Impact and cost of a 2-week community-based screening and awareness program for diabetes and cardiovascular risk factors in a Swiss canton

BACKGROUND: Community-based diabetes screening programs can help sensitize the population and identify new cases. However, the impact of such programs is rarely assessed in high-income countries, where concurrent health information and screening opportunities are common place. INTERVENTION AND METHODS: A 2-week screening and awareness campaign was organized as part of a new diabetes program in the canton of Vaud (population of 697,000) in Switzerland. Screening was performed without appointment in 190 out of 244 pharmacies in the canton at the subsidized cost of 10 Swiss Francs per participant. Screening included questions on risk behaviors, measurement of body mass index, blood pressure, blood cholesterol, random blood glucose (RBG), and A1c if RBG was >/=7.0 mmol/L. A mass media campaign promoting physical activity and a healthy diet was channeled through several media, eg, 165 spots on radio, billboards in 250 public places, flyers in 360 public transport vehicles, and a dozen articles in several newspapers. A telephone survey in a representative sample of the population of the canton was performed after the campaign to evaluate the program. RESULTS: A total of 4222 participants (0.76% of all persons aged >/=18 years) underwent the screening program (median age: 53 years, 63% females). Among participants not treated for diabetes, 3.7% had RBG >/= 7.8 mmol/L and 1.8% had both RBG >/= 7.0 mmol/L and A1c >/= 6.5. Untreated blood pressure >/=140/90 mmHg and/or untreated cholesterol >/=5.2 mmol/L were found in 50.5% of participants. One or several treated or untreated modifiable risk factors were found in 78% of participants. The telephone survey showed that 53% of all adults in the canton were sensitized by the campaign. Excluding fees paid by the participants, the program incurred a cost of CHF 330,600. CONCLUSION: A community-based screening program had low efficiency for detecting new cases of diabetes, but it identified large numbers of persons with elevated other cardiovascular risk factors. Our findings suggest the convenience of A1c for mass screening of diabetes, the usefulness of extending diabetes screening to other cardiovascular risk factors, and the importance of a robust background communication campaign

The demand for money in developing countries: Assessing the role of financial innovation

Traditional specifications of money demand have been commonly plagU4:!d by persistent overprediction, implausible parameter estimates, and highly autocorrelated errors. This paper argues that some of those problems stem from the failure to account for the impact of financial innovation. We estimate money demand for ten developing countries employing various proxies for the innovation process and provide an assessment of the relative importance of this variable. We find that financial innovation plays an important role in determining money demand and its fluctuations, and that the importance of this role increases with the rate of inflation.

Susceptibility of the one-dimensional, dimerized Hubbard model

We show that the zero temperature susceptibility of the one-dimensional, dimerized Hubbard model at quarter-filling can be accurately determined on the basis of exact diagonalization of small clusters. The best procedure is to perform a finite-size scaling of the spin velocity $u_\sigma$, and to calculate the susceptibility from the Luttinger liquid relation $\chi=2/\pi u_\sigma$. We show that these results are reliable by comparing them with the analytical results that can be obtained in the weak and strong coupling limits. We have also used quantum Monte Carlo simulations to calculate the temperature dependence of the susceptibility for parameters that should be relevant to the Bechgaard salts. This shows that, used together, these numerical techniques are able to give precise estimates of the low temperature susceptibility of realistic one-dimensional models of correlated electrons.Comment: 10 pages, latex, figures available from the authors. To appear in Phys. Rev. B, Rapid Comm

Charge gap in the one--dimensional dimerized Hubbard model at quarter-filling

We propose a quantitative estimate of the charge gap that opens in the one-dimensional dimerized Hubbard model at quarter-filling due to dimerization, which makes the system effectively half--filled, and to repulsion, which induces umklapp scattering processes. Our estimate is expected to be valid for any value of the repulsion and of the parameter describing the dimerization. It is based on analytical results obtained in various limits (weak coupling, strong coupling, large dimerization) and on numerical results obtained by exact diagonalization of small clusters. We consider two models of dimerization: alternating hopping integrals and alternating on--site energies. The former should be appropriate for the Bechgaard salts, the latter for compounds where the stacks are made of alternating $TMTSF$ and $TMTTF$ molecules. % $(TMTSF)_2 X$ and $(TMTTF)_2 X$ ($X$ denotes $ClO_4$, $PF_6$, $Br$...).Comment: 33 pages, RevTeX 3.0, figures on reques

