Parent and adolescent communication with healthcare professionals about Type 1 diabetes management at adolescents’ outpatient clinic appointments

Aim: This study aimed to identify the ways in which adolescents living with Type 1 diabetes and their parents communicate about Type 1 diabetes management with healthcare professionals in a clinical setting. Methods: Twenty‐nine adolescents (aged 11–17 years) and their parents were purposively recruited from two outpatient clinics for non‐participant observations. Outpatient clinic appointments, which consisted of multiple consultations with healthcare professionals, were observed and audio‐recorded. Outpatient clinic appointments were categorized based on the nature and extent of communication by the adolescent and their parent(s) in relation to Type 1 diabetes management activities. Results: Data from 29 outpatient clinic appointments, consisting of a total of 68 observed consultations, were analysed and a continuum consisting of three patterns of communication was identified (parent‐led, collaborative and adolescent‐led). Healthcare professionals should attend to the nature and extent of communication by adolescents and their parents in relation to Type 1 diabetes management activities because parent and adolescent engagement in communication during clinic appointments may also reflect their degree of involvement in daily Type 1 diabetes management. Conclusions: This continuum provides a framework for healthcare professionals to use to identify communication patterns in consultations which in turn may allow healthcare professionals to encourage more effective communication about Type 1 diabetes management from adolescents and their parents in clinic consultations. This may have a positive impact on the sharing of Type 1 diabetes management responsibilities and adolescents’ developing self‐management skills as roles change during this developmental period

Length of stay and associated costs of obesity related hospital admissions in Ireland

BACKGROUND: Obesity is the cause of other chronic diseases, psychological problems, obesity shortens the lifespan and puts strain on health systems. The risk associated with childhood obesity in particular, which will accelerate the development of adult morbidity and mortality, has been identified as an emerging public health problem. METHODS: To estimate the length of stay and associated hospital costs for obesity related illnesses a cost of illness study was set up. All discharges from all acute hospitals in the Republic of Ireland from 1997 to 2004 with a principal or secondary diagnostic code for obesity for all children from 6 to 18 years of age and for adults were collected.A discharge frequency was calculated by dividing obesity related discharges by the total number of diagnoses (principal and secondary) for each year. The hospital costs related to obesity was calculated based on the total number of days care. RESULTS: The discharge frequency of obesity related conditions increased from 1.14 in 1997 to 1.49 in 2004 for adults and from 0.81 to 1.37 for children. The relative length of stay (number of days in care for obesity related conditions per 1000 days of hospital care given) increased from 1.47 in 1997 to 4.16 in 2004 for children and from 3.68 in 1997 to 6.74 in 2004 for adults.Based on the 2001 figures for cost per inpatient bed day, the annual hospital cost was calculated to be 4.4 Euromillion in 1997, increasing to 13.3 Euromillion in 2004. At a 20% variable hospital cost the cost ranges from 0.9 Euromillion in 1997 to 2.7 Euromillion in 2004; a 200% increase. CONCLUSION: The annual increase in the proportion of hospital discharges related to obesity is alarming. This increase is related to a significant increase in economic costs. This paper emphasises the need for action at an early stage of life. Health promotion and primary prevention of obesity should be high on the political agenda

Effects of edible bird's nest (EBN) on cultured rabbit corneal keratocytes

<p>Abstract</p> <p>Background</p> <p>There has been no effective treatment or agent that is available for corneal injury in promoting corneal wound healing. Previous studies on edible bird's nest extract (EBN) had reported the presence of hormone-like substance; avian epidermal growth factor that could stimulate cell division and enhance regeneration. This study aimed to investigate the effects of EBN on corneal keratocytes proliferative capacity and phenotypical changes.</p> <p>Methods</p> <p>Corneal keratocytes from six New Zealand White Rabbits were isolated and cultured until Passage 1. The proliferative effects of EBN on corneal keratocytes were determined by MTT assay in serum-containing medium (FDS) and serum-free medium (FD). Keratocytes phenotypical changes were morphologically assessed and gene expression of aldehyde dehydrogenase (ALDH), collagen type 1 and lumican were determined through RT-PCR.</p> <p>Results</p> <p>The highest cell proliferation was observed when both media were supplemented with 0.05% and 0.1% EBN. Cell proliferation was also consistently higher in FDS compared to FD. Both phase contrast micrographs and gene expression analysis confirmed the corneal keratocytes retained their phenotypes with the addition of EBN.</p> <p>Conclusions</p> <p>These results suggested that low concentration of EBN could synergistically induce cell proliferation, especially in serum-containing medium. This could be a novel breakthrough as both cell proliferation and functional maintenance are important during corneal wound healing. The in vitro test is considered as a crucial first step for nutri-pharmaceutical formation of EBN-based eye drops before in vivo application.</p

