) = 200 GeV

We report a measurement of the longitudinal double-spin asymmetry A_LL and the differential cross section for inclusive midrapidity jet production in polarized proton collisions at sqrt(s)=200 GeV. The cross section data cover transverse momenta 5 < pT < 50 GeV/c and agree with next-to-leading order perturbative QCD evaluations. The A_LL data cover 5 < pT < 17 GeV/c and disfavor at 98% C.L. maximal positive gluon polarization in the polarized nucleon.Comment: 6 pages, 3 figures. Minor changes from review process in Phys. Rev. Lett. Plain text tables of data in STAR publications may be found at http://www.star.bnl.gov/central/publications