A qualitative assessment of using lay trainers with type 2 diabetes in an intervention programme for people at risk of type 2 diabetes

Objective: More knowledge is needed on the impact of expert patients within health intervention programmes. The University of East Anglia Impaired Fasting Glucose (UEA-IFG) feasibility programme was a structured dietary and exercise intervention to reduce the risk of type 2 diabetes mellitus (T2DM) in susceptible individuals. Lay volunteers with T2DM (T2 trainers) were recruited to support participants in adopting healthier lifestyles. This study aimed to explore the acceptability, perceived effectiveness and sustainability of lay trainers within the programme. Design: A qualitative focus group study. Setting: A clinical research unit in Norwich, United Kingdom (UK). Method: Focus groups were conducted with: (1) T2 trainers (n = 15); (2) programme participants who had received their support (n = 11); and (3) salaried staff facilitators who had worked alongside the T2 trainers (n = 3). Framework analysis was applied to identify the different experiences of the lay trainer role. Results: All groups perceived advantages for peer support, particularly in sharing the day-to-day experiences of living with T2DM. However, staff facilitators raised the importance of role boundaries, emphasizing that T2 trainers should not provide medical advice. Acceptability of T2 trainers was enhanced by contacting participants at a convenient time and before substantial lifestyle changes had been made. Conclusion: Lay trainers were seen as a complementary method to motivate individuals to reduce their risks of T2DM. A less prescriptive approach needs to be adopted to enable full integration of lay trainers, allowing them a greater level of contribution. To sustain effective use of lay trainers, health professionals need to work alongside volunteers and be trained to encourage peer involvement

The travel diaries of tetanus and botulinum neurotoxins

Tetanus (TeNT) and botulinum (BoNT) neurotoxins, the causative agents of tetanus and botulism, respectively, are the most potent toxic molecules known to mankind. This extreme potency is attributed to: i) their specificity for essential components of the neurotransmitter release machinery present at vertebrate synapses, and ii) their high-affinity targeting to motor neurons by binding to polysialogangliosides and protein receptors. Comprising the clostridial neurotoxin family, TeNT and BoNTs engage distinct surface receptors and intracellular sorting pathways in neurons. BoNTs bind to the intraluminal domain of specific synaptic vesicle proteins that are exposed to the extracellular milieu upon exocytosis, and are taken up by synaptic vesicle recycling. A sizeable proportion of BoNT molecules remain at the neuromuscular junction, where their protease moiety is released into the cytoplasm, blocking synaptic transmission and causing flaccid paralysis. In contrast, TeNT undergoes binding to specific components of the basal membrane at the neuromuscular junction, is endocytosed into motor neurons and sorted to axonal signalling endosomes. Following this, TeNT is transported to the soma of motor neurons located in the spinal cord or brainstem, and then transcytosed to inhibitory interneurons, where it blocks synaptic transmission. TeNT-induced impairment of inhibitory input leads to hyperactivity of motor neurons, causing spastic paralysis, which is the hallmark of tetanus. This review examines the molecular mechanisms leading to the entry, sorting and intracellular trafficking of TeNT and BoNTs

Is technology optimism justified? A discussion towards a comprehensive narrative

This paper is based on a discussion developed by one of the thematic working groups at the Biennial International Workshop Advances in Energy Studies (BIWAES) 2017 hold in Naples, Italy. The topic was the role of technology in energy transition and global problems. Owing to the heterogeneity of the participants in the working group, different viewpoints were put together, leading to some shared conclusions. In particular, the role played by the different narratives used in discussing the role of technology in facing global problems was pointed out as the origin of cognitive dissonance. The presented reflections address some conceptual weaknesses in the current debate on technology and global issues, framed in global policies that appear incapable to obtain tangible results. The technology optimism seems, in fact, to be based on the elusive use of both the concepts of technology and sustainability, that are put together for narrative purposes without an explicit conceptual assessment. On one hand, the factual role of technology and its beneficiary are almost never clearly addressed in the debate. On the other hand, the fact that any new technology will serve the cause of sustainability is not questioned whatsoever, without taking into account the social, political and ethical framework in which technology is supposed to be operated

Sand fly synthetic sex-aggregation pheromone co-located with insecticide reduces the incidence of infection in the canine reservoir of visceral leishmaniasis: a stratified cluster randomised trial

