In pursuing a new resolution on sexual violence Security Council significantly undermines women’s reproductive rights

Louise Allen and Laura Shepherd explore the complex politics of Resolution 2467

The role of online support groups for parents of adolescents with type 1 diabetes during the transition to adult diabetes services

Paediatric type 1 diabetes is often referred to as a 'family disease' due to the importance of family interactions and parental supervision required to achieve optimal blood glucose levels and quality of life. The treatment regime for this chronic disease in children is complex and requires co-management by parents, many of whom experience psychosocial problems whilst undertaking this responsibility. Parents managing their child’s diabetes care need informational and emotional support that is not always adequately met by existing sources of support. With Internet access becoming increasingly ubiquitous, parents can search online for health information, advice and support, augmented by the use of diabetes online support groups. Previous research has identified potential benefits health-related online support groups can afford patients with chronic health conditions; addressing their information and support needs in a safe, non-judgemental environment with others in a similar situation, shown to empower individuals. However, little is known about the role of diabetes online support groups for parents of children with type 1 diabetes as they transition from paediatric to adult diabetes services during late adolescence; a particularly stressful event for some parents. The present thesis aimed to address this disparity by exploring parents of adolescent’s experiences of using diabetes online support groups during a period of change; investigating if group membership affects psychological well-being and if participation empowers parents. Using a mixed methods approach, three empirical studies were conducted. The first study used an online survey completed by 88 parents. This garnered information about parents’ experiences of using diabetes online support groups. It assessed the illness representations held about diabetes, along with reported levels of parental diabetes distress. Perceptions of empowering processes and outcomes within the diabetes online support groups were also investigated. For Study 2, qualitative one-to-one interviews were carried out with 13 parents who had previously completed the online survey, to gain a greater understanding of parents’ initial motivation to join a diabetes online support group, and what factors influence their continued participation. The final study was a thematic analysis of 945 messages posted on two UK diabetes online support groups to identify and examine the types of social support in group members’ communications. The combined results from the three studies indicate diabetes online support groups play an important role in providing informational and emotional support to parents of adolescents with type 1 diabetes. Furthermore, the availability and reciprocity of social support within diabetes online group were considered empowering by parents, with positive psychosocial benefits noted as being associated with group membership rather than dependant on the level of participation. Findings from this thesis also identified a disparity between mothers and fathers using diabetes online support groups, suggesting a more targeted approach should be considered for future research to investigate fathers’ perspectives and experiences. This thesis provides a deeper understanding of issues pertinent to the use of diabetes online support groups by parents of adolescents with type 1 diabetes. It provides a unique insight into the implications and potential benefits diabetes online support groups can have for the psychological well-being of parents for whom relinquishing control of their child’s diabetes management may be a determinant of increased anxiety, fear and diabetes distress

CydDC-mediated reductant export in Escherichia coli controls the transcriptional wiring of energy metabolism and combats nitrosative stress

The glutathione/cysteine exporter CydDC maintains redox balance in Escherichia coli. A cydD mutant strain was used to probe the influence of CydDC upon reduced thiol export, gene expression, metabolic perturbations, intracellular pH homeostasis, and tolerance to nitric oxide (NO). Loss of CydDC was found to decrease extracytoplasmic thiol levels, whereas overexpression diminished the cytoplasmic thiol content. Transcriptomic analysis revealed a dramatic up-regulation of protein chaperones, protein degradation (via phenylpropionate/phenylacetate catabolism), ?-oxidation of fatty acids, and genes involved in nitrate/nitrite reduction. 1H NMR metabolomics revealed elevated methionine and betaine and diminished acetate and NAD+ in cydD cells, which was consistent with the transcriptomics-based metabolic model. The growth rate and ?pH, however, were unaffected, although the cydD strain did exhibit sensitivity to the NO-releasing compound NOC-12. These observations are consistent with the hypothesis that the loss of CydDC-mediated reductant export promotes protein misfolding, adaptations to energy metabolism, and sensitivity to NO. The addition of both glutathione and cysteine to the medium was found to complement the loss of bd -type cytochrome synthesis in a cydD strain (a key component of the pleiotropic cydDC phenotype), providing the first direct evidence that CydDC substrates are able to restore the correct assembly of this respiratory oxidase. These data provide an insight into the metabolic flexibility of E. coli , highlight the importance of bacterial redox homeostasis during nitrosative stress, and report for the first time the ability of periplasmic low molecular weight thiols to restore haem incorporation into a cytochrome complex

The role of online support groups for parents of adolescents with type 1 diabetes during the transition to adult diabetes services

