Exploring cultural barriers and TEK connections of Kānaka Maoli students in academia

Traditional Ecological Knowledge (TEK) is a Knowledge-belief-practice system acquired through intergenerational direct and indirect observations representing past and current understandings of environments and integrates Indigenous value systems. TEK has become a popular topic recently as Indigenous stewarded lands contain more biodiversity and are more adaptable. It is critical for Indigenous Peoples to maintain their TEK, even in diaspora. This thesis addresses the challenges and barriers that Kānaka Maoli (Native Hawaiian) students face as they attend university away from their communities and addresses Oregon State University by exploring the land grant institution legacy and proposing changes to OSU. It is important to understand how TEK is impacted as students leave their communities; however, TEK is community-specific and cannot be applied across communities because of the subjective nature of how Indigenous Peoples honor, carry, and pass on their Knowledges between and within communities. OSU’s land grant institution legacy makes it a potent place for settler colonialism, and with mindful work, can become a better place for Kānaka Maoli students and their Knowledges to survive and thrive. By following the recommendations and acknowledging this is not the only work to be done, OSU can take the first step in the right direction.Keywords: Traditional Ecological Knowledge, Kānaka Maoli, Academi

Pre-adolescent children’s experiences of receiving diabetes-related support from friends and peers: a qualitative study

BackgroundWhile pre�adolescent children with type 1 diabetes receive most support from their parents/caregivers, others also contribute to their care. This study explored pre�adolescent children's experiences of receiving diabetes�related support from friends and peers. The objective was to identify how children could be better supported by their friends and peers to undertake diabetes self�management.MethodsIn�depth interviews with 24 children (aged 9�12 years) with type 1 diabetes. Data were analysed using an inductive, thematic approach.ResultsChildren gave mixed accounts of their experiences of speaking to their school/class about diabetes with some indicating that this had resulted in unwanted attention. Most individuals reported that other children had a limited understanding of diabetes and sometimes acted in insensitive ways or said things they found upsetting. Virtually all children described having a small number of close friends who were interested in learning about diabetes and provided them with support. These friends provided support in three overlapping ways, as �monitors and prompters,� �helpers� and �normalizers.� While some children described benefiting from meeting peers with type 1 diabetes, most indicated that they would prefer to develop friendships based on shared interests rather than a common disease status.Discussion and conclusionsFriends and peers provide several kinds of support to pre�adolescent children with diabetes. Health professionals could consider ways to assist small friendship groups to undertake monitoring and prompting, helping and normalizing roles. Parents, schools and health professionals could explore ways to normalize self�management practices to better support children with diabetes in school settings.</p

The challenges of optimising glycaemic control in children with type 1 diabetes: a qualitative study of parents’ experiences and views

Aims To explore the difficulties parents encounter in trying to achieve clinically recommended blood glucose levels and how they could be better supported to optimize their child's glycaemic control. Methods In-depth interviews were conducted with 54 parents of children with Type 1 diabetes (≤ 12 years). Data were analysed thematically. Results Parents described being reluctant and finding it difficult to keep their child's blood glucose levels consistently within clinically recommended ranges. As well as worrying about their child's ability to detect/report hypoglycaemia, parents highlighted a multitude of factors that had an impact on their child's blood glucose levels and over which they could exercise little control. These included: leaving their child with other caregivers who could not be trusted to detect hypoglycaemia; difficulties remotely monitoring and regulating their child's food consumption and activity; and physical and social changes accompanying childhood development. Most parents used two sets of blood glucose targets, with clinically recommended targets employed when their child was in their immediate care and higher targets when in the care of others. Parents described health professionals as lacking understanding of the difficulties they encountered keeping blood glucose within target ranges and needing more empathetic, tailored and realistic advice. Conclusion It is not parents' fear of hypoglycaemia in isolation that leads to decisions to raise their child's blood glucose but, rather, parental fear in conjunction with other factors and considerations. Hence, to improve diabetes management in children, these factors may need to be addressed; for instance, by training others in diabetes management and using new technologies. Changes to consultations are also recommended

Bridging the Digital Divide: The UNBIASED national study to unravel the impact of ethnicity and deprivation on diabetes technology disparities in the United Kingdom

While diabetes technology offers significant clinical and quality-of-life benefits to people with type 1 diabetes, persistent inequalities in technology use based on ethnicity and deprivation are becoming increasingly evident. To date, there is limited research into the challenges and barriers to accessing and using diabetes technology and concerns felt by end-users from racially minoritised and socioeconomically disadvantaged groups. Their views are often under-represented in the literature, and healthcare professionals’ perspectives on barriers to technology access have also been neglected. This article explores the nuanced relationship between ethnicity, socioeconomic status, and technology access. By understanding the parallels between health and technology inequalities, we can pave the way for targeted interventions to bridge the digital gap and create a more inclusive technological landscape. The UNBIASED study is currently being conducted across England, and is exploring the lived experiences of under-represented children and young people with type 1 diabetes regarding the (lack of) utilisation of life-changing diabetes technologies. The study is also consulting healthcare professionals who can act as gatekeepers to technology, with the ultimate goal of identifying and dismantling existing barriers and inequities to access. By synthesising the perspectives of both people with type 1 diabetes and healthcare providers, this research seeks to develop inclusive, practical, and implementable solutions to foster improved access to cutting-edge diabetes technologies within the National Health Service (NHS)

