Cultural Influences on Dietary Self-Management of Type 2 Diabetes in East Asian Americans: A Mixed-Methods Systematic Review

Purpose: Many East Asian Americans (EAAs) (populations originating from China, Korea, Japan, and Taiwan) with type 2 diabetes mellitus (T2DM) experience unique challenges in managing their disease, including language barriers and traditional cultural beliefs, particularly among first-generation immigrants. The purpose of this mixed-methods systematic review was to examine cultural perspectives of EAAs that influence dietary self-management of T2DM and identify education interventions and their approaches to enhance EAAs\u27 dietary self-management of diabetes. Methods: A mixed-methods systematic review was conducted to examine EAAs\u27 perspectives from qualitative studies and to identify education interventions and their approaches from quantitative studies. A literature search was conducted using PubMed/MEDLINE, SCOPUS, CINAHL, and Web of Science from 1995 to 2018. Sixteen studies (10 qualitative and 6 quantitative) met criteria for analysis. Thematic synthesis of qualitative data was conducted using a line-by-line coding strategy. Extracted quantitative data were assessed for cultural approaches used in the interventions and diabetes-related outcomes. Results: In the qualitative studies, beliefs about food impacted EAAs\u27 abilities to adopt appropriate dietary recommendations for diabetes management. Requiring a specialized diet disrupted social harmony and made EAAs feel burdensome to others. Having bilingual and bicultural resources eased the stress of making dietary modifications. The most commonly incorporated approaches in diabetes education interventions were bilingual education and culturally specific dietary recommendations. Social roles and harmony were not discussed. Significant reductions in hemoglobin A1c and increases in diabetes knowledge were reported post-intervention. Conclusions: Beliefs about food, beliefs about social roles, and access to culturally competent care play an important role in dietary self-management of T2DM among EAAs. Understanding the cultural influences on dietary self-management of T2DM and tailoring interventions to meet the needs of EAAs are essential in effort to address the growing epidemic and improve patient outcomes

Promoting Moderate-Vigorous Physical Activity in Overweight Minority Girls

There is limited research on the types of activities that are most effective for promoting MVPA in children. Purpose. To assess which types of activities elicit MVPA in overweight minority girls. Methods. Sample consisted of 31 overweight (BMI ≥ 85th percentile) Latina and African-American girls (mean age 10.3 ± 1.2 years). Participants wore an Actical accelerometer each day for 8 hours for 15 days to assess engagement in MVPA during their participation in a three-week activity intervention that included traditional fitness, sport skills, games, dancing, and flexibility sessions. Results. On average 62% of participants met the MVPA recommended guidelines (60 min/5d/wk) with an average of 68.5 ± 14 minutes of MVPA across the three weeks. Traditional fitness sessions elicited the highest percent of MVPA (mean time spent in MVPA = 32%), followed by dancing and games (mean time spent in MVPA = 21%), sports skills (mean time spent in MVPA = 18%), and flexibility (mean time spent in MVPA = 7%). Step aerobics and rumba fitness elicited the highest proportions of MVPA. Conclusion. Traditional fitness activities were identified as the most successful in eliciting MVPA in overweight Latina and African American girls

Seeing what works:Identifying and enhancing successful interprofessional collaboration between pathology and surgery.

Utilising frozen section technologies, Mayo Clinic has one of the lowest reoperation rates for breast lumpectomy in the United States. The research reported on sought to understand the successful teamwork between the Breast Surgery Team and the Frozen Section Laboratory at Mayo Clinic. Researchers worked collaboratively with healthcare staff from breast surgery and the frozen section pathology laboratory to identify communication styles and strategies that contribute to the timely and accurate intraoperative evaluation of breast cancer specimens. Using the video-reflexive ethnography (VRE) methodology underpinned by a positive theoretical approach to researching quality and safety in healthcare, the researchers video-recorded the communications associated with specimen resections in surgery and the subsequent pathology diagnoses. Then, 57 staff from the breast surgery and frozen section laboratory teams attended video-reflexivity sessions to collaboratively analyse their communication practices and identify opportunities to optimize interprofessional communication. In this article, we focus on how the flexible, interdisciplinary, and cross-hierarchical communication within the frozen section laboratory supports a rapid and accurate intraoperative evaluation and communication, previously conceptualized by staff as being performed in a linear fashion. Moreover, we detail how the VRE methodology led surgeons and pathologists to implement new strategies and optimize their interprofessional communication

