title: A model for predicting the resolution of type 2 diabetes in severely obese subjects following roux-en y gastric bypass surgery

authors: Hayes, Mark Thomas

subjects: mathematical model

abstract: Background Severely obese type 2 diabetics who undergo Roux-en Y gastric bypass surgery have significant improvements in glycaemic control. Little work has been undertaken to establish the independent predictors of such resolution or to develop a predictive model. The aim of this study was to develop a mathematical model and establish independent predictors for the resolution of diabetes. Methods A consecutive sample of 130 severely obese type 2 diabetics who underwent gastric bypass surgery for weight loss from November 1997 to May 2007 with prospective pre-operative documentation of biochemical and clinical measurements was followed up over 12 months. Logistic discrimination analysis was undertaken to identify those variables with independent predictive value and to develop a predictive model for resolution of type 2 diabetes. Consecutive samples of 130 patients with body mass index (BMI)≥35 with type 2 diabetes were selected. One hundred and twenty-seven patients completed the study with a sufficient data set. Patients were deemed unresolved if (1) diabetic medication was still required after surgery; (2) if fasting plasma glucose (FPG) remained >7 mmol/L; or (3) HbA1c remained >7%. Results Resolution of diabetes was seen in 84%, while diabetes remained but was improved in 16% of patients. Resolution was rapid and sustained with 74% of those on medication before surgery being able to discontinue this by the time of discharge 6 days following surgery. Five preoperative variables were found to have independent predictive value for resolution of diabetes, including BMI, HbA1c, FPG, hypertension and requirement for insulin. Two models have been proposed for prediction of diabetes resolution, each with 86% correct classification in this cohort of patients. Conclusions Type 2 diabetes resolves in a very high percentage of patients undergoing gastric bypass surgery for severe obesity. The key predictive variables include preoperative BMI, HbA1c, FPG, the presence of hypertension and diabetic status.

text: A model for predicting the resolution of type 2 diabetes in severely obese subjects following roux-en y gastric bypass surgery Background Severely obese type 2 diabetics who undergo Roux-en Y gastric bypass surgery have significant improvements in glycaemic control. Little work has been undertaken to establish the independent predictors of such resolution or to develop a predictive model. The aim of this study was to develop a mathematical model and establish independent predictors for the resolution of diabetes. Methods A consecutive sample of 130 severely obese type 2 diabetics who underwent gastric bypass surgery for weight loss from November 1997 to May 2007 with prospective pre-operative documentation of biochemical and clinical measurements was followed up over 12 months. Logistic discrimination analysis was undertaken to identify those variables with independent predictive value and to develop a predictive model for resolution of type 2 diabetes. Consecutive samples of 130 patients with body mass index (BMI)≥35 with type 2 diabetes were selected. One hundred and twenty-seven patients completed the study with a sufficient data set. Patients were deemed unresolved if (1) diabetic medication was still required after surgery; (2) if fasting plasma glucose (FPG) remained >7 mmol/L; or (3) HbA1c remained >7%. Results Resolution of diabetes was seen in 84%, while diabetes remained but was improved in 16% of patients. Resolution was rapid and sustained with 74% of those on medication before surgery being able to discontinue this by the time of discharge 6 days following surgery. Five preoperative variables were found to have independent predictive value for resolution of diabetes, including BMI, HbA1c, FPG, hypertension and requirement for insulin. Two models have been proposed for prediction of diabetes resolution, each with 86% correct classification in this cohort of patients. Conclusions Type 2 diabetes resolves in a very high percentage of patients undergoing gastric bypass surgery for severe obesity. The key predictive variables include preoperative BMI, HbA1c, FPG, the presence of hypertension and diabetic status.

year: 2011

title: Conscious enterprise emergence: Shared value creation through expanded conscious awareness

authors: Pavlovich, Kathryn

subjects: conscious enterprise

abstract: We propose conscious awareness as a mechanism for creating "shared value"; a form of value that Porter describes as putting social and community needs before profit. We explore the mechanism empirically in an entrepreneurial context and find that spiritual practices increase conscious awareness which, in turn, shapes entrepreneurial intentions and venture characteristics focused on shared value.

text: Conscious enterprise emergence: Shared value creation through expanded conscious awareness We propose conscious awareness as a mechanism for creating "shared value"; a form of value that Porter describes as putting social and community needs before profit. We explore the mechanism empirically in an entrepreneurial context and find that spiritual practices increase conscious awareness which, in turn, shapes entrepreneurial intentions and venture characteristics focused on shared value.

year: 2013

title: Wāhine Whaiora: Māori Women's Experiences of Bipolar Disorder and their Pathways to Recovery

authors: Harris, Parewahaika Erenora Te Korowhiti

subjects: Māori health

abstract: This research examines the unique, lived experiences of wāhine Māori (Māori women) who have been diagnosed with bipolar affective disorder and who are currently living ‘well’. Recent literature indicates that Māori present at higher rates than non-Māori with bipolar disorder. However, there is little qualitative information about the nature of their experiences, as well as sparse detail of the impacts that bipolar has on their everyday living.

The purpose of this research is to highlight Māori women’s experiences of bipolar disorder from initial presentation and assessment through to diagnosis, treatment and recovery.  It focuses on the impact bipolar disorder has on women’s relationships with their tamariki (children), whānau (family), and partners, while also exploring social and personal impacts, help-seeking patterns, and stories of recovery.
This research heard the stories of 11 wāhine Māori using a narrative-storying technique to allow wāhine to share their unique experiences as they recalled them. A thematic analysis was then used to identify key themes that depicted their journeys of:

•	Illness and symptom presentation;
•	Consequences and impacts of bipolar disorder; 
•	Support and help-seeking; and
•	Wellness and recovery.

The intent of this research is to create an awareness of the nature of bipolar disorder as it affects wāhine Māori. It endeavours to expose the experiences they have encountered and their aspirations to be better supported by whānau, and community organisations in their attempts to live active and well lives.

text: Wāhine Whaiora: Māori Women's Experiences of Bipolar Disorder and their Pathways to Recovery This research examines the unique, lived experiences of wāhine Māori (Māori women) who have been diagnosed with bipolar affective disorder and who are currently living ‘well’. Recent literature indicates that Māori present at higher rates than non-Māori with bipolar disorder. However, there is little qualitative information about the nature of their experiences, as well as sparse detail of the impacts that bipolar has on their everyday living.

The purpose of this research is to highlight Māori women’s experiences of bipolar disorder from initial presentation and assessment through to diagnosis, treatment and recovery.  It focuses on the impact bipolar disorder has on women’s relationships with their tamariki (children), whānau (family), and partners, while also exploring social and personal impacts, help-seeking patterns, and stories of recovery.
This research heard the stories of 11 wāhine Māori using a narrative-storying technique to allow wāhine to share their unique experiences as they recalled them. A thematic analysis was then used to identify key themes that depicted their journeys of:

•	Illness and symptom presentation;
•	Consequences and impacts of bipolar disorder; 
•	Support and help-seeking; and
•	Wellness and recovery.

The intent of this research is to create an awareness of the nature of bipolar disorder as it affects wāhine Māori. It endeavours to expose the experiences they have encountered and their aspirations to be better supported by whānau, and community organisations in their attempts to live active and well lives.

year: 2014