Risk prediction models for the development of diabetes in Mauritian Indians

Aims To develop risk prediction models of future diabetes in Mauritian Indians. Methods Three thousand and ninety‐four Mauritian Indians (1141 men, aged 20–65 years) without diabetes in 1987 or 1992 were followed up to 1992 or 1998. Subjects underwent repeated oral glucose tolerance tests and diabetes was diagnosed according to 2006 World Health Organization/International Diabetes Federation criteria. Cox regression models for interval censored data were performed using data from 1544 randomly selected participants. Predicted probabilities for diabetes were calculated and validated in the remaining 1550 subjects. Results Over 11 years of follow‐up, there were 511 cases of diabetes. Among variables tested, family history of diabetes, obesity (body mass index, waist circumference) and glucose were significant predictors of diabetes. Predicted probabilities derived from a simple model fitted with sex, family history of diabetes and obesity ranged from 0.05 to 0.64 in men and 0.03 to 0.49 in women. To predict the onset of diabetes, area under the receiver operating characteristic (ROC) curve (AROC) of predicted probabilities was 0.62 (95% confidence interval, 0.56–0.68) in men and 0.64 (0.59–0.69) in women. At a cut‐off point of 0.12, the sensitivity and specificity were 0.72 (0.71–0.74) and 0.47 (0.45–0.49) in men and 0.77 (0.75–0.78) and 0.50 (0.48–0.52) in women, respectively. Addition of fasting plasma glucose (FPG) to the model improved the prediction slightly [AROC curve 0.70 (0.65–0.76) in men, 0.71 (0.67–0.76) in women]. Conclusions A diabetes prediction model based on obesity and family history yielded moderate discrimination in Mauritian Indians, which was slightly inferior to the model with the FPG but may be useful in low‐income countries to promote identification of people at high risk of diabetes.     

Quality of life in persons after traumatic brain injury as self-perceived and as perceived by the caregivers

The primary aim of the study was to adopt QOLIBRI (quality of life after brain injury) questionnaire in a proxy version (Q-Pro), i.e., to use caregivers for comparison and to evaluate whether TBI patients’ judgment corresponds to that of their caregivers since the possible self-awareness deficit of the persons with TBI. A preliminary sample of 19 outpatients with TBI and their proxies was first evaluated with the Patient Competency Rating Scale to assess patients’ self-awareness; then they were evaluated with the QOLIBRI Patient version (Q-Pt) and a patient-centered version of the Q-Pro. Subsequently, 55 patients and their caregivers were evaluated using the patient-centered and the caregiver-centered Q-Pro versions. Q-Pt for assessing Quality of Life (QoL) after TBI, as patients’ subjective perspective and Q-Pro to assess the QoL of patients as perceived by the caregivers. The majority of patients (62.2%) showed better self-perception of QoL than their proxies; however, patients with low self-awareness were less satisfied than patients with adequate self-awareness. Low self-awareness does not impair the ability of patients with TBI to report on satisfaction with QoL as self-perceived.     

Humor und Gehirn

In recent years, a number of studies have been published on cerebral activation induced by funny stimuli. This article provides an overview on the structures involved and findings concerning the neuropsychological faculties necessary for joke comprehension, e.g., working memory and mental flexibility. On the other hand, there are also many aspects of humor, like joke production, that are not neuropsychologically well studied; an overview of current knowledge will be given. In addition, there is little research on the effect of aging on the different aspects of cerebral humor processing.     

Infection control for practice standards

This report was compiled as part of the author’s work in the completion of the BVNA’s LANTRA approved course Infection Control for Practice Standards, and was an interesting and proactive exercise in interrogating, evaluating and applying the biosecurity knowledge gleaned throughout the course, with a view to identifying the current strengths and areas for implementing improvement for infection control within one general practice.     

Detecting exacerbations using the Clinical COPD Questionnaire

Background  

Early treatment of COPD exacerbations has shown to be important. Despite a non-negligible negative impact on health related quality of life, a large proportion of these episodes is not reported (no change in treatment). Little is known whether (low burden) strategies are able to capture these unreported exacerbations.