Modelling Inductive Sensors for Arc Fault Detection in Aviation.

Modern aircraft are being equipped with high-voltage and direct current (HVDC) architectures to address the increase in electrical power. Unfortunately, the rise of voltage in low pressure environments brings about a problem with unexpected ionisation phenomena such as arcing. Series arcs in HVDC cannot be detected with conventional means, and finding methods to avoid the potentially catastrophic hazards of these events becomes critical to assure further development of more electric and all electric aviation. Inductive sensors are one of the most promising detectors in terms of sensitivity, cost, weight and adaptability to the circuit wiring in aircraft electric systems. In particular, the solutions based on the detection of the high-frequency (HF) pulses created by the arc have been found to be good candidates in practical applications. This paper proposes a method for designing series arc fault inductive sensors able to capture the aforementioned HF pulses. The methodology relies on modelling the parameters of the sensor based on the physics that intervenes in the HF pulses interaction with the sensor itself. To this end, a comparative analysis with different topologies is carried out. For every approach, the key parameters influencing the HF pulses detection are studied theoretically, modelled with a finite elements method and tested in the laboratory in terms of frequency response. The final validation tests were conducted using the prototypes in real cases of detection of DC series arcs.

Conhecimento dos profissionais de saúde sobre cuidados paliativos: Análise de um hospital central português / Health professionals' knowledge of palliative care: Analysis of a Portuguese central hospital / Conocimiento de los profesionales de la salud sobre cuidados paliativos: Análisis de un hospital central portugués

Resumo Enquadramento: A evidência científica revela lacunas de conhecimento dos profissionais de saúde em cuidados paliativos, influenciando a qualidade dos cuidados. Objetivo: Caracterizar o conhecimento em cuidados paliativos dos profissionais de saúde, num hospital central universitário português. Metodologia: Estudo quantitativo, descritivo-correlacional, transversal, tendo como população-alvo os profissionais de saúde de um hospital central universitário. Aplicou-se um questionário para avaliar os conhecimentos sobre cuidados paliativos. Resultados: Dos 401 profissionais da amostra, 16,96% detém experiência e 26,18% formação específica em cuidados paliativos. Em média, identificou-se 80,53% de respostas corretas sobre filosofia dos cuidados paliativos. O conhecimento sobre controlo de sintomas e apoio à família relacionam-se negativamente com o tempo de exercício profissional (p < 0,001). Conclusão: A maioria dos profissionais demonstra conhecimento em cuidados paliativos, todavia é essencial investir na formação, particularmente nos profissionais com maior tempo de exercício profissional.

Abstract Background: Scientific evidence shows gaps in the knowledge of health professionals about palliative care, influencing the quality of care. Objective: To characterise health professionals' knowledge about palliative care in a Portuguese central university hospital. Methodology: Quantitative, descriptive-correlational, cross-sectional study, with health professionals from a central university hospital as target population. A questionnaire was applied to assess their knowledge about palliative care. Results: Of the 401 professionals in the sample, 16.96% have experience and 26.18% specific training in palliative care. On average, 80.53% of correct answers were given regarding the philosophy of palliative care. The knowledge about symptom control and family support was negatively correlated with the length of professional experience (p < 0.001). Conclusion: Most professionals demonstrate knowledge in palliative care, however it's essential to invest in training, particularly in professionals with more length of professional practice.

Resumen Marco contextual: La evidencia científica revela lagunas en los conocimientos de los profesionales de la salud en materia de cuidados paliativos, lo que influye en la calidad de la atención. Objetivo: Caracterizar los conocimientos sobre cuidados paliativos de los profesionales de la salud en un hospital central universitario portugués. Metodología: Estudio cuantitativo, descriptivo-correlacional, transversal, con profesionales de la salud de un hospital central universitario como población objetivo. Se aplicó un cuestionario para evaluar los conocimientos sobre cuidados paliativos. Resultados: De los 401 profesionales de la muestra, el 16,96% tenía experiencia y el 26,18% formación específica en cuidados paliativos. Por término medio, se identificó un 80,53% de respuestas correctas sobre la filosofía de los cuidados paliativos. Los conocimientos sobre el control de los síntomas y el apoyo familiar están relacionados negativamente con la duración del ejercicio profesional (p < 0,001). Conclusión: La mayoría de los profesionales demuestran tener conocimientos en cuidados paliativos, sin embargo, es fundamental invertir en formación, sobre todo para los profesionales con mayor tiempo de ejercicio profesional.

Deep vicariance and frequent transoceanic dispersal shape the evolutionary history of a globally distributed fern family.

PREMISE: The historical biogeography of ferns is typically expected to be dominated by long-distance dispersal due to their minuscule spores. However, few studies have inferred the historical biogeography of a large and widely distributed group of ferns to test this hypothesis. Our aims were to determine the extent to which long-distance dispersal vs. vicariance have shaped the history of the fern family Blechnaceae, to explore ecological correlates of dispersal and diversification, and to determine whether these patterns differ between the northern and southern hemispheres. METHODS: We used sequence data for three chloroplast loci to infer a time-calibrated phylogeny for 154 of 265 species of Blechnaceae, including representatives of all genera in the family. This tree was used to conduct ancestral range reconstruction and stochastic character mapping, estimate diversification rates, and identify ecological correlates of diversification. RESULTS: Blechnaceae originated in Eurasia and began diversifying in the late Cretaceous. A lineage comprising most extant diversity diversified principally in the austral Pacific region around the Paleocene-Eocene Thermal Maximum. Land connections that existed near the poles during periods of warm climates likely facilitated migration of several lineages, with subsequent climate-mediated vicariance shaping current distributions. Long-distance dispersal is frequent and asymmetrical, with New Zealand/Pacific Islands, Australia, and tropical America being major source areas. CONCLUSIONS: Ancient vicariance and extensive long-distance dispersal have shaped the history of Blechnaceae in both the northern and southern hemispheres. The exceptional diversity in austral regions appears to reflect rapid speciation in these areas; mechanisms underlying this evolutionary success remain uncertain.

Isolation, characterization, and mode of action of a class III bacteriocin produced by Lactobacillus helveticus 34.9.

Traditionally fermented foods and beverages are still produced and consumed at a large scale in Romania. They are rich sources for novel lactic acid bacteria with functional properties and with potential application in food industry or health. Lactobacillus helveticus 34.9, isolated from a home-made fermented milk is able to inhibit the growth of other bacteria, such as other lactic acid bacteria, but also strains of Bacillus subtilis, Bacillus cereus, Staphylococcus aureus, and Halobacillus hunanensis, a halobacterium isolated from the degraded wall of a Romanian monastery. L. helveticus 34.9 produces a large bacteriocin (35 KDa), active in a wide pH range, but inactivated by heat and proteinase K treatment. It shares about 20% sequence coverage with helveticin J, as determined by LC-MS analysis. Bacteriocin production was enhanced under stress conditions, especially when combined stresses were applied. Its mode of action and degree of inhibition depended on the concentration and on the indicator strain that was used; L. delbrueckii subsp. bulgaricus LMG 6901T cells from a suspension were killed, but the viability of H. hunanensis 5Hum cells was only reduced to 60%, within 8 h. However, the bacteriocin was able to prevent the bacterial growth of both indicator strains when added to the cultivation medium prior inoculation. Scanning electron microscopy images revealed morphological changes induced by the bacteriocin treatment in both sensitive strains, but more severe in the case of L. delbrueckii subsp. bulgaricus. Due to the broad antibacterial spectrum and its production under various stress conditions, the bacteriocin or the producing strain may find application in health, food and non-food related fields, including in the restoration of historical buildings.

