Understanding and supporting women with polycystic ovary syndrome: a qualitative study in an ethnically diverse UK sample

OBJECTIVE: Polycystic ovary syndrome (PCOS) is a lifelong condition. Its symptoms have been linked with psychological consequences, but less attention has been given to the daily implications of living with PCOS. We aimed to explore women's experiences living with PCOS, and the potential acceptability of group education sessions for this target group. METHODS: Women with PCOS were recruited from an ethnically diverse UK community. Twelve semi-structured interviews were conducted. Analysis was underpinned by the constant comparative approach and involved the identification and exploration of key themes. RESULTS: Participants reported a range of symptoms linked with PCOS, including problems relating to menstruation and weight difficulties. Hirsutism was reported as the most distressing symptom. Emergent themes included perceptions about symptoms and delays in receiving a diagnosis; psychological distress; practical implications of living with the condition; coping with PCOS and perceived support needs. Some findings were specific to cultural backgrounds. Participants were supportive of the idea of group education for women with PCOS and suggested a need to provide education within the community and health care providers. DISCUSSION: Women with PCOS experience high psychological distress and difficulties with coping with their condition. Suggested strategies to reduce the negative psychological impact include education at various levels

Barriers and Facilitators to Healthy Lifestyle Changes in Minority Ethnic Populations in the UK: a Narrative Review.

Minority ethnic populations experience a disproportionate burden of health inequalities compared with the rest of the population, including an increased risk of type 2 diabetes (T2DM). The purpose of this narrative review was to explore knowledge and attitudes around diabetes, physical activity and diet and identify barriers and facilitators to healthy lifestyle changes in minority ethnic populations in the UK. The narrative review focused on three key research topics in relation to barriers and facilitators to healthy lifestyle changes in minority adult ethnic populations: (i) knowledge and attitudes about diabetes risk; (ii) current behaviours and knowledge about physical activity and diet; and (iii) barriers and facilitators to living a healthier lifestyle. Nearly all of the studies that we identified reported on South Asian minority ethnic populations; we found very few studies on other minority ethnic populations. Among South Asian communities, there was generally a good understanding of diabetes and its associated risk factors. However, knowledge about the levels of physical activity required to gain health benefits was relatively poor and eating patterns varied. Barriers to healthy lifestyle changes identified included language barriers, prioritising work over physical activity to provide for the family, cultural barriers with regard to serving and eating traditional food, different perceptions of a healthy body weight and fear of racial harassment or abuse when exercising. Additional barriers for South Asian women included expectations to remain in the home, fear for personal safety, lack of same gender venues and concerns over the acceptability of wearing 'western' exercise clothing. Facilitators included concern that weight gain might compromise family/carer responsibilities, desire to be healthy, T2DM diagnosis and exercise classes held in 'safe' environments such as places of worship. Our findings suggest that South Asian communities are less likely to engage in physical activity than White populations and highlight the need for health promotion strategies to engage people in these communities. There is a gap in knowledge with regard to diabetes, physical activity, diet and barriers to healthy lifestyle changes among other ethnic minority populations in the UK; we recommend further research in this area

COSMIC mutations called in the primary tumor and axillary lymph node.

<p>Mutations were not present in the normal blood sample. Three mutations were unique to the tumor whilst the node harbored a single unique mutation: a frameshift in the coding sequence of <i>PDS5B</i>, a gene that interacts with the cohesion complex to maintain accurate sister chromatid segregation during mitosis and meiosis and suggested previously as a tumor suppressor <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0115346#pone.0115346-Denes1" target="_blank">[27]</a>, <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0115346#pone.0115346-Kim1" target="_blank">[28]</a>.</p><p>COSMIC mutations called in the primary tumor and axillary lymph node.</p

Known and novel variant counts at a read-depth of ≥100 that overlapped genes and their flanking regions.

<p>Variants were judged as known by their being listed in dbSNP. Variant counts for those unique to both samples are also shown. The lowest frequency variant detected for each variant type (SNV, insertion, deletion, and substitution, respectively) in each sample was 0.88%, 3.7%, 10.07%, and 4.57% in the tumor, and 7.41%, 3.01%, 10.07%, 2.78% in the node.</p><p>Known and novel variant counts at a read-depth of ≥100 that overlapped genes and their flanking regions.</p

Total output (Gb) and depth of coverage for each sample.

<p>The amount that was successfully mapped to the reference genome for each sample was >97%, with a mean of 92.7% of each base achieving ≥40x coverage (or 96.4% for the exome fraction).</p><p>Total output (Gb) and depth of coverage for each sample.</p

Development of a lifestyle intervention using the MRC framework for diabetes prevention in people with impaired glucose regulation.

BACKGROUND: We report development of a group-based lifestyle intervention, Let's Prevent, using the UK Medical Research Council (MRC) framework, and delivered by structured education to prevent type 2 diabetes mellitus (T2DM) in people with impaired glucose regulation (IGR) in a UK multi-ethnic population. METHODS: Diabetes Education and Self-Management for Ongoing and Newly Diagnosed (DESMOND) is the first national T2DM programme that meets National Institute for Health and Care Excellence criteria and formed the basis for Let's Prevent. An iterative cycle of initial development, piloting, collecting and collating qualitative and quantitative data, and reflection and modification, was used to inform and refine lifestyle intervention until it was fit for evaluation in a definitive randomized controlled trial (RCT). The programme encouraged IGR self-management using simple, non-technical language and visual aids. RESULTS: Qualitative and quantitative data suggested that intervention resulted in beneficial short-term behaviour change such as healthier eating patterns, improved health beliefs and greater participant motivation and empowerment. We also demonstrated that recruitment strategy and data collection methods were feasible for RCT implementation. CONCLUSIONS: Let's Prevent was developed following successful application of MRC framework criteria and the subsequent RCT will determine whether it is feasible, reliable and transferable from research into a real-world NHS primary healthcare setting. TRIAL REGISTRATION: ISRCTN80605705