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3. The rise and fall of the Twelve : a study in the use of story structure in Acts

Author

Mansell, Peter William

Subjects
220, 220 Bible, 225 New Testament
Abstract

The aim of this thesis is to demonstrate the value of proper attention to ‘story structure’ in the study of Acts. The thesis works towards this aim in three stages. First, in chapters 1 and 2, the thesis develops the methodological framework of story structure which is proposed to consist of two interacting components: (top down) macro-structure which places an individual episode within the governing context of the story layers to which it contributes, and (bottom up) the way the meaning of an individual episode is shaped from and by its narrative clauses. Second, chapters 3-5 use the methodology of chapters 1-2 to support and guide a close reading of the narrative arc of the twelve apostles as Luke narrates their evolving story in Acts 1–12. This reading is focused by a question, appropriate to the narrative properties of Luke-Acts, about the goals of the Twelve (disclosed primarily in Luke 22:14-30 and Acts 1:1-12) and the steps taken by the Twelve to actualise those goals. Attention to the story structure of Acts 1–12 reveals that the narrative arc of the Twelve complies with Aristotle’s preferred ‘tragic’ shape, pivoting from initial rising success to ultimate failure around the turning point of 6:1-7, which discloses that the downfall of the Twelve is caused by their over-emphasis of the mission to Jerusalem and their ‘tragic flaw’ of hubris. Third, chapter 6 considers the implications of the methodology and application stages of chapters 1-5 for the contested debate over the restoration of the kingdom to Israel (Acts 1:6) and concludes against those like Jervell who see a completed restoration of Israel in Acts. The thesis then ends by considering implications of the research for wider exegetical issues such as the genre, plot and purpose of Acts.

Published
2017

9. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial

Author

Grisoni, Jeannie, Byrne, Carolyn, Davenport, Katy, Neoh, Sandra, Gougeon, Claire, Oldford, Carolyn, Young, Catherine, Green, Louisa, Rossi, Benedetta, Rogers, Helen, Cleave, Barbara, Strom, Michelle, Adelantado, Juan María, Isabel Chico, Ana, Tundidor, Diana, Malcolm, Janine, Henry, Kathy, Morris, Damian, Rayman, Gerry, Fowler, Duncan, Mitchell, Susan, Rosier, Josephine, Temple, Rosemary, Turner, Jeremy, Canciani, Gioia, Hewapathirana, Niranjala, Piper, Leanne, Kudirka, Anne, Watson, Margaret, Bonomo, Matteo, Pintaudi, Basilio, Bertuzzi, Federico, Daniela, Giuseppina, Mion, Elena, Lowe, Julia, Halperin, Ilana, Rogowsky, Anna, Adib, Sapida, Lindsay, Robert, Carty, David, Crawford, Isobel, Mackenzie, Fiona, McSorley, Therese, Booth, John, McInnes, Natalia, Smith, Ada, Stanton, Irene, Tazzeo, Tracy, Weisnagel, John, Mansell, Peter, Jones, Nia, Babington, Gayna, Spick, Dawn, MacDougall, Malcolm, Chilton, Sharon, Cutts, Terri, Perkins, Michelle, Scott, Eleanor, Endersby, Del, Dover, Anna, Dougherty, Frances, Johnston, Susan, Heller, Simon, Novodorsky, Peter, Hudson, Sue, Nisbet, Chloe, Ransom, Thomas, Coolen, Jill, Baxendale, Darlene, Holt, Richard, Forbes, Jane, Martin, Nicki, Walbridge, Fiona, Dunne, Fidelma, Conway, Sharon, Egan, Aoife, Kirwin, Collette, Maresh, Michael, Kearney, Gretta, Morris, Juliet, Quinn, Susan, Bilous, Rudy, Mukhtar, Rasha, Godbout, Ariane, Daigle, Sylvie, Lubina, Alexandra, Jackson, Margaret, Paul, Emma, Taylor, Julie, Houlden, Robyn, Breen, Adriana, Banerjee, Anita, Brackenridge, Anna, Briley, Annette, Reid, Anna, Singh, Claire, Newstead-Angel, Jill, Baxter, Janet, Philip, Sam, Chlost, Martyna, Murray, Lynne, Castorino, Kristin, Frase, Donna, Lou, Olivia, Pragnell, Marlon, Feig, Denice S, Donovan, Lois E, Corcoy, Rosa, Murphy, Kellie E, Amiel, Stephanie A, Hunt, Katharine F, Asztalos, Elizabeth, Barrett, Jon F R, Sanchez, J Johanna, de Leiva, Alberto, Hod, Moshe, Jovanovic, Lois, Keely, Erin, McManus, Ruth, Hutton, Eileen K, Meek, Claire L, Stewart, Zoe A, Wysocki, Tim, O'Brien, Robert, Ruedy, Katrina, Kollman, Craig, Tomlinson, George, and Murphy, Helen R

