Primary care providers\u27 experience in the management of paediatric type 1 diabetes in Western Sydney, New South Wales

Background and objectives: It is unknown to what degree general practitioners (GPs) are able to diagnose and assist in the management of children with type 1 diabetes (T1D). This study examined the experiences of GPs when faced with paediatric T1D. Method: A qualitative study using semistructured interviews was conducted with a sample of GPs in Western Sydney. Data were analysed thematically. Results: Thirty GPs reported varied experiences with paediatric T1D. Two themes emerged: \u27You don\u27t think of T1D everyday\u27 (GPs do not frequently encounter T1D) and \u27We need to be equipped\u27 (despite low patient numbers, GPs want to be able to recognise, refer and assist in the management of children with T1D). Discussion: There is limited Australian research into GPs\u27 ability to diagnose and manage children with T1D. This study highlights the current level of knowledge and referral practices of a sample of GP

Does health and medical research consider geographic factors affecting study participants: a retrospective snapshot analysis of 11 leading journals

Background: Research has identified that rurally located persons face health inequities when compared to their urban peers. While health policies and practice frameworks to address the needs of rural people are largely developed on the principles of evidence-based medicine, it is not clear whether this evidence base appropriately considers geographic factors that may impact participant outcomes. The purpose of this project was to examine whether research within leading health and medical journals identified the geographic classification (location) of their participants, thus enabling the original authors and subsequent readers to appropriately consider this factor in the making of policy and practice recommendations. Methods: A retrospective analysis of study participants’ geographic identifiers within articles from medical and health journals was carried out in this project. Eleven journals were chosen for evaluation, with 300 consecutive eligible papers from each journal retrospectively reviewed. All 3300 papers were analyzed to determine whether the research participants’ geographic location was identified. This classification was then stratified into varying categories of rural or urban, as appropriate. Results: It was not possible to identify participants’ geographic location in 2193 (66%) of the 3300 reviewed articles. A total of 121 papers (4%) had sole focus on rural residents, with another 95 articles (3%) comparing outcomes between rural and urban locations. Slightly more than a quarter (27%) of the articles either just featured urban participants or made no distinction between rural and urban locations. Conclusions: These findings indicate that insufficient attention is given to the geographic location of participants. This failure means that the outcomes and recommendations of the research base may be invalid for a large section of the world’s population and result in inequities in healthcare services. There is an emerging concern about using this evidence base for developing health guidelines and policy frameworks, as the needs of a substantial proportion of the population may not have been appropriately captured

Introduction to epigenetic inheritance: Definition, mechanisms, implications and relevance.

Complex phenotypes result from the interaction between genetic and environmental informations. Almost a decade ago, the discovery of acquired epigenetic inheritance has shown that individual’s environmental experiences can influence developmental and phenotypic trajectories across several generations. The field is now starting to unveil the molecular mechanisms, while its relevance for complex disease risk and adaptive evolution is still unclear and strongly debated. The aim of this chapter is to introduce the reader to the concept of epigenetic inheritance, provide an overview on the underlying molecular determinants and highlight its potential relevance for individual’s susceptibility to complex, non-mendelian, diseases