Fatness and fitness: how do they influence health-related quality of life in type 2 diabetes mellitus?

<p>Abstract</p> <p>Objective</p> <p>We examined whether adiposity and fitness explain the decrease in health-related quality of life (HRQOL) associated with type 2 diabetes mellitus.</p> <p>Methods</p> <p>This was a cross-sectional study using baseline data from two exercise training interventions. One study enrolled people with and the other without type 2 diabetes. We assessed aerobic fitness ("fitness") as peak oxygen uptake during treadmill testing, adiposity ("fatness") as percentage of total body fat by dual-energy x-ray absorptiometry, and HRQOL by the Medical Outcomes Study SF-36. Bivariate and multivariate linear regression analyses were used examine determinants of HRQOL were used to examine determinants of HRQOL.</p> <p>Results</p> <p>There were 98 participants with and 119 participants without type 2 diabetes. Participants with type 2 diabetes had a mean hemoglobin A1c of 6.6% and, compared with participants without diabetes had lower HRQOL on the physical component summary score (<it>P </it>= 0.004), role-physical (<it>P </it>= 0.035), vitality (<it>P </it>= 0.062) and general health (<it>P </it>< 0.001) scales after adjusting for age, sex and race. These associations of HRQOL with type 2 diabetes were attenuated by higher fitness, even more than reduced fatness. Only general health remained positively associated with type 2 diabetes after accounting for fatness or fitness (<it>P </it>= 0.003). There were no significant differences between participants with and without diabetes in the mental component score.</p> <p>Conclusion</p> <p>Improved fitness, even more than reduced fatness, attenuated the association of type 2 diabetes with HRQOL. The potential to improve HRQOL may motivate patients with type 2 diabetes to engage in physical activity aimed at increasing fitness. Findings from this cross-sectional analysis will be addressed in the ongoing trial of exercise training in this cohort of participants with type 2 diabetes.</p> <p>Trial registration</p> <p>NCT00212303</p

LOSS AND RESTORATION IN LATER LIFE: AN EXAMINATION OF DUAL PROCESS MODEL OF COPING WITH BEREAVEMENT

The Dual Process Model (DPM) of Coping with Bereavement identified two oscillating coping processes, loss and restoration (Stroebe &amp; Schut, 1999). The utility of the model is investigated in two studies. In the first, we carried out secondary analyses on a large-scale qualitative study that we had conducted previously. In the second, we conducted a small-scale study specifically examining the DPM. In the first study we re-examined the interviews for Loss- (LO) and Restoration-Oriented (RO) Coping and examined whether these were associated with psychological adjustment. The results showed that those adjusting well reported the stressors New Roles/Identities/Relationships and Intrusion of Grief significantly more. Those adjusting less well reported the stressors Denial/Avoidance of Restoration Changes and Distraction/Avoidance of Grief significantly more. In the second study, we asked participants about four RO stressors of the DPM: Attending to Life Changes; New Roles/Identities/Relationships; Distraction from Grief; and New Activities. These data showed that not all participants experienced all aspects of RO Coping. In particular, participants had diverse views about the utility of Distraction from Grief as a coping mechanism. The article concludes by discussing the challenges of testing the DPM empirically. </jats:p

Sources of Airborne Endotoxins in Ambient Air and Exposure of Nearby Communities—A Review

Endotoxin is a bioaerosol component that is known to cause respiratory effects in exposed populations. To date, most research focused on occupational exposure, whilst much less is known about the impact of emissions from industrial operations on downwind endotoxin concentrations. A review of the literature was undertaken, identifying studies that reported endotoxin concentrations in both ambient environments and around sources with high endotoxin emissions. Ambient endotoxin concentrations in both rural and urban areas are generally below 10 endotoxin units (EU) m−3; however, around significant sources such as compost facilities, farms, and wastewater treatment plants, endotoxin concentrations regularly exceeded 100 EU m−3. However, this is affected by a range of factors including sampling approach, equipment, and duration. Reported downwind measurements of endotoxin demonstrate that endotoxin concentrations can remain above upwind concentrations. The evaluation of reported data is complicated due to a wide range of different parameters including sampling approaches, temperature, and site activity, demonstrating the need for a standardised methodology and improved guidance. Thorough characterisation of ambient endotoxin levels and modelling of endotoxin from pollution sources is needed to help inform future policy and support a robust health-based risk assessment process

A Controlled Study on the Characterisation of Bioaerosols Emissions from Compost

Bioaerosol emissions arising from biowaste treatment are an issue of public concern. To better characterise the bioaerosols, and to assess a range of measurement methods, we aerosolised green waste compost under controlled conditions. Viable and non-viable Andersen samplers, cyclone samplers and a real time bioaerosol detection system (Spectral Intensity Bioaerosol Sensor (SIBS)) were deployed simultaneously. The number-weighted fraction of fluorescent particles was in the range 22–26% of all particles for low and high emission scenarios. Overall fluorescence spectral profiles seen by the SIBS exhibited several peaks across the 16 wavelength bands from 298 to 735 nm. The size-fractionated endotoxin profile showed most endotoxin resided in the 2.1–9 μm aerodynamic diameter fraction, though up to 27% was found in a finer size fraction. A range of microorganisms were detected through culture, Matrix Assisted Laser Desorption and Ionisation Time of Flight Mass Spectrometry (MALDI-TOF) and quantitative polymerase chain reaction (qPCR), including Legionella pneumophila serogroup 1. These findings contribute to our knowledge of the physico-chemical and biological characteristics of bioaerosols from composting sites, as well as informing future monitoring approaches and data interpretation for bioaerosol measurement

Genetic stock structure of white steenbras Lithognathus lithognathus (Cuvier, 1829), an overexploited fishery species in South African waters

White steenbras Lithognathus lithognathus (Teleostei: Sparidae) is an overexploited marine fish species endemic to South Africa. Overexploitation in recreational, subsistence and commercial fisheries has resulted in stock collapse and the need for improved management of the species. Adults are thought to undertake large-scale annual spawning migrations, yet studies of their movement indicate low levels of connectivity among coastal regions. To address this, mitochondrial DNA sequencing and genotyping of microsatellite loci in the nuclear genome were conducted to determine the genetic stock structure and level of gene flow in this species. Genetic diversity was high throughout the species’ core distribution, with no evidence of isolation by way of distance or localised spawning. Low, non-significant pairwise fixation indices (FST, RST and Jost’s Dest) indicated low genetic differentiation and high levels of gene flow. The observed results, and agreement between mitochondrial and microsatellite DNA, confirm that white steenbras exists as a single genetic stock with high levels of gene flow throughout its distribution.The South African Institute for Aquatic Biodiversity (SAIAB), a grant from Marine and Coastal Management, and the University of Pretoria.http://www.tandfonline.com/loi/tams202019-01-30hj2017Genetic

Grouping practices in the primary school: what influences change?

During the 1990s, there was considerable emphasis on promoting particular kinds of pupil grouping as a means of raising educational standards. This survey of 2000 primary schools explored the extent to which schools had changed their grouping practices in responses to this, the nature of the changes made and the reasons for those changes. Forty eight percent of responding schools reported that they had made no change. Twenty two percent reported changes because of the literacy hour, 2% because of the numeracy hour, 7% because of a combination of these and 21% for other reasons. Important influences on decisions about the types of grouping adopted were related to pupil learning and differentiation, teaching, the implementation of the national literacy strategy, practical issues and school self-evaluation

Enrichment of dynamic chromosomal crosslinks drive phase separation of the nucleolus

Regions of highly repetitive DNA, such as those found in the nucleolus, show a self-organization that is marked by spatial segregation and frequent self-interaction. The mechanisms that underlie the sequestration of these sub-domains are largely unknown. Using a stochastic, bead-spring representation of chromatin in budding yeast, we find enrichment of protein-mediated, dynamic chromosomal cross-links recapitulates the segregation, morphology and self-interaction of the nucleolus. Rates and enrichment of dynamic crosslinking have profound consequences on domain morphology. Our model demonstrates the nucleolus is phase separated from other chromatin in the nucleus and predicts that multiple rDNA loci will form a single nucleolus independent of their location within the genome. Fluorescent labeling of budding yeast nucleoli with CDC14-GFP revealed that a split rDNA locus indeed forms a single nucleolus. We propose that nuclear sub-domains, such as the nucleolus, result from phase separations within the nucleus, which are driven by the enrichment of protein-mediated, dynamic chromosomal crosslinks

A drop-in centre for treating mental health problems in children with chronic illness: outcomes for parents and their relationship with child outcomes

