To the point - diabetes information for people with intellectual disability and their carers

Objective: To describe the perceptions and experiences of living with diabetes as told by people with intellectual disability and their carers and support staff. Design: Qualitative semi-structured interview study. Setting: Southeast Queensland, Australia. Subjects: 67 people - adults with intellectual disability (9), paid carers and support staff of adults with intellectual disability (31), family carers and support staff of adults with intellectual disability (8), service co-ordinators (12), health professionals (6) and other workers in the sector. Methods: Focus group discussions were held with the participants. Their perceptions and experiences of living with and managing intellectual disability and diabetes were recorded and the themes of the discussions studied. Results: The findings revealed a number of shortcomings in relation to diabetes care in a population of people with intellectual disability and their carers and support staff. There are higher than average support needs when diabetes is present. There is resentment at intrusion in their lives by diabetes from people with disability. There are feelings of fear and insecurity about diabetes in carers and support staff. Carers and support staff feel that generally they lack knowledge and also lack support from their organizations to manage both the intellectual disability and the diabetes. Conclusion: The general lack of confidence and knowledge about diabetes makes it difficult for people with intellectual disability and their carers and support staff to function in a effective and satisfying way. There is a need for guidelines

Memory Encoding and Dopamine in the Aging Brain: A Psychopharmacological Neuroimaging Study

Normal aging brings with it changes in dopaminergic and memory functions. However, little is known about how these 2 changes are related. In this study, we identify a link between dopamine, episodic memory networks, and aging, using pharmacological functional magnetic resonance imaging. Young and older adults received a D2-like agonist (Bromocriptine, 1.25 mg), a D2-like antagonist (Sulpiride, 400 mg), and Placebo, in a double-blind crossover procedure. We observed group differences, during memory encoding, in medial temporal, frontal, and striatal regions and moreover, these regions were differentially sensitive across groups to dopaminergic perturbation. These findings suggest that brain systems underlying memory show age-related changes and that dopaminergic function may be key in understanding these changes. That these changes have behavioral consequences was suggested by the observation that drug modulations were most pronounced in older subjects with poorer recognition memory. Our findings provide direct evidence linking ageing, memory, and dopaminergic change

Prospects for the future of pink salmon in three oceans: From the native Pacific to the novel Arctic and Atlantic

While populations of other migratory salmonids suffer in the Anthropocene, pink salmon (Oncorhynchus gorbusca Salmonidae) are thriving, and their distribution is expanding both within their natural range and in the Atlantic and Arctic following introduction of the species to the White Sea in the 1950s. Pink salmon are now rapidly spreading in Europe and even across the ocean to North America. Large numbers of pink salmon breed in Norwegian rivers and small numbers of individuals have been captured throughout the North Atlantic since 2017. Although little is known about the biology and ecology of the pink salmon in its novel distribution, the impacts of the species' introduction are potentially highly significant for native species and watershed productivity. Contrasts between pink salmon in the native and extended ranges will be key to navigating management strategies for Atlantic nations where the pink salmon is entrenching itself among the fish fauna, posing potential threats to native fish communities. One key conclusion of this paper is that the species' heritable traits are rapidly selected and drive local adaptation and evolution. Within the Atlantic region, this may facilitate further establishment and spread. The invasion of pink salmon in the Atlantic basin is ultimately a massive ecological experiment and one of the first examples of a major faunal change in the North Atlantic Ocean that is already undergoing rapid changes due to other anthropogenic stressors. New research is urgently needed to understand the role and potential future impacts of pink salmon in Atlantic ecosystems. Atlantification, biological invasions, climate adaptation, Pacific Ocean, regime shiftpublishedVersio

The role of alcohol in constructing gender & class identities among young women in the age of social media

