656 research outputs found
Parity and diabetes risk among Hispanic women from Colombia: Cross-sectional evidence
Objective
The association between parity and type 2 diabetes has been studied in developed countries and in Singapore and Chinese women but not in Hispanics. Herein we evaluated the association between parity (number of live births) with diabetes in a group of Hispanic postmenopausal women from Colombia.
Research design and methods
Herein we evaluated the association between parity and diabetes in a population of 1,795 women from Colombia. Women were divided in birth categories (0 [referent], 1 or 2, 3–5, 6 or \u3e births). Medical history of diabetes and anthropometric characteristics were recorded. Logistic regressions were performed in order to find the association between parity and diabetes in bivariable and multivariable models after controlling for age, body mass index (BMI), waist hip ratio (WHR) and diabetes family history, among other variables.
Results
In our study, there was an association between parity and diabetes after adjusting for age, BMI and diabetes family history in the multiparous women groups when compared to the women with no births (Referent group) [1–2 births vs. referent OR 5.2 (95 CI 1.2–22.9), 3–5 births vs. referent OR 5.5 (1.3–23.0) and ≥6 births vs. referent OR 7.5 (1.8–31.8), respectively]. The association was maintained in two of the groups in the multivariable analysis [OR 5.0 (1.1–22.9) and 5.3 (1.2–23.5)], for 1 or 2 births and 6 or \u3e births versus 0 births, respectively. Positive diabetes family history and WHR were also associated with an increased risk of diabetes [OR 4.6 (3.0–7.0) and 4.1 (2.0–8.1), respectively].
Conclusions
In postmenopausal Hispanic women, multiparity, as well as a positive family history of diabetes and a high waist-hip ratio were associated with higher diabetes risk
An evaluation of education in an orthodontic training centre
This thesis is an evaluation of interprofessional education (IPE) in Leamington Spa Orthodontics (LSO), a primary care outreach training centre. It is relevant, as there are no IPE studies in dentistry and timely, offering a model of integrated education and patient care. As a longitudinal study, where IPE is the organisational philosophy, it is significant in informing theorisation of IPE.
The methodology is realist evaluation, which aims to describe and understand the educational environment and identify how stakeholders perceive their experiences. The study group spans the full spectrum of stakeholders in LSO education, selected by purposive sampling. Data collection is by semi-structured interviews and focus groups. Thematic analysis allows in-depth data immersion, developing theory iteratively until saturation is achieved. Identified theories are tested and refined by stakeholders, thus providing respondent validation.
Findings show IPE in LSO to be successful for the orthodontic team. A core philosophy and attitude are the initiating contexts, which, with time, allow development of an appropriate skill-mix, organization and setting to facilitate learning. Empowerment leads to aspects of unlearning, reflection, formal and informal learning, combining with situated learning to deliver interprofessional learning. Outcomes include individual and team development, enhanced teamwork, communication and depth of learning. IPE evolves through situated learning in a conducive community of practice, where individuals develop their own identities, or learning trajectories, unrestricted by professional protectionism. To be sustainable, IPE must become organisationally contextual, which is dependent upon emergence of new leaders and, requires buy-in from and continuing motivation of the majority of stakeholders.