Published
2017
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10. Efficacy and safety of dapagliflozin in patients with inadequately controlled type 1 diabetes (DEPICT-1): 24 week results from a multicentre, double-blind, phase 3, randomised controlled trial

Author

Proietto, Joseph, Stranks, Stephen, Chen, Roger, O'Neal, David, Pape, Alexia, Forbes, Mark, Morbey, Claire, Luger, Anton, Hanusch, Ursula, Schnack, Christoph, Fliesser-Goerzer, Evelyn, Hoelzl, Bertram, Ebenbichler, Christoph, Prager, Rudolf, Van Gaal, Luc, Vercammen, Chris, Scheen, Andre, Mathieu, Chantal, Duyck, Francis, Nobels, Frank, Ruige, Johannes, Aggarwal, Naresh, Woo, Vincent, St-Pierre, Bruno, Dumas, Richard, Hramiak, Irene, Elliott, Thomas, Krarup Hansen, Troels, Henriksen, Jan Erik, Gram, Jeppe, Lihn, Aina, Bruun, Jens, Saltevo, Juha, Taurio, Jyrki, Strand, Jorma, Valle, Timo, Nieminen, Sakari, Pietilainen, Kirsi, Guerci, Bruno, Hadjadj, Samy, Cariou, Bertrand, Verges, Bruno, Borot, Sophie, Penfornis, Alfred, Schaum, Thomas, Tschoepe, Diethelm, Marck, Cornelia, Horacek, Thomas, Rose, Ludger, Klausmann, Gerhard, Luedemann, Joerg, Appelt, Steffi, Aigner, Ulrich, Goebel, Rolf, Behnke, Thomas, Ziegler, Anette-Gabriele, Peterfai, Eva, Kerenyi, Zsuzsanna, Oroszlan, Tamas, Kiss, Gyula G., Konyves, Laszlo, Piros, Gyorgyi, Phillip, Moshe, Mosenzon, Ofri, Shehadeh, Naim, Adawi, Faiad, Wainstein, Julio, Dotta, Francesco, Piatti, Piermarco, Genovese, Stefano, Consoli, Agostino, Di Bartolo, Paolo, Mannucci, Edoardo, Giordano, Carla, Lapolla, Annunziata, Aguilar, Carlos, Esteban, Alberto, Ruiz, Bazzoni, Ramirez, Guillermo Mondragon, Pelayo Orozco, Emilia, Alejandro, Carlos, de Alba, Stobschinski, Medina Pech, Carlos, Garza Ruiz, Jose, Sauque Reyna, Leobardo, Llamas Esperon, Guillermo, Nevarez Ruiz, Luis Alejandro, Vidrio Velazquez, Maricela, Flores Lozano, Fernando, Gonzalez Gonzalez, Jose Gerardo, Garcia-Hernandez, Pedro Alberto, Araujo-Silva, Roberto, Villeda - Espinosa, Efrain, Mistodie, Cristina, Popescu, Daniela, Constantin, Ciprian, Nicolau, Alina, Popa, Bogdan, Timar, Romulus, Serafinceanu, Cristian, Pintilei, Ella, Soto, Alfonso, Gimenez, Margarita, Merino-Torres, Juan Francisco, Morales, Cristobal, Mezquita, Pedro, Jendle, Johan, Tengmark, Bengt-Olov, Eriksson, Jan, Londahl, Magnus, Eliasson, Bjorn, Gunstone, Anthony, Heller, Simon, Darzy, Ken, Mansell, Peter, Davies, Melanie, Reed, Rory, Browne, Duncan, Courtney, Hamish, Turner, Wayne, Blagden, Mark, McCrimmon, Rory, Bergenstal, Richard, Lane, Wendy, Lucas, Kathryn, White, Alexander, Bao, Shichun, White, Judith, Jantzi, Curtis, Rasouli, Neda, Ervin, William, Lewy-Alterbaum, Lorena, Handelsman, Yehuda, Miranda-Palma, Bresta, Cleland, Alan, Fink, Raymond, Rodbard, Helena, Nakhle, Samer, Greenberg, Craig, Schorr, Alan, Bays, Harold, Simmons, Debra, Klein, Eric, Kane, Laurie, Fishman, Norman, Ipp, Eli, Garg, Satish, Bhargava, Anuj, Singh, Michelle Zaniewski, Rosenstock, Julio, Thrasher, James, Warren, Mark, Young, Laura, Aroda, Vanita, Pettus, Jeremy, Liljenquist, David, Busch, Robert, Dandona, Paresh, Wise, Jonathan, Kayne, David, Biggs, William, Hansen, Lars, Griffen, Steven C, Tschöpe, Diethelm, Thorén, Fredrik, Xu, John, and Langkilde, Anna Maria