Characterization of Some Salt-Tolerant Bacterial Hydrolases with Potential Utility in Cultural Heritage Bio-Cleaning.

Salt-tolerant enzymes produced by halophilic and halotolerant microorganisms have been proposed to be used in various applications that involve high saline conditions. Considering their biotechnological significance and the current need for more efficient producers of such catalysts, the present study aimed to evaluate the extracellular proteolytic, esterolytic, cellulolytic and xylanolytic activities of some halotolerant strains, and to characterize their functional parameters. A total of 21 bacterial and fungal strains belonging to the genera Bacillus, Virgibacillus, Salinivibrio, Salinicoccus, Psychrobacter, Nocardiopsis, Penicillium, Aspergillus, and Emericellopsis were assayed by quantitative methods. Among them, the members of the Bacillus genus exhibited the highest catalytic activities. The exoenzymes produced by three selected Bacillus strains were active over wide ranges of salinity, temperature and pH. Proteases were active at 20-80 °C, pH 6-10, and 0-1 M NaCl, while esterases showed good catalytic activities at 20-80 °C, pH 7.5-10, and 0-4 M NaCl. Cellulases and xylanases were active at 20-80 °C, pH 5-10, and 0-5 M NaCl. Due to such properties, these hydrolases could be used in a newly proposed application, namely to clean aged consolidants and organic deposits accumulated over time from the surfaces of salt-loaded wall paintings.

Biocatalytic Strategy for Grafting Natural Lignin with Aniline.

This paper presents an enzyme biocatalytic method for grafting lignin (grafting bioprocess) with aniline, leading to an amino-derivatized polymeric product with modified properties (e.g., conductivity, acidity/basicity, thermostability and amino-functionalization). Peroxidase enzyme was used as a biocatalyst and H2O2 was used as an oxidation reagent, while the oxidative insertion of aniline into the lignin structure followed a radical mechanism specific for the peroxidase enzyme. The grafting bioprocess was tested in different configurations by varying the source of peroxidase, enzyme concentration and type of lignin. Its performance was evaluated in terms of aniline conversion calculated based on UV-vis analysis. The insertion of amine groups was checked by 1H-NMR technique, where NH protons were detected in the range of 5.01-4.99 ppm. The FTIR spectra, collected before and after the grafting bioprocess, gave evidence for the lignin modification. Finally, the abundance of grafted amine groups was correlated with the decrease of the free -OH groups (from 0.030 to 0.009 -OH groups/L for initial and grafted lignin, respectively). Additionally, the grafted lignin was characterized using conductivity measurements, gel permeation chromatography (GPC), thermogravimetric analysis (TGA), temperature-programmed desorption (TPD-NH3/CO2) and scanning electron microscopy (SEM) analyses. The investigated properties of the developed lignopolymer demonstrated its disposability for specific industrial applications of derivatized lignin.

Value-based health care in obstetrics.

RATIONALE, AIMS, AND OBJECTIVES: We strive to maximize outcomes that are relevant to the women who deliver in our hospital. We demonstrate a practical method of using value-based health care (VBHC) concepts to analyse how care can be improved. METHOD: Using International Consortium of Health Outcome Measurements (ICHOM) set, a practical outcome set was constructed for women who go into spontaneous labour at term of a singleton in cephalic presentation and used for benchmarking. We included data on interventions that are major drivers of outcomes. Data from two hospitals in Amsterdam and for The Netherlands for 2011 to 2015 were collected. RESULTS: Benchmarking of readily available data helped identify a number of statistically significant and clinically relevant differences in obstetric outcomes. Caesarean section rate was significantly different at 13.7% in hospital 2 compared with 11.5% in hospital 1 with similar neonatal outcomes. Third and fourth degree tearing rates were significantly higher for hospital 1 at 5.5% compared with 3.6% for hospital 2 and the national average of 3.5%. On the basis of the guidelines, literature, and discussion, initiatives on how to improve these outcomes were then identified. These include caesarean section audit and guidelines regarding caesarean section decision making. In order to reduce the rate of third and fourth degree tearing, routine episiotomy on vaginal operative deliveries was introduced, and a training programme was set up to make care providers more aware of risk factors and potential preventive measures. CONCLUSION: Defining, measuring, and comparing relevant outcomes enable care providers to identify improvements. Collection and comparison of readily available data can provide insights in where care can be improved. Insights from literature and comparison of care practices and processes can lead to how care can be improved. Continuous monitoring of outcomes and expanding the set of outcomes that is readily available are key in the process towards value-based care provision.

