A systematic review of telemedicine interventions for type 2 diabetes patients

Telemedicine is the use of telecommunications to support health care services and it incorporates a wide range of technology and devices. This systematic review seeks to determine which types of telemedicine technologies have been the most effective at improving the major health factors of subjects with type 2 diabetes. The major health factors identified were blood glucose, systolic and diastolic blood pressure, LDL cholesterol, weight, BMI, triglyceride levels, and waist circumference. A literature search was performed using peer reviewed, scholarly articles focused on the health outcomes of type 2 diabetes patients served by various telemedicine interventions. A total of 15 articles met the search criteria and were then analyzed to determine the significant health outcomes of each telemedicine interventions for type 2 diabetes patients. Results showed that telemedicine interventions using videoconferencing technology resulted in significant improvements in five health factor outcomes (total body weight, BMI, blood glucose, LDL cholesterol, and blood pressure), while telemedicine interventions using web applications and health monitors/modems only produced significant improvements in blood glucose. Future research should focus on examining the costs and benefits of videoconferencing and other telemedicine technologies for type 2 diabetes patients.^

Evaluation of a wellness program at a large private sector petrochemical company in Texas

The study purpose was to analyze the effects Integrated Health Solutions (IHS), an employee wellness program that has been implemented for one year on the corporate campus of a major private sector petrochemical company in Houston, TX, has on employee health. ^ Chronic diseases are the leading causes of morbidity and mortality in the United States and are the most preventable of all health problems. The costs of chronic diseases in the working-age adult population include not only health problems and a decrease in quality of life, but also an increase the cost of health care and costs to businesses and employers, both directly and indirectly. These emerging costs to employers as well as the fact that adults now spend the majority of waking hours at the office have increased the interest in worksite health promotion programs that address many of the behavioral factors that lead to chronic conditions. Therefore, implementing and evaluating programs that are aimed at promoting health and decreasing the prevalence of chronic diseases at worksites is very important. ^ Data came from existing data that were collected by IHS staff during employee biometric screenings at the company in 2010 and 2011. Data from employees who participated in screenings in both 2010 and 2011 were grouped into a cohort by IHS staff. ^ One-tailed t-tests were conducted to determine if there were significant improvements in the biometric measures of body fat percentage, BMI, waist circumference, systolic and diastolic blood pressures, total, HDL, and LDL cholesterol levels, triglycerides, blood glucose levels, and cardiac risk ratios. Sensitivity analysis was conducted to determine if there were differences in program outcomes when stratified by age, gender, job type, and time between screenings. ^ Mean differences for the variables from 2010 to 2011 were small and not always in the desired direction for health improvement indicators. Through conducting t-tests, it was found that there were significant improvements in HDL, cardiac risk ratio, and glucose levels. There were significant increases in cholesterol, LDL, and diastolic blood pressures. For the IHS program, it appears that gender, job type, and time between screenings were possible modifiers of program effectiveness. When program outcome measures were stratified by these factors, results suggest that corporate employees had better outcomes than field employees, males had better outcomes overall than females, and more positive program effects were seen for employees with less time between their two screenings. ^ Recommendations for the program based on the results include ensuring validity of instruments and initial and periodic training of measurement procedures and equipment handling, using normative data or benchmarks to decrease chances for biased estimates of program effectiveness, measuring behaviors as well as biometric and physiologic statuses and changes, and collecting level of engagement data.^

Risk factors for metabolic syndrome among overweight and obese Hispanic children attending a pediatric clinic in New Braunfels, Texas

Childhood obesity is a persistent problem in the U.S., especially among Hispanics. Health complications like hypertension, type II diabetes, and metabolic syndrome (Met-S) are being seen at younger ages, and current screening procedures may be inadequate. This study sought to describe the risk factors for Met-S present in a sample of 106 overweight and obese Hispanic children, aged 5-14 years, participating in Nutrition and Exercise Start Today (NEST), a randomized weight management intervention trial at a rural health clinic in New Braunfels, Texas; and to determine associations between these factors and other clinical and socio-demographic characteristics linked to obesity. Baseline data was analyzed for the prevalence of large waist circumference (WC), elevated blood pressure (BP), high fasting serum glucose and serum triglycerides (TG), and low serum HDL cholesterol, in relationship with selected sample characteristics. Main findings included high baseline prevalence rates of large WC (77%), reduced HDL (57%), and elevated BP (30%). WC was significantly associated with BMI percentile and the serum liver function test alanine aminotransferase (ALT) by Fisher's exact test (p<0.001 and p=0.032, respectively), while there were significant relationships between HDL and both female gender and ALT. BMI percentile and ALT were associated with all sets of Met-S diagnostic criteria examined. BMI percentile also had a strong association (p=0.005) with total number of Met-S risk factors, while ALT had a weaker association (p=0.093). WC is a low-cost, simple measure whose use may improve clinic surveillance for childhood obesity and complications like Met-S. WC, BP, HDL and ALT may be used as part of targeted screening for obesity complications like Met-S, particularly in situations where resources are limited.^