Published
2017
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13. Who gains clinical benefit from using insulin pump therapy? A qualitative study of the perceptions and views of health professionals involved in the Relative Effectiveness of Pumps over MDI and Structured Education (REPOSE) trial

Author

Lawton, J., Kirkham, J., Rankin, D., White, D. A., Elliott, J., Jaap, A., Smithson, W. H., Heller, S., Gianfrancesco, Carla, Gordon, Valerie, Greaves, Linda, Hudson, Susan, Naylor, Valerie, Nisbet, Chloe, Taylor, Carolin, Towse, Karen, Baillie, Jane, Brown, Helen, Callaby, Karen, Davenport, Katy, Donald, Sarah, Evans, Mark, Faghahati, Leila, Hartnell, Sara, Housden, Allison, Pabla, Kalbir Kaur, Ward, Candice, Croxon, Nicola, Green, Fiona, Macdonald, Sheena, Mohammed, Muna, Steel, Vicky, Valentine, Katy, Young, Pamela, Boal, Ann, Clerkin, Patsy, Doran, Lynn, Flynn, Joanne, Gibb, Emma, Kennon, Brian, Lindsay, Robert, Peddie, Hilary, Quinn, Bernie, Shepherd, Janice, Carling, Janet, Collins, Ann, Dinning, Laura, Hammond, Peter, Hare, Christine, Lodge, Joyce, Ray, Sutapa, Brown, Debora, Farmer, Jenny, Amiel, Stephanie, Beckwith, Anita, Cox, Alison, Cheyette, Chris, Choudhary, Pratik, East, Linda, Ellul, June, Hunt, Katharine, Rogers, Helen, Shaw, Kimberley, Stothard, Ben, Diamond, Lucy, Aniello, Lindsay, Anderson, Debbie, Cockerell, Kathy, Heaney, Vida, Hutchison, Alison, Zammitt, Nicola, Babington, Gayna, Bird, Gail, Evans, Janet, Gazis, Tasso, Maude, Nicola, Mansell, Peter, Nunnick, Karen, Spick, Dawn, Fenn, Laura, Basarir, Hasan, Bradburn, Mike, Brennan, Alan, Campbell, Michael, Carr, Lucy, Chater, Tim, Cooper, Cindy, Dimairo, Munya, Dixon, Simon, Hackney, Gemma, Lee, Ellen, Papaioannou, Diana, Pemberton, Kirsty, Pollard, Daniel, Thokala, Praveen, Whatley, Emma, Barnard, Katharine, Royle, Pamela, Waugh, Norman, Thompson, Gill, Walker, Sharon, and Cowling, Pauline

