Continuous glucose monitors and virtual care in high-risk, racial and ethnic minority populations: Toward promoting health equity

Continuous glucose monitors (CGMs) have become an important tool to aid self-management of blood glucose for many patients with diabetes in the U.S., and the benefits of CGM use are well-documented. However, disparities in CGM use exist, with lower use in certain marginalized racial and ethnic groups. CGM may be an important and underutilized tool to help reduce inequities. Evidence supporting the use of CGMs as a part of virtual care is discussed, with an emphasis on designing virtual diabetes care programs to promote health equity. Recommendations for clinical practice and research are presented. In clinical practice, CGM should be an option for all people with diabetes who qualify based on clinical practice guidelines, regardless of race, ethnicity, or other individual characteristics. Future research should characterize the use of, benefit from, and preferences for CGM among individuals from racial and ethnic groups to guide interventions at the health system, clinic, provider, and patient levels to promote equitable, evidence-based, and guideline-directed CGM use in marginalized racial and ethnic groups with diabetes

Intricate Correlation between Body Posture, Personality Trait and Incidence of Body Pain: A Cross-Referential Study Report

OBJECTIVE: Occupational back pain is a disorder that commonly affects the working population, resulting in disability, health-care utilization, and a heavy socioeconomic burden. Although the etiology of occupational pain remains largely unsolved, anecdotal evidence exists for the contribution of personality and posture to long-term pain management, pointing to a direct contribution of the mind-body axis. In the current study, we have conducted an extensive evaluation into the relationships between posture and personality. METHOD: We have sampled a random population of 100 subjects (50 men and 50 women) in the age range of 13-82 years based on their personality and biomechanical profiles. All subjects were French-Canadian, living in Canada between the Québec and Sorel-Tracy areas. The Biotonix analyses and report were used on the subjects being tested in order to distinguish postural deviations. Personality was determined by using the Myers-Briggs Type Indicator questionnaire. RESULTS: We establish a correlation between ideal and kyphosis-lordosis postures and extraverted personalities. Conversely, our studies establish a correlative relationship between flat back and sway-back postures with introverted personalities. CONCLUSION: Overall, our studies establish a novel correlative relationship between personality, posture and pain

Determinants of adults' intention to vaccinate against pandemic swine flu

This article has been made available through the Brunel Open Access Publishing Fund.This article has been made available through the Brunel Open Access Publishing Fund.Background: Vaccination is one of the cornerstones of controlling an influenza pandemic. To optimise vaccination rates in the general population, ways of identifying determinants that influence decisions to have or not to have a vaccination need to be understood. Therefore, this study aimed to predict intention to have a swine influenza vaccination in an adult population in the UK. An extension of the Theory of Planned Behaviour provided the theoretical framework for the study. Methods: Three hundred and sixty two adults from the UK, who were not in vaccination priority groups, completed either an online (n = 306) or pen and paper (n = 56) questionnaire. Data were collected from 30th October 2009, just after swine flu vaccination became available in the UK, and concluded on 31st December 2009. The main outcome of interest was future swine flu vaccination intentions. Results: The extended Theory of Planned Behaviour predicted 60% of adults’ intention to have a swine flu vaccination with attitude, subjective norm, perceived control, anticipating feelings of regret (the impact of missing a vaccination opportunity), intention to have a seasonal vaccine this year, one perceived barrier: “I cannot be bothered to get a swine flu vaccination” and two perceived benefits: “vaccination decreases my chance of getting swine flu or its complications” and “if I get vaccinated for swine flu, I will decrease the frequency of having to consult my doctor,” being significant predictors of intention. Black British were less likely to intend to have a vaccination compared to Asian or White respondents. Conclusions: Theoretical frameworks which identify determinants that influence decisions to have a pandemic influenza vaccination are useful. The implications of this research are discussed with a view to maximising any future pandemic influenza vaccination uptake using theoretically-driven applications.This article is available through the Brunel Open Access Publishing Fund

Subregional DXA-derived vertebral bone mineral measures are stronger predictors of failure load in specimens with lower areal bone mineral density, compared to those with higher areal bone mineral density

Measurement of areal bone mineral density (aBMD) in intravertebral subregions may increase the diagnostic sensitivity of dual-energy X-ray absorptiometry (DXA)-derived parameters for vertebral fragility. This study investigated whether DXA-derived bone parameters in vertebral subregions were better predictors of vertebral bone strength in specimens with low aBMD, compared to those with higher aBMD. Twenty-five lumbar vertebrae (15 embalmed and 10 fresh-frozen) were scanned with posteroanterior- (PA) and lateral-projection DXA, and then mechanically tested in compression to ultimate failure. Whole-vertebral aBMD and bone mineral content (BMC) were measured from the PA- and lateral-projection scans and within 6 intravertebral subregions. Multivariate regression was used to predict ultimate failure load by BMC, adjusted for vertebral size and specimen fixation status across the whole specimen set, and when subgrouped into specimens with low aBMD and high aBMD. Adjusted BMC explained a substantial proportion of variance in ultimate vertebral load, when measured over the whole vertebral area in lateral projection (adjusted R2 0.84) and across the six subregions (ROIs 2–7) (adjusted R2 range 0.58–0.78). The association between adjusted BMC, either measured subregionally or across the whole vertebral area, and vertebral failure load, was increased for the subgroup of specimens with identified ‘low aBMD’, compared to those with ‘high aBMD’, particularly in the anterior subregion where the adjusted R2 differed by 0.44. The relative contribution of BMC measured in vertebral subregions to ultimate failure load is greater among specimens with lower aBMD, compared to those with higher aBMD, particularly in the anterior subregion of the vertebral body

