Sensibilidad a la insulina mediante la prueba de tolerancia oral a la glucosa en adultos mayores en el cantón Cuenca, en el año 2015

INTRODUCCIÓN: Si se valora a tiempo la Sensibilidad a la insulina, se evitara padecer diabetes tipo 2; en los adultos mayores hay cambios como el aumento de tejido adiposo y sarcopenia, relacionados con disminución de la sensibilidad a la insulina. OBJETIVO: Determinar la sensibilidad a la insulina mediante la prueba de tolerancia oral a la glucosa en la población adulta mayor del cantón Cuenca, en el año 2015. METODOLOGÍA: Estudio descriptivo en 120 adultos mayores del cantón Cuenca; 60 casos con síndrome metabólico según el criterio ATP III y 60 casos sin síndrome metabólico. Se trata de una muestra no probabilística por conveniencia debido al costo de las pruebas de laboratorio. Se tomaron dos muestras de sangre una en ayunas y otra postprandial y se dosifico glucosa e insulina. Los datos fueron analizados en SPSS 22, Excel empleando frecuencias, porcentajes, medidas de tendencia central como mediana, promedio, medidas de dispersión, desvío stándar. RESULTADOS: El 39,2 % de adultos mayores presentó insulinemia postprandial alterada. Según el método HOMA-IR el 42 % presenta baja sensibilidad a la insulina y según el método QUICKI el 91,7 % presenta sensibilidad disminuida a la insulina. La baja sensibilidad a la insulina según género, edad y estado civil no fue significativa; en cambio con el IMC elevado se tiene más probabilidad de padecer insulinorresistencia (p=0,03) .Siendo más significativo los pacientes con síndrome metabólico aumenta dos veces la probabilidad de padecer insulinorresistencia (p=0.02, OR 2.3 IC 95% 1.09 – 4.85)

Sensibilidad a la insulina mediante la prueba de tolerancia oral a la glucosa en adultos mayores en el cantón Cuenca, en el año 2015

INTRODUCCIÓN: Si se valora a tiempo la Sensibilidad a la insulina, se evitara padecer diabetes tipo 2; en los adultos mayores hay cambios como el aumento de tejido adiposo y sarcopenia, relacionados con disminución de la sensibilidad a la insulina. OBJETIVO: Determinar la sensibilidad a la insulina mediante la prueba de tolerancia oral a la glucosa en la población adulta mayor del cantón Cuenca, en el año 2015. METODOLOGÍA: Estudio descriptivo en 120 adultos mayores del cantón Cuenca; 60 casos con síndrome metabólico según el criterio ATP III y 60 casos sin síndrome metabólico. Se trata de una muestra no probabilística por conveniencia debido al costo de las pruebas de laboratorio. Se tomaron dos muestras de sangre una en ayunas y otra postprandial y se dosifico glucosa e insulina. Los datos fueron analizados en SPSS 22, Excel empleando frecuencias, porcentajes, medidas de tendencia central como mediana, promedio, medidas de dispersión, desvío stándar. RESULTADOS: El 39,2 % de adultos mayores presentó insulinemia postprandial alterada. Según el método HOMA-IR el 42 % presenta baja sensibilidad a la insulina y según el método QUICKI el 91,7 % presenta sensibilidad disminuida a la insulina. La baja sensibilidad a la insulina según género, edad y estado civil no fue significativa; en cambio con el IMC elevado se tiene más probabilidad de padecer insulinorresistencia (p=0,03) .Siendo más significativo los pacientes con síndrome metabólico aumenta dos veces la probabilidad de padecer insulinorresistencia (p=0.02, OR 2.3 IC 95% 1.09 – 4.85).

Oral food perception and polyphenol-rich foods acceptance - the importance of knowing individuals saliva characteristics for promoting consumption

Polyphenols are widely present in fruits, vegetables, cereals and beverages. Their study gained scientific interest because of their beneficial effects on health. Although there is currently no official dietary recommendation for polyphenol intake, health professionals recommend the consumption of 5-8 daily portions of fruits and vegetables. This is not always achieved and, despite possible causes associated to practical schedule difficulties, the aversive bitter and astringent sensations associated to polyphenols may also lead to avoidance. As such, a better understanding on mechanisms responsible for differences among people, in polyphenol oral perception, is needed for promoting healthier choices. Saliva has been linked to polyphenol consumption. We have previously observed, in animal models, changes in salivary proteome induced by tannin-enriched diets. Moreover, differences in astringency perception were attributed to differences in salivary protein composition. In a recent experiment, we observed differences among individuals with dissimilar tannic-acid perception: people with high sensitivity for the oral sensations elicited by tannins have higher amounts of salivary cystatins and lower capacity to maintain their levels after tannic-acid ingestion. Additionally, and similarly to previous studies, salivary amylase was observed to be involved in tannin perception. In this presentation, oral cavity characteristics influencing the perception of polyphenol-containing foods will be discussed.

