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The purpose of this study is to gain insights of American Indian (AI) communities on the role of social support in type 2 diabetes (T2D) management. Social support is a means of enhancing social and personal resources that can address underlying stressors that contribute to T2D inequities and represents a potential channel of intervention to improve management of T2D in these communities. This community-based participatory research included AI adults from the Bois Forte and Lac Courte Oreilles Bands of Ojibwe and consisted of focus groups that were conducted with people with T2D, social support persons, and service providers. Overall findings underscore the importance of social support in T2D management, especially in providing emotional support, fulfilling an appraisal function, and enabling positive health behaviors. It is also important for policies and practices to consider the social and cultural contexts, particularly the socio-historical context of life within AI communities that has inevitably shaped certain mindsets that may present barriers to care-seeking and optimal T2D management. These findings can inform interventions related to T2D management, especially in incorporating social support and complementing community strengths in achieving a broader goal of reducing diabetes inequities in AI communities.

Foot care education is an important strategy in reducing lower limb complications. There is evidence that contemporary communication approaches can improve patient education outcomes. To inform the potential of such methods in diabetic foot education, we trialled a collaborative approach in patient education counselling in a podiatry clinic. We conducted a single-blind pragmatic randomised controlled trial on 52 diabetes patients who had an active foot ulcer. Participants were randomised to either collaborative education or traditional didactic education. Outcomes on knowledge and self-care behaviours were collected via a pre and post study questionnaire (max score: 75). The study ended at 12 weeks or when the wound healed prior. 42 (80.7%) participants completed the study. The collaborative patient education group had a significant increase in score post-study (38.8 ± 8.5) compared to pre-study (32.8 ± 6.9; P

BackgroundUnderstanding the factors associated with disease severity and mortality in Coronavirus disease (COVID-19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19.MethodsWe searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently.ResultsAmong 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender (RR 1.45, 95%CI 1.23–1.71), dyspnea (RR 2.55, 95%CI 1.88–2.46), diabetes (RR 1.59, 95%CI 1.41–1.78), hypertension (RR 1.90, 95%CI 1.69–2.15). Congestive heart failure (OR 4.76, 95%CI 1.34–16.97), hilar lymphadenopathy (OR 8.34, 95%CI 2.57–27.08), bilateral lung involvement (OR 4.86, 95%CI 3.19–7.39) and reticular pattern (OR 5.54, 95%CI 1.24–24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis(>10.0 ×109/L), lymphopenia(< 1.1 ×109/L), elevated C-reactive protein(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality.ConclusionKnowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19.Primary Funding SourceNone.

Background Understanding the factors associated with disease severity and mortality in Coronavirus disease (COVID-19) is imperative to effectively triage patients. We performed a systematic review to determine the demographic, clinical, laboratory and radiological factors associated with severity and mortality in COVID-19. Methods We searched PubMed, Embase and WHO database for English language articles from inception until May 8, 2020. We included Observational studies with direct comparison of clinical characteristics between a) patients who died and those who survived or b) patients with severe disease and those without severe disease. Data extraction and quality assessment were performed by two authors independently. Results Among 15680 articles from the literature search, 109 articles were included in the analysis. The risk of mortality was higher in patients with increasing age, male gender (RR 1.45, 95%CI 1.23–1.71), dyspnea (RR 2.55, 95%CI 1.88–2.46), diabetes (RR 1.59, 95%CI 1.41–1.78), hypertension (RR 1.90, 95%CI 1.69–2.15). Congestive heart failure (OR 4.76, 95%CI 1.34–16.97), hilar lymphadenopathy (OR 8.34, 95%CI 2.57–27.08), bilateral lung involvement (OR 4.86, 95%CI 3.19–7.39) and reticular pattern (OR 5.54, 95%CI 1.24–24.67) were associated with severe disease. Clinically relevant cut-offs for leukocytosis(>10.0 x109/L), lymphopenia(< 1.1 x109/L), elevated C-reactive protein(>100mg/L), LDH(>250U/L) and D-dimer(>1mg/L) had higher odds of severe disease and greater risk of mortality. Conclusion Knowledge of the factors associated of disease severity and mortality identified in our study may assist in clinical decision-making and critical-care resource allocation for patients with COVID-19.

Field B is a marginal green field located offshore Sarawak, Malaysia with formation depth of less than 1000 meters. The compressional sonic transit time range is from 100 – 115 μs/ft, which immediately triggered the possibility of using active downhole sand control as this range is assumed to be unconsolidated. However, the rock mechanical strength characterization tests from sidewall core indicated contradictory result of a consolidated formation. Since the field is considered as a small field, the cost of the well especially on downhole sand control device need to be extensively optimized. Hence, sand prediction study for a small green field development using field and laboratory measurements was performed. Several methodologies of sand prediction were utilized to evaluate the optimum sandface completion and sand control management for the field. Empirical and analytical sand prediction based on the well logs, sidewall cores analysis, and sand prediction software are employed to evaluate the likelihood of sand production and the optimum well completion design for the field development. The available data from appraisal wells of Field B is also calibrated to the nearby brown field, Field A that has been producing for more than 30 years. This paper will discuss on the sand onset prediction results between full perforation versus oriented perforation, and pressure depletion impact on the sand production. The study shows that the formation is not prone to sand production especially in the early part of the production life with high reservoir pressure and low watercut. The expected Critical Drawdown Pressure (CDP) generated from different methods show large variation of sand onset pressure if the sandface is completed using full perforation. Oriented perforation tremendously expands the sand free drawdown limit. Based on the results of the study, expected reservoir pressure depletion and watercut, the completion of the wells adopted Oriented Perforation with no other downhole sand control equipment. This paper is beneficial for petroleum and well completion engineers especially on sand prediction part of well completion design in development stage. This will assist in ensuring the field meets the EUR and bring forward economic value as well as well integrity assurance.