Best Practices for the Prevention and Management of Diabetes and Obesity-Related Chronic Disease among Indigenous Peoples in Canada: A Review

AbstractObjectivesTo carry out a systematic review of interventions that have aimed at improving screening, treatment, prevention and management of type 2 diabetes and obesity-related chronic disease in Indigenous communities in Canada from 2008 to 2014, with the aim of identifying current best practices.MethodsA comprehensive literature review was carried out through an electronic database search using Medline, EMBASE, PubMED and Google scholar.ResultsWe identified 17 publications, comprising 13 evaluated interventions. Of them, 7 were school-based programs focused on children, 5 focused on adults, and 1 included both adults and children. Most interventions aimed at encouraging behaviour change, especially dietary change, but did little to address the underlying context of systemic marginalization and colonialism experienced in many Indigenous communities. Interventions focused on improving fitness were more effective than those aimed at dietary change. Overall, we found a range of successes among these interventions. Those that met with limited success reported that complex social issues and poverty presented challenges to effective intervention work in these communities. Participatory action research methods and community ownership of the intervention were found to be essential for project success.ConclusionsDiabetes-focused intervention research in Indigenous communities appears to be a low priority for Canadian funders and policymakers. More intervention research is urgently needed in these communities. To be effective, this work must take an approach that is historically deep and sufficiently broad as to enable the ideologic, policy and institutional changes necessary in order to achieve true equity. This will involve addressing colonialism, racism and social exclusion as broader determinants of health

OKT3 and viral disease in pediatric liver transplant recipients

Seventy-four consecutive pediatric liver transplant recipients were reviewed to assess the effect of the monoclonal anti-T-lymphocyte antibody OKT3 on subsequent viral infection (9 patients were excluded due to postoperative demise during the 1st week). Twenty-two patients received OKT3 in addition to standard cyclosporine-prednisone immunosuppression for either steroid-resistant acute rejection (18) or to facilitate reduction of cyclosporine due to severe renal impairment (4). Invasive infections were diagnosed by histology or culture in tissue biopsies or bronchoalveolar lavage specimens. The overall incidence of viral infection was 58%, half of which was due to cytomegalovirus (CMV). Invasive viral disease was associated with increased mortality (37% vs. 3% p = 0.001). Viral-related deaths were due to CMV (5), disseminated adenovirus (3), disseminated enterovirus (1) and respiratory syncytial viral pneumonia (1). The use of OKT3 was associated with increased viral disease (59% vs. 33% p = 0.04) and invasive primary CMV disease (58% vs. 19% p = 0.04). Trends were observed toward increased overall viral infection (73% vs. 51% p = 0.08), primary CMV infection (58% vs. 25% p = 0.08) and overall mortality (27% vs. 9% p = 0.08) following OKT3 therapy. We conclude that pediatric liver transplant recipients who require OKT3 therapy may be at increased risk for invasive viral disease and especially invasive primary CMV disease

Initiation of skin basement membrane formation at the epidermo-dermal interface involves assembly of laminins through binding to cell membrane receptors

To study the mechanism of basement membrane formation, we determined by immunochemistry temporal and spatial expression of laminin-5 (Ln-5), laminin-1 (Ln-1) and their integrin receptors during early skin morphogenesis. A 3-dimensional skin culture was used that allows the study of the sequential molecular events of basement membrane formation at the epidermodermal interface. During early anchorage of keratinocytes to the extracellular matrix there is expression of Ln-5, BP-230 antigen and &#945;3, &#946;1 integrin subunits. During epidermal stratification and prior to the formation of the lamina densa there is assembly of Ln-5, Ln-1, collagen IV and nidogen accompanied by keratinocyte basal clustering of &#945;2, &#945;3, &#945;6, &#946;1, and &#946;4 integrin subunits. The assembly pattern of Ln-1 and Ln-5 can be disturbed with functional antibodies against the &#946;1 (AIIB2) and &#945;6 (GoH3) integrin subunits. Ln-1 assembly can also be disturbed with antibodies against its E8 domain and by competitive inhibition with a synthetic peptide (AG-73) derived from its G-4 domain. Quantitative RT-PCR showed that the dermis contributes about 80% of the laminin &#947;1 chain mRNA while 20% is produced by the epidermis which emphasizes its dual tissue origin and the major contribution of the mesenchyma in laminin production. The laminin &#947;2 chain mRNA, present in Ln-5, was mostly of epidermal origin. This study presents evidence that during the initiation of basement membrane formation, laminins bind to keratinocyte plasma membrane receptors and thus may serve as nucleation sites for further polymerization of these compounds by a self-assembly process.</p