Employability initiatives in undergraduate education and application to human nutrition: A scoping review

Human nutrition is a growing field with an increasing job market and high demand for university study, yet graduates report feeling underprepared for and unaware of potential job opportunities. This scoping review aimed to identify employment initiatives used in undergraduate programs to support an evidence-based approach to the development of future initiatives for human nutrition courses. The scoping review following PRISMA-ScR criteria was initially conducted in October 2018 and updated in April 2020. Search terms were selected to identify studies that reported on employability or work-readiness embedded within the course curriculum for undergraduate students. Fourteen papers met the eligibility criteria. Papers included were from Australia (9), United Kingdom (2), United States (1), New Zealand (1) and Germany (1). Papers described initiatives fitting broad categories of placements, project-based industry collaboration, practice-based eLearning, mentoring and building graduate attributes. Placements were the most common type of initiative and project-based industry collaboration demonstrated the highest levels of student and employer satisfaction. The success of initiatives was often attributed to incorporating diverse approaches to real-world, problem-solving skills. Mentoring and eLearning were used to promote employability soft skills, while industry-based placements provided students with practical experience. Placement in specific workplace settings should be representative of the diverse job options for nutrition graduates. Human nutrition degrees should consider incorporating strategies that develop soft skills and project-based skills while exposing students to diverse workplace settings within industry

An exploratory study of industry perspectives to inform undergraduate nutrition employability initiatives

Aim The aim of this study was to explore nutrition professionals' perspectives of nutrition graduates' employability skills, and knowledge and skills required in the industry to understand gaps in undergraduate nutrition curriculum. Methods Nutrition professionals (n = 26) across Australia were approached to participate in semi-structured interviews via telephone in 2018. Interviews were transcribed verbatim, data analysed using thematic analysis, and results interpreted and discussed. Results Nine participants across six work environments completed interviews. Common work roles were identified in their diverse areas of practice: nutrition educators, food developers, team members, and business leaders. Nutrition professionals identified that, in addition to evidence-based discipline knowledge, key skills and knowledge needed for their roles were interpersonal communication, including writing and listening. Participants highlighted the need for employability skills to be embedded within curriculum with emphasis on professional skills, business skills and discipline-specific skills in communicating complex science messages to a range of audiences. Networking, and formal and informal work-integrated learning were viewed as important vehicles for developing required skills. Participants expected that universities develop curriculum to address gaps; however, reflection by the academic researchers suggested this should be a joint role. Conclusions Early career planning, professional skill development, work experience and networking opportunities should enhance graduate employability

Feeding Cannabidiol (CBD)-Containing Treats Did Not Affect Canine Daily Voluntary Activity

Growing public interest in the use of cannabidiol (CBD) for companion animals has amplified the need to elucidate potential impacts. The purpose of this investigation was to determine the influence of CBD on the daily activity of adult dogs. Twenty-four dogs (18.0 ± 3.4 kg, 9 months−4 years old) of various mixed breeds were utilized in a randomized complete block design with treatments targeted at 0 and 2.5 mg (LOW) and at 5.0 mg (HIGH) CBD/kg body weight (BW) per day split between two treats administered after twice-daily exercise (0700–0900 and 1,700–1,900 h). Four hours each day [1,000–1,200 h (a.m.) and 1,330–1,530 h (p.m.)] were designated as times when no people entered the kennels, with 2 h designated as Quiet time and the other 2 h as Music time, when calming music played over speakers. Quiet and Music sessions were randomly allotted to daily a.m. or p.m. times. Activity monitors were fitted to dogs\u27 collars for continuous collection of activity data. Data were collected over a 14-day baseline period to establish the activity patterns and block dogs by activity level (high or low) before randomly assigning dogs within each block to treatments. After 7 days of treatment acclimation, activity data were collected for 14 days. Data were examined for differences using the MIXED procedure in SAS including effects of treatment, day, session (Quiet or Music), time of day (a.m. or p.m.), and accompanying interactions. CBD (LOW and HIGH) did not alter the total daily activity points (P = 0.985) or activity duration (P = 0.882). CBD tended (P = 0.071) to reduce total daily scratching compared with the control. Dogs were more active in p.m. sessions than in a.m. sessions (P \u3c 0.001). During the p.m. session, dogs receiving HIGH tended (P = 0.091) to be less active than the control (CON). During the a.m. and p.m. sessions, CBD reduced scratching compared with CON (P = 0.030). CBD did not affect the activity duration during exercise periods (P = 0.143). These results indicate that, when supplemented with up to 4.5 mg CBD/kg BW/day, CBD does not impact the daily activity of adult dogs, but may exert an antipruritic effect

Psychiatry training in autism spectrum disorder and intellectual disability: Ongoing gaps and emerging opportunities

Children, adolescents, and adults with autism spectrum disorder and intellectual disability experience high rates of co-occurring psychiatric conditions throughout their lifetime. However, there is a shortage of psychiatrists to treat these populations. We evaluated how much education psychiatrists-in-training receive on how to care for individuals with autism spectrum disorder/intellectual disability. We found that in many psychiatry programs, residents receive limited training experiences in autism spectrum disorder/intellectual disability involving lectures and patient contact and that psychiatry program directors would benefit from more resources to strengthen education in autism spectrum disorder/intellectual disability

Rabies disease dynamics in naȉve dog populations in Australia

Currently, Australia is free from terrestrial rabies but an incursion from nearby Indonesia, where the virus is endemic, is a feasible threat. Here, we aimed to determine whether the response to a simulated rabies incursion would vary between three extant Australian dog populations; free-roaming domestic dogs from a remote indigenous community in northern Australia, and free-roaming domestic and wild dogs in peri-urban areas of north-east New South Wales. We further sought to predict how different management strategies impacted disease dynamics in these populations. We used simple stochastic state-transition models and dog demographic and contact rate data from the three dog populations to simulate rabies spread, and used global and local sensitivity analyses to determine effects of model parameters. To identify the most effective control options, dog removal andvaccination strategies were also simulated. Responses to simulated rabies incursions varied between the dog populations. Free-roaming domestic dogs from north-east New South Wales exhibited the lowest risk for rabies maintenance and spread. Due to low containment and high contact rates, rabies progressed rapidly through free-roaming dogs from the remote indigenous community in northern Australia. In contrast, rabies remained at relatively low levels within the north-east New South Wales wild dog population for over a year prior to an epidemic. Across all scenarios, sensitivity analyses revealed that contact rates and the probability of transmission were the most important drivers of the number of infectious individuals within a population. The number of infectious individuals was less sensitive to birth and death rates. Removal of dogs as a control strategy was not effective for any population modelled, while vaccination rates in excess of 70% of the population resulted in significant reductions in disease progression. The variability in response between these distinct dog groups to a rabies incursion, suggests that a blanket approach to management would not be effective or feasible to control rabies in Australia. Control strategies that take into account the different population and behavioural characteristics of these doggroups will maximise the likelihood of effective and efficient rabies control in Australia

Functional profiling of single CRISPR/Cas9-edited human long-term hematopoietic stem cells.

In the human hematopoietic system, rare self-renewing multipotent long-term hematopoietic stem cells (LT-HSCs) are responsible for the lifelong production of mature blood cells and are the rational target for clinical regenerative therapies. However, the heterogeneity in the hematopoietic stem cell compartment and variable outcomes of CRISPR/Cas9 editing make functional interrogation of rare LT-HSCs challenging. Here, we report high efficiency LT-HSC editing at single-cell resolution using electroporation of modified synthetic gRNAs and Cas9 protein. Targeted short isoform expression of the GATA1 transcription factor elicit distinct differentiation and proliferation effects in single highly purified LT-HSC when analyzed with functional in vitro differentiation and long-term repopulation xenotransplantation assays. Our method represents a blueprint for systematic genetic analysis of complex tissue hierarchies at single-cell resolution