Premature cardiovascular events and mortality in south Asians with type 2 diabetes in the United Kingdom Asian Diabetes Study - effect of ethnicity on risk

Background/Aim - People of south Asian origin have an excessive risk of morbidity and mortality from cardiovascular disease. We examined the effect of ethnicity on known risk factors and analysed the risk of cardiovascular events and mortality in UK south Asian and white Europeans patients with type 2 diabetes over a 2 year period. Methods - A total of 1486 south Asian (SA) and 492 white European (WE) subjects with type 2 diabetes were recruited from 25 general practices in Coventry and Birmingham, UK. Baseline data included clinical history, anthropometry and measurements of traditional risk factors – blood pressure, total cholesterol, HbA1c. Multiple linear regression models were used to examine ethnicity differences in individual risk factors. Ten-year cardiovascular risk was estimated using the Framingham and UKPDS equations. All subjects were followed up for 2 years. Cardiovascular events (CVD) and mortality between the two groups were compared. Findings - Significant differences were noted in risk profiles between both groups. After adjustment for clustering and confounding a significant ethnicity effect remained only for higher HbA1c (0.50 [0.22 to 0.77]; P?=?0.0004) and lower HDL (-0.09 [-0.17 to -0.01]; P?=?0.0266). Baseline CVD history was predictive of CVD events during follow-up for SA (P?

Comparative risk of microalbuminuria and proteinuria in UK residents of south Asian and white European ethnic background with type 2 diabetes:a report from UKADS

Objective - This study investigated and compared the prevalence of microalbuminuria and overt proteinuria and their determinants in a cohort of UK resident patients of white European or south Asian ethnicity with type 2 diabetes mellitus. Research design and methods - A total of 1978 patients, comprising 1486 of south Asian and 492 of white European ethnicity, in 25 general practices in Coventry and Birmingham inner city areas in England were studied in a cross-sectional study. Demographic and risk factor data were collected and presence of microalbuminuria and overt proteinuria assessed. Main outcome measures - Prevalences of microalbuminuria and overt proteinuria. Results - Urinary albumin:creatinine measurements were available for 1852 (94%) patients. The south Asian group had a lower prevalence of microalbuminuria, 19% vs. 23% and a higher prevalence of overt proteinuria, 8% vs. 3%, X2?=?15.85, 2df, P?=?0.0004. In multiple logistic regression models, adjusted for confounding factors, significantly increased risk for the south Asian vs. white European patients for overt proteinuria was shown; OR (95% CI) 2.17 (1.05, 4.49), P?=?0.0365. For microalbuminuria, an interaction effect for ethnicity and duration of diabetes suggested that risk for south Asian patients was lower in early years following diagnosis; OR for SA vs. WH at durations 0 and 1 year were 0.56 (0.37, 0.86) and 0.59 (0.39, 0.89) respectively. After 20 years’ duration, OR?=?1.40 (0.63, 3.08). Limitations - Comparability of ethnicity defined groups; statistical methods controlled for differences between groups, but residual confounding may remain. Analyses are based on a single measure of albumin:creatinine ratio. Conclusions - There were significant differences between ethnicity groups in risk factor profiles and microalbuminuria and overt proteinuria outcomes. Whilst south Asian patients had no excess risk of microalbuminuria, the risk of overt proteinuria was elevated significantly, which might be explained by faster progression of renal dysfunction in patients of south Asian ethnicity.

White working-class neighbourhoods:common themes and policy suggestions

What does it mean to be white and working class in modern Britain? The Joseph Rowntree Foundation’s studies of traditionally white estates in Bradford, London, Coventry and Birmingham are part of a growing body of research into ‘white identities’. This paper: • identifies common findings from JRF research into traditionally white estates, in the context of other similar work; • suggests how issues of white identity can be better understood and makes recommendations for policy and practice. Key points: • Profound economic and social change has increased isolation and fear in traditionally white estates. Residents often claim that things were better in the past. • ‘Estatism’ refers to specific social dynamics associated with council estates and prejudice towards residents based on where they live. This can result in lowered self-esteem and reluctance to participate in community campaigns. • People on traditionally white estates often feel they are not listened to by outside agencies. Consultations can raise hopes but ultimately reinforce disengagement. Initiatives to ensure equality have become associated with political correctness (‘PC’). • White working-class people feel they are bound by values of hard work, reciprocity and support. They are frustrated by the closure and lack of access to community facilities. The social class system simultaneously disadvantages the working class while giving advantage to other classes. • There is a strong desire for allocation of resources to be fair, with a widespread perception that minorities are given preference. Blaming incomers for decline is common, with the target of blame differing between sites. Participants did not want to be considered racist and felt that labelling ideas as racist prevents discussion. Similarly, the term ‘PC’ can also be used to shut down debate. • Recommendations include community-twinning, new ways of accessing local authorities, involvement from the private sector in disadvantaged areas and local panels to define and develop the ‘Big Society’. Initiatives aimed solely at white working-class people are unlikely to be successful.