Todas as criaturas do mundo: a arte dos mapas como elemento de orientação geográfica

Vague in the outlines and abounding in figures of real or fabulous creatures, the iconography of medieval maps played a significant role in helping users to recognize lands that were virtually unknown to Christendom. In a world with no reliable latitudes and longitudes, the land contours, inhabitants and even certain elements of fauna and flora could become variables of utmost importance for geographic orientation. Notwithstanding the higher levels of precision achieved in their efforts to represent geographic space, the considerable advancements made in latitude determination, and their continuous pursuit of a practical method for the establishment of longitudes, the cartographers of the Age of Discoveries still went to the trouble of depicting notable elements - whether real or imaginary - to help travelers get their bearings around different regions of the globe. As the presence of Europeans continued to expand and an authentic scientific revolution took place in the 17th century, the lengthy notes and eye¿catching representations of nature and local inhabitants soon lost their utility as points of reference on 17th-century maps to become mere accessories of aesthetic and commercial value. The advent of the 18th century consolidated, once and for all, the transformation of such illustrations into essentially decorative elements with no other relevant role to play in mapmaking. In addition to decreasing in number, the figures became more stylized and moved to the borders of the maps as ornamental motifs. Although they often maintained some sort of relation with the geographic space depicted on the map, the motifs chosen could also constitute a rather independent element. In fact, allegories, compositions with a variety of mythological figures, and historical representations were often used to underscore the power of certain political agents

The organic food philosophy. A qualitative exploration of the practices, values, and beliefs of Dutch organic consumers within a cultural-historical frame

Food consumption has been identified as a realm of key importance for progressing the world towards more sustainable consumption overall. Consumers have the option to choose organic food as a visible product of more ecologically integrated farming methods and, in general, more carefully produced food. This study aims to investigate the choice for organic from a cultural-historical perspective and aims to reveal the food philosophy of current organic consumers in The Netherlands. A concise history of the organic food movement is provided going back to the German Lebensreform and the American Natural Foods Movement. We discuss themes such as the wish to return to a more natural lifestyle, distancing from materialistic lifestyles, and reverting to a more meaningful moral life. Based on a number of in-depth interviews, the study illustrates that these themes are still of influence among current organic consumers who additionally raised the importance of connectedness to nature, awareness, and purity. We argue that their values are shared by a much larger part of Dutch society than those currently shopping for organic food. Strengthening these cultural values in the context of more sustainable food choices may help to expand the amount of organic consumers and hereby aid a transition towards more sustainable consumption. © 2012 The Author(s)

The avian cell line AGE1.CR.pIX characterized by metabolic flux analysis

Lohr V, Haedicke O, Genzel Y, et al. The avian cell line AGE1.CR.pIX characterized by metabolic flux analysis. BMC Biotechnology. 2014;14(1): 72.Background: In human vaccine manufacturing some pathogens such as Modified Vaccinia Virus Ankara, measles, mumps virus as well as influenza viruses are still produced on primary material derived from embryonated chicken eggs. Processes depending on primary cell culture, however, are difficult to adapt to modern vaccine production. Therefore, we derived previously a continuous suspension cell line, AGE1.CR.pIX, from muscovy duck and established chemically-defined media for virus propagation. Results: To better understand vaccine production processes, we developed a stoichiometric model of the central metabolism of AGE1.CR.pIX cells and applied flux variability and metabolic flux analysis. Results were compared to literature dealing with mammalian and insect cell culture metabolism focusing on the question whether cultured avian cells differ in metabolism. Qualitatively, the observed flux distribution of this avian cell line was similar to distributions found for mammalian cell lines (e.g. CHO, MDCK cells). In particular, glucose was catabolized inefficiently and glycolysis and TCA cycle seem to be only weakly connected. Conclusions: A distinguishing feature of the avian cell line is that glutaminolysis plays only a minor role in energy generation and production of precursors, resulting in low extracellular ammonia concentrations. This metabolic flux study is the first for a continuous avian cell line. It provides a basis for further metabolic analyses to exploit the biotechnological potential of avian and vertebrate cell lines and to develop specific optimized cell culture processes, e.g. vaccine production processes