Evaluation of a Patient Education Program for Patients with Non-Insulin Dependent Diabetes (Type II)

The purpose of this study was to evaluate a group outpatient program for patients with non-insulin dependent diabetes (Type II). It endeavoured to establish whether at the completion of a patient education program, and again at the 3 month follow-up period, the patients were complying with : (a) the recommended dietary plan, (b) the exercise program, and (c) were monitoring blood glucose levels at home, as evidenced by weight loss and metabolic control of their diabetes. The study also investigated factors influencing non-compliance. The theoretical rationale used for this study was Pender\u27s Health Promotion Model, which theorises that health-promoting behaviour is motivated by a desire for increased well-being and quality of life. Health-promoting behaviours are adopted in order to change behaviour to achieve an improved health status. The study sample was a convenience sample of 24 outpatients who enrolled in and completed an education program, and who volunteered to participate in the study. The study used a pretest/posttest design with a 3 month follow-up, with a pretest prior to commencing the education program, the posttest on completion of the program, and a follow-up 3 months later. Instrumentation included: a questionnaire to measure dietary and exercise compliance, blood glucose monitoring, and factors influencing non-compliance; a blood glucose test, a glycosylated haemoglobin blood test and body weight recording. Findings of the study indicate that there was a significant improvement in: (a) dietary compliance at the posttest, but this was not maintained at the follow-up; and (b) the number of subjects performing self blood glucose monitoring at the posttest, which was maintained at followup. There were no significant improvements in exercise compliance, nor in the outcome variables of weight and blood glucose levels. However, there was a significant improvement in the outcome variable, blood glycosylated haemoglobin. Factors influencing non-compliance included hunger, temptation, stress, and self-management. The study has some limitations including the short time span between the education program and the follow-up, which makes it difficult to draw long term conclusions from the study. The findings of this study have implications for Diabetes Nurse Educators, and the following recommendations are made: (a) that the teaching strategies for exercise be reviewed, (b) that follow-up of patients be implemented on a regular basis, and (c) that the ongoing diabetes education of fellow health professionals be emphasised

Reflecting on time, timing and timeliness in public sector supply networks

Despite recent research on time (e.g. Hedaa & Törnroos, 2001), consideration of the time dimension in data collection, analysis and interpretation in research in supply networks is, to date, still limited. Drawing on a body of literature from organization studies, and empirical findings from a six-year action research programme and a related study of network learning, we reflect on time, timing and timeliness in interorganizational networks. The empirical setting is supply networks in the English health sector wherein we identify and elaborate various issues of time, within the case and in terms of research process. Our analysis is wide-ranging and multi-level, from the global (e.g. identifying the notion of life cycles) to the particular (e.g. different cycle times in supply, such as daily for deliveries and yearly for contracts). We discuss the ‘speeding up’ of inter-organizational ‘e’ time and tensions with other time demands. In closing the paper, we relate our conclusions to the future conduct of the research programme and supply research more generally, and to the practice of managing supply (in) networks

The Mid-Infrared Instrument for the James Webb Space Telescope, VII: The MIRI Detectors

The MIRI Si:As IBC detector arrays extend the heritage technology from the Spitzer IRAC arrays to a 1024 x 1024 pixel format. We provide a short discussion of the principles of operation, design, and performance of the individual MIRI detectors, in support of a description of their operation in arrays provided in an accompanying paper (Ressler et al. (2015)). We then describe modeling of their response. We find that electron diffusion is an important component of their performance, although it was omitted in previous models. Our new model will let us optimize the bias voltage while avoiding avalanche gain. It also predicts the fraction of the IR-active layer that is depleted (and thus contributes to the quantum efficiency) as signal is accumulated on the array amplifier. Another set of models accurately predicts the nonlinearity of the detector-amplifier unit and has guided determination of the corrections for nonlinearity. Finally, we discuss how diffraction at the interpixel gaps and total internal reflection can produce the extended cross-like artifacts around images with these arrays at short wavelengths, ~ 5 microns. The modeling of the behavior of these devices is helping optimize how we operate them and also providing inputs to the development of the data pipeline

Age-related mitochondrial DNA depletion and the impact on pancreatic beta cell function

