Glycaemic control in children with type 1 Diabetes Mellitus in Malta (2013 - 2014)

Background: Suboptimal glycaemic control, measured by glycosylated haemoglobin (HbA1c), increases the risk for long-term complications in Type 1 diabetes mellitus (T1DM). Aims and objectives: To calculate and compare glycaemic control in children with T1DM in Malta during the period 2013 to 2014. To identify any need for changing way services are structured and delivered. Methods: An estimated 96% of all children with T1DM less than 16 years of age in Malta are cared for by the same paediatric diabetes team, based at the main state hospital. The average HbA1c of all measurements taken every 3 months by HbA1c analyser was calculated for each patient and these results were validated by annual laboratory measurement of HbA1c from venous samples. Results: Overall, 43.8% of participants in 2013 and 49.6% of participants in 2014 achieved an HbA1c target of < 7.5%. The mean HbA1c in 2013 was 7.69±0.16% and in 2014 7.67±0.17%. A higher proportion of patients in the younger age-group achieved an HbA1c target of <7.5%. The patients most likely to have a higher HbA1c were in the older age-groups. Conclusion: Glycaemic control achieved in Malta in children aged < 16 years with T1DM was stable over the two years analysed. Our data is comparable, or slightly better, to that achieved in other European countries. However, there is always room for improvement, as Swedish data have shown. Multidisciplinary team meetings could be one way to address those patients not achieving adequate control.peer-reviewe

Excitable neurons, firing threshold manifolds and canards

We investigate firing threshold manifolds in a mathematical model of an excitable neuron. The model analyzed investigates the phenomenon of post-inhibitory rebound spiking due to propofol anesthesia and is adapted from McCarthy et al. (SIAM J. Appl. Dyn. Syst. 11(4):1674-1697, 2012). Propofol modulates the decay time-scale of an inhibitory GABAa synaptic current. Interestingly, this system gives rise to rebound spiking within a specific range of propofol doses. Using techniques from geometric singular perturbation theory, we identify geometric structures, known as canards of folded saddle-type, which form the firing threshold manifolds. We find that the position and orientation of the canard separatrix is propofol dependent. Thus, the speeds of relevant slow synaptic processes are encoded within this geometric structure. We show that this behavior cannot be understood using a static, inhibitory current step protocol, which can provide a single threshold for rebound spiking but cannot explain the observed cessation of spiking for higher propofol doses. We then compare the analyses of dynamic and static synaptic inhibition, showing how the firing threshold manifolds of each relate, and why a current step approach is unable to fully capture the behavior of this model

Animal health and the role of communities: an example of trypanasomosis control options in Uganda

In many African countries, governments are re-thinking the role of the state in centrally providing certain goods and services. The rights and responsibilities for providing various public goods are being decentralized to lower levels of government administration, and/or being devolved directly to local citizens or user groups themselves. It is thus critical to ask: under what circumstances will local groups provide the socially optimal level of the public good? In this paper, we apply this question to the case of controlling an important vector-borne livestock disease in Uganda, trypanosomosis, which is transmitted by the tsetse fly. We investigate the underlying epidemiology of transmission and different options for control, and the implications for group provision of control, within the framework of a game-theoretic model. Results indicate that individual incentives to uptake tsetse and trypanosomosis control differ widely across different control methods. Since the costs of successfully implementing collective action are affected by individual incentives to participate in collective action, the model predicts which method/s are likely to be successfully implemented at the community level. More broadly, the model highlights under what circumstances community-provision is not likely to be optimal, depending on the underlying epidemiology of the disease, technological parameters, prevailing market characteristics, and socio-cultural conditions.

The tourist experience of heritage urban spaces : Valletta as a case study

This article provides an understanding of how tourists experience heritage urban spaces by investigating features that influence tourist experiences most. It is framed within urban design literature which refers to three elements of urban space namely physical setting (or form), activity, and meaning. These elements are used to explore how urban spaces are experienced by tourists. Its findings are derived from an in-depth qualitative analysis of interviews with tourists to Valletta, Malta. The research suggests that the intrinsic qualities of the space are relevant to the tourist experience but what is even more relevant are the interactions of the tourist with different elements within that space, namely interactions with surroundings, interactions with others, and interactions with self/meaning. Within this broad conceptual model, the research identifies important sub-themes. Some of these reinforce the findings of existing work on tourist experiences, but others are often under-estimated or neglected.peer-reviewe

