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503 results on '"Speight, J"'

1. The geometry of the space of vortices on a two-sphere in the Bradlow limit

Author

Lara, R. I. Garcia and Speight, J. M.

Subjects
Mathematics - Differential Geometry, 53C80, 70S15, 35Q51
Abstract

It is proved that the normalized $L^2$ metric on the moduli space of $n$-vortices on a two-sphere, endowed with any Riemannian metric, converges uniformly in the Bradlow limit to the Fubini-Study metric. This establishes, in a rigorous setting, a longstanding informal conjecture of Baptista and Manton., Comment: 19 pages, 0 figures. Minor corrections, accepted version

Published
2022

3. The geometry of the space of BPS vortex-antivortex pairs

Author

Romão, Nuno M. and Speight, J. Martin

Subjects
Mathematics - Differential Geometry, High Energy Physics - Theory, Mathematical Physics, Mathematics - Analysis of PDEs, 53C80, 70S15, 35Q70
Abstract

The gauged sigma model with target $\mathbb{P}^1$, defined on a Riemann surface $\Sigma$, supports static solutions in which $k_+$ vortices coexist in stable equilibrium with $k_-$ antivortices. Their moduli space is a noncompact complex manifold $M_{(k_+,k_-)}(\Sigma)$ of dimension $k_++k_-$ which inherits a natural K\"ahler metric $g_{L^2}$ governing the model's low energy dynamics. This paper presents the first detailed study of $g_{L^2}$, focussing on the geometry close to the boundary divisor $D=\partial M_{(k_+,k_-)}(\Sigma)$. On $\Sigma=S^2$, rigorous estimates of $g_{L^2}$ close to $D$ are obtained which imply that $M_{(1,1)}(S^2)$ has finite volume and is geodesically incomplete. On $\Sigma=\mathbb{R}^2$, careful numerical analysis and a point-vortex formalism are used to conjecture asymptotic formulae for $g_{L^2}$ in the limits of small and large separation. All these results make use of a localization formula, expressing $g_{L^2}$ in terms of data at the (anti)vortex positions, which is established for general $M_{(k_+,k_-)}(\Sigma)$. For arbitrary compact $\Sigma$, a natural compactification of the space $M_{(k_+,k_-)}(\Sigma)$ is proposed in terms of a certain limit of gauged linear sigma models, leading to formulae for its volume and total scalar curvature. The volume formula agrees with the result established for $Vol(M_{(1,1)}(S^2))$, and allows for a detailed study of the thermodynamics of vortex-antivortex gas mixtures. It is found that the equation of state is independent of the genus of $\Sigma$, and that the entropy of mixing is always positive., Comment: 53 pages, 5 figures; final version, to appear in Commun. Math. Phys

Published
2018

4. A simple mass-splitting mechanism in the Skyrme model

Author

Speight, J. M.

Subjects
High Energy Physics - Theory
Abstract

It is shown that the addition of a single chiral symmetry breaking term to the standard omega meson variant of the nuclear Skyrme model can reproduce the proton-neutron mass difference., Comment: 8 pages, 2 figures

Published
2018
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5. Chern-Simons deformation of vortices on compact domains

Author

Flood, S. P. and Speight, J. M.

Subjects
High Energy Physics - Theory
Abstract

Existence of Maxwell-Chern-Simons-Higgs (MCSH) vortices in a Hermitian line bundle $\L$ over a general compact Riemann surface $\Sigma$ is proved by a continuation method. The solutions are proved to be smooth both spatially and as functions of the Chern-Simons deformation parameter $\kappa$, and exist for all $|\kappa|<\kappa_*$, where $\kappa_*$ depends, in principle, on the geometry of $\Sigma$, the degree $n$ of $\L$, which may be interpreted as the vortex number, and the vortex positions. A simple upper bound on $\kappa_*$, depending only on $n$ and the volume of $\Sigma$, is found. Further, it is proved that a positive {\em lower} bound on $\kappa_*$, depending on $\Sigma$ and $n$, but independent of vortex positions, exists. A detailed numerical study of rotationally equivariant vortices on round two-spheres is performed. We find that $\kappa_*$ in general does depend on vortex positions, and, for fixed $n$ and radius, tends to be larger the more evenly vortices are distributed between the North and South poles. A generalization of the MCSH model to compact K\"ahler domains $\Sigma$ of complex dimension $k\geq 1$ is formulated. The Chern-Simons term is replaced by the integral over spacetime of $A\wedge F\wedge \omega^{k-1}$, where $\omega$ is the K\"ahler form on $\Sigma$. A topological lower bound on energy is found, attained by solutions of a deformed version of the usual vortex equations on $\Sigma$. Existence, uniqueness and smoothness of vortex solutions of these generalized equations is proved, for $|\kappa|<\kappa_*$, and an upper bound on $\kappa_*$ depending only on the K\"ahler class of $\Sigma$ and the first Chern class of $\L$ is obtained., Comment: 22 pages, 3 figures

Published
2017
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6. The volume of a vortex and the Bradlow bound

Author

Adam, C., Speight, J. M., and Wereszczynski, A.

Subjects
High Energy Physics - Theory, Mathematical Physics
Abstract

We demonstrate that the geometric volume of a soliton coincides with the thermodynamical volume also for field theories with higher-dimensional vacuum manifolds (e.g., for gauged scalar field theories supporting vortices or monopoles). We apply this observation to understand Bradlow type bounds for general abelian gauge theories supporting vortices. In the case of SDiff BPS models (being examples of perfect fluid models) we show that the geometric "volume" (area) of the vortex, which is base-space independent, is exactly equal to the Bradlow volume (a minimal volume for which a BPS soliton solution exists). This can be finite for compactons or infinite for infinitely extended solitons (in flat Minkowski space-time)., Comment: Latex, 31 pages, 1 figure

Published
2017
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7. Bringing an end to diabetes stigma and discrimination: an international consensus statement on evidence and recommendations

