Development and evaluation of a screening tool to identify people with diabetes at increased risk of medication problems relating to hypoglycaemia and medication non-adherence

Abstract Aims: To develop and evaluate a screening tool to identify people with diabetes at increased risk of medication problems relating to hypoglycaemia and medication non-adherence. Methods: A retrospective audit of attendances at a diabetes outpatient clinic at a public, teaching hospital over a 16-month period was conducted. Logistic regression was undertaken to examine risk factors associated with medication problems relating to hypoglycaemia and medication non-adherence and the most predictive set of factors comprise the Diabetes Medication Risk Screening Tool. Evaluating the tool involved assessing sensitivity and specificity, positive and negative predictive values, cut-off scores, inter-rater reliability, and content validity. Results: The Diabetes Medication Risk Screening Tool comprises seven predictive factors: age, living alone, English language, mental and behavioural problems, comorbidity index score, number of medications prescribed, and number of high-risk medications prescribed. The tool has 76.5% sensitivity, 59.5% specificity, and has a 65.1% positive predictive value, and a 71.8% negative predictive value. A score of 27 or more out of 62 was associated with high-risk of a medication problem. The inter-rater reliability of the tool was high (κ = 0.79, 95% CI 0.75 - 0.84) and the content validity index was 99.4%. Conclusion: The Diabetes Medication Risk Screening Tool has good psychometric properties and can proactively identify people with diabetes at greatest risk of medication problems relating to hypoglycaemia and medication non-adherence

Spreading dynamics of an infection in a growing population

Models of front propagation like the famous FKPP equation have extensive applications across scientific disciplines e.g., in the spread of infectious diseases. A common feature of such models is the existence of a static state into which to propagate, e.g., the uninfected host population. Here, we instead model an infectious front propagating into a growing host population. The infectious agent spreads via self-similar waves whereas the amplitude of the wave of infected organisms increases exponentially. Depending on the population under consideration, wave speeds are either advanced or retarded compared to the non-growing case. We identify a novel selection mechanism in which the shape of the infectious wave controls the speeds of the various waves and we propose experiments with bacteria and bacterial viruses to test our predictions. Our work reveals the complex interplay between population growth and front propagation.Comment: Main text: 6 pages, 2 figures Supplementary material: 8 pages, 3 figure

Polyunsaturated fatty acids inhibit k_v1.4 by interacting with positively charged extracellular pore residues

Polyunsaturated fatty acids (PUFAs) modulate voltage-gated K(+) channel inactivation by an unknown site and mechanism. The effects of ω-6 and ω-3 PUFAs were investigated on the heterologously expressed K(v)1.4 channel. PUFAs inhibited wild-type K(v)1.4 during repetitive pulsing as a result of slowing of recovery from inactivation. In a mutant K(v)1.4 channel lacking N-type inactivation, PUFAs reversibly enhanced C-type inactivation (K(d), 15–43 μM). C-type inactivation was affected by extracellular H(+) and K(+) as well as PUFAs and there was an interaction among the three: the effect of PUFAs was reversed during acidosis and abolished on raising K(+). Replacement of two positively charged residues in the extracellular pore (H508 and K532) abolished the effects of the PUFAs (and extracellular H(+) and K(+)) on C-type inactivation but had no effect on the lipoelectric modulation of voltage sensor activation, suggesting two separable interaction sites/mechanisms of action of PUFAs. Charge calculations suggest that the acidic head group of the PUFAs raises the pK(a) of H508 and this reduces the K(+) occupancy of the selectivity filter, stabilizing the C-type inactivated state

Adverse Childhood Experiences Among Females in Substance Use Treatment and Their Children: A Pilot Study

Women with substance use disorder (SUD) often have experienced adverse childhood experiences (ACEs). The intergenerational nature of ACEs also put their children at risk for experiencing ACEs. However, no research has explored the prevalence of ACEs in children whose mothers have SUD. This study assessed ACE scores in mothers with SUD and their children and compared them with non-SUD participants. Females with SUD were recruited from a treatment center (n = 50) and compared to females without SUD from the same area (n = 50). The ACE scores of the participants and their children were measured as well as sociodemographic variables. ANOVA and Fisher’s Exact tests were used to examine univariate differences. Multivariate regression models assessed the difference in ACE scores between the groups and their children and the relationship between maternal and child ACE scores while including sociodemographic confounders. The mean ACE score was significantly higher in SUD participants (4.9, SD = 2.9) when compared to non-SUD participants (1.9, SD = 2.0) after controlling for sociodemographic variables (p \u3c .01). Children of treatment participants also had significantly higher mean ACE scores (3.9, SD = 2.3) than children of comparison participants (1.3, SD = 2.0, p \u3c .01). Maternal ACE score was positively related to children’s ACE score after controlling for sociodemographic variables. Given the intergenerational nature of ACEs and their high burden in both mothers and children in substance use treatment, these preliminary findings suggest that mother–child trauma-informed interventions may be appropriate for this population

Globular cluster number density profiles using Gaia DR2

Using data from Gaia DR2, we study the radial number density profiles of the Galactic globular cluster sample. Proper motions are used for accurate membership selection, especially crucial in the cluster outskirts. Due to the severe crowding in the centres, the Gaia data are supplemented by literature data from HST and surface brightness measurements, where available. This results in 81 clusters with a complete density profile covering the full tidal radius (and beyond) for each cluster. We model the density profiles using a set of single-mass models ranging from King and Wilson models to generalized lowered isothermal LIMEPY models and the recently introduced SPES models, which allow for the inclusion of potential escapers. We find that both King and Wilson models are too simple to fully reproduce the density profiles, with King (Wilson) models on average underestimating (overestimating) the radial extent of the clusters. The truncation radii derived from the LIMEPY models are similar to estimates for the Jacobi radii based on the cluster masses and their orbits. We show clear correlations between structural and environmental parameters, as a function of Galactocentric radius and integrated luminosity. Notably, the recovered fraction of potential escapers correlates with cluster pericentre radius, luminosity, and cluster concentration. The ratio of half mass over Jacobi radius also correlates with both truncation parameter and PE fraction, showing the effect of Roche lobe filling

Are Compression Stockings an Effective Treatment for Orthostatic Presyncope?

