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?Asian patients with type 2 diabetes in the UK have a higher cardiovascular risk and present with cardiovascular events at a significantly younger age than white Europeans. Enhanced and ethnicity specific targets and effective treatments are needed if these inequalities are to be reduced.

What factors influence concordance with medications? Findings from the UK Asian Diabetes study

Aims: To investigate concordance with medication, as assessed at baseline and at 1- and 2-year follow-up, and to examine factors associated with non-concordance in a UK-resident South-Asian population. Methods: Data from the UK Asian Diabetes Study were analysed. Concordance with medications was assessed and recorded at three time points during the study. Multiple logistic regression was used to investigate the factors associated with non-concordance; the associations of baseline factors with year 1 concordance and baseline plus year 1 factors with year 2 concordance. Results: Data for 403 patients from seven practices participating in the UK Asian Diabetes Study were analysed. The numbers of patients who were non-concordant were: 63 (16%) at baseline 101 (25%) at year 1; and 122 (30%) at year 2. The baseline-measured variables that were significantly associated with year 1 non-concordance included diabetes duration, history of cardiovascular disease, components of the EuroQol quality of life questionnaire, the EQ-5D score, and number of medications prescribed. In multivariable analyses, the most important determinant of year 1 non-concordance was baseline non-concordance: odds ratio 13.6 (95% confidence limits 4.7, 39.9). Number of medications prescribed for blood pressure control was also significant: odds ratio 1.8 (95% confidence limits 1.4, 2.4). Similar results were observed for year 2 non-concordance. Conclusions: Non-concordance with medications was common and more likely in people prescribed more medications. The current target-driven management of risk factor levels may lead to increasing numbers and doses of medications. Considering the high cost of medications and the implications of poor health behaviours on morbidity and mortality, further investigation of prescribing behaviours and the factors affecting patient concordance are required.

Pivot or periphery? Xinjiang's regional development and Chinese-Central Asian relations at the century's end

Xinjiang, once described by Owen Lattimore as the "pivot of Asia", has played a strategically important role in China's national defense and security. Historically linked on the famous Silk Road with Central Asia, Xinjiang was crucial to East-West economic and cultural exchanges. During the period of Russian/Soviet expansion into Central Asia and Sino-Soviet rivalry, China's need for Xinjiang's defense and territorial integrity became paramount, and consequently Xinjiang's economy was relegated to the periphery.^ The demise of the Soviet Union--which resulted in the independence of five Central Asian states--and China's reform suggest dramatic new possibilities for Xinjiang's regional development as well as interregional cooperation. As China has begun to shift regional emphasis to the interior, Xinjiang's economic development will be accelerated. With the growth of Sino/Xinjiang-Central Asian relations, Xinjiang's importance will not only be borne out in terms of defense and security, but more significantly in terms of trade and economics. At the century's end and the beginning of the 21st century, Xinjiang will likely move away from the periphery and play an increasingly pivotal role in the economy. ^

Molecular markers and human history: A tale of two haplogroup systems

To chronicle demographic movement across African Asian corridors, a variety of molecular (sequence analysis, restriction mapping and denaturing high performance liquid chromatography etc.) and statistical (correspondence analysis, AMOVA, calculation of diversity indices and phylogenetic inference, etc.) techniques were employed to assess the phylogeographic patterns of mtDNA control region and Y chromosomal variation among 14 sub-Saharan, North African and Middle Eastern populations. The patterns of genetic diversity revealed evidence of multiple migrations across several African Asian passageways as well within the African continent itself. The two-part analysis uncovered several interesting results which include the following: (1) a north (Egypt and Middle East Asia) to south (sub-Saharan Africa) partitioning of both mtDNA and Y chromosomal haplogroup diversity, (2) a genetic diversity gradient in sub-Saharan Africa from east to west, (3) evidence in favor of the Levantine Corridor over the Horn of Africa as the major genetic conduit since the Last Glacial Maximum, (4) a substantially higher mtDNA versus Y chromosomal sub-Saharan component in the Middle East collections, (5) a higher representation of East versus West African mtDNA haplotypes in the Arabian Peninsula populations versus no such bias in the Levant groups and lastly, (6) genetic remnants of the Bantu demographic expansion in sub-Saharan Africa. ^