Published
2016
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15. Examining [HbA.sub.1c] and quality of life in adults with type 1 diabetes: A quantitative study

Author

Jeyes, Luke, Evans, Elizabeth, Mansell, Peter, and Adams, Gary

Subjects
Type 1 diabetes -- Care and treatment -- Research, Adults -- Health aspects -- Research -- Usage, Educational programs -- Usage -- Health aspects -- Research, Quality of life -- Health aspects -- Research -- Usage, Health, Health care industry
Abstract

There has been little published research regarding the DAFNE (Dose Adjustment For Normal Eating) education programme. With the number of DAFNE centres increasing both nationally and internationally, the authors undertook [...]

Published
2009

24. Invited review: The welfare of young calves transported by road.

Author

Roadknight, Natalie, Mansell, Peter, Jongman, Ellen, Courtman, Natalie, and Fisher, Andrew

Subjects
*CALVES, *ADULTS, *FOOD transportation, *CATTLE, *AFFECT (Psychology), *ROADS, *DENSITY
Abstract

The transport of young calves is a welfare concern. Young calves aged ≤3 mo are particularly vulnerable to compromised welfare, and are at a relatively high risk of morbidity and mortality compared with adult cattle. Calves face several potential challenges to welfare during and after transport, including food and water deprivation, disease, injury, and stress from handling, social mixing, and new environments. The key risk factors identified for poor calf welfare associated with transport include long transport and fasting durations, young age at transport, poor colostral immunity, timing within the calving season, lack of bedding in trucks, and high stocking density. Maximizing calf welfare thus requires a multifaceted approach, such as minimizing transport and fasting durations, transporting at an appropriate stocking density with comfortable bedding, only transporting calves that are healthy and fit, and optimizing pre-transport calf management. More research is needed to understand the effect of transport on the mental or affective state of calves. [ABSTRACT FROM AUTHOR]

Published
2021
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25. Biochemistry and hematology reference intervals for neonatal dairy calves aged 5‐12 days.

Author

Roadknight, Natalie W., Courtman, Natalie F., Mansell, Peter D., Jongman, Ellen C., Loh, Ziyang A., and Fisher, Andrew D.

Subjects
CALVES, BIOCHEMISTRY, BLOOD cell count, HEMATOLOGY, REFERENCE values, AGE groups
Abstract

Background: Comprehensive hematology and biochemistry RIs are currently lacking in the literature for young dairy calves based on sample sizes more than 120. Young dairy calves are at a relatively high risk of poor health and welfare outcomes. They have a high risk of morbidity and mortality in the first 2 weeks of life, and many are transported and fasted during this time. For example, non‐replacement calves in Australia and New Zealand are usually 5‐12 days old when transported to abattoirs, meaning that calves of this age group are potentially at risk of both health and welfare compromise. Given these factors, sound, comprehensive, age‐specific biochemical and hematologic RIs are needed for both veterinary clinical practice and to inform research on calf health and welfare. Objectives: The aim of this study was to generate age‐specific hematology and biochemistry RIs for dairy calves aged 5‐12 days. Methods: We collected blood samples from 141 fasted, healthy dairy calves on 10 Australian farms. Reference Value Advisor software was used to calculate nonparametric RIs for multiple biochemistry and hematology variables. Results: RIs for a panel of hematology and biochemistry variables in dairy calves aged 5‐12 days old were derived. Conclusions: These RIs will be useful for clinical veterinary practice, as well as for research on dairy calf health and welfare. [ABSTRACT FROM AUTHOR]

Published
2021
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27. Risk management: Peter Mansell, a director at the National Patient Safety Agency, argues that patient safety research is improved by the involvement of the patients themselves

Author

Mansell, Peter

Subjects
Patients -- Care and treatment, Risk management -- Methods -- Reports, Company business management, Risk management, Health, Health care industry
Abstract

IF PEOPLE unconnected to the NHS were asked to estimate the number of patient safety incidents (PSIs) that occur in it each day, they would give a wide variety of [...]

