Who benefits most from participating in chronic disease self-management programs?

Objectives: To quantify the benefits that people receive from participating in self-management courses and identify subgroups that benefit most.Research Design: People with a wide range of chronic conditions attending self-management courses (N=1,341 individuals) were administered the generic Health Education Impact Questionnaire (HEI-Q). Data were collected before the first session (baseline) and at the end of courses (follow-up) resulting in 842 complete responses. The median (interquartile range) age was 64 (54 to 73) years and most participants were female (75%). Outcomes were categorized as Substantial improvement (Effect Size, ES &ge; 0.5), Minimal/No change (ES -0.49 to 0.49) and Substantial decline (ES &le; -0.5).Results: On average, one third of participants reported substantial benefits after attending a self-management course. Proportions of participants reporting substantial benefits ranged from 49% in Skill and technique acquisition to 27% in Health service navigation. Stratification by gender, age and education showed that younger participants were more likely to benefit, particularly young women. No further subgroup differences were observed.Conclusions: Given that the health of people with chronic diseases tends to decline, this evaluation is reassuring in that about one third of participants coming from a wide range of backgrounds receive substantial improvements in their self-management skills.<br /

The Association of Surgeons in Training Conference: #ASiT2015 Glasgow

AbstractThe Association of Surgeons in Training (ASiT) is a professional body and registered charity working to promote excellence in surgical training for the benefit of junior doctors and patients alike. ASiT is in-dependent of the National Health Service (NHS), Surgical Royal Colleges, and specialty associations and represents trainees in all ten surgical specialties.ASiT was delighted to welcome a number of distinguished guests and speakers to Glasgow for #ASiT2015. The theme of ‘The Future of Surgery’ delved into challenges surgical training faces, exciting developments into using technology to help patients, a glance at the past with the development of the Glasgow Coma Score and whether mortality truly is the future of measured outcomes. More than £3500 of prizes was awarded by the incoming President, Miss. Rhiannon Harries to the highest scoring papers presented selected from over 1000 abstracts submitted

Metabolomic changes in lactating multiparous naturally MAP-infected Holstein-Friesian dairy cows suggest changes in mitochondrial energy pathways

Mycobacterium avium subspecies paratuberculosis (MAP) is the causative organism of Johne's Disease, a chronic intestinal infection of ruminants. Infected cows begin shedding MAP within the asymptomatic, subclinical stage of infection before clinical signs, such as weight loss, diarrhoea and reduced milk yields develop within the clinical stages of disease. Herein, we examine the milk metabolomic profiles of naturally MAP-infected Holstein-Friesian cows. The study used biobanked milk samples which were collected 73.4 ± 3.79 (early lactation) and 143 ± 3.79 (mean ± SE) (mid-lactation) days post-calving from 5 MAP-infected and 5 control multiparous cows. The milk metabolome was assessed using flow infusion electrospray high-resolution mass spectrometry (FIE-HRMS) for sensitive, non-targeted metabolite fingerprinting. Metabolite fingerprinting assessments using partial least squares discriminate analyses (PLS-DA) indicated that lactation stage was a larger source of variation than MAP status. Examining each lactation stage separately for changes associated to MAP-infection status identified 45 metabolites, 33 in early lactation and 12 in mid-lactation, but only 6 metabolites were targeted in both stages of lactation. Pathway enrichment analysis suggested that MAP affected the malate-aspartate shuffle during early lactation. Pearson's correlation analysis indicated relationships between milk lactose concentrations in mid-lactation and 6 metabolites that were tentatively linked to MAP-infection status. The targeted metabolites were suggestive of wider changes in the bioenergetic metabolism that appear to be an acceleration of the effects of progressing lactation in healthy cows. Additionally, milk lactose concentrations suggest that MAP reduces the availability of lactose derivatives

Fingertip whole blood as an indicator of omega-3 long-chain polyunsaturated fatty acid changes during dose-response supplementation in women: comparison with plasma and erythrocyte fatty acids