Author

Speight, J., Holmes-Truscott, E., Garza, M., Scibilia, R., Wagner, S., Kato, A., Pedrero, V., Deschênes, S., Guzman, S.J., Joiner, K.L., Liu, Shengxin, Willaing, I., Babbott, K.M., Cleal, B., Dickinson, J.K., Halliday, J.A., Morrissey, E.C., Nefs, G.M., O'Donnell, S., Serlachius, A., Winterdijk, P., Alzubaidi, H., Arifin, B., Cambron-Kopco, L., Ana, C. Santa, Davidsen, E., Groot, Mary de, Wit, M. de, Deroze, P., Haack, S., Holt, R.I.G., Jensen, W., Khunti, K., Nielsen, K. Kragelund, Lathia, T., Lee, C.J., McNulty, B., Naranjo, D., Pearl, R.L., Prinjha, S., Puhl, R.M., Sabidi, A., Selvan, C., Sethi, J., Seyam, M., Sturt, J., Subramaniam, M., Maindal, H. Terkildsen, Valentine, V., Vallis, M., Skinner, T.C., Speight, J., Holmes-Truscott, E., Garza, M., Scibilia, R., Wagner, S., Kato, A., Pedrero, V., Deschênes, S., Guzman, S.J., Joiner, K.L., Liu, Shengxin, Willaing, I., Babbott, K.M., Cleal, B., Dickinson, J.K., Halliday, J.A., Morrissey, E.C., Nefs, G.M., O'Donnell, S., Serlachius, A., Winterdijk, P., Alzubaidi, H., Arifin, B., Cambron-Kopco, L., Ana, C. Santa, Davidsen, E., Groot, Mary de, Wit, M. de, Deroze, P., Haack, S., Holt, R.I.G., Jensen, W., Khunti, K., Nielsen, K. Kragelund, Lathia, T., Lee, C.J., McNulty, B., Naranjo, D., Pearl, R.L., Prinjha, S., Puhl, R.M., Sabidi, A., Selvan, C., Sethi, J., Seyam, M., Sturt, J., Subramaniam, M., Maindal, H. Terkildsen, Valentine, V., Vallis, M., and Skinner, T.C.

Abstract

Contains fulltext : 305057.pdf (Publisher’s version ) (Closed access), People with diabetes often encounter stigma (ie, negative social judgments, stereotypes, prejudice), which can adversely affect emotional, mental, and physical health; self-care, access to optimal health care; and social and professional opportunities. To accelerate an end to diabetes stigma and discrimination, an international multidisciplinary expert panel (n=51 members, from 18 countries) conducted rapid reviews and participated in a three-round Delphi survey process. We achieved consensus on 25 statements of evidence and 24 statements of recommendations. The consensus is that diabetes stigma is driven primarily by blame, perceptions of burden or sickness, invisibility, and fear or disgust. On average, four in five adults with diabetes experience diabetes stigma and one in five experience discrimination (ie, unfair and prejudicial treatment) due to diabetes, such as in health care, education, and employment. Diabetes stigma and discrimination are harmful, unacceptable, unethical, and counterproductive. Collective leadership is needed to proactively challenge, and bring an end to, diabetes stigma and discrimination. Consequently, we achieved unanimous consensus on a pledge to end diabetes stigma and discrimination.

Published
2024

8. A unified approach to nuclei: The BPS Skyrme Model

Author

Adam, C., Naya, C., Sanchez-Guillen, J., Speight, J. M., Vazquez, R., and Wereszczynski, A.

Subjects
High Energy Physics - Theory, Nuclear Theory
Abstract

We present a concrete model of a low energy effective field theory of QCD, the well-known Skyrme Model. Specifically, we will work with the BPS submodel in order to describe the binding energies of nuclei. This BPS Skyrme model is characterized by having a saturated bound for the energy proportional to the baryon number of the nuclei. After presenting this classical result, we will proceed with a semi-classical quantization of the coordinates of spin and isospin. Then, with the further inclusion of the Coulomb interaction as well as a small explicit breaking of the isospin symmetry, we finally calculate the binding energies of nuclei, where an excellent agreement has been found for the nuclei with high baryon number. Besides this, we also apply this model to the study of some thermodynamic properties and to neutron stars., Comment: 7 pages, 4 figures; Proceedings for the 37th International Conference on High Energy Physics (ICHEP), Valencia 2014

Published
2014

9. Ricci magnetic geodesic motion of vortices and lumps

Author

Alqahtani, L. S. and Speight, J. M.

Subjects
Mathematical Physics, High Energy Physics - Theory
Abstract

Ricci magnetic geodesic (RMG) motion in a k\"ahler manifold is the analogue of geodesic motion in the presence of a magnetic field proportional to the ricci form. It has been conjectured to model low-energy dynamics of vortex solitons in the presence of a Chern-Simons term, the k\"ahler manifold in question being the $n$-vortex moduli space. This paper presents a detailed study of RMG motion in soliton moduli spaces, focusing on the cases of hyperbolic vortices and spherical $\mathbb{C}P^1$ lumps. It is shown that RMG flow localizes on fixed point sets of groups of holomorphic isometries, but that the flow on such submanifolds does not, in general, coincide with their intrinsic RMG flow. For planar vortices, it is shown that RMG flow differs from an earlier reduced dynamics proposed by Kim and Lee, and that the latter flow is ill-defined on the vortex coincidence set. An explicit formula for the metric on the whole moduli space of hyperbolic two-vortices is computed (extending an old result of Strachan's), and RMG motion of centred two-vortices is studied in detail. Turning to lumps, the moduli space of static $n$-lumps is $Rat_n$, the space of degree $n$ rational maps, which is known to be k\"ahler and geodesically incomplete. It is proved that $Rat_1$ is, somewhat surprisingly, RMG complete (meaning that that the initial value problem for RMG motion has a global solution for all initial data). It is also proved that the submanifold of rotationally equivariant $n$-lumps, $Rat_n^{eq}$, a topologically cylindrical surface of revolution, is intrinsically RMG incomplete for $n=2$ and all $n\geq 5$, but that the extrinsic RMG flow on $Rat_2^{eq}$ (defined by the inclusion $Rat_2^{eq}\hookrightarrow Rat_2$) is complete.

Published
2014
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11. Producing a preference-based quality of LIFE measure to quantify the impact of HYPOGLYCAEMIA on people living with diabetes: A mixed-methods research protocol.

Author

Carlton, J., Powell, P., Rowen, D., Broadley, M., Pouwer, F., Speight, J., Heller, S., Gall, M.A., Rosilio, M., Child, C.J., Comins, J., McCrimmon, R.J., Galan, B.E. de, Brazier, J., Carlton, J., Powell, P., Rowen, D., Broadley, M., Pouwer, F., Speight, J., Heller, S., Gall, M.A., Rosilio, M., Child, C.J., Comins, J., McCrimmon, R.J., Galan, B.E. de, and Brazier, J.

