Meeting the challenge of diabetes in ageing and diverse populations: a review of the literature from the UK

The impact of type 2 diabetes on ageing societies is great and populations across the globe are becoming more diverse. Complications of diabetes unequally affect particular groups in the UK older people, and people with a South Asian background are two population groups with increased risk whose numbers will grow in the future. We explored the evidence about diabetes care for older people with South Asian ethnicity to understand the contexts and mechanisms behind interventions to reduce inequalities. We used a realist approach to review the literature, mapped the main areas where relevant evidence exists, and explored the concepts and mechanisms which underpinned interventions. From this we constructed a theoretical framework for a programme of research and put forward suggestions for what our analysis might mean to providers, researchers, and policy makers. Broad themes of cultural competency; comorbidities and stratification; and access emerged as mid-level mechanisms which have individualised, culturally intelligent, and ethical care at their heart and through which inequalities can be addressed. These provide a theoretical framework for future research to advance knowledge about concordance; culturally meaningful measures of depression and cognitive impairment; and care planning in different contexts which support effective diabetes care for aging and diverse populations

Evidencing impact: the challenges of mapping impacts frompublic engagement and communication

Clare Wilkinson and Emma Weitkamp from the University of the West of England, Bristol offer support for researchers looking to track and evidence the unique, creative and often qualitative outcomes of public engagement and communication activities. Rather than an add-on to the research, it may be possible to embed evaluation within the research project itself

Quality improvements in diabetes care, how holistic have they been? a case-study from the United Kingdom

Aims: As quality in diabetes care includes patient centred support for self-management, investigating patients’ experiences upon diagnosis can help improve access to this element of care among diverse populations. This research explored this care in the context of recent national quality improvement initiatives which support self-management. Methods: South Asian and White European patients over 16 years with a recent (< 1 year) diagnosis of diabetes were recruited from 18 General Practitioner (GP) practices in three UK locations - Luton, West London and Leicester. A semi-structured qualitative interview was conducted with 47 patients. Results: Twenty one out of 47 (45%) reported unmet support and information needs at diagnosis. Although there was a small proportion of participants (8 out of 47, 17% of all respondents) who felt they did not require any help or support with managing their diabetes because their GP had provided comprehensive and efficient care, there was an equal number who voiced a negative view of the care they had received to date. This concerned information giving, support and communication, suggesting that recently implemented national quality improvement interventions may not have been successful in improving all aspects of diabetes care, particularly those encouraging self-management. The emerging analysis led to consideration of concordance as an important concept through which to understand inequalities and improve access to quality diabetes care. In order to encourage self-management from the start, care providers need to be cognisant that patients are not homogeneous and be responsive to their different information needs and emotional responses to diagnosis. Conclusions: In order to support self-management and deliver patient centred care in diverse populations, care providers will need to be adaptable to individual needs around diagnosis

A New Species of Skin-Feeding Caecilian and the First Report of Reproductive Mode in Microcaecilia (Amphibia: Gymnophiona: Siphonopidae)

A new species of siphonopid caecilian, Microcaecilia dermatophaga sp. nov., is described based on nine specimens from French Guiana. The new species is the first new caecilian to be described from French Guiana for more than 150 years. It differs from all other Microcaecilia in having fewer secondary annular grooves and/or in lacking a transverse groove on the dorsum of the first collar. Observations of oviparity and of extended parental care in M. dermatophaga are the first reproductive mode data for any species of the genus. Microcaecilia dermatophaga is the third species, and represents the third genus, for which there has been direct observation of young animals feeding on the skin of their attending mother. The species is named for this maternal dermatophagy, which is hypothesised to be characteristic of the Siphonopidae.Organismic and Evolutionary Biolog

Statin regulated ERK5 stimulates tight junction formation and reduces permeability in human cardiac endothelial cells

The MEKK3/MEK5/ERK5 signaling axis is required for cardiovascular development in vivo. We analyzed the physiological role of ERK5 in cardiac endothelial cells and the consequence of activation of this kinase by the statin class of HMG Co‐A reductase inhibitor drugs. We utilized human cardiac microvascular endothelial cells (HCMECs) and altered ERK5 expression using siRNA mediated gene silencing or overexpression of constitutively active MEK5 and ERK5 to reveal a role for ERK5 in regulating endothelial tight junction formation and cell permeability. Statin treatment of HCMECs stimulated activation of ERK5 and translocation to the plasma membrane resulting in co‐localization with the tight junction protein ZO‐1 and a concomitant reduction in endothelial cell permeability. Statin mediated activation of ERK5 was a consequence of reduced isoprenoid synthesis following HMG Co‐A reductase inhibition. Statin pretreatment could overcome the effect of doxorubicin in reducing endothelial tight junction formation and prevent increased permeability. Our data provide the first evidence for the role of ERK5 in regulating endothelial tight junction formation and endothelial cell permeability. Statin mediated ERK5 activation and the resulting decrease in cardiac endothelial cell permeability may contribute to the cardioprotective effects of statins in reducing doxorubicin‐induced cardiotoxicity

Royal Society education outreach training course evaluation

This evaluation explores the perceptions of Royal Society Research Fellows to education outreach and the drivers that stimulate them to undertake it. It also reports on the successes and challenges of a pilot training course for Research Fellows on education outreach. The pilot scheme was organised by The Training Group and covered a wide variety of topics including; theoretical information about learning styles and the UK education system, discussion activities for the Research Fellows, and activities to brainstorm and test potential outreach activities.The evaluation used a variety of data collection methods to elicit the views of participating Research Fellows and Royal Society staff and was conducted by the Science Communication Unit at the University of the West of England, Bristol. The report presents the indicators for impacts from education outreach, the methods and toolkit for undertaking the evaluation, and the results and recommendations from the pilot scheme

Investigating the Links Between Science Communication Actors and Between Actors and their Audiences

The audiences reached by those engaged in science communication and the nature of the connections with those audiences is of central importance to the science-society relationship. It determines who is reading, listening and watching information about science but also characterises those interactions. Do the interactions involve a one-directional ‘broadcast’ of information from communicator to audience, or is the relationship more of a two-way approach that fosters a more integrated relationship between science and society?To answer such questions, an online questionnaire was distributed in seven European countries: Italy, The Netherlands, Poland, Portugal, Serbia, Sweden and the UK. This explored the audiences these communicators sought to reach and the nature of their connections with them. Further insights into audience connections were provided by ‘Rethinkerspace’ workshops held in the same seven European countries. These workshops involved a variety of ‘actors’ involved in science communication, as well as academics. A high proportion of the questionnaire respondents said that their intended audience is individuals already interested in science, technology and/or health topics to some degree. The discussions with Rethinkerspace members show that a lack of time to communicate science is a barrier that transcends actors and European countries. In terms of digital communications, many communicators reported a sense of disconnect with their audience