Implementing a structured education program for children with diabetes: lessons learnt from an integrated process evaluation

There is recognition of an urgent need for clinic-based interventions for young people with type 1 diabetes mellitus that improve glycemic control and quality of life. The Child and Adolescent Structured Competencies Approach to Diabetes Education (CASCADE) is a structured educational group program, using psychological techniques, delivered primarily by diabetes nurses. Composed of four modules, it is designed for children with poor diabetic control and their parents. A mixed methods process evaluation, embedded within a cluster randomized control trial, aimed to assess the feasibility, acceptability, fidelity, and perceived impact of CASCADE

The effect of acquired microbial enzymes on assimilation efficiency in the common woodlouse, Tracheoniscus rathkei

The digestive tract of the common woodlouse, Tracheoniscus rathkei Brandt (Isopoda: Oniscoidea), contains digestive enzymes active against α-1,4-glucans, which are the chief storage polysaccharides of vascular plants, algae, fungi, and animals, and β-1,3-glucans, which are present in algae and fungi. Digestive tract extracts also exhibit significant activity toward xylan and carboxymethyl-cellulose but negligible activity toward microcrystalline cellulose, substrates representative of the major structural polysaccharides of vascular plants. Low activity was detected toward pectin, and no activity was detected toward chitin. Activity toward xylan is due in part to microbial enzymes acquired from the leaf litter which was the isopod's normal food. Although ingested microbial xylanases are stable and active in the gut fluid, they do not make a quantitatively significant contribution to the isopod's ability to assimilate the hemicellulosic component of its diet. However, the assimilation of carbon from labeled plant fiber is enhanced in isopods which have acquired a cellulase by ingestion of leaf litter amended with a commercial preparation of the cellulase complex from the fungus, Penicillium funiculosum . This result demonstrates the potential contribution of acquired enzymes to the digestion of plant fiber in terrestrial detritivores. We urge caution, however, in assigning an important digestive function to ingested enzymes on the basis of evidence that only indicates that such enzymes are present in the gut fluid without additional evidence that their presence results in an enhancement of digestive efficiency.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/47763/1/442_2004_Article_BF00377057.pd

Progressive ductile shearing during till accretion within the deforming bed of a palaeo-ice stream

This paper presents the results of a detailed microstructural study of a thick till formed beneath the Weichselian (Devensian) Odra palaeo-ice stream, west of Środa Wielkopolska, Poland. This SE-flowing ice stream was one of a number of corridors of faster flowing ice which drained the Scandinavian Ice Sheet in the Baltic region. Macroscopically, the massive, laterally extensive till which formed the bed of this ice stream lacks any obvious evidence of glaciotectonism (thrusting, folding). However, microscale analysis reveals that bed deformation was dominated by foliation development, recording progressive ductile shearing within a subhorizontal subglacial shear zone. Five successive generations of clast microfabric (S1 to S5) have been identified defining a set of up-ice and down-ice dipping Riedel shears, as well as a subhorizontal shear foliation coplanar to the ice-bed interface. Cross-cutting relationships between the shear fabrics record temporal changes in the style of deformation during this progressive shear event. Kinematic indicators (S-C and ECC-type fabrics) within the till indicate a consistent SE-directed shear sense, in agreement with the regional ice flow pattern. A model of bed deformation involving incremental progressive simple shear during till accretion is proposed. The relative age of this deformation was diachronous becoming progressively younger upwards, compatible with subglacial shearing having accompanied till accretion at the top of the deforming bed. Variation in the relative intensity of the microfabrics records changes in the magnitude of the cumulative strain imposed on the till and the degree of coupling between the ice and underlying bed during fast ice flow

The development of a take-off performance monitor (TOPM)

SIGLEAvailable from British Library Document Supply Centre-DSC:DX195862 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Current and never smokers: Differentials in characteristics, knowledge and perceptions

ABSTRACT A cross-sectional interview survey of tobacco use was conducted in Alexandria, Egypt, comparing current smokers with never smokers. Among men, the risk of current tobacco use was significantly higher among married participants (OR = 1.74), especially those with low educational or occupational status. In contrast, although few women smoked, tobacco use was significantly higher among those holding a university degree (OR = 15.33). Never smokers were significantly more knowledgeable than current smokers about tobacco-related health hazards. Never smokers had significantly better perceptions of the danger of tobacco use, susceptibility to health-related hazards and the benefits of being tobacco-free. Multivariate analysis revealed that tobacco use is independently predicted by participants' sex, age and educational attainment as well as their perceptions. Fumeurs actuels et personnes n'ayant jamais fumé : différences dans les caractéristiques dé-mographiques, les connaissances et les perceptions RESUME Une enquête transversale par entretien sur la consommation de tabac a été réalisée à Alexandrie (Egypte), comparant les fumeurs actuels et les personnes n'ayant jamais fumé. Chez les hommes, le risque de consommation actuelle de tabac était significativement plus élevé chez les participants mariés (OR = 1,74), notamment chez ceux qui avaient un faible niveau d'instruction ou un statut professionnel peu élevé. Par contre, même si peu de femmes fumaient, la consommation de tabac était significativement plus élevée chez celles qui étaient titulaires d'un diplôme universitaire (OR = 15,33). Les personnes n'ayant jamais fumé connaissaient beaucoup mieux les risques pour la santé liés au tabagisme que les fumeurs actuels. Les personnes n'ayant jamais fumé avaient des perceptions significativement meilleures du danger de la consommation de tabac, de la sensibilité aux risques pour la santé liés au tabagisme et des avantages de ne pas fumer. L'analyse multivariée a révélé que la consommation de tabac est prédite indépendamment par le sexe et l'âge des participants, par leur niveau d'études ainsi que par leurs perceptions