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Spinous nanostructures with long tips could improve the SERS detection of sulfathiazole by creating more hot spots in the vicinity of particles.

Eliminating extreme poverty and reducing poverty levels among marginalized groups are essential to achieving the Sustainable Development Goals. Despite broad national-level studies on multidimensional poverty, there is a lack of specific research focusing on marginalized groups, particularly ethnic minorities. This study aims to identify the multidimensional poverty status and determinants of poverty among ethnic farmers in Thua Thien Hue province, Central Vietnam, based on a survey of 283 respondents. The Alkire–Foster method was utilized to measure multidimensional poverty, and a binary logistic regression model was applied to identify the determinants of multidimensional poverty among farmers. The results showed that about 33.57% of households are in multidimensional poverty. The deprivation in the six poverty dimensions was inconsistent, with income at 68.23%, education and health at 9.69%, housing at 7.19%, information access at 3.65%, and living conditions at 1.56%. Nine factors significantly affect the multidimensional poverty of ethnic minority households, including the age of household heads, family size, number of shocks, labor, farm size, tropical livestock units (TLUs), customers, traded input values, and training participation. Diversifying livelihood activities, building the infrastructure system to have closer access to central markets and main roads, and enhancing the capacity of farmers to cope with shocks are necessary solutions to reduce the multidimensional poverty of ethnic minorities in Central Vietnam.

Palms are beneficial for urban ornamental horticulture, since they symbolize the tropics, but only few are adapted to temperate climates. Our objective was to monitor responses of the leaves to cold reflected by the changes in chlorophyll fluorescence of leaves of Trachycarpus geminisectus, T. nanus, T. takil, T. ukhrulensis, T. wagnerianus species with the use of a chlorophyll fluorometer during the fall of 2018. Our results indicate that there was a gradual decline of maximum quantum efficiency of photosystem II (PSII) represented by Fv/Fm values from the end of September till the end of November 2018. This change corresponds well with the change in air temperature. Some species like T. ukhrulensis seemed to be more sensitive to cold since the rate of decline was the greatest in this species, also in most cases the difference was significant compared to the other species. The smallest decline in Fv/Fm values could be observed in T. wagnerianus. However, the difference compared to the other species was only significant until the middle of October after which it was not significantly better than the other well performing species such as T. takil and T. geminisectus. T. nanus was intermediate in its values, since it had significantly lower values until the beginning of October compared to T. takil and T. geminisectus, but during the remaining measurement period was not significantly different from these species. T. geminisectus seemed to perform on average with the other species. We found that there was a correlation in some cases between the changes in minimum air temperature and that of the maximum quantum efficiency of photosystem II (PSII). The correlation was strongest in T. nanus, T. wagnerianus and T. ukhrulensis. It was weaker in T. geminisectus and none in T. takil.

Although there has been substantial literature on the economic impact of labour legislation in the world, the number of studies related to Vietnam is, surprisingly, very small. Our article provides the first evidence on the link between labour law and various labour market outcomes using the Vietnamese context. We examine how labour supply, earnings and social protection outcomes adjusted to labour contract reform under the 2012 Labour Code. The study uses three waves of the Vietnam Labour Force Survey to examine both medium‐term and short‐term impacts of the reform. Difference‐in‐differences and fixed‐effect techniques are utilised. Overall, we find that the law change significantly affected hours worked, work absenteeism, monthly allowance and incidence of bonuses among contracted workers. However, the effects on workers’ monthly wages, overtime remuneration and other allowances, and the social protection‐related outcomes were not clear in the short run.

A floristic survey of the marine algal biodiversity of Antsiranana Bay, northern Madagascar, was conducted during November 2018. This represents the first inventory encompassing the three major macroalgal classes (Phaeophyceae, Florideophyceae and Ulvophyceae) for the little-known Malagasy marine flora. Combining morphological and DNA-based approaches, we report from our collection a total of 110 species from northern Madagascar, including 30 species of Phaeophyceae, 50 Florideophyceae and 30 Ulvophyceae. Barcoding of the chloroplast-encoded rbcL gene was used for the three algal classes, in addition to tufA for the Ulvophyceae. This study significantly increases our knowledge of the Malagasy marine biodiversity while augmenting the rbcL and tufA algal reference libraries for DNA barcoding. These efforts resulted in a total of 72 new species records for Madagascar. Combining our own data with the literature, we also provide an updated catalogue of 442 taxa of marine benthic macroalgae from Madagascar, comprising 85 Phaeophyceae, 1 Compsopogonophyceae, 240 Florideophyceae and 116 Ulvophyceae. This diversity holds 29 (ca. 6.5%) endemic species to Madagascar. Our results are discussed in the context of increasing threats to biodiversity on Madagascar’s coastal reefs from both anthropic and anthropogenic activities including sewage effluent runoffs and unsustainable agricultural practices such as massive deforestation, leading to ecosystem shifts to algal dominance on reefs, which are recommended to be addressed through integrated land-sea management in a Reef-to-Ridge conservation approach.

