Prevalence and trends of the diabetes epidemic in South Asia : a systematic review and meta-analysis

Background Diabetes mellitus has reached epidemic proportions worldwide. South Asians are known to have an increased predisposition for diabetes which has become an important health concern in the region. We discuss the prevalence of pre-diabetes and diabetes in South Asia and explore the differential risk factors reported. Methods Prevalence data were obtained by searching the Medline® database with; ‘prediabetes’ and ‘diabetes mellitus’ (MeSH major topic) and ‘Epidemology/EP’ (MeSH subheading). Search limits were articles in English, between 01/01/1980–31/12/2011, on human adults (≥19 years). The conjunction of the above results was narrowed down with country names. Results The most recent reported prevalence of pre-diabetes:diabetes in regional countries were; Bangladesh–4.7%:8.5% (2004–2005;Rural), India–4.6%:12.5% (2007;Rural); Maldives–3.0%:3.7% (2004;National), Nepal–19.5%:9.5% (2007;Urban), Pakistan–3.0%:7.2% (2002;Rural), Sri Lanka–11.5%:10.3% (2005–2006;National). Urban populations demonstrated a higher prevalence of diabetes. An increasing trend in prevalence of diabetes was observed in urban/rural India and rural Sri Lanka. The diabetes epidemicity index decreased with the increasing prevalence of diabetes in respective countries. A high epidemicity index was seen in Sri Lanka (2005/2006–52.8%), while for other countries, the epidemicity index was comparatively low (rural India 2007–26.9%; urban India 2002/2005–31.3%, and urban Bangladesh–33.1%). Family history, urban residency, age, higher BMI, sedentary lifestyle, hypertension and waist-hip ratio were associated with an increased risks of diabetes. Conclusion A significant epidemic of diabetes is present in the South Asian region with a rapid increase in prevalence over the last two decades. Hence there is a need for urgent preventive and curative strategies .

The obesity epidemic in Sri Lanka revisited

Obesity has reached epidemic levels in most affluent countries. In contrast, South Asia is presently considered a minimally affected region as malnutrition and infectious diseases are still their main health concerns.1 South Asians have poor attitudes toward obesity and being obese is considered as a sign of prosperity...

Melt textured Y123 bulk and thick film

YBa2Cu3O7-δ - 25mol%Y2BaCuO5 bars and thick films have been melt textured using a stationary furnace with a temperature gradient of 3 or 6°C/cm. Samples are heated above the peritectic reaction temperature and quenched to just above the solidification temperature and then slowly cooled below the solidification temperature. All bar shaped samples consist of 2-5 mm grains though the grain orientations strongly depend on the heat treatment conditions. The bar shows the maximum Jc of above 3,000 A/cm2, whereas the maximum Jc of 200 A/cm2 and Tczero of 88K are obtained for the thick film on (100) LaAlO3 single crystal.

Binder effect on microstructure and properties of YBa2Cu3O7-x extruded wires

YBa2Cu3O7-x wires have been extruded with 2 and 5 wt.% of hydroxy propyl methylcellulose (HPMC) as binder. Both sets of wires sintered below 930°C have equiaxed grains while the wires sintered above this temperature have elongated grains. In the temperature range which gives equiaxed grains, the wires extruded with 5 wt.% HPMC have higher grain size and density. Cracks along the grain boundaries are often observed in the wires having elongated grains. Critical current density, Jc, increases initially, reaches a peak and then decreases with the sintering temperature. The sintering temperature giving a peak in Jc strongly depends on the heat treatment scheme for the wires extruded with 5 wt.% HPMC. TEM studies show that defective layers are formed along grain boundaries for the wires extruded with 5 wt.% HPMC after 5 h oxygenation. After 55 h oxygenation, the defective layers become more localised and grain boundaries adopt an overall cleaner appearance. Densification with equiaxed grains and clean grain boundaries produces the highest Jc's for polycrystalline YBa2Cu3O7 wires.

Synthesis and characterisation of nanoscale magnesium oxide powders and their application in thick films of Bi2Sr2CaCu2O8

Nanoscale MgO powder was synthesized from magnesite ore by a wet chemical method. Acid dissolution was used to obtain a solution from which magnesium containing complexes were precipitated by either oxalic acid or ammonium hydroxide, The transformation of precipitates to the oxide was monitored by thermal analysis and XRD and the transformed powders were studied by electron microscopy. The MgO powders were added as dopants to Bi2SrCa2CuO8 powders and high temperature superconductor thick films were deposited on silver. Addition of suitable MgO powder resulted in increase of critical current density, J(c), from 8,900 Acm(-2) to 13,900 Acm(-2) measured at 77 K and 0 T. The effect of MgO addition was evaluated by XRD, electron microscopy and critical current density measurements. (C) 1998 Elsevier Science B.V.