National environmental quality assessment and monitoring of atmospheric heavy metal pollution - A moss bag approach.

As airborne pollution is recognised as the single largest environmental health hazard in Europe, the necessity to develop effective systems for monitoring and reducing the level of air pollutants, becomes imperative. The paper describes a tested and implemented long-term biomonitoring system for airborne heavy metals at a national scale. Moss bags (Hylocomium splendens) were exposed in 142 monitoring stations designated in Romania, and the content of Pb, Cd, Ni and As was quantified using inductively coupled plasma mass spectrometry. The results revealed that the accumulation of heavy metals exceeded the established thresholds, marking high pollution levels in 8.8% of samples for As, in 5.63% samples for Cd, in 3.17% samples for Pb, and in 0.35% samples for Ni. The maximum heavy metal concentration was 113.77 mg kg-1 dry weight for Pb, 44.93 mg kg-1 dry weight for Ni, 14.68 mg kg-1 dry weight for As, and 3.88 mg kg-1 dry weight for Cd, with several overlaps for at least two metals, thus marking pollution hotspots. In order to process, summarise and communicate the obtained data, a software named BioMonRo has been developed as the core part of a complex monitoring and warning-informative system. The software is able to generate heavy metal pollution maps and specific reports, depicting the levels and patterns of distribution, which can be automatically sent to a number of interested recipients. The results show that the developed national system is functional, cost-effective, and could be successfully used for long-term monitoring of airborne heavy metals.

Occupational well-being in pediatricians-a survey about work-related posttraumatic stress, depression, and anxiety.

The objective of this study was to study mental health, coping, and support after work-related adverse events among pediatricians. Physicians are frequently exposed to adverse events. It makes them at risk for posttraumatic stress disorder (PTSD), depression, and anxiety disorders. Besides the personal impact, physicians could pose a threat towards patients, as mental health problems are associated with medical errors. A questionnaire was sent to all members of the Pediatric Association of The Netherlands in October 2016. The questionnaire focused on adverse events, coping, and support. The Hospital Anxiety and Depression Scale and the Trauma Screening Questionnaire were included for evaluation of anxiety, depression, and posttraumatic stress. Four hundred ten questionnaires (18.9%) were eligible for analysis. Seventy-nine % (n = 325) of the respondents experienced adverse events, with "missing a diagnosis" having the most emotional impact and "aggressive behavior" as the most common adverse event. Nine (2.2%) pediatricians scored above the cut-off value on the Trauma Screening Questionnaire, indicative of PTSD. In total, 7.3% (n = 30) and 14.1% (n = 58) scored above the cut-off values in the Hospital Anxiety and Depression Scale, indicative of depression and anxiety. Only 26.3% reported to have a peer support protocol available for emotional support following adverse events.Conclusion: Pediatricians experience a considerable amount of adverse and potentially traumatizing events associated with significantly higher mental health problems compared to the general high-income population. Aggression towards pediatricians seems to be a common problem. Protocolled (peer) support should be implemented. What is known: • Physicians are frequently exposed to adverse events. It makes physicians at risk for depression, anxiety, and posttraumatic stress. • Physicians who are affected by these events pose a threat towards patients, as mental health problems are associated with medical errors. What is new: • Pediatricians experience a considerable amount of adverse and potentially traumatizing events associated with significantly higher mental health problems. • It is advised that (peer) support after adverse events is protocolled and education on coping strategies is implemented, to improve mental well-being of pediatricians.