Screening for drugs in oral fluid : illicit drug use and drug driving in a sample of urban and regional Queensland motorists

Police services in a number of Australian states and overseas jurisdictions have begun to implement or consider random road-side drug testing of drivers. This paper outlines research conducted to provide an estimate of the extent of drug driving in a sample of Queensland drivers in regional, rural and metropolitan areas. Oral fluid samples were collected from 2657 Queensland motorists and screened for illicit substances including cannabis (delta 9 tetrahydrocannibinol [THC]), amphetamines, ecstasy, and cocaine. Overall, 3.8% of the sample (n = 101) screened positive for at least one illicit substance, although multiple drugs were identified in a sample of 23 respondents. The most common drugs detected in oral fluid were ecstasy (n = 53), and cannabis (n = 46) followed by amphetamines (n = 23). A key finding was that cannabis was confirmed as the most common self-reported drug combined with driving and that individuals who tested positive to any drug through oral fluid analysis were also more likely to report the highest frequency of drug driving. Furthermore, a comparison between drug vs. drink driving detection rates for one region of the study, revealed a higher detection rate for drug driving (3.8%) vs. drink driving (0.8%). This research provides evidence that drug driving is relatively prevalent on Queensland roads, and may in fact be more common than drink driving. This paper will further outline the study findings’ and present possible directions for future drug driving research.

Orals ain't orals : how instruction and assessment practices affect delivery choices with prepared student oral presentations.

Despite an ostensibly technology-driven society, the ability to communicate orally is still seen as an essential ability for students at school and university, as it is for graduates in the workplace. The need to develop effective oral communication skills is often tied to future work-related tasks. One tangible way that educators have assessed proficiency in this area is through prepared oral presentations. While some use the terms oral communication and oral presentation interchangeably, other writers question the role more formal presentations play in the overall development of oral communication skills. Adding to the discussion, this paper is part of a larger study examining the knowledge and skills students bring into the academy from previous educational experiences. The study examines some of the teaching and assessment methods used in secondary schools to develop oral communication skills through the use of formal oral presentations. Specifically, it will look at assessment models and how these are used as a form of instruction as well as how they contribute to an accurate evaluation of student abilities. The purpose of this paper is to explore key terms and identify tensions between expectations and practice. Placing the emphasis on the ‘oral’ aspect of this form of communication this paper will particularly look at the ‘delivery’ element of the process.

Contrast sensitivity changes due to glaucoma and normal aging: low-spatial-frequency losses in both magnocellular and parvocellular pathways

PURPOSE: To explore the effects of glaucoma and aging on low-spatial-frequency contrast sensitivity by using tests designed to assess performance of either the magnocellular (M) or parvocellular (P) visual pathways. METHODS: Contrast sensitivity was measured for spatial frequencies of 0.25 to 2 cyc/deg by using a published steady- and pulsed-pedestal approach. Sixteen patients with glaucoma and 16 approximately age-matched control subjects participated. Patients with glaucoma were tested foveally and at two midperipheral locations: (1) an area of early visual field loss, and (2) an area of normal visual field. Control subjects were assessed in matched locations. An additional group of 12 younger control subjects (aged 20-35 years) were also tested. RESULTS: Older control subjects demonstrated reduced sensitivity relative to the younger group for the steady (presumed M)- and pulsed (presumed P)-pedestal conditions. Sensitivity was reduced foveally and in the midperiphery across the spatial frequency range. In the area of early visual field loss, the glaucoma group demonstrated further sensitivity reduction relative to older control subjects across the spatial frequency range for both the steady- and pulsed-pedestal tasks. Sensitivity was also reduced in the midperipheral location of "normal" visual field for the pulsed condition. CONCLUSIONS: Normal aging results in a reduction of contrast sensitivity for the low-spatial-frequency-sensitive components of both the M and P pathways. Glaucoma results in a further reduction of sensitivity that is not selective for M or P function. The low-spatial-frequency-sensitive channels of both pathways, which are presumably mediated by cells with larger receptive fields, are approximately equivalently impaired in early glaucoma.

