In search of quality evidence for lifestyle management and glycemic control in children and adolescents with type 2 diabetes: A systematic review

<p>Abstract</p> <p>Background</p> <p>Our purpose was to evaluate the impact of lifestyle behavior modification on glycemic control among children and youth with clinically defined Type 2 Diabetes (T2D).</p> <p>Methods</p> <p>We conducted a systematic review of studies (randomized trials, quasi-experimental studies) evaluating lifestyle (diet and/or physical activity) modification and glycemic control (HbA1c). Our data sources included bibliographic databases (EMBASE, CINAHL^®, Cochrane Library, Medline^®, PASCAL, PsycINFO^®, and Sociological Abstracts), manual reference search, and contact with study authors. Two reviewers independently selected studies that included any intervention targeting diet and/or physical activity alone or in combination as a means to reduce HbA1c in children and youth under the age of 18 with T2D.</p> <p>Results</p> <p>Our search strategy generated 4,572 citations. The majority of citations were not relevant to the study objective. One study met inclusion criteria. In this retrospective study, morbidly obese youth with T2D were treated with a very low carbohydrate diet. This single study received a quality index score of < 11, indicating poor study quality and thus limiting confidence in the study's conclusions.</p> <p>Conclusions</p> <p>There is no high quality evidence to suggest lifestyle modification improves either short- or long-term glycemic control in children and youth with T2D. Additional research is clearly warranted to define optimal lifestyle behaviour strategies for young people with T2D.</p

Breeding progress and preparedness for mass‐scale deployment of perennial lignocellulosic biomass crops switchgrass, miscanthus, willow and poplar

UK: The UK‐led miscanthus research and breeding was mainly supported by the Biotechnology and Biological Sciences Research Council (BBSRC), Department for Environment, Food and Rural Affairs (Defra), the BBSRC CSP strategic funding grant BB/CSP1730/1, Innovate UK/BBSRC “MUST” BB/N016149/1, CERES Inc. and Terravesta Ltd. through the GIANT‐LINK project (LK0863). Genomic selection and genomewide association study activities were supported by BBSRC grant BB/K01711X/1, the BBSRC strategic programme grant on Energy Grasses & Bio‐refining BBS/E/W/10963A01. The UK‐led willow R&D work reported here was supported by BBSRC (BBS/E/C/00005199, BBS/E/C/00005201, BB/G016216/1, BB/E006833/1, BB/G00580X/1 and BBS/E/C/000I0410), Defra (NF0424) and the Department of Trade and Industry (DTI) (B/W6/00599/00/00). IT: The Brain Gain Program (Rientro dei cervelli) of the Italian Ministry of Education, University, and Research supports Antoine Harfouche. US: Contributions by Gerald Tuskan to this manuscript were supported by the Center for Bioenergy Innovation, a US Department of Energy Bioenergy Research Center supported by the Office of Biological and Environmental Research in the DOE Office of Science, under contract number DE‐AC05‐00OR22725. Willow breeding efforts at Cornell University have been supported by grants from the US Department of Agriculture National Institute of Food and Agriculture. Contributions by the University of Illinois were supported primarily by the DOE Office of Science; Office of Biological and Environmental Research (BER); grant nos. DE‐SC0006634, DE‐SC0012379 and DE‐SC0018420 (Center for Advanced Bioenergy and Bioproducts Innovation); and the Energy Biosciences Institute. EU: We would like to further acknowledge contributions from the EU projects “OPTIMISC” FP7‐289159 on miscanthus and “WATBIO” FP7‐311929 on poplar and miscanthus as well as “GRACE” H2020‐EU.3.2.6. Bio‐based Industries Joint Technology Initiative (BBI‐JTI) Project ID 745012 on miscanthus.Peer reviewedPostprintPublisher PD

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Knowing and teaching the indigenous other : teachers’ engagement with Aboriginal and Torres Strait Islander cultures

This is the first empirical study of teacher knowledge and classroom practice in Aboriginal and Torres Strait Islander education. It describes the construction of a survey instrument to measure non-Indigenous Australian teachers’ knowledge of Indigenous culture and place, frequency of everyday intercultural exchanges, and attempts to integrate Indigenous knowledge into classroom practice. Many teachers reported low levels of knowledge of Indigenous cultures, and limited encounters outside of school. While the cohort expressed dissatisfaction with pre-service training, exposure to pre- and in-service courses in Indigenous education correlated with higher levels of cultural knowledge and cultural engagement. Teachers with higher levels of cultural engagement were more likely to attempt to integrate Indigenous knowledges in curriculum and pedagogy