Foreground Contamination in Interferometric Measurements of the Redshifted 21 cm Power Spectrum

Subtraction of astrophysical foreground contamination from "dirty" sky maps produced by simulated measurements of the Murchison Widefield Array (MWA) has been performed by fitting a 3rd-order polynomial along the spectral dimension of each pixel in the data cubes. The simulations are the first to include the unavoidable instrumental effects of the frequency-dependent primary antenna beams and synthesized array beams. They recover the one-dimensional spherically-binned input redshifted 21 cm power spectrum to within approximately 1% over the scales probed most sensitively by the MWA (0.01 < k < 1 Mpc^-1) and demonstrate that realistic instrumental effects will not mask the EoR signal. We find that the weighting function used to produce the dirty sky maps from the gridded visibility measurements is important to the success of the technique. Uniform weighting of the visibility measurements produces the best results, whereas natural weighting significantly worsens the foreground subtraction by coupling structure in the density of the visibility measurements to spectral structure in the dirty sky map data cube. The extremely dense uv-coverage of the MWA was found to be advantageous for this technique and produced very good results on scales corresponding to |u| < 500 wavelengths in the uv-plane without any selective editing of the uv-coverage.Comment: Replaced with version accepted by ApJ. 19 pages, including 3 figure

Effectiveness of GonaCon as an immunocontraceptive in colony-housed cats

Objectives Non-surgical contraceptive management of free-roaming cat populations is a global goal for public health and humane reasons. The objectives of this study were to measure the duration of contraception following a single intramuscular injection of a gonadotropin-releasing hormone-based vaccine (GonaCon) and to confirm its safe use in female cats living in colony conditions. Methods GonaCon (0.5 ml/cat) was administered intramuscularly to 20 intact female cats (queens), and saline was administered to 10 queens serving as sham-treated controls. Beginning in late February, 4 months after injection, all cats were housed with fertile male cats in a simulated colony environment. Time to pregnancy, fetal counts and vaccine-elicited injection-site reactions were evaluated. Results All control cats (n = 10/10) and 60% (n = 12/20) of vaccinated cats became pregnant within 4 months of the introduction of males. Two additional vaccinates became pregnant (70%; n = 14/20) within 1 year of treatment. Average fetal counts were significantly lower in vaccinated cats than in control cats. Vaccinates had a significantly longer (P = 0.0120) median time to conception (212 days) compared with controls (127.5 days). Injection-site reactions ranging from swelling to transient granulomatous masses were observed in 45% (n = 9/20) of vaccinated cats. Conclusions and relevance A single dose of GonaCon provided contraception lasting for a minimum of 1 year in 30% (n = 6/20) of treated cats. The level of contraception induced by this GonaCon dose and vaccine lot was not sufficiently effective to be recommended for use in free-roaming cats

Effectiveness of GonaCon as an immunocontraceptive in colony-housed cats

Objectives Non-surgical contraceptive management of free-roaming cat populations is a global goal for public health and humane reasons. The objectives of this study were to measure the duration of contraception following a single intramuscular injection of a gonadotropin-releasing hormone-based vaccine (GonaCon) and to confirm its safe use in female cats living in colony conditions. Methods GonaCon (0.5 ml/cat) was administered intramuscularly to 20 intact female cats (queens), and saline was administered to 10 queens serving as sham-treated controls. Beginning in late February, 4 months after injection, all cats were housed with fertile male cats in a simulated colony environment. Time to pregnancy, fetal counts and vaccine-elicited injection-site reactions were evaluated. Results All control cats (n = 10/10) and 60% (n = 12/20) of vaccinated cats became pregnant within 4 months of the introduction of males. Two additional vaccinates became pregnant (70%; n = 14/20) within 1 year of treatment. Average fetal counts were significantly lower in vaccinated cats than in control cats. Vaccinates had a significantly longer (P = 0.0120) median time to conception (212 days) compared with controls (127.5 days). Injection-site reactions ranging from swelling to transient granulomatous masses were observed in 45% (n = 9/20) of vaccinated cats. Conclusions and relevance A single dose of GonaCon provided contraception lasting for a minimum of 1 year in 30% (n = 6/20) of treated cats. The level of contraception induced by this GonaCon dose and vaccine lot was not sufficiently effective to be recommended for use in free-roaming cats

Resource shifts in Malagasy dung beetles : contrasting processes revealed by dissimilar spatial genetic patterns

The endemic dung beetle subtribe Helictopleurina has 65 species mostly in wet forests in eastern Madagascar. There are no extant native ungulates in Madagascar, but three Helictopleurus species have shifted to the introduced cattle dung in open habitats in the past 1500 years. Helictopleurus neoamplicollis and Helictopleurus marsyas exhibit very limited cytochrome oxidase subunit 1 haplotype diversity and a single haplotype is present across Madagascar, suggesting that these species shifted to cattle dung in a small region followed by rapid range expansion. In contrast, patterns of molecular diversity in Helictopleurus quadiipunctatus indicate a gradual diet shift across most of southern Madagascar, consistent with somewhat broader diet in this species. The three cattle dung-using Helictopleurus species have significantly greater geographical ranges than the forest-dwelling species, apparently because the shift to the currently very abundant new resource relaxed interspecific competition that hinders range expansion in the forest species.The endemic dung beetle subtribe Helictopleurina has 65 species mostly in wet forests in eastern Madagascar. There are no extant native ungulates in Madagascar, but three Helictopleurus species have shifted to the introduced cattle dung in open habitats in the past 1500 years. Helictopleurus neoamplicollis and Helictopleurus marsyas exhibit very limited cytochrome oxidase subunit 1 haplotype diversity and a single haplotype is present across Madagascar, suggesting that these species shifted to cattle dung in a small region followed by rapid range expansion. In contrast, patterns of molecular diversity in Helictopleurus quadiipunctatus indicate a gradual diet shift across most of southern Madagascar, consistent with somewhat broader diet in this species. The three cattle dung-using Helictopleurus species have significantly greater geographical ranges than the forest-dwelling species, apparently because the shift to the currently very abundant new resource relaxed interspecific competition that hinders range expansion in the forest species.The endemic dung beetle subtribe Helictopleurina has 65 species mostly in wet forests in eastern Madagascar. There are no extant native ungulates in Madagascar, but three Helictopleurus species have shifted to the introduced cattle dung in open habitats in the past 1500 years. Helictopleurus neoamplicollis and Helictopleurus marsyas exhibit very limited cytochrome oxidase subunit 1 haplotype diversity and a single haplotype is present across Madagascar, suggesting that these species shifted to cattle dung in a small region followed by rapid range expansion. In contrast, patterns of molecular diversity in Helictopleurus quadiipunctatus indicate a gradual diet shift across most of southern Madagascar, consistent with somewhat broader diet in this species. The three cattle dung-using Helictopleurus species have significantly greater geographical ranges than the forest-dwelling species, apparently because the shift to the currently very abundant new resource relaxed interspecific competition that hinders range expansion in the forest species.Peer reviewe

Initial conditions for star formation in clusters: physical and kinematical structure of the starless core Oph A-N6

We present high spatial (<300 AU) and spectral (0.07 km/s) resolution Submillimeter Array observations of the dense starless cluster core Oph A-N6, in the 1 mm dust continuum and the 3-2 line of N2H+ and N2D+. The dust continuum observations reveal a compact source not seen in single-dish observations, of size ~1000 AU and mass 0.005-0.01 M\odot. The combined line and single-dish observations reveal a core of size 3000 \times 1400 AU elongated in a NW-SE direction, with almost no variation in either line width or line center velocity across the map, and very small non-thermal motions. The deuterium fraction has a peak value of ~0.15 and is >0.05 over much of the core. The N2H+ column density profile across the major axis of Oph A-N6 is well represented by an isothermal cylinder, with temperature 20 K, peak density 7.1 \times 10^6 cm^{-3}, and N2H+ abundance 2.7 \times 10^{-10}. The mass of Oph A-N6 is estimated to be 0.29 M\odot, compared to a value of 0.18 M\odot from the isothermal cylinder analysis, and 0.63 M\odot for the critical mass for fragmentation of an isothermal cylinder. Compared to isolated low-mass cores, Oph A-N6 shows similar narrow line widths and small velocity variation, with a deuterium fraction similar to "evolved" dense cores. It is significantly smaller than isolated cores, with larger peak column and volume density. The available evidence suggests Oph A-N6 has formed through the fragmentation of the Oph A filament and is the precursor to a low-mass star. The dust continuum emission suggests it may already have begun to form a star.Comment: 42 pages, 12 figures, accepted by Ap

Leadership development through action learning sets: An evaluation study

This article examines the use of action learning sets in a leadership module delivered by a university in south east England. An evaluation research study was undertaking using survey method to evaluate student engagement with action learning sets, and their value, impact and sustainability. Data were collected through a questionnaire with a mix of Likert-style and open-ended questions and qualitative and quantitative data analysis was undertaken. Findings show that engagement in the action learning sets was very high. Action learning sets also had a positive impact on the development of leadership knowledge and skills and are highly valued by participants. It is likely that they would be sustainable as the majority would recommend action learning to colleagues and would consider taking another module that used action learning sets. When compared to existing literature on action learning, this study offers new insights as there is little empirical literature on student engagement with action learning sets and even less on value and sustainability