History education and the construction of national identity in Iran

This study examined the representation of national and religious dimensions of Iranian history and identity in Iranian middle school history textbooks. Furthermore, through a qualitative case study in a school in the capital city of Tehran, teachers' use of textbooks in classrooms, students' response, their perceptions of the country's past, and their definitions of national identity is studied. The study follows a critical discourse analysis framework by focusing on the subjectivity of the text and examining how specific concepts, in this case collective identities, are constructed through historical narratives and how social actors, in this case students, interact with , and make sense of, the process. My definition of national identity is based on the ethnosymbolism paradigm (Smith, 2003) that accommodates both pre-modern cultural roots of a nation and the development and trajectory of modern political institutions. Two qualitative approaches of discourse analysis and case study were employed. The textbooks selected were those published by the Ministry of Education; universally used in all middle schools across the country in 2009. The case study was conducted in a girls' school in Tehran. The students who participated in the study were ninth grade students who were in their first year of high school and had just finished a complete course of Iranian history in middle school. Observations were done in history classes in all three grades of the middle school. The study findings show that textbooks present a generally negative discourse of Iran's long history as being dominated by foreign invasions and incompetent kings. At the same time, the role of Islam and Muslim clergy gradually elevates in salvaging the country from its despair throughout history, becomes prominent in modern times, and finally culminates in the Islamic Revolution as the ultimate point of victory for the Iranian people. Throughout this representation, Islam becomes increasingly dominant in the textbooks' narrative of Iranian identity and by the time of the Islamic Revolution morphs into its single most prominent element. On the other hand, the students have created their own image of Iran's history and Iranian identity that diverges from that of the textbooks especially in their recollection of modern times. They have internalized the generally negative narrative of textbooks, but have not accepted the positive role of Islam and Muslim clergy. Their notion of Iranian identity is dominated by feelings of defeat and failure, anecdotal elements of pride in the very ancient history, and a sense of passivity and helplessness.

The Kyoto School and Confucianism: a Confucian reading of the philosophy of history and political thought of Masaaki Kosaka

This dissertation examines the philosophy of Masaaki Kōsaka (1900-1969) from the East Asian perspective of Confucianism, which I believe is the most appropriate moral paradigm for comprehending his political speculations. Although largely neglected in post-war scholarship, Kōsaka was a prominent member of the Kyoto School during the 1930s and 40s. This was a group of Japanese thinkers strongly associated with the philosophies of Kitarō Nishida and Hajime Tanabe. Kōsaka is now best known for his participation in the three Chūō Kōron symposia held in 1941 and 1942. These meetings have been routinely denounced by liberal historians due to the participants’ support for the Pacific War and the Co-Prosperity Sphere. However, many of these liberal portrayals have failed to take into account the full extent of the group’s resistance to the military junta of Hideki Tōjō. Adopting the methods and techniques of the empirical disciplines of academic history and Orientalism, I develop an interpretative framework that is more receptive to the political values that mattered to Kōsaka as a Confucian inspired intellectual. This has necessitated the rejection of moral history, which typically prioritises modern liberal values brought a priori to the historical record of wartime Japan, as well as recognition of the different ontological foundations that inform the unique political theories of the East Asian intellectual tradition. Reinforced by the prior research of Michel Dalissier and Graham Parkes, as well as my own reading of the Confucian canon, I adopt David Williams’s thesis of ‘Confucian Revolution’ as my principle schema of interpretation. This, I believe, is better able to reconcile Kōsaka’s support for the war with his strong condemnation of the imperialist practices of the Japanese military. Moreover, acknowledging the importance of Confucianism allows us to fully appreciate Kōsaka’s strong affinity for Kant’s practical metaphysics, Hegel’s political philosophy and Ranke’s historiography.