Converging Technologies, Shifting Boundaries

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Relative Throughput of the Near-IR Science Instruments for the James Webb Space Telescope as Measured During Ground Testing the Integrated Science Instrument Module

Data were obtained for the purpose of measuring the relative throughput of the Near-IR Science Instruments (SIs) of the James Webb Space Telescope (JWST) as part of the second and third cryogenic-vacuum tests (CV2CV3) of the Integrated Science Instrument Module (ISIM) conducted at the Goddard Space Flight Center (GSFC) in 2014 and 20152016, at the beginning and end of the environmental test program, respectively. This Poster focuses on data obtained as part of the Initial Optical Baseline and as part of the Final Performance test -- two epochs that roughly bracket the CV3 test. The purpose of the test is to trend relative throughput to monitor for any potential changes from gross problems such as contamination or degradation of an optical element. Point source data were taken at a variety of wavelengths for NIRCam Module A and Module B, NIRSpec, NIRISS, Guider 1 and Guider 2 using the Laser Diode (LD) 1.06 micron, LD 1.55 micron, 2.1 micron LED and 3.5 micron LED, as well as for NIRCam Mod A and B and NIRISS using a tungsten source and the F277W, and F480M filters. Spectra were taken using the G140M, G235M, and G395M gratings for NIRSpec, the GRISMR grism for NIRCam Mod A and B and the GR150C grism for NIRISS. The results of these measurements are compared to what would be expected given the efficiency of each of the optical elements in each SI. Although these data were taken as a check against gross problems, they can also be used to provide the first relative throughput estimate for each SI through the various filters source wavelengths measured in their flight-like configurations

Становище Заславського римо-католицького деканату в ХІХ столітті (The situation of the Zaslavsky Roman-Catholic Deanery in the 19th century)

Стаття присвячена аналізу римо-католицизму на Заславщині у ХІХ ст. Доведено, що становище Заславського римо-католицького деканату протягом ХІХ століття погіршувалося, що відповідало загальним тенденціям ситуації РКЦ в Російській імперії. (The article is devoted to the analysis of Roman Catholicism in Zaslavsk region in the 19th century. It is proved that the situation of Zaslavsky Roman Catholic deanery during the 19th century worsened, which corresponded to the general tendencies of the situation of the RCC in the Russian Empire.

'Food hates' over the life course : an analysis of food narratives from the UK Mass Observation Archive

This article presents data from the UK Mass Observation Archive drawn from the 1982 Winter Food Directive, which focuses on memories of childhood food ‘hates’. Through our analysis of these data, we identify three main findings: (a) there is a discrepancy between individual-level and collective aggregate level food hates, which problematises the notion of commensality; (b) a small but powerful ‘outlier’ group of respondents, which we refer to as ‘visceral repulsors’, show relatively extreme reactions to certain foods throughout their lives; and (c) the duration and temporalities of food hates can be used to sketch a rough model of change and continuity of food hates over the life course. Finally, the discussion focuses on the food hate trajectories through the life course, situated in a social context, to explore the implications the findings may have for food and health policy more generally

Methylphenidate Treatment in Children with Borderline IQ and Mental Retardation: Analysis of Three Aggregated Studies

Objective: To determine response of low-IQ children with attention deficit hyperactivity disorder (ADHD) symptoms to methylphenidate (MPH). Methods: An aggregated analysis was conducted in 90 children with low IQ who received the same dose regimen of MPH in three independent, placebo-controlled studies. Active drug and placebo were given from 2 to 4 weeks each. Outcome measures included teacher and parent ratings on standardized behavior scales (mean n = 84), performance on computer-controlled cognitive-motor tests (n = 62), and measures of cardiovascular response (n = 85). Results: Both teachers and parents rated the children consistently as being improved on subscales assessing attention, overactivity, and conduct problems. Some 44% of the subjects showed at least a 30% reduction compared with placebo on teacher ratings. MPH improved accuracy on several cognitive tests, response speed was increased on some, and seat activity declined for one of three tests; heart rate was mildly increased (3.9 beats/minute) with MPH. Analyses of IQ and mental age as moderator variables suggested that lower functional level (especially lower IQ) may be associated with a less favorable response to MPH. Conclusions: Children with low IQ and ADHD clearly respond to MPH, but their rate of beneficial response appears to be well under that of normal-IQ children and more varied. Different attentional mechanisms may moderate response to psychostimulants