Type 2 diabetes is characterised by an age-related decline in insulin secretion. We previously identified a 50% age-related decline in mitochondrial DNA (mtDNA) copy number in isolated human islets. The purpose of this study was to mimic this degree of mtDNA depletion in MIN6 cells to determine whether there is a direct impact on insulin secretion. Transcriptional silencing of mitochondrial transcription factor A, TFAM, decreased mtDNA levels by 40% in MIN6 cells. This level of mtDNA depletion significantly decreased mtDNA gene transcription and translation, resulting in reduced mitochondrial respiratory capacity and ATP production. Glucose-stimulated insulin secretion was impaired following partial mtDNA depletion, but was normalised following treatment with glibenclamide. This confirms that the deficit in the insulin secretory pathway precedes K+ channel closure, indicating that the impact of mtDNA depletion is at the level of mitochondrial respiration. In conclusion, partial mtDNA depletion to a degree comparable to that seen in aged human islets impaired mitochondrial function and directly decreased insulin secretion. Using our model of partial mtDNA depletion following targeted gene silencing of TFAM, we have managed to mimic the degree of mtDNA depletion observed in aged human islets, and have shown how this correlates with impaired insulin secretion. We therefore predict that the age-related mtDNA depletion in human islets is not simply a biomarker of the aging process, but will contribute to the age-related risk of type 2 diabetes

Connecting

Connecting Helen Walker - Teaching/Seeing Jesus Jan Buley - The Realization S. Rebecca Leigh - Celebrating Ways of Learning Christopher M. Bache - The Opening Question Bette B. Bauer - Teaching as a Spiritual Practice Rachel Forrester - Appalachia Finally in the Spring Laurence Musgrove - Syllabu

Managing the transition to work: the role of the planning network in British town planning education

The development of town planning education in the United Kingdom can be traced back over at least sixty years and has always enjoyed a close relationship with practitioners, employers and the professional body, the Royal Town Planning Institute (RTPI). In order to ensure an intake of sufficient quality to a growing profession, the Institute offered its own exams until the 1980s and then initiated the current system of accrediting both undergraduate and postgraduate programmes of study. This system of accreditation emphasises the importance of relevant knowledge, skills and values as well as core and specialised studies. The vocational nature of town planning requires that graduates have the breadth of understanding as well as the practical skills in order to practice effectively. Thus accredited courses have over time developed strong links with employers and practitioners. Rapid developments in the scope and range of planning, and the skills needed to work in it, have reflected changes in public policy and growing number of agencies concerned with the built environment. The system of regular quinquennial visits to accredit courses has helped ensure that this acceptance of change has become part of the culture of planning schools

Nurses\u27 Alumnae Association Bulletin - Volume 6 Number 10

Financial Report Calendar of Events Attention, Class of 1945! Miss Shafer Retires Review of the Alumnae Association Meetings Institutional Staff Nurses\u27 Section Report of Staff Activites - 1948-1949 The Staff Stockings! Stockings! Stockings! Pop-Up Toaster It\u27s Not Too Soon Any White Elephants? Private Duty Section The Jefferson Hospital Private Duty Nurses\u27 Register Report for Barton Memorial Hospital Progress of the Orthopedic Department Just Under the Date Line Pediatrics at Jefferson Controlled Respiration in Anesthesia Anesthesia Progress Physical Advances at Jefferson During the Past Year The White Haven Division The Clara Melville Scholarship Fund The Relief Fund The Busy Year for the Nurses\u27 Home Committee of the Women\u27s Board The Gray Ladies Memories Lost Miscellaneous Items Medical College News Marriages Births Deaths Condolences Prizes District No. 1 Dues Help! Help! Help! Jap Prison School Spurs Nurse to Win University Degree Twenty Ways to Kill an Organization The Bulletin Committee Attention, Alumnae New Addresse

Parenting Programme in Health Centres:What you do with baby really matters: implementation manual

This is the implementation manual of a programme that teaches mothers how to care, talk and play with their child in a way to improve their development. When they get older, this will help them to be ready for school and be happy and well behaved children. The programme uses a new approach of including parenting in routine child health visits