Published
2007

28. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial

Author

Feig, Denice S, Donovan, Lois E, Corcoy, Rosa, Murphy, Kellie E, Amiel, Stephanie A, Hunt, Katharine F, Asztalos, Elizabeth, Barrett, Jon F R, Sanchez, J Johanna, de Leiva, Alberto, Hod, Moshe, Jovanovic, Lois, Keely, Erin, McManus, Ruth, Hutton, Eileen K, Meek, Claire L, Stewart, Zoe A, Wysocki, Tim, O'Brien, Robert, Ruedy, Katrina, Kollman, Craig, Tomlinson, George, Murphy, Helen R, Grisoni, Jeannie, Byrne, Carolyn, Davenport, Katy, Neoh, Sandra, Gougeon, Claire, Oldford, Carolyn, Young, Catherine, Green, Louisa, Rossi, Benedetta, Rogers, Helen, Cleave, Barbara, Strom, Michelle, Adelantado, Juan María, Isabel Chico, Ana, Tundidor, Diana, Malcolm, Janine, Henry, Kathy, Morris, Damian, Rayman, Gerry, Fowler, Duncan, Mitchell, Susan, Rosier, Josephine, Temple, Rosemary, Turner, Jeremy, Canciani, Gioia, Hewapathirana, Niranjala, Piper, Leanne, Kudirka, Anne, Watson, Margaret, Bonomo, Matteo, Pintaudi, Basilio, Bertuzzi, Federico, Daniela, Giuseppina, Mion, Elena, Lowe, Julia, Halperin, Ilana, Rogowsky, Anna, Adib, Sapida, Lindsay, Robert, Carty, David, Crawford, Isobel, Mackenzie, Fiona, McSorley, Therese, Booth, John, McInnes, Natalia, Smith, Ada, Stanton, Irene, Tazzeo, Tracy, Weisnagel, John, Mansell, Peter, Jones, Nia, Babington, Gayna, Spick, Dawn, MacDougall, Malcolm, Chilton, Sharon, Cutts, Terri, Perkins, Michelle, Scott, Eleanor, Endersby, Del, Dover, Anna, Dougherty, Frances, Johnston, Susan, Heller, Simon, Novodorsky, Peter, Hudson, Sue, Nisbet, Chloe, Ransom, Thomas, Coolen, Jill, Baxendale, Darlene, Holt, Richard, Forbes, Jane, Martin, Nicki, Walbridge, Fiona, Dunne, Fidelma, Conway, Sharon, Egan, Aoife, Kirwin, Collette, Maresh, Michael, Kearney, Gretta, Morris, Juliet, Quinn, Susan, Bilous, Rudy, Mukhtar, Rasha, Godbout, Ariane, Daigle, Sylvie, Lubina, Alexandra, Jackson, Margaret, Paul, Emma, Taylor, Julie, Houlden, Robyn, Breen, Adriana, Banerjee, Anita, Brackenridge, Anna, Briley, Annette, Reid, Anna, Singh, Claire, Newstead-Angel, Jill, Baxter, Janet, Philip, Sam, Chlost, Martyna, Murray, Lynne, Castorino, Kristin, Frase, Donna, Lou, Olivia, and Pragnell, Marlon

Subjects
endocrine system diseases
Abstract

Background: \ud Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes.\ud \ud Methods: \ud In this multicentre, open-label, randomised controlled trial, we recruited women aged 18–40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy. Participants were pregnant (≤13 weeks and 6 days' gestation) or planning pregnancy from 31 hospitals in Canada, England, Scotland, Spain, Italy, Ireland, and the USA. We ran two trials in parallel for pregnant participants and for participants planning pregnancy. In both trials, participants were randomly assigned to either CGM in addition to capillary glucose monitoring or capillary glucose monitoring alone. Randomisation was stratified by insulin delivery (pump or injections) and baseline glycated haemoglobin (HbA1c). The primary outcome was change in HbA1c from randomisation to 34 weeks' gestation in pregnant women and to 24 weeks or conception in women planning pregnancy, and was assessed in all randomised participants with baseline assessments. Secondary outcomes included obstetric and neonatal health outcomes, assessed with all available data without imputation. This trial is registered with ClinicalTrials.gov, number NCT01788527.\ud \ud Findings: \ud Between March 25, 2013, and March 22, 2016, we randomly assigned 325 women (215 pregnant, 110 planning pregnancy) to capillary glucose monitoring with CGM (108 pregnant and 53 planning pregnancy) or without (107 pregnant and 57 planning pregnancy). We found a small difference in HbA1c in pregnant women using CGM (mean difference −0·19%; 95% CI −0·34 to −0·03; p=0·0207). Pregnant CGM users spent more time in target (68% vs 61%; p=0·0034) and less time hyperglycaemic (27% vs 32%; p=0·0279) than did pregnant control participants, with comparable severe hypoglycaemia episodes (18 CGM and 21 control) and time spent hypoglycaemic (3% vs 4%; p=0·10). Neonatal health outcomes were significantly improved, with lower incidence of large for gestational age (odds ratio 0·51, 95% CI 0·28 to 0·90; p=0·0210), fewer neonatal intensive care admissions lasting more than 24 h (0·48; 0·26 to 0·86; p=0·0157), fewer incidences of neonatal hypoglycaemia (0·45; 0·22 to 0·89; p=0·0250), and 1-day shorter length of hospital stay (p=0·0091). We found no apparent benefit of CGM in women planning pregnancy. Adverse events occurred in 51 (48%) of CGM participants and 43 (40%) of control participants in the pregnancy trial, and in 12 (27%) of CGM participants and 21 (37%) of control participants in the planning pregnancy trial. Serious adverse events occurred in 13 (6%) participants in the pregnancy trial (eight [7%] CGM, five [5%] control) and in three (3%) participants in the planning pregnancy trial (two [4%] CGM and one [2%] control). The most common adverse events were skin reactions occurring in 49 (48%) of 103 CGM participants and eight (8%) of 104 control participants during pregnancy and in 23 (44%) of 52 CGM participants and five (9%) of 57 control participants in the planning pregnancy trial. The most common serious adverse events were gastrointestinal (nausea and vomiting in four participants during pregnancy and three participants planning pregnancy).\ud \ud Interpretation: \ud Use of CGM during pregnancy in patients with type 1 diabetes is associated with improved neonatal outcomes, which are likely to be attributed to reduced exposure to maternal hyperglycaemia. CGM should be offered to all pregnant women with type 1 diabetes using intensive insulin therapy. This study is the first to indicate potential for improvements in non-glycaemic health outcomes from CGM use.\ud \ud Funding: \ud Juvenile Diabetes Research Foundation, Canadian Clinical Trials Network, and National Institute for Health Research.

Published
2017

33. The Performance of Three Immune Assays to Assess the Serological Status of Cattle Experimentally Exposed to Mycoplasma bovis.

Author

Schibrowski, Meghan L., Barnes, Tamsin S., Wawegama, Nadeeka K., Vance, Megan E., Markham, Philip F., Mansell, Peter D., Marenda, Marc S., Kanci, Anna, Perez-Casal, José, Browning, Glenn F., Gibson, Justine S., and Mahony, Timothy J.

Subjects
SEROLOGY, MYCOPLASMA bovis, CATTLE disease prevention, ENZYME-linked immunosorbent assay, WESTERN immunoblotting
Abstract

Mycoplasma bovis is associated with several clinical syndromes of cattle. Currently, limited information is available on the sensitivity (Se) and specificity (Sp) of serological assays used for the detection of M. bovis-specific antibodies. Consequently, it is difficult to critically evaluate the outcomes of studies that use these assays. Therefore, the current study used bovine sera sourced from M. bovis exposure studies from three countries to estimate the Se and Sp of two commercial M. bovis enzyme-linked immunosorbent assays (ELISA), BIO K302 and BIO K260, and Western blotting. Western blotting had the highest Se estimate of 74% (95% confidence interval (CI): 16-98%), compared to the BIO K302: 47% (95% CI: 10-87%) and BIO K260: 28% (95% CI: 1-92%). However, for Sp, the BIO K302: 96% (95% CI: 87-99%) and the BIO K260: 100% (95% CI: 93-100%) out-performed Western blotting: 88% (95% CI: 56-98%). Western blotting was the best assay for detecting seroconversion, correctly identifying 61% (95% CI: 29-86%) of exposed animals compared to 35% for BIO K302 (95% CI: 21-54%) and 8% for BIO K260 (95% CI: 0-87%). While none of the methods assessed had high Se and Sp, the availability of these estimates will aid in the interpretation of studies that use these assays. The results of this study highlight the difficulties encountered when using serology to detect exposure to M. bovis in cattle. [ABSTRACT FROM AUTHOR]

Published
2018
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36. Fetal Growth in Diabetic Pregnancies

Author

Anblagan, Devasuda, Deshpande, Ruta, Jones, Nia, Pitiot, Alain, Costigan, Carolyn, Allcock, Kirsty, Raine-Fenning, Nick, Leach, Lopa, Bugg, George, Mansell, Peter, and Gowland, Penny A

Published
2012

37. The Effect of Maternal Diabetes on Fetal Adiposity

Author

Anblagan, Devasuda, Deshpande, Ruta, Pitiot, Alain, Costigan, Carolyn, Jones, Nia W., Bugg, George, Mansell, Peter, Raine-Fenning, Nick, Leach, Lopa, and Gowland, Penny A.

Published
2011

42. Exercise Metabolism in Nonobese Patients with Type 2 Diabetes Following the Acute Restoration of Normoglycaemia.

Author

Gaffney, Christopher J., Mansell, Peter, Stephens, Francis B., Macdonald, Ian A., and Tsintzas, Kostas

Subjects
*ENERGY metabolism, *EXERCISE physiology, *TYPE 2 diabetes
Abstract

This study investigated how acute restoration of normoglycaemia affected energy metabolism during exercise in nonobese patients with type 2 diabetes. Six subjects (mean ± SEM) aged 56.2 ± 2.7 years, with a BMI of 24.5 ± 1.5 kg/m2 and a VO2 peak of 28.7 ml/kg/min, attended the lab on two randomised occasions for a four-hour resting infusion of insulin or saline, followed by 30 minutes cycling at 50% VO2 peak. During the 4 h resting infusion, there was a greater (P<0.0001) reduction in blood glucose in insulin treatment (INS) (from 11.2 ± 0.6 to 5.6 ± 0.1 mmol/l) than in saline treatment/control (CON) (from 11.5 ± 0.7 to 8.5 ± 0.6 mmol/l). This was associated with a lower (P<0.05) resting metabolic rate in INS (3.87 ± 0.17) than in CON (4.39 ± 0.30 kJ/min). During subsequent exercise, blood glucose increased significantly in INS from 5.6 ± 0.1 at 0 min to 6.3 ± 0.3 mmol/l at 30 min (P<0.01), which was accompanied by a lower blood lactate response (P<0.05). Oxygen uptake, rates of substrate utilization, heart rate, and ratings of perceived exertion were not different between trials. Insulin-induced normoglycaemia increased blood glucose during subsequent exercise without altering overall substrate utilization. [ABSTRACT FROM AUTHOR]

Published
2017
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45. The Impact of Diabetes-Related Complications on Preference-Based Measures of Health-Related Quality of Life in Adults with Type I Diabetes.

Author

Peasgood, Tessa, Brennan, Alan, Mansell, Peter, Elliott, Jackie, Basarir, Hasan, and Kruger, Jen

Abstract

Introduction. This study estimates health-related quality of life (HRQoL) or utility decrements associated with type 1 diabetes mellitus (T1DM) using data from a UK research program on the Dose Adjustment For Normal Eating (DAFNE) education program. Methods. A wide range of data was collected from 2341 individuals who undertook a DAFNE course in 2009–2012, at baseline and for 2 subsequent years. We use fixed- and random-effects linear models to generate utility estimates for T1DM using different instruments: EQ-5D, SF-6D, and EQ-VAS. We show models with and without controls for HbA1c and depression, which may be endogenous (if, for example, there is reverse causality in operation). Results. We find strong evidence of an unobserved individual effect, suggesting the superiority of the fixed-effects model. Depression shows the greatest decrement across all the models in the preferred fixed-effects model. The fixed-effects EQ-5D model also finds a significant decrement from retinopathy, body mass index, and HbA1c (%). Estimating a decrement using the fixed-effects model is not possible for some conditions where there are few new cases. In the random-effects model, diabetic foot disease shows substantial utility decrements, yet these are not significant in the fixed-effects models. Conclusion. Utility decrements have been calculated for a wide variety of health states in T1DM that can be used in economic analyses. However, despite the large data set, the low incidence of several complications leads to uncertainty in calculating the utility weights. Depression and diabetic foot disease result in a substantial loss in HRQoL for patients with T1DM. HbA1c (%) appears to have an independent negative impact on HRQoL, although concerns remain regarding the potential endogeneity of this variable. [ABSTRACT FROM AUTHOR]

Published
2016
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49. Open Eye: 'It's the most accessible institution' Opening Up

Author

Mansell, Peter

Subjects
Radar systems, Video production companies, General interest, News, opinion and commentary, The Open University
Abstract

PETER MANSELL is chief executive of RADAR - the Royal Association for Disability and Rehabilitation. As an unskilled manual labourer, he began studying with the Open University after an accident [...]

Published
2000

50. Fish oil omega-3 fatty acids partially prevent lipid-induced insulin resistance in human skeletal muscle without limiting acylcarnitine accumulation.

Author

STEPHENS, Francis B., MENDIS, Buddhike, SHANNON, Chris E., COOPER, Scott, ORTORI, Catharine A., BARRETT, David A., MANSELL, Peter, and TSINTZAS, Kostas

Subjects
THERAPEUTIC use of omega-3 fatty acids, FISH oils, INSULIN resistance, SKELETAL muscle, CARNITINE, PYRUVATE dehydrogenase complex, PREVENTION, THERAPEUTICS
Abstract

Acylcarnitine accumulation in skeletal muscle and plasma has been observed in numerous models of mitochondrial lipid overload and insulin resistance. Fish oil n3PUFA (omega-3 polyunsaturated fatty acids) are thought to protect against lipid-induced insulin resistance. The present study tested the hypothesis that the addition of n3PUFA to an intravenous lipid emulsion would limit muscle acylcarnitine accumulation and reduce the inhibitory effect of lipid overload on insulin action. On three occasions, six healthy young men underwent a 6-h euglycaemic-hyperinsulinaemic clamp accompanied by intravenous infusion of saline (Control), 10% Intralipid® [n6PUFA (omega-6 polyunsaturated fatty acids)] or 10% Intralipid® +10% Omegaven® (2:1; n3PUFA). The decline in insulin-stimulated whole-body glucose infusion rate, muscle PDCa (pyruvate dehydrogenase complex activation) and glycogen storage associated with n6PUFA compared with Control was prevented with n3PUFA. Muscle acetyl-CoA accumulation was greater following n6PUFA compared with Control and n3PUFA, suggesting that mitochondrial lipid overload was responsible for the lower insulin action observed. Despite these favourable metabolic effects of n3PUFA, accumulation of total muscle acylcarnitine was not attenuated when compared with n6PUFA. These findings demonstrate that n3PUFA exert beneficial effects on insulin-stimulated skeletal muscle glucose storage and oxidation independently of total acylcarnitine accumulation, which does not always reflect mitochondrial lipid overload. [ABSTRACT FROM AUTHOR]

Published
2014
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