Adherence to two methods of education and metabolic control in Type 2 diabetics

BACKGROUND: Education in diabetes optimizes metabolic control, prevents acute and chronic complications, and improves quality of life. Our main objective was to evaluate if a better metabolic control is achieved in diabetic patients undergoing a program of intensive interactive care than in those with traditional care and written information.METHODS: Patients with type 2 diabetes mellitus (T2DM), aged 20-60 years, education level at least of primary school, serum creatinine . 2.5 mg/dl, self-sufficient and HbA1c . 7.1% were allocated in two groups of education, 1) minimal education (MEG) and 2) full education (FEG). The MEG patients followed predefined diet; FEG patients chose the diet by selecting foods from each group in a list of matches, teaching them to count nutrients, kilocalories (kcal) and percentage of nutrients.RESULTS: A follow-up of 31 patients in each group was obtained. The proportion of patients who had initial adherence was 13.33% in the MEG group and 9.67% in the FEG group while, at the end of the study, these percentages were of 73.3% and 58.38% respectively. The final HbA1c decreased in both groups, with or without good adherence. The FEG group had a higher decline in the values of cholesterol (p = 0.036) and LDL (p = 0.002) than the MEG group.CONCLUSION: Education programs in T2DM contribute to a decrease in HbA1c within six months, but an intensive program is more effective in reducing cholesterol and LDL.KEYWORDS: diabetes mellitus, education, metabolic control

Process evaluation of a community-based intervention promoting multiple maternal and neonatal care practices in rural Nepal

<p>Abstract</p> <p>Background</p> <p>The challenge of delivering multiple, complex messages to promote maternal and newborn health in the <it>terai </it>region of Nepal was addressed through training Female Community Health Volunteers (FCHVs) to counsel pregnant women and their families using a flipchart and a pictorial booklet that was distributed to clients. The booklet consists of illustrated messages presented on postcard-sized laminated cards that are joined by a ring. Pregnant women were encouraged to discuss booklet content with their families.</p> <p>Methods</p> <p>We examined use of the booklet and factors affecting adoption of practices through semi-structured interviews with district and community-level government health personnel, staff from the Nepal Family Health Program, FCHVs, recently delivered women and their husbands and mothers-in-law.</p> <p>Results</p> <p>The booklet is shared among household members, promotes discussion, and is referred to when questions arise or during emergencies. Booklet cards on danger signs and nutritious foods are particularly well-received. Cards on family planning and certain aspects of birth preparedness generate less interest. Husbands and mothers-in-law control decision-making for maternal and newborn care-seeking and related household-level behaviors.</p> <p>Conclusions</p> <p>Interpersonal peer communication through trusted community-level volunteers is an acceptable primary strategy in Nepal for promotion of household-level behaviors. The content and number of messages should be simplified or streamlined before being scaled-up to minimize intervention complexity and redundant communication.</p

Sandwich enzyme-linked immunosorbent assay (ELISA) analysis of plant cell wall glycan connections

Sandwich ELISA is a highly sensitive method that can be used to determine if two epitopes are part of the same macromolecule or supramolecular complex. In the case of plant cell wall glycans, it can reveal the existence of inter-polymers linkages, leading to better understanding of overall cell wall architectures. This development of a conventional sandwich ELISA protocol uses a carbohydrate-binding module (CBM), a small protein domain found in some carbohydrate catalysing or activating enzymes, and rat monoclonal antibodies (mAbs) which can be combined in the same ELISA plate without risk of cross reaction; the secondary anti-rat HRP antibody being only able to bind to the rat mAb and not the CBM. This protocol was developed and modified in the Prof. J. Paul Knox lab at the University of Leed

Lammi Kivitalot Oy:n teollisesti valmistettujen asuinrakennusten laadunvarmistusohje