The Japanese History Textbook Controversy Amid Post-War Sino-Japanese Relations

The relations between China and Japan are strained and continue to foster negative emotions partly because of China’s grievances about Japan’s actions during World War II and the allegedly false historiographical accounts found in Japanese history textbooks. This study will utilize historical analysis of the events leading up to the Nanjing Massacre in December of 1937, examine the Japanese Ministry of Education’s (MEXT) critical and contentious role in the selection of textbooks, used for primary and secondary schools, and will also juxtapose the controversial 2001 Atarashii rekishi kyōkasho with current Japanese history textbooks. The study will also include a syntactical analysis of key terms through my own original translations of multiple Japanese history textbooks, which are currently used in the Japanese school curriculum, to reveal that the textbook publishers, MEXT, and regulation councils are involved in adjusting the content causing the information to reveal various degrees of whitewashing.

[how The Gynecologist Can Guide Women With A Family History Of Cancer?].

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Natural history and population data of fishes in caves of the Serra do Ramalho karst area, Middle São Francisco basin, northeastern Brazil

During the exploration and mapping of new caves in Serra do Ramalho karst area, southern Bahia state, cavers from the Grupo Bambuí de Pesquisas Espeleológicas - GBPE (Belo Horizonte) noticed the presence of troglomorphic catfishes (species with reduced eyes and/or melanic pigmentation), which we intensively investigated with regards to their ecology and behavior since 2005. Non-troglomorphic fishes regularly found in the studied caves were included in this investigation. We present here data on the natural history of two troglobitic (exclusively subterranean troglomorphic species) fishes - Rhamdia enfurnada Bichuette & Trajano, 2005 (Heptapteridae; Gruna do Enfurnado) and Trichomycterus undescribed species (Trichomycteridae; Lapa dos Peixes and Gruna da Água Clara), and non-troglomorphic Hoplias cf. malabaricus, probably a troglophile (able to form populations both in epigean and subterranean habitats) in the Gruna do Enfurnado, and Pimelodella sp., a species with a sink population in the Lapa dos Peixes.

Ecology and natural history of Akodon lindberghi (Rodentia, Sigmodontinae) in southeastern Brazil

We studied the ecology and natural history of the globally threatened and poorly known Akodon lindberghi Hershkovitz, 1990 in Parque Nacional da Serra da Canastra (PNSC) and Juiz de Fora (JF), southeastern Brazil. From November 1998 to September 2001 a total of 131 individuals were captured in wire-cage live-traps and 52 by pitfalls traps. They were all marked and released at the site. The largest abundances were registered during the dry season, and most of the captures occurred in open habitats. The mean body mass of the two populations was significantly different (18.1 g at PNSC versus 13.1 g at JF; H = 46.2678, g.l.=2, p<0.001). In PNSC, individuals were reproductively active from August to February, and juveniles were present from May to August. The results suggest that the changes in vegetation structure caused by deforestation and intensive agricultural activities could increase the predation rate, affecting the mean body mass of the population.

New data on the natural history and description of the immatures of Fulgeochlizus bruchi, a bioluminescent beetle from Central Brazil (Elateridae, Pyrophorini)

The mature larva and pupa of Fulgeochlizus bruchi (Candèze, 1896) are described and illustrated. Bioluminescent patterns are also given. Comments, new data on the first instar larva and natural history data are presented. The first instar larvae differ from the mature larvae mainly in their chaetotaxy, which is sparse and more symmetrically distributed.

Calibration of the dietary data obtained from the Brazilian center of the Natural History of HPV Infection in Men study: the HIM Study

The objective of this study was to estimate the regressions calibration for the dietary data that were measured using the quantitative food frequency questionnaire (QFFQ) in the Natural History of HPV Infection in Men: the HIM Study in Brazil. A sample of 98 individuals from the HIM study answered one QFFQ and three 24-hour recalls (24HR) at interviews. The calibration was performed using linear regression analysis in which the 24HR was the dependent variable and the QFFQ was the independent variable. Age, body mass index, physical activity, income and schooling were used as adjustment variables in the models. The geometric means between the 24HR and the calibration-corrected QFFQ were statistically equal. The dispersion graphs between the instruments demonstrate increased correlation after making the correction, although there is greater dispersion of the points with worse explanatory power of the models. Identification of the regressions calibration for the dietary data of the HIM study will make it possible to estimate the effect of the diet on HPV infection, corrected for the measurement error of the QFFQ.