Ethnic specific obesity cut-offs for diabetes risk: cross-sectional study of 490, 288 UK Biobank participants

OBJECTIVE To compare the relationship between adiposity and prevalent diabetes across ethnic groups in the UK Biobank cohort and to derive ethnic-specific obesity cutoffs that equate to those developed in white populations in terms of diabetes prevalence.<p></p> RESEARCH DESIGN AND METHODS UK Biobank recruited 502,682 U.K. residents aged 40–69 years. We used baseline data on the 490,288 participants from the four largest ethnic subgroups: 471,174 (96.1%) white, 9,631 (2.0%) South Asian, 7,949 (1.6%) black, and 1,534 (0.3%) Chinese. Regression models were developed for the association between anthropometric measures (BMI, waist circumference, percentage body fat, and waist-to-hip ratio) and prevalent diabetes, stratified by sex and adjusted for age, physical activity, socioeconomic status, and heart disease.<p></p> RESULTS Nonwhite participants were two- to fourfold more likely to have diabetes. For the equivalent prevalence of diabetes at 30 kg/m2 in white participants, BMI equated to the following: South Asians, 22.0 kg/m2; black, 26.0 kg/m2; Chinese women, 24.0 kg/m2; and Chinese men, 26.0 kg/m2. Among women, a waist circumference of 88 cm in the white subgroup equated to the following: South Asians, 70 cm; black, 79 cm; and Chinese, 74 cm. Among men, a waist circumference of 102 cm equated to 79, 88, and 88 cm for South Asian, black, and Chinese participants, respectively.<p></p> CONCLUSIONS Obesity should be defined at lower thresholds in nonwhite populations to ensure that interventions are targeted equitably based on equivalent diabetes prevalence. Furthermore, within the Asian population, a substantially lower obesity threshold should be applied to South Asian compared with Chinese groups.<p></p&gt

Association between grip strength and diabetes prevalence in black, South Asian, and white European ethnic groups: a cross-sectional study of 418,656 UK Biobank participants

Aims: To quantify the extent to which ethnic differences in muscular strength might account for the substantially higher prevalence of diabetes in black and South-Asian compared with white European adults. Methods: This cross-sectional study used baseline data from the UK Biobank study on 418 656 white European, black and South-Asian participants, aged 40–69 years, who had complete data on diabetes status and hand-grip strength. Associations between hand-grip strength and diabetes were assessed using logistic regression and were adjusted for potential confounding factors. Results: Lower grip strength was associated with higher prevalence of diabetes, independent of confounding factors, across all ethnicities in both men and women. Diabetes prevalence was approximately three- to fourfold higher in South-Asian and two- to threefold higher in black participants compared with white European participants across all levels of grip strength, but grip strength in South-Asian men and women was ~5–6 kg lower than in the other ethnic groups. Thus, the attributable risk for diabetes associated with low grip strength was substantially higher in South-Asian participants (3.9 and 4.2 cases per 100 men and women, respectively) than in white participants (2.0 and 0.6 cases per 100 men and women, respectively). Attributable risk associated with low grip strength was also high in black men (4.3 cases) but not in black women (0.4 cases). Conclusions: Low strength is associated with a disproportionately large number of diabetes cases in South-Asian men and women and in black men. Trials are needed to determine whether interventions to improve strength in these groups could help reduce ethnic inequalities in diabetes prevalence

Political Architecture, Electoral Dynamics and Public Delivery of Nigeria’s Fourth Republic: An Assessment

Political development of Nigeria, electoral experience and public delivery has been influenced and impacted by ethnic chauvinism, flawed elections and skewed education. Historical and analytical methods were adopted in conducting this research. It was found out in the research that Nigeria is a forced merger of Great Britain.  Her electoral landscape is punctuated by ballot snatching, vote-for-cash and result manipulation perpetuated by desperate politicians. Nonetheless, legal framework, e-registration and e-accreditation as well as the resolve of Nigerians is changing the tide. Education sector has made steady progress. Based on the findings, it was recommended that credible election begins with credible party primaries. Politicians must embrace change and tolerate risk through competitive primaries. The people must stand up to be counted by insisting that vote count and are counted. Ultimately, Nigerians must cultivate a tolerant spirit. That spirit must first dwell in the political leadership. Keywords: Politics, Nigeria, Education, Election, Credible, Governmen