Research suggests young women view drinking as a pleasurable aspect of their social lives but that they face challenges in engaging in a traditionally ‘masculine’ behaviour whilst maintaining a desirable ‘femininity’. Social network sites such as Facebook make socialising visible to a wide audience. This paper explores how young people discuss young women’s drinking practices, and how young women construct their identities through alcohol consumption and its display on social media. We conducted 21 friendship-based focus groups (both mixed and single sex) with young adults aged 18–29 years and 13 individual interviews with a subset of focus group respondents centred on their Facebook practices. We recruited a purposive sample in Glasgow, Scotland (UK) which included ‘middle class’ (defined as students and those in professional jobs) and ‘working class’ respondents (employed in manual/service sector jobs), who participated in a range of venues in the night time economy. Young women’s discussions revealed a difficult ‘balancing act’ between demonstrating an ‘up for it’ sexy (but not too sexy) femininity through their drinking and appearance, while still retaining control and respectability. This ‘balancing act’ was particularly precarious for working class women, who appeared to be judged more harshly than middle class women both online and offline. While a gendered double standard around appearance and alcohol consumption is not new, a wider online audience can now observe and comment on how women look and behave. Social structures such as gender and social class remain central to the construction of identity both online and offline

Predation of Atlantic salmon across ontogenetic stages and impacts on populations

Managers and stakeholders increasingly ask whether predation is a driving force behind the poor status of many species, and whether predator control is likely to be a successful management action to intervene. We review existing literature on Atlantic salmon Salmo salar predation and predator control, as well as general ecological theory on the role of predation in the life cycle of this iconic fish. Many bird, mammal, and fish predators target salmon at different life stages. In healthy salmon populations, predation is likely compensated for by reduced intra-specific competition during the freshwater stage. There is little evidence that predation alone has been an underlying mechanism for driving salmon populations below conservation limits. However, depending on the predator’s response to salmon abundance, predation may keep decimated populations from recovering, even when the actual causes of decline have been removed. Under such a scenario, predation control may contribute to recovery, but there are no strong examples that clearly demonstrate the efficacy of managing predators to recover threatened salmon populations, challenging further applications.publishedVersio

Health Conditions and Their Impact among Adolescents and Young Adults with Down Syndrome

Objective: To examine the prevalence of medical conditions and use of health services among young adults with Down syndrome and describe the impact of these conditions upon their lives. Methods: Using questionnaire data collected in 2011 from parents of young adults with Down syndrome we investigated the medical conditions experienced by their children in the previous 12 months. Univariate, linear and logistic regression analyses were performed. Results: We found that in addition to the conditions commonly experienced by children with Down syndrome, including eye and vision problems (affecting 73%), ear and hearing problems (affecting 45%), cardiac (affecting 25%) and respiratory problems (affecting 36%), conditions also found to be prevalent within our young adult cohort included musculoskeletal conditions (affecting 61%), body weight (affecting 57%), skin (affecting 56%) and mental health (affecting 32%) conditions and among young women menstrual conditions (affecting 58%). Few parents reported that these conditions had no impact, with common impacts related to restrictions in opportunities to participate in employment and community leisure activities for the young people, as well as safety concerns. Conclusion: There is the need to monitor, screen and provide appropriate strategies such as through the promotion of healthy lifestyles to prevent the development of comorbidities in young people with Down syndrome and, where present, to reduce their impact

Co-design of an NHS primary care health check for autistic adults

Autistic people experience more health conditions and earlier mortality. This study investigated views about a primary care health check for autistic adults to inform its design. Fifty-one people participated in consultation groups and interviews, comprising autistic adults (some with co-occurring intellectual disabilities), adults with intellectual disabilities, supporters and health professionals. Participants wanted the health check to cover physical and mental health and social functioning. They emphasised the importance of sharing information about individual needs and associated adjustments before the health check. They highlighted the need to change the way healthcare services communicate with autistic people, such as reducing phone contact and booking appointments online. They wanted individual choice in how the health check was completed, with video call or email offered alongside face-to-face. Participants raised the need for further training of primary care staff on autism, to highlight the diversity of experiences of autistic people and ways in which difficulties, such as pain, may present differently. Clinicians raised questions about the capacity of mental health and social care services to meet the additional needs potentially identified through the health check. This study represents a key step in the development and co-design of a UK primary care health check for autistic people