Electronic band structure and carrier effective mass in calcium aluminates

First-principles electronic band structure investigations of five compounds of the CaO-Al2O3 family, 3CaO.Al2O3, 12CaO.7Al2O3, CaO.Al2O3, CaO.2Al2O3 and CaO.6Al2O3, as well as CaO and alpha-, theta- and kappa-Al2O3 are performed. We find that the conduction band in the complex oxides is formed from the oxygen antibonding p-states and, although the band gap in Al2O3 is almost twice larger than in CaO, the s-states of both cations. Such a hybrid nature of the conduction band leads to isotropic electron effective masses which are nearly the same for all compounds investigated. This insensitivity of the effective mass to variations in the composition and structure suggests that upon a proper degenerate doping, both amorphous and crystalline phases of the materials will possess mobile extra electrons

Listening to women: experiences of using closed-loop in type 1 diabetes pregnancy

Introduction: Recent high-profile calls have emphasized that women's experiences should be considered in maternity care provisioning. We explored women's experiences of using closed-loop during type 1 diabetes (T1D) pregnancy to inform decision-making about antenatal rollout and guidance and support given to future users. Methods: We interviewed 23 closed-loop participants in the Automated insulin Delivery Among Pregnant women with T1D (AiDAPT) trial after randomization to closed-loop and ∼20 weeks later. Data were analyzed thematically. Results: Women described how closed-loop lessened the physical and mental demands of diabetes management, enabling them to feel more normal and sleep better. By virtue of spending increased time-in-range, women also worried less about risks to their baby and being judged negatively by health care professionals. Most noted that intensive input and support during early pregnancy had been crucial to adjusting to, and developing confidence in, the technology. Women emphasized that attaining pregnancy glucose targets still required ongoing effort from themselves and the health care team. Women described needing education to help them determine when, and how, to intervene and when to allow the closed-loop to operate without interference. All women reported more enjoyable pregnancy experiences as a result of using closed-loop; some also noted being able to remain longer in paid employment. Conclusions: Study findings endorse closed-loop use in T1D pregnancy by highlighting how the technology can facilitate positive pregnancy experiences. To realize fully the benefits of closed-loop, pregnant women would benefit from initial intensive oversight and support together with closed-loop specific education and training. Clinical Trial Registration number: NCT04938557

Apparently synonymous substitutions in FGFR2affect splicing and result in mild Crouzon syndrome

BACKGROUND: Mutations of fibroblast growth factor receptor 2 (FGFR2) account for a higher proportion of genetic cases of craniosynostosis than any other gene, and are associated with a wide spectrum of severity of clinical problems. Many of these mutations are highly recurrent and their associated features well documented. Crouzon syndrome is typically caused by heterozygous missense mutations in the third immunoglobulin domain of FGFR2. CASE PRESENTATION: Here we describe two families, each segregating a different, previously unreported FGFR2 mutation of the same nucleotide, c.1083A>G and c.1083A>T, both of which encode an apparently synonymous change at the Pro361 codon. We provide experimental evidence that these mutations affect normal FGFR2 splicing and document the clinical consequences, which include a mild Crouzon syndrome phenotype and reduced penetrance of craniosynostosis. CONCLUSIONS: These observations add to a growing list of FGFR2 mutations that affect splicing and provide important clinical information for genetic counselling of families affected by these specific mutations

What Training, Support, and Resourcing Do Health Professionals Need to Support People Using a Closed-Loop System? A Qualitative Interview Study with Health Professionals Involved in the Closed Loop from Onset in Type 1 Diabetes (CLOuD) Trial.

Background: We explored health professionals' views about the training, support, and resourcing needed to support people using closed-loop technology in routine clinical care to help inform the development of formal guidance. Methods: Interviews were conducted with health professionals (n = 22) delivering the Closed Loop from Onset in Type 1 Diabetes (CLOuD) trial after they had ≥6 months' experience of supporting participants using a closed-loop system. Data were analyzed descriptively. Results: Interviewees described how, compared with other insulin regimens, teaching and supporting individuals to use a closed-loop system could be initially more time-consuming. However, they also noted that after an initial adjustment period, users had less need for initiating contact with the clinical team compared with people using pumps or multiple daily injections. Interviewees highlighted how a lessened need for ad hoc clinical input could result in new challenges; specifically, they had fewer opportunities to reinforce users' diabetes knowledge and skills and detect potential psychosocial problems. They also observed heightened anxiety among some parents due to the constant availability of data and unrealistic expectations about the system's capabilities. Interviewees noted that all local diabetes teams should be empowered to deliver closed-loop system care, but stressed that health professionals supporting closed-loop users in routine care will need comprehensive technology training and standardized clinical guidance. Conclusion: These findings constitute an important starting point for the development of formal guidance to support the rollout of closed-loop technology. Our recommendations, if actioned, will help limit the potential additional burden of introducing closed-loop systems in routine clinical care and help inform appropriate user education and support.NIHR Wellcome Trust Strategic Award (100574/Z/12/Z