Exploring ethnic variations in lifestyle and diabetes: using evidence from UK Biobank Data

Type 2 diabetes mellitus (T2DM) is an important public health problem, with prevalence rapidly rising in the last decade by 65% in the United Kingdom. Those with type 2 diabetes carry twice the risk of developing cardiovascular disease and premature mortality amongst adults. The UK population is now ageing and the number of multi-ethnic populations in UK is increasing, the burden of T2DM is of prime importance. Improved lifestyle behaviours could significantly prevent the onset and also improve the effect of diabetes disease. However, the underpinning evidences have largely been obtained from studies of populations of white European descent. It is unclear whether these recommendations are appropriate for other ethnic groups. The prevalence of T2DM, it's impacts and controls differ between ethnic populations. T2DM is more common, more severe, develops at an earlier age as well as develops at lower obesity levels in the non-white minority population living within the United Kingdom compared with the majority White population. Therefore, more inclusive epidemiological information is critical for effective planning and designing of interventions to improve population health, particularly amongst non-white minority groups. The aim of this thesis was to assess and analyse epidemiological data on the ethnic differences in sex, adiposity and lifestyle factors on T2DM risk among middle-aged adults in the United Kingdom with focus on European white, South Asians (people originating from India, Pakistan and Bangladesh), Blacks (Black African and Black Caribbean) and Chinese descent populations

Exploring the use of adjusted body mass index thresholds based on equivalent insulin resistance for defining overweight and obesity in UK South Asian children

Background Body mass index (BMI) overweight/obesity thresholds in South Asian (SA) adults, at equivalent type-2 diabetes risk are lower than for white Europeans (WE). We aimed to define adjusted overweight/obesity thresholds for UK–SA children based on equivalent insulin resistance (HOMA-IR) to WE children. Methods In 1138 WE and 1292 SA children aged 9.0–10.9 years, multi-level regression models quantified associations between BMI and HOMA-IR by ethnic group. HOMA-IR levels for WE children were calculated at established overweight/obesity thresholds (at 9.5 years and 10.5 years), based on UK90 BMI cut-offs. Quantified associations in SA children were then used to estimate adjusted SA weight-status thresholds at the calculated HOMA-IR levels. Results At 9.5 years, current WE BMI overweight and obesity thresholds were 19.2 kg/m2, 21.3 kg/m2 (boys) and 20.0 kg/m2, 22.5 kg/m2 (girls). At equivalent HOMA-IR, SA overweight and obesity thresholds were lower by 2.9 kg/m2 (95% CI: 2.5–3.3 kg/m2) and 3.2 kg/m2 (95% CI: 2.7–3.6 kg/m2) in boys and 3.0 kg/m2 (95% CI: 2.6–3.4 kg/m2) and 3.3 kg/m2 (95% CI: 2.8–3.8 kg/m2) in girls, respectively. At these lower thresholds, overweight/obesity prevalences in SA children were approximately doubled (boys: 61%, girls: 56%). Patterns at 10.5 years were similar. Conclusions SA adjusted overweight/obesity thresholds based on equivalent IR were markedly lower than BMI thresholds for WE children, and defined more than half of SA children as overweight/obese

LEADER 5: prevalence and cardiometabolic impact of obesity in cardiovascular high-risk patients with type 2 diabetes mellitus: baseline global data from the LEADER trial