Yield associated with different tourist types

The programme “Enhancing Financial and Economic Yield in Tourism” has completed a range of investigations into various dimensions of private sector yield of tourism businesses, as well as public sector yield of tourism at local and national levels. Results from the earlier studies raised the question whether different types of tourists would differ with respect to their yield generated in the private sector and their costs posed to the public sector. Yield in this report is understood as net benefit – financial, economic, environmental or social. For the private sector yield, the measures of Value Added, Free Financial Cash Flow and Economic Value Added will be used, and for public sector yield the ratios between costs and revenue will be derived as a yield measure. The research objectives were to: 1. Understand tourist activity patterns in relation to impacts on the private and public sectors; 2. Derive yields for different types of visitors; and 3. Assess visitor satisfaction as one aspect of (social) yield

Investigating the pro-cognitive and anti-depressant efficacy of metformin: a systematic review and meta-analysis of randomised controlled trials

Background The preclinical and clinical data regarding the efficacy of metformin as a pro-cognitive and anti-depressant therapy is mixed. We conducted a systematic review and meta-analysis of randomised controlled trials investigating the effects of metformin on cognition and depressive symptoms. Methods The study was conducted in accordance with PRISMA guidelines (PROSPERO identifier: CRD42020184547). PubMed and Web of Science were searched (inception through to May 6, 2020) for trials which measured the effects (change from baseline to end-of-treatment) of metformin on cognition and depressive symptoms, compared to either placebo or other oral antidiabetic therapies. When feasible, pooled meta-analytic estimates were provided using a random-effects model. Results Eight studies met the inclusion criteria: four assessed only cognition, three assessed only depressive symptoms, and one study assessed both cognition and depressive symptoms. Results suggested that metformin was significantly superior to placebo in improving cognitive function in patients suffering with clinical conditions associated with cognitive impairment (SMD: 0.80; 95%CI: 0.46 to 1.15; p < 0.001; N = 2 studies; I2 = 0.0%). One study reported an association between improved cognition and depressive symptoms in a cohort of patients with type 2 diabetes mellitus and depression. Two studies investigating metformin versus pioglitazone showed a superior, but not significant, effect of pioglitazone on depressive symptoms (SMD: 1.56; 95%CI: −0.52 to 3.56; p = 0.13;I2 = 94.9%; N = 2 studies). Limitations Assessment of risk of bias identified two studies as having “some concerns”. Conclusions Our findings suggest that metformin might be re-purposed for the treatment of cognitive deficits in select clinical conditions

Research priority setting in UK podiatric surgery

Abstract Evidence-based practice provides the foundation for high quality patient care, and in the NHS, research is seen as vital to enable service transformation and improve outcomes. Research is one of the four pillars of enhanced and advanced clinical practice and is therefore a fundamental part of podiatric surgery services. In order to meet the UK health research strategies, the most recent being ‘Saving and Improving Lives: The Future of UK Clinical Research Delivery’ (2021), the Faculty of Podiatric Surgery in the UK agreed to support the development of research priorities in order to inform a future research strategy. The Podiatric Surgery Research Strategy Group was set up and embarked on a project with the aim of engaging its members in formulating and agreeing national research priorities. The initial stage included a national research scoping survey to identify key themes, topic, and research questions. The final stage consisted of developing and enabling a live consensus vote conducted at the 2022 national Faculty of Podiatric Surgery Conference. At the end of the vote, the top five research topics that met the agreement criteria were: 1. Surgical treatment – forefoot, 2. Patient reported outcome measures, 3. Post-operative management, 4. Surgical treatment – midfoot and 5. Service delivery. The top five research questions that met the criteria were1. How does quality of life improve following elective foot surgery? 2. How does podiatric surgery benefit the health of the population? 3. How does podiatric surgery benefit the health of the population in the at-risk foot? 4. What is the most effective Lapidus fixation option? and 5. What is the benefit of utilising PASCOM-10 to improve large scale outcome data? These will inform the initial UK podiatric surgery research priorities in the next three to five years