The sensitivity of fingertip whole blood to reflect habitual dietary and dose-dependent supplemental omega-3 long-chain polyunsaturated fatty acid (n-3 LCPUFA) intake in premenopausal women was compared to that of venous erythrocytes and plasma fatty acids. Samples were obtained from women in a randomised, double-blind, placebo-controlled trial in which premenopausal women (n = 53) were supplemented with DHA-rich tuna oil capsules and/or placebo (Sunola oil) capsules (6 capsules per day) for 8 weeks to achieve doses of either 0, 0.35, 0.7 or 1.05 g/day n-3 LCPUFA. All blood biomarkers were very similar in their ability to reflect dietary n-3 LCPUFA intake (r = 0.38–0.46 for EPA and DHA intake), and in their dose-dependent increases in n-3 LCPUFA levels after supplementation (R2 = 0.41–0.51 for dose effect on biomarker EPA and DHA levels (mol %)). Fingertip whole blood is an effective alternative to erythrocytes and plasma as a biomarker n-3 LCPUFA intake in premenopausal women.Barbara J. Meyer, Cassandra Sparkes, Andrew J. Sinclair, Robert A. Gibson and Paul L. Els

Effect of ZrO2 stoichiometry on the structural and electrical properties of Na3Zr2−xSi2PO12-2x solid electrolyte

Na3Zr2Si2P2O12 (NZSP) has potential use as a solid electrolyte in Na-ion solid-state batteries due to its high ionic conductivity (10−3–10−4 Scm−1) at room temperature. It is established that all previous preparations involving the solid-state method for NZSP compositions contain m-ZrO2 as a secondary phase. Here, the solid-state method is used to prepare single-phase NZSP by modifying the mole fractions of the ZrO2 reactant. Reducing ZrO2 concentration may also create Zr and O vacancies and potentially increase the hopping sites for Na-ion conduction. X-ray diffraction, scanning electron microscopy, Raman and Fourier Transform Infrared spectroscopy, dilatometry and impedance spectroscopy were used to characterise the structure, morphology and electrical properties of single-phase NZSP, and the results were compared with samples that have m-ZrO2 secondary phase (Na3Zr2Si2PO12). The role of m-ZrO2 impurities on the conductivity of NZSP is investigated and compared with available literature

High sensitivity measurement of 224Ra and 226Ra in water with an improved hydrous titanium oxide technique at the Sudbury Neutrino Observatory

The existing hydrous titanium oxide (HTiO) technique for the measurement of 224Ra and 226Ra in the water at the Sudbury Neutrino Observatory (SNO) has been changed to make it faster and less sensitive to trace impurities in the HTiO eluate. Using HTiO-loaded filters followed by cation exchange adsorption and HTiO co-precipitation, Ra isotopes from 200-450 tonnes of heavy water can be extracted and concentrated into a single sample of a few millilitres with a total chemical efficiency of 50%. Combined with beta-alpha coincidence counting, this method is capable of measuring 2.0x10^3 uBq/kg of 224Ra and 3.7x10^3 uBq/kg of 226Ra from the 232Th and 238U decay chains, respectively, for a 275 tonne D2O assay, which are equivalent to 5x10^16 g Th/g and 3x10^16 g U/g in heavy water.Comment: 8 Pages, 2 figures and 2 table

Glycaemic control and hypoglycaemia risk with insulin glargine 300 U/mL versus glargine 100 U/mL: A patient-level meta-analysis examining older and younger adults with type 2 diabetes

Abstract Aim Older people with type 2 diabetes (T2DM) are at an increased risk of hypoglycaemia and its consequences. However, efficacy and safety data for basal insulin therapy are limited in these individuals. This patient-level meta-analysis assessed the treatment effects of insulin glargine 300 U/mL (Gla-300) versus glargine 100 U/mL (Gla-100) in people with T2DM ≥ 65 years old. Methods Data were pooled for patients randomised to receive Gla-300 or Gla-100 in the Phase 3a, treat-to-target EDITION 1, 2 and 3 trials. Glycaemic efficacy, hypoglycaemia, changes in body weight and insulin dosage and adverse events were examined over 6 months' treatment with Gla-300 versus Gla-100 for participants aged ≥ 65 and  Results Of 2496 participants randomised, 662 were ≥ 65 years (Gla-300, n = 329; Gla-100, n = 333). Glycaemic control was comparable for Gla-300 and Gla-100 in participants ≥ 65 years (LS mean [95% CI] difference in HbA1c change from baseline to month 6: 0.00 [−0.14 to 0.15] %; 0.00 [−1.53 to 1.64] mmol/mol) and  Conclusion Gla-300 was associated with a reduced risk of nocturnal hypoglycaemia versus Gla-100, accompanied by comparable glycaemic improvement, for people aged ≥ 65 an