Mobile health (m-Health) for diabetes management

Diabetes is a major health challenge with a global impact regardless of age, country or economic condition. The increased prevalence of diabetes is reaching alarming levels. The necessity and urgency to find innovative care delivery solutions is becoming more important, particularly in the digital age. It is expected in the near future that more people with diabetes, especially the younger generations will be empowered by their smartphones and relevant mobile health (m-Health) innovations, to take more responsibility of their condition. Clinicians and healthcare providers are increasingly likely to assume the role of ‘navigators’ and ‘advisors’ rather than simply the medical gatekeeper for their patients. In this article, we describe the general architecture of current m-Health systems and applications for diabetes management. We also discuss the clinical evidence for impact from these important and innovative approaches to diabetes self-care and management and likely future trends in their usage. The latest statistics indicate that there are more than 1200 diabetes smartphone ‘apps’ and this area is growing exponentially in terms of ideas, technologies, devices and the associated industry. M-Health for diabetes care is now a major business stream for the medical device, mobile phone and IT telecommunication industries with high expectations arising from the potential benefits to be gained by both patients and healthcare providers. However, this potential has not yet been fully developed on the clinical side. This may be due to many factors including the reluctance of clinicians to engage with these technologies due to the lack of clinical evidence for their efficacy, poor adherence of people with diabetes to long-term use of these apps and the reluctance of healthcare funders to reimburse mobile diabetes

Comparative Adsorption of Saturated and Unsaturated Fatty Acids at the Iron Oxide/Oil Interface.

A detailed comparison of the adsorption behavior of long straight chain saturated and unsaturated fatty acids at the iron oxide/oil interface has been considered using a combination of surface study techniques. Both depletion isotherms and polarized neutron reflectometry (PNR) show that the extent of adsorption decreases as the number of double bonds in the alkyl chains increases. Sum frequency generation spectroscopic measurements demonstrate that there is also an increase in chain disorder within the adsorbed layer as the unsaturation increases. However, for the unsaturated analogues, a decrease in peak intensity is seen for the double bond peak upon heating, which is thought to arise from isomerization in the surface-bound layer. The PNR study of oleic acid adsorption indicates chemisorbed monolayer adsorption, with a further diffuse reversible adsorbed layer formed at higher concentrations.Mary Wood is grateful for funding from the Oppenheimer Trust. The PNR data were collected using the V6 instrument at the Helmholtz-Zentrum Berlin (experiment number MAT-04-2131).This is the author accepted manuscript. The final version is available from the American Chemical Society via http://dx.doi.org/10.1021/acs.langmuir.5b0443

Weight loss surgery for non-morbidly obese populations with type 2 diabetes: is this an acceptable option for patients?

Aim To explore the views of non-morbidly obese people (BMI 30-40 kg/m2) with type 2 diabetes regarding: (a) the acceptability of bariatric surgery (BS) as a treatment for type 2 diabetes, and (b) willingness to participate in randomised controlled trials comparing BS versus non-surgical intervention. BACKGROUND: Despite weight management being a key therapeutic goal in type 2 diabetes, achieving and sustaining weight loss is problematic. BS is an effective treatment for people with morbid obesity and type 2 diabetes; it is less certain whether non-morbidly obese patients (BMI 30-39.9 kg/m2) with type 2 diabetes benefit from this treatment and whether this approach would be cost-effective. Before evaluating this issue by randomised trials, it is important to understand whether BS and such research are acceptable to this population. METHODS: Non-morbidly obese people with type 2 diabetes were purposively sampled from primary care and invited to participate in semi-structured interviews. Interviews explored participants' thoughts surrounding their diabetes and weight, the acceptability of BS and the willingness to participate in BS research. Data were analysed using Framework Analysi

Mites Parasitic on Australasian and African Spiders Found in the Pet Trade; a Redescription of Ljunghia pulleinei Womersley

Parasitic mites associated with spiders are spreading world-wide through the trade in tarantulas and other pet species. Ljunghia pulleinei Womersley, a mesostigmatic laelapid mite originally found in association with the mygalomorph spider Selenocosmia stirlingi Hogg (Theraphosidae) in Australia, is redescribed and illustrated on the basis of specimens from the African theraphosid spider Pterinochilus chordatus (Gersta¨cker) kept in captivity in the British Isles (Wales). The mite is known from older original descriptions of Womersley in 1956; the subsequent redescription of Domrow in 1975 seems to be questionable in conspecificity of treated specimens with the type material. Some inconsistencies in both descriptions are recognised here as intraspecific variability of the studied specimens. The genus Arachnyssus Ma, with species A. guangxiensis (type) and A. huwenae, is not considered to be a valid genus, and is included in synonymy with Ljunghia Oudemans. A new key to world species of the genus Ljunghia is provided

Negotiating power relations, gender equality, and collective agency: are village health committees transformative social spaces in northern India?

