Behavioral Factors Influencing Health Outcomes in Youth with Type 1 Diabetes

The Pediatric Self-Management Model provides an overview of how behavioral factors influence children’s chronic medical illnesses. This general framework is used to organize the present review of how self-management behaviors, contextual factors, and processes impact health outcomes for adolescent youth with type 1 diabetes. Adherence has been widely studied in the diabetes literature, and there are consistent findings demonstrating associations between aspects of self-management, adherence, and metabolic control, yet there are still equivocal approaches to adherence assessment methodology (e.g. global versus specific measures). Metabolic control is a hallmark health outcome for youth with type 1 diabetes, but additional outcomes need to be further explored. Future research should utilize the Pediatric Self-Management Model’s operational definitions to guide empirically-supported interventions for youth with type 1 diabetes

Parent-Adolescent Communication about Health Risk Behaviors Among Adolescents with type 1 diabetes mellitus

Health risk behaviors, like drinking alcohol or using tobacco, are a common problem among adolescents in the United States. For healthy adolescents, health risk behaviors may be hazardous to their health; for adolescents with chronic illnesses, the risks associated with these types of behavior are compounded and may further impact their health status. This is particularly true for adolescents with type 1 diabetes mellitus (T1DM), whose blood sugar may be directly impacted by consumption of alcohol or use of tobacco. Parent-child communication has been found to act as a protective factor against adolescent engagement in health risk behaviors; however, this relationship has not been explored within the context families raising an adolescent with T1DM. As such, the present study will examine the relationships among health risk behavior of adolescents with T1DM, aspects of maternal caregiver-female adolescent communication, diabetes management, and metabolic control. Fifty-four female caregivers and fifty-two female adolescents (ages 14-19) diagnosed with T1DM completed the study. Parents and adolescents completed questionnaires assessing adolescent lifetime and previous 12 month use of alcohol and cigarettes or tobacco, various aspects of communication, and adherence to diabetes management tasks. Additionally, adolescents\u27 medical records were reviewed to collect most recent hemoglobin A1C (HbA1C values), which represent metabolic control during the past 2-3 months. In general, adolescents reported low rates of engagement in health risk behaviors. Results generally supported our hypotheses in that adolescents who reported lifetime or previous 12 month engagement in health risk behaviors had poorer parent- and self- reported treatment adherence; however, health risk behavior engagement was not associated with metabolic control. Additionally, parent- and adolescent-reported open and problem communication and parent-reported comfort with discussing risk behaviors were associated with and predicted adolescent-reported lifetime use of alcohol and cigarettes and previous 12 month use of alcohol. Together, aspects of parent- and adolescent-reported communication and adolescent health risk behavior engagement predicted parent- and adolescent-reported adherence to diabetes management tasks. Overall, present findings suggest that diabetes health care providers should discuss the potential impact of health risk behavior engagement on diabetes management and how the quality of parent-adolescent communication may influence adolescent health risk behaviors

Sleep, Internalizing Symptoms, Executive Functioning, and Diabetes Outcomes in Adolescents with Type 1 Diabetes Mellitus

Insufficient sleep is a nearly universal problem during adolescence and is likely associated with various biopsychosocial and contextual factors present with this developmental period. Youth with type 1 diabetes mellitus (T1DM) may experience greater sleep difficulties, poorer sleep quality, and greater daytime sleepiness/fatigue compared to healthy youth. Also, sleep difficulties are associated with poorer diabetes outcomes (e.g., treatment adherence). Understanding how sleep may impact illness management during adolescence is critical given increasing rates of non-adherence during this developmental period. Although research suggests poor sleep is associated with decreased neurocognitive functioning and increased internalizing behavior among healthy youth, limited research has examined these relationships in adolescents with T1DM. Further, adolescents with T1DM are at increased risk for difficulties with executive functioning and internalizing behaviors compared to healthy peers, and these difficulties have been implicated in T1DM-related outcomes. As such, the present study examined relationships among adolescent-reported sleep quality, quantity, and diabetes-related outcomes and the indirect effects of sleep quality on T1DM-related outcomes through internalizing symptoms and executive functioning. Eighty-one adolescents diagnosed with T1DM (ages 12-17) and their caregivers completed the study. Caregivers and adolescents completed questionnaires assessing adolescents’ executive functioning and adherence to diabetes management tasks. Adolescents completed additional questionnaires assessing sleep quality, daytime sleepiness, and internalizing symptoms. Adolescents’ medical records were reviewed to collect most recent hemoglobin A1c (HbA1c) values, which represent metabolic control. Results partially supported hypotheses in that poorer sleep quality, greater daytime sleepiness, and longer sleep duration on the weekend were associated with poorer treatment adherence, but not metabolic control. As predicted, sleep quality was associated with adherence through anxiety, depression, and executive functioning. Daytime sleepiness was associated with adherence through anxiety and had a direct effect on adherence independent of anxiety, depression, and executive functioning. Overall, results underscore the importance of assessing sleep quality and quantity in adolescents’ with T1DM. Targeting sleep as a point of intervention may help to improve adherence behaviors through internalizing symptoms and executive functioning