The Other Race Effect (ORE), i.e., recognition facilitation for own-race faces, is a well-established phenomenon with broad evidence in adults and infants. Nevertheless, the ORE in older children is poorly understood, and even less so for emotional face processing. This research samples 87 9-year-old children from Vietnamese and Swiss schools. In two separate studies, we evaluated the children’s abilities to perceive the disappearance of emotions in Asian and Caucasian faces in an offset task. The first study evaluated an “emotional ORE” in Vietnamese-Asian, Swiss-Caucasian, and Swiss-Multicultural children. Offset times showed an emotional ORE in Vietnamese-Asian children living in an ethnically homogeneous environment, whereas mixed ethnicities in Swiss children seem to have balanced performance between face types. The second study compared socioemotionally trained versus untrained Vietnamese-Asian children. Vietnamese children showed a strong emotional ORE and tend to increase their sensitivity to emotion offset after training. Moreover, an effect of emotion consistent with previous observation in adults could suggest a cultural sensitivity to disapproval signs. Taken together, the results suggest that 9-year-old children can present an emotional ORE, but that a heterogeneous environment or an emotional training could strengthen face-processing abilities without reducing skills on their own-group.

In this study, we examined the dependence of fluorescent intensity on different factors in the synthesis process of Fe3O4-cyanine 5.5 nanoparticles. The results showed that Fe3O4 nanoparticles needed to be covered with a layer of NH2 group before reacting with cyanine 5.5-NHS ester. The best cyanine 5.5 NHS ester:Fe3O4 and cyanine 5.5 NHS ester :APTES ratios were 1:20 and 1:3, respectively. The drug delivery did not affect much on the fluorescent property while increasing in excitation wavelength could lead to increase in fluorescent intensity of the system.

Teacher professional development (TPD) plays a vital role in enhancing student achievement and the education quality improvement at general education schools. Vietnam is carrying out the general education reforms including the curriculum, teaching methodology and textbook replacement. In order to make those reforms succeed, a lot of things have been done so far in which TPD is considered a key measure. This qualitative case-study research aimed to find out the perceptions of principals and the teachers in three selected K12 schools on TPD in response to the education reforms implementation in Vietnam using the data from the open-ended interviews with the principals, the questionnaires from teachers, and the school policy-related documents. The importance of TPD related closely to the general education reforms implementation at three schools was highly perceived and highly appreciated by the principals and teachers in similar vein. These made a strong link between their beliefs and TPD practices at their schools for promoting the education reforms. Link athttps://www.researchgate.net/publication/341641860_Significance_of_teacher_professional_development_in_response_to_the_current_general_education_reforms_in_Vietnam_perceptions_of_school_principals_and_teachers Doi:10.33225/pec/20.78.449

Emotional intelligence (EI) has a significant role in psychological well-being and is affected by parenting styles. There is no evidence about this relationship in countries with the impact of Confucianism and feudalism, in which parents use authoritarian caregiving to foster their children. The aim of the current study was to examine the association between parenting styles and EI among Vietnamese adolescents. This is a cross-sectional school survey using multilevel regression analyses controlling for potential confounders and school cluster effects. The principal data sources were the Trait Emotional Intelligence Questionnaire—Adolescent Short Form, which has been translated into Vietnamese, and the locally validated Parental Bonding Instrument, which assesses three main parenting styles: warmth, overprotectiveness, and authoritarianism. Results from 1,593 students revealed that boys had significantly higher overall EI, Well-Being, and Self-Control subscale scores than girls. The warmth of parents during childhood was associated with higher EI, while overprotectiveness and authoritarianism from mothers were associated with lower EI among adolescents. This study supports the impact of parenting styles on EI. The warmth and care from both mother and father will benefit the emotional development of their children in Vietnam.

Aims The type 2 diabetes risk following gestational diabetes mellitus (GDM) is high, particularly among South Asian women in Western countries. Our study aimed to advance the knowledge regarding the mechanisms behind suboptimal follow-up in the Nordic and South Asian women with previous GDM by comparing: 1) their experiences, 2) health and disease perceptions, and 3) barriers to and facilitators of health-promoting behaviours. Methods This qualitative study was conducted in three hospital outpatient clinics in Norway, comprising 6 focus group interviews with 28 women 1-3 years after a pregnancy with GDM. The participants were purposively sampled and grouped according to their ethnicity. The data were analysed using thematic analysis, and a theoretical approach was applied to support the analysis and discuss the study's findings. Results Five main themes were identified: lack of resilience, emotional distress, 'caught between a rock and a hard place', postpartum abandonment, and insufficient guidance. The key determinants of the maintenance of unwanted health behaviours after GDM were consistent across the ethnic groups. Although the importance of a culturally sensitive approach was emphasised, it appeared secondary to the need for a more organised public healthcare during and after GDM. Conclusions Women's real-life constraints, combined with the inadequate healthcare-service implementation, could explain the non-adherence to the lifestyle-changes guidelines essential for preventing diabetes post-GDM. We suggest promoting specific coping strategies and changing the healthcare service approach rather than relying on women's capacity to initiate the necessary changes.

Aims To identify individual and general practitioner (GP) characteristics associated with potential over- and undertreatment of hyperglycaemia in type 2 diabetes and with HbA1c not being measured. Methods A cross-sectional study that included 10233 individuals with type 2 diabetes attending 282 GPs. Individuals with an HbA1c measurement during the last 15 months were categorized as potentially overtreated if they were prescribed a sulphonylurea and/or insulin when the HbA1c was less than 53 mmol/mol (7%) when aged over 75 years or less than 48 mmol/mol (6.5%) when aged between 65 and 75 years. Potential undertreatment was defined as age less than 60 years and HbA1c > 64 mmol/mol (8.0%) or HbA1c > 69 mmol/mol (8.5%) and treated with lifestyle modification and/or monotherapy. We used multilevel binary and multinominal logistic regression models to examine associations. Results Overall, 4.1% were potentially overtreated, 7.8% were potentially undertreated and 11% did not have HbA1c measured. Characteristics associated with potential overtreatment were as follows: long diabetes duration, prescribed antihypertensive medication, cardiovascular disease and renal failure. Potential undertreatment was associated with male gender, non-western origin and low educational level. Characteristics associated with not having an HbA1c measurement performed were male gender, age < 50 years and cardiovascular diseases. GP specialist status and GPs’ use of a Noklus diabetes application reduced the risk of not having an HbA1c measurement performed. Conclusion Potential overtreatment in elderly individuals with type 2 diabetes was relatively low. Nevertheless, appropriate de-intensification or intensification of treatment and regular HbA1c measurement in identified subgroups is warranted. publishedVersion

Aims To explore variation in general practitioners’ (GPs’) performance of six recommended procedures in type 2 diabetes patients 60 years and heavier workload were associated with poorer performance. Conclusion We found large variations in GPs’ performance of processes of care. Factors reflecting structure and workload were strongly associated with performance. publishedVersion

(1) Background: Metal pollution in the Nhue-Day River basin has impacted approximately 12 million people. However, none of the previous studies considered the entire basin’s environmental and health risks. Thus, this research aims to fill knowledge gaps and reduce risks. (2) Methods: Sediment and fish samples from the basin were analyzed to determine the levels of Zn, Cu, Pb, and Cd pollution and their potential ecological (EF, modified Pollution Index—mPI, and expanded, modified potential ecological risk index—emRI) and human health risks (THQ, HI, and TR indices). (3) Results: Metal levels in sediment exceeded Canadian aquatic life protection guidelines, indicating moderate to severe contamination (EFs: 1.3–58.5 and mPIs: 4–39). Compared to the new proposed ecological risk threshold, all river sites and Site 1 for ponds had elevated metal levels; and these posed a very high ecological risk in spring (emRI > 4.5), with Cd being the most hazardous. Lead levels in all fish tissues surpassed Vietnamese and EU food regulations. In agreement with THQ, EWI (Zn, Cu) and EMI (Cd) were both less than 2.5% of the PTWI and PTMI, respectively. However, HI values of 0.67–1.26 suggested a moderate health risk. Carcinogenic risk (TR > 10−6; estimated for Pb) was detected in several localities for Common carp and Tilapia during the warm season. (4) Conclusions: Metals had a negative impact on the basin’s ecosystem, with Cd being the most dangerous. Because of lead, consumption of Common carp and Tilapia from the basin may pose both non-carcinogenic and carcinogenic health concerns.