Background: Epidemiological data on obesity are needed, particularly in patients with type 2 diabetes mellitus (T2DM) and high cardiovascular (CV) risk. We used the baseline data of liraglutide effect and action in diabetes: evaluation of CV outcome results—A long term Evaluation (LEADER) (a clinical trial to assess the CV safety of liraglutide) to investigate: (i) prevalence of overweight and obesity; (ii) relationship of the major cardiometabolic risk factors with anthropometric measures of adiposity [body mass index (BMI) and waist circumference (WC)]; and (iii) cardiometabolic treatment intensity in relation to BMI and WC. Methods: LEADER enrolled two distinct populations of high-risk patients with T2DM in 32 countries: (1) aged ≥50 years with prior CV disease; (2) aged ≥60 years with one or more CV risk factors. Associations of metabolic variables, demographic variables and treatment intensity with anthropometric measurements (BMI and WC) were explored using regression models (ClinicalTrials.gov identifier: NCT01179048). Results: Mean BMI was 32.5 ± 6.3 kg/m2 and only 9.1 % had BMI <25 kg/m2. The prevalence of healthy WC was also extremely low (6.4 % according to International Joint Interim Statement for the Harmonization of the Metabolic Syndrome criteria). Obesity was associated with being younger, female, previous smoker, Caucasian, American, with shorter diabetes duration, uncontrolled blood pressure (BP), antihypertensive agents, insulin plus oral antihyperglycaemic treatment, higher levels of triglycerides and lower levels of high-density lipoprotein cholesterol. Conclusions: Overweight and obesity are prevalent in high CV risk patients with T2DM. BMI and WC are related to the major cardiometabolic risk factors. Furthermore, treatment intensity, such as insulin, statins or oral antihypertensive drugs, is higher in those who are overweight or obese; while BP and lipid control in these patients are remarkably suboptimal. LEADER confers a unique opportunity to explore the longitudinal effect of weight on CV risk factors and hard endpoints

An assessment of counseling quality provided by community pharmacies to patients during expedition of pseudoephedrine.

Badanie zaprojektowano w celu oceny jakości konsultacji farmaceutycznej towarzyszącej ekspedycji pseudoefedryny Metodyka: Badanie terenowe z zastosowaniem metodologii "tajemniczego pacjenta" przeprowadzone w 142 aptekach w Polsce. Badanie przeprowadzono z wykorzystaniem dwóch scenariuszy (scenariusz I: lek dla dziecka, II: dla pacjenta 75-letniego) oraz listy kontrolnej. W obydwu sytuacjach farmaceuta powinien odradzić lek. Listy kontrolne uzupełniano po opuszczeniu apteki. Dane analizowano zbiorczo. Oceniano, czy dokonano identyfikacji użytkownika i wykluczono przeciwwskazania do zastosowania leku. Wyniki: Analizowano 142 konsultacje (I n=72, II n= 70). Spontanicznej identyfikacji pacjenta dokonało jedynie 24 ze 142 farmaceutów. Scenariusz I: 21 farmaceutów nie zadało żadnego pytania. Scenariusz II: tylko 22% ekspediujących lek dla "starszej osoby" ustaliło jej wiek. 50% konsultujących nie zapytało o choroby/inne leki stosowane przez niego. Wnioski: Konieczna jest edukacja farmaceutów w zakresie przeprowadzania wywiadu i wprowadzenie algorytmów ekspedycji niektórych leków.The study was designed to investigate the quality of pharmaceutical counseling accompanying the expedition of pseudoephedrine. Method: the "mystery patient" study carried out in 142 community pharmacies in Poland. The study was conducted using two scenarios and a check-list. The scenario I: drug for child, II: 75-year-old man. In both situations, the pharmacy staff should discourage the use of the drug. The checklists were completed after leaving the pharmacy. The data were analyzed collectively. It was assessed whether the pharmacists/ technicians identify the drug user and/or exclude contraindications. Results: 142 consultations were analyzed (I n=72, II n=70). Only 24 out of 142 pharmacists/technicians identified the patient. Scenario I: 21 pharmacists did not ask any questions. Scenario II: only 22% pharmacists/technicians informed that the drug is for the "elderly person" determined his age, 50% of consultants did not ask about diseases/other medicines used by him. Conclusions: It is necessary to educate pharmacists about conducting interviews and introducing algorithms for the expedition of OTC drugs

