Method: This study was conducted between November and December 2016 at two primary care clinics that offered integrated diabetes care at the time. These sites were selected to assess the discriminative validity of the PACIC. Site 1 is a Malaysian Ministry of Health-run primary care clinic while site 2 is a university-run hospital-based primary care clinic. Only site 1 annually monitors patient performance and encourages them to achieve their HbA1c targets using a standard checklist. Patients with diabetes mellitus who understood English were recruited. Participants were asked to fill out the PACIC at baseline and two weeks later.
Results: A total of 200 out of the 212 invited agreed to participate (response rate=94.3%). Confirmatory factor analysis confirmed the 5-factor structure of the PACIC. The overall PACIC score and the score in two of the five domains were significantly higher at site 1 than at site 2. The overall Cronbach's alpha was 0.924. At test-retest, intra-class correlation coefficient values ranged from 0.641 to 0.882.
Conclusion: The English version of the PACIC was found to be a valid and reliable instrument to assess the quality of care among patients with diabetes mellitus in Malaysia.
METHODS: CJ57BL/6 breeder F0 mice were fed with EBN (10 mg/kg) from different sources. After 6 weeks of diet supplementations, the F0 animals were bred to produce F1 and F2 animals. At 6 weeks of age, the F1 and F2 animals were tested for spatial recognition memory using a Y-maze test. The sialic acid content from EBN and brain gene expression were analyzed using HPLC and PCR, respectively.
RESULTS: All EBN samples contained glycoprotein with high level of sialic acid. Dietary EBN supplementation also showed an upregulation of GNE, ST8SiaIV, SLC17A5, and BDNF mRNA associated with an improvement in Y-maze cognitive performance in both generations of animal. Qualitatively, the densities of synaptic vesicles in the presynaptic terminal were higher in the F1 and F2 animals which might derive from maternal EBN supplementation.
CONCLUSION: This study provided a solid foundation toward the growing research on nutritional intervention from dietary EBN supplementation on cognitive and neurological development in the generation of mammals.