This thesis identifies contexts required for IPE, mechanisms which generate defined outcomes, and suggests that a customized primary care setting is ideally suited for its’ development. IPE has struggled to transform healthcare professional education. An institutional teaching model, with IPE as the core philosophy, may achieve this goal. This thesis therefore suggests that IPE should be an overarching educational theory in its own right, within which other social science and education theories combine, to maximize integrated learning and patient care
Profound Intraoperative Metabolic Acidosis and Hypotension in a Child Undergoing Multilevel Spinal Fusion
The prone position may cause cardiovascular system depression. Yet, the mechanisms involved and preemptive measures are not well understood (Edgcombe et al. (2008)). During spinal surgery in the prone position, hypotension may occur. Implicated factors include prolonged abdominal compression impeding venous return resulting in increased blood loss, decreased cardiovascular reserve, and the use of total intravenous anesthesia (TIVA) which has been shown to blunt the sympathetic response more than inhalation anesthesia. We present a case of hypotension during spinal surgery with all its challenges. Hypotension and acidosis persisted despite all supporting measures, and only to improve with supine positioning. Differential diagnosis for such an event are discussed. Although abdominal compression may not be obvious before the start of surgery, compressing the spine during surgery may lead to abdominal compression and hypoperfusion to abdominal organs
Interplay between pulsations and mass loss in the blue supergiant 55 Cygnus = HD 198478
Blue supergiant stars are known to display photometric and spectroscopic
variability that is suggested to be linked to stellar pulsations. Pulsational
activity in massive stars strongly depends on the star's evolutionary stage and
is assumed to be connected with mass-loss episodes, the appearance of
macroturbulent line broadening, and the formation of clumps in the wind. To
investigate a possible interplay between pulsations and mass-loss, we carried
out an observational campaign of the supergiant 55 Cyg over a period of five
years to search for photospheric activity and cyclic mass-loss variability in
the stellar wind. We modeled the H, He I, Si II and Si III lines using the
nonlocal thermal equilibrium atmosphere code FASTWIND and derived the
photospheric and wind parameters. In addition, we searched for variability in
the intensity and radial velocity of photospheric lines and performed a moment
analysis of the line profiles to derive frequencies and amplitudes of the
variations. The Halpha line varies with time in both intensity and shape,
displaying various types of profiles: P Cygni, pure emission, almost complete
absence, and double or multiple peaked. The star undergoes episodes of variable
mass-loss rates that change by a factor of 1.7-2 on different timescales. We
also observe changes in the ionization rate of Si II and determine a
multiperiodic oscillation in the He I absorption lines, with periods ranging
from a few hours to 22.5 days. We interpret the photospheric line variations in
terms of oscillations in p-, g-, and strange modes. We suggest that these
pulsations can lead to phases of enhanced mass loss. Furthermore, they can
mislead the determination of the stellar rotation. We classify the star as a
post-red supergiant, belonging to the group of alpha Cyg variables.Comment: 20 pages, 18 figures, 3 tables, accepted to Astronomy & Astrophysic
PCN115 Cost of Skeletal-Related Events (SREs) in Patients with Bone Metastases to solid Tumours Based on the Health Resource Utilisation (HRU) Collected in a Prospective European Multinational Observational Study
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A large-scale experiment finds no evidence that a seismic survey impacts a demersal fish fauna
Seismic surveys are used to locate oil and gas reserves below the seabed and can be a major source of noise in marine environments. Their effects on commercial fisheries are a subject of debate, with experimental studies often producing results that are difficult to interpret. We overcame these issues in a large-scale experiment that quantified the impacts of exposure to a commercial seismic source on an assemblage of tropical demersal fishes targeted by commercial fisheries on the North West Shelf of Western Australia. We show that there were no short-term (days) or long-term (months) effects of exposure on the composition, abundance, size structure, behavior, or movement of this fauna. These multiple lines of evidence suggest that seismic surveys have little impact on demersal fishes in this environment
Discovery of Small-Scale Spiral Structures in the Disk of SAO 206462 (HD 135344B): Implications for the Physical State of the Disk from Spiral Density Wave Theory
We present high-resolution, H-band, imaging observations, collected with
Subaru/HiCIAO, of the scattered light from the transitional disk around SAO
206462 (HD 135344B). Although previous sub-mm imagery suggested the existence
of the dust-depleted cavity at r~46AU, our observations reveal the presence of
scattered light components as close as 0.2" (~28AU) from the star. Moreover, we
have discovered two small-scale spiral structures lying within 0.5" (~70AU). We
present models for the spiral structures using the spiral density wave theory,
and derive a disk aspect ratio of h~0.1, which is consistent with previous
sub-mm observations. This model can potentially give estimates of the
temperature and rotation profiles of the disk based on dynamical processes,
independently from sub-mm observations. It also predicts the evolution of the
spiral structures, which can be observable on timescales of 10-20 years,
providing conclusive tests of the model. While we cannot uniquely identify the
origin of these spirals, planets embedded in the disk may be capable of
exciting the observed morphology. Assuming that this is the case, we can make
predictions on the locations and, possibly, the masses of the unseen planets.
Such planets may be detected by future multi-wavelengths observations.Comment: 8 pages, 5 figures, ApJL in press, typo correcte
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