Consequences of health condition labelling: protocol for a systematic scoping review

Introduction When health conditions are labelled it is often to classify and communicate a set of symptoms. While diagnostic labelling can provide explanation for an individual's symptoms, it can also impact how individuals and others view those symptoms. Despite existing research regarding the effects of labelling health conditions, a synthesis of these effects has not occurred. We will conduct a systematic scoping review to synthesise the reported consequences and impact of being given a label for a health condition from an individual, societal and health practitioner perspective and explore in what context labelling of health conditions is considered important. Methods and analysis The review will adhere to the Joanna Briggs Methodology for Scoping Reviews. Searches will be conducted in five electronic databases (PubMed, Embase, PsycINFO, Cochrane, CINAHL). Reference lists of included studies will be screened and forward and backward citation searching of included articles will be conducted. We will include reviews and original studies which describe the consequences for individuals labelled with a non-cancer health condition. We will exclude hypothetical research designs and studies focused on the consequences of labelling cancer conditions, intellectual disabilities and/or social attributes. We will conduct thematic analyses for qualitative data and descriptive or meta-analyses for quantitative data where appropriate. Ethics and dissemination Ethical approval is not required for a scoping review. Results will be disseminated via publication in a peer-reviewed journal, conference presentations and lay-person summaries on various online platforms. Findings from this systematic scoping review will identify gaps in current understanding of how, when, why and for whom a diagnostic label is important and inform future research

On the reduction of the CSP dichotomy conjecture to digraphs

It is well known that the constraint satisfaction problem over general relational structures can be reduced in polynomial time to digraphs. We present a simple variant of such a reduction and use it to show that the algebraic dichotomy conjecture is equivalent to its restriction to digraphs and that the polynomial reduction can be made in logspace. We also show that our reduction preserves the bounded width property, i.e., solvability by local consistency methods. We discuss further algorithmic properties that are preserved and related open problems.Comment: 34 pages. Article is to appear in CP2013. This version includes two appendices with proofs of claims omitted from the main articl

CSP for binary conservative relational structures

We prove that whenever A is a 3-conservative relational structure with only binary and unary relations then the algebra of polymorphisms of A either has no Taylor operation (i.e. CSP(A) is NP-complete), or generates a congruence meet semidistributive variety (i.e. CSP(A) has bounded width).Comment: 9 pages, 3 figure

Treatment with LY2409021, a Glucagon Receptor Antagonist, Increases Liver Fat in Patients with Type 2 Diabetes

Aims To evaluate whether treatment with LY2409021, a novel, selective glucagon receptor antagonist, is associated with changes in hepatic fat and other safety variables related to the benefit–risk profile for chronic use in patients with type 2 diabetes (T2D). Methods Safety and efficacy were assessed in patients with T2D taking metformin and sulphonylurea who were randomized to LY2409021 20 mg (n = 65), placebo (n = 68), or sitagliptin 100 mg (n = 41). Key endpoints included change from baseline to month 6 in hepatic fat fraction (HFF), assessed by magnetic resonance imaging; hepatic aminotransferases; blood pressure; lipid profile; fasting plasma glucose; and glycated haemoglobin (HbA1c). Results A significant increase in HFF was seen with LY2409021 vs sitagliptin (least squares [LS] mean difference 3.72%; P < .001) and placebo (4.44%; P < .001), accompanied by significant elevations in alanine aminotransferase levels with LY2409021 vs sitagliptin (6.8 U/L; P = .039) and vs placebo (10.7 U/L; P < .001). No patients had concomitant elevations in bilirubin levels. LY2409021 treatment showed significant HbA1c reductions vs placebo (LS mean difference −0.77%; P < .001) but not sitagliptin (−0.20%; P = .383). Similar results were observed for fasting plasma glucose. LY2409021 was also associated with significant increases in systolic blood pressure vs sitagliptin (4.9 mm Hg; P = .030) and vs placebo (4.3 mm Hg; P = .029), as well as significant increases in body weight and total cholesterol. All effects of LY2409021 were reversible. Conclusion In this cohort of patients with T2D, chronic glucagon receptor antagonism with LY2409021 was associated with glucose-lowering but also demonstrated increases in hepatic fat, hepatic aminotransferases, and other adverse effects

Designing Efficient Taxi Pickup Operations at Airports

This paper provides a practical procedure for designing efficient taxi pickup operations at airports. How to do this effectively is an open question. Solutions are not available, and practices vary. They reflect different approaches to and lack of research on the subject. The solutions are often unsatisfactory. At many airports, passengers routinely suffer long waits outdoors, exposed to the elements, after a tiring journey. Such disagreeable experiences are avoidable. Designing efficient taxi pickup operations at airports is problematic. The peculiarities of the process preclude easy solutions. First, the process involves queuing, so system performance is a nonlinear function of the loads. Second, it features unstable transient situations, since travelers typically arrive in bulk over short periods. Third, traffic is significantly differentiated and consists of a wide variety of groups implying different service characteristics. Standard results from queuing theory thus do not have a useful application to this problem. The design process uses simulation that is based on detailed observation of local practices. It involves four steps: (a) detailed local measurements of the arrival of both travelers and taxis, and the service rates provided by taxis in different queuing positions; (b) creation and validation of a simulation model sufficiently detailed to account for these realities; (c) exploration of design alternatives to estimate the characteristics of the service they would provide; and (d) selection of a preferred design that properly balances efforts to minimize average and extreme wait times. The paper demonstrates the procedure through application to Lisbon International Airport, Portugal.SIMUL8 Corporatio