Tämä opinnäytetyö on tehty Lammi-Kivitalot Oy:n tuotekehitysyksikölle. Tavoitteena oli luoda Lammi-Kivitalot Oy:lle laadunvarmistusohjeistus siten, että Lammi-Kivitalot Oy voi käyttää RT-kortin 80-10974 mukaisen laadunvarmistusohjeistuksen periaatteiden mukaisesti valmistamillansa asuinrakennuksilla ilmoitusmenettelyn mukaista vuotolukuarvoa. Tiukentuvat rakennusmääräykset ja energiatehokkuusvaatimukset ovat luoneet painetta rakennuksen ilmatiiveyden parantamiseksi. Rakennuksen ilmatiiveydellä on suuri merkitys rakennuksen asumisviihtyvyydelle, energiatehokkuudelle ja rakennuksen ulkovaipan rakennusfysikaaliselle toimivuudelle. Tutkimuksen lähtökohtana olivat Suomen ilmatiiveysmittaukseen liittyvät määräykset ja ohjeet. Aluksi perehdyttiin tiiviysmittauksia ohjaavaan standardiin SFS-EN 13829 sekä teollisesti valmistettujen asuinrakennusten laadunvarmistusohjeen ohjekorttiin RT 80-10974 sekä muihin aiheesta kirjoitettuihin teoksiin. Tutkimuksen teettäjä, Lammi Kivitalot Oy, halusi tutkituttaa koko tuotantoprosessinsa suunnittelusta valmiiseen asuinrakennukseen asti laadunvarmistusohjeistuksen mukaisesti. Tavoitteena oli tutkia ja kartoittaa prosessin heikot kohdat. Tavoitteena oli myös kehittää käytettyjä rakennedetaljeja ja kerätä työmailta arvokasta tietoa ja palautetta. Tämän tutkimuksen tuloksena parannettiin rakennedetaljit vastaamaan nykyisiä ilmatiiviysvaatimuksia. Asennuksen työohjeita parannettiin ja tämän tutkimuksen yhteydessä tehtiin yhtenäiset ilmatiiviysohjeet työmaille. Rakennustyömaan valvonnan helpottamiseksi koottiin vastaavalle työnjohtajalle valvonta-asiakirja, johon on kerätty ilmatiiveyteen liittyvät tärkeimmät työvaiheet. Rakennustietokortista 80-10974 löytyvän ilmoitusmenettelyn avulla saatiin Lammi Kivitalot Oy:n talotyypin suunnitteluarvoksi laskettua 1,0 m3/(h m2).The thesis was commissioned by Lammi Kivitalot Oy product development unit. The purpose of this study was to draw up quality control instructions for the company. The aim of the instructions is to enable the company to use the air leak value in residential buildings according to the principles set in RT 80-10974. The tightening building regulations and energy-efficiency requirements have put a pressure to improve the air tightness of the building. The air tightness of the building plays a significant role in the living comfort of the building, the energy-efficiency and in the building physical functionality of the envelope of the building. The regulations and instructions related to air tightness of buildings in Finland were studied. First, the standard SFS-EN 13829 directing air tightness measurements in Finland and the quality control instructions for residential buildings contained in RT 80-10974 were studied. The company’s whole manufacturing process all the way from the planning phase to the finished residential building was examined according to the quality control instructions to find the weak spots of the process. As a result of this thesis the structural details were improved to meet the present air tightness standards of residential buildings. The installation manuals were improved and the air tightness instructions were drawn up for the sites. A supervision document was compiled containing the most important stages related to the air tightness to help the supervision of the building site. The planning value for the house type manufactured by the company was calculated to be 1,0 m3/(h m2) based on the declaration method in RT 80-10974

LM6-M: A high avidity rat monoclonal antibody to pectic α-1,5-L-arabinan

1,5-arabinan is an abundant structural feature of side chains of pectic rhamnogalacturonan-I which is a matrix constituent of plant cell walls. The study of arabinan in cells and tissues is driven by putative roles for this polysaccharide in the generation of cell wall and organ mechanical properties. The biological function(s) of arabinan is still uncertain and high quality molecular tools are required to detect its occurrence and monitor its dynamics. Here we report a new rat monoclonal antibody, LM6-M, similar in specificity to the published rat monoclonal antibody LM6 (Willats et al. (1998) Carbohydrate Research 308: 149-152). LM6-M is of the IgM immunoglobulin class and has a higher avidity for α-1-5-L-arabinan than LM6. LM6-M displays high sensitivity in its detection of arabinan in in-vitro assays such as ELISA and epitope detection chromatography and in in-situ analyses