Information Technology Use in West African Agriculture – challenges and opportunities: a panel discussion

Many countries in the Economic Community of West African States (ECOWAS) are using Information Communications Technology (ICT) to enhance agriculture development and production. To do this efficiently the John Ogonowski and Doug Bereuter Farmer-to-Farmer Program managed for West Africa by Winrock International has been tasked with providing volunteer assignments to ministries of agriculture. The University of Missouri - Saint Louis (UMSL) has entered a partnership with Winrock International to offer upper-level undergraduate and graduate students the opportunity to provide technical assistance to international government entities. In this panel; we discuss findings and opportunities for improvement in Guinea and Senegal as they relate to ICT discovered through the onsite support provided

O impacto adverso do isolamento racial no desempenho dos alunos: um estudo na Carolina do Norte.

This study examines the impact of racial isolation on high school student performance in North Carolina, a state in the southeast United States. Our research goal is to investigate if increased isolation negatively impacts Black students’ academic performance. Employing the North Carolina State Department of Public Instruction (NCDPI) dataset, we test for this using Algebra I and English I scores on End-of-Course exams for ninth graders (N = 134,646) during the 2007-2008 school year. We control for student-level characteristics, such as race and ethnicity, economic disadvantage (eligibility for free and reduced-price lunch), and designation as gifted. We also analyze the effect of school-level characteristics, such as teacher experience, teacher training (advanced degree), teacher accreditation (fully licensed), and the percentage of students who were Black or Latino. Our results suggest racial isolation adversely impacts student performance on Algebra I by as much as three points. With our restricted hierarchical dataset and multi-level modeling, we (a) contribute to the growing body of literature, which finds a negative association between racial isolation/segregation and student performance, and (b) find teacher attributes can moderate some of the adverse student outcomes.Este estudio examina el impacto del aislamiento racial en el desempeño de estudiantes de escuelas secundarias en Carolina del Norte, un estado en el sureste de Estados Unidos. Nuestra objetivo de investigación fue investigar si el mayor aislamiento repercute negativamente en  el rendimiento académico de los estudiantes negros. Empleando datos del Departamento de Instrucción Pública del Estado de Carolina del Norte ( NCDPI ) de puntuaciones Álgebra I y Inglés I en exámenes de Fin de Curso para estudiantes de noveno grado (N = 134.646 ) durante el año escolar 2007-2008. Controlando las características a nivel estudiantil, como raza y origen étnico, desventaja económica (la elegibilidad para programas de almuerzo gratis o a precio reducido), y su designación como intelectualmente dotado. También se analizó el efecto de las características a nivel de la escuela, como experiencia docente, formación del profesorado (título avanzado), la acreditación del profesorado (con licencia), y el porcentaje de estudiantes Negros o Latinos. Nuestros resultados sugieren que el aislamiento racial afecta negativamente en hasta tres puntos el desempeño estudiantil en Algebra I. Con nuestra base de datos jerárquica y modelización multinivel, contribuimos al creciente cuerpo de literatura que ( a) encuentra una asociación negativa entre el aislamiento racial segregación y rendimiento de los estudiantes, y (b ) que ciertos atributos de los docentes pueden moderar algunos de los resultados adversos en los estudiantes.O presente estudo analisa o impacto do isolamento racial no desempenho de estudantes de ensino médio na Carolina do Norte, um estado no sudeste dos Estados Unidos. Nosso objetivo de pesquisa foi investigar se o aumento do isolamento afeta negativamente o desempenho acadêmico dos estudantes negros. Utilizamos dados do Departamento de Instrução Pública da Carolina do Norte ( NCDPI ) das avaliações de Álgebra I e Inglês I em exames de Fim de do curso para os calouros (N = 134.646 ) para o ano letivo de 2007-2008. Controlando pelas características de nível estudantil, tais como raça e etnia, desvantagem econômica (elegibilidade para os programas de almoço gratutitos ou de prezo reduzidos), e a designação como intelectualmente dotado. Também se controlo o efeito das características do nível da escola, tais como experiência de ensino , formação de professores ( nível avançado) , credenciamento de professor (licenciado ), e o percentual de estudantes negros ou latinos também foi analisada. Nossos resultados sugerem que o isolamento racial afeta negativamente até em três pontos o desempenho dos alunos em Álgebra I. Com o nosso banco de dados hierárquico e modelagem multinível, contribuímos para o crescente corpo de literatura indicando que (a) a uma associação negativa entre a segregação racial e isolamento no desempenho do aluno, e ( b) que certos atributos dos professores podem moderar alguns dos resultados adversos para os alunos

Implementing Organizational Change in a Multidimensional Community College District: A Case Study