Paediatric type 1 diabetes is often referred to as a 'family disease' due to the importance of family interactions and parental supervision required to achieve optimal blood glucose levels and quality of life. The treatment regime for this chronic disease in children is complex and requires co-management by parents, many of whom experience psychosocial problems whilst undertaking this responsibility. Parents managing their child’s diabetes care need informational and emotional support that is not always adequately met by existing sources of support. With Internet access becoming increasingly ubiquitous, parents can search online for health information, advice and support, augmented by the use of diabetes online support groups. Previous research has identified potential benefits health-related online support groups can afford patients with chronic health conditions; addressing their information and support needs in a safe, non-judgemental environment with others in a similar situation, shown to empower individuals. However, little is known about the role of diabetes online support groups for parents of children with type 1 diabetes as they transition from paediatric to adult diabetes services during late adolescence; a particularly stressful event for some parents. The present thesis aimed to address this disparity by exploring parents of adolescent’s experiences of using diabetes online support groups during a period of change; investigating if group membership affects psychological well-being and if participation empowers parents. Using a mixed methods approach, three empirical studies were conducted. The first study used an online survey completed by 88 parents. This garnered information about parents’ experiences of using diabetes online support groups. It assessed the illness representations held about diabetes, along with reported levels of parental diabetes distress. Perceptions of empowering processes and outcomes within the diabetes online support groups were also investigated. For Study 2, qualitative one-to-one interviews were carried out with 13 parents who had previously completed the online survey, to gain a greater understanding of parents’ initial motivation to join a diabetes online support group, and what factors influence their continued participation. The final study was a thematic analysis of 945 messages posted on two UK diabetes online support groups to identify and examine the types of social support in group members’ communications. The combined results from the three studies indicate diabetes online support groups play an important role in providing informational and emotional support to parents of adolescents with type 1 diabetes. Furthermore, the availability and reciprocity of social support within diabetes online group were considered empowering by parents, with positive psychosocial benefits noted as being associated with group membership rather than dependant on the level of participation. Findings from this thesis also identified a disparity between mothers and fathers using diabetes online support groups, suggesting a more targeted approach should be considered for future research to investigate fathers’ perspectives and experiences. This thesis provides a deeper understanding of issues pertinent to the use of diabetes online support groups by parents of adolescents with type 1 diabetes. It provides a unique insight into the implications and potential benefits diabetes online support groups can have for the psychological well-being of parents for whom relinquishing control of their child’s diabetes management may be a determinant of increased anxiety, fear and diabetes distress

Anonymity, veracity and power in online patient feedback : A quantitative and qualitative analysis of staff responses to patient comments on the ‘Care Opinion’ platform in Scotland

Funding: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by NHS Grampian Endowments Fund (grant number 2018UA012).Peer reviewedPublisher PD

Delivery of alcohol advice to dental patients

• Alcohol harms have significant health, social and economic costs in Scotland• Alcohol is a major risk factor for oral and throat cancers• Dental Professionals (DPs) are ideally placed to screen their patients’ alcohol consumption and provide brief advice to those who may have an increased risk of cancer• Many DPs in the UK are reluctant to deliver alcohol advice to patient

How LGBT+ Young People Use the Internet in Relation to Their Mental Health and Envisage the Use of e-Therapy: Exploratory Study

Background: Lesbian, gay, bisexual, and transgender (LGBT) youth and other young people diverse in terms of their sexuality and gender (LGBT+) are at an elevated risk of mental health problems such as depression. Factors such as isolation and stigma mean that accessing mental health services can be particularly challenging for LGBT+ young people, and previous studies have highlighted that many prefer to access psychological support on the Web. Research from New Zealand has demonstrated promising effectiveness and acceptability for an LGBT+ focused, serious game–based, computerized cognitive behavioral therapy program, Rainbow Smart, Positive, Active, Realistic, X-factor thoughts (SPARX). However, there has been limited research conducted in the area of electronic therapy (e-therapy) for LGBT+ people. Objective: This study aimed to explore how and why LGBT+ young people use the internet to support their mental health. This study also sought to explore LGBT+ young people’s and professionals’ views about e-therapies, drawing on the example of Rainbow SPARX. Methods: A total of 3 focus groups and 5 semistructured interviews were conducted with 21 LGBT+ young people (aged 15-22 years) and 6 professionals (4 health and social care practitioners and 2 National Health Service commissioners) in England and Wales. A general inductive approach was used to analyze data. Results: LGBT+ youth participants considered that the use of the internet was ubiquitous, and it was valuable for support and information. However, they also thought that internet use could be problematic, and they highlighted certain internet safety and personal security considerations. They drew on a range of gaming experiences and expectations to inform their feedback about Rainbow SPARX. Their responses focused on the need for this e-therapy program to be updated and refined. LGBT+ young people experienced challenges related to stigma and mistreatment, and they suggested that strategies addressing their common challenges should be included in e-therapy content. Professional study participants also emphasized the need to update and refine Rainbow SPARX. Moreover, professionals highlighted some of the issues associated with e-therapies needing to demonstrate effectiveness and challenges associated with health service commissioning processes. Conclusions: LGBT+ young people use the internet to obtain support and access information, including information related to their mental health. They are interested in LGBT-specific e-therapies; however, these must be in a contemporary format, engaging, and adequately acknowledge the experiences of LGBT+ young people

Care conversations

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Effect of pulsed delivery and bouillon base on saltiness and bitterness perceptions of salt delivery profiles partially substituted with KCl

Reducing salt levels in processed food is an important target for a growing numbers of food manufacturers. The effects of pulsed delivery (Dynataste) and bouillon base on saltiness and bitterness perception of partially substituted solutions (KCl) were investigated. Pulsed delivery did not enhance salt perception and resulted in greater Overall Bitterness Scores for the same level of substitution with KCl. The presence of the bouillon base masked to a certain extent the loss of saltiness induced by the substitution and resulted in lower Overall Bitterness Scores of the substituted profiles