In situ He⁺ irradiation of the double solid solution (Ti_0.5,Zr_0.5)₂(Al_0.5,Sn_0.5)C MAX phase:Defect evolution in the 350–800 °C temperature range

Thin foils of the double solid solution (Zr0.5,Ti0.5)2(Al0.5,Sn0.5)C MAX phase were in situ irradiated in a transmission electron microscope (TEM) up to a fluence of 1.3 × 1017 ions⋅cm-2 (∼7.5 dpa), using 6 keV He+ ions. Irradiations were performed in the 350–800 °C temperature range. In situ and post-irradiation examination (PIE) by TEM was used to study the evolution of irradiation-induced defects as function of dose and temperature. Spherical He bubbles and string-like arrangements thereof, He platelets, and dislocation loops were observed. Dislocation loop segments were found to lie in non-basal-planes. At irradiation temperatures ≥ 450 °C, grain boundary tearing was observed locally due to He bubble segregation. However, the tears did not result in transgranular crack propagation. The intensity of specific spots in the selected area electron diffraction patterns weakened upon irradiation at 450 and 500 °C, indicating an increased crystal symmetry. Above 700 °C this was not observed, indicating damage recovery at the high end of the investigated temperature range. High-resolution scanning TEM imaging performed during the PIE of foils previously irradiated at 700 °C showed that the chemical ordering and nanolamination of the MAX phase were preserved after 7.5 dpa He+ irradiation. The size distributions of the He platelets and spherical bubbles were evaluated as function of temperature and dose.</p

Evaluation of the Finnish Diabetes Risk Score as a screening tool for undiagnosed type 2 diabetes and dysglycaemia among early middle-aged adults in a large-scale European cohort. The Feel4Diabetes-study

Aim: To assess the diagnostic accuracy of the FINDRISC for undiagnosed type 2 diabetes mellitus (T2DM) and dysglycaemia (i.e. the presence of prediabetes or T2DM) among early middle-aged adults from vulnerable groups in a large-scale European cohort. Methods: Participants were recruited from low-socioeconomic areas in high-income countries (HICs) (Belgium-Finland) and in HICs under austerity measures (Greece-Spain) and from the overall population in low/middle-income countries (LMICs) (Bulgaria-Hungary). Study population comprised of 2116 parents of primary-school children from families identified at increased risk of T2DM, based on parental self-reported FINDRISC. Sensitivity (Se), specificity (Sp), area under the receiver operating characteristic curves (AUC-ROC) and the optimal cut-offs of FINDRISC that indicate an increased probability for undiagnosed T2DM or dysglycaemia were calculated. Results: The AUC-ROC for undiagnosed T2DM was 0.824 with optimal cut-off =14 (Se = 68%, Sp = 81.7%) for the total sample, 0.839 with optimal cut-off =15 (Se = 83.3%, Sp = 86.9%) for HICs, 0.794 with optimal cut-off =12 (Se = 83.3%, Sp = 61.1%) for HICs under austerity measures and 0.882 with optimal cut-off =14 (Se = 71.4%, Sp = 87.8%) for LMICs. The AUC-ROC for dysglycaemia was 0.663 with optimal cut-off =12 (Se = 58.3%, Sp = 65.7%) for the total sample, 0.656 with optimal cut-off =12 (Se = 54.5%, Sp = 64.8%) for HICs, 0.631 with optimal cut-off =12 (Se = 59.7%, Sp = 62.0%) for HICs under austerity measures and 0.735 with optimal cut-off =11 (Se = 72.7%, Sp = 70.2%) for LMICs. Conclusion: FINDRISC can be applied for screening primarily undiagnosed T2DM but also dysglycaemia among vulnerable groups across Europe, considering the use of different cut-offs for each subpopulation

Students\u2019 experiences of cooperation with nurse teacher during their clinical placements: an empirical study in a Western European context.

In many European countries during the last decade, the clinical role of the nurse teacher has changed from a clinical skilled practitioner to a liaison person working between educational and health care provider organisations. This study explored pre-registration nursing students' perceptions of cooperation with nurse teachers during their clinical placements in nine Western European countries. The study also assessed the type and range of e-communication between students and nurse teachers and whom the students\u2019 perceived as their most important professional role model. The study is a descriptive survey. Quantitative data were collected from 17 higher education institutes of nursing located in the northern, middle and southern parts of Europe. The purposive sample (N=1903) comprised students who had participated in courses which included clinical placements. The data were analysed using descriptive statistics. Comparisons between the groups were made using cross-tabulation. The majority (57%) of students met their nurse teacher 1-3 times during their placement while 13% of the students did not meet their nurse teacher at all. Additionally, 66% of respondents used some form of e-communication (e-mail, mobile text messages etc.) to communicate with their nurse teacher. It is important to clarify the division of labour between nurse teachers and Mentors. There are both opportunities and challenges in how to utilise information technology to more effectively promote cooperation between students and nurse teachers

Lifestyle changes observed among adults participating in a family- and community-based intervention for diabetes prevention in Europe : the 1st year results of the Feel4Diabetes-study

