Self monitoring of blood glucose - a survey of Diabetes UK members with type 2 diabetes who use SMBG

Background: aim - to survey members of Diabetes UK who had Type 2 diabetes and who used self monitoring of blood glucose (SMBG), to elicit their views on its usefulness in the management of their diabetes, and how they used the results. A questionnaire was developed for the Diabetes UK website. The questionnaire was posted on the Diabetes UK website until over 500 people had responded. Questions asked users to specify the benefits gained from SMBG, and how these benefits were achieved. We carried out both quantitative analysis and a thematic analysis for the open ended free-text questions.Findings: 554 participants completed the survey, of whom 289 (52.2%) were male. 20% of respondents were recently diagnosed (&lt; 6 months). Frequency of SMBG varied, with 43% of participants testing between once and four times a day and 22% testing less than once a month or for occasional periods.80% of respondents reported high satisfaction with SMBG, and reported feeling more 'in control' of their diabetes management using it. The most frequently reported use of SMBG was to make adjustments to food intake or confirm a hyperglycaemic episode.Women were significantly more likely to report feelings of guilt or self-chastisement associated with out of range readings (p = &lt; .001).Conclusion: SMBG was clearly of benefit to this group of confirmed users, who used the results to adjust diet, physical activity or medications. However many individuals (particularly women) reported feelings of anxiety and depression associated with its use.<br/

Dimensionality of social networks using motifs and eigenvalues

We consider the dimensionality of social networks, and develop experiments aimed at predicting that dimension. We find that a social network model with nodes and links sampled from an $m$-dimensional metric space with power-law distributed influence regions best fits samples from real-world networks when $m$ scales logarithmically with the number of nodes of the network. This supports a logarithmic dimension hypothesis, and we provide evidence with two different social networks, Facebook and LinkedIn. Further, we employ two different methods for confirming the hypothesis: the first uses the distribution of motif counts, and the second exploits the eigenvalue distribution.Comment: 26 page

Metabotropic Glutamate Receptors as Novel Therapeutic Targets on Visceral Sensory Pathways

Metabotropic glutamate receptors (mGluR) have a diverse range of structures and molecular coupling mechanisms. There are eight mGluR subtypes divided into three major groups. Group I (mGluR1 and 5) is excitatory; groups II (mGluR2 and 3) and III (mGluR 4, 6, and 7) are inhibitory. All mGluR are found in the mammalian nervous system but some are absent from sensory neurons. The focus here is on mGluR in sensory pathways from the viscera, where they have been explored as therapeutic targets. Group I mGluR are activated by endogenous glutamate or constitutively active without agonist. Constitutive activity can be exploited by inverse agonists to reduce neuronal excitability without synaptic input. This is promising for reducing activation of nociceptive afferents and pain using mGluR5 negative allosteric modulators. Many inhibitory mGluR are also expressed in visceral afferents, many of which markedly reduce excitability. Their role in visceral pain remains to be determined, but they have shown promise in inhibition of the triggering of gastro-esophageal reflux, via an action on mechanosensory gastric afferents. The extent of reflux inhibition is limited, however, and may not reach a clinically useful level. On the other hand, negative modulation of mGluR5 has very potent actions on reflux inhibition, which has produced the most likely candidates so far as therapeutic drugs. These act probably outside the central nervous system, and may therefore provide a generous therapeutic window. There are many unanswered questions about mGluR along visceral afferent pathways, the answers to which may reveal many more therapeutic candidates

Piloting of the Concerns-based Adoption Model: Farmer Concerns About the Participatory Guarantee System in Cambodia

While there is a large body of adoption and agricultural extension literature on the process of introducing a new technology, agricultural development projects are often expected to produce immediate results that do not always allow for the integration of these theories into practice. The Concerns-based Adoption Model (CBAM) is a framework that places participants at the center of the change process to identify their concerns and challenges, providing a roadmap for projects to guide individuals with the correct support for their particular stage of adoption. CBAM has typically been used for the introduction of new curriculum in formal education. But this study assessed the potential for CBAM to be applied to agriculture innovations. In this study, we adapted and piloted the CBAM “Stages of Concern” model to assess adoption of an agriculture innovation. The innovation is the Participatory Guarantee System (PGS) for Cambodian vegetable farmers. We assessed the potential for CBAM as a tool for agricultural development project management. We found that the adapted survey consistently placed farmers in the anticipated Stage of Concern. Identifying users’ Stages of Concern can inform program designers and practitioners, assisting in tailoring support across the adoption process. CBAM has the potential to inform participatory project design and give project administrators an evidence-based, systematic protocol for assessing the adoption process, adding another tool to the development practitioners’ toolbox