ASSESSMENT OF WIC COST-CONTAINMENT PRACTICES; EXECUTIVE SUMMARY

The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) provides both nutrition education and supplemental foods containing nutrients determined by nutritional research to be lacking in the diets of pregnant, breastfeeding, and postpartum women, infants, and children. State WIC agencies have implemented practices designed to reduce the cost of food packages containing these prescribed foods. For instance, one of the WIC program's primary cost-saving practices is negotiating rebate contracts with manufacturers of infant formula. Additional practices include limiting authorized vendors to stores with lower food prices; limiting approved brands, package sizes, forms, or prices; and negotiating rebates with food manufacturers or suppliers. There is concern that these practices may inadvertently counter the program's goal of providing supplemental foods and nutrition education. Based on a review of cost-containment practices in six States, including interviews with the various stakeholders and analysis of WIC administrative files, the study draws three major conclusions: (1) costcontainment practices reduced average food package costs by 0.2 to 21.4 percent, depending on practices implemented and local conditions; (2) the cost-containment practices had few adverse outcomes for WIC participants; and (3) administrative costs of the practices were low, averaging about 1.5 percent of food package savings. The full report, Assessment of WIC Cost-Containment Practices: Final Report, is available online at http://www.ers.usda.gov/publications/efan03005.WIC Program, cost-containment, food-item restrictions, vendor restrictions, manufacturers' rebates, food package costs, Food Consumption/Nutrition/Food Safety, Food Security and Poverty,

Frequency control in synchronized networks of inhibitory neurons

We analyze the control of frequency for a synchronized inhibitory neuronal network. The analysis is done for a reduced membrane model with a biophysically-based synaptic influence. We argue that such a reduced model can quantitatively capture the frequency behavior of a larger class of neuronal models. We show that in different parameter regimes, the network frequency depends in different ways on the intrinsic and synaptic time constants. Only in one portion of the parameter space, called `phasic', is the network period proportional to the synaptic decay time. These results are discussed in connection with previous work of the authors, which showed that for mildly heterogeneous networks, the synchrony breaks down, but coherence is preserved much more for systems in the phasic regime than in the other regimes. These results imply that for mildly heterogeneous networks, the existence of a coherent rhythm implies a linear dependence of the network period on synaptic decay time, and a much weaker dependence on the drive to the cells. We give experimental evidence for this conclusion.Comment: 18 pages, 3 figures, Kluwer.sty. J. Comp. Neurosci. (in press). Originally submitted to the neuro-sys archive which was never publicly announced (was 9803001

Reconnection and Disconnection: Observations of Suprathermal Electron Heat Flux Dropouts

Suprathermal electron heat flux dropouts (HFD) serve as a sensitive test of the magnetic topology of the inner heliosphere. Since the heat flux electron strahl always flows away from the Sun, a heat flux dropout should indicate either that the magnetic field line is completely disconnected from the Sun or that the heat flux strahl is scattered into other pitch angles. We present observations of two suprathermal electron heat flux dropout events observed by the Advanced Composition Explorer (ACE) spacecraft which occur simultaneously with impulsive energetic ion events. Since suprathermal electrons encompass the same velocity range as ions with energies of a few MeV/nucleon, the similarities and differences between them as observed at 1 AU probes the sources and transport of these two species. We compare the two events to show the difference between the signatures of a simple disconnection and a more complicated reconnection scenario. Comparing suprathermal electron modulations with energetic ion modulations is a powerful technique for determining the magnetic topology between particle injection at the Sun and observation at 1 AU

FEEDER CATTLE PRICE DIFFERENTIALS IN GEORGIA TELEAUCTIONS

Three Georgia feeder cattle teleauction markets were analyzed from 1977 to 1988 to estimate the impacts of cattle characteristics and market conditions on prices. Cattle characteristic price impacts were similar to those in previous studies. The impact of feeder cattle futures price on teleauction price was positive but varied across markets. Optimal lot size ranged from 143 to 276 head. In one market, 14 lots were necessary to generate positive price impacts. Additional buyers were estimated to have a $.30/cwt per buyer impact on price.Demand and Price Analysis,