Syncope, or fainting, affects approximately 6.2% of the population, and is associated with significant comorbidity. Many syncopal events occur secondary to excessive venous pooling and capillary filtration in the lower limbs when upright. As such, a common approach to the management of syncope is the use of compression stockings. However, research confirming their efficacy is lacking. We aimed to investigate the effect of graded calf compression stockings on orthostatic tolerance

Globular cluster number density profiles using Gaia DR2

Using data from Gaia DR2, we study the radial number density profiles of the Galactic globular cluster sample. Proper motions are used for accurate membership selection, especially crucial in the cluster outskirts. Due to the severe crowding in the centres, the Gaia data is supplemented by literature data from HST and surface brightness measurements, where available. This results in 81 clusters with a complete density profile covering the full tidal radius (and beyond) for each cluster. We model the density profiles using a set of single-mass models ranging from King and Wilson models to generalised lowered isothermal limepy models and the recently introduced spes models, which allow for the inclusion of potential escapers. We find that both King and Wilson models are too simple to fully reproduce the density profiles, with King (Wilson) models on average underestimating(overestimating) the radial extent of the clusters. The truncation radii derived from the limepy models are similar to estimates for the Jacobi radii based on the cluster masses and their orbits. We show clear correlations between structural and environmental parameters, as a function of Galactocentric radius and integrated luminosity. Notably, the recovered fraction of potential escapers correlates with cluster pericentre radius, luminosity and cluster concentration. The ratio of half mass over Jacobi radius also correlates with both truncation parameter and PE fraction, showing the effect of Roche lobe filling.Comment: 23 pages, 23 figures. Accepted in MNRA

Individual bacteria in structured environments rely on phenotypic resistance to phage

This is the final version. Available on open access from Public Library of Science via the DOI in this recordData Availability: All relevant data are within the paper and its Supporting Information files.Bacteriophages represent an avenue to overcome the current antibiotic resistance crisis, but evolution of genetic resistance to phages remains a concern. In vitro, bacteria evolve genetic resistance, preventing phage adsorption or degrading phage DNA. In natural environments, evolved resistance is lower possibly because the spatial heterogeneity within biofilms, microcolonies, or wall populations favours phenotypic survival to lytic phages. However, it is also possible that the persistence of genetically sensitive bacteria is due to less efficient phage amplification in natural environments, the existence of refuges where bacteria can hide, and a reduced spread of resistant genotypes. Here, we monitor the interactions between individual planktonic bacteria in isolation in ephemeral refuges and bacteriophage by tracking the survival of individual cells. We find that in these transient spatial refuges, phenotypic resistance due to reduced expression of the phage receptor is a key determinant of bacterial survival. This survival strategy is in contrast with the emergence of genetic resistance in the absence of ephemeral refuges in well-mixed environments. Predictions generated via a mathematical modelling framework to track bacterial response to phages reveal that the presence of spatial refuges leads to fundamentally different population dynamics that should be considered in order to predict and manipulate the evolutionary and ecological dynamics of bacteria-phage interactions in naturally structured environments.Medical Research Council (MRC)Engineering and Physical Sciences Research Council (EPSRC)Gordon and Betty and Gordon Moore FoundationEuropean Research Council (ERC)Biotechnology and Biological Sciences Research Council (BBSRC)Natural Environment Research Council (NERC)Marie Skłodowska-Curie ActionsDefence Science and Technology Laboratory (Dstl)Royal Societ

Social media for physiotherapy clinics: considerations in creating a Facebook page

Social media websites play a prominent role in modern society, and the most popular of these websites is Facebook. Increasingly, physiotherapy clinics have begun to utilize Facebook in order to create pages to publicize their services. There are many factors to consider in the planning, implementing, and maintenance of Facebook pages for physiotherapy clinics, including ethical and privacy issues. The primary purpose of creating a page must be clearly defined, with dedicated clinicians given adequate time to manage the page. This technical article discusses these factors and summarizes the experiences at the University of Otago, New Zealand, in creating a Facebook page for the physiotherapy clinic and provides suggestions for physiotherapy clinicians in operating a Facebook page

Domain-wall pinning, nonadiabatic spin-transfer torque, and spin-current polarization in permalloy wires doped with vanadium

Copyright © 2010 The American Physical SocietyUsing pulsed-current measurements we investigate the domain-wall depinning via spin-transfer torque from pinning potentials in V-doped Ni80Fe20 wires. The domain-wall depinning boundary, showing the variation of threshold current density with longitudinal magnetic field is measured and reproduced using micromagnetic simulations. This method allows us to determine the spin-current polarization and nonadiabaticity parameter in these materials. By increasing the V concentration we show that the nonadiabaticity parameter is increased while the Gilbert damping is unaffected. On the other hand the spin-current polarization is decreased, resulting in larger threshold current densities