The Feel4Diabetes intervention was a school and community-based intervention aiming to promote healthy lifestyle and tackle obesity and obesity-related metabolic risk factors for the prevention of type 2 diabetes (T2D) among families at risk of developing this disease. The current study aims to present the results on lifestyle behaviors obtained from parents during the first year of the Feel4Diabetes intervention. This multicomponent intervention had a cluster randomized design and was implemented in Belgium, Bulgaria, Finland, Greece, Hungary and Spain over two years (2016–2018). Standardized protocols and procedures were used by the participating centers in all countries to collect data on parents’ lifestyle behaviors (diet, physical activity, sedentary behavior). The Feel4Diabetes intervention was registered at clinicaltrials.gov (registration number: NCT02393872). In total, 2110 high-risk parents participated in the baseline and 12-month follow-up examination measurements. Participants allocated to the intervention group reduced their daily consumption of sugary drinks (p = 0.037) and sweets (p = 0.031) and their daily screen time (p = 0.032), compared with the control group. In addition, participants in the intervention group in Greece and Spain increased their consumption of breakfast (p = 0.034) and fruits (p = 0.029), while in Belgium and Finland they increased their water intake (p = 0.024). These findings indicate that the first year of the Feel4Diabetes intervention resulted in the improvement of certain lifestyle behaviors in parents from high-risk families

Methodology of the health economic evaluation of the Feel4Diabetes-study

Background: The clinical and economic burden of type 2 diabetes mellitus on society is rising. Effective and efficient preventive measures may stop the increasing prevalence, given that type 2 diabetes mellitus is mainly a lifestyle-driven disease. The Feel4Diabetes-study aimed to tackle unhealthy lifestyle (unhealthy diet, lack of physical activity, sedentary behaviour, and excess weight) of families with a child in the first grades of elementary school. These schools were located in regions with a relatively low socio-economic status in Belgium, Bulgaria, Finland, Greece, Hungary and Spain. Special attention was paid to families with a high risk of developing type 2 diabetes mellitus. Methods: The aim of this paper is to describe the detailed methodology of the intervention’s cost-effectiveness analysis. Based on the health economic evaluation of the Toybox-study, both a decision analytic part and a Markov model have been designed to assess the long-term (time horizon of 70 year with one-year cycles) intervention’s value for money. Data sources used for the calculation of health state incidences, transition probabilities between health states, health state costs, and health state utilities are listed. Intervention-related costs were collected by questionnaires and diaries, and attributed to either all families or high risk families only. Conclusions: The optimal use of limited resources is pivotal. The future results of the health economic evaluation of the Feel4Diabetes-study will contribute to the efficient use of those resources.Publication of this supplement was funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement n° 643708

Perinatal, sociodemographic and lifestyle correlates of increased total and visceral fat mass levels in schoolchildren in Greece: the Healthy Growth Study

OBJECTIVE: To identify possibly independent associations of perinatal, sociodemographic and lifestyle factors with childhood total and visceral body fat. DESIGN: A representative sample of 2655 schoolchildren (9-13 years) participated in the Healthy Growth Study, a cross-sectional epidemiological study. SETTING: Seventy-seven primary schools in four large regions in Greece. SUBJECTS: A sample of 1228 children having full data on total and visceral fat mass levels, as well as on anthropometric, dietary, physical activity, physical examination, socio-economic and perinatal indices, was examined. RESULTS: Maternal (OR=3·03 and 1·77) and paternal obesity (OR=1·62 and 1·78), maternal smoking during pregnancy (OR=1·72 and 1·93) and rapid infant weight gain (OR=1·42 and 1·96) were significantly and positively associated with children's increased total and visceral fat mass levels, respectively. Children's television watching for >2 h/d (OR=1·40) and maternal pre-pregnancy obesity (OR=2·46) were associated with children's increased total and visceral fat mass level, respectively. Furthermore, increased children's physical activity (OR=0·66 and 0·47) were significantly and negatively associated with children's total and visceral fat mass levels, respectively. Lastly, both father's age >46 years (OR=0·57) and higher maternal educational level (OR=0·45) were associated with children's increased total visceral fat mass level. CONCLUSIONS: Parental sociodemographic characteristics, perinatal indices and pre-adolescent lifestyle behaviours were associated with children's abnormal levels of total and visceral fat mass. Any future programme for childhood prevention either from the perinatal age or at late childhood should take these indices into consideration

Transcending the MAX phases concept of nanolaminated early transition metal carbides/nitrides -- the ZIA phases

A new potential class of nanolaminated and structurally complex materials, herein conceived as the Zigzag IntermetAllic (ZIA) phases, is proposed. A study of the constituent phases of a specific Nb--Si--Ni intermetallic alloy revealed that its ternary H-phase, \textit{i.e.}, the Nb$_3$SiNi$_2$ intermetallic compound (IMC), is a crystalline solid with the close-packed \textit{fcc} Bravais lattice, the 312 MAX phase stoichiometry and a layered atomic arrangement that may define an entire class of nanolaminated IMCs analogous to the nanolaminated ceramic compounds known today as the MAX phases. The electron microscopy investigation of the Nb$_{3}$SiNi$_{2}$ compound -- the first candidate ZIA phase -- revealed a remarkable structural complexity, as its ordered unit cell is made of 96 atoms. The ZIA phases extend the concept of nanolaminated crystalline solids well beyond the MAX phases family of early transition metal carbides/nitrides, most likely broadening the spectrum of achievable material properties into domains typically not covered by the MAX phases. Furthermore, this work uncovers that both families of nanolaminated crystalline solids, \textit{i.e.}, the herein introduced \textit{fcc} ZIA phases and all known variants of the \textit{hcp} MAX phases, obey the same overarching stoichiometric rule $P_{x+y}A_xN_y$, where $x$ and $y$ are integers ranging from 1 to 6