Patients with advanced cancer frequently experience anxiety, depression and poor quality of life (QOL), as well as physical symptoms such as fatigue and weakness. Physical exercise has potential to help control these symptoms but the optimal training prescription is still not clear. We performed a study comparing medical Qigong (QG) and standard endurance and strength training (SET) in patients with advanced stage non-small cell lung (NSCLC) and gastrointestinal (GI) cancers. A randomized, cross-over study was performed in patients with advanced NSCLC and GI cancers receiving or eligible for chemotherapy. Patients received supervised QG or SET twice-weekly for 6 weeks. Psychological functioning, QOL, symptoms and physical functioning were assessed before and after each intervention period. Nineteen patients completed both interventions. Comparing interventions revealed no difference between QG and SET on change in anxiety or depression scores or QOL. However, SET treatment was better at improving perceived strength (P = 0.05) and walking distance (P = 0.02). The order in which interventions were performed had a significant impact on the improvement in certain symptoms (sleep quality, breathlessness, P

The abstract not available.

Background Ethnic minority groups from Asia and Africa living in Western countries have a higher prevalence of type 2 diabetes (T2DM) than the general population. We aimed to assess ethnic differences in diabetes care by gender. Methods Population-based, cross-sectional study identified 10,161 individuals with T2DM cared for by 282 General Practitioners (GP) in Norway. Ethnicity was based on country of birth. Multilevel regression models adjusted for individual and GP factors were applied to evaluate ethnic differences by gender. Results Diabetes was diagnosed at a younger mean age in all other ethnic groups compared with Westerners (men: 45.9–51.6 years vs. 56.4 years, women: 44.9–53.8 years vs. 59.1 years). Among Westerners mean age at diagnosis was 2.7 years higher in women compared with men, while no gender difference in age at diagnosis was found in any minority group. Daily smoking was most common among Eastern European, South Asian and Middle East/North African men. In both genders, we found no ethnic differences in processes of care (GPs’ measurement of HbA1c, blood pressure, LDL-cholesterol, creatinine). The proportion who achieved the HbA1c treatment target was higher in Westerners (men: 62.3%; women: 66.1%), than in ethnic minorities (men 48.2%; women 53.5%). Compared with Western men, the odds ratio (OR) for achieving the target was 0.45 (95% CI 0.27 to 0.73) in Eastern European; 0.67 (0.51 to 0.87) in South Asian and 0.62 (0.43 to 0.88) in Middle Eastern/North African men. Compared with Western women, OR was 0.49 (0.28 to 0.87) in Eastern European and 0.64 (0.47 to 0.86) South Asian women. Compared with Westerners, the blood pressure target was more often achieved in South Asians and Middle Easterners/North Africans in both genders. Small ethnic differences in achieving the LDL-cholesterol treatment target by gender were found. Conclusion Diabetes was diagnosed at a considerably earlier age in both minority men and minority women compared with Westerners. Several minority groups had worse glycaemic control compared with Westerners in both genders, which implies that it is necessary to improve glucose lowering treatment for the minority groups. Smoking cessation advice should particularly be offered to men in most minority groups.

There is widespread recognition that cities in the Global South need to transition toward sustainable water practices. This is particularly true of places experiencing growth and impacts from climate change concomitantly, as are Bangkok and Hanoi. We evaluate case studies in each of these two Southeast Asian cities to explore possible sustainable water management practices that their urban communities, and others experiencing similar issues, could adopt in the near term. Our analysis of these case studies supports four key conclusions: Simple expansion of rigid infrastructure does not necessarily meet local needs for water, communities can themselves provide insights and creative models, governments at any scale can be flexible and such flexibility can achieve appropriate solutions, and small-scale experimentation can and does work and can be successfully scaled up with government encouragement and support.