Abstract

Item does not contain fulltext, BACKGROUND: Assessment of patient-reported outcome measures (PROMs), including quality of life (QoL), is essential in diabetes research and care. However, a recent review concluded that current hypoglycaemia-specific PROMs have limited evidence of validity, reliability and responsiveness for assessing the impact of hypoglycaemia on QoL in people living with diabetes. None of the PROMs identified could be used directly to inform the cost-effectiveness of treatments and interventions. There is a need for a new hypoglycaemia-specific QoL PROM, which can be used directly to inform economic evaluations. AIMS: This project has three aims: (a) To develop draft PROM content for measuring the impact of hypoglycaemia on QoL in adults with diabetes. (b) To refine the draft content using cognitive debriefing interviews and psychometrics. This will result in a condition-specific PROM that can be used to quantify the impact of hypoglycaemia upon QoL. (c) To generate a preference-based measure (PBM) that will enable utility values to be calculated for economic evaluation. METHODS: A mixed-methods, three-stage design is used: (a) Qualitative interviews will inform the draft PROM content. (b) Cognitive debriefing interview data will be used to refine the draft PROM content. The PROM will be administered in a large-scale survey to enable psychometric validation. Final item selection for the PROM will be informed by psychometric performance, translatability assessment and input from stakeholder groups. (c) A classification system will be generated, comprising a reduced number of items from the PROM. A valuation survey will be conducted to derive a value set for the PBM.

Published
2023

12. Effectiveness of educational and behavioural interventions for reducing fear of hypoglycaemia among adults with type 1 diabetes: Systematic review and meta-analyses.

Author

Chatwin, H., Broadley, M., Galan, B.E. de, Bazelmans, E., Speight, J., Pouwer, F., Nefs, G.M., Chatwin, H., Broadley, M., Galan, B.E. de, Bazelmans, E., Speight, J., Pouwer, F., and Nefs, G.M.

Abstract

Item does not contain fulltext, AIMS: To summarize and critically appraise evidence regarding the effectiveness of educational and/or behavioural interventions in reducing fear of hypoglycaemia among adults with type 1 diabetes. METHODS: Systematic searches of medical and psychology databases were conducted. Risk-of-bias was assessed using the Joanna Briggs Institute Critical Appraisal Tools. Data were synthesized using random-effects meta-analyses for randomized controlled trials (RCTs) and narrative synthesis for observational studies. RESULTS: Five RCTs (N = 682) and seven observational studies (N = 1519) met the inclusion criteria, reporting on behavioural, structured education and cognitive-behavioural therapy (CBT) interventions. Most studies assessed fear of hypoglycaemia using the Hypoglycaemia Fear Survey Worry (HFS-W) and Behaviour (HFS-B) subscales. Mean fear of hypoglycaemia at baseline was relatively low across studies. Meta-analyses showed a significant effect of interventions on HFS-W (SMD = -0.17, p = 0.032) but not on HFS-B scores (SMD = -0.34, p = 0.113). Across RCTs, Blood Glucose Awareness Training (BGAT) had the largest effect on HFS-W and HFS-B scores, and one CBT-based program was as effective as BGAT in reducing HFS-B scores. Observational studies showed that Dose Adjustment for Normal Eating (DAFNE) was associated with significant fear of hypoglycaemia reductions. CONCLUSIONS: Current evidence suggests that educational and behavioural interventions can reduce fear of hypoglycaemia. However, no study to date has examined these interventions among people with high fear of hypoglycaemia.

Published
2023

13. Impact of glycaemic technologies on quality of life and related outcomes in adults with type 1 diabetes: A narrative review

Author

Speight, J, Choudhary, P, Wilmot, EG, Hendrieckx, C, Forde, H, Cheung, WY, Crabtree, T, Millar, B, Traviss-Turner, G, Hill, A, Ajjan, RA, Speight, J, Choudhary, P, Wilmot, EG, Hendrieckx, C, Forde, H, Cheung, WY, Crabtree, T, Millar, B, Traviss-Turner, G, Hill, A, and Ajjan, RA

Abstract

AIMS: To explore the association between the use of glycaemic technologies and person-reported outcomes (PROs) in adults with type 1 diabetes (T1D). METHODS: We included T1D and technology publications reporting on PROs since 2014. Only randomised controlled trials and cohort studies that used validated PRO measures (PROMs) were considered. RESULTS: T1D studies reported on a broad range of validated PROMs, mainly as secondary outcome measures. Most studies examined continuous glucose monitoring (CGM), intermittently scanned CGM (isCGM), and the role of continuous subcutaneous insulin infusion (CSII), including sensor-augmented CSII and closed loop systems. Generally, studies demonstrated a positive impact of technology on hypoglycaemia-specific and diabetes-specific PROs, including reduced fear of hypoglycaemia and diabetes distress, and greater satisfaction with diabetes treatment. In contrast, generic PROMs (including measures of health/functional status, emotional well-being, depressive symptoms, and sleep quality) were less likely to demonstrate improvements associated with the use of glycaemic technologies. Several studies showed contradictory findings, which may relate to study design, population and length of follow-up. Differences in PRO findings were apparent between randomised controlled trials and cohort studies, which may be due to different populations studied and/or disparity between trial and real-world conditions. CONCLUSIONS: PROs are usually assessed as secondary outcomes in glycaemic technology studies. Hypoglycaemia-specific and diabetes-specific, but not generic, PROs show the benefits of glycaemic technologies, and deserve a more central role in future studies as well as routine clinical care.

Published
2023

14. The impact of hypoglycaemia on quality of life among adults with type 1 diabetes: Results from 'YourSAY: Hypoglycaemia'.

Author

Chatwin, H., Broadley, M., Hendrieckx, C., Carlton, J., Heller, S., Amiel, S.A., Galan, B.E. de, McCrimmon, R.J., Pedersen-Bjergaard, U., Pouwer, F., Speight, J., Chatwin, H., Broadley, M., Hendrieckx, C., Carlton, J., Heller, S., Amiel, S.A., Galan, B.E. de, McCrimmon, R.J., Pedersen-Bjergaard, U., Pouwer, F., and Speight, J.

