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Covid-19: Campaigner calls for national guidance to stop DNR orders being made without discussion with patients and families




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MEIZITANG OBAT PELANGSING BADAN HERBAL ALAMI - Rahasia Pria

Meizitang Obat Pelangsing Badan Herbal Merupakan Suplemen Diet Herbal Berbentuk SOFTGEL Yang Sangat Berkhasiat Melangsingkan Tubuh Dengan Cepat Dan Aman,



  • Sports and Health

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OBAT PELANGSING BADAN HERBAL FATLOSS DIET ALAMI - Rahasia Pria

Obat Pelangsing Badan Herbal Fatloss Jimpness Beauty Penghilang Lemak Seketika Merupakan Obat Pelangsing Badan Yang Aman Dikonsumsi Untuk Pria Maupun Wanita



  • Sports and Health

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Pelangsing Badan Herbal Lida Obat Diet Alami - Rahasia Pria

Pelangsing Badan Herbal Lida Daidaihua Adalah Pelangsing Badan Yang Mengandung Bahan Herbal Yang Sangat Cepat Menurunkan Berat Badan, Aman Dan Cepat .



  • Sports and Health

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Krim Pelangsing Badan Alami Geen Tea - Rahasia Pria

Krim Pelangsing Badan Alami Green Tea adalah pelangsing herbal berbentuk krim berguna untuk melangsingkan dan mempercepat pembakaran lemak perut, lengan dl



  • Sports and Health

dan

We don’t dance anymore

We don’t dance anymore, And it happened so quickly. We sold our souls on the galactic market, For peanuts. The Earth recovered though, its Nature. We sold everything to be together, We did, and Life happened. This far down the line, we’re all that’s left and You still are, The most beautiful thing about me. […]




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Danielia Mclean A powerhouse in business

M arketing guru and smashing entrepreneur Danielia McLean is known to the business and communication worlds as a powerhouse fiercely working to clutch success. Finding a novel business idea can be difficult; pursuing it, successfully, even more so...




dan

Diabetes Insipidus - the danger of misunderstanding diabetes

Diabetes is synonymous with sugar, but diabetes insipidus, "water diabetes", can't be forgotten. Between 2009 and 2016, 4 people died in hospital in England, when lifesaving treatment for the condition was not given. In this podcast, we hear some practical tips for non-specialists to aid diagnosis, and how patients should be managed during...




dan

From dance class to social prescription - starting and evaluating an idea

If you read the Christmas BMJ in the last few weeks, you might have noticed a lot around art and health - the way in which engagement in arts can help in prevention and treatment, but can also affect those more nebulous things which really matter to patients - loneliness, self expression, being connected to the wider community. That obviously...




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Feeling the fear with Iona Heath and Danielle Ofri

A new podcast from The BMJ, to help GP's feel more connected, heard, and supported. Subscribe on; Apple podcasts - https://bit.ly/applepodsDBI Spotify - https://bit.ly/spotifyDBI Google podcasts - https://bit.ly/googlepodsDBI This week, our topic is fear: we try to get a better understanding of fear, how it affects all of us as clinicians for...




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Relation Between Antioxidant Enzyme Gene Expression and Antioxidative Defense Status of Insulin-Producing Cells

Markus Tiedge
Nov 1, 1997; 46:1733-1742
Original Article




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Intrauterine exposure to diabetes conveys risks for type 2 diabetes and obesity: a study of discordant sibships

D Dabelea
Dec 1, 2000; 49:2208-2211
Articles




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Famine Threatens South Sudan

9 July 2014

Rob Bailey

Former Research Director, Energy, Environment and Resources
Despite early warnings that the country could soon be facing famine, a half-funded appeal and muted media coverage suggest that lessons from Somalia’s 2011 humanitarian crisis have not been learned.

20140709SSUDANW.jpg

Thousands of people wait in the hot sun in Leer, South Sudan 5 July, 2014 for the first air drops by the ICRC for nearly two decades. Photo by Nichole Sobecki/AFP/Getty Images.

On its third anniversary, South Sudan is teetering on the brink of humanitarian disaster. Without urgent action, some parts of the country face famine as a result of conflict, a poor harvest and high, pre-existing levels of malnutrition and poverty. If all this sounds eerily familiar, it should. In July 2011 similar conditions saw famine strike in Somalia, just as South Sudan gained its independence. It is estimated that more than a quarter of a million people died during this catastrophe, most of them children.

The situation in South Sudan shows the lessons of 2011 have not been learned. Early warnings of disaster in Somalia accumulated for almost a year before famine was eventually declared by the UN. The threat was first explicitly raised by the Famine Early-Warning Systems Network (FEWSNET) in March 2011 and again in May. Yet the humanitarian system remained dormant. Had donors and agencies intervened early, they could have prevented the downward spiral into destitution and starvation. The reasons why early warnings did not lead to early action were documented in a major Chatham House report that concluded with numerous recommendations for how programmes, funding and decision-making should be reformed to avoid such a failure ever happening again.