Objective Increasing numbers of cancer patients are using Chinese herbs (CHs). However, differences among prior studies make it difficult to draw firm conclusions about the clinical usefulness of any specific CH formula. The primary objective of this study was to establish the acceptability of taking a standardized CH formula for patients with advanced lung cancer. The secondary objective was to identify any toxicities attributable to this CH formula and to measure changes in quality of life. Methods A single-arm, prospective study of a 6-week intervention with a selected CH formula in 15 patients with stage 4 nonsmall-cell lung cancer (NSCLC, Seventh American Joint Committee on Cancer TNM staging system). Results Patients with advanced lung cancer were interested in using the CH formula. Completion (93%) and adherence (98%) levels were very high and most patients perceived the CH treatment as easy to take and were willing to take the CHs used in the study again if it was available. About half of the patients reported adverse events, all of which were mild (Grade 1 or 2) and only a small minority (8%) were potentially related to CHs. No biochemical or hematological evidence of toxicity was observed. Overall, there were improvement in quality of life, and reduced feelings of tiredness and sleepiness. Conclusion This study provides preliminary evidence that short-term use of a carefully selected and prepared CH formula in patients with stage 4 NSCLC is acceptable and safe.

The context of technical terms is very important. It is part of information in text which supports users in understanding the exact meaning of technical terms in particular specialized circumstances, especially in education and research. However, most of current dictionary systems only focus on the lookup function and the standard meaning of terms without considering related contexts. In this paper, we proposed the model for searching technical terms and context of terms based on analyzing, evaluating and choosing an optimal algorithm in pattern matching technique. Then, the model was integrated on a dictionary system and experimented on 1500 terms in the context of information system and electronic commerce. This dictionary system supports searching with technical terms both in Vietnamese and English.

Background The Nordic ‘health paradox’ designates the seemingly puzzling empirical reality in which, despite the presence of strong welfare policies targeting structural inequalities, distinct health disparities persist in Scandinavian societies. In Norway, previous research has shown that inequalities in diabetes prevalence are particularly salient, notably between ethnic groups. These have often been attributed to lifestyle, socioeconomic factors, or genetics. No previous research has sought to investigate the sociospatial mediation of diabetes inequities. Methods In this article, we examine the social geography of diabetes in Oslo to examine whether the link between ethnicity and diabetes is confounded by place. We use data from the 2002 Oslo Health Study (n = 17 325) to fit logistic regression models, assessing whether contextual factors, such as the concentration of fast food outlets, predict self-reported diabetes outcomes after controlling for relevant individual level covariates. We also test for spatial autocorrelation in the geographical distribution of diabetes. Results The findings suggest that the organisation of urban space and the spatial distribution of health-related resources exert an independent effect on diabetes prevalence, controlling for ethnicity and other covariates. Living on the east side of Oslo increases the odds of suffering from diabetes by almost 60%, whilst living in a neighbourhood characterized by a relative concentration of fast food and relative absence of healthy food shops and physical exercise facilities increases the odds by 30%. Conclusion Spatial context and toxic environments contribute to diabetes inequalities in Oslo, Norway. Future research and policy-making should take the geography of health disparities into account.

Objectives Patients with cancer cachexia have severely impaired quality of life (QoL). Multidisciplinary, multimodal treatment approaches have potential for stabilising weight and correcting other features of this syndrome, but the impact on QoL is unknown. Methods A retrospective analysis of QoL in patients with advanced cancer, referred for the management of cachexia by a specialised multidisciplinary clinic (The McGill Cancer Nutrition Rehabilitation Program clinic at the Jewish General Hospital (CNR-JGH)). QoL was assessed at visits 1–3 using a dedicated QoL tool for cachexia, and the change in QoL was calculated for each patient. The correlation between clinical features and QoL at baseline and subsequent change in QoL was analysed, to determine what factors predict improvements in QoL during the CNR-JGH intervention. Results 374 patients assessed at visit 1 with mean weight loss of 10.2% over the preceding 6 months. Baseline QoL scores were severely impaired but clinically important improvements were observed over visits 1–3 to the CNR-JGH clinic. Improvements in QoL were not determined by baseline characteristics and were similar in all patient subgroups. However, those patients who gained weight and increased their 6 min walk test (6MWT) had the greatest improvements in QoL. Conclusions Improving management of all facets of the cancer cachexia syndrome, including poor QoL, remains a priority. The multimodal approach to management of cancer cachexia offered by the CNR-JGH results in clinically important improvements in QoL. All patients who are able to receive this type of intervention have similar potential to improve their QoL, but the greatest benefits are seen in those who gain weight and improve their 6MWT.