Abstract

Contains fulltext : 300138.pdf (Publisher’s version ) (Open Access), AIMS: Research on hypoglycaemia and quality of life (QoL) has focused mostly on severe hypoglycaemia and psychological outcomes, with less known about other aspects of hypoglycaemia (e.g., self-treated episodes) and impacts on other QoL domains (e.g., relationships). Therefore, we examined the impact of all aspects of hypoglycaemia on QoL in adults with type 1 diabetes (T1DM). METHODS: Participants completed an online survey, including assessment of hypoglycaemia-specific QoL (using the 12-item Hypoglycaemia Impact Profile). Mann-Whitney U tests examined differences in hypoglycaemia-specific QoL by hypoglycaemia frequency, severity, and awareness. Hierarchical linear regression examined associations with QoL. RESULTS: Participants were 1028 adults with T1DM (M ± SD age: 47 ± 15 years; diabetes duration: 27 ± 16 years). Severe and self-treated hypoglycaemia and impaired awareness negatively impacted on overall QoL and several QoL domains, including leisure activities, physical health, ability to keep fit/be active, sleep, emotional well-being, spontaneity, independence, work/studies, and dietary freedom. Diabetes distress was most strongly associated with hypoglycaemia-specific QoL, followed by generic emotional well-being, fear of hypoglycaemia, and confidence in managing hypoglycaemia. Hypoglycaemia frequency and awareness were no longer significantly associated with QoL once psychological factors were considered. CONCLUSIONS: Hypoglycaemia negatively impacts on several QoL domains. Psychological factors supersede the effect of hypoglycaemia frequency and awareness in accounting for this negative impact., 01 november 2023

Published
2023

15. Assessing the Content Validity, Acceptability, and Feasibility of the Hypo-METRICS App: Survey and Interview Study.

Author

Søholm, U., Zaremba, N., Broadley, M., Axelsen, J.L., Divilly, P., Martine-Edith, G., Amiel, S.A., Mader, J.K., Pedersen-Bjergaard, U., McCrimmon, R.J., Renard, E., Evans, M., Galan, B.E. de, Heller, S., Hendrieckx, C., Choudhary, P., Speight, J., Pouwer, F., Søholm, U., Zaremba, N., Broadley, M., Axelsen, J.L., Divilly, P., Martine-Edith, G., Amiel, S.A., Mader, J.K., Pedersen-Bjergaard, U., McCrimmon, R.J., Renard, E., Evans, M., Galan, B.E. de, Heller, S., Hendrieckx, C., Choudhary, P., Speight, J., and Pouwer, F.

Abstract

Contains fulltext : 296933.pdf (Publisher’s version ) (Open Access), BACKGROUND: The Hypoglycaemia - MEasurement, ThResholds and ImpaCtS (Hypo-METRICS) smartphone app was developed to investigate the impact of hypoglycemia on daily functioning in adults with type 1 diabetes mellitus or insulin-treated type 2 diabetes mellitus. The app uses ecological momentary assessments, thereby minimizing recall bias and maximizing ecological validity. It was used in the Hypo-METRICS study, a European multicenter observational study wherein participants wore a blinded continuous glucose monitoring device and completed the app assessments 3 times daily for 70 days. OBJECTIVE: The 3 aims of the study were to explore the content validity of the app, the acceptability and feasibility of using the app for the duration of the Hypo-METRICS study, and suggestions for future versions of the app. METHODS: Participants who had completed the 70-day Hypo-METRICS study in the United Kingdom were invited to participate in a brief web-based survey and an interview (approximately 1h) to explore their experiences with the app during the Hypo-METRICS study. Thematic analysis of the qualitative data was conducted using both deductive and inductive methods. RESULTS: A total of 18 adults with diabetes (type 1 diabetes: n=10, 56%; 5/10, 50% female; mean age 47, SD 16 years; type 2 diabetes: n=8, 44%; 2/8, 25% female; mean age 61, SD 9 years) filled out the survey and were interviewed. In exploring content validity, participants overall described the Hypo-METRICS app as relevant, understandable, and comprehensive. In total, 3 themes were derived: hypoglycemia symptoms and experiences are idiosyncratic; it was easy to select ratings on the app, but day-to-day changes were perceived as minimal; and instructions could be improved. Participants offered suggestions for changes or additional questions and functions that could increase engagement and improve content (such as providing more examples with the questions). In exploring acceptability and feasibility, 5 themes were d

Published
2023

17. The impact of hypoglycaemia in children and adolescents with type 1 diabetes on parental quality of life and related outcomes: A systematic review

Author

Jensen, M.V., Broadley, M., Speight, J., Chatwin, H., Scope, A., Cantrell, A., Heller, S., Galan, B.E., Hendrieckx, C., and Pouwer, F.

Subjects
Parents, Quality of life, YOUNG-CHILDREN, STRESS, Adolescent, Endocrinology, Diabetes and Metabolism, Hypoglycemia/psychology, FEAR, systematic review, Internal Medicine, Humans, Prospective Studies, Child, pediatric diabetes, MOTHERS, Metabolic Disorders Radboud Institute for Molecular Life Sciences [Radboudumc 6], ADULTS, Hypoglycemia, Diabetes Mellitus, Type 1, Pediatrics, Perinatology and Child Health, Quality of Life, Diabetes Mellitus, Type 1/complications, BURDEN, EMOTIONAL DISTRESS, FATHERS, Parents/psychology
Abstract

Contains fulltext : 286877.pdf (Publisher’s version ) (Closed access) This systematic review aims to summarize and critically evaluate the current evidence regarding the impact of hypoglycaemia in children and adolescents with type 1 diabetes on parental quality of life. MEDLINE, PsycINFO, CINAHL, and the Cochrane Library were searched. Inclusion criteria were: 1) quantitative design, 2) included parents of children or adolescents with type 1 diabetes, 3) assessment of hypoglycemia in children/adolescents with type 1 diabetes, 4) assessment of parent quality of life (or related domains of life), and 5) analysis of the relationship(s) between the child's hypoglycaemia and parents' quality of life. The data were summarised in accordance with Synthesis Without Meta-Analysis Guidelines. Twelve studies were included, reporting data from 1895 parents across six countries. Ten studies were cross-sectional; two included prospective data. Evidence suggested that greater frequency and severity of hypoglycemia was associated with greater parental fear of hypoglycemia, emotional distress and family burden. Children's hypoglycaemia has a negative impact on the well-being of parents, but there is an absence of evidence regarding the impact on their overall quality of life. Research into the hypoglycaemia-specific quality of life of parents is needed to explore the impact on various areas, such as social and physical dimensions.