Comparison of body mass index at diagnosis of diabetes in a multi-ethnic population:a case-control study with matched non-diabetic controls

Aims: To investigate the probability of developing type 2 diabetes mellitus (T2DM) at different body mass index levels compared to matched non-diabetic controls in a multi-ethnic population. Materials and methods: This was a case-control study of 90 367 patients with incident diabetes and 362 548 age-sex-ethnicity matched controls from UK primary care. The probability of developing T2DM was estimated. Results: Case and control patients were 56 years old at index and 56% were male. Patients with T2DM had significantly higher mean BMI levels by about 5 kg/m2 at diagnosis (32.2 kg/m2) compared to the matched controls (27.4 kg/m2). White Europeans (n = 79 270), African-Caribbeans (n = 4115) and South Asians (n = 7252) were 58, 48 and 46 years old with a mean BMI of 32.5, 31.1 and 29.2 kg/m2, respectively, at diagnosis. More South Asians developed T2DM at BMI below 30 kg/m2 (38%) than White Europeans (26%) and African-Caribbeans (29%) (all P <.01). Within the 18 to 70-year age range, South Asian males and females had a significantly higher probability of developing diabetes in the continuously measured BMI range of 18 to 30 kg/m2, compared to White Europeans and African-Caribbeans. Across all age groups <70 years, South Asians and African-Caribbeans had a significantly higher probability of developing T2DM in the normal weight and overweight categories, compared to White Europeans. However, this risk pattern of developing diabetes was reversed amongst the obese in all age groups. Conclusion: Risk patterns of developing diabetes at different levels of obesity varies among ethnic groups across all ages, while South Asians and African-Caribbeans carry the highest risk at a younger age and at lower adiposity burden

How Nigeria’s 2015 presidential election outcome was forecasted with geodemographics and public sentiment analytics

In 2015, Nigeria held one of the most fiercely contested presidential elections in the nation’s recent democratic history. The outcome of the election was expected to exert significant influence on democratic practices on the African continent. The stiffness of the contest also meant that it was difficult to predict the likely winner of the election. This paper summarizes how an empirical approach was used to forecast the outcome of the election by modeling public sentiment data-set using a geodemographic framework. Results indicate that the main electorates that determined the outcome of the election were situated in thirteen battleground states. Additionally, results showed that two years before the presidential election, Goodluck Jonathan’s public approval ratings on corruption, insecurity, and the economy (the main drivers of the 2015 election) had nose-dived across many of the battleground states. This eventually contributed toward his loss

Cognitive Test Scores in UK Biobank:Data Reduction in 480,416 Participants and Longitudinal Stability in 20,346 Participants

UK Biobank includes 502,649 middle- and older-aged adults from the general population who have undergone detailed phenotypic assessment. The majority of participants completed tests of cognitive functioning, and on average four years later a sub-group of N = 20,346 participants repeated most of the assessment. These measures will be used in a range of future studies of health outcomes in this cohort. The format and content of the cognitive tasks were partly novel. The aim of the present study was to validate and characterize the cognitive data: to describe the inter-correlational structure of the cognitive variables at baseline assessment, and the degree of stability in scores across longitudinal assessment. Baseline cognitive data were used to examine the inter-correlational/factor-structure, using principal components analysis (PCA). We also assessed the degree of stability in cognitive scores in the subsample of participants with repeat data. The different tests of cognitive ability showed significant raw inter-correlations in the expected directions. PCA suggested a one-factor solution (eigenvalue = 1.60), which accounted for around 40% of the variance. Scores showed varying levels of stability across time-points (intraclass correlation range = 0.16 to 0.65). UK Biobank cognitive data has the potential to be a significant resource for researchers looking to investigate predictors and modifiers of cognitive abilities and associated health outcomes in the general population