Deducing correlation parameters from optical conductivity in the Bechgaard salts

Numerical calculations of the kinetic energy of various extensions of the one-dimensional Hubbard model including dimerization and repulsion between nearest neighbours are reported. Using the sum rule that relates the kinetic energy to the integral of the optical conductivity, one can determine which parameters are consistent with the reduction of the infrared oscillator strength that has been observed in the Bechgaard salts. This leads to improved estimates of the correlation parameters for both the TMTSF and TMTTF series.Comment: 12 pages, latex, figures available from the author

Best practices for operating underwater gliders in Atlantic Canada

Ocean gliders are versatile tools for making ocean observations. This paper summarizes the experience, of nearly two decades, of glider observing activity in Atlantic Canada. It reviews key considerations for operating gliders based on the experience and the lessons learned. This paper has three main goals: 1. To provide new and emerging glider users with guidance and considerations for developing a glider program. 2. Review the literature on sensor development for gliders and the use of gliders. 3. To highlight different mission scenarios that include enough practical considerations to support operating gliders. The use of gliders is rapidly expanding, but the documentation and consolidation of best practices for their operational use in Atlantic Canada remains underdeveloped. This summary provides a guide that should be helpful both to new and experienced glider operators and potential users, to observe the oceanography of this region and addresses regional challenges. We believe documenting our experience will be also helpful to the global glider community. We summarize the most critical considerations of utilizing gliders. We review the issues specific to the platform use and concerns about how to optimize the use of key sensors to contribute to an oceanographic observing program

Variable viral clearance despite adequate ganciclovir plasma levels during valganciclovir treatment for cytomegalovirus disease in D+/R- transplant recipients

ABSTRACT: BACKGROUND: Valganciclovir, the oral prodrug of ganciclovir, has been demonstrated equivalent to iv ganciclovir for CMV disease treatment in solid organ transplant recipients. Variability in ganciclovir exposure achieved with valganciclovir could be implicated as a contributing factor for explaining variations in the therapeutic response. This prospective observational study aimed to correlate clinical and cytomegalovirus (CMV) viral load response (DNAemia) with ganciclovir plasma concentrations in patients treated with valganciclovir for CMV infection/disease. METHODS: Seven CMV D+/R- transplant recipients (4 kidney, 2 liver and 1 heart) were treated with valganciclovir (initial dose was 900-1800 mg/day for 3-6.5 weeks, followed by 450-900 mg/day for 2-9 weeks). DNAemia was monitored by real time quantitative PCR and ganciclovir plasma concentration was measured at trough (Ctrough) and 3 h after drug administration (C3h) by HPLC. RESULTS: Four patients presented with CMV syndrome, two had CMV tissue-invasive disease after prophylaxis discontinuation, and one liver recipient was treated pre-emptively for asymptomatic rising CMV viral load 5 weeks post-transplantation in the absence of prophylaxis. CMV DNAemia decreased during the first week of treatment in all recipients except in one patient (median decrease: -1.2 log copies/mL, range: -1.8 to 0) despite satisfactory ganciclovir exposure (AUC0-12 = 48 mg.h/L, range for the 7 patients: 40-118 mg.h/L). Viral clearance was obtained in five patients after a median of time of 34 days (range: 28-82 days). Two patients had recurrent CMV disease despite adequate ganciclovir exposure (65 mg.h/L, range: 44-118 mg.h/L). CONCLUSIONS: Valganciclovir treatment for CMV infection/disease in D+/R- transplant recipients can thus result in variable viral clearance despite adequate ganciclovir plasma concentrations, probably correlating inversely with anti-CMV immune responses after primary infection