Diabetes educators: Perceived experiences, supports and barriers to use of common diabetes-related technologies

© 2016 Diabetes Technology Society. Background: Various technologies are commonly used to support type 1 diabetes management (continuous subcutaneous insulin infusion therapy, continuous glucose monitoring systems, smartphone and tablet applications, and video conferencing) and may foster self-care, communication, and engagement with health care services. Diabetes educators are key professional supporters of this patient group, and ideally positioned to promote and support technology use. The aim of this study was to examine diabetes educators' perceived experiences, supports, and barriers to use of common diabetes-related technologies for people with type 1 diabetes. Methods: This qualitative ethnographic study recruited across metropolitan, regional and rural areas of Australia using purposive sampling of Australian Diabetes Educators Association members. Data were collected by semistructured telephone interviews and analyzed using thematic analysis. Results: Participants (n = 31) overwhelmingly indicated that overall the use of technology in the care of patients with type 1 diabetes was burdensome for them. They identified 3 themes involving common diabetes-related technologies: access to technology, available support, and technological advances. Overall, these themes demonstrated that while care was usually well intentioned it was more often fragmented and inconsistent. Most often care was provided by a small number of diabetes educators who had technology expertise. Conclusions: To realize the potential benefits of these relatively new but common diabetes technologies, many diabetes educators need to attain and retain the skills required to deliver this essential component of care. Furthermore, policy and strategy review is required, with reconfiguration of services to better support care delivery

What does the arthropathy of alkaptonuria teach us about disease mechanisms in osteoarthritis and ageing of joints? Lessons from a rare disease

AKU Society, the Rosetrees Foundation, the Childwick Trust, the Big Lottery and EUFP

The Open Navigation Surface Project

Many hydrographic and oceanographic agencies have moved or are moving towards gridded bathymetric products. However, there is no accepted format to allow these grids to be exchanged while maintaining data and metadata integrity. This paper describes the Open Navigation Surface (ONS) Project, which aims to fill this gap. The ONS Project is an open-source software project designed to provide a freely available, portable source-code library to encapsulate gridded bathymetric surfaces with associated uncertainty values. The data file format is called a Bathymetric Attributed Grid (BAG). The BAG is developed and maintained by the ONS Working Group (ONSWG), and the source code is available via the ONS websit

Cobalt Complexes of Bulky PNP Ligand: H2 Activation and Catalytic Two-Electron Reactivity in Hydrogenation of Alkenes and Alkynes

The reactivity of cobalt pincer complexes supported by the bulky tetramethylated PNP ligands Me4PNPR(R = iPr, tBu) has been investigated. In these ligands, the undesired H atom loss reactivity observed earlier in some classical CH2-arm PNP cobalt complexes is blocked, allowing them to be utilized for promoting two-electron catalytic transformations at the cobalt center. Accordingly, reaction of the formally CoIMe complex 3 with H2 under ambient pressure and temperature afforded the CoIII trihydride 4-H, in a reaction cascade reasoned to proceed by two-electron oxidative addition and reductive eliminations. This mechanistic proposal, alongside the observance of alkene insertion and ethane production upon sequential exposure of 3 to ethylene and H2, prompted an exploration into 3 as a catalyst for hydrogenation. Complex 4-H, formed in situ from 3 under H2, was found to be active in the catalytic hydrogenation of alkenes and alkynes. The proposed two-electron mechanism is reminiscent of the platinum group metals and demonstrates the utility of the bulky redox-innocent Me4PNPR ligand in the avoidance of one-electron reactivity, a concept that may show broad applicability in expanding the scope of earth-abundant first-row transition-metal catalysis.journal articl

Observations and simulations of nova Vul 1984 no. 2: A nova with ejecta rich in oxygen, neon, and magnesium

Nova Vul 1984 no. 2 was observed with IUE from Dec. 1984 through Nov. 1987. The spectra are characterized by strong lines from Mg, Ne, C, Si, O, N, and other elements. Data obtained in the ultraviolet, infrared, and optical show that this nova is ejecting material rich in oxygen, neon, and magnesium

What is embodiment? a psychometric approach

What is it like to have a body? The present study takes a psychometric approach to this question. We collected structured introspective reports of the rubber hand illusion, to systematically investigate the structure of bodily self-consciousness. Participants observed a rubber hand that was stroked either synchronously or asynchronously with their own hand and then made proprioceptive judgments of the location of their own hand and used Likert scales to rate their agreement or disagreement with 27 statements relating to their subjective experience of the illusion. Principal components analysis of this data revealed four major components of the experience across conditions, which we interpret as: embodiment of rubber hand, loss of own hand, movement, and affect. In the asynchronous condition, an additional fifth component, deafference, was found. Secondary analysis of the embodiment of runner hand component revealed three subcomponents in both conditions: ownership, location, and agency. The ownership and location components were independent significant predictors of proprioceptive biases induced by the illusion. These results suggest that psychometric tools may provide a rich method for studying the structure of conscious experience, and point the way towards an empirically rigorous phenomenology

Weather and Age Ratios of Northern Bobwhites in South Texas

Understanding the effects of weather on quail reproduction in semiarid environments requires simultaneous consideration of temperature and precipitation data. Therefore, we used neural modeling to assess the interactive effects of summer (Jun–Aug) temperatures (monthly means of daily maxima) and seasonal precipitation (totals) on age ratios (juvenile/adult) of northern bobwhites (Colinus virginianus) in south Texas based on data collected during 1940–97 (n = 35, 23 years missing). Age ratios increased with June temperature. Ratios were insensitive to mean maximum daily temperature in July up to 36 C, when they began to decline rapidly. Ratios were insensitive to August temperatures. Ratios increased in an asymptotic manner with fall (Sep–Nov), spring (Mar–May), and summer precipitation, and were least sensitive to fall precipitation and most sensitive to spring precipitation. Based on our analysis, temperature and precipitation influenced bobwhite production in a complex, nonlinear manner that seemed to contain thresholds and asymptotes. Low temperatures can ameliorate the negative effects of drought, and high temperatures can suppress the positive effects of precipitation. The apparent asymptotic effect of precipitation, given temperature, illustrates that assumed linearity between precipitation and production may lead to errors of interpretation and expectation for production in a particular year

Integration of microRNA changes in vivo identifies novel molecular features of muscle insulin resistance in type 2 diabetes

Skeletal muscle insulin resistance (IR) is considered a critical component of type II diabetes, yet to date IR has evaded characterization at the global gene expression level in humans. MicroRNAs (miRNAs) are considered fine-scale rheostats of protein-coding gene product abundance. The relative importance and mode of action of miRNAs in human complex diseases remains to be fully elucidated. We produce a global map of coding and non-coding RNAs in human muscle IR with the aim of identifying novel disease biomarkers. We profiled >47,000 mRNA sequences and >500 human miRNAs using gene-chips and 118 subjects (n = 71 patients versus n = 47 controls). A tissue-specific gene-ranking system was developed to stratify thousands of miRNA target-genes, removing false positives, yielding a weighted inhibitor score, which integrated the net impact of both up- and down-regulated miRNAs. Both informatic and protein detection validation was used to verify the predictions of in vivo changes. The muscle mRNA transcriptome is invariant with respect to insulin or glucose homeostasis. In contrast, a third of miRNAs detected in muscle were altered in disease (n = 62), many changing prior to the onset of clinical diabetes. The novel ranking metric identified six canonical pathways with proven links to metabolic disease while the control data demonstrated no enrichment. The Benjamini-Hochberg adjusted Gene Ontology profile of the highest ranked targets was metabolic (P < 7.4 × 10-8), post-translational modification (P < 9.7 × 10-5) and developmental (P < 1.3 × 10-6) processes. Protein profiling of six development-related genes validated the predictions. Brain-derived neurotrophic factor protein was detectable only in muscle satellite cells and was increased in diabetes patients compared with controls, consistent with the observation that global miRNA changes were opposite from those found during myogenic differentiation. We provide evidence that IR in humans may be related to coordinated changes in multiple microRNAs, which act to target relevant signaling pathways. It would appear that miRNAs can produce marked changes in target protein abundance in vivo by working in a combinatorial manner. Thus, miRNA detection represents a new molecular biomarker strategy for insulin resistance, where micrograms of patient material is needed to monitor efficacy during drug or life-style interventions