One-Pot Enzymatic Production of Lignin-Composites.

A novel and efficient one-pot system for green production of artificial lignin bio-composites has been developed. Monolignols such as sinapyl (SA) and coniferyl (CA) alcohols were linked together with caffeic acid (CafAc) affording a polymeric network similar with natural lignin. The interaction of the dissolved SA/CA with CafAc already bound on a solid support (SC2/SC6-CafAc) allowed the attachment of the polymeric product direct on the support surface (SC2/SC6-CafAc-L1 and SC2/SC6-CafAc-L2, from CA and SA, respectively). Accordingly, this procedure offers the advantage of a simultaneous polymer production and deposition. Chemically, oxi-copolymerization of phenolic derivatives (SA/CA and CAfAc) was performed with H2O2 as oxidation reagent using peroxidase enzyme (2-1B mutant of versatile peroxidase from Pleurotus eryngii) as catalyst. The system performance reached a maximum of conversion for SA and CA of 71.1 and 49.8%, respectively. The conversion is affected by the system polarity as resulted from the addition of a co-solvent (e.g., MeOH, EtOH, or THF). The chemical structure, morphology, and properties of the bio-composites surface were investigated using different techniques, e.g., FTIR, TPD-NH3, TGA, contact angle, and SEM. Thus, it was demonstrated that the SA monolignol favored bio-composites with a dense polymeric surface, high acidity, and low hydrophobicity, while CA allowed the production of thinner polymeric layers with high hydrophobicity.

Bifunctional carbohydrate biopolymers entrapped lipase as catalyst for the two consecutive conversions of α-pinene to oxy-derivatives.

Bifunctional catalysts designed as carbohydrate biopolymers entrapping lipase have been investigated for the biotransformation of a natural compound (α-pinene) to oxy-derivatives. Lipases assisted the epoxidation of α-pinene using H2O2 as oxidation reagent and ethyl acetate as both acetate-supplier and solvent affording α-pinene oxide as the main product. Further, the biopolymer promoted the isomerization of α-pinene oxide to campholenic aldehyde and trans-carenol. In this case, the biopolymers played double roles of the support and also active part of the bifunctional catalyst. Screening of enzymes and their entrapping in a biopolymeric matrix (e.g. Ca-alginate and κ-carrageenan) indicated the lipase extracted from Aspergillus niger as the most efficient. In addition, the presence of biopolymers enhanced the catalytic activity of the immobilized lipase (i.e. 13.39×10(3), 19.76×10(3)and 26.46×10(3) for the free lipase, lipase-carrageenan and lipase-alginate, respectively). The catalysts stability and reusability were confirmed in eight consecutively reaction runs.

Bandeira de broadrick para o restabelecimento do plano oclusal com utilização de prótese Overlay / Rehabilitation with Broadrick flag for restoring occlusal plane and use of type Overlay prosthesis

O correto restabelecimento da dimensão vertical de oclusão (DVO), do posicionamento mandibular e do nivelamento do plano oclusal devem ser requisitos básicos nas reabilitações onde houve um colapso oclusal. Porém, em muitos casos essas soluções requerem tratamentos complexos e de alto custo para a maioria da população. O presente trabalho teve como objetivo revisar os princípios envolvidos, indicação clínica, planejamento e execução, com o objetivo de discutir a viabilidade clínica e efetividade de próteses parciais removíveis (PPR) provisórias tipo Overlay e do nivelamento oclusal com o auxílio do dispositivo de Broadrick, identificando suas indicações, vantagens e desvantagens através da apresentação de um caso clínico. Concluiu-se que a PPR tipo Overlay pode ser indicada como alternativa de tratamento para pacientes com necessidade do nivelamento oclusal e do restabelecimento da DVO, podendo ser empregada como tratamento temporário ou definitivo; e o método de Broadrick pode ser útil na orientação da determinação da curva de Spee em pacientes com plano oclusal desequilibrado.

