120 research outputs found

    Diabetes and lipid screening among patients in primary care: A cohort study

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    <p>Abstract</p> <p>Background</p> <p>Obesity is associated with increased cardiovascular diseases and diabetes mellitus. Guidelines call for intensified glucose and lipid screening among overweight and obese patients. Data on compliance with these guidelines are scarce. The purpose of this study was to assess rates of diabetes and lipid screening in primary care according to demographic variables and weight status.</p> <p>Methods</p> <p>Over a 3-year follow-up period, we assessed screening rates for blood glucose, triglycerides, and HDL- and LDL-cholesterol among 5025 patients in primary care. From proportional hazards models we estimated screening rates among low, moderate, high, and very-high risk patients and compared them with recommendations of the American Diabetes Association (ADA), National Cholesterol Education Program (ATP III) and U.S. Preventive Services Task Force (USPSTF).</p> <p>Results</p> <p>Mean (SD) age was 47.4 (15.6); 69% were female, 21% were non-white, and 30% of males and 25% of females were obese (BMI ≥ 30 kg/m<sup>2</sup>). For both diabetes and lipid screening, the adjusted hazard was 260–330% higher among ≥65 than <35 year-olds, 50–90% higher in persons with BMI ≥ 35 than <25 kg/m<sup>2</sup>, 10–30% lower for females than males, and not lower among racial/ethnic minorities. Screening rates were at least 80% among very-high risk persons, which we defined as 55–64 years old, BMI ≥ 35 kg/m<sup>2</sup>, non-white, with baseline hypertension. In contrast, high-risk persons who were younger (35–44 years old) and less obese (BMI 30–<35 kg/m<sup>2</sup>) were screened less often (43% for LDL-cholesterol among females to 83% for diabetes among males) even though ADA, ATP III and USPSTF recommend diabetes and lipid screening among them.</p> <p>Conclusion</p> <p>Patients with higher BMI or age were more likely to be screened for cardiometabolic risk factors. Women were screened at lower rates than men. Even in a highly structured medical group practice, some obese patients were under-screened for diabetes and dyslipidemia.</p

    17 ways to say yes:Toward nuanced tone of voice in AAC and speech technology

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    People with complex communication needs who use speech-generating devices have very little expressive control over their tone of voice. Despite its importance in human interaction, the issue of tone of voice remains all but absent from AAC research and development however. In this paper, we describe three interdisciplinary projects, past, present and future: The critical design collection Six Speaking Chairs has provoked deeper discussion and inspired a social model of tone of voice; the speculative concept Speech Hedge illustrates challenges and opportunities in designing more expressive user interfaces; the pilot project Tonetable could enable participatory research and seed a research network around tone of voice. We speculate that more radical interactions might expand frontiers of AAC and disrupt speech technology as a whole

    Commemorating the First World War in Britain: A Cultural Legacy of Media Remembrance

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    One of the often-overlooked legacies of the First World War is how the conflict established the media’s role in remembrance. In the years that have followed, media’s circulation of iconic images of national and local commemoration have enabled individuals to engage with public remembrance. This article takes a historical approach to First World War remembrance in Britain, looking at how the practices and meaning of remembrance became established, although they were never fixed but instead constantly shifting, reinvented and contested. They are also gendered, in remembrance, as in war, women, are often seen as to be playing supportive roles; yet within media texts, women have always found spaces to exert influence over who is remembered and how, as memories jostle for prominence

    A broken silence? Mass Observation, Armistice Day and ‘everyday life’ in Britain 1937–1941

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    Between 1937 and 1941 the social survey organization Mass Observation collected material on the ways that the British people experienced and thought about the commemorative practices that marked the anniversary of the Armistice of 1918. What they found was that while people were largely united in their observation of the rituals of remembrance, their thoughts and feelings about these practices were diverse. For some, the acts of commemoration were a fitting way to pay tribute to both the dead and the bereaved. For others, these acts were hypocritical in a nation preparing for war. This article draws on the Mass Observation material to trace some of the diverse ways that remembrance was embodied in everyday life, practised, experienced and understood by the British people as the nation moved once again from peace to war, arguing that studies of the practices of remembrance alone tell us little about how they have been understood by participants
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