Cognitive and Emotional Changes in Peer Educators of Type 2 Diabetes Patients After Starting Peer-Support Activities

Background: Diabetes self-management education through peer support has beneficial effects, especially in regions with limited medical resources. To ensure peer educators continue to provide peer-led education programs, it is important that they remain motivated to instruct patients. Here, to explore measures to enhance peer-educators’ motivation toward such programs, we examined the cognitive and emotional changes in Filipino type 2 diabetics after 7-month activities as peer educators. Methods: We individually performed semi-structured interviews with 13 peer educators with 20 years of age or above in August 2017 (immediately before starting their peer-education activities) and in March 2018 (7 months after the start). The first interview was performed after the peer educators had received 2-day training of diabetes self-management. In both interviews, we asked the peer educators about their feelings toward peer-led educational activities (e.g., satisfaction, difficulty, reward, confidence, and challenges). Their replies about their own cognition and emotions were interpreted and integrated, and then analyzed qualitatively. Results: Four and seven categories were extracted from the first and second interviews, respectively. The category “Cognition of patients’ active learning attitudes and of positive changes in patients’ physical conditions and behavior” observed in the second interview led to “Cognition of growth as a peer educator” and “Satisfaction with supporting patients as a peer educator.” These two feelings gave the peer educators’ “Increased motivation to continue the activities as a peer educator.” This motivation was also associated with “Active collaboration among peer educators,” which was affected by “Difficulties and concerns in working as a peer educator.” Conclusion: To sustain diabetic peer-led education programs, we suggest that interventions be implemented that increase peer educators’ motivation toward their activities and stimulate their awareness of the importance of collaborating with one another. Such collaboration should help to overcome the difficulties they may face in providing peer-led education

A Conceptual Model for Quality of Life Among People with Type 2 Diabetes in the Philippines

[Background] The increased prevalence of chronic diseases is a social issue in developing countries. [Methods] To create a conceptual model representing the quality of life of low-income people with type 2 diabetes in the Philippines, 117 low-income adult participants in a public support group were studied, and the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores on quality of life (QOL) were analyzed in terms of their relationships with the following factors: basic attributes, physical factors (glycated hemoglobin level, complications, comorbidities, and symptoms), social factors (support, education, and financial status), and cognitive factors (knowledge, attitude, self-efficacy, and self-management behavior). [Results] Based on correlation coefficients among variables and goodness-of-fit test results through a path analysis, 2 models representing causal relationships were created, both of which showed sufficient goodness-of-fit. [Conclusion] Glycated hemoglobin levels, knowledge of blood glucose levels, self-efficacy, and self-management behavior (exercise) influenced PCS scores, while age, glycated hemoglobin levels, neuropathy, knowledge of insulin, self-efficacy, and self-management behavior (exercise) influenced MCS scores. The influence of self-efficacy was prominent in both cases, providing an important insight for healthcare professionals to develop effective support methods

Effects of a Self-efficacy Theory-Based Training Program for Peers of Patients with Type 2 Diabetes

[Background] Training peer leaders to deliver patient education is expected to be a low-cost approach to providing healthcare in urban-poor areas affected by a shortage of healthcare professionals. The purpose of this study was to examine the effects of a training program on the self-efficacy and knowledge of peer leaders with type 2 diabetes. [Methods] A single-group longitudinal survey with baseline, intervention, and follow-up periods was conducted at a diabetes clinic in a small municipality in Metro Manila, Philippines. The intervention, a self-efficacy theory-based training program for peer-leaders of diabetic patients conducted in August 2017, comprised hands-on learning, demonstrations, quizzes, role-playing, group sharing, physical exercise, and a buffet lunch. The primary outcome was participants’ self-efficacy for management of their diabetes. Secondary outcomes were participants’ knowledge of diabetes and levels of emotional distress, motivation, and confidence for guiding their peers, satisfaction with the training program, hemoglobin A1c, and quality of life. [Results] At 12 and 18 months after the intervention, participants’ knowledge of diabetes was significantly increased compared with baseline (both P < 0.05). At earlier time points, an increasing, but not significant, trend was observed. The change in knowledge of diabetes from baseline to 18 months after intervention tended to be positively correlated with the change in self-efficacy (r = 0.594, P = 0.054). No significant differences were observed for any of the other outcomes, although the descriptive statistics showed an increasing trend for all of the outcomes except motivation. [Conclusion] The training program significantly improved participants’ knowledge of diabetes at 12 and 18 months after the training programs compared with baseline. A positive correlation between the changes in the levels of knowledge and self-efficacy suggested that the observed improvement of self-efficacy was facilitated by the improvement of knowledge of diabetes

Impact of Hands-on Experience of a Cadaver Dissection on the Professional Identity Formation of Health Sciences Students

[Background] In Japan, some nursing and health science universities that train nurses and/or clinical laboratory technicians have a curriculum in which students observe medical students performing a cadaver dissection. Observing a cadaver dissection is believed to affect the formation of a student’s professional identity. This study aimed to investigate the effects of observing a cadaver dissection on the professional identity of nursing and clinical laboratory science students to find an effective educational support system for developing professional identity. [Methods] Sophomores majoring in nursing science or clinical laboratory science were asked to complete a questionnaire with a professional identity scale before and after hands-on experience of a cadaver dissection performed by medical students. After their hands-on session was complete, they responded to a free-answer question about acquiring a professional identity. [Results] The professional identity score of nursing students significantly decreased after the hands-on experience of the cadaver dissection. No significant change in professional identity score was observed in the clinical laboratory science students. However, the effect size (r) was moderate. [Conclusion] Although professional identity formation fluctuates immediately after the experience of the hands-on experience of a cadaver dissection, the findings do suggest that these hands-on sessions will be effective for developing their professional identity if educational support is provided to help them utilize what they learned through reflection

Development of Technetium-99m-Labeled BODIPY-Based Probes Targeting Lipid Droplets Toward the Diagnosis of Hyperlipidemia-Related Diseases

Hyperlipidemia causes systemic lipid disorder, which leads to hepatic steatosis and atherosclerosis. Thus, it is necessary to detect these syndromes early and precisely to improve prognosis. In the affected regions, abnormal formation and growth of lipid droplets is observed; therefore, lipid droplets may be a suitable target for the diagnosis of hyperlipidemia-related syndromes. In this study, we designed and synthesized [99mTc]Tc-BOD and [99mTc]Tc-MBOD composed of one technetium-99m and two BODIPY scaffolds with hydroxamamide (Ham) or N-methylated hydroxamamide (MHam) in radiochemical yields of 54 and 35%, respectively, with a radiochemical purity of over 95%. [99mTc]Tc-BOD showed significantly higher accumulation levels in foam cells than in non-foam cells (foam cells: 213.8 &plusmn; 64.8, non-foam cell: 126.2 &plusmn; 26.9 %dose/mg protein, p &lt; 0.05) 2 h after incubation. In contrast, [99mTc]Tc-MBOD showed similar accumulation levels in foam cells and non-foam cells (foam cells: 92.2 &plusmn; 23.3, non-foam cell: 83.8 &plusmn; 19.8 %dose/mg protein). In normal mice, [99mTc]Tc-BOD exhibited gradual blood clearance (0.5 h: 4.98 &plusmn; 0.35, 6 h: 1.94 &plusmn; 0.12 %ID/g) and relatively high accumulation in the liver 6 h after administration (15.22 &plusmn; 1.72 %ID/g). Therefore, [99mTc]Tc-BOD may have potential as an imaging probe for detecting lipid droplets in disease lesions of hyperlipidemia

Molecular clearance of ataxin-3 is regulated by a mammalian E4

Insoluble aggregates of polyglutamine-containing proteins are usually conjugated with ubiquitin in neurons of individuals with polyglutamine diseases. We now show that ataxin-3, in which the abnormal expansion of a polyglutamine tract is responsible for spinocerebellar ataxia type 3 (SCA3), undergoes ubiquitylation and degradation by the proteasome. Mammalian E4B (UFD2a), a ubiquitin chain assembly factor (E4), copurified with the polyubiquitylation activity for ataxin-3. E4B interacted with, and thereby mediated polyubiquitylation of, ataxin-3. Expression of E4B promoted degradation of a pathological form of ataxin-3. In contrast, a dominant-negative mutant of E4B inhibited degradation of this form of ataxin-3, resulting in the formation of intracellular aggregates. In a Drosophila model of SCA3, expression of E4B suppressed the neurodegeneration induced by an ataxin-3 mutant. These observations suggest that E4 is a rate-limiting factor in the degradation of pathological forms of ataxin-3, and that targeted expression of E4B is a potential gene therapy for SCA3

Effect of Guide Vane in Ring Groove Arrangement for a Small Turbocharger

A high-pressure ratio and a wide operating range are highly required for a turbocharger in diesel engines. Ring groove arrangement is effective for flow range enhancement of centrifugal compressors. Two ring grooves on the suction pipe and the shroud casing wall are connected by means of the annular passage, and the stable recirculation flow is formed at small flow rates from the downstream groove toward the upstream groove through the annular bypass. It is well known that the ring groove arrangement shows the following two merits; (1) the formation of recirculation flow removes the low energy fluid around the downstream groove located near the splitter blade leading edge, (2) the flow incidence can be reduced because the recirculation flow merges again with the incoming main flow upstream of the impeller inlet. In the present study, the ring groove arrangement was applied to the high speed centrifugal compressor, in addition, in order to suppress too large pre-whirl due to the recirculation flow, the effects of guide vane installed in the annular passage and the ring groove configuration on the pre-whirl were analyzed numerically. The numerical flow analysis was carried out by using the commercial code produced by ANSYS-CFX. The simulation results show the multi-ring grooves are fairly effective in combination with the suitable configuration of guide vanes for improvement in the inlet velocity distortion.THE 10TH ASIAN INTERNATIONAL CONFERENCE ON FLUID MACHINERY : Kuala Lumpur (Malaysia), 21–23 October 200