Implementing organizational change within complex organizations involves responding to external forces that impact business operations. Leaders guide their organizations through planned change processes by implementing strategic initiatives that affect the entire organization, impact business operations, and influence organizational values (Nadler & Tushman, 1989; Tushman & Nadler, 2012). Community colleges implement change initiatives on behalf of historically, non-dominant students to address systemic issues through developing more inclusive higher education practices (Harris & Wood, 2016; Tate IV, 2008). The following study investigated a matrix-structured community college district located in the Pacific Northwest that implemented change across multiple dimensions to improve student success outcomes for systemically minoritized populations. The purpose of the study was to investigate perceptions held by leaders and staff associated with change management implementation within a multidimensional higher education organization with a focus on Black male student outcomes. Through a qualitative, case study approach, the study analyzed data collected within six focus group interviews with 12 participants. Analysis of RQ1 established four major themes including high turnover/attrition, effectiveness of change, effectiveness of communication, and cross-functional teams; and RQ2 established three major themes including heightened awareness of opportunity gaps, shared vision, and cross-functional teams. Findings produced primary recommendations (integrate Achieving the Dream (ATD) into the formal structure of the district, clarifying decision-making and processes, improve transparency and communication, and thoughtful collaboration) and recommendations for future research (1) contributes to emerging literature on multidimensional higher education institutions; (2) improving educational experiences for Black male community college students; and (3) understanding organizational change processes on community college campuses

Illness perceptions within 6 months of cancer diagnosis are an independent prospective predictor of health-related quality of life 15 months post-diagnosis

Objective: Studies have found that illness perceptions explain significant variance in health outcomes in numerous diseases. However, most of the research is cross-sectional and non-oncological. We examined, for the first time in breast, colorectal and prostate cancer patients, if cognitive and emotional illness perceptions near diagnosis predict future multidimensional health-related quality of life (HRQoL). Methods: UK-based patients (N = 334) completed the illness perception questionnaire-revised within 6 months post-diagnosis and the quality of life in adult cancer survivors scale 15 months post-diagnosis. Sociodemographic and clinical data were obtained from medical records. Hierarchical multiple regression analyses were conducted. Results: The sociodemographic and clinical factors collectively significantly predicted 8/12 HRQoL domains, although for 5/8 accounted for <10% of the variance. For all 12 HRQoL domains, illness perceptions collectively explained significant substantial additional variance (∆R² range: 5.6–27.9%), and a single illness perception questionnaire-revised dimension was the best individual predictor of 9/12 HRQoL domains. The consequences dimension independently predicted 7/12 HRQoL domains; patients who believed their cancer would have a more serious negative impact on their life reported poorer future HRQoL. The emotional representations and identity dimensions also predicted multiple HRQoL domains. Conclusions: Future research should focus on realising the potential of illness perceptions as a modifiable target for and mediating mechanism of interventions to improve patients' HRQoL

De novo mutations in PURA are associated with hypotonia and developmental delay

PURA is the leading candidate gene responsible for the developmental phenotype in the 5q31.3 microdeletion syndrome. De novo mutations in PURA were recently reported in 15 individuals with developmental features similar to the 5q31.3 microdeletion syndrome. Here we describe six unrelated children who were identified by clinical whole-exome sequencing (WES) to have novel de novo variants in PURA with a similar phenotype of hypotonia and developmental delay and frequently associated with seizures. The protein Puralpha (encoded by PURA) is involved in neuronal proliferation, dendrite maturation, and the transport of mRNA to translation sites during neuronal development. Mutations in PURA may alter normal brain development and impair neuronal function, leading to developmental delay and the seizures observed in patients with mutations in PURA

Placental glucocorticoid receptor isoforms in a sheep model of maternal allergic asthma

Maternal asthma increases the risk of adverse pregnancy outcomes and may affect fetal growth and placental function by differential effects on the expression of glucocorticoid receptor (GR) isoforms, leading to altered glucocorticoid signalling. Our aim was to examine the effect of maternal asthma on placental GR profiles using a pregnant sheep model of asthma. Nine known GR isoforms were detected. There was a significant increase in the expression of placental GR isoforms that are known to have low trans-activational activity in other species including GR A, GR P and GRγ which may result in a pro-inflammatory environment in the presence of allergic asthma

Diversity of Phylogenetic Information According to the Locus and the Taxonomic Level: An Example from a Parasitic Mesostigmatid Mite Genus

Molecular markers for cladistic analyses may perform differently according to the taxonomic group considered and the historical level under investigation. Here we evaluate the phylogenetic potential of five different markers for resolving evolutionary relationships within the ectoparasitic genus Dermanyssus at the species level, and their ability to address questions about the evolution of specialization. COI provided 9–18% divergence between species (up to 9% within species), 16S rRNA 10–16% (up to 4% within species), ITS1 and 2 2–9% (up to 1% within species) and Tropomyosin intron n 8–20% (up to 6% within species). EF-1α revealed different non-orthologous copies within individuals of Dermanyssus and Ornithonyssus. Tropomyosin intron n was shown containing consistent phylogenetic signal at the specific level within Dermanyssus and represents a promising marker for future prospects in phylogenetics of Acari. Phylogenetic analyses revealed that the generalist condition is apomorphic and D. gallinae might represent a complex of hybridized lineages. The split into hirsutus-group and gallinae-group in Dermanyssus does not seem to be appropriate based upon these results and D. longipes appears to be composed of two different entities