BACKGROUND: Participatory health initiatives ideally support progressive social change and stronger collective agency for marginalized groups. However, this empowering potential is often limited by inequalities within communities and between communities and outside actors (i.e. government officials, policymakers). We examined how the participatory initiative of Village Health, Sanitation, and Nutrition Committees (VHSNCs) can enable and hinder the renegotiation of power in rural north India. METHODS: Over 18 months, we conducted 74 interviews and 18 focus groups with VHSNC members (including female community health workers and local government officials), non-VHSNC community members, NGO staff, and higherlevel functionaries. We observed 54 VHSNC-related events (such as trainings and meetings). Initial thematic network analysis supported further examination of power relations, gendered “social spaces,” and the “discourses of responsibility” that affected collective agency. RESULTS: VHSNCs supported some re-negotiation of intra-community inequalities, for example by enabling some women to speak in front of men and perform assertive public roles. However, the extent to which these new gender dynamics transformed relations beyond the VHSNC was limited. Furthermore, inequalities between the community and outside stakeholders were re-entrenched through a “discourse of responsibility”: The comparatively powerful outside stakeholders emphasized community responsibility for improving health without acknowledging or correcting barriers to effective VHSNC action. In response, some community members blamed peers for not taking up this responsibility, reinforcing a negative collective identity where participation was futile because no one would work for the greater good. Others resisted this discourse, arguing that the VHSNC alone was not responsible for taking action: Government must also intervene. This counter-narrative also positioned VHSNC participation as futile. CONCLUSIONS: Interventions to strengthen participation in health systems can engender social transformation. However they must consider how changing power relations can be sustained outside participatory spaces, and how discourse frames the rationale for community participation.ISIScopu

Neutron reflection study of the adsorption of the phosphate surfactant NaDEHP onto alumina from water.

The adsorption of a phosphorus analogue of the surfactant AOT, sodium bis(2-ethylhexyl) phosphate (NaDEHP), at the water/alumina interface is described. The material is found to adsorb as an essentially water-free bilayer from neutron reflection measurements. This is similar to the behavior of AOT under comparable conditions, although AOT forms a thicker, more hydrated layer. The NaDEHP shows rather little variation with added salt, but a small thickening of the layer on increasing the pH, in contrast to the behavior of AOT.We thank BP plc and EPSRC for financial support for this work as well as the ISIS and ILL staff and scientists for the allocation of beam time and technical assistance with NR measurements. We also appreciate Chris Sporikou at Department of Chemistry, University of Cambridge, for help with the surfactant synthesis.This is the final version of the article. It first appeared at http://dx.doi.org/10.1021/la504837

Systematic in situ hydration neutron reflectometry study on Nafion thin films

Reported herein is a neutron reflectometry (NR) study on hydrated Nafion thin films (∼30 nm) on a silicon substrate with native oxide. The Nafion morphology is investigated systematically across the whole relative humidity range using both H2O and D2O vapours to enable a comparative study. By utilising this systematic approach two key results have been obtained. The first is that by leveraging the strong positive scattering signal from the D2O vapour, a complete and systematic water adsorption isotherm (Type II) for a Nafion thin film is produced. Utilising the slight negative scattering signal of the H2O enabled the quantification of the hydration dependent evolution of the formation of Nafion/water lamellae near the substrate surface. The number of lamellae layers increases continuously with hydration, and does not form abruptly. We also report the effects of swelling on the thin films across the relative humidity ranges. The work reported should prove useful in quantifying other hydration dependent properties of Nafion thin films such as conductivity and understanding Nafion/semiconductor based devices, as well as showcasing a NR methodology for other hydrophilic polymers

Does Gas-Phase Sulfur Dioxide Remove Films of Atmosphere-Extracted Organic Material from the Aqueous Aerosol Air-Water Interface?

The reaction of gas-phase SO2 with unsaturated carbon-carbon double bonds forms organosulfates. Previous works have focused on reaction products and not the fate of organic films in the atmosphere. Neutron reflectometry was used to study the interaction of gas-phase SO2 at the air-water interface with organic material extracted from atmospheric particulate matter and pure proxy chemicals to determine whether the reaction of organic films with SO2 removes the film and is there a product film. Films formed from atmospheric aerosol collected in urban and woodland environments typically produced a layer of approximately 0.6 nm thickness, whereas a thick (>40 nm) film was formed by the woodsmoke sample. Fitting of this thicker woodsmoke film suggested a three-layered structure at the interface that has been interpreted to be consistent with a surfactant-rich layer next to the air-water interface, a mid-layer rich in PAH and topped with a more aliphatic region. The multilayer structure of atmospheric extracted material at the air-water interface is potentially an exciting result that requires further study. Gas-Phase SO2 was confirmed to react with pure insoluble surfactant molecules at the air-water interface that contained carbon-carbon double bonds (oleic acid) and did not react with a similar saturated surfactant (stearic acid). No reaction was observed during the interaction of SO2 and atmospheric material extracted from urban and woodland environments, and no material appeared to be removed from the interface; however, films made from woodsmoke-extracted material did appear to be altered by SO2 suggesting a reaction with Poly Aromatic Hydrocarbons (PAHs) but no material was lost from the interface. In addition, the gas-phase ozone levels in the neutron blockhouse, which have historically been of some concern for reactions with organics, were found to be of the order 15ppb, with no evidence of additional production in the neutron beam-path. Owing to a lack of substantial removal of material from real atmospheric extracted films, SO2 is not considered atmospherically significant for the removal of organic films from the air-water interfac