An appraisal of food serving characteristics among patients with type 2 diabetes mellitus attending a tertiary care diabetes facility in Sri Lanka

AbstractIntroduction: The primary objective of the present study was to identify food consumption characteristics among adult type 2 diabetic patients in Sri Lanka.Materials and Methods: One hundred and twenty three randomly selected adult type 2 diabetic patients attending a tertiary care diabetes facility in Sri Lanka were studied in a cross sectional survey. Starch, fruits, vegetables, meat or alternative, pulses, dairy and added sugar consumption assessed according to standard methods using a 24-hour dietary recall.Results: Forty six percent of participants exceeded the national recommendation of 4.5 to 9 servings of starch per day for patients with diabetes. Mean daily consumption of starch was 10.5 servings.  Only 26% and 45% of participants consumed the recommended 2 servings of fruits and 3 servings of vegetables per day. Thirty three percent and 8% did not consume any fruits or vegetables respectively. Dairy products were consumed by 25% only. Added sugar was not used by 99% of participants. The mean proportions of total Carbohydrates, proteins and fats comprising total energy intake were 68.1%, 11.5% and 20.2% respectively. Discussion: Medical nutrition therapy in diabetes recommends a mixed diet with carbohydrates from a variety of sources such as cereals, fruits and vegetables. Although Sri Lankan patients with diabetes consume less starch and more fruits and vegetables compared to non-diabetic counterparts,  a substantial proportion still fail to meet the recommendations.Â

Comorbidities and Ethnocultural Factors Limit the Physical Activity of Rural Sri Lankan Patients with Diabetes Mellitus

South Asians have high prevalence of diabetes, cardiovascular risk, and physical inactivity. Reasons for physical inactivity have not been explored among Asians living within their endogenous environments. During phase 1 of the study, we assessed the physical activity (PA) of the population using a quantitative, descriptive, cross-sectional research method. During phase 2 of the study, a qualitative method with in-depth interviews was used to collect data on barriers of PA. Four hundred patients with type 2 diabetes, comprising 113 (28.2%) males and 287 (71.7%) females, were enrolled. The overall prevalence of physical inactivity was 21.5% (males: 15.9%, females: 23.7%). The majority (44.8%) of the study population was active and 33.8% were minimally active. The mean weekly MET minutes was 4381.6 (SD 4962). The qualitative study (n=45) identified health-related issues—lifestyle and time management and social embarrassment, prioritizing household activities over PA as significant factors that limited PA

Adaptive video streaming for bandwidth variation with optimum quality

Bandwidth scarcity is a common problem faced in video transmission over broadband networks, particularly in wireless medium. It is important to find solutions for that since high bandwidth consuming video applications such as video streaming, video conferencing are of high interest to the broadband and mobile users today. This thesis presents adaptive video streaming based methodology to address the given problem. Adaptive streaming is discussed through transcoding. It is a solution that can be adopted to overcome this problem in any network environment. Conversion of video to a form that has less information so that the resulting data volume is appropriate for streaming over a low bandwidth scenario can be done with transcoding. But the video quality drops due to transcoding. A compromise can be made between the video quality and network delay. Effect on video quality and data volume with the variation of transcoding parameters are analyzed in this research, especially with the temporal scaling parameters. A relationship between the transcoding parameters, the data volume reducing factor and the video quality is obtained through numerical methods. Hence a methodology derived from the numerical method is proposed to achieve an adaptive streaming solution. One of the significant outcomes of this thesis is the video quality measurement mechanism proposed that could be used in the presence of spatial and temporal scaling. This solution presents the best transcoding parameters to achieve optimum quality video in a low bandwidth situation. With that, when there is a large number of users are sharing the network, they could watch a video at a lower, but acceptable quality with no interruption. Keywords – Adaptive stream, Transcode, Video quality, Frame Rate, Quantizatio

Lack of infrastructure, social and cultural factors limit physical activity among patients with type 2 diabetes in rural Sri Lanka, a qualitative study.

South Asians have high prevalence of diabetes, increased cardiovascular risk and low levels of physical activity (PA). Reasons for low levels of PA have not previously been explored among Asians living within their endogenous environment. This qualitative study was performed to explore the contextual reasons that limited PA among type 2 diabetic patients living in a rural community.Purposeful sampling recruited 40 participants with long standing type 2 diabetes for this qualitative study. Semi-structered questions utilising in-depth interviews were used to collect data on PA patterns, barriers to PA and factors that would facilitate PA. The interviews were digitally recorded and transcribed. Data were analyzed using a framework approach.The sample consisted of 11 males and 29 females. Mean age was 55.4 (SD 8.9) years. The mean duration of diabetes in the study population was 8.5 (SD 6.8) years. Inability to differentitate household and daily activities from PA emerged as a recurring theme. Most did not have a clear understanding of the type or duration of PA that they should perform. Health related issues, lifestyle and time management, envronmental and social factors like social embarrassment, prioritizing household activities over PA were important factors that limited PA. Most stated that the concept of exercising was alien to their culture and lifestyle.Culturally appropriate programmes that strengthen health education and empower communities to overcome socio-economic barriers that limit PA should be implemented to better manage diabetes among rural Sri Lankan diabetic patients