Diabetes service provision:a qualitative study of newly diagnosed Type 2 diabetes patients' experiences and views

Aims: To explore newly diagnosed Type 2 diabetes patients' views about Scottish diabetes services at a time when these services are undergoing a major reorganization. To provide recommendations to maximize opportunities brought by the devolvement of services from secondary to primary healthcare settings. Methods: Qualitative panel study with 40 patients newly diagnosed with Type 2 diabetes, recruited from hospital clinics and general practices in Lothian, Scotland. Patients were interviewed three times over 1 year. The study was informed by grounded theory, which involves concurrent data collection and analysis. Results: Patients were generally satisfied with diabetes services irrespective of the types of care received. Most wanted their future care/review to be based in general practice for reasons of convenience and accessibility, although they dis-liked it when appointments were scheduled for different days. Many said they lacked the knowledge/confidence to know how to manage their diabetes in particular situations, and needed access to healthcare professionals who could answer their questions promptly. Patients expressed a need for primary care professionals who had diabetes expertise, but who had more time and were more accessible than general practitioners. Patients who had encountered practice lead nurses for diabetes spoke particularly positively of these professionals. Conclusions: Nurses with diabetes training are particularly well placed to provide information and support to patients in primary care. Ideally, practices should run 'one-stop' diabetes clinics to provide structured care, with easily accessible dietetics, podiatry and retinopathy screening. Newly diagnosed patients may benefit from being made more aware of specific services provided by charitable organizations such as Diabetes UK. © 2005 Diabetes UK.

The retinopathy of prematurity: a study of incidence and the identification of those babies at risk: myopia associated with prematurity

The ocular problems associated with premature birth have been with us ever since it was discovered that the application of high levels of inspired oxygen provided a reduction in mortality. The consequence of this reduction in mortality has been a rise in morbidity; these mortality and morbidity rates have oscillated during the attempt to find a reasonable balance. The use of contemporary technology during the attempt both to understand the premature baby's delicate physiology and to maintain life to younger and lighter babies has not yet produced stability. The incidence of typical retinal maldevelopment, retinopathy of prematurity (RCP), was analysed by serial weekly ophthalmoscopy examinations in a regional special care baby unit, 579 examinations being made on 138 babies. The best instrument for this examination was found to be a compact indirect ophthalmoscope incorporating an inverting eyepiece - the Reichert Jung monocular indirect ophthalmoscope. The optimum time for ocular examination to discover potential ocular morbidity was at 33 weeks post-conceptual age (PCA) with continued examinations to the age of 37 weeks PCA. The babies that were found to be at risk of a significant grade of RCP were found to be of a birth weight of less than 1251 grams or had an estimated gestational age at birth of 30 weeks or less. A refractive state of myopia was found to be the norm. The myopia reduced as life progressed to attain emmetropia around the age of 50 weeks PCA or 22 weeks survival. The reduction of the myopic state was found to be dependent on birth weight and gestational age at birth, the youngest and therefore the lightest being more predictable in attaining emmetropia. Refractive variations were found to be coincident with the timings of certain medical treatment regimes and a hypothesis is postulated as to the mechanism of this association.

Certain Properties of Fractional Calculus Operators Associated with Generalized Mittag-Leffler Function

Mathematics Subject Classification: 26A33, 33E12, 33C20.

Health related quality of life and perception of stigmatisation in adolescents living with sickle cell disease in Nigeria:a cross sectional study

Background: Sickle cell disease impacts the physical, emotional and psychological aspects of life of the affected persons, often times exposing them to disease associated stigma from the society and alters the health related quality of life (HRQoL). This study compared the HRQoL of adolescents with sickle cell disease with their healthy peers, identified socio-demographic and clinical factors impacting HRQoL, and determined the extent and effects of SCD related stigma on quality of life. Procedure: We conducted a cross-sectional survey among 160 adolescents, 80 with SCD and 80 adolescents without SCD. Socio-demographic and clinical data were collected using a pre-tested questionnaire. HRQoL was investigated using the Short Form (SF-36v2) Health Survey. SCD perceived stigma was measured using an adaptation of a perceived stigma questionnaire. Results: Adolescents with SCD have significantly worse HRQoL than their peers in all of the most important dimensions of HRQoL (physical functioning, physical roles limitation, emotional roles limitation, social functioning, bodily pain, vitality and general health perception) except mental health. Recent hospital admission and SCD related complication further lowered HRQoL scores. Over seventy percent of adolescents with SCD have moderate to high level of perception of stigmatisation. Hospitalisation, SCD complication, SCD stigma were inversely, and significantly associated with HRQoL. Conclusions: Adolescents living with SCD in Nigeria have lower health related quality of life compared to their healthy peers. They also experience stigma that impacts their HRQoL. Complications of SCD and hospital admissions contribute significantly to this impairment. Pediatr Blood Cancer 2015;62:1245-1251.

