A cross-sectional survey of general practice health workers' perceptions of their provision of culturally competent services to ethnic minority people with diabetes

Aims To explore General Practice teams cultural-competence, in particular, ethnicity, linguistic skillset and cultural awareness. The practice teams’ access to diabetes-training, and overall perception of cultural-competence were also assessed. Methods A cross-sectional single-city-survey with one in three people with diabetes from an ethnic minority group, using 35 semi-structured questions was completed. Self-reported data analysed using descriptive statistics, interpreted with reference to the Culturally-Competent-Assessment-Tool. Results Thirty-four (52%) of all 66 practices in Coventry responded between November 2011 and January 2012. Key findings: (1) One in five practice staff was from a minority group in contrast with one in ten of Coventry’s population, (2) 164 practice staff (32%) spoke a second language relevant to the practice's minority population, (3) 56% of practices were highly culturally-competent at providing diabetes services for minority populations, (4) 94% of practices reported the ethnicity of their populations, and (5) the most frequently stated barriers to culturally-competent service delivery were language and knowledge of nutritional habits. Conclusions Culturally-competent diabetes care is widespread across the city. Language barriers are being addressed, cultural knowledge of diabetes-related-nutrition requires further improvement. Further studies should investigate if structured cultural-competence training for diabetes service providers produces positive effects in diabetes-related outcome-measures in minority populations

Symmetry-Projected Hartree-Fock-Bogoliubov Equations

Symmetry-projected Hartree-Fock-Bogoliubov (HFB) equations are derived using the variational ansatz for the generalized one-body density-matrix in the Valatin form. It is shown that the projected-energy functional can be completely expressed in terms of the HFB density-matrix and the pairing-tensor. The variation of this projected-energy is shown to result in HFB equations with modified expressions for the pairing-potential and the Hartree-Fock field. The expressions for these quantities are explicitly derived for the case of particle number-projection. The numerical applicability of this projection method is studied in an exactly soluble model of a deformed single-j shell.Comment: 24 pages, 1 figur

Effects of alpine hydropower operations on primary production in a downstream lake

Abstract.: During the past century, the construction of hydropower dams in the watershed of Lake Brienz has significantly altered the dynamics of turbidity, which has important implications for lake productivity. To assess these effects, we measured in situ carbon assimilation rates and ambient light intensities over 18months. Based on experimental data, a numerical model was developed to assess gross primary production under present light conditions and those under a hypothetical case without upstream dams. Light conditions for the hypothetical ‘no-dam' situation were estimated from pre-dam Secchi depths and simulated ‘no-dam' particle concentrations. Current gross primary production is low (~66 gC m−2 yr−1), and could increase ~44% if the lake was less turbid. Disregarding nutrient retention in reservoirs, we estimate gross primary production would be ~35% lower in summer and ~23% higher in winter in the absence of reservoirs. The annual primary production (~58 gC m−2 yr−1) would decrease ~12% compared to the current primary production with dams. According to model calculations, hydropower operations have significantly altered the seasonal dynamics, but have little effect on annual primary production in Lake Brien

Editorial:Developing research potential in the primary and community-nursing workforce

the impact of a community of practic

Prediagnostic serum biomarkers as early detection tools for pancreatic cancer in a large prospective cohort study

Background: The clinical management of pancreatic cancer is severely hampered by the absence of effective screening tools. Methods: Sixty-seven biomarkers were evaluated in prediagnostic sera obtained from cases of pancreatic cancer enrolled in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO). Results: The panel of CA 19-9, OPN, and OPG, identified in a prior retrospective study, was not effective. CA 19-9, CEA, NSE, bHCG, CEACAM1 and PRL were significantly altered in sera obtained from cases greater than 1 year prior to diagnosis. Levels of CA 19-9, CA 125, CEA, PRL, and IL-8 were negatively associated with time to diagnosis. A training/validation study using alternate halves of the PLCO set failed to identify a biomarker panel with significantly improved performance over CA 19-9 alone. When the entire PLCO set was used for training at a specificity (SP) of 95%, a panel of CA 19-9, CEA, and Cyfra 21-1 provided significantly elevated sensitivity (SN) levels of 32.4% and 29.7% in samples collected 1 year prior to diagnosis, respectively, compared to SN levels of 25.7% and 17.2% for CA 19-9 alone. Conclusions: Most biomarkers identified in previously conducted case/control studies are ineffective in prediagnostic samples, however several biomarkers were identified as significantly altered up to 35 months prior to diagnosis. Two newly derived biomarker combinations offered advantage over CA 19-9 alone in terms of SN, particularly in samples collected >1 year prior to diagnosis. However, the efficacy of biomarker-based tools remains limited at present. Several biomarkers demonstrated significant velocity related to time to diagnosis, an observation which may offer considerable potential for enhancements in early detection. © 2014 Nolen et al

The neurological level of spinal cord injury and cardiovascular risk factors: a systematic review and meta-analysis.

STUDY DESIGN Systematic review and meta-analysis. OBJECTIVE To determine the difference in cardiovascular risk factors (blood pressure, lipid profile, and markers of glucose metabolism and inflammation) according to the neurological level of spinal cord injury (SCI). METHODS We searched 5 electronic databases from inception until July 4, 2020. Data were extracted by two independent reviewers using a pre-defined data collection form. The pooled effect estimate was computed using random-effects models, and heterogeneity was calculated using I2 statistic and chi-squared test (CRD42020166162). RESULTS We screened 4863 abstracts, of which 47 studies with 3878 participants (3280 males, 526 females, 72 sex unknown) were included in the meta-analysis. Compared to paraplegia, individuals with tetraplegia had lower systolic and diastolic blood pressure (unadjusted weighted mean difference, -14.5 mmHg, 95% CI -19.2, -9.9; -7.0 mmHg 95% CI -9.2, -4.8, respectively), lower triglycerides (-10.9 mg/dL, 95% CI -19.7, -2.1), total cholesterol (-9.9 mg/dL, 95% CI -14.5, -5.4), high-density lipoprotein (-1.7 mg/dL, 95% CI -3.3, -0.2) and low-density lipoprotein (-5.8 mg/dL, 95% CI -9.0, -2.5). Comparing individuals with high- vs. low-thoracic SCI, persons with higher injury had lower systolic and diastolic blood pressure (-10.3 mmHg, 95% CI -13.4, -7.1; -5.3 mmHg 95% CI -7.5, -3.2, respectively), while no differences were found for low-density lipoprotein, serum glucose, insulin, and inflammation markers. High heterogeneity was partially explained by age, prevalent cardiovascular diseases and medication use, body mass index, sample size, and quality of studies. CONCLUSION In SCI individuals, the level of injury may be an additional non-modifiable cardiovascular risk factor. Future well-designed longitudinal studies with sufficient follow-up and providing sex-stratified analyses should confirm our findings and explore the role of SCI level in cardiovascular health and overall prognosis and survival