Identification of genes associated with quantitative traits involved in cardiovascular disease and lipoprotein metabolism

Cardiovascular disease (CVD) is a threat to public health. It has been reported to be the leading cause of death in United States. The invention of next generation sequencing (NGS) technology has revolutionized the biomedical research. To investigate NGS data of CVD related quantitative traits would contribute to address the unknown etiology and disease mechanism of CVD. NHLBI's Exome Sequencing Project (ESP) contains CVD related phenotypes and their associated NGS exomes sequence data. Initially, a subset of next generation sequencing data consisting of 13 CVD-related quantitative traits was investigated. Only 6 traits, systolic blood pressure (SBP), diastolic blood pressure (DBP), height, platelet counts, waist circumference, and weight, were analyzed by functional linear model (FLM) and 7 currently existing methods. FLM outperformed all currently existing methods by identifying the highest number of significant genes and had identified 96, 139, 756, 1162, 1106, and 298 genes associated with SBP, DBP, Height, Platelet, Waist, and Weight respectively. ^

Epiphytic orchid diversity and community composition in managed and natural moist evergreen Afromontane forest in SW Ethiopia

In SW Ethiopia, the moist evergreen Afromontane forest has become extremely fragmented and most of the remnants are intensively managed for coffee cultivation (Coffea arabica), with considerable impacts on biodiversity and ecosystem functioning. Because epiphytic orchids are potential indicators for forest quality and a proxy for overall forest biodiversity, we assessed the effect of forest management and forest fragmentation on epiphytic orchid diversity. We selected managed forest sites from both large and small forest remnants and compared their epiphytic orchid diversity with the diversity of natural unfragmented forest. We surveyed 339 canopy trees using rope climbing techniques. Orchid richness decreased and community composition changed, from the natural unfragmented forest, over the large managed forest fragments to the small managed forest fragments. This indicates that both forest management and fragmentation contribute to the loss of epiphytic orchids. Both the removal of large canopy trees typical for coffee management, and the occurrence of edge effects accompanying forest fragmentation are likely responsible for species loss and community composition changes. Even though some endangered orchid species persist even in the smallest fragments, large managed forest fragments are better options for the conservation of epiphytic orchids than small managed forests. Our results ultimately show that even though shade coffee cultivation is considered as a close-to-nature practice and is promoted as biodiversity conservation friendly, it cannot compete with the epiphytic orchid conservation benefit generated by unmanaged moist evergreen Afromontane forests.

Exploraciones y estudios sobre los nuevos espacios económicos durante el siglo XIX. Santiago del Estero, 1850-1875

El objeto de la presente comunicación es analizar los modos en que, desde mediados del siglo XIX, la elite liberal santiaguena, planteó la implantación capitalista y los diversos proyectos modernizadores en el área económica, en un territorio signado por la marginalidad histórica, espacios ecológicos dispares y extremos y escasos recursos económicos para concretar acciones estratégicas de magnitud. Enrolada en la filosofía del progreso, seguidora de los postulados alberdianos y dispuesta a incorporar a las producciones santiaguenas en los circuitos económicos del sistema capitalista, en tanto Estado, llevaron adelante unas prácticas que tuvieron como primer gran objetivo, estudiar los espacios económicos potencialmente aptos para desarrollar las producciones pecuarias que el mercado europeo demandaba. De modo que una conjunción de intereses entre aspiraciones locales y demandas europeas, dará como resultado la evaluación de las potencialidades de tres espacios: la cuenca del río Salado del Norte, la cuenca del río Dulce y el espacio del "mesón de fierro". Enlazando las tres áreas, los proyectos ferroviarios con trazados que las relacionaban entre sí y con los puertos sobre el Paraná.

Efectos de un programa de flexibilidad en el desarrollo de la fuerza muscular en jugadoras de fútbol femenil

Se analizó el impacto de un programa de entrenamiento de flexibilidad sobre el desarrollo de la fuerza muscular en 16 jugadores de futbol con edad de 19.032.7 años. Se entrenó durante 30 días y 5 veces por semanas, donde el grupo "A" realizó entrenamiento de flexibilidad, mientras que "B" el entrenamiento regular. Se midió la flexibilidad, 1RM, salto vertical, peso, talla, circunferencia de pantorrilla y muslo. Los resultados muestran valores para A y B respectivamente, donde el IGF fue de 91.01 18.3 y 111.93 23.5; 78.22 29, y 79.03 29.1. La circunferencia femoral, 48.04 3.6 cms y 49.54 3.4 cms.; 47.56 4.9 y 47.89 5.2. Circunferencia de pantorrilla, 33.83 2.7 cm y 35.21 2.4 cm; 33.83 2 y 33.73 2.8. Fuerza 48.13 7.8 Kg. y 53.38 8.2 Kg.; 52.63 8.6 Kg. y 53.39 9.1 Kg. Potencia anaeróbica, 34.13 2.9 cm. y 36.63 1.7 cm; 38.25 4.7 y 37.06 3.4. Como conclusión se tiene que el uso la flexibilidad impacta de forma positiva en el IGF y por tanto en el desarrollo favorable muscular de jugadoras de fútbol.

Exploraciones y estudios sobre los nuevos espacios económicos durante el siglo XIX. Santiago del Estero, 1850-1875

El objeto de la presente comunicación es analizar los modos en que, desde mediados del siglo XIX, la elite liberal santiaguena, planteó la implantación capitalista y los diversos proyectos modernizadores en el área económica, en un territorio signado por la marginalidad histórica, espacios ecológicos dispares y extremos y escasos recursos económicos para concretar acciones estratégicas de magnitud. Enrolada en la filosofía del progreso, seguidora de los postulados alberdianos y dispuesta a incorporar a las producciones santiaguenas en los circuitos económicos del sistema capitalista, en tanto Estado, llevaron adelante unas prácticas que tuvieron como primer gran objetivo, estudiar los espacios económicos potencialmente aptos para desarrollar las producciones pecuarias que el mercado europeo demandaba. De modo que una conjunción de intereses entre aspiraciones locales y demandas europeas, dará como resultado la evaluación de las potencialidades de tres espacios: la cuenca del río Salado del Norte, la cuenca del río Dulce y el espacio del "mesón de fierro". Enlazando las tres áreas, los proyectos ferroviarios con trazados que las relacionaban entre sí y con los puertos sobre el Paraná.

Efectos de un programa de flexibilidad en el desarrollo de la fuerza muscular en jugadoras de fútbol femenil

Se analizó el impacto de un programa de entrenamiento de flexibilidad sobre el desarrollo de la fuerza muscular en 16 jugadores de futbol con edad de 19.032.7 años. Se entrenó durante 30 días y 5 veces por semanas, donde el grupo "A" realizó entrenamiento de flexibilidad, mientras que "B" el entrenamiento regular. Se midió la flexibilidad, 1RM, salto vertical, peso, talla, circunferencia de pantorrilla y muslo. Los resultados muestran valores para A y B respectivamente, donde el IGF fue de 91.01 18.3 y 111.93 23.5; 78.22 29, y 79.03 29.1. La circunferencia femoral, 48.04 3.6 cms y 49.54 3.4 cms.; 47.56 4.9 y 47.89 5.2. Circunferencia de pantorrilla, 33.83 2.7 cm y 35.21 2.4 cm; 33.83 2 y 33.73 2.8. Fuerza 48.13 7.8 Kg. y 53.38 8.2 Kg.; 52.63 8.6 Kg. y 53.39 9.1 Kg. Potencia anaeróbica, 34.13 2.9 cm. y 36.63 1.7 cm; 38.25 4.7 y 37.06 3.4. Como conclusión se tiene que el uso la flexibilidad impacta de forma positiva en el IGF y por tanto en el desarrollo favorable muscular de jugadoras de fútbol.

Exploraciones y estudios sobre los nuevos espacios económicos durante el siglo XIX. Santiago del Estero, 1850-1875

El objeto de la presente comunicación es analizar los modos en que, desde mediados del siglo XIX, la elite liberal santiaguena, planteó la implantación capitalista y los diversos proyectos modernizadores en el área económica, en un territorio signado por la marginalidad histórica, espacios ecológicos dispares y extremos y escasos recursos económicos para concretar acciones estratégicas de magnitud. Enrolada en la filosofía del progreso, seguidora de los postulados alberdianos y dispuesta a incorporar a las producciones santiaguenas en los circuitos económicos del sistema capitalista, en tanto Estado, llevaron adelante unas prácticas que tuvieron como primer gran objetivo, estudiar los espacios económicos potencialmente aptos para desarrollar las producciones pecuarias que el mercado europeo demandaba. De modo que una conjunción de intereses entre aspiraciones locales y demandas europeas, dará como resultado la evaluación de las potencialidades de tres espacios: la cuenca del río Salado del Norte, la cuenca del río Dulce y el espacio del "mesón de fierro". Enlazando las tres áreas, los proyectos ferroviarios con trazados que las relacionaban entre sí y con los puertos sobre el Paraná.

Efectos de un programa de flexibilidad en el desarrollo de la fuerza muscular en jugadoras de fútbol femenil

Se analizó el impacto de un programa de entrenamiento de flexibilidad sobre el desarrollo de la fuerza muscular en 16 jugadores de futbol con edad de 19.032.7 años. Se entrenó durante 30 días y 5 veces por semanas, donde el grupo "A" realizó entrenamiento de flexibilidad, mientras que "B" el entrenamiento regular. Se midió la flexibilidad, 1RM, salto vertical, peso, talla, circunferencia de pantorrilla y muslo. Los resultados muestran valores para A y B respectivamente, donde el IGF fue de 91.01 18.3 y 111.93 23.5; 78.22 29, y 79.03 29.1. La circunferencia femoral, 48.04 3.6 cms y 49.54 3.4 cms.; 47.56 4.9 y 47.89 5.2. Circunferencia de pantorrilla, 33.83 2.7 cm y 35.21 2.4 cm; 33.83 2 y 33.73 2.8. Fuerza 48.13 7.8 Kg. y 53.38 8.2 Kg.; 52.63 8.6 Kg. y 53.39 9.1 Kg. Potencia anaeróbica, 34.13 2.9 cm. y 36.63 1.7 cm; 38.25 4.7 y 37.06 3.4. Como conclusión se tiene que el uso la flexibilidad impacta de forma positiva en el IGF y por tanto en el desarrollo favorable muscular de jugadoras de fútbol.

Origin and evolution of Cycladophora davisiana (Radiolaria) in DSDP Hole 19-192, Northwest Pacific

This paper documents the evolutionary history of Cycladophora davisiana Ehrenberg from an uppermost Miocene to Pleistocene sedimentary record in the high-latitude Northwest Pacific. It apparently evolved from C. sakaii Motoyama through a series of intermediates. C. sakaii has a relatively large shell with an external spongy layer. The evolutionary transition is characterized by a relatively rapid decrease in thorax size with a reduction of the spongy appendage. This change occurred during about 0.4 m.y. from 2.8 to 2.4 Ma without cladogenesis. Following this interval, a decrease in thorax size continued gradually up to the Recent, resulting in a very small morphology. Although the population of C. davisiana first appeared at about 2.5 Ma, some morphotypic specimens may occur in earlier periods as indistinguishable very small endmembers in the C. sakaii populations. Timing of the first appearance events both of morphotypic specimens and of a population of C. davisiana in Site 192 and previously reported cores does not disprove the idea that C. davisiana evolved first in the Northwest Pacific region, and later migrated into other regions of the world ocean. Biometrics clearly indicate no direct phylogenetic relationships between C. davisiana and C. cornutoides Kling in the studied core. Thus, the latter species, which was originally described as a variation and later elevated to a subspecies of the former species, is separated from the former species and raised to the species rank.

Epiphytic orchid diversity found on trees and shrubs in coffee cultivated Afromontane rainforest, SW Ethiopia

The moist evergreen Afromontane forest of SW Ethiopia has become extremely fragmented and most remnants are intensively managed for cultivation of coffee (Coffea arabica). We investigated the distributions of epiphytic orchids in shade trees and their understory in forests with contrasting management intensity to determine biodiversity losses associated with coffee cultivation and to determine the capacity of coffee shrubs to act as refugia for orchid species. We studied epiphytic orchids in managed forests and natural forests and recorded orchid diversity and abundance in different tree zones of 339 trees and in the understory. Coffee management was associated with a downward shift of orchid species as orchid species were occurring in significantly lower tree zones in managed forest. The number of shrubs in the understory of managed forest was not higher than in natural forests, yet orchid abundance was higher in the understory of managed forests. Local extinctions of epiphytic orchids and species losses in the outer tree zones (a contraction of habitat) in managed forests are most likely driven by losses of large, complex-structured climax trees, and changes in microclimate, respectively. Coffee shrubs and their shade trees in managed forests are shown here to be a suitable habitat for only a limited set of orchid species. As farmers continue to convert natural forest into managed forest for coffee cultivation, further losses of habitat quality and collateral declines in regional epiphytic orchid diversity can be expected. Therefore, the conservation of epiphytic orchid diversity, as well as other components of diversity of the coffee forests, must primarily rely on avoiding coffee management intensification in the remaining natural forest. Convincing farmers to keep forest-climax trees in their coffee forest and to tolerate orchids on their coffee shrubs may also contribute to a more favorable conservation status of orchids in Ethiopian coffee agroecosystems.