A kreativitás megítélése a munkaerőpiacon (Creativity from view of job market)

A cikk két, felsőoktatásban dolgozó oktató és kutató törekvése arra, hogy feltérképezze a frissen végzett egyetemi hallgatókkal szemben, a munkaerőpiac oldaláról érkező kreativitással kapcsolatos elvárásokat. Az alapötlet egy EU-kreativitáskutatásból nőtt ki, melyben magyar középiskolai tanárok is közreműködtek. A szerzők kutatásukba beépítettek egy válaszokat tartalmazó adatbázist (337 fő). Ezt követően generáltak egy másik mintát, amely az egyetemi hallgatókat fedte le (292 fő). A lánc harmadik elemeként on-line formában és személyes lekérdezéssel 112 HR-szakember véleményét kérdezték meg a kreativitás fontosságával, mérhetőségével, az ötletet adó EU-projekt kreativitással kapcsolatos állításaival és a kreativitás definíciójával kapcsolatban. Cikkük a válaszok kvantitatív feldolgozásának eredményeit ismerteti. ______ The paper is the product of a professor’s and a researcher’s (both working in higher education) aim to determine the expectations of the job market as regards creativity in fresh graduates. The idea for this came from an EU creativity study which had included Hungarian high school teachers. The authors have integrated the database (337 persons) of these teachers’ answers into the study. They also generated a second sample that covered university students (292 persons). As a third element, the authors assessed the opinion of 112 HR managers online and in person as regards the importance and measurability of creativity, as well as their views on the statements pertaining to and definition of creativity as given in the EU creativity project. The paper presents the results of the quantitative analysis of the responses.

Valentin Nechita (left) and Rafael Travieso (right) with a Burmese python at SRS-6, Shark River Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.

Cultural Competence in Health Care: Implications for Human Resource Development

This paper reviews the need for cultural competence in health care, the barriers faced by health care professionals as they attempt to deliver culturally competent care, and the implications for human resource development initiatives.

Hospitality Administration Program Administrators View Core Areas of Knowledge

In 1992 the Accrediting Commission on Programs of Hospitality Administration established standards for hospitality administration programs. The authors surveyed program administrators regarding the current and preferred location for the teaching of the common core areas of hospitality administration knowledge.

The Beacon, October 20, 2008

Vol. 21, Issue 30, 8 pages

Global compilation of benthic data sets I

Approaches to quantify the organic carbon accumulation on a global scale generally do not consider the small-scale variability of sedimentary and oceanographic boundary conditions along continental margins. In this study, we present a new approach to regionalize the total organic carbon (TOC) content in surface sediments (<5 cm sediment depth). It is based on a compilation of more than 5500 single measurements from various sources. Global TOC distribution was determined by the application of a combined qualitative and quantitative-geostatistical method. Overall, 33 benthic TOC-based provinces were defined and used to process the global distribution pattern of the TOC content in surface sediments in a 1°x1° grid resolution. Regional dependencies of data points within each single province are expressed by modeled semi-variograms. Measured and estimated TOC values show good correlation, emphasizing the reasonable applicability of the method. The accumulation of organic carbon in marine surface sediments is a key parameter in the control of mineralization processes and the material exchange between the sediment and the ocean water. Our approach will help to improve global budgets of nutrient and carbon cycles.

Insulin-like growth factor receptor activity in cancer biology & therapy responses

The Insulin-like Growth Factor 1 Receptor (IGF-1R) has an essential function in normal cell growth and in cancer progression. However, anti-IGF-1R therapies have mostly been withdrawn from clinical trials owing to a lack of efficacy and predictive biomarkers. IGF-1R activity and signalling in cancer cells is regulated by its C-terminal tail, and in particular, by a motif that encompasses tyrosines 1250 and 1251 flanked by serines 1248 and 1252 (1248- SFYYS-1252). Mutation of Y1250/1251 greatly reduces IGF-1-promoted cell migration, interaction with the scaffolding protein RACK1 in the context Integrin signalling, and IGF- 1R kinase activity. Here we investigated the phosphorylation of the SFYYS motif and characterise the conditions under which this motif may be phosphorylated under. As phosphorylated residues, the SFYYS motif may also serve to recruit interacting proteins to the IGF-1R. To this end we identified a novel IGF-1R interacting partner which requires phosphorylated residues in the SFYYS motif to interact with the IGF-1R. This interaction was found to be IGF-1-dependent, and required the scaffold protein RACK1. The interaction of this binding protein with the IGF-1R likely functions to promote maximal phosphorylation of Shc and ERK in IGF-1-stimulated cell migration, and may be important for IGF-1 signalling in cancer cells. Lastly, we have investigated possible kinases that may confer resistance or sensitivity to the IGF-1R kinase inhibitor BMS-754807. In this screen we identified ATR as a mediator of resistance and showed that suppression or chemical inhibition of ATR synergised with BMS-754807 to reduce colony formation. This work has contributes to our understanding of IGF-1R kinase regulation and signalling and suggests that administration of anti-IGF-1R drugs with ATR inhibitors may have therapeutic benefit.

Investigative Interviewing and Memory: How Accurate Are Interviewers’ Recollections of Investigative Interviews?

Contrary to interviewing guidelines, a considerable portion of witness interviews are not recorded. Investigators’ memory, their interview notes, and any subsequent interview reports therefore become important pieces of evidence; the accuracy of interviewers’ memory or such reports is therefore of crucial importance when interviewers testify in court regarding witness interviews. A detailed recollection of the actual exchange during such interviews and how information was elicited from the witness will allow for a better assessment of statement veracity in court. Two studies were designed to examine interviewers’ memory for a prior witness interview. Study One varied interviewer note-taking and type of subsequent interview report written by interviewers by including a sample of undergraduates and implementing a two-week delay between interview and recall. Study Two varied levels of interviewing experience in addition to report type and note-taking by comparing experienced police interviewers to a student sample. Participants interviewed a mock witness about a crime, while taking notes or not, and wrote an interview report two weeks later (Study One) or immediately after (Study Two). Interview reports were written either in a summarized format, which asked interviewers for a summary of everything that occurred during the interview, or verbatim format, which asked interviewers to record in transcript format the questions they asked and the witness’s responses. Interviews were videotaped and transcribed. Transcriptions were compared to interview reports to score for accuracy and omission of interview content. Results from both studies indicate that much interview information is lost between interview and report especially after a two-week delay. The majority of information reported by interviewers is accurate, although even interviewers who recalled information immediately after still reported a troubling amount of inaccurate information. Note-taking was found to increase accuracy and completeness of interviewer reports especially after a two week delay. Report type only influenced recall of interviewer questions. Experienced police interviewers were not any better at recalling a prior witness interview than student interviewers. Results emphasize the need to record witness interviews to allow for more accurate and complete interview reconstruction by interviewers, even if interview notes are available.

(Table 1) Age determination of sediment cores EW9302-JPC1 and EW9302-JPC2

Results from two deep sea cores from northeast of Newfoundland at 1251 and 2527 m water depth, respectively, indicate that during the time period from 160,000 to 10,000 years BP, ice rafting events in the Labrador Sea were accompanied by rapid variations in deep and surface water circulation. Twelve ice-rafting events occurred, each coinciding with high concentrations of detrital carbonate and oxygen isotopic depletion of both surface and bottom waters. Eleven of these can be correlated with the North Atlantic Heinrich events H1-H11. The remaining very conspicuous ice-rafting event took place early in MIS substage 5e, at a time when the planktic faunal assemblage suggests marked warming of the sea surface. In the shallower core, benthic d13C values rise from a minimum during the deglaciation to peak substage 5e values following the last ice-rafting event, indicating that the ventilation of intermediate depths was renewed after the deglaciation was complete and continued throughout substage 5e. The benthic foraminifera suggest that this well-ventilated water mass was comparable to the modern Labrador Sea Water (LSW). The benthic faunas suggest that a relatively warm intermediate water mass entered the SE Labrador Sea during Heinrich events. Generally low benthic d13C values indicate that this water mass was poorly ventilated and rich in inorganic nutrients. Isotope data and benthic faunal distributions indicate that North Atlantic Deep Water (NADW) formed in the Norwegian-Greenland Sea reached the SE Labrador Sea between the Heinrich events.