From the total crude ethanol extract of Jasminum undulatum Ker Gawl.’s leaves and stems, five fractionss were obtained by partitioning with petroleum ether, chloroform, ethyl acetate and n-butanol solvents. These five fractions were investigated for antioxidative activity using the DPPH radical scavenging and nitric oxide-inhibitory assay. All the fractions showed antioxidative activity except the petroleum ether fraction. Among the fractionss, the ethyl acetate fraction was the most potent fraction in both assays with the SC50 values of 5.30 μg/ml and 80.90 μg/ml, respectively. Further investigation on the eight sub-fractions isolated and extracted from the ethyl acetate fraction showed that one of these sub-fractions, the TE6 sub-fraction, showed the most significant antioxidative activity with the SC50 values of 3.15 μg/ml and 61.83 μg/ml respectively in the DPPH radical scavenging and nitric oxide-inhibitory assay. From the TE4 and TE6 sub-fractions, three compounds were isolated, including p-tyrosol (1), protocatechuic acid (2) and hydroxytyrosol (3). The structure of those compounds were elucidated by spectrometric methods IR, MS, 1D-NMR, and 2D-NMR.

Objective: To assess the status of type 2 diabetes care in general practice and changes in the quality of care between 2005 and 2014, and to identify areas of diabetes care requiring improvement. Research design and methods: Two cross-sectional surveys were performed that included patients with type 2 diabetes in selected areas (n=9464 in 2014, n=5463 in 2005). Quality of care was assessed based on key recommendations in national guidelines. Differences in clinical performance between 2005 and 2014 were assessed in regression models adjusting for age, sex, counties and clustering within general practices. Results: Treatment targets were achieved in a higher proportion of patients in 2014 compared with 2005: hemoglobin A1c ≤7.0% (≤53 mmol/mol) in 62.8% vs 54.3%, blood pressure ≤135/80 mm Hg in 44.9% vs 36.6%, and total cholesterol ≤4.5 mmol/L in 49.9% vs 33.5% (all adjusted P≤0.001). Regarding screening procedures for microvascular complications, fewer patients had recorded an eye examination (61.0% vs 71.5%, adjusted P

Background Ethnic minority groups have higher prevalence of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). We assessed general practitioners’ (GPs’) performance with respect to the pharmacological prevention of CVD in patients with T2DM from different ethnic backgrounds in Oslo. Methods Of 1653 T2DM patients cared for by 49 GPs in 2005, 380 had a diagnosis of CVD. Ethnicity was categorized as Norwegian, South Asian and other. Risk factor levels, medication use, achievement of treatment targets (HbA1c ≤ 7.5%, systolic blood pressure (SBP) ≤ 140 mmHg, total cholesterol/HDL-cholesterol < 4) and therapeutic intensity (number of drugs targeting each risk factor) were recorded. Chi-square, Wald tests and multiple linear regression analyses were used. Results Of the 1273 patients receiving primary prevention, 1.5% had their Hb1Ac, 4.8% SBP and 12.7% lipids levels above treatment thresholds without relevant prescriptions. Among patients on pharmacological therapy, 66% reached the HbA1c, 62% SBP and 62% lipid target. Proportions not achieving the HbA1c target were 26% in Norwegians, 38% in South Asians and 29% in others (p = 0.008). Proportions not achieving the SBP target were 42% in Norwegians, 22% in South Asians and 25% in others (p ≤ 0.001). Of those not achieving the HbA1c and SBP targets, 43% and 35% respectively, used only one agent. In secondary prevention, 0.8% of the patients had their HbA1c, 0.5% SBP and 7.4% lipid levels above treatment thresholds without relevant prescriptions. Among patients on pharmacological therapy, 65% reached the HbA1c, 64% SBP and 66% lipid target. Proportions not achieving the HbA1c target were 26% in Norwegians, 47% in South Asians and 40% in others (p = 0.03). Proportions not achieving the SBP target were 36% in Norwegians, 22% in South Asians and 56% in others (p = 0.050). Of those not achieving HbA1c and SBP targets, 49% and 21% respectively, were on mono-therapy. Conclusions Norwegian GPs comply reasonably well with guidelines for pharmacological prevention of CVD in T2DM patients across ethnic groups. However, lipid-lowering therapy was generally underused, and the achievement of treatment targets for HbA1c in ethnic minorities and for BP in Norwegians could be improved.