The correct restoration of vertical dimension of occlusion, the mandible positioning and leveling of the occlusal plane should be basic requirements in rehabilitation where there was a collapse occlusal. But in many cases these solutions require complex treatments and expensive for the vast majority of the population. This study aimed to review the principals involved, clinical indication, planning, in order to discuss the feasibility and clinical effectiveness of prosthesis type overlay and leveling the occlusal technique Broadrick, identifying their indications, advantages and disadvantages through the presentation of a clinical case. It was concluded that the overlay PPR may be an alternative treatment for patients in need of restoring the vertical dimension may be used as temporary or permanent treatment, and the method Broadlick may be useful in determining the orientation of the curve of Spee in patients with occlusal plane incorrect.

Gengiva artificial com restauração da papila em próteses unitárias sobre implantes mal posicionados: uma alternativa estética e de fácil higienização / Artificial gingiva with papilla restoration in sigle prostheses over malpositioned implants: An aesthetic and easy to clean alternative

A reabilitação bucal com implantes tem se tornado uma ótima opção de tratamento; no entanto, implantes mal posicionados muitas vezes apresentam dificuldade em uma resolução estética favorável. O presente trabalho teve como objetivo relatar uma abordagem alternativa para uma condição clínica de posicionamento desfavorável de implantes, com um planejamento protético inicial também desfavorável. Por meio de uma caso clínico foi apresentada uma alternativa viável para essas situações, de coroas individuais sobre implante com gengiva artificial, trazendo de volta a região das papilas, demonstrando ser essa uma alternativa eficiente no que diz respeito à estética e de fácil higienização — fator importante na manutenção da saúde peri-implantar

Oral rehabilitation with implants has become a great treatment option, however, poorly positioned implants often present dificulty in a esthetically favorable resolution. This study aimed to describe an alternative approach to clinical conditions with unfavorable positioning of implants and also unfavorable initial prosthetic planning. By means of a clinical case report it was presented a viable alternative for these situations, using individual crowns over implant with artificial gingiva, giving back the poper papillae region, proving to be an effective alternative with aesthetic benefits and easy cleaning, an important factor in maintaining peri-implant health

[Concomitant carotid and coronary artery surgery in the prevention of postoperative stroke]. / Cirurgia carotídea e coronária simultâneas na prevenção do acidente vascular cerebral pós-operatório.

OBJECTIVES: To review the use of simultaneous carotid and coronary surgery in the prevention of perioperative stroke. METHODS: The research was conducted between May and September 2012, through Medline. The selection was based on a review of the titles and abstracts. In addition, we performed a review of reference lists of each article. RESULTS: Perioperative stroke influences the patient's prognosis after coronary artery bypass surgery and is one of the most serious and deleterious consequences of this surgical procedure. Moreover, despite perioperative stroke etiology being multifactorial, carotid disease is frequently implicated. The management of patients with extracranial carotid and coronary disease is controversial and a solid approach remains unclear. Carotid revascularization can help reduce early or long term risk. CONCLUSION: The presence of an experienced surgical team, in a center with a large number of treated patients, is critical to a successful simultaneous surgery. This approach should be considered in symptomatic carotid stenosis and asymptomatic severe bilateral stenosis. In asymptomatic patients with severe carotid stenosis, the decision should be balanced with strict patient selection criteria.

Alças esterilizáveis para refletor odontológico / Handles sterilizable to dental reflector

Pesquisas demonstram um aumento no índice de doenças infectocontagiosas que podemser adquiridas através da infecção cruzada, como os vírus da Hepatite B, Herpes, HIV,entre outros, além de bactérias e fungos. Diante da ameaça constante desses micro-organismos patogênicos, o controle da infecção tem sido uma fonte de preocupação aosCDs. Dessa forma, investir na produção de uma alça de refletor esterilizável contribuirápara o controle de infecção, protegendo e ajudando o profissional preocupado com a suasaúde e as de seus pacientes. O objetivo do estudo foi verificar junto aos fabricantes deequipamentos odontológicos no Brasil, quais disponibilizam a alça esterilizável para orefletor e se este acessório elevaria o custo final do equipamento. Foram consultadas seisfábricas de equipamentos odontológicos do Brasil através de um questionário compreendendoinformações sobre a existência, importância, custo e interesse dos fabricantesna comercialização de um dispositivo para aumentar a praticidade na manutenção dabiossegurança nos procedimentos cirúrgicos odontológicos. Apenas uma das fábricasentrevistadas disponibiliza o acessório autoclavável para a alça do refletor. As demaisempresas demonstraram interesse e consideram relevante o uso do mesmo, mas não ooferecem aos profissionais.

Researches shows an increase in the infectious diseases rate that can be acquired throughcross-infection such as Hepatitis B, Herpes, HIV, among others, besides bacteria andfungi. Facing the constant threat of these pathogens microorganisms, infection controlhas been a source of concern to dentists. Thus, to invest in the production of a reflectorsterilizable handle will contribute to the infection control, protecting and assisting thedentist worried with its health and the health of their patients. The aim of this studywas to check with the manufacturer of dental equipment in Brazil, who provide thesterilizable handle for the reflector and if its production will increase the final cost of theequipment. We interviewed six dental equipment factories in Brazil through a questionnairecontaining information about the existence, importance, cost and manufacturersinterest in the commercialization of a device to increase convenience to maintenance ofbiosecurity in dental surgical procedures. Only one of the interviewed factories providesthe autoclavable accessory to the reflector handle. The other factories showed interestand considered relevant the use of this accessory, but do not offers to the professionalto commercialize.

The efficacy of multiple daily insulin injection (MDI) and patient's satisfaction with MDI regimen among Filipinos

BACKGROUND: The long term complications of diabetes lead to diminished quality of life. As a means to avoid these complicationss, insulin therapy had evolved into a specialized regimen to achieve physiologic control of blood glucose, the so-called Multiple Daily Insulin (MDI) regimen which is a relatively new technique in the Philippines. OBJECTIVE: To study the efficacy of Multiple Daily Insulin regimen in controlling plasma glucose and to evaluate patient's satisfaction with MDI regimen among Filipino type 2 diabetics who have been on MDI for at least 2 months. RESEARCH DESIGN AND METHODS: Filipino patients (n=107) with uncontrolled diabetes were included in the study protocol. The majority were male, more than 60 years old and had been diabetic for more than 6 years. The mean body mass index was 27 kg/m2 and the mean baseline HbA1c was 9.2% + 2.65. This prospective cohort study was conducted between January 2006 to September 2008 at Cebu Doctors University Hospital Out-Patient Department. Efficacy was evaluated by HbA1c and treatment satisfaction was assessed with the Diabetes Treatment Satisfaction Questionnaire (DTSQ). Enrolled patients were followed up at week 12, 24 and 48.                                                                                                       RESULTS: Mean HbA1c fell by 2.43 + 2.68 at week 12, 2.03 + 2.35 at week 24 and 1.73 + 2.23 at week 48 showing a statistically significant decrease of HbA1c among the 3 groups was not statistically significant (p = 0.52). The proportion of patients achieving an HbA1c of CONCLUSION: Multiple Daily Insulin Regimen is an effective treatment modality based on a significant lowering of HbA1c among the study population with uncontrolled type 2 diabetes mellitus. Patients were satisfied with the ragimen based on the positive treatment satisfaction. This, however, is contrary to popular belief that patients' quality of life is affected by insulin administration. Keywords: Multiple Daily Insulin Injection, Type Diabetes Mellitus, Treatment Satisfaction.