Angiotensin Converting Enzyme Insertion/Deletion Gene Polymorphism: An Observational Study among Diabetic Hypertensive Subjects in Malaysia

Purpose: This study investigated the influence of angiotensin-1 converting enzyme (ACE) insertiondeletion (ID) gene polymorphism on the treatment responses of type 2 diabetic subjects at varying stages of nephropathy to ACE inhibitors (ACEI) with regard to blood pressure (MAP) and renal response (GFR). Methods: The pharmacological effect of ACE inhibition on mean arterial pressure (MAP) and glomerular filtration rate (GFR) were observed among a total of 62 subjects for a short-term duration of 15 months. MAP and GFR were calculated by standard mathematical formulae while the ACE ID genotype was determined using triple primer PCR. The general linear model repeated measures were applied to study the modulation of ACE inhibition on these parameters. Results: ACE ID genotyping of the 62 subjects showed that 19 (30.6 %) subjects had the II genotype, while 35 (56.4 %) subjects showed ID genotype and 8 (12.9 %) subjects had the DD genotype. Significant mean MAP reduction (p 0.05) from baseline values were observed among the subjects following antihypertensive treatment. However, when stratified according to ACE genotypes, no significant mean MAP and GFR changes were observed between genotypes following antihypertensive treatment (p > 0.05).Conclusion: ACE ID gene polymorphism does not determine the treatment efficacy of ACE inhibitors in the Malaysian population.Keywords: ACE genotype, ACE inhibitor, Type 2 diabetes mellitus, Diabetic nephropath

High Performance Simulation for Brain Tumours Growth Using Parabolic Equation on Heterogeneous Parallel Computer System

ABSTRACT Brain tumour is one of the prevalent cancers in the worl

Implementing CoreNet to Reach Out to Businesses - A Case Study of the Singapore Government\u27s IT Initiatives

Over the years, more and more sophisticated e-government systems are being created to reach out to both businesses and citizens alike. However, many such projects have been fraught with difficulties due to myriad barriers which may hinder adoption and inhibit progress during the various phases of the implementation. Against this backdrop, an example of a country with an advanced e-government agenda and a successful track record is Singapore. In this study, we first propose a 3-stage theoretical framework that takes into account the barriers that may hinder a successful e-government implementation and the corresponding change intervention actions to address such barriers. We then demonstrate and refine the applicability of the proposed framework in the context of the Singapore Government’s experience in implementing the CORENET project in the construction and real estate industry. The insights gained and the lessons learnt from this study may have valuable implications for research and practice

Scoping study on natural resources and climate change in Southeast Asia with a focus on agriculture. Final report

Climate change / Natural resources / Environmental effects / Agroecology / Agricultural production / Crops / Cropping systems / Farming systems / Livestock / Fisheries / Food security / Water management / Economic aspects / Rural poverty / Policy / Nutrient management / South East Asia / Cambodia / Laos / Thailand / Vietnam / Myanmar / China / Greater Mekong Subregion / Tonle Sap / Yunnan

Geographical Concentration of Rural Poverty in Bangladesh

This paper was presented at the dialogue on Mapping Poverty for Rural Bangladesh: Implications for Pro-poor Development. The dialogue was organised as part of CPD's ongoing agricultural policy research and advocacy activities with IRRI under the PETRRA project. The study reported geographical concentration of rural poverty in Bangladesh for 425 upazilas in 2000-01. The study measured and mapped incidence of poverty (using Headcount Index), intensity of poverty (using Poverty Gap Index) and severity of poverty (using Squared Poverty Gap Index). It has analyzed factors contributing to the spatial concentration of poverty. It is hoped that the findings of the study would be helpful in identifying target areas and priorities for agricultural R&D interventions and poverty reduction programmes.Poverty, Rural Poverty, Bangladesh

Validation of the diabetes, hypertension and hyperlipidemia (DHL) knowledge instrument in Malaysia

