To further understanding of the genetic basis of type 2 diabetes (T2D) susceptibility, we aggregated published meta-analyses of genome-wide association studies (GWAS) including 26,488 cases and 83,964 controls of European, East Asian, South Asian, and Mexican and Mexican American ancestry. We observed significant excess in directional consistency of T2D risk alleles across ancestry groups, even at SNPs demonstrating only weak evidence of association. By following up the strongest signals of association from the trans-ethnic meta-analysis in an additional 21,491 cases and 55,647 controls of European ancestry, we identified seven novel T2D susceptibility loci. Furthermore, we observed considerable improvements in fine-mapping resolution of common variant association signals at several T2D susceptibility loci. These observations highlight the benefits of trans-ethnic GWAS for the discovery and characterisation of complex trait loci, and emphasize an exciting opportunity to extend insight into the genetic architecture and pathogenesis of human diseases across populations of diverse ancestry.

This study has identified predictors of physical activity among women with previous GDM that can inform intervention studies. Interventions targeting this population need to include planning strategies and enhance self-efficacy.

Introduction Cardiovascular disease (CVD) prevention guidelines recommend lifetime risk stratification for primary prevention of CVD, but no such risk stratification has been performed in India to date. Methods We estimated short-term and lifetime predicted CVD risk among 10 054 disease free, adult Indians in the age group of 20-69 years who participated in a nationwide risk factor surveillance study. The study population was then stratified into high shortterm ($10% 10-year risk or diabetes), low short-term (<10%)/high lifetime and low short-term/low lifetime CVD risk groups. Results The mean age (SD) of the study population (men¼63%) was 40.8+10.9 years. High short-term risk for coronary heart disease was prevalent in more than one fifth of the population (23.5%, 95% CI 22.7 to 24.4). Nearly half of individuals with low short-term predicted risk (48.2%, 95% CI 47.1 to 49.3) had a high predicted lifetime risk for CVD. While the proportion of individuals with all optimal risk factors was 15.3% (95% CI 14.6 to 16.0), it was 20.6% (95% CI 18.7 to 22.6) and 8.8% (95% CI 7.7 to 10.5) in the highest and lowest educational groups, respectively. Conclusion Approximately 1 in 2 men and 3 in 4 women in India had low short-term predicted risks for CVD in this national study, based on aggregate risk factor burden. However, 2 in 3 men and 1 in 2 women had high lifetime predicted risks for CVD, highlighting a key limitation of short-term risk stratification. Background Women who have higher systolic blood pressure (SBP) and diastolic blood pressure (DBP) in early pregnancy are more prone to develop pregnancy complications such as hypertension, preeclampsia and eclampsia. These complications contribute significantly to morbidity, stillbirth and neonatal mortality. Objective To evaluate the effect of pre-pregnancy body mass index (BMI) on first trimester SBP, DBP and mean arterial pressure (MAP). Methods 118 pregnant women between 20 and 40 years of age, up to 13 weeks and free from chronic or infectious diseases were investigated. SBP and DBP were obtained with automatic arm sphygmomanometer (Omron) and MAP was calculated as (SBP +DBP32)/3. Statistical analysis was performed using ANOVA, correlation and multivariate linear regression. Adjustments were made for age, skin colour, parity and smoking. Results Women were 26.364.9 years of age, had 8.762.7 years of schooling, per-capita income (US$) of 291.26166.4 and pre-pregnancy BMI of 25.665.1 kg/m 2 . There was a moderate positive correlation between pre-pregnancy BMI and SBP (r¼0.52; p<0.001), DBP (r¼0.33; p<0.001) and MAP (r¼0.44; p<0.001). Mean MAP (mm Hg) increased with BMI categories (underweight¼76.5; normal weight¼77.4; overweight¼82.9 and obesity¼88.7, p<0.001) as did SBP (underweight¼100.3; normal weight¼105.8; overweight¼112.4 and obesity¼121.2, p<0.001) and DBP (underweight¼64.8; normal weight¼63.5; overweight¼68.3 and obesity¼72.6, p<0.001). Multivariate linear regression showed that an increase of 1.0 kg/m 2 in pre-pregnancy BMI raised SBP in 1.24 mm Hg (p<0.001) ...

Aim The aim of this study is to characterise the nature and caseload of general paediatric outpatient clinics in rural Queensland and to compare the findings with national data. Methods A retrospective clinical audit of medical records in paediatric clinics at two rural hospitals was undertaken over a 6‐month period. Data extracted included demographics, diagnostic category and onward referral outcomes. The same diagnostic categories were used as the national Children Attending Paediatricians Study (CAPS) to facilitate comparison. Results A total of 346 records were reviewed, 56 (16.2%) documented Aboriginal and Torres Strait Islander descent. Compared to national data, significantly more children with behavioural/developmental diagnoses were seen in the rural clinics (CAPS 33.8%; rural 59.2%; P < 0.001). In contrast, children presenting with medical conditions (CAPS 48.2%; rural 28.6%; P < 0.001) and mixed medical/developmental conditions (CAPS 17.9%; rural 12.1%; P = 0.006) were seen less frequently in the rural clinics. Referral rates from the rural sites were lower than the rates reported by CAPS for children with behavioural/developmental diagnoses (CAPS 35.9%, rural 24.9%; P = 0.002) and mixed diagnoses (CAPS 40.6%, rural 19.0%; P = 0.005), while there was no difference in referral rates for children with medical diagnoses (CAPS 16.1%, rural 18.2%; P = 0.575). Conclusions Rural paediatricians' caseloads are dominated by developmental/behavioural conditions, however children with these conditions are less likely to be referred to allied health and psychology services. The reasons for lower referral rates and specific pressures upon rural health services need to be investigated in future studies to provide better health services for rural children.