Dendrochronological dating of coal mine workings at the Joggins Fossil Cliffs, Nova Scotia, Canada

Joggins, Nova Scotia was one of the first places in North America where coal was mined. In this paper we employ dendrochronology to date timber pit props preserved within relic coal mine workings on the closely adjacent Fundy and Dirty seams. These remains comprise a system of adits created through ‘room and pillar’ mining. Of the seventy-three samples collected, forty-eight were successfully cross-dated against a local red spruce (Picea rubens Sarg.) master chronology thereby establishing the year in which each individual sample was cut as a live tree. Results indicate cut dates of 1849-1875 which are generally consistent with written archival records of mining activity on these coal seams. Our analysis of fourteen separate adits allows us to distinguish two phases of mining. Most adits (numbers 1-9 and 11-12 with cut dates of 1849-1868) are relics of an initial operation by the General Mining Association (1865-1871), which opened a mine entered at beach level. Dendrochronological dates preceding the opening of this mine may suggest that timber stockpiled from the nearby Joggins Mine (opened 1847) was used in its construction. The remaining adits (numbers 10 and 13-14 with cut dates of 1873-1875) are probably relics of a later mine opened by the Joggins Coal Mining Company (1872-1877). Although this mine was centered ~500 m inland, its western peripheral workings passed through the earlier workings to the shore. Findings improve knowledge of the industrial archaeology of the UNESCO World Heritage Site and help refine the regional master red spruce chronology for future dendrochronological studies

Weight Status: A Predictor of the Receipt of and Interest in Health Promotion Information among College Students

Background: Negative health behaviors such as consumption of excess calories, low intake of fruits and vegetables, sedentariness and weight gain are associated with entry into college. Purpose: To determine if weight status is associated with students’ receipt of health promotion (nutrition, physical activity and stress reduction) information, and students’ interest in receiving these types of information from their college or university. Methods: Data from the Spring 2011 ACHA-NCHA II dataset was used to complete secondary data analyses. Students (N=116,254) from 148 postsecondary institutions completed the Spring 2011 ACHA-NCHA II survey. Logistic regression was used to examine the effect of BMI category on receipt of, and interest in receiving, health promotion information. Results: Approximately 32% of respondents were overweight or obese. Students in the obese class III category were the least likely to receive health promotion information and least likely to be interested in receiving the information. Conclusion: Weight status based on BMI classification is a weak predictor of the dissemination of health promotion information. The largest gaps related to the dissemination appear to be among obese students. Future research is needed to determine factors contributing to the observed gaps and strategies should be developed to reach underserved groups

Prostate Surgery for Men with Lower Urinary Tract Symptoms: Do We Need Urodynamics to Find the Right Candidates?:Exploratory Findings from the UPSTREAM Trial

BackgroundIdentifying men whose lower urinary tract symptoms (LUTS) may benefit from surgery is challenging.ObjectiveTo identify routine diagnostic and urodynamic measures associated with treatment decision-making, and outcome, in exploratory analyses of the UPSTREAM trial.Design, setting, and participantsA randomised controlled trial was conducted including 820 men, considering surgery for LUTS, across 26 hospitals in England (ISCTRN56164274).InterventionMen were randomised to a routine care (RC) diagnostic pathway (n = 393) or a pathway that included urodynamics (UDS) in addition to RC (n = 427).Outcome measurements and statistical analysisMen underwent uroflowmetry and completed symptom questionnaires, at baseline and 18 mo after randomisation. Regression models identified baseline clinical and symptom measures that predicted recommendation for surgery and/or surgical outcome (measured by the International Prostate Symptom Score [IPSS]). We explored the association between UDS and surgical outcome in subgroups defined by routine measures.Results and limitationsThe recommendation for surgery could be predicted successfully in the RC and UDS groups (area under the receiver operating characteristic curve 0.78), with maximum flow rate (Qmax) and age predictors in both groups. Surgery was more beneficial in those with higher symptom scores (eg, IPSS >16), age 47.6, and bladder contractility index >123.0. In the UDS group, urodynamic measures were more strongly predictive of surgical outcome for those with Qmax >15, although patient-reported outcomes were also more predictive in this subgroup.ConclusionsTreatment decisions were informed with UDS, when available, but without evidence of change in the decisions reached. Despite the small group sizes, exploratory analyses suggest that selective use of UDS could detect obstructive pathology, missed by routine measures, in certain subgroups.Patient summaryBaseline clinical and symptom measurements were able to predict treatment decisions. The addition of urodynamic test results, while useful, did not generally lead to better surgical decisions and outcomes over routine tests alone