Validation and implementation of low-cost dynamic insulin sensitivity tests

DTM2011 handbook/programme is given in files and also available as a hard copyObjective: Insulin sensitivity (SI) tests can provide important information for type 2 diabetes risk assessment and investigations of metabolism or pre-diabetes. Our group previously presented the dynamic insulin sensitivity and secretion test (DISST) and the real-time quick DISST (DISTq) as low-cost, low-burden and accurate alternatives to established tests. The DISST provides concurrent SI and endogenous insulin secretion (UN) metrics, the DISTq does not require insulin or C-peptide assays for SI identification, but can return an immediate result. This study validates the DISST and DISTq in comparison to the euglycemic, hyperinsulinemic clamp (EIC) Method: Fifty participants (with 10 BMI>30; 10 BMI>25, <30; and 5 BMI<25 of each gender) underwent the EIC and DISST. The DISST protocol requires 5 samples from a 30 minute protocol similar to the IM-IVGTT. Data from the DISST protocol was sufficient to identify SI using both the DISST and DISTq parameter identification methods and UN from the DISST. Result: DISST and DISTq SI values correlated well to the EIC (R=0.81 and R=0.76, respectively) and each other (R=0.84). UN values obtained during the DISST showed clinically relevant distinctions between participants, and clearly differentiated the beta-cell function of impaired glucose tolerant participants who had the same EIC SI. Participant acceptance of the protocol was high with very minor reported adverse effects. Conclusion: The DISST and DISTq correlated well against the EIC compared to most established insulin sensitivity tests. The DISST can better differentiate patients as it provides UN metrics that the EIC does not. A computer program makes uptake and use of the model-based DISST and DISTq tests straightforward for clinicians and researchers

Measuring the Cultural Competence of Latinx Domestic Violence Service Organizations

Domestic violence (DV) represents a significant public health concern in the United States, including among Latinx populations. Despite the negative consequences associated with experiencing DV, research has shown that Latinx DV survivors may be less likely than others to utilize important services. One potential barrier is cultural competence (CC) in the provision of services specific to Latinx survivors among DV organizations. Thus, a beneficial addition to the field of DV service provision for such survivors is a better understanding and measurement of CC for this unique population. The exploratory, cross-sectional study herein presents the development and evaluation of a novel instrument for measuring the CC of DV organizations. Exploratory factor analysis was used on a purposive sample of 76 organizations in North Carolina who completed a comprehensive survey on their characteristics, practices, norms, and values. Psychometric results found best support for a 29-item, 4-factor bifactor model with both a general CC factor as well as three sub-factors. The general scale was named “General Cultural Competence,” while the three sub-scales were named “Organizational Values and Procedures,” “Latinx Knowledge and Inclusion,” and “Latinx DV Knowledge.” The final measure also demonstrated convergent validity with key organizational characteristics. Overall, higher CC scores were associated with organizations having more DV services in Spanish, a higher percentage of staff attending CC training, a higher percentage of staff attending Latinx service provision training, and a medium or greater presence in the Latinx community, and a moderate or stronger relationship with the Latinx community. The development of this measure is particularly useful in addressing knowledge gaps regarding the measurement of CC for Latinx DV services. Implications have importance for both the measurement of organizational CC and the scope of the measure’s associations with organizational, provider, and client outcomes

Understanding Intimate Partner Violence Service Delivery for Latinx Survivors in Rural Areas

Using a statewide survey, this exploratory, cross-sectional study examined 78 domestic violence (DV) service organizations? service delivery practices and perceived challenges to serving Latinx survivors in the context of rurality. Findings showed that DV organizations in rural areas perceived more challenges to delivering culturally appropriate services for Latinx survivors compared to those in other geographic settings even after accounting for client characteristics, service provision characteristics, and community resources. The study finding offers critical insights to ensure and enhance the provision of linguistically and culturally accessible services for rural Latinx survivors of intimate partner violence

Riverhood: political ecologies of socionature commoning and translocal struggles for water justice

Mega-damming, pollution and depletion endanger rivers worldwide. Meanwhile, modernist imaginaries of ordering ‘unruly waters and humans’ have become cornerstones of hydraulic-bureaucratic and capitalist development. They separate hydro/social worlds, sideline river-commons cultures, and deepen socio-environmental injustices. But myriad new water justice movements (NWJMs) proliferate: rooted, disruptive, transdisciplinary, multi-scalar coalitions that deploy alternative river–society ontologies, bridge South–North divides, and translate river-enlivening practices from local to global and vice-versa. This paper's framework conceptualizes ‘riverhood’ to engage with NWJMs and river commoning initiatives. We suggest four interrelated ontologies, situating river socionatures as arenas of material, social and symbolic co-production: ‘river-as-ecosociety’, ‘river-as-territory’, ‘river-as-subject’, and ‘river-as-movement’

Linearly polarised photon beams at ELSA and measurement of the beam asymmetry in pi^0-photoproduction off the proton

At the electron accelerator ELSA a linearly polarised tagged photon beam is produced by coherent bremsstrahlung off a diamond crystal. Orientation and energy range of the linear polarisation can be deliberately chosen by accurate positioning of the crystal with a goniometer. The degree of polarisation is determined by the form of the scattered electron spectrum. Good agreement between experiment and expectations on basis of the experimental conditions is obtained. Polarisation degrees of P = 40% are typically achieved at half of the primary electron energy. The determination of P is confirmed by measuring the beam asymmetry, \Sigma, in pi^0 photoproduction and a comparison of the results to independent measurements using laser backscattering.Comment: 9 pages, 10 figures, submitted to EPJ

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries