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Background: Women who have had gestational diabetes during pregnancy are at very high risk of developing type 2 diabetes later in life, but their understanding of the risks is often limited. In this study we explored the views of health care professionals regarding offering brief opportunistic advice to women after their pregnancy, during unrelated consultations in primary care, relating to reducing diabetes risk. Methods: The study took place in three Health Boards in Scotland. We conducted semi-structured one-to-one interviews (either face-to-face or telephone) with two health visitors, three practice nurses, two GPs, two diabetes consultants and two obstetricians. A focus group with five health visitors was also held. A topic guide was followed, covering the feasibility and acceptability of delivering brief opportunistic advice during a routine consultation, the optimal way to identify and recall women with previous gestational diabetes, and the possible content and timing of any such intervention. A thematic approach was used to analyse the qualitative data generated. Results: The interviews/discussion lasted from 15 to 51 min. There was widespread support from all participants for offering opportunistic advice, and general consensus that health visitors would be best placed to do this as part of the Universal Health Visiting Pathway in Scotland. Thematic analysis generated three significant points of discussion: implications for training of health visitors, the need for a systematic approach to identifying women with gestational diabetes, and the optimal timing of delivery. Despite an already demanding schedule of providing advice and education to women, health visitors were confident that they could offer educational advice, provided that they received appropriate training to do so. However, there would need to be a watertight system for identifying women in their care who had had gestational diabetes. In terms of timing, later visits around 6–8 months after delivery were considered most suitable. Conclusions: There is support from health care professionals, and most pertinently from health visitors, that the frequency of routine visits with women during the Universal Health Visiting Pathway programme in Scotland provides potential opportunities for education around future diabetes risk to women who have had gestational diabetes. [ABSTRACT FROM AUTHOR]

Walking is widely accepted as a safe and effective method of promoting rehabilitation and a return to physical activity after a cancer diagnosis. Little research has considered the therapeutic qualities of landscape in relation to understanding women's recovery from breast cancer, and no study has considered the supportive and therapeutic benefits that walking groups might contribute to their wellbeing. Through a study of a volunteer-led walking group intervention for women living with and beyond breast cancer (Best Foot Forward) we address this gap. A mixed-methods design was used including questionnaires with walkers (n = 35) and walk leaders (n = 13); telephone interviews with walkers (n = 4) and walk leaders (n = 9); and walking interviews conducted outdoors and on the move with walkers (n = 15) and walk leaders (n = 4). Questionnaires were analysed descriptively. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Our study found that the combination of walking and talking enabled conversations to roam freely between topics and individuals, encouraging everyday and cancer-related conversation that created a form of 'shoulder-to-shoulder support' that might not occur in sedentary supportive care settings. Walking interviews pointed to three facets of the outdoor landscape – as un/natural, dis/placed and im/mobile – that walkers felt imbued it with therapeutic qualities. 'Shoulder-to-shoulder support' was therefore found to be contingent on the therapeutic assemblage of place, walk and talk. Thus, beyond the physical benefits that walking brings, it is the complex assemblage of walking and talking in combination with the fluid navigation between multiple spaces that mobilises a therapeutic assemblage that promotes wellbeing in people living with and beyond breast cancer. • Walking groups are a safe, effective way to promote recovery after breast cancer. • Walking and talking, together, created a form of 'shoulder-to-shoulder support'. • Shoulder-to-shoulder support was not thought possible in sedentary settings. • Walkers imbued landscape with therapeutic qualities that aided recovery. • Walks mobilised a therapeutic assemblage of walk, talk and place. [ABSTRACT FROM AUTHOR]

Understanding the inherent characteristics of a local agricultural industry is imperative in designing policies that are responsive to the context, needs, and challenges of its stakeholders. Grounded in this premise, this study unpacked the complexities of the mango industry in the Island Garden City of Samal, an agricultural city in the southern Philippines. Specifically, it aims to understand its labor dynamics and market arrangements using a qualitative approach. This study presents an overview of the mango production cycle in the garden city, which includes the corresponding labor requirements and market of the local mango industry. In terms of labor, aside from the quantity and quality of labor needed, this paper also presents the roles of men and women that are inherent in local mango production. Likewise, the study also enumerates the different issues and challenges faced by the local mango producers. These issues and challenges were concerns related to erratic prices, labor needs, and high production costs. Moreover, the study offers explanations for the existing labor dynamics in the garden city. This includes the interplay between the material nature of the commodity and the gender dynamics in the labor force. In addition, a discussion on the varying quality standards of different target markers is also provided. Finally, this study also explained the rationale behind the prevailing contractual arrangements within the local mango industry. The results presented in this paper offer insights into designing context-based programs and policies, which could further support the local mango industry. [ABSTRACT FROM AUTHOR]

Positioned within a hybrid of the human and technology, professional nursing practice has always occupied a space that is more than human. In nursing education, technology is central in providing tools with which practice knowledge is mobilized so that students can safely engage with simulated human patients without causing harm to real people. However, while there is an increased emphasis on deploying these simulated humans as emissaries from person-centred care to demonstrate what it is like to care for real humans, the nature of what is really going on in simulation-what is real and what is simulated-is very rarely discussed and poorly understood. This paper explores how elements of postcolonial critical thought can aid in understanding the challenges of educating nurses to provide person-centred care within a healthcare culture that is increasingly reliant on technology. Because nursing education is itself a hybrid of real and simulated practice, it provides an appropriate case study to explore the philosophical question of technology in healthcare discourse, particularly as it relates to the relationship between the human patient and its uncanny simulated double. Drawing on postcolonial elements such as the uncanny, diaspora, hybridity, and créolité, the hybrid conditions of nursing education are examined in order to open up new possibilities of thinking about how learning to care is entangled with this technological space to assist in shaping professional knowledge of person-centred care. Considering these issues through a postcolonial lens opens up questions about the nature of the difficulty in using simulated human technologies in clinical education, particularly with the paradoxical aim of providing person-centred care within a climate that increasingly characterized as posthuman. [ABSTRACT FROM AUTHOR]

Highly sensitive and selective detection of morphine is exhibited using a capacitive transducer coated with cathodically electropolymerized and molecularly imprinted poly( p aminostyrene). Through molecular imprinting, morphine-specific recognition sites have been fabricated throughout the film, which shows exceptional binding activity toward morphine based from electrochemical capacitance measurements. The thin film sensor has a linear response to morphine solutions with 20-40 × 10−6 m concentrations and a detection limit of 5.95 × 10−6 m. It demonstrates high selectivity toward morphine as compared to other analog molecules including nicotine and cholesterol. The formation of the polymer film is facilitated and monitored using electrochemical-quartz crystal microbalance and characterized by X-ray photoelectron spectroscopy. Infrared spectroscopy confirms the loading and removal of the analyte from the film. Based on molecular modeling calculations, strong hydrogen-bonding interactions between the monomer, cross-linker, and analyte form a stable pre-polymerization complex, which is critical in successfully imprinting morphine into the film and effective sensing of the analyte. [ABSTRACT FROM AUTHOR]

The highly selective and sensitive detection of a chemical nerve agent analog pinacolyl methylphosphonate (PMP) was demonstrated using an electrochemically molecularly imprinted polymer (MIP) polythiophene film onto a quartz crystal microbalance (QCM) transducer surface. The fabrication and optimization of the sensor film was monitored by in situ electrochemistry-QCM (EC-QCM) measurements, which determined the change in mass and simultaneous change in redox properties of the polymer film. The film deposition, template loading, and template removal were evidenced by a combination of surface characterization techniques such as the attenuated total reflection infrared spectroscopy and high-resolution X-ray photoelectron spectroscopy. The fabricated MIP film demonstrated a limit of detection and a limit of quantification of ∼60 and ∼197 μM, respectively. The linear sensing range is between 125 and 250 μM concentration of PMP. Finally, theoretical modeling (AM1 semiempirical quantum calculations) studies revealed that a stable prepolymerization complex is formed in solution with the existence of H-bonding interactions using the 2:1 monomer-to-template ratio. © 2011 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem, 2012 [ABSTRACT FROM AUTHOR]

Evidence is presented demonstrating that the magnitudes of the 13C chemical shifts originating from heme meso carbons provide a straightforward diagnostic tool to elucidate the coordination state of high-spin heme proteins and enzymes. Pentacoordinate high-spin heme centers exhibit 13C meso shifts centered at approximately 250 ppm, whereas their hexacoordinate counterparts exhibit 13C shifts centered at approximately -80 ppm. The relatively small spectral window (400 to -100 ppm) covering the meso-13C shifts, the relatively narrow lines of these resonances, and the availability of biosynthetic methods to prepare 13C-labeled heme (Rivera, M.; Walker, F. A. Anal. Biochem. 1995, 230, 295-302) make this approach practical. The theoretical basis for the distinct chemical shifts observed for meso carbons from hexacoordinate high-spin hemes relative to their pentacoordinate counterparts are now well understood (Cheng, R.-J.; Chen, P. Y.; Lovell, T.; Liu, T.; Noodleman, L.; Case, D. A. J. Am. Chem. Soc. 2003, 125, 6774-6783), which indicates that the magnitude of the meso-carbon chemical shifts can be used as a simple and reliable diagnostic tool for determining the coordination state of the heme active sites, independent of the nature of the proximal ligand. Proof of the principle for the 13C NMR spectroscopic approach is demonstrated using hexa- and pentacoordinate myoglobin. Subsequently, 13C NMR spectroscopy has been used to unambiguously determine that a recently discovered heme protein from Shigella dysenteriae (ShuT) is pentacoordinate. [ABSTRACT FROM AUTHOR]

Abstract: Background: Psammocarcinoma is a subtype of serous ovarian carcinoma characterized by low-grade papillary atypia and psammoma body formation, presenting with abdominal distension, pelvic mass and/or ascites. Psammomatous carcinoma is rare, with few cases having been reported to date. Case: A 58 year old woman presented with one month of progressive shortness of breath. Initial chest X-ray showed extensive left pleural thickening and right-sided effusion. Thoracoscopy with biopsies of the pleura and pericardium revealed extensive psammoma body formation. Ovarian masses were detected on pelvic CT, without ascites, and subsequent biopsy revealed papillary tumors with low-grade cytological appearance. Conclusion: This is a unique case of a rare ovarian carcinoma. Here we present clinical, laboratory, diagnostic, and pathologic findings of a previously undescribed presentation. [Copyright &y& Elsevier]

Purpose: To compare diabetic retinopathy (DR) severity identified on handheld retinal imaging with ultrawide field (UWF) images. Methods: Mydriatic images of 225 eyes of 118 diabetic patients were prospectively imaged with the Aurora (AU) handheld retinal camera [5‐field protocol (macula‐centred, disc‐centred, temporal, superior, inferior)] and compared with UWF images. Images were classified based on the international classification for DR. Sensitivity, specificity, kappa statistics (K/Kw) were calculated on an eye and person‐level. Results: Distribution of DR severity by AU/UWF images (%) by eye was no DR 41.3/36.0, mild non‐proliferative DR (NPDR) 18.7/17.8, moderate 10.2/10.7, severe 16.4/15.1, proliferative DR (PDR) 13.3/20.4. Agreement between UWF and AU was exact in 64.4%, within 1‐step 90.7%, k = 0.55 (95% CI:0.45–0.65), and kw = 0.79 (95% CI:0.73–0.85) by eye, and exact in 68%, within 1‐step 92.9%, k = 0.58 (95% CI:0.50–0.66), and kw = 0.76 (95% CI:0.70–0.81) by person. Sensitivity/specificity for any DR, refDR, vtDR and PDR were as follows: 0.90/0.83, 0.90/0.97, 0.82/0.95 and 0.69/1.00 by person and 0.86/0.90, 0.84/0.98, 0.75/0.95 and 0.63/0.99 by eye. Handheld imaging missed 37% (17/46) eyes and 30.8% (8/26) persons with PDR. Only 3.9% (1/26) persons or 6.5% (3/46) eyes with PDR were missed if a referral threshold of moderate NPDR was used. Conclusions: Data from this study show that comparing UWF and handheld images, when PDR was the referral threshold for handheld devices, 37.0% of eyes or 30.8% of patients with PDR were missed. Due to the identification of neovascular lesions outside of the handheld fields, lower referral thresholds are needed if handheld devices are used. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to compare 2-field (2F) and 5-field (5F) mydriatic handheld retinal imaging for the assessment of diabetic retinopathy (DR) severity in a community-based DR screening program (DRSP). Methods: This was a prospective, cross-sectional diagnostic study, evaluating images of 805 eyes from 407 consecutive patients with diabetes acquired from a community-based DRSP. Mydriatic standardized 5F imaging (macula, disc, superior, inferior, temporal) with handheld retinal camera was performed. 2F (disc, macula), and 5F images were independently assessed using the International DR classification at a centralized reading center. Simple (K) and weighted (Kw) kappa statistics were calculated for DR. Sensitivity and specificity for referable DR ([refDR] moderate nonproliferative DR [NPDR] or worse) and vision-threatening DR ([vtDR] severe NPDR or worse) for 2F compared to 5F imaging were calculated. Results: Distribution of DR severity by 2F/5F images (%): no DR 66.0/61.7, mild NPDR 10.7/14.4, moderate NPDR 7.9/8.1, severe NPDR 3.3/5.6, proliferative DR 5.6/4.6, ungradable 6.5/5.6. Exact agreement of DR grading between 2F and 5F was 81.7%, within 1-step 97.1% (K = 0.64, Kw = 0.78). Sensitivity/specificity for 2F compared 5F was refDR 0.80/0.97, vtDR 0.73/0.98. The ungradable images rate with 2F was 16.1% higher than with 5F (6.5 vs. 5.6%, p < 0.001). Conclusions: Mydriatic 2F and 5F handheld imaging have substantial agreement in assessing severity of DR. However, the use of mydriatic 2F handheld imaging only meets the minimum standards for sensitivity and specificity for refDR but not for vtDR. When using handheld cameras, the addition of peripheral fields in 5F imaging further refines the referral approach by decreasing ungradable rate and increasing sensitivity for vtDR. [ABSTRACT FROM AUTHOR]

Introduction: Handheld retinal imaging cameras are relatively inexpensive and highly portable devices that have the potential to significantly expand diabetic retinopathy (DR) screening, allowing a much broader population to be evaluated. However, it is essential to evaluate if these devices can accurately identify vision-threatening macular diseases if DR screening programs will rely on these instruments. Thus, the purpose of this study was to evaluate the detection of diabetic macular pathology using monoscopic macula-centered images using mydriatic handheld retinal imaging compared with spectral domain optical coherence tomography (SDOCT). Methods: Mydriatic 40°–60° macula-centered images taken with 3 handheld retinal imaging devices (Aurora [AU], SmartScope [SS], RetinaVue 700 [RV]) were compared with the Cirrus 6000 SDOCT taken during the same visit. Images were evaluated for the presence of diabetic macular edema (DME) on monoscopic fundus photographs adapted from Early Treatment Diabetic Retinopathy Study (ETDRS) definitions (no DME, noncenter-involved DME [non-ciDME], and center-involved DME [ciDME]). Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each device with SDOCT as gold standard. Results: Severity by ETDRS photos: no DR 33.3%, mild NPDR 20.4%, moderate 14.2%, severe 11.6%, proliferative 20.4%, and ungradable for DR 0%; no DME 83.1%, non-ciDME 4.9%, ciDME 12.0%, and ungradable for DME 0%. Gradable images by SDOCT (N = 217, 96.4%) showed no DME in 75.6%, non-ciDME in 9.8%, and ciDME in 11.1%. The ungradable rate for images (poor visualization in >50% of the macula) was AU: 0.9%, SS: 4.4%, and RV: 6.2%. For DME, sensitivity and specificity were similar across devices (0.5–0.64, 0.93–0.97). For nondiabetic macular pathology (ERM, pigment epithelial detachment, traction retinal detachment) across all devices, sensitivity was low to moderate (0.2–0.5) but highly specific (0.93–1.00). Conclusions: Compared to SDOCT, handheld macular imaging attained high specificity but low sensitivity in identifying macular pathology. This suggests the importance of SDOCT evaluation for patients suspected to have DME on fundus photography, leading to more appropriate referral refinement. [ABSTRACT FROM AUTHOR]

Background: The benefits of physical activity are well established, yet large numbers of people are not sufficiently active to gain health benefits. Certain population groups are less physically active than others, including older women from areas of high economic deprivation. The Well!Bingo project was established with the aim of engaging such women in the development of a health promotion intervention in a bingo club. This paper reports on the assessment of health status, physical activity and sedentary behaviour of women attending a bingo club in central Scotland, UK as part of the Well!Bingo project.Methods: Women attending the bingo club were invited to provide information on demographic characteristics, and self-reported physical activity and sedentary behaviour via a self-complete questionnaire as part of a cross-sectional study (n = 151). A sub-sample (n = 29) wore an accelerometer for an average of 5.7 ± 1.4 days. Differences between younger (under 60 years) and older adults (60 years and over) were assessed using a chi-square test for categorical data and the independent samples t-test was used to assess continuous data (p < 0.05).Results: The mean age was 56.5 ± 17.7 years, with 57% living in areas of high deprivation (Scottish Index of Multiple Deprivation quintile one and two). Sixty-three percent of women (n = 87) reported they were meeting physical activity guidelines. However, objective accelerometer data showed that, on average, only 18.1 ± 17.3 min a day were spent in moderate to vigorous physical activity. Most accelerometer wear time was spent sedentary (9.6 ± 1.7 h). For both self-report and accelerometer data, older women were significantly less active and more sedentary than younger women. On average, older women spent 1.8 h more than younger women in sedentary activities per day, and took part in 21 min less moderate to vigorous physical activity (9.4 mins per day).Conclusion: The findings of this study suggest that bingo clubs are settings that attract women from areas of high deprivation and older women in bingo clubs in particular would benefit from interventions to target their physical activity and sedentary behaviour. Bingo clubs may therefore be potential intervention settings in which to influence these behaviours. [ABSTRACT FROM AUTHOR]

Background: Our aim was to use participatory methods to investigate the feasibility and acceptability of using Bingo clubs for the design and delivery of an evidence-based physical activity and/or healthy eating intervention to socio-economically disadvantaged women. This paper describes the participatory process that has resulted in a physical activity intervention for women aged >55 years, ready for pilot-testing in a Bingo club setting.Methods: Studies using different quantitative and qualitative approaches were conducted among customers and staff of a Bingo club in a city of 85,000 inhabitants in central Scotland. These were designed to take the views of different stakeholders into account, with a view to enhancing uptake, engagement and effectiveness with any proposed intervention.Results: Sixteen relevant studies were identified in a literature review that generated ideas for intervention components. A questionnaire completed by 151 women in the Bingo club showed that almost half (47 %) aged >55 years were not meeting physical activity guidelines; evidence backed up by accelerometer data from 29 women. Discussions in six focus groups attended by 27 club members revealed different but overlapping motivations for attending the Bingo club (social benefits) and playing Bingo (cognitive benefits). There was some scepticism as to whether the Bingo club was an appropriate setting for an intervention, and a dietary intervention was not favoured. It was clear that any planned intervention needed to utilise the social motivation and habitual nature of attendance at the Bingo club, without taking women away from Bingo games. These results were taken forward to a 5-h long participative workshop with 27 stakeholders (including 19 Bingo players). Intervention design (form and content) was then finalised during two round table research team meetings.Conclusions: It was possible to access and engage with women living in areas of socio-economic disadvantage through a Bingo club setting. A physical activity intervention for women >55 years is realistic for recruitment, will address the needs of potential recipients in the Bingo club, appears to be feasible and acceptable to club members and staff, and has been designed with their input. A pilot study is underway, investigating recruitment, retention and feasibility of delivery. [ABSTRACT FROM AUTHOR]

This study evaluates the impact of farmer field schools (FFS) on knowledge, insecticide use, and yield using a nonconsecutive, two-year panel data that allows one to control for nonrandom selection. Regression analysis using a difference-in-difference approach indicates FFS training did not result in statistically significant impacts on insecticide use and yield over the period of time examined. However, there is some evidence that FFS had an 'initial' knowledge impact, but it was not sustained over time. Retraining FFS graduates may be an attractive option to help maintain knowledge and improve performance over time, but we do not find empirical evidence on the effectiveness of this strategy based on a small sample of retrained farmers. La présente étude examine l'impact du programme Champ-École-Paysan (CEP) (Farmer Field Schools - FFS) sur l'acquisition des connaissances, l'utilisation d'insecticides et le rendement, à l'aide de données de panel non consécutives recueillies sur une période de deux ans et permettant de maîtriser la sélection non aléatoire. Une analyse de régression utilisant la méthode de différence de différences a révélé que la formation offerte dans le cadre du programme CEP n'a pas eu d'impact statistiquement significatif sur l'utilisation d'insecticides ni sur le rendement au cours de la période visée par l'étude. Toutefois, il semble que le programme CEP a eu un impact sur l'acquisition des connaissances au début, mais que cet impact n'a pas été soutenu au fil du temps. Le recyclage des participants au programme CEP peut constituer une option intéressante pour le maintien des connaissances et l'amélioration du rendement au fil du temps. Par contre, l'étude d'un petit échantillon de producteurs recyclés n'a pas fourni de preuve empirique permettant de croire à l'efficacité de cette stratégie. [ABSTRACT FROM AUTHOR]

Because habitat loss due to urbanization is a primary threat to biodiversity, and land-use decisions in urbanizing areas are mainly made at the local level, land-use planning by municipal planning departments has a potentially important—but largely unrealized—role in conserving biodiversity. To understand planners’ perspectives on the factors that facilitate and impede biodiversity conservation in local planning, we interviewed directors of 17 municipal planning departments in the greater Seattle (Washington, U.S.A.) area and compared responses of planners from similar-sized jurisdictions that were “high” and “low performing” with respect to incorporation of biodiversity conservation in local planning. Planners from low-performing jurisdictions regarded mandates from higher governmental levels as the primary drivers of biodiversity conservation, whereas those from high-performing jurisdictions regarded community values as the main drivers, although they also indicated that mandates were important. Biodiversity conservation was associated with presence of local conservation flagship elements (e.g., salmonids) and human-centered benefits of biodiversity conservation (e.g., quality of life). Planners from high- and low-performing jurisdictions favored different planning mechanisms for biodiversity conservation, perhaps reflecting differences in funding and staffing. High performers reported more collaborations with other entities on biodiversity issues. Planners’ comments indicated that the term may be problematic in the context of local planning. The action most planners recommended to increase biodiversity conservation in local planning was public education. These results suggest that to advance biodiversity conservation in local land-use planning, conservation biologists should investigate and educate the public about local conservation flagships and human benefits of local biodiversity, work to raise ecological literacy and explain biodiversity more effectively to the public, and promote collaboration on biodiversity conservation among jurisdictions and inclusion of biodiversity specialists in planning departments. [ABSTRACT FROM AUTHOR]