BACKGROUND: Children with chronic health conditions and their parents are at greater risk of developing emotional and behavioural problems compared to their physically healthy peers. The psychological impact on parents is crucial to understand given the relationship between parental mental health and child emotional and behavioural difficulties. This study was part of a broader research project examining the acceptability, feasibility and impact of a ‘Mental Health and Psychological Wellbeing Drop-in Centre’ in a paediatric hospital providing access to support and intervention for children and their families. This paper aimed to investigate the impact of the centre on parents (n = 148). METHODS: Parental anxiety and depression were assessed using the GAD-7 and PHQ-9 at baseline and 6-month post-baseline. Child mental health was assessed using the parent-report Strengths and Difficulties Questionnaire (SDQ). If parents had significant mental health needs, a brief intervention/signposting to relevant services was provided. RESULTS: At baseline, 48% of parents scored above clinical threshold for anxiety and 41% for depression, and parent reported child SDQ scores were correlated with parental anxiety and parental low mood. Self-reported parental anxiety and low mood decreased at 6-months post-baseline (parental anxiety: mean decrease = 2.29 [1.22–3.36], d = 0.38; parental low mood: mean decrease = 1.81 [0.64–3.00], d = 0.28). There were no significant correlations between change in parent reported child wellbeing and changes in parental low mood and anxiety between baseline and 6-month post-baseline. CONCLUSIONS: Assessing and providing a brief treatment to address the mental health needs of parents of children with comorbidity may bring important benefits. It is recommended that children's mental health services consider assessment of parental mental health as part of routine care

Practical, open-ended and extended investigative projects in science

The purpose of this study is to report on teachers’ use of open-ended investigative work post-16. The Gatsby Good Practical science report identifies opportunities to carry out open-ended work as one of their ten benchmarks for good practical science, yet there is currently no requirement for students in England to have access to the opportunity to carry out such work, which means that such work is often pushed to the margins. This study aimed to find out why and how teachers use open- ended investigative work with students in order to identify ways in which it can be possible in schools in England. Short questionnaires and extended semi-structured interviews were used to collect data. A total of seventeen teachers responded to the questionnaire and twelve teachers were interviewed. All teachers interviewed had been teaching for longer than 5 years and worked in schools or colleges rated ‘good’ or ‘outstanding’ by Ofsted. Teachers were asked about enablers and barriers to the work, and the ways in which they negotiated these. Findings are presented as case studies in order to be relatable to other teachers. The case studies provide information about the project, who participates, intended and perceived learning outcomes, the role of the teacher, school support and advice for other teachers. Open-ended investigative projects were characterised according to their degree of open-ness, i.e. what was provided to students from the following dimensions: problem and background, procedures, design or methodology, analysis and conclusions. Projects in which teachers provided all dimensions (confirmatory projects) were excluded from the report. Most teachers in the sample provided the theoretical context, with students able to make decisions about research design, analysis and conclusions. Ongoing or ad-hoc support was a feature of many projects, and whilst most projects were not assessed, they were often used to meet the Common Practical Assessment Criteria (CPAC) or made to ‘count’ in other ways. Most projects were carried out during class time, sometimes including collapsed days in the summer term. Five big themes were identified in terms of what teachers wanted students to learn: ‘real’ science, the state of the field, research design, iteration and data handling. Enablers of open-ended investigative work in the curriculum include teacher experience and autonomy, technical support, support from senior leadership, laboratory space and equipment budget, examination specifications, and external support and recognition. Challenges in providing access for students to open-ended investigative projects include access to literature, laboratory space, expertise and equipment, numbers of students and technicians in relation to number of teachers. Teachers in the sample found ways to negotiate or to overcome these barriers, which are likely to be useful to teachers considering offering open-ended project work in the curriculum. Time remains an intractable issue for all teachers in the sample. This report includes data only from teachers who were dedicated to providing open-ended investigative projects to their students; there may be additional barriers to doing this that affect the wider science teacher population. All of the teachers are based in schools or colleges rated outstanding or good by Ofsted, and many teach within their specialism. The conditions in other institutions may contribute to barriers to open-ended investigative projects and care must be taken to avoid widening educational inequalities in terms of access to open-ended investigative projects. Whilst open-ended investigative projects can be integrated into the post-16 curriculum, where this is not a requirement of the specification, it tends to rely on work beyond timetabled hours from teachers. Several teachers in this sample found ways of making project work ‘count’, for example by relating it to the CPAC, linking to award schemes, offering as an alternative to other scheduled teaching and learning activities and encouraging students to write about their experiences on UCAS applications. Some teachers in this study believed that open-ended investigative work had a positive impact on attainment post-16, and there may be value in researching this claim because if evidence did support the claim, more teachers may be convinced to introduce project work, even if not required by specifications. To increase the uptake of open-ended investigative project work at post-16, we recommend a range of actions. Exemplars of ‘making open-ended investigative projects count,’ could be made available to teachers, with attention to ways of minimising risk (particularly in chemistry projects), and teacher and technician time for project work through workload models and buy-out could be valued. Research investigating claims about the impact of open-ended investigative work on attainment would build a more convincing case to teachers who are currently reluctant to introduce open- ended project work. Assessment is an important driver for classroom practice, and a way to ensure that this happens is to change policy to require open-ended investigative work in post-16 examination specifications. However, where open-ended investigative work is to be included in specifications, care must be taken to avoid assessment methods that result in a formulaic approach to investigative project work