Background The population in Norway has become multi-ethnic due to migration from Asia and Africa over the recent decades. The aim of the present study was to explore differences in the self-reported prevalence of cardiovascular disease (CVD) and associated risk factors by diabetes status in five ethnic minority groups compared to ethnic Norwegians. Methods Pooled data from three population-based cross-sectional studies conducted in Oslo between 2000 and 2002 was used. Of 54,473 invited individuals 24,749 (45.4%) participated. The participants self-reported health status, underwent a clinical examination and blood samples were drawn. A total of 17,854 individuals aged 30 to 61 years born in Norway, Sri-Lanka, Pakistan, Iran, Vietnam or Turkey were included in the study. Chi-square tests, one-way ANOVAs, ANCOVAs, multiple and logistic regression were used. Results Age- and gender-standardized prevalence of self-reported CVD varied between 5.8% and 8.2% for the ethnic minority groups, compared to 2.9% among ethnic Norwegians (p < 0.001). Prevalence of self-reported diabetes varied from 3.0% to 15.0% for the ethnic minority groups versus 1.8% for ethnic Norwegians (p < 0.001). Among individuals without diabetes, the CVD prevalence was 6.0% versus 2.6% for ethnic minorities and Norwegians, respectively (p < 0.001). Corresponding CVD prevalence rates among individuals with diabetes were 15.3% vs. 12.6% (p = 0.364). For individuals without diabetes, the odds ratio (OR) for CVD in the ethnic minority groups remained significantly higher (range 1.5-2.6) than ethnic Norwegians (p < 0.05), after adjustment for age, gender, education, employment, and body height, except for Turkish individuals. Regardless of diabetes status, obesity and physical inactivity were prevalent in the majority of ethnic minority groups, whereas systolic- and diastolic- blood pressures were higher in Norwegians. In nearly all ethnic groups, individuals with diabetes had higher triglycerides, waist-to-hip ratio (WHR), and body mass index compared to individuals without diabetes. Age, diabetes, hypertension, hypercholesterolemia, and WHR were significant predictors of CVD in both ethnic Norwegians and ethnic minorities, but significant ethnic differences were found for age, diabetes, and hypercholesterolemia. Conclusions Ethnic differences in the prevalence of CVD were prominent for individuals without diabetes. Primary CVD prevention including identification of undiagnosed diabetes should be prioritized for ethnic minorities without known diabetes.

Background In recent decades immigration to Norway from Asia, Africa and Eastern Europe has increased rapidly. The aim of this study was to assess the quality of care for type 2 diabetes mellitus (T2DM) patients from these ethnic minority groups compared with the care received by Norwegians. Methods In 2006, electronic medical record data were screened at 11 practices (49 GPs; 58857 patients). 1653 T2DM patients cared for in general practice were identified. Ethnicity was defined as self-reported country of birth. Chi-squared tests, one-way ANOVAs, multiple regression, linear mixed effect models and generalized linear mixed models were used. Results Diabetes was diagnosed at a younger age in patients from the ethnic minority groups (South Asians (SA): mean age 44.9 years, Middle East/North Africa (MENA): 47.2 years, East Asians (EA): 52.0 years, others: 49.0 years) compared with Norwegians (59.7 years, p < 0.001). HbA1c, systolic blood pressure (SBP) and s-cholesterol were measured in >85% of patients in all groups with minor differences between minority groups and Norwegians. A greater proportion of the minority groups were prescribed hypoglycaemic medications compared with Norwegians (≥79% vs. 72%, p < 0.001). After adjusting for age, gender, diabetes duration, practice and physician unit, HbA1c (geometric mean) for Norwegians was 6.9% compared to 7.3-7.5% in the minority groups (p < 0.05). The proportion with poor glycaemic control (HbA1c > 9%) was higher in minority groups (SA: 19.6%, MENA: 18.9% vs. Norwegians: 5.6%, p < 0.001. No significant ethnic differences were found in the proportions reaching the combined target: HbA1c ≤ 7.5%, SBP ≤ 140 mmHg, diastolic blood pressure (DBP) ≤ 85 mmHg and total s-cholesterol ≤5.0 mmol/L (Norwegians: 25.5%, SA: 24.9%, MENA: 26.9%, EA: 26.1%, others:17.5%). Conclusions Mean age at the time of diagnosis of T2DM was 8-15 years younger in minority groups compared with Norwegians. Recording of important processes of care measures is high in all groups. Only one in four of most patient groups achieved all four treatment targets and prescribing habits may be sub-optimal. Patients from minority groups have worse glycaemic control than Norwegians which implies that it might be necessary to improve the guidelines to meet the needs of specific ethnic groups.