Fast forward to 2014 and head 1,000 miles west, and little seems to have changed. FEWSNET warned of famine in South Sudan in early May, yet official UN data reveals no subsequent increase in funding. If anything, contributions to the South Sudan emergency appeal appear to have slowed, with April, May and June showing markedly less being received than in previous months. With the lean season (when food insecurity peaks) now well underway, the appeal is less than half-funded.

Experience shows that the thing most likely to mobilize emergency funding is not early warning but media coverage, which can lead to pressure from publics for donor governments to act. News of the situation in South Sudan has been muted, however. According to Google Trends, there was no increase in the number of headlines on South Sudan following the famine warning in May for example. Three years ago in Somalia, it was not until famine was declared that the crisis caught the global media’s attention and donors finally responded. By then it was, by definition, too late to avert catastrophe.

Despite these alarming similarities, it is not inevitable that South Sudan will mark its third anniversary with famine. Like all complex forecasts, famine early warnings do not deal in certainties. And, although the window of opportunity for preventive action has probably closed by now and the challenge of reaching communities in the midst of conflict is huge, it is still possible for humanitarian actors to mitigate the worst-case scenario with a concerted and coordinated push to distribute aid and scale-up emergency infant nutrition programmes in the worst-affected areas. But even if famine is avoided, communities in South Sudan will be left weaker, poorer and more vulnerable to the next crisis. The risk will remain. 

To comment on this article, please contact Chatham House Feedback




dan

Vitamin C in Human Health and Disease: Effects, Mechanisms of Action, and New Guidance on Intake




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Preoperative Localization of Adenomas in Primary Hyperparathyroidism: The Value of 11C-Choline PET/CT in Patients with Negative or Discordant Findings on Ultrasonography and 99mTc-Sestamibi SPECT/CT

We aimed to assess the value of 11C-choline PET in patients with primary hyperparathyroidism and negative or discordant results on 99mTc-sestamibi imaging and neck ultrasound. Methods: Eighty-seven such patients were assessed and subsequently underwent parathyroidectomy. PET/CT image data were analyzed semiquantitatively using SUVmax and SUV ratios (target to contralateral thyroid gland and carotid artery). A positive PET/CT result was defined as focal uptake significantly higher than regular thyroid tissue. Ectopic foci were also considered positive. Inconclusive PET/CT cases were defined as a lesion with uptake equal to normal thyroid tissue. If no prominent or ectopic uptake was detectable, the PET/CT result was considered negative. Results: When dichotomizing the 11C-choline PET/CT imaging results by defining lesions with both positive and inconclusive uptake as positive, we found 84 of 92 lesions (91.3%) to have true-positive uptake whereas 8 lesions (8.7%) had false-positive uptake. One lesion showed false-negative uptake; the sensitivity was 98.8%. The corresponding positive predictive value for lesions was 91.3%. The mean SUVmax was 6.15 ± 4.92 in 72 lesions with positive uptake (70 patients) and 2.96 ± 2.32 in 20 lesions with inconclusive uptake (18 patients). Conclusion: These results in a large group of patients indicate that 11C-choline PET/CT is a promising tool for parathyroid adenoma localization when ultrasound and 99mTc-sestamibi imaging yield negative or discordant results.




dan

Covid-19: Coroners needn’t investigate PPE policy failures in deaths of NHS staff, new guidance says




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Spiraling Violence and Drought Drive Refugee Crisis in South Sudan

Nearly 4 million South Sudanese have been driven from their homes by violence or food insecurity since late 2013, roughly half seeking refuge in neighboring countries. Drought and conflict have converged in the young country to fuel one of the world's most severe humanitarian emergencies. This article examines refugee flows from South Sudan, underlying drivers, and regional and international responses to the crisis.




dan

Brooks Koepka learned not to smack talk Michael Jordan on golf course

PGA Tour star Brooks Koepka said he'll no longer smack talk Michael Jordan on the golf course after he lost a round to the basketball legend.




dan

Look: Dangling raccoon rescued from under California highway on-ramp

Animal rescuers in California said they reached over the side of a freeway on-ramp to rescue a raccoon seen dangling from a metal beam under the ramp.




dan

Drug may curb dangerous urges in pedophiles, study says

A testosterone-lowering drug can reduce male pedophiles' risk of sexually abusing children, according to a new Swedish study.