Quality-based benefit design in health insurance : the impact of a product benefit design change on the utilisation of oral health services by members of a private health insurance fund in regional and rural New South Wales, Australia

Objective: To examine the impact on dental utilisation following the introduction of a participating provider scheme (Regional and Rural Oral Health Program {RROHP)). In this model dentists receive higher third party payments from a private health insurance fund for delivering an agreed range of preventive and diagnostic benefits at no out-ofpocket cost to insured patients. Data source/Study setting: Hospitals Contribution Fund of Australia (HCF) dental claims for all members resident in New South Wales over the six financial years from l99811999 to 200312004. Study design: This cohort study involves before and after analyses of dental claims experience over a six year period for approximately 81,000 individuals in the intervention group (HCF members resident in regional and rural New South Wales, Australia) and 267,000 in the control group (HCF members resident in the Sydney area). Only claims for individuals who were members of HCF at 31 December 1997 were included. The analysis groups claims into the three years prior to the establishment of the RROHP and the three years subsequent to implementation. Data collection/Extraction methods: The analysis is based on all claims submitted by users of services for visits between 1 July 1988 and 30 June 2004. In these data approximately 1,000,000 services were provided to the intervention group and approximately 4,900,000 in the control group. Principal findings: Using Statistical Process Control (SPC) charts, special cause variation was identified in total utilisation rate of private dental services in the intervention group post implementation. No such variation was present in the control group. On average in the three years after implementation of the program the utilisation rate of dental services by regional and rural residents of New South Wales who where members of HCF grew by 12.6%, over eight times the growth rate of 1.5% observed in the control group (HCF members who were Sydney residents). The differences were even more pronounced in the areas of service that were the focus of the program: diagnostic and preventive services. Conclusion: The implementation of a benefit design change, a participating provider scheme, that involved the removal of CO-payments on a defined range of preventive and diagnostic dental services combined with the establishment and promotion of a network of dentists, appears to have had a marked impact on HCF members' utilisation of dental services in regional and rural New South Wales, Australia.

A qualitative study of the experience of oral cancer among Taiwanese men

The incidence and mortality of oral cancer in Taiwanese men have increased over the past decade, primarily associated with a surge in the popularity of betel quid chewing. The aim of this study was to examine the experience of six Taiwanese men with oral cancer, who were aged between 40 and 60 years, using a qualitative approach. The three major themes emerging from the data include: (i) understanding the cancer diagnosis; (ii) the challenges of cancer treatment; and (iii) adapting to difference. Increasing nurses' understanding of the experiential aspects of oral cancer in this population is required if nurses are to develop successful health promotion programmes and nursing interventions to meet these patients' needs.

Sensitivity of proximal femoral stiffness and areal bone mineral density to changes in bone geometry and density

Areal bone mineral density (aBMD) is the most common surrogate measurement for assessing the bone strength of the proximal femur associated with osteoporosis. Additional factors, however, contribute to the overall strength of the proximal femur, primarily the anatomical geometry. Finite element analysis (FEA) is an effective and widely used computerbased simulation technique for modeling mechanical loading of various engineering structures, providing predictions of displacement and induced stress distribution due to the applied load. FEA is therefore inherently dependent upon both density and anatomical geometry. FEA may be performed on both three-dimensional and two-dimensional models of the proximal femur derived from radiographic images, from which the mechanical stiffness may be redicted. It is examined whether the outcome measures of two-dimensional FEA, two-dimensional, finite element analysis of X-ray images (FEXI), and three-dimensional FEA computed stiffness of the proximal femur were more sensitive than aBMD to changes in trabecular bone density and femur geometry. It is assumed that if an outcome measure follows known trends with changes in density and geometric parameters, then an increased sensitivity will be indicative of an improved prediction of bone strength. All three outcome measures increased non-linearly with trabecular bone density, increased linearly with cortical shell thickness and neck width, decreased linearly with neck length, and were relatively insensitive to neck-shaft angle. For femoral head radius, aBMD was relatively insensitive, with two-dimensional FEXI and threedimensional FEA demonstrating a non-linear increase and decrease in sensitivity, respectively. For neck anteversion, aBMD decreased non-linearly, whereas both two-dimensional FEXI and three dimensional FEA demonstrated a parabolic-type relationship, with maximum stiffness achieved at an angle of approximately 15o. Multi-parameter analysis showed that all three outcome measures demonstrated their highest sensitivity to a change in cortical thickness. When changes in all input parameters were considered simultaneously, three and twodimensional FEA had statistically equal sensitivities (0.41±0.20 and 0.42±0.16 respectively, p = ns) that were significantly higher than the sensitivity of aBMD (0.24±0.07; p = 0.014 and 0.002 for three-dimensional and two-dimensional FEA respectively). This simulation study suggests that since mechanical integrity and FEA are inherently dependent upon anatomical geometry, FEXI stiffness, being derived from conventional two-dimensional radiographic images, may provide an improvement in the prediction of bone strength of the proximal femur than currently provided by aBMD.