Gestational diabetes in a rural setting.

Women who are already diabetic and become pregnant, as well as women who develop gestational diabetes, have increased risks of complications to both fetus and mother. These risks in gestational diabetes mellitus (GDM) can be reduced to near that of a non-diabetic mother by normalizing the blood sugar. The current recommended standards are reviewed. Utilizing a team approach, care was provided to patients with GDM in a rural primary care setting in order to attempt to normalize the blood sugar to the recommended level. Review of the outcomes of these pregnancies supports the conclusion that acceptable care for patients with GDM can be provided away from the tertiary care centers and in the primary care setting

A Portable Rainfall Simulator for Plot–Scale Runoff Studies

Rainfall simulators have a long history of successful use in both laboratory and field investigations. Many plot–scale simulators, however, have been difficult to operate and transport in the field, especially in remote locations where water or electricity is unavailable. This article describes a new rainfall simulator that is relatively easy to operate and transport to and from the field while maintaining critical intensity, distribution, and energy characteristics of natural rainfall. The simulator frame is constructed from lightweight aluminum pipe with a single 50 WSQ nozzle centered at a height of 3 m (9.8 ft). An operating nozzle pressure of 28 kPa (4.1 psi) yields continuous flow at an intensity of 70 mm h-1 (2.8 in. h-1 ) over a 1.5– x 2–m (4.9– x 6.6–ft) plot area with a coefficient of uniformity of 93%. Kinetic energy of the rainfall is about 25 J m-2 mm-1 (142.8 ft–lb ft-2 in.-1), approximately 87% of natural rainfall. The simulator can be easily transported by two field personnel and completely assembled or disassembled in approximately 10 min. Water usage is at a minimum as the simulator utilizes only one nozzle

The mini-CIDEX GC/IMS: Analysis of cometary ice and dust

Comets are recognized as among the most scientifically important objects in the solar system. They are presumed relics of the early primitive material in the solar nebula and are believed to have provided a general enrichment of volatiles to the inner solar system. The Cometary Coma Chemical Composition (C4) Mission, a proposed Discovery-Class Mission, will analyze materials released into the coma, providing information leading to the understanding of the chemical composition and make-up of the cometary nucleus. As one of two scientific instruments in the C4 spacecraft, an advanced and streamlined version of the Cometary Ice and Dust Experiment (CIDEX), a mini-CIDEX, will employ an X-Ray Fluorescence (XRF) spectrometer to determine bulk elemental composition of cometary dust grains and a Gas Chromatograph/Ion Mobility Spectrometer (GC/IMS) for determination of the molecular composition of dust and ices following stepwise pyrolysis and combustion. A description of the mini-CIDEX IMS will be provided as well as data from analyses conducted using the mini-CIDEX breadboard instrument

Changes in cardiovascular risk factors in relation to increasing ethnic inequalities in cardiovascular mortality:comparison of cross-sectional data in the Health Surveys for England 1999 and 2004

OBJECTIVES: Reducing disease inequalities requires risk factors to decline quickest in the most disadvantaged populations. Our objective was to assess whether this happened across the UK's ethnic groups. DESIGN: Secondary analysis of repeated but independent cross-sectional studies focusing on Health Surveys for England 1999 and 2004. SETTING: Community-based population level surveys in England. PARTICIPANTS: Seven populations from the major ethnic groups in England (2004 sample sizes): predominantly White general (6704), Irish (1153), Chinese (723), Indian (1184), Pakistani (941), Bangladeshi (899) and Black Caribbean (1067) populations. The numbers were smaller for specific variables, especially blood tests. OUTCOME MEASURES: Data on 10 established cardiovascular risk factors were extracted from published reports. Differences between 1999 and 2004 were defined a priori as occurring when the 95% CI excluded 0 (for prevalence differences), or 1 (for risk ratios) or when there was a 5% or more change (independent of CIs). RESULTS: Generally, there were reductions in smoking and blood pressure and increases in the waist–hip ratio, body mass index and diabetes. Changes between 1999 and 2004 indicated inconsistent progress and increasing inequalities. For example, total cholesterol increased in Pakistani (0.3 mmol/L) and Bangladeshi men (0.3 mmol/L), and in Pakistani (0.3 mmol/L), Bangladeshi (0.4 mmol/L) and Black Caribbean women (0.3 mmol/L). Increases in absolute risk factor levels were common, for example, in Pakistani (five risk factors), Bangladeshi (four factors) and general population women (four factors). For men, Black Caribbeans had the most (five factor) increases. The changes relative to the general population were also adverse for three risk factors in Pakistani and Black Caribbean men, four in Bangladeshi women and three in Pakistani women. CONCLUSIONS: Changes in populations with the most cardiovascular disease and diabetes did not decline the quickest. Cardiovascular screening programmes need more targeting

Improving the mental health of farmers: what types of remote support are acceptable, feasible, and improve outcomes? A feasibility RCT

Background: The farming community have high rates of poor mental health, and are relatively ‘hard to reach’ with mental health services. The aim of this study was therefore to undertake a feasibility RCT, based on two mental health interventions. These were (1) CBT based ‘Living Life to the Full for Farming Communities’ (LLTTF-F; www.llttf.com), and (2) a holistic social and emotional support service delivered by the Royal Scottish Agricultural Benevolent Institution (RSABI). The feasibility was supplemented by process evaluation. Methods: This feasibility study aimed to recruit 40 individuals from the farming community who were experiencing a common health problem defined as a score of > = 8 on PHQ-9. A snowball approach was used to recruit interested individuals who had an association with farming. An initial telephone call screened for eligibility and obtained consent to randomisation to the two specified interventions, or to a thirdly group receiving a combination of both LLTTF-F and ‘Social and emotional support’. Participants were permitted to override the randomised option if they expressed a strong preference before the interventions began. Results: Thirty-two participants provided baseline and three-month data. All three interventions showed positive improvements on PHQ-9 scores as follows: the ‘combined intervention’ mean baseline score was 18.1 compared to 12.0 at 3-month follow-up (mean change 6.1). ‘Social and emotional support’ mean baseline score was 11.3 compared to 6.7 at 3-month follow-up (mean change 4.6). ‘LLTTF-F CBT-based intervention only’ mean baseline score was 11.8 compared to 4.5 at 3-month follow-up (mean change 7.3). The retention rate was 81% at three months. In a sub-group of the LLTTF-F CBT-based intervention online materials were supplemented by telephone guided support. This approach received very positive feedback. Conclusions: Recruitment from the farming community required intense effort, and good engagement can then be retained for at least three months. There is evidence that the interventions used were feasible, and tentative evidence that they had a demonstrable effect on mental wellbeing, with the LLTTFF providing the largest effect on PHQ-9 scores. Trial Registration Number ISRCTN27173711, submitted 25/08/2023, confirmed 22/092023