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CDC to offer coronavirus guidance during webinar Jan. 31

The Centers for Disease Control and Prevention will provide interim guidance to clinicians regarding the coronavirus outbreak during a webinar at 2 p.m. EST Jan. 31.




dan

ADA opposes CMS’ Medicaid block grant guidance

The ADA said it believes a new policy from the Centers for Medicare and Medicaid could be “detrimental” to the millions of adults who rely on Medicaid for dental care.




dan

OSHA issues coronavirus guidance

The Occupational Safety and Health Administration has issued new guidance for health care providers to prepare workplaces for COVID-19.




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ADA develops guidance on dental emergency, nonemergency care

The ADA provided its members and their patients detailed guidance on March 18 on what to consider dental emergencies and nonemergencies dental care as part of an effort to curb the spread of the coronavirus disease, COVID-19, and alleviate the burden on hospital and emergency departments.




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ADA urges CDC to provide ‘immediate guidance’ on protecting dental patients, staff from COVID-19 during emergency treatments

The American Dental Association is urging the Centers for Disease Control and Prevention to provide immediate guidance on the best way to protect dental patients and staff from the transmission of COVID-19 during emergency and urgent care situations.




dan

Labor Dept. releases new guidance in response to Families First Coronavirus Response Act

The U.S. Department of Labor Wage and Hour Division released new guidance March 26 to help workers and employers understand provisions included in the Families First Coronavirus Response Act.




dan

ADA releases interim guidance on minimizing COVID-19 transmission risk when treating dental emergencies

The American Dental Association has released interim guidance for dentists on how to minimize the risk of COVID-19 transmission before, during and after treating dental emergencies.




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ADA advises dentists to follow science-backed guidance regarding COVID-19 testing, avoid 'gray market'

The ADA is urging dentists to be cautious about using novel coronavirus diagnostic tests before they have been properly evaluated and made available for dentists.




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ADA offers interim guidance as some states consider reopening

“To aid dentists who may be reopening their practices when state mandates are lifted,” the ADA issued an updated statement and interim guidance April 18 on the personal protective equipment recommended in order to practice during this pandemic and minimize the risk of virus transmission.




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ADA task force assembles interim guidance toolkit for dentists returning to work

The ADA's Advisory Task Force on Dental Practice Recovery has developed a toolkit to help dentists return to more normal practice operations while taking precautions to protect staff, patients and themselves from COVID-19 as some states reopen.




dan

ADA urges CDC to update guidance for dental personnel

The American Dental Association is urging the Centers for Disease Control and Prevention to “quickly provide guidance” on how to safely reopen dental practices during the deceleration phase of the COVID-19 outbreak.




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ADA tip sheet includes CDC guidance on identifying counterfeit N95 masks

The American Dental Association has created a tip sheet with guidance from the National Institute for Occupational Safety and Health group at the Centers for Disease Control and Prevention to help health care professionals avoid buying or using counterfeit N95 respirators, which are often simply referred to as masks.




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Risk of Major Adverse Cardiovascular Events, Severe Hypoglycemia, and All-Cause Mortality for Widely Used Antihyperglycemic Dual and Triple Therapies for Type 2 Diabetes Management: A Cohort Study of All Danish Users

OBJECTIVE

The vast number of antihyperglycemic medications and growing amount of evidence make clinical decision making difficult. The aim of this study was to investigate the safety of antihyperglycemic dual and triple therapies for type 2 diabetes management with respect to major adverse cardiovascular events, severe hypoglycemia, and all-cause mortality in a real-life clinical setting.

RESEARCH DESIGN AND METHODS

Cox regression models were constructed to analyze 20 years of data from the Danish National Patient Registry with respect to effect of the antihyperglycemic therapies on the three end points.

RESULTS

A total of 66,807 people with type 2 diabetes were treated with metformin (MET) including a combination of second- and third-line therapies. People on MET plus sulfonylurea (SU) had the highest risk of all end points, except for severe hypoglycemia, for which people on MET plus basal insulin (BASAL) had a higher risk. The lowest risk of major adverse cardiovascular events was seen for people on a regimen including a glucagon-like peptide 1 (GLP-1) receptor agonist. People treated with MET, GLP-1, and BASAL had a lower risk of all three end points than people treated with MET and BASAL, especially for severe hypoglycemia. The lowest risk of all three end points was, in general, seen for people treated with MET, sodium–glucose cotransporter 2 inhibitor, and GLP-1.

CONCLUSIONS

Findings from this study do not support SU as the second-line treatment choice for patients with type 2 diabetes. Moreover, the results indicate that adding a GLP-1 for people treated with MET and BASAL could be considered, especially if those people suffer from severe hypoglycemia.




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Metabolic Factors, Lifestyle Habits, and Possible Polyneuropathy in Early Type 2 Diabetes: A Nationwide Study of 5,249 Patients in the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) Cohort

OBJECTIVE

To investigate the association of metabolic and lifestyle factors with possible diabetic polyneuropathy (DPN) and neuropathic pain in patients with early type 2 diabetes.