Microstructural studies of quenched partially-melted Y-123 materials and Y-123 with Y-211, PtO2 and CeO2 additions

The microstructure of YBa2Cu3O7-delta (Y-123) materials partially-melted in air and quenched from the temperature range 900-1100 degrees C, has been characterized using a combination of X-ray diffractometry, optical microscopy, scanning electron microscopy, electron microprobe analyses, transmission electron microscopy and energy and wave dispersive X-ray spectrometries. The microstructural studies reveal significant changes in the character of the quenched partial-melt as a function of temperature and time before quenching. BaCu2O2 and BaCuO2 are found to co-exist in stoichiometric samples quenched from the temperature range 920-960 degrees C. Under suitable cooling conditions, large pockets of melt cristallize as BaCuO2 with an exsolution of BaCu2O2 in the form of thin plates (approximate to 50-100 nm thick) along facets. Y2BaCuO5 (Y-211) additions are associated with the formation of BaCu2O2 at 1100 degrees C. Preliminary results on the effects of PtO2 and CeO2 additions to Y-123 (and Y-123 with Y-211 additions) show that these enhace the formation of BaCu2O2 at the melting temperature of 1100 degrees C. (C) 1998 Elsevier Science S.A. All rights reserved.

Partial melt processing and electrical properties of Bi-Sr-Ca-Cu-o superconducting thick films on (100) MgO substrates

Superconducting thick films of Bi2Sr2CaCu2Oy (Bi-2212) on single-crystalline (100) MgO substrates have been prepared using a doctor-blade technique and a partial-melt process. It is found that the phase composition and the amount of Ag addition to the paste affect the structure and superconducting properties of the partially melted thick films. The optimum heat treatment schedule for obtaining high Jc has been determined for each paste. The heat treatment ensures attainment of high purity for the crystalline Bi-2212 phase and high orientation of Bi-2212 crystals, in which the c-axis is perpendicular to the substrate. The highest Tc, obtained by resistivity measurement, is 92.2 K. The best value for Jct (transport) of these thick films, measured at 77 K in self-field, is 8 × 10 3 Acm -2.

Progress towards slip-casting YBa2Cu3O7-x monoliths

Sintered bars of YBa2Cu3O7-x obtained by slip-casting are investigated for drying and sintering behaviour. High J(cm) values (approximate to 10(6) A/cm(2) at 77K) are obtained, although J(ct) values are low (approximate to 10(2) A/cm(2) at 77K). Microstructural characterisation is undertaken on selected samples which demonstrate significant differences in physical density and critical current density.

Microstructural characterization of quenched melt-textured YBa2Cu3O7-δ materials

The microstructure of YBa2Cu3O7-δ (YBCO) materials, melt-textured in air and quenched from the temperature range 900-990°C, has been characterized using a combination of x-ray diffractometry, optical microscopy, scanning electron microscopy, transmission electron microscopy, and energy dispersive x-ray spectrometry. BaCu2O2 and BaCuO2 were found to coexist in samples quenched from the temperature range 920-960°C. The formation of BaCu2O2 preceded the formation of YBCO. Once the YBCO had formed, BaCu2O2 was present at the solidification front filling the space between nearly parallel platelets of YBCO. Large Y2BaCuO5 particles at the solidification front appeared divided into smaller ones as a result of their dissolution in the liquid that quenched as BaCu2O2.

Reaction products between Bi-Sr-Ca-Cu-oxide thick films and alumina substrates

The structure and composition of reaction products between Bi-Sr-Ca-Cu-oxide (BSCCO) thick films and alumina substrates have been characterized using a combination of electron diffraction, scanning electron microscopy and energy dispersive X-ray spectrometry (EDX). Sr and Ca are found to be the most reactive cations with alumina. Sr4Al6O12SO4 is formed between the alumina substrates and BSCCO thick films prepared from paste with composition close to Bi-2212 (and Bi-2212 + 10 wt.% Ag). For paste with composition close to Bi(Pb)-2223 + 20 wt.% Ag, a new phase with f.c.c. structure, lattice parameter about a = 24.5 A and approximate composition Al3Sr2CaBi2CuOx has been identified in the interface region. Understanding and control of these reactions is essential for growth of high quality BSCCO thick films on alumina. (C) 1997 Elsevier Science S.A.