The predominant sand fly vector of the intracellular parasite Leishmania infantum, that causes human and canine visceral leishmaniasis in the Americas, is Lutzomyia longipalpis. Dogs are the proven reservoir. Vector control tools to reduce transmission suited to this predominantly exophilic vector are lacking. Insecticide-impregnated dog collars protect dogs against infectious bites from sand fly vectors, and result in reductions of new infections in both dogs and humans. However, collars are costly for endemic communities, and alternative approaches are needed. Recently the bulk synthesised sex-aggregation pheromone of male Lu. longipalpis was shown to attract large numbers of conspecific females to lethal pyrethroid insecticides, indicating the potential for use in a vector control application. This study, conducted in Brazil, evaluated the efficacy of this novel lure-and-kill approach to reduce seroconversion and infection incidence with L. infantum in the canine reservoir, in addition to measuring its impact on household abundance of Lu. longipalpis. Deployed in 14 stratified clusters, the outcomes were compared to those attributed to insecticide impregnated collars fitted to dogs in another 14 clusters; each intervention was compared to 14 clusters that received placebo treatments. The beneficial effects of the lure-and-kill method were most noticeable on confirmed infection incidence and clinical parasite loads, and in reducing sand fly abundance. The overall effect of the two interventions were not statistically dissimilar, though the confidence intervals were broad. We conclude that the novel low-cost lure-and-kill approach should be added to the vector control toolbox against visceral leishmaniasis in the Americas

The temple builders of prehistoric Malta

Nowhere in the world have men discovered a temple culture similar to that of the Neolithic Maltese. Thus it appears logical to me to seek the reasons for this remarkable neolithic efflorescence within their own socio-economic context, firstly by examining their cultural remains, and secondly by inference, deduction and sometimes analogy. Copper being absent, I propose abandoning the term "Maltese Chalcolithic" while distinguishing between Neolithic A and B groups. This step is required by the material finds; it allows us to see the developments as originating within the microcosm of Malta, and to examine the considerable cultural achievements as responses to indigenous factors rather than diffusionism. I hold that the main factors were ecological and social. It is my further contention that there is sufficient evidence to show a substantial growth in population in the Gg and Tx phases, and that the resultant pressure on land and resources created a rare neolithic consciousness of 'territorial rights' which found an important and parochial expression in building temples. As these were probably associated with reverence for the dead ("ancestor worship") as well as fertility, the temples became the form through which a community could establish its claim to ancestral lands. Thus a specifically Maltese cult developed, expressing and enacting their ideas and religious beliefs. Though there is evidence for a degree of specialisation unusual in neolithic communities (masons, sculptors, and especially architects and priesthood), I do not find any material evidence for chiefdoms - a Chalcolithic feature. Instead I find that the burial evidence points to a continuing neolithic egalitarianism, without the specialists forming a true elite. I find religious features of a matristic kind, with the worship of a chthonic goddess associated with cereals. Finally I find evidence indicating a reason for the abandonment of Malta c. 2500 B.C.: demographic pressures combined with drier conditions and drought

Untersuchungen zur Langzeitsicherheit von Endlagern fuer umweltgefaehrdende Abfaelle in Salzformationen der flachen Lagerung im Zusammenhang mit dem Verformungs- und Bruchverhalten in und um Grubengebaeuden Anlagen Kapitel 9. Abschlussbericht

Available from TIB Hannover: F95B2118+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman

Geotechnische Untersuchungen im Salinar zur Ermittlung des gebirgsmechanischen Verhaltens von Anhydrit und Salzton. Bd. 2 Bohrtechnik und In-situ-Untersuchungen. Abschlussbericht

For geotechnical exploration of the anhydrite and salt clay cavity locations in Poethen and Bernburg (Saxony-Anhalt) by drilling experiments a new boring equipment has been developed. Long-term in situ tension and deformation measurements were carried out at 1013 m (Poethen) and 410-510 m (Bernburg) depths using the hydrofrac method and the hole vent method for tension determination and extensometers for precision deformation measurements. Both tension methods yielded consistent results. Significant deformations and any overstepping of stability could be excluded. Tensions in the anhydrite of Bernburg can be explained by enlarged model assumptions. Load redistortions of the salt clay could be observed in both locations. (WEN)SIGLEAvailable from TIB Hannover: F95B2132+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman

Geotechnische Untersuchungen im Salinar zur Ermittlung des gebirgsmechanischen Verhaltens von Anhydrit und Salzton. Bd. 1 Geologie und Petrographie. Abschlussbericht

Geologic investigations are reported which have been performed in the Volkenroda/Roethen mine and in the Bernburg mine, and petrographic and petrologic investigations. The geologic data and results are summarized and compiled. (HS)Es wird berichtet ueber: Geologische Untersuchungen in der Grube Volkenroda/Roethen und in der Grube Bernburg; petrographisch-petrologische Untersuchungen; Zusammenfassung der geologischen Untersuchungen. (HS)SIGLEAvailable from TIB Hannover: F95B2131+a / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekBundesministerium fuer Bildung, Wissenschaft, Forschung und Technologie, Bonn (Germany)DEGerman