Effectiveness of group-based self-management education for individuals with Type 2 diabetes:A systematic review with meta-analyses and meta-regression

Aims: Patient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes. Methods: Six electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c, and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self-efficacy. Results: Fifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group-based education compared with controls at 6–10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): −0.48, −0.15; P = 0.0002], 12–14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: −0.49, −0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: −1.26, −0.18; P = 0.009] and 36–48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: −1.52, −0.34; P = 0.002], but not at 24 months. Outcomes also favoured group-based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer-led interventions. Conclusions: Group-based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.No Full Tex

Language and social/emotional problems identified at a universal developmental assessment at 30 months

Non peer reviewedPublisher PD

Sensitivity and discovery potential of the proposed nEXO experiment to neutrinoless double beta decay

The next-generation Enriched Xenon Observatory (nEXO) is a proposed experiment to search for neutrinoless double beta ($0\nu\beta\beta$) decay in $^{136}$Xe with a target half-life sensitivity of approximately $10^{28}$ years using $5\times10^3$ kg of isotopically enriched liquid-xenon in a time projection chamber. This improvement of two orders of magnitude in sensitivity over current limits is obtained by a significant increase of the $^{136}$Xe mass, the monolithic and homogeneous configuration of the active medium, and the multi-parameter measurements of the interactions enabled by the time projection chamber. The detector concept and anticipated performance are presented based upon demonstrated realizable background rates.Comment: v2 as publishe

Characterization of an Ionization Readout Tile for nEXO

A new design for the anode of a time projection chamber, consisting of a charge-detecting "tile", is investigated for use in large scale liquid xenon detectors. The tile is produced by depositing 60 orthogonal metal charge-collecting strips, 3~mm wide, on a 10~\si{\cm} $\times$ 10~\si{\cm} fused-silica wafer. These charge tiles may be employed by large detectors, such as the proposed tonne-scale nEXO experiment to search for neutrinoless double-beta decay. Modular by design, an array of tiles can cover a sizable area. The width of each strip is small compared to the size of the tile, so a Frisch grid is not required. A grid-less, tiled anode design is beneficial for an experiment such as nEXO, where a wire tensioning support structure and Frisch grid might contribute radioactive backgrounds and would have to be designed to accommodate cycling to cryogenic temperatures. The segmented anode also reduces some degeneracies in signal reconstruction that arise in large-area crossed-wire time projection chambers. A prototype tile was tested in a cell containing liquid xenon. Very good agreement is achieved between the measured ionization spectrum of a $^{207}$Bi source and simulations that include the microphysics of recombination in xenon and a detailed modeling of the electrostatic field of the detector. An energy resolution $\sigma/E$=5.5\% is observed at 570~\si{keV}, comparable to the best intrinsic ionization-only resolution reported in literature for liquid xenon at 936~V/\si{cm}.Comment: 18 pages, 13 figures, as publishe

Methods for conducting systematic reviews of risk factors in low- and middle-income countries.

BACKGROUND: Rates of youth violence are disproportionately high in many low- and middle-income countries [LMICs] but existing reviews of risk factors focus almost exclusively on high-income countries. Different search strategies, including non-English language searches, might be required to identify relevant evidence in LMICs. This paper discusses methodological issues in systematic reviews aiming to include evidence from LMICs, using the example of a recent review of risk factors for child conduct problems and youth violence in LMICs. METHODS: We searched the main international databases, such as PsycINFO, Medline and EMBASE in English, as well as 12 regional databases in Arabic, Chinese, English, French, Spanish, Portuguese and Russian. In addition, we used internet search engines and Google Scholar, and contacted over 200 researchers and organizations to identify potentially eligible studies in LMICs. RESULTS: The majority of relevant studies were identified in the mainstream databases, but additional studies were also found through regional databases, such as CNKI, Wangfang, LILACS and SciELO. Overall, 85% of eligible studies were in English, and 15% were reported in Chinese, Spanish, Portuguese, Russian or French. Among eligible studies in languages other than English, two-thirds were identified only by regional databases and one-third was also indexed in the main international databases. CONCLUSIONS: There are many studies on child conduct problems and youth violence in LMICs which have not been included in prior reviews. Most research on these subjects in LMICs has been produced in the last two-three decades and mostly in middle-income countries, such as China, Brazil, Turkey, South Africa and Russia. Based on our findings, it appears that many studies of child conduct problems and youth violence in LMICs are reported in English, Chinese, Spanish and Portuguese, but few such studies are published in French, Arabic or Russian. If non-English language searches and screening had not been conducted in the current review, 15% of eligible studies would have been missed. Although there are benefits to non-English language searches and the inclusion of non-English studies in meta-analyses, systematic reviewers also need to consider the resources required to incorporate multi-lingual research.We are grateful to the Wellcome Trust [089963/Z/09/Z] and Bernard van Leer Foundation for financial support for the research

Cognitive behaviour therapy for anxiety in psychosis: A systematic review and meta-analysis

Background : Anxiety is common in people with psychosis. Cognitive Behaviour Therapy (CBT) is an effective treatment for anxiety in people without psychosis.Given the prevalence of anxiety in those with psychosis, the efficacy of CBT in this population is important to consider. This review and meta-analysis therefore investigates the efficacy of CBT for anxiety in people with psychosis. Method : Twenty-nine studies were identified through systematic review, including controlled, uncontrolled and case report designs. Seventeen controlled anduncontrolled studies were included in the quantitative synthesis. Results : A medium, significant effect was found at post-treatment and follow-up when controlled and uncontrolled data were combined. For controlled between-groups data only, a small, significant effect was found at post-treatment and follow-up. The effect of CBT for anxiety on psychotic symptoms was investigated, resulting in a medium, significant effect for controlled and uncontrolled post-treatment data and a small, significant effect for controlled between-group data. Conclusions : CBT might have some effect in treating anxiety in people with psychosis. However, this review highlights a lack of scientifically rigorous studies in this area. Further research is required, including the use of well-designed randomised controlled trials (RCTs)