BACKGROUND: Patient's knowledge on diabetes, hypertension and hyperlipidaemia and its medications can be used as one of the outcome measures to assess the effectiveness of educational intervention. To date, no such instrument has been validated in Malaysia. Therefore, the aim of this study was to evaluate the validity and reliability of the Diabetes, Hypertension and Hyperlipidemia (DHL) knowledge instrument for assessing the knowledge of patients with type 2 diabetes in Malaysia. METHODS: A 28-item instrument which comprised of 5 domains: diabetes, hypertension, hyperlipidemia, medications and general issues was designed and tested. One point was given for every correct answer, whilst zero was given for incorrect answers. Scores ranged from 0 to 28, which were then converted into percentage. This was administered to 77 patients with type 2 diabetes in a tertiary hospital, who were on medication(s) for diabetes and who could understand English (patient group), and to 40 pharmacists (professional group). The DHL knowledge instrument was administered again to the patient group after one month. Excluded were patients less than 18 years old. RESULTS: Flesch reading ease was 60, which is satisfactory, while the mean difficulty factor(SD) was 0.74(0.21), indicating that DHL knowledge instrument was moderately easy. Internal consistency of the instrument was good, with Cronbach's alpha = 0.791. The test-retest scores showed no significant difference for 26 out of the 28 items, indicating that the questionnaire has achieved stable reliability. The overall mean(SD) knowledge scores was significantly different between the patient and professional groups 74.35(14.88) versus 93.84(6.47), p < 0.001. This means that the DHL knowledge instrument could differentiate the knowledge levels of participants. The DHL knowledge instrument shows similar psychometric properties as other validated questionnaires. CONCLUSIONS: The DHL knowledge instrument shows good promise to be adopted as an instrument for assessing diabetic patients' knowledge concerning their disease conditions and medications in Malaysia

Comparison Study Of Energy Efficiency Activities Programs Among The Selected Region And Countries: Lessons Learned For Malaysia

This study reviews the contemporary tendencies in energy efficiency performance in chosen regions and countries. It also reviews the energy efficiency strategies and activities accomplished in these countries which pursue the program of reduction in energy consumption while maintaining the comfort level. These become the objectives and today’s energy efficiency requirement. This study also aims to highlight these activities and the outcomes of the energy efficiency implementation. The extent of this action and its effectiveness is being ascertained. The indicator used to evaluate the Energy Efficiency activities is the Energy Intensity Indicator which is provided by International Energy Agency (IEA). The reports and measurements of the International Energy Agency (IEA) are considered in order to make comparison among the selected countries. The main reason of focus on Energy Intensity levels is because this indicator reflects the result of all activities in different sectors and make sense which country has fulfilled the requirement of Energy Efficiency. The regions and countries are selected on the basis that their level of achievement in the energy efficiency programs are high. However, comparison is still made because each region and country has different emphasis and focus. Despite that Malaysia is a developing country, the achievement towards satisfactory energy efficiency implementation can be considered as encouraging and can only advance further if energy efficiency practice in these selected countries will be learned

Enhancing off-site manufacturing through early contractor involvement (ECI) in New Zealand

Procurement strategies that enable early contractor involvement (ECI) in design may enhance off-site manufacturing (OSM) by overcoming previously identified barriers to its uptake. Involving constructors during the design stage can reduce the risk of design buildability issues, and standardising traditionally bespoke ECI processes may help overcome cultural resistance to unfamiliar OSM technology. Following literature review and using case studies, document analysis and legal doctrine, a two-stage ECI conceptual process model for New Zealand is proposed. This was tested and refined following feedback at a conference. The model comprises a first-stage pre-construction contract and a second-stage standard-form construction contract. Key process variables are considered with solutions to provide collaboration and transparency while maintaining competitive fixed pricing across the supply chain. Legal doctrine analysis is used to distinguish between design buildability obligations and design codes compliance. The model contributes towards the development of a standard form for pre-construction contracts