Psycho-educational interventions for children and young people with Type 1 diabetes.

Background A systematic review of the literature in 2000 revealed numerous methodological shortcomings in education research, but in recent years progress has been made in the quantity and quality of psycho‐educational intervention studies. Summary of contents This review focuses on diabetes education programmes developed for children, young people and their families in the past 5 years. A comprehensive review of the literature identified 27 articles describing the evaluation of 24 psycho‐educational interventions. Data summary tables compare the key features of these, and comparisons are made between individual, group and family‐based interventions. Effect sizes are calculated for nine of the randomized studies. Three research questions are posed: firstly has the recent literature addressed the problems highlighted in the previous review; secondly is there sufficient evidence to recommend adaptation of a particular programme; and, finally, what do we still need to do? Conclusions Progress in the quality and quantity of educational research has not resulted in improved effectiveness of interventions. There is still insufficient evidence to recommend adaptation of a particular educational programme and no programme that has been proven effective in randomized studies for those with poor glycaemic control. To develop a range of effective educational interventions, further research involving larger sample sizes with multicentre collaboration is required.     

The importance of selenium to human health

The essential trace mineral, selenium, is of fundamental importance to human health. As a constituent of selenoproteins, selenium has structural and enzymic roles, in the latter context being best-known as an antioxidant and catalyst for the production of active thyroid hormone. Selenium is needed for the proper functioning of the immune system, and appears to be a key nutrient in counteracting the development of virulence and inhibiting HIV progression to AIDS. It is required for sperm motility and may reduce the risk of miscarriage. Deficiency has been linked to adverse mood states. Findings have been equivocal in linking selenium to cardiovascular disease risk although other conditions involving oxidative stress and inflammation have shown benefits of a higher selenium status. An elevated selenium intake may be associated with reduced cancer risk. Large clinical trials are now planned to confirm or refute this hypothesis. In the context of these health effects, low or diminishing selenium status in some parts of the world, notably in some European countries, is giving cause for concern.     

Functionalization of porous BCP scaffold by generating cell‐derived extracellular matrix from rat bone marrow stem cells culture for bone tissue engineering

The potential of decellularized cell‐derived extracellular matrix (ECM) deposited on biphasic calcium phosphate (BCP) scaffold for bone tissue engineering was investigated. Rat derived bone marrow mesenchymal stem cells were cultured on porous BCP scaffolds for 3 weeks and decellularized with two different methods (freeze–thaw [F/T] or sodium dodecyl sulfate [SDS]). The decellularized ECM deposited scaffolds (dECM‐BCP) were characterized through scanning electron microscopy, energy dispersive X‐ray spectrometer, and confocal microscopy. The efficiency of decellularization was evaluated by quantifying remaining DNA, sulfated glycosaminoglycans, and collagens. Results revealed that F/T method was more effective procedure for removing cellular components of cultured cells (95.21% DNA reduction) than SDS treatment (92.49%). Although significant loss of collagen was observed after decellularization with both F/T (56.68%) and SDS (70.87%) methods, F/T treated sample showed higher retaining amount of sulfated glycosaminoglycans content (75.64%) than SDS (33.28%). In addition, we investigated the cell biocompatibility and osteogenic effect of dECM‐BCP scaffolds using preosteoblasts (MC3T3‐E1). Compared to bare BCP scaffolds, dECM‐BCP_F/T scaffolds showed improved cell attachment and proliferation based on immunofluorescence staining and water soluble tetrazolium salts assay (p < .001). Moreover, dECM‐BCP scaffolds showed increased osteoblastic differentiation of newly seeded preosteoblasts by up‐regulating three types of osteoblastic genes (osteopontin, alkaline phosphatase, and bone morphogenic protein‐2). This study demonstrated that functionalization of BCP scaffold using cell‐derived ECM could be useful for improving the bioactivity of materials and providing suitable microenvironment, especially for osteogenesis. Further study is needed to determine the potential of dECM‐BCP scaffold for bone formation and regeneration in vivo.     

Spontaneous transmitter release recruits postsynaptic mechanisms of long-term and intermediate-term facilitation in Aplysia

Whereas short-term (minutes) facilitation at Aplysia sensory–motor neuron synapses is presynaptic, long-term (days) facilitation involves synaptic growth, which requires both presynaptic and postsynaptic mechanisms. How are the postsynaptic mechanisms recruited, and when does that process begin? We have been investigating the possible role of spontaneous transmitter release from the presynaptic neuron. In the previous paper, we found that spontaneous release is critical for the induction of long-term facilitation, and this process begins during an intermediate-term stage of facilitation that is the first stage to involve postsynaptic as well as presynaptic mechanisms. We now report that increased spontaneous release during the short-term stage acts as an orthograde signal to recruit postsynaptic mechanisms of intermediate-term facilitation including increased IP3, Ca²⁺, and membrane insertion and recruitment of clusters of AMPA-like receptors, which may be first steps in synaptic growth during long-term facilitation. These results suggest that the different stages of facilitation involve a cascade of pre- and postsynaptic mechanisms, which is initiated by spontaneous release and may culminate in synaptic growth.     

Quality of life in head and neck cancer survivors at 1 year after treatment: the mediating role of unmet supportive care needs

Purpose

The aim of the study was to test a hypothesised model that supportive care needs (SCNs) have a mediating effect on the relationship between characteristics of (Chinese) head and neck cancer (HNC) survivors and their quality of life (QoL).

Methods

A total of 285 Chinese HNC survivors who had finished cancer treatment 1 year earlier completed a self-reported survey covering demographic and clinical characteristics, the Chinese version of the Short-Form Supportive Care Needs Questionnaire (SCNS-SF34-C), the supplementary module of access to healthcare and ancillary support services and the Functional Assessment of Cancer Therapy for Head and Neck Cancer (FACT-H&N).

Results

The final path model showed that optimism, educational level, any coexisting disease, number of somatic symptoms, household income, eating ability, support from others, whether the cancer is under control or not and travelling time from home to hospital have direct or indirect effects, or both, on the QoL of HNC survivors, by way of unmet SCNs in the psychological, physical and/or health system information domains, which account for 64 % of the variance in the total FACT-H&N score.

Conclusions

Our study demonstrated the mediating effects of SCNs in the association between HNC survivors and their QoL. Early needs assessment may help healthcare professionals to identify the actual needs of these survivors, and providing the information that HNC survivors want is a significant factor in meeting their psychological needs and thereby improving their overall QoL.     

Iodine concentration of organic and conventional milk: implications for iodine intake

Iodine is required for adequate thyroid hormone production, which is essential for brain development, particularly in the first trimester of pregnancy. Milk is the principal source of iodine in UK diets, and while small studies in Europe have shown organic milk to have a lower iodine concentration than conventional milk, no such study has been conducted in Britain. In view of the increasing popularity of organic milk in the UK, we aimed to compare the iodine concentration of retail organic and conventional milk and to evaluate regional influences in iodine levels. Samples of organic milk (n 92) and conventional milk (n 80), purchased from retail outlets in sixteen areas of the UK (southern England, Wales and Northern Ireland), were analysed for iodine using inductively coupled plasma MS. The region of origin of the milk was determined from information on the label. Organic milk was 42·1 % lower in iodine content than conventional milk (median iodine concentration 144·5 v. 249·5 ng/g; P < 0·001). There was no difference in the iodine concentration of either conventional or organic milk by area of purchase. However, a difference was seen in iodine concentration of organic milk by region of origin (P < 0·001). The lower iodine concentration of organic milk has public-health implications, particularly in view of emerging evidence of iodine deficiency in UK population sub-groups, including pregnant women. Individuals who choose organic milk should be aware that their iodine intake may be compromised and should ensure adequate iodine intake from alternative sources.     

Assessment of Diabetic Neuropathy Using a Point-of-Care Nerve Conduction Device Shows Significant Associations With the LDIFLARE Method and Clinical Neuropathy Scoring

Background:Accurate assessment of diabetes polyneuropathy (DPN) is important in the prevention of foot ulcerations and amputations. Simple screening methods including the 10 g monofilament and the 128-Hz tuning fork are not sensitive enough nor intended for detection of early neuropathy, while more confirmatory tests such as nerve conduction studies are not universally available. We evaluated a rapid, low-cost, point-of-care nerve conduction device (POCD; NC-stat®|DPNCheck™) for the assessment of DPN and compared it with the LDI_FLARE technique—an established method for early detection of small fibre dysfunction.Methods:A total of 162 patients with diabetes (DM) and 80 healthy controls (HC) were recruited. Based on the 10-point Neuropathy Disability Score (NDS), DPN was categorized into none (<2), mild (3-5) moderate (6-7), and severe (8-10). The LDI_FLARE was performed in all patients according to previously described methodology. The associations between POCD outcomes and the LDI_FLARE within the NDS categories were evaluated using regression analysis.Results:In HC and DM, SNCV measured with the POCD correlated significantly with the LDI_FLARE technique (r < 0.90 and r = 0.78, respectively) as did SNAP (r = 0.88 and r = 0.73, respectively); in addition, significance was found in all categories of DPN (r = 0.64 to 0.84; p= ≤ 0.03). ROC curves within each category of DPN showed that the POCD was sensitive in the assessment of DPN.Conclusion:We report highly significant linear relationships between the POCD with both comparators—the LDI_FLARE technique and clinical neuropathy scores. Thus, the NC-stat|DPNCheck™ system appears to be an excellent adjunctive diagnostic tool for diagnosing DPN in the clinical setting.