Investigating tiredness and ad complexity effects on visual processing of advertisements:an eye-tracking study

Although advertising is pervasive in our daily, it proves to be not necessarily efficient all the times due to bad conditions or bad contexts of reception. Indeed, the communication process might be jeopardized at its very last stage because of advertising exposure quality. However critical it may be, ad exposure quality is not very much examined by researchers or practitioners. In this paper, we investigate how tiredness combined with ad complexity might influence the way consumers extract and process ad elements. Investigating tiredness is useful because it is a common daily state experienced by everyone at various moments of the day. And although it might drastically alter ad reception, it has not been studied in advertising for the moment. In this regards, we observe eye movement patterns of consumers viewing simple or complex advertisements being tired or not. We surprisingly find that tired subjects viewing complex ads don’t adopt a lessening effort visual strategy. They rather use a resource demanding one. We assume that the Sustained Attention strategy occurring is a kind of adaptive strategy allowing to deal with an anticipated lack of resource.

Resolving ambiguous descriptions through visual information

The project “Reference in Discourse” deals with the selection of a specific object from a visual scene in a natural language situation. The goal of this research is to explain this everyday discourse reference task in terms of a concept generation process based on subconceptual visual and verbal information. The system OINC (Object Identification in Natural Communicators) aims at solving this problem in a psychologically adequate way. The system’s difficulties occurring with incomplete and deviant descriptions correspond to the data from experiments with human subjects. The results of these experiments are reported.

Impact of electric vehicles on GB electricity demand and associated benefits for system control

This paper investigates the impact that electric vehicle uptake will have on the national electricity demand of Great Britain. Data from the National Travel Survey, and the Coventry and Birmingham Low Emissions Demonstration (CABLED) are used to model an electrical demand profile in a future scenario of significant electric vehicle market penetration. These two methods allow comparison of how conventional cars are currently used, and the resulting electrical demand with simple substitution of energy source, with data showing how electric vehicles are actually being used at present. The report finds that electric vehicles are unlikely to significantly impact electricity demand in GB. The paper also aims to determine whether electric vehicles have the potential to provide ancillary services to the grid operator, and if so, the capacity for such services that would be available. Demand side management, frequency response and Short term Operating Reserve (STOR) are the services considered. The report finds that electric cars are unlikely to provide enough moveable demand peak shedding to be worthwhile. However, it is found that controlling vehicle charging would provide sufficient power control to viably act as frequency response for dispatch by the transmission system operator. This paper concludes that electric vehicles have technical potential to aid management of the transmission network without adding a significant demand burden. © 2013 IEEE.

Low-emission vehicle adoption in a UK local authority fleet:economic barriers and air quality benefits

Local air quality was one of the main stimulants for low carbon vehicle development during the 1990s. Issues of national fuel security and global air quality (climate change) have added pressure for their development, stimulating schemes to facilitate their deployment in the UK. In this case study, Coventry City Council aimed to adopt an in-house fleet of electric and hybrid-electric vehicles to replace business mileage paid for in employee's private vehicles. This study made comparisons between the proposed vehicle technologies, in terms of costs and air quality, over projected scenarios of typical use. The study found that under 2009 conditions, the electric and hybrid fleet could not compete on cost with the current business model because of untested assumptions, but certain emissions were significantly reduced >50%. Climate change gas emissions were most drastically reduced where electric vehicles were adopted because the electricity supply was generated by renewable energy sources. The study identified the key cost barriers and benefits to adoption of low-emission vehicles in current conditions in the Coventry fleet. Low-emission vehicles achieved significant air pollution-associated health cost and atmospheric emission reductions per vehicle, and widespread adoption in cities could deliver significant change. © The Author 2011. Published by Oxford University Press. All rights reserved.