RESEARCH DESIGN AND METHODS

We thoroughly characterized 6,726 patients with recently diagnosed diabetes. After a median of 2.8 years, we sent a detailed questionnaire on neuropathy, including the Michigan Neuropathy Screening Instrument questionnaire (MNSIq), to identify possible DPN (score ≥4) and the Douleur Neuropathique en 4 Questions (DN4) questionnaire for possible associated neuropathic pain (MNSIq ≥4 + pain in both feet + DN4 score ≥3).

RESULTS

Among 5,249 patients with data on both DPN and pain, 17.9% (n = 938) had possible DPN, including 7.4% (n = 386) with possible neuropathic pain. In regression analyses, central obesity (waist circumference, waist-to-hip ratio, and waist-to-height ratio) was markedly associated with DPN. Other important metabolic factors associated with DPN included hypertriglyceridemia ≥1.7 mmol/L, adjusted prevalence ratio (aPR) 1.36 (95% CI 1.17; 1.59); decreased HDL cholesterol <1.0/1.2 mmol/L (male/female), aPR 1.35 (95% CI 1.12; 1.62); hs-CRP ≥3.0 mg/L, aPR 1.66 (95% CI 1.42; 1.94); C-peptide ≥1,550 pmol/L, aPR 1.72 (95% CI 1.43; 2.07); HbA1c ≥78 mmol/mol, aPR 1.42 (95% CI 1.06; 1.88); and antihypertensive drug use, aPR 1.34 (95% CI 1.16; 1.55). Smoking, aPR 1.50 (95% CI 1.24; 1.81), and lack of physical activity (0 vs. ≥3 days/week), aPR 1.61 (95% CI 1.39; 1.85), were also associated with DPN. Smoking, high alcohol intake, and failure to increase activity after diabetes diagnosis associated with neuropathic pain.

CONCLUSIONS

Possible DPN was associated with metabolic syndrome factors, insulin resistance, inflammation, and modifiable lifestyle habits in early type 2 diabetes.




dan

[ Politics ] Open Question : Is Camp David going to be the new Trump “White House“ since Melania’s White House is at the top of the avoidance list for germaphobes?




dan

Bbq barramundi, Jamon, minted peas, Dijon mustard dressing & Danish fetta

Delicious fish dish for a summer night.





dan

The dangers of a noisy ocean -- and how we can quiet it down | Nicola Jones

The ocean is a naturally noisy place full of singing whales, grunting fish, snapping shrimp, cracking ice, wind and rain. But human-made sounds -- from ship engines to oil drilling -- have become an acute threat to marine life, says science journalist Nicola Jones. Watch (and listen) as she discusses the strange things that happen to underwater creatures in the face of ocean noise pollution -- and shares straightforward ways we can dial down the sound to see almost immediate impacts.




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An ethical plan for ending the pandemic and restarting the economy | Danielle Allen

As COVID-19 continues to spread, the world is facing two existential threats at once: a public health emergency and an economic crisis. Political theorist Danielle Allen describes how we can ethically and democratically address both problems by scaling up "smart testing," which would track positive cases with peer-to-peer software on people's cell phones -- so we can end the pandemic and get back to work. (This virtual conversation is part of the TED Connects series, hosted by head of TED Chris Anderson and business curator Corey Hajim. Recorded April 6, 2020)




dan

New Hampshire offers guidance on high school graduations




dan

New Hampshire offers guidance on high school graduations




dan

Former Oregon kicker Aidan Schneider details the day his passion for football died

It was subtle and unexpected move for Schneider, but it was the right one.




dan

Employment, termination, redundancy : “what about the tax” / by Brett Zimmermann, DW Fox Tucker Lawyers.




dan

Employment law constraints on the implementation of redundancies / presented by Kaye Smith, EMA Legal.




dan

Advising employers on redundancy / presented by Michael Ats, Lieschke & Weatherill.




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General guidance on dealing with probate applications and also difficult applications (probate and intestacy) and more / presented by Gaetano Aiello, Treloar & Treloar.




dan

Setting Aside Judgements and Enforcement Processes : The Defendant’s Guide.




dan

Forum 2019 : 10B due diligence pressure points : personnel, privacy and proprietary data / sliides presented by Cam Steele, Jessica Nicholls and Daniel Kiley, HWL Ebsworth Lawyers.




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Retirement living contracts : advising residents / [Danielle Macolino], Fisher Jefferies Barristers & Solicitors.




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"That's what she said" : how to draft a clear and effective affidavit in family law / paper presented by Marita Pangallo, Howard Zelling Chambers and Daniel Praolini, Capmpbell Chambers.