Published
2022

18. Nudged elastic bands and lightly bound skyrmions

Author

Speight, J. M. and Winyard, T.

Subjects
High Energy Physics - Theory, High Energy Physics - Theory (hep-th), FOS: Physical sciences
Abstract

It has become clear in recent years that the configuration space of the nuclear Skyrme model has, in each topological class, many almost degenerate local energy minima and that the number of such minima grows with the degree (or baryon number) $B$. Rigid body quantization, in which one quantizes motion on the spin-isospin orbit of just one minimum, is thus an ill-justified approximation. Instead, one should identify a (finite dimensional) moduli space of configurations containing all local minima (for a given $B$) as well as fields interpolating smoothly between them. This paper proposes a systematic computational scheme for generating such a moduli space: one constructs an energy minimizing path between each pair of local minima, then defines the moduli space to be the union of spin-isospin orbits of points on the union of these curves, a principal bundle over a graph. The energy minimizing curves may be constructed in practice using the nudged elastic band method, a standard tool in mathematical chemistry for analyzing reaction paths and computing activation energies. To illustrate, we apply this scheme to the lightly bound Skyrme model in the point particle approximation, constructing the graphs for $5\leq B\leq 10$. We go on to complete the quantization for $B=7$, in which the graph has two vertices and a single edge. The low-lying quantum states with isospin $1/2$ do not strongly localize around either of the local energy minima (the vertices). Their energies rise monotonically with spin, conflicting with experimental data for Lithium-7., Comment: 31 pages, 4 figures

Published
2023
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23. Evaluating telehealth lifestyle therapy versus telehealth psychotherapy for reducing depression in adults with COVID-1 9 related distress: the curbing anxiety and depression using lifestyle medicine (CALM) randomised non-inferiority trial protocol

Author

Young, LM, Moylan, S, John, T, Turner, M, Opie, R, Hockey, M, Saunders, D, Bruscella, C, Jacka, F, Teychenne, M, Rosenbaum, S, Banker, K, Mahoney, S, Tembo, M, Lai, J, Mundell, N, McKeon, G, Yucel, M, Speight, J, Absetz, P, Versace, V, Chatterton, ML, Berk, M, Manger, S, Mohebbi, M, Morgan, M, Chapman, A, Bennett, C, O'Shea, M, Rocks, T, Leach, S, O'Neil, A, Young, LM, Moylan, S, John, T, Turner, M, Opie, R, Hockey, M, Saunders, D, Bruscella, C, Jacka, F, Teychenne, M, Rosenbaum, S, Banker, K, Mahoney, S, Tembo, M, Lai, J, Mundell, N, McKeon, G, Yucel, M, Speight, J, Absetz, P, Versace, V, Chatterton, ML, Berk, M, Manger, S, Mohebbi, M, Morgan, M, Chapman, A, Bennett, C, O'Shea, M, Rocks, T, Leach, S, and O'Neil, A

Abstract

BACKGROUND: There is increasing recognition of the substantial burden of mental health disorders at an individual and population level, including consequent demand on mental health services. Lifestyle-based mental healthcare offers an additional approach to existing services with potential to help alleviate system burden. Despite the latest Royal Australian New Zealand College of Psychiatrists guidelines recommending that lifestyle is a 'first-line', 'non-negotiable' treatment for mood disorders, few such programs exist within clinical practice. Additionally, there are limited data to determine whether lifestyle approaches are equivalent to established treatments. Using an individually randomised group treatment design, we aim to address this gap by evaluating an integrated lifestyle program (CALM) compared to an established therapy (psychotherapy), both delivered via telehealth. It is hypothesised that the CALM program will not be inferior to psychotherapy with respect to depressive symptoms at 8 weeks. METHODS: The study is being conducted in partnership with Barwon Health's Mental Health, Drugs & Alcohol Service (Geelong, Victoria), from which 184 participants from its service and surrounding regions are being recruited. Eligible participants with elevated psychological distress are being randomised to CALM or psychotherapy. Each takes a trans-diagnostic approach, and comprises four weekly (weeks 1-4) and two fortnightly (weeks 6 and 8) 90-min, group-based sessions delivered via Zoom (digital video conferencing platform). CALM focuses on enhancing knowledge, behavioural skills and support for improving dietary and physical activity behaviours, delivered by an Accredited Exercise Physiologist and Accredited Practising Dietitian. Psychotherapy uses cognitive behavioural therapy (CBT) delivered by a Psychologist or Clinical Psychologist, and Provisional Psychologist. Data collection occurs at baseline and 8 weeks. The primary outcome is depressive symptoms (assessed

Published
2022

24. 'I need someone to believe in me and walk the journey with me': A qualitative analysis of preferred approaches to weight management discussions in clinical care among adults with type 2 diabetes

Author

Geerling, R, Gray, SM, Holmes-Truscott, E, Speight, J, Geerling, R, Gray, SM, Holmes-Truscott, E, and Speight, J

Abstract

AIMS: To explore the preferences of adults with type 2 diabetes regarding the approach to weight management discussions in clinical care. METHODS: Online survey of Australian adults with type 2 diabetes, recruited via a national diabetes registry. Three open-ended questions explored participants' experiences and ideal approach to discussing weight management with health professionals. Data subjected to inductive thematic template analysis. RESULTS: Participants were 254 adults, 58% aged 60+ years, 52% women and 35% insulin-treated. Five themes were developed to categorise participants' preferences for, as well as differing experiences of, weight management discussions: (1) collaborative, person-centred care: working together to make decisions and achieve outcomes, taking personal context into consideration; (2) balanced communication: open, clear messages encouraging action, empathy and kindness; (3) quality advice: knowledgeable health professionals, providing specific details or instructions; (4) weight management intervention: suitable modalities to address weight management and (5) system-wide support: referral and access to appropriate multi-disciplinary care. CONCLUSIONS: Participants expressed preferences for discussing weight management in collaborative, person-centred consultations, with quality advice and personalised interventions across the health system, delivered with empathy. By adopting these recommendations, health professionals may build constructive partnerships with adults with type 2 diabetes and foster weight management.

Published
2022

25. Effect of routinely assessing and addressing depression and diabetes distress on clinical outcomes among adults with type 2 diabetes: a systematic review

Author

McMorrow, R, Hunter, B, Hendrieckx, C, Kwasnicka, D, Speight, J, Cussen, L, Ho, FCS, Emery, J, Manski-Nankervis, J-A, McMorrow, R, Hunter, B, Hendrieckx, C, Kwasnicka, D, Speight, J, Cussen, L, Ho, FCS, Emery, J, and Manski-Nankervis, J-A

Abstract

OBJECTIVES: This study examined the effect of using patient-reported outcome measures (PROMs) routinely to assess and address depressive symptoms and diabetes distress among adults with type 2 diabetes. DESIGN: A systematic review of published peer-reviewed studies. DATA SOURCES: Medline, Embase, CINAHL Complete, PsycINFO, The Cochrane Library and Cochrane Central Register of Controlled Trials were searched. ELIGIBILITY CRITERIA: Studies including adults with type 2 diabetes, published in English, from the inception of the databases to 24 February 2022 inclusive; and where the intervention included completion of a PROM of depressive symptoms and/or diabetes distress, with feedback of the responses to a healthcare professional. DATA EXTRACTION AND SYNTHESIS: Using Covidence software, screening and risk of bias assessment were conducted by two reviewers independently with any disagreements resolved by a third reviewer. RESULTS: The search identified 4512 citations, of which 163 full-text citations were assessed for eligibility, and nine studies met the inclusion criteria. Five studies involved assessment of depressive symptoms only, two studies assessed diabetes distress only, and two studies assessed both. All studies had an associated cointervention. When depressive symptoms were assessed (n=7), a statistically significant between-group difference in depressive symptoms was observed in five studies; with a clinically significant (>0.5%) between-group difference in HbA1c in two studies. When diabetes distress was assessed (n=4), one study demonstrated statistically significant difference in depressive symptoms and diabetes distress; with a clinically significant between-group difference in HbA1c observed in two studies. CONCLUSION: Studies are sparse in which PROMs are used to assess and address depressive symptoms or diabetes distress during routine clinical care of adults with type 2 diabetes. Further research is warranted to understand how to integrate PROMs into

Published
2022

26. Investigating the day-to-day impact of hypoglycaemia in adults with type 1 or type 2 diabetes: design and validation protocol of the Hypo-METRICS application.

Author

Søholm, U, Broadley, M, Zaremba, N, Divilly, P, Nefs, G, Mahmoudi, Z, de Galan, B, Pedersen-Bjergaard, U, Brennan, A, Pollard, DJ, McCrimmon, RJ, A Amiel, S, Hendrieckx, C, Speight, J, Choudhary, P, Pouwer, F, Hypo-RESOLVE Consortium, Søholm, U, Broadley, M, Zaremba, N, Divilly, P, Nefs, G, Mahmoudi, Z, de Galan, B, Pedersen-Bjergaard, U, Brennan, A, Pollard, DJ, McCrimmon, RJ, A Amiel, S, Hendrieckx, C, Speight, J, Choudhary, P, Pouwer, F, and Hypo-RESOLVE Consortium

Abstract

INTRODUCTION: Hypoglycaemia is a frequent adverse event and major barrier for achieving optimal blood glucose levels in people with type 1 or type 2 diabetes using insulin. The Hypo-RESOLVE (Hypoglycaemia-Redefining SOLutions for better liVEs) consortium aims to further our understanding of the day-to-day impact of hypoglycaemia. The Hypo-METRICS (Hypoglycaemia-MEasurement, ThResholds and ImpaCtS) application (app) is a novel app for smartphones. This app is developed as part of the Hypo-RESOLVE project, using ecological momentary assessment methods that will minimise recall bias and allow for robust investigation of the day-to-day impact of hypoglycaemia. In this paper, the development and planned psychometric analyses of the app are described. METHODS AND ANALYSIS: The three phases of development of the Hypo-METRICS app are: (1) establish a working group-comprising diabetologists, psychologists and people with diabetes-to define the problem and identify relevant areas of daily functioning; (2) develop app items, with user-testing, and implement into the app platform; and (3) plan a large-scale, multicountry study including interviews with users and psychometric validation. The app includes 7 modules (29 unique items) assessing: self-report of hypoglycaemic episodes (during the day and night, respectively), sleep quality, well-being/cognitive function, social interactions, fear of hypoglycaemia/hyperglycaemia and work/productivity. The app is designed for use within three fixed time intervals per day (morning, afternoon and evening). The first version was released mid-2020 for use (in conjunction with continuous glucose monitoring and activity tracking) in the Hypo-METRICS study; an international observational longitudinal study. As part of this study, semistructured user-experience interviews and psychometric analyses will be conducted. ETHICS AND DISSEMINATION: Use of the novel Hypo-METRICS app in a multicountry clinical study has received ethical approval in eac

Published
2022

27. Web-based intervention to reduce psychological barriers to insulin therapy among adults with non-insulin-treated type 2 diabetes: study protocol for a two-armed randomised controlled trial of 'Is insulin right for me?'

Author

Holmes-Truscott, E, Holloway, EE, Husin, HM, Furler, J, Hagger, V, Skinner, TC, Speight, J, Holmes-Truscott, E, Holloway, EE, Husin, HM, Furler, J, Hagger, V, Skinner, TC, and Speight, J

Abstract

INTRODUCTION: Psychological barriers to insulin therapy are associated with the delay of clinically indicated treatment intensification for people with type 2 diabetes (T2D), yet few evidence-based interventions exist to address these barriers. We describe the protocol for a randomised controlled trial (RCT) examining the efficacy of a novel, theoretically grounded, psychoeducational, web-based resource designed to reduce psychological barriers to insulin among adults with non-insulin treated T2D: 'Is insulin right for me?'. METHODS AND ANALYSIS: Double-blind, parallel group RCT. A target sample of N=392 participants (n=196/arm) will be randomised (1:1) to 'Is insulin right for me?' (intervention) or widely available online resources (control). Eligible participants include adults (18-75 years), residing in Australia, currently taking oral hypoglycaemic agents to manage T2D. They will be primarily recruited via invitations and reminders from the national diabetes registry (from a purposefully selected sample of N≥12 000). EXCLUSION CRITERIA: experience of self-administered injectable; previously enrolled in pilot RCT; 'very willing' to start insulin as baseline. Outcomes will be assessed via online survey at 2 weeks and 6 months. Primary outcome between-group: difference in mean negative Insulin Treatment Appraisal Scores (ITAS negative) at 2-week and 6-month follow-up. SECONDARY OUTCOMES: between-group differences in mean positive insulin appraisals (ITAS positive) and percentage difference in intention to commence insulin at follow-up time points. All data analyses will be conducted according to the intention-to-treat principle. ETHICS AND DISSEMINATION: Deakin University Human Research Ethics Committee (2020-073). Dissemination via peer-reviewed journals, conferences and a plain-language summary. TRIAL REGISTRATION NUMBER: ACTRN12621000191897; Australian and New Zealand Clinical Trials Registry.

Published
2022

29. Changes in quality of life following hypoglycaemia in adults with type 2 diabetes: A systematic review of longitudinal studies

Author

Matlock, K.A., Broadley, M., Hendrieckx, C., Clowes, M., Sutton, A., Heller, S.R., Galan, B.E. de, Pouwer, F., Speight, J., Matlock, K.A., Broadley, M., Hendrieckx, C., Clowes, M., Sutton, A., Heller, S.R., Galan, B.E. de, Pouwer, F., and Speight, J.

Abstract

Item does not contain fulltext, AIM: To conduct a systematic review of published studies reporting on the longitudinal impacts of hypoglycaemia on quality of life (QoL) in adults with type 2 diabetes. METHOD: Database searches with no restrictions by language or date were conducted in MEDLINE, Cochrane Library, CINAHL and PsycINFO. Studies were included for review if they used a longitudinal design (e.g. cohort studies, randomised controlled trials) and reported on the association between hypoglycaemia and changes over time in patient-reported outcomes related to QoL. RESULTS: In all, 20 longitudinal studies published between 1998 and 2020, representing 50,429 adults with type 2 diabetes, were selected for review. A descriptive synthesis following Synthesis Without Meta-analysis guidelines indicated that self-treated symptomatic hypoglycaemia was followed by impairments in daily functioning along with elevated symptoms of generalised anxiety, diabetes distress and fear of hypoglycaemia. Severe hypoglycaemic events were associated with reduced confidence in diabetes self-management and lower ratings of perceived health over time. Frequent hypoglycaemia was followed by reduced energy levels and diminished emotional well-being. There was insufficient evidence, however, to conclude that hypoglycaemia impacted sleep quality, depressive symptoms, general mood, social support or overall diabetes-specific QoL. CONCLUSIONS: Longitudinal evidence in this review suggests hypoglycaemia is a common occurrence among adults with type 2 diabetes that impacts key facets in the physical and psychological domains of QoL. Nonetheless, additional longitudinal research is needed-in particular, studies targeting diverse forms of hypoglycaemia, more varied facets of QoL and outcomes assessed using hypoglycaemia-specific measures.

Published
2022

30. Hypo-METRICS: Hypoglycaemia-MEasurement, ThResholds and ImpaCtS-A multi-country clinical study to define the optimal threshold and duration of sensor-detected hypoglycaemia that impact the experience of hypoglycaemia, quality of life and health economic outcomes: The study protocol

Author

Divilly, P., Zaremba, N., Mahmoudi, Z., Søholm, U., Pollard, D.J., Broadley, M., Abbink, E.J., Galan, B.E. de, Pedersen-Bjergaard, U., Renard, E., Evans, M., Speight, J., Brennan, A., McCrimmon, R.J., Müllenborn, M., Heller, S., Seibold, A., Mader, J.K., Amiel, S.A., Pouwer, F., Choudhary, P., Divilly, P., Zaremba, N., Mahmoudi, Z., Søholm, U., Pollard, D.J., Broadley, M., Abbink, E.J., Galan, B.E. de, Pedersen-Bjergaard, U., Renard, E., Evans, M., Speight, J., Brennan, A., McCrimmon, R.J., Müllenborn, M., Heller, S., Seibold, A., Mader, J.K., Amiel, S.A., Pouwer, F., and Choudhary, P.

Abstract

Item does not contain fulltext, INTRODUCTION: Hypoglycaemia is a significant burden to people living with diabetes and an impediment to achieving optimal glycaemic outcomes. The use of continuous glucose monitoring (CGM) has improved the capacity to assess duration and level of hypoglycaemia. The personal impact of sensor-detected hypoglycaemia (SDH) is unclear. Hypo-METRICS is an observational study designed to define the threshold and duration of sensor glucose that provides the optimal sensitivity and specificity for events that people living with diabetes experience as hypoglycaemia. METHODS: We will recruit 600 participants: 350 with insulin-treated type 2 diabetes, 200 with type 1 diabetes and awareness of hypoglycaemia and 50 with type 1 diabetes and impaired awareness of hypoglycaemia who have recent experience of hypoglycaemia. Participants will wear a blinded CGM device and an actigraphy monitor to differentiate awake and sleep times for 10 weeks. Participants will be asked to complete three short surveys each day using a bespoke mobile phone app, a technique known as ecological momentary assessment. Participants will also record all episodes of self-detected hypoglycaemia on the mobile app. We will use particle Markov chain Monte Carlo optimization to identify the optimal threshold and duration of SDH that have optimum sensitivity and specificity for detecting patient-reported hypoglycaemia. Key secondary objectives include measuring the impact of symptomatic and asymptomatic SDH on daily functioning and health economic outcomes. ETHICS AND DISSEMINATION: The protocol was approved by local ethical boards in all participating centres. Study results will be shared with participants, in peer-reviewed journal publications and conference presentations.

Published
2022

31. Unmet support needs relating to hypoglycaemia among adults with type 1 diabetes: Results of a multi-country web-based qualitative study

Author

Chatwin, H., Broadley, M., Hendrieckx, C., Carlton, J., Heller, S., Amiel, S.A., Galan, B.E. de, Hermanns, N., Finke-Groene, K., Speight, J., Pouwer, F., Chatwin, H., Broadley, M., Hendrieckx, C., Carlton, J., Heller, S., Amiel, S.A., Galan, B.E. de, Hermanns, N., Finke-Groene, K., Speight, J., and Pouwer, F.

Abstract

Item does not contain fulltext, OBJECTIVE: Hypoglycaemic episodes and fear of hypoglycaemia can be burdensome for adults with type 1 diabetes. This study explored support needs relating to hypoglycaemia among adults with type 1 diabetes living in Denmark, Germany, the Netherlands and the United Kingdom. RESEARCH DESIGN AND METHODS: Respondents participated in a web-based qualitative study involving four open-ended questions that asked what they wished other people understood about hypoglycaemia and what other people could do differently to support them with hypoglycaemia. Responses were analyzed using reflexive thematic analysis. RESULTS: Participants were 219 adults with type 1 diabetes (mean ± SD age 39 ± 13 years; mean ± SD diabetes duration 20 ± 14 years). They described unmet needs relating to: (1) Clinical support, involving access to new diabetes technologies, training on hypoglycaemia prevention, personalised care and psychological support; (2) Practical support, involving family and friends better supporting them with hypoglycaemia management and prevention; (3) Education for other people, involving others becoming more informed about hypoglycaemia; and (4) An appreciation of the burden, involving others recognizing the experience and impact of episodes, and the burden of living with the risk of hypoglycaemia. CONCLUSIONS: Adults with type 1 diabetes report several unmet support needs relating to hypoglycaemia. Service delivery should be person-centred and prioritise the individual's support needs. Clinical conversations are needed to identify the individual's support needs and develop tailored support plans. People with diabetes and their family members should be offered hypoglycaemia-specific education and training.

Published
2022

32. Assessing and addressing diabetes distress among adults with type 2 diabetes: An online survey of Australian general practitioners

Author

McMorrow, R, Hunter, B, Hendrieckx, C, Speight, J, Emery, J, Manski-Nankervis, J-A, McMorrow, R, Hunter, B, Hendrieckx, C, Speight, J, Emery, J, and Manski-Nankervis, J-A

Abstract

AIM: Diabetes distress is experienced by up to 36% of adults with type 2 diabetes. Australian type 2 diabetes guidelines recommend annual assessment of diabetes distress in general practice. This study explores general practitioners' knowledge, current practice, and factors influencing implementation of guidelines, including Person Reported Outcome Measure (PROM) use. METHODS: A cross-sectional online survey was disseminated via e-mail to 4776 Australian general practitioners listed on the Australasian Medical Publishing Company database. RESULTS: 264 (5%) surveys were returned. 75% indicated that general practitioners were the most appropriate professionals to assess diabetes distress. Sixteen percent reported asking about diabetes distress during type 2 diabetes consultations more than half the time, with 13% using a PROM more than half the time: 64% use the Kessler-10, and 1.9% use the Problem Areas in Diabetes (PAID) scale. While general practitioners had positive beliefs about the consequences of assessing and addressing diabetes distress, they also reported barriers in motivation, environment, and knowledge of guidelines. CONCLUSION: Most respondents endorsed general practitioners' role in assessing diabetes distress, but few ask about or assess diabetes distress in routine consultations. To support uptake of guideline recommendations for diabetes-specific PROM use, environmental factors, specifically time, need to be addressed.

Published
2022

33. Barriers to and enablers of postpartum health behaviours among women from diverse cultural backgrounds with prior gestational diabetes: A systematic review and qualitative synthesis applying the theoretical domains framework

Author

Neven, ACH, Lake, AJ, Williams, A, O'Reilly, SL, Hendrieckx, C, Morrison, M, Dunbar, JA, Speight, J, Teede, H, Boyle, JA, Neven, ACH, Lake, AJ, Williams, A, O'Reilly, SL, Hendrieckx, C, Morrison, M, Dunbar, JA, Speight, J, Teede, H, and Boyle, JA

Abstract

AIMS: Racial and ethnic disparities exist in gestational diabetes prevalence and risk of subsequent type 2 diabetes mellitus (T2DM). Postpartum engagement in healthy behaviours is recommended for prevention and early detection of T2DM, yet uptake is low among women from diverse cultural backgrounds. Greater understanding of factors impacting postpartum health behaviours is needed. Applying the Theoretical Domains Framework (TDF) and Capability, Opportunity, Motivation-Behaviour (COM-B) model, our aim was to synthesise barriers to and enablers of postpartum health behaviours among women from diverse cultural backgrounds with prior GDM and identify relevant intervention components. METHODS: Databases, reference lists and grey literature were searched from September 2017 to April 2021. Two reviewers screened articles independently against inclusion criteria and extracted data. Using an inductive-deductive model, themes were mapped to the TDF and COM-B model. RESULTS: After screening 5148 citations and 139 full texts, we included 35 studies (N = 787 participants). The main ethnicities included Asian (43%), Indigenous (15%) and African (11%). Barriers and enablers focused on Capability (e.g. knowledge), Opportunity (e.g. competing demands, social support from family, friends and healthcare professionals, culturally appropriate education and resources) and Motivation (e.g. negative emotions, perceived consequences and necessity of health behaviours, social/cultural identity). Five relevant intervention functions are identified to link the barriers and enablers to evidence-based recommendations for communications to support behaviour change. CONCLUSIONS: We provide a conceptual model to inform recommendations regarding the development of messaging and interventions to support women from diverse cultural backgrounds in engaging in healthy behaviours to reduce risk of T2DM.

Published
2022

34. The Social and Emotional Well-being of Indigenous Peoples Living With Diabetes: A Systematic Review Protocol.

Author

Speight, J, Baptista, S, Lee, C, Sher, L, Skinner, TC, Brown, A, Speight, J, Baptista, S, Lee, C, Sher, L, Skinner, TC, and Brown, A

Abstract

INTRODUCTION: Globally, Indigenous people have a greater incidence and earlier onset of diabetes than the general population and have higher documented rates of emotional distress and mental illness. This systematic review will provide a synthesis and critical appraisal of the evidence focused on the social and emotional well-being of Indigenous peoples living with diabetes, including prevalence, impact, moderators, and the efficacy of interventions. METHODS: We will search MEDLINE Complete, EMBASE, APA PsycINFO, and CINAHL Complete from inception until late April 2021. Search strategies will include keywords related to Indigenous peoples, diabetes, and social and emotional well-being. All abstracts will be rated independently by two researchers against specified inclusion criteria. Eligible studies will report social and emotional well-being data for Indigenous people with diabetes, and/or report on the efficacy of interventions designed to address social and emotional well-being in this population. For each eligible study, quality will be rated using standard checklists to appraise each study's internal validity, to be determined based on study type. Any discrepancies will be resolved through discussions and consultation with other investigators as needed. We expect to present a narrative synthesis of the evidence. DISCUSSION: The findings of the systematic review will enable greater understanding of the impact of relationships between diabetes and emotional well-being among Indigenous peoples to inform research, policy and practice. The findings will be accessible to Indigenous people affected by diabetes through a summary published in plain language on our research centre's website. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number: CRD42021246560.

Published
2022

35. Feasibility and acceptability of e-learning to upskill diabetes educators in supporting people experiencing diabetes distress: a pