The Impact of Situational Constraints, Role Stressors, and Commitment on Employee Altruism

This study investigated relations between 3 work-related stressors (role ambiguity, role conflict, and organizational constraints) and altruistic behavior in the workplace. It was predicted that each stressor would be negatively related to altruism and that these relations would be moderated by affective commitment (AC). Data from 144 incumbent-supervisor dyads revealed that all 3 stressors; were weakly and negatively related to altruism. Two of these relationships were moderated by AC, although not as predicted. Organizational constraints were positively related to altruism among those reporting high levels of AC but negatively related among those reporting low levels of AC. The pattern was exactly opposite for role conflict. Implications of these findings are discussed

Outcomes of mindfulness-based stress reduction and mindfulness-based cognitive therapy in adults with diabetes: a systematic review

Objectives: Diabetes Mellitus (DM) is a global and progressive chronic medical condition with increasing prevalence and associated costs throughout the world. Psychological problems are common in people with DM and when they co-occur are associated with negative patient and societal outcomes. Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) were to be effective in treating a variety of psychological problems in various health conditions. Thus, using MBSR and MBCT in DM patients may help alleviate psychological problems of anxiety and depression and improve glycaemic control as a result. In this systematic review, we investigated the effectiveness of MBSR and MBCT in improving glycaemic control, anxiety and depression in adults with DM. Interventions: Randomised-Controlled Trials (RCTs) and Pilot Studies (RCPS) evaluated the effectiveness of MBSR or MBCT. Electronic searches were carried out of the following databases CINAHL, CENTRAL, EMBASE, MEDLINE, PsycINFO, PubMed, and ongoing clinical trials websites. Main outcomes: This research examined the effectiveness of MBSR and MBCT on depression, anxiety and glycaemic control in adults with T1DM or T2DM. Results: Research evidence has shown that patients with mental illnesses such as schizophrenia and anxiety disorders have a higher risk of developing DM than the general population. Explicitly, evidence indicates that the prevalence of psychological problems is much higher than in the general population and globally, with a two-fold increase in the prevalence of depression and anxiety in DM patients. 3 RCTs and 1 RCPS found a total of 365 participants. Narrative and data synthesis indicated significant reduction in levels of anxiety and depression at short-term and long-term time points. However, no significant effect on glycaemic control was established. MBSR and MBCT are feasible and efficacious methods for depression and anxiety treatment in adults with T1DM or T2DM

Effectiveness of Community Health Worker-led Diabetes Self-Management Education on Type 2 diabetes patients: A Systematic Review and Meta-Analysis

Objective: Community Health Workers are important in building individual and community capacity through outreach, community education, informal counselling, social support and advocacy programs, which enhance health knowledge and self-sufficiency. Our aim was to examine the effectiveness of a Community Health Worker-led Diabetes Self-Management Education in improving clinical and psychosocial outcomes. Methods: A thorough systematic literature search was undertaken in Medline, Pubmed, Ovid, PsyINFO, EMBASE and JBI databases (searched from December 2018 to 31st January 2019). Once selected articles were retrieved, all titles and abstracts were screened, and eligible articles identified for full text inclusion. These retrieved full texts articles were screened for eligibility and selected according to established inclusion criteria. Of the 182 studies retrieved, 20 were included for examination. Results: HbA1c outcomes were statistically significant for short and long terms with effect sizes of –0.21 (95%CI -0.31, - 0.10) and -0.26 (95% CI -0.36, -0.15) respectively and favored the CHW group. Values for secondary outcomes measured except diabetes knowledge yielded statistical significance for the CHW group. Conclusion: The CHW-intervention is an effective model that has significant impact on glycemic control, diabetes knowledge, self-care behaviors and emotional distress and well-being

Management of Diabetes Patients across the Peri- Operative Pathway: A Systematic Review

Peri-operative environments are a hazardous setting for diabetes patients. A systematic review of literature regarding the management of diabetes patients across the peri-operative pathway has been undertaken to assess if the management of patients within this pathway is suitable and effective for patients. Methods A database search of Google Scholar, CINAHAL, Embase, OVID, Cochrane Library, Joanna Briggs institute and PUBMED was undertaken from 15 th of March 2019 to 30 th of March 2019. A total of 57 papers were found and reduced down to 11 final papers that answered the review question and met the inclusion and exclusion criteria. Inclusion criteria were: Full text, English language, human subjects, adult patients only and studies that focused on diabetes care in a section of the peri-operative pathway. Exclusion criteria: children or adults and children, studies that looked a one particular intervention or type of surgery. No date limit was set. PICO tool was used to frame the study question. Results Three main themes emerged from the literature. 1. Poor patient outcomes; 2. Longer length of stay (LOS); 3. Lack of adherence to guidance and or protocols and glycaemic control. Elective patients had advantageous outcomes compared to emergency surgical patients. Hyperglycaemia still remained a problem with an increase in other medical complications for diabetes patients. LOS in hospital was found to have increased due to medical complications. Adherence to protocols and guidance was found to be beneficial in monitoring and managing hyperglycaemia. However, this review found that best practice guidance and hospital protocol is not always adhered to. A liberal approach to glycaemic control is beneficial. Conclusion This systematic review investigated the management of diabetes patients across the peri-operative pathway. Three main themes emerged from the literature: poor patient outcomes; length of stay; and lack of adherence to guidance and or protocols and glycaemic control. We concluded the peri-operative environment is a hazardous setting for a diabetes patients. Elective patients had slightly more advantageous outcomes than emergency patients. Hyperglycaemia still remains a problem which leads to poor patient outcomes and longer LOS. Adherence to protocols and guidance was found to be beneficial in monitoring and managing hyperglycaemia

A novel analytical ultracentrifugation based approach to the low resolution structure of gum arabic

Under investigation are the structural properties of gum arabic, an industrially important biopolymer for use as a stabilizer or in drug delivery, using Analytical Ultracentrifugation—a well-established, matrix-free probe for macromolecular size and shape. These results are combined with chromatographically-coupled methods (multi-angle light scattering, differential press imbalance viscometry) to provide a global analysis of its structure in varying ionic strength conditions. This analysis indicates that gum Arabic may have a compact, elliptical structure in solution, the significance of which for biotechnological use is indicated. This modelling method can be applied to other biopolymers and synthetic polymers

Is Liraglutide a Safe and Effective Medication to Treat Hyperglycaemia?: A Systematic Review

Background: The aim of this systematic review is to examine the effectiveness of Liraglutide on glycemic control and Systolic Blood Pressure (SBP) in patients with Type 2 Diabetes (T2D) mellitus and to investigate whether Liraglutide leads to any Gastrointestinal (GI) adverse effects. Materials and Methods: seven databases were searched, including CINAHL, MEDLINE, PubMed, EMBASE, Cochrane, Joana Briggs Institute (JBI). Only Randomized Controlled Trials (RCTs) that assessed safety and efficacy of Liraglutide in patients with type 2 diabetes were included. The extracted outcome measures were HbA1c, SBP, and GI disturbances. Results: 40 RCTs were included with overall numbers of participants were 16,113. Liraglutide as monotherapy or as adjunct treatments to other diabetes treatments showed significant reduction in HbA1c levels in patients with T2D. Nine studies compared Liraglutide to a placebo and Liraglutide was superior to the placebo at HbA1c reduction. Four studies compared Liraglutide to Sitagliptin, five to Glimepiride, and one to Rosiglitazone, in these studies Liraglutide was also superior at HbA1c reduction. Two studies compared it to Metformin, in one of them Liraglutide was superior. One study compared Liraglutide to variety of Oral Anti-Diabetes Medications (OADs); Liraglutide was superior at HbA1c reduction. Ten studies compared Liraglutide to variety of insulin therapy, the combination of Liraglutide plus Insulin showed greater reduction at HbA1c levels than Liraglutide or Insulin alone. In addition, Liraglutide was superior when compared to insulin as part and insulin glargine at HbA1c reduction. Eight studies compared Liraglutide to glucagon-like peptide-1 receptor agonist (Exenatide, Dulaglutide, Lixisenatide, Albiglutide, and Semaglutide), Liraglutide was superior to Exenatide, Lixisenatide, and Albiglutide at HbA1c reduction. In most of the included studies Liraglutide showed significant reduction in SBP. Liraglutide can lead to different GI events, most frequently nausea, vomiting, and diarrhea, which are transient in nature. Conclusion: The results of this systematic review indicated that Liraglutide as a monotherapy or as adjunct treatments to other diabetes treatments could significantly lower HbA1c levels and SBP. Although the gastrointestinal adverse event is common with Liraglutide, Liraglutide can be effective choice in T2D treatment

Relationship between Lipohypertrophy, Injection Techniques and Education in adults with Type 2 Diabetes: A Systematic Review

Introduction: This systematic review examines Lipohypertrophy (LH) in patients presenting with Type 1/2 Diabetes (T1/2DM) in relation to education and injection techniques. LH is a condition, which occurs in diabetes individuals at injection sights. The most common method used is palpation in detecting LH, however preventing LH can be challenging due to a number of risk factors associated with LH.Method: Seven electronic databases were systematically searched for the most appropriate studies to be included. Articles were identified using Critical Appraisal Skills Programme (CASP) for eligibility. Key words were used to search the database. A PRISMA-based systematic review was used to identify studies. Results: A total of 49 studies were identified for consideration for this review, to consolidate the studies the abstracts were examined and from these 8 studies were deemed appropriate. Three themes identified from the studies were selected: Theme 1, Risk factors in the development of LH; Theme 2, Patient education influences the development of LH and Theme 3, Do injec¬tion techniques cause LH?Conclusion: There are number of risk factors associated with the cause of LH. Education plays a key role in the prevention of LH although this is not without its limitations. Further selective studies are required in order to establish if there is one stand¬alone factor

Does ethnicity and culture affect the non- compliancy of cervical cancer screening?

Background: Globally, an estimated 528,000 women develop cervical cancer (CC) each year, 266,000 of whom die from the disease. CC is the fourth most-common cancer in women worldwide and fourteenth in the UK, where 3,200 cases are diagnosed each year. In England CC is more common among White females and more common among women in deprived areas. In 1989, the NHS Cervical ScreeningProgramme (NHSCSP) developed a screening programme aimed at identifying women who may be at risk of developing CC. However, incidence rates for CC are projected to rise by 43% in the UK between 2014 and 2035, to 17 cases per 100,000 females by2035, which suggests that there are ongoing barriers that may be preventing women from attending cervical cancer screening (CCS). The primary goal of this extended literature review, it to examine these barriers, with particular emphasis on the extent to which they are shaped by ethnicity.Methodology: The research question and selection of relevant keywords were formulated using the PICO(S) framework. Six databases were used to search for relevant literature. Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline and SCOPUS provided literature specific to the nursing and allied health perspectives while PsycINFO and Applied Social Sciences Index andAbstract (ASSIA) were used to find studies focused on sociological and psychological aspects of the research question. The use of the Cochrane database provided previous research papers relevant to the topic. All papers were screened for eligibility against the inclusion and exclusion criteria and critically appraised, and quality assessed using the Joanna Briggs Institute (JBI) checklist for systematic reviews, with reference to the Boland, Cherry & Dickson3 theories of methodology.Results: Thematic analysis of the eight studies was carried out in line with the process outlined by Braun & Clark4 to identify recurring themes and barriers to CCS access: (1) Psychological and emotional barriers (2) Financial barriers (3) Perceptions and previous experiences.Discussion: The barriers are applicable to women from all ethnicities, to varying degrees. However, females from marginalized, educationally deprived or underserved groups are less likely to attend CCS screening due to the barriers identified. This has immense implications for CC policy and practice

Tachyon Condensation and Black Strings

We show that under certain conditions, closed string tachyon condensation produces a topology changing transition from black strings to Kaluza-Klein "bubbles of nothing." This can occur when the curvature at the horizon is much smaller than the string scale, so the black string is far from the correspondence point when it would make a transition to an excited fundamental string. This provides a dramatic new endpoint to Hawking evaporation. A similar transition occurs for black p-branes, and can be viewed as a nonextremal version of a geometric transition. Applications to AdS black holes and the AdS soliton are also discussed.Comment: 23 pages, 1 figure, v2: references adde

The effectiveness of information-motivation-behavioural skills model-based diabetes self-management education among patients with type 2 diabetes in Jordan (IMB-DSME): trial protocol

Abstract for UKSBM conference: Background: According to the World Health Organization in 2014, 9% of adults over 18 years old are diagnosed with diabetes and more than 1.5 million deaths occur directly by diabetes in low and middle-income countries. Ajlouni et al (2008) estimated that approximately one million people in Jordan have been diagnosed with type 2 diabetes; a figure that is increasing. To prevent diabetes microvascular and macro vascular complications, increased efforts and attention need to be directed towards improving glycaemic levels and improving metabolic outcomes through appropriate glycaemic management and this may be best achieved through educating patients in self-management of diabetes. Barriers in diabetes self-management behaviours were found to be consistent with Information-Motivation-Behavioural skills (IMB) Model of behavioural change. 2- Aim: to examine the effects of IMB Model-based Diabetes Self-Management Educational (DSME) intervention on three self-management activities: patients’ eating habits, physical activity and medications management, in patients who attend the (NCDEG). 3- Research protocol and methods: A two group trial with randomised allocation of 230 participants on 1:1 average for both groups. Intervention group will receive the educational intervention. Control group will receive usual clinical care and referral to diabetes educational consultation if required. This study will implement an individualised DSME program based on Information-Motivation-Behavioural (IMB) skills theory. IMB behavioural change theory assumption proposes that health-related behaviour information, motivation and behavioural skills are primary determinants of promoting health behaviour. Researcher will use a validated DSME toolkit and will be delivered using motivational interviewing techniques through two face-to-face sessions (one at the beginning and one at the end) and several phone calls intervention for each participant during a period of 3 months from participation. Both groups will be assessed at 2 follow-up times (after 3 months and 6 months) for self-management knowledge, motivation, behavioural skills, diabetes level (HbA1c), blood pressure and weight from baseline assessment (time of participation). After delivering the intervention to participants in the intervention group immediately (after 3 month), a purposive sampling approach will be used to choose 15 participants for an interview to ask them to evaluate the process of implementing of the educational intervention. 4- Implications for practice/research: This clinical trial will make a knowledge contribution about conceptualizing behavioural change techniques as well as individually and culturally tailored needs, within self-management educational intervention for patients with DM. Moreover, this trial designed on three main operations: assessing, implementation and evaluation. Competently, each operation is constructed on IMB model elements, which will provide a comprehensive understanding of how Jordanian patients’ Knowledge, Motivation, Behavioural skills and metabolic outcomes changes overtime, in tandem with performing self-management behaviours over three main points of time, pre-and-post intervention and post follow up