Designing Postgraduate Pedagogies: Connecting Internal and External Learners

Learning is the new resource driving the knowledge economy. Now everyone is expected to make themselves available to learn : un-learn : re-learn. Much has been written about new modes of learning, as well the new technologies that promise to deliver information 24/7. Paradoxically, however, in the field of educational sociology there has been little systematic theorisation of the pedagogies designed to facilitate learning in the knowledge economy. Nor have there been systematic efforts to connect macro economic, technological and social changes to state official policies and institutional pedagogic practices. The Bernsteinian theoretical corpus models the power and control relations generating pedagogic discourses, practices and identities from the macro level of policy formation to the micro level of pedagogic interactions. It is therefore useful in examining the new pedagogies designed to generate the learning resources of the knowledge economy. In this paper, we draw on and extend Bernstein's theory of pedagogic discourse and identities to analyse the design and implementation of a postgraduate unit in educational research. This unit aimed to be: rigorous in disciplinary knowledge, technologically innovative, cost efficient; and responsive to diverse student needs and market contingencies

Rapid on-site evaluation of fine needle aspiration specimens by cytology scientists: a review of 3032 specimens

Objectives To determine: (1) the accuracy of cytology scientists at assessing specimen adequacy by rapid on-site evaluation (ROSE) at fine needle aspiration (FNA) cytology collections; and (2) whether thyroid FNA with ROSE has lower inadequacy rates than non-attended FNAs. Methods The ROSE of adequacy for 3032 specimens from 17 anatomical sites collected over a 20-month period was compared with the final report assessment of adequacy. ROSE was performed by 19 cytology scientists. The report profile for 1545 thyroid nodules with ROSE was compared with that for 1536 consecutive non-ROSE thyroid FNAs reported by the same cytopathologists during the study period. Results ROSE was adequate in 75% (2276/3032), inadequate in 12% (366/3032) and in 13% (390/3032) no opinion was rendered. Of the 2276 cases assessed as adequate by ROSE, 2268 (99.6%) were finally reported as adequate for assessment; eight specimens had adequacy downgraded on the final report. Fifty eight per cent of cases with a ROSE assessment of inadequate were reported as adequate (212/366), whereas 93% (363/390) with no opinion rendered were reported as adequate. The overall final report adequacy rate for the 3032 specimens was 94% (2843/3032). Confirmation of a ROSE of adequacy at reporting was uniformly high amongst the 19 scientists, ranging from 98% to 100%. The inadequacy rate for thyroid FNAs with ROSE (6%) was significantly (P < 0.0001) lower than for non-ROSE thyroid FNAs (17%). A significantly (P = 0.02) higher proportion of adequate ROSE thyroid specimens was reported with abnormalities, compared with non-ROSE thyroid collections. Conclusions Cytology scientists are highly accurate at determining specimen adequacy at ROSE for a wide range of body sites. ROSE of thyroid FNAs can significantly reduce inadequate reports

The influence of perceived maternal psychological control on academic performance in Chinese adolescents: Moderating roles of adolescents’ age, gender and filial piety

Existing studies with East-Asian samples have reported inconsistent findings on the association between parental psychological control and academic performance in children and adolescents. A Moderation effect is present, when the magnitude or direction of the association between two variables significantly changes with another variable called a moderator. This study explored moderators for the association between maternal psychological control and academic performance. 338 Chinese secondary school students aged 14 to 20 years completed self-report measures of perceived maternal psychological control, academic performance, and attitudes toward filial piety. Structural equation modelling suggested that adolescent age moderated the association of interest: the influence of perceived maternal psychological control on academic performance significantly varied between middle adolescents aged 14 to 17 years and late adolescents aged 18 to 20 years. Based on the findings, this study offers a possible rationale for the inconsistent findings in studies with East-Asian samples and proposes that parenting effect should be assessed developmentally

Smoking cessation programmes in radon affected areas: can they make a significant contribution to reducing radon-induced lung cancers?

Raised radon levels in houses in parts of the UK can increase the risk of lung cancer in the occupants. In Northamptonshire, 6.3% of houses have average radon levels over the UK Action Level of 200 Bq m-3. Environmental health campaigns, which have targeted home-owners to encourage them to test for radon and remediate their homes, have only been partially successful - 40% of houses have been tested, and only 15% of these have been remediated. Radon and smoking combine to increase the risk by around 4 times. We have shown that only 9% of those who remediate smoked compared to a countywide average of 28.8%. These results suggest that current strategies to reduce radon are not reaching those most at risk. Local NHS Stop Smoking Services assisted 2,808 smokers in 2004-5 to quit for 4 weeks, and around 30% of these remained quitters at 1 year. Assessing individual occupants’ risk of developing lung cancer, we have shown that this anti-smoking campaign makes a significant contribution to reducing the risk from radon. Further, it contributes a greater health benefit than reducing radon levels in the smokers’ homes, whilst they remain smokers. In addition, a questionnaire was given to quitters to assess why they sought help to give up smoking, and whether knowledge of radon risks influenced this decision. The impact of these findings on potential future public health campaigns to reduce the health impact of both radon and smoking will be discusse