Microstructural investigation of Bi-Sr-Ca-Cu-oxide thick films on alumina substrates

The microstructure of Bi-Sr-Ca-Cu-oxide (BSCCO) thick films on alumina substrates has been characterized using a combination of X-ray diffractometry, scanning electron microscopy, transmission electron microscopy of sections across the film/substrate interface and energy-dispersive X-ray spectrometry. A reaction layer formed between the BSCCO films and the alumina substrates. This chemical interaction is largely responsible for off-stoichiometry of the films and is more significant after partial melting of the films. A new phase with fee structure, lattice parameter a = 2.45 nm and approximate composition Al3Sr2CaBi2CuOx has been identified as reaction product between BSCCO and Al2O3.

Fine-grained Y2Cu2O5 powder from a co-precipitated precursor

A co-precipitation process is utilized to manufacture Y2Cu2O5 precursor powders. Upon calcination at high temperatures, such as 800 degrees C, the co-precipitated powder transforms to Y2Cu2O5. By selective variation of calcination parameters, grain-growth can be controlled to yield different sized Y2Cu2O5 powder, including sub-micron average sizes. ICP analysis, X-ray diffraction, electron microscopy, a.c. magnetic susceptibility and FT Raman are used to characterize phase development, morphology and purity of the powders.

Shape-formed ceramic superconductors by slip-casting

In order to rigorously test emerging applications using prototypes and pilot designs, high temperature superconductor (HTS) materials must be fabricated into a variety of shapes in an economical manner. We have developed a simple, economical, ceramic slip-casting approach to form complex shaped monolithic HTS articles for which high bulk density has been achieved. The sintered articles exhibit good Meissner signal and consist of phase-pure HTSC phase. A low transport critical current density is observed and is explained on the basis of densification and grain growth. © 1995 The Metallurgical of Society of AIME.

Manufacture of fine-grained Y2BaCuO5 powder by coprecipitation

Quantities of Y2BaCuO5 powder greater than 500g have been manufactured by a co-precipitation process. By suitable heat treatments, the particle size of these powders can be varied from 5µm to less than 500nm. Sub-micrometer size powders may, under some conditions, have a duller green colour which is attributed to <2% unreacted material. However, after re-grinding and re-firing of this powder, high-purity powders can be achieved without significant grain growth. Inductively coupled plasma (ICP) spectroscopy is used to measure the stoichiometry of the powders and X-ray diffraction is used to determine phase purity. In both cases, the bulk composition is consistent with Y2BaCuO5 and phase purity is considered better than 95%.

Community interventions for physical activity : the role of a new Cochrane systematic review

Introduction: Systematic reviews are essential in summarising the results of a range of research studies on a specific topic into a single report. They serve as a key source of evidence-based information to support and develop policy and practice for healthy communities. This presentation will examine a new review of community-wide strategies to increase population levels of physical activity and compare it to an earlier Community Guide Review (CGR) of Community-wide campaigns to increase physical activity which recommended community wide interventions. Methods: We registered a Cochrane Systematic Review (CSR) title, published a protocol and recently completed the review of Community-wide interventions to increase physical activity. We compared the definitions, design and findings of the CSR to the CGR. Results: The two reviews differed remarkably in their conclusions with the CGR recommending “strong evidence exists that community-wide campaigns are effective in increasing levels of physical activity”, and the new CSR stating “The body of evidence in this review does not support the hypothesis that multi-component community wide interventions effectively increase population levels of physical activity”. We observed that both reviews examined multi-component interventions as a “combined package”. Possible explanations for the different conclusions may be due to the definition of community (CSR defined community as “comprising those persons residing in a geographically defined community, such as a village, town, or city”, excluding interventions which were whole of state or country, and CGR as “a group of individuals who share one or more characteristics. The CSR utilised a logic model at various stages of the review process and explicitly defined a combination of strategies encompassed within the intervention. The CSR included 25 and CGR 10 studies, respectively. Six of the 10 studies that were included in CGR were excluded from the CSR due to issues relating to study design, intervention definition or duration. The two reviews also differ in function as the CSR seeks to summarise global evidence and included 7 studies in low-income countries, where as the CGR contained only studies deemed relevant to the USA context. Discussion: Differences in the findings between older and newer reviews can be due to a variety of factors. For example, in updating a review the definition of an intervention can be changed. Further, differences may also be due to improvements in the standards and methodologies for systematic reviews as well as the inclusion of newer studies. These factors need to be understood whenever differences between newer and older reviews are considered.