Diabetic patients detected by population-based stepwise screening already have a diabetic cardiovascular risk profile

OBJECTIVE - To describe a population-based two-step screening procedure for type 2 diabetes and to study the cardiovascular risk profile of the patients identified by the screening. RESEARCH DESIGN AND METHODS - The first step of the screening procedure consisted of the Symptom Risk Questionnaire (SRQ), and the second step was a fasting capillary glucose measurement. In subjects with an SRQ score of >6 and a capillary glucose level of >5.5 mmol/l, an oral glucose tolerance test was performed. RESULTS - A total of 11,679 inhabitants of the West-Friesland region of the Netherlands, aged 50-75 years, were invited. Of the inhabitants, 9,169 (78%) responded, and, of those, 417 had previously diagnosed diabetes. The SRQ score was calculated for 7,736 participants, and 3,301 of those had a score of >6. A total of 2,885 subjects (87.3%) attended for capillary glucose measurement. Diagnostic testing was carried out in 509 participants, and we identified 217 diabetic patients. In these patients detected by screening, mean Hb

'Balance': the development of a social enterprise business performance analysis tool

Social enterprise managers are challenged to constantly adapt to ever-changing environments; a balancing act requiring strategic reflection and analysis to achieve ongoing sustainability. Performance measurement through business analysis tools may offer organisations help in managing this process. This paper outlines the development of a sector specific business performance measurement tool – ‘Balance’, grounded in the business practices of social enterprises after in-depth qualitative research. Drawing on Kaplan and Norton’s Balanced Scorecard, and Kolb and Fry’s organisational learning cycle as the conceptual framework, the paper explains how the tool was designed. The paper analyses results of a pilot phase of 30 social enterprises utilizing the Balance tool. The research findings provide a snapshot of the business capabilities of social enterprises and by highlighting both strengths and areas where greater support may be required the research has both policy and practitioner implications. It is envisaged such a tool may therefore be a catalyst in generating stronger social businesses that capitalise on opportunities and generate change through offering viable alternatives to the private sector

A psychophysiological investigation of the interplay between orienting and executive control during stimulus conflict: A heart rate variability study

Background It has been hypothesized that resting state cardiac vagal activity (CVA) - an indicator of parasympathetic nervous system activity - is a specific psychophysiological marker of executive control function. Here, we propose an alternative hypothesis - that CVA is associated with early stage attention orientation, promoting the flexible uptake of new information, on which the later operation of such executive control functions depends. We therefore predicted that CVA would predict the interaction between orienting and executive control. This was tested using the revised version of the Attention Network Test (ANT-R) that was developed to distinguish between orienting and executive attention during a stimulus conflict task. Methods Healthy adults (N = 48) performed the ANT-R and their resting CVA was measured over a 5 min period using ECG recordings. Results Multiple regression analyses indicated that, when other factors were controlled for, CVA was more strongly associated with the interaction between the orienting and executive control terms than with either factor individually. Conclusion Higher levels of CVA are specifically implicated in the modulation of executive control by intrinsic orientation operating at early stages of conflict detection. These initial findings of higher CVA on orienting attention in conflict detection need to be replicated in larger samples

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Organization of olfactory centres in the malaria mosquito Anopheles gambiae

Mosquitoes are vectors for multiple infectious human diseases and use a variety of sensory cues (olfactory, temperature, humidity and visual) to locate a human host. A comprehensive understanding of the circuitry underlying sensory signalling in the mosquito brain is lacking. Here we used the Q-system of binary gene expression to develop transgenic lines of Anopheles gambiae in which olfactory receptor neurons expressing the odorant receptor co-receptor (Orco) gene are labelled with GFP. These neurons project from the antennae and maxillary palps to the antennal lobe (AL) and from the labella on the proboscis to the suboesophageal zone (SEZ), suggesting integration of olfactory and gustatory signals occurs in this brain region. We present detailed anatomical maps of olfactory innervations in the AL and the SEZ, identifying glomeruli that may respond to human body odours or carbon dioxide. Our results pave the way for anatomical and functional neurogenetic studies of sensory processing in mosquitoes