Postpartum care for Aboriginal and non-Aboriginal women with Gestational Diabetes Mellitus across urban, rural and remote locations : a protocol for a cohort linkage study

Background: Gestational diabetes mellitus (GDM) is increasing, along with obesity and type 2 diabetes (T2DM), with Aboriginal and Torres Strait Islander people* in Australia particularly affected. GDM causes serious complications in pregnancy, birth, and the longer term, for both women and their infants. Women diagnosed with GDM have an eightfold risk of developing T2DM after pregnancy, compared with women who have not had GDM. Indigenous women have an even higher risk, at a younger age, and progress more quickly from GDM to T2DM, compared to non-Indigenous women. If left undetected and untreated, T2DM can lead to heart disease, stroke, renal disease, kidney failure, amputations and blindness. A GDM diagnosis offers a ‘window of opportunity’ for diabetes health interventions and it is vital that acceptable and effective prevention, treatment, and post-pregnancy care are provided. Low rates of post-pregnancy screening for T2DM are reported among non-Aboriginal women in Australia and among Indigenous women in other countries, however data for Aboriginal women are scarce. Breastfeeding, a healthy diet, and exercise can also help to prevent T2DM, and together with T2DM screening are recommended elements of ‘post-pregnancy care’ for women with GDM, This paper describes methods for a data linkage study to investigate rates of post-pregnancy care among women with GDM. Methods/Design: This retrospective cohort includes all women who gave birth at Cairns Base Hospital in Far North Queensland, Australia, from 2004 to 2010, coded as having GDM in the Cairns Base Hospital Clinical Coding system. Data linkage is being conducted with the Queensland Perinatal Data Collection, and three laboratories. Hospital medical records are being reviewed to validate the accuracy of GDM case ascertainment, and gather information on breastfeeding and provision of dietary advice. Multiple logistic regression is being used to compare post-pregnancy care between Aboriginal and non-Aboriginal women, while adjusting for other factors may impact on post-pregnancy care. Survival analysis is being used to estimate the rates of progression from GDM to T2DM. Discussion: There are challenges to collecting post-pregnancy data for women with GDM. However, research is urgently needed to ensure adequate post-pregnancy care is provided for women with GDM in Australia.

Dengue or Kokobera? A case report from the top end of the Northern Territory

In early April 1998, the Centre for Disease Control in Darwin was notified of a possible case of dengue which appeared to have been acquired in the Northern Territory. Because dengue is not endemic to the Northern Territory, locally acquired infection has significant public health implications, particularly for vector identification and control to limit the spread of infection. Dengue IgM serology was positive on two occasions, but the illness was eventually presumptively identified as Kokobera infection. This case illustrates the complexity of interpreting flavivirus serology. Determining the cause of infection requires consideration of the clinical illness, the incubation period, the laboratory results and vector presence. Waiting for confirmation of results, before the institution of the public health measures necessary for a true case of dengue, was ultimately justified in this case. This is a valid approach in the Northern Territory, but may not be applicable to areas of Australia with established vectors for dengue. Commun Dis Intell 1998;22:105-107.

A case presenting diagnostic difficulties : making sense of flavivirus serology in the Top End of the Northern Territory

In early April 1998 the Centre for Disease Control (CDC) in Darwin was notified of a case with positive dengue serology. The illness appeared to have been acquired in the Northern Territory (NT). Because dengue is not endemic to the NT, locally acquired infection has significant public health implications, particularly for vector identification and control to limit the spread of infection. Dengue IgM serology was positive on two occasions but the illness was eventually presumptively identified as Kokobera infection. This case illustrates some important points about serology. The interpretation of flavivirus serology is complex and can be misleading, despite recent improvements. The best method of determining the cause of infection is still attempting to reconcile clinical illness details with incubation times and vector presence, as well as laboratory results. This approach ultimately justified the initial period of waiting for confirmatory results in this case, before the institution of public health measures necessary for a true case of dengue.

Associations with low rates of postpartum glucose screening after gestational diabetes among Indigenous and non-Indigenous Australian women

OBJECTIVES To explore factors associated with postpartum glucose screening among women with Gestational Diabetes Mellitus (GDM). METHODS A retrospective study using linked records from women with GDM who gave birth at Cairns Hospital in Far North Queensland, Australia, from 1 January 2004 to 31 December 2010. RESULTS The rates of postpartum Oral Glucose Tolerance Test (OGTT) screening, while having increased significantly among both Indigenous* and non-Indigenous women from 2004 to 2010 (HR 1.15 per year, 95%CI 1.08-1.22, p<0.0001), remain low, particularly among Indigenous women (10% versus 27%, respectively at six months postpartum). Indigenous women in Cairns had a longer time to postpartum OGTT than Indigenous women in remote areas (HR 0.58, 0.38-0.71, p=0.01). Non-Indigenous women had a longer time to postpartum OGTT if they: were born in Australia (HR 0.76, 0.59-1.00, 0.05); were aged <25 years (HR 0.45, 0.23-0.89, p=0.02); had parity >5 (HR 0.33, 0.12-0.90, p=0.03); smoked (HR 0.48, 0.31-0.76, p=0.001); and did not breastfeed (HR 0.09, 0.01-0.64, p=0.02). CONCLUSIONS Postpartum diabetes screening rates following GDM in Far North Queensland are low, particularly among Indigenous women, with lower rates seen in the regional centre; and among non-Indigenous women with indicators of low socioeconomic status. IMPLICATIONS Strategies are urgently needed to improve postpartum diabetes screening after GDM that reach women most at risk.

Broadside; For the German mothers of the 12000 Jewish soldiers who fell in combat during World War I Posters and Signs

An die deutschen Muetter! 12000 juedische Soldaten sind fuer das Vaterland auf dem Felde der Ehre gefallen. Christliche und juedische Helden haben gemeinsam gekaempft und ruhen gemeinsam in fremder Erde. 12000 Juden fielen im Kampf! Blindwuetiger Parteihass macht vor den Graebern der Toten nicht halt. Deutsche Frauen, duldet nicht, dass die juedische Muetter in ihrem Schmerz verhoehnt wird. Reichsbund juedischer Frontsoldaten e.V.

Unidentified family dressed in costume; Milan.

Handwritten caption: Mein Bruder Eduard links und Familie in Mailand Italien

Exterior view of expressionist painter Emil Luethy's home; Gotthardstr. 41 (Basel?) Architecture Residences Exterior

Handwritten on verso: zu obest mein Atelier (My studio on the top floor)

Exterior view of Josef Altschuler standing in the doorway of his joinery, Max Klamper Tischlermeister; Aßmayergasse 34, Wien XII (Vienna).

Josef Altschuler was the father of Robert Altschuler

Broadside; For the German mothers of the 12000 Jewish soldiers who fell in combat during World War I Posters and Signs

An die deutschen Muetter! 12000 juedische Soldaten sind fuer das Vaterland auf dem Felde der Ehre gefallen. Christliche und juedische Helden haben gemeinsam gekaempft und ruhen gemeinsam in fremder Erde. 12000 Juden fielen im Kampf! Blindwuetiger Parteihass macht vor den Graebern der Toten nicht halt. Deutsche Frauen, duldet nicht, dass die juedische Muetter in ihrem Schmerz verhoehnt wird. Reichsbund juedischer Frontsoldaten e.V.

Exterior view of expressionist painter Emil Luethy's home; Gotthardstr. 41 (Basel?) Architecture Residences Exterior

Handwritten on verso: zu obest mein Atelier (My studio on the top floor)

Photographs from Rueckblick und Blick in die Ferne.

To view photographs from this memoir online, please use the links below. If no links are available, please contact the LBI photo archivist.

Erzählungen für die reifere Jugend und ihre Kreise

Contents : Mein Sohn. - Das bunte Haus. - Klara. - Die Freunde

降雨条件下土壤入渗的规律研究

本文从描述非饱和土壤中水分流动的基本方程出发,对4种不同典型土壤在各种假定的均匀降雨速率下的入渗速率进行了数值模拟。结果表明,在降雨初期,由于降雨率低于入渗率,故全部雨量入渗,但当雨率大于入渗速率之后,入渗流动可以比拟为饱和水柱向非饱和区推进的柱塞流,其速率与饱和水柱长度成反比,而与分隔非饱和区与饱和水柱的湿润阵面上吸力大小成正比。如果对实际计算的吸力与Mein及Larson所推荐的理论计算吸力分别按各自最大吸力进行无量纲化,发现二者值吻合得很好。根据柱塞流这样一个概念,本文推导了决定入渗率等于雨率时的时间及该时的湿润锋面位置,并继而推导了在此以后,如果雨率永远大于入渗率情况下(并且不考虑地表有积水)入渗速率与湿润锋面位置的解析解,大大地简化了入渗率的工作量,具有实际应用的意义。

Studies on diversity of Hara's Laft-Khamir and Sout Beaches of the Gheshm polychaete

One of the most important marine ecologic phenomenon , is the study of animal community among the bed or benthic fauna. Macrobenthoses are the graet part of the benthic faune , that are more biomasses than meiofauna and microfauna. To study polychaetes diversity of Mangroves, located in Khoore-Khooran , sampling was conducted on a bimonthly and carried out from December 2001 to October 2002. Bottom samples were collected by Van Veen grab (0.025 m2)at 6 station from 2 transect Insitu measurement of temperature , pH , Do and salinity were done . Atotal of polychaetes werw identified within study 32 Family and 43 Genus . Cirriphormia and Nephtys were the most dominant genus in the studies . The range fomumerical abundance of polychaets was between 3006 per m2 in the station A3 to 559individual per mein the station A1 and the variation was done to different bottom , texture the variable environment conditions govrtneng the different parts of each creeks as well as within creeks . Application of diversity indices (Shannon H') on the dominant polychates assambladges has higher H' in the Azar and lower 1-1/ in the Mehr . and the stations B3 has the highest H' and the station A2 has the lowest H' Application of diversity and Richness, Evennes were studied and showed that the station A3 has the lowest evenness and the most individual , and station A1 has the middle pollution.