Coronary artery disease screening in diabetic patients: how good is guideline adherence?

INTRODUCTION: Diabetic patients are at high risk for coronary artery disease (CAD), which is the leading cause of death in this population. The Swiss Society of Endocrinology-Diabetology (SSED) recommends CAD screening for diabetic patients with > or = 2 additional cardiovascular risk factors (CVRF), by stress echocardiography (SE) or myocardial perfusion imaging (MPI). The aim of this study was to assess the application of these guidelines and the treatment of CVRF in the diabetes outpatient clinics of the five Swiss University Hospitals. METHODS: The study was initiated in Lausanne and the study questionnaires were circulated to the endocrinologists of the five Swiss University Hospitals. Practitioners were asked to include consecutive patients attending the diabetes outpatient clinics over one month. Prevalence of CAD, screening methods for CAD, prevalence of CVRF, biological analyses over the last 6 months and medical therapy were recorded. RESULTS: A total of 302 subjects were included. The mean age was 53 +/- 14 years, 68% had type 2 diabetes, 27% type 1 and 5% other types. Among T2DM with > or = 2 CVRF, 45% were screened for CAD according to SSED guidelines. In T2DM 25% had blood pressure < or = 130/80 mm Hg, 15% a lipid profile within target, 23% HbA1c < or = 7.0%. Overall, 2% achieved all 3 targets. CONCLUSIONS: Only 45% of T2DM with > or = 2 CVRF were screened for CAD according to SSED guidelines and 2% of T2DM had proper control over all CVRF. Efforts are still necessary to improve CAD prevention and screening of diabetic patients in Swiss University Hospitals.

Missale ad usum ecclesiae Aquensis.

F. 1-6v Calendrier de l'église d'Aix-en-Provence (7 juin: « Sancti Maximini Aquensis archiepiscopi... »; 7 août: « Dedicatio ecclesie Sancti Salvatoris »). F. 7-282 Temporal de toute l'année. F. 282v-286v Préfaces. F. 287-290v Canon de la messe. F. 291v-292 Peintures du Canon. F. 293-425 Sanctoral et commun des saints (f. 332v: s. Maximin; f. 352v: ste Marie-Madeleine; f. 361: dédicace de l'église; f. 374: s. Agricol; f. 393: s. Mitre). F. 425-431 « Orationes processionales per totum annum ». F. 431v-432v Bénédictions. F. 432v-433v Bénédictions et préface du mariage. F. 434-435 Messes de divers saints (dont s. Cannat, évêque de Marseille). F. 435v Colophon.

Environmental Assessment: IA 12 in Mason City From S. Monroe Ave to S. Carolina Ave, Cerro Gordo County, Iowa, NHSX-122-1(14)--3H-17, 2013

DESCRIPTION OF PROPOSED ACTION This Environmental Assessment (EA) has been prepared in compliance with the requirements of the National Environmental Policy Act of 1969 (NEPA). This EA informs the public and interested agencies of the proposed action and alternatives to the proposed action in order to gather feedback on the improvements under consideration. Proposed Action The Iowa Department of Transportation (Iowa DOT) and the Federal Highway Administration (FHWA) are evaluating potential alternatives to improve IA 122 in the City of Mason City. IA 122/Business US 18 is a primary east-west travel route through the City that transitions from a 4- lane undivided roadway, to 2-lane one-way pairs, then back to a 4-lane undivided roadway (Figure 1-1). The Iowa DOT proposes to flatten the tight reverse curves on the east end of the project. The one-way pairs will be narrowed by eliminating on-street parking along the corridor to more clearly define travel lanes. This will serve to calm traffic flows and reduce crashes along the highway. Additionally, improvements to intersections as well as consolidating or removing access points to improve traffic operations are proposed within the project corridor. A new access road for the Mason City Fire Department on the west end of the project will allow emergency trucks better access to travel south and east. Study Area The primary area of investigation for the Project is generally bounded by IA 122 through Mason City, known locally as 5th and 6th Street Southwest from South Monroe Avenue to South Carolina Avenue. US 65, known locally as Federal Avenue, bisects the study area. At this intersection of US 65 and Iowa 122, the 5th and 6th Street SW changes to 5th and 6th St SE. For the purposes of this discussion, this area will be referred to collectively as the IA 122 corridor. The Study Area boundaries were established to allow the development of a wide range of alternatives that could address the purpose and need for the project. The Study Area is larger than the area proposed for construction activities for the Project. However, some impacts may extend beyond the Study Area; where this occurs, it will be noted and addressed in the Environmental Analysis Section (Section 5). Figure 1-1 outlines the Study Area of the proposed action.

L'efficacité c'est bien, l'impact c'est top [Efficacy is good, impact is great].

This article summarizes the different stages of research for the development of medical interventions and their specific characteristics in terms of design, population, resources, importance of results and scientific interest. The emphasis is focused on the two final stages of development, the effectiveness and the impact. An example from our own experience is given to illustrate the reduction of the effect of an intervention against malaria in young children at different stages of the development of the intervention, and the parallel decrease of the recognition by the scientific community of the importance of these results.

Having a good relationship with their mother: a protective factor against sexual risk behavior among adolescent females?

STUDY OBJECTIVE: To assess whether having a good relationship with their mother was a protective factor against risky sexual behavior for female adolescents and whether it was independent of family structure. DESIGN: Cross-sectional survey of in-school adolescents aged 14-19 years. SETTING: Catalonia, in northeast Spain. PARTICIPANTS: A total of 3677 females divided according on whether they had a good (n=3335) or a bad (n=342) relationship with their mother. MAIN OUTCOME MEASURES: Rates of sexual activity and sexual behavior. RESULTS: Adolescents in the good relationship group were significantly younger, more likely to live in an intact family, to have a good relationship with their father and siblings, and to talk about sexuality and their partner with their mother. They were also less likely to have ever had sexual intercourse. Among those sexually experienced, they were significantly older at first intercourse and less likely to have multiple partners or a history of STI. After adjusting for potential confounders, females in the good relationship group were less likely to be sexually active and to have had multiple partners, independently of family structure. CONCLUSIONS: Having a good relationship with their mother is a protective factor against sexual intercourse and having multiple sexual partners independently of family structure. Communication between generations and having a good relationship with their father and siblings also play an important role.

University of Iowa John Pappajohn Entrepreneurial Center annual report, FY 2011.

Annual report of the John Pappajohn Entrepreneurial Center at the University of Iowa.

University of Iowa John Pappajohn Entrepreneurial Center annual report, FY 2012.

Annual report of the John Pappajohn Entrepreneurial Center at the University of Iowa.

University of Iowa John Pappajohn Entrepreneurial Center annual report, FY 2013.

Annual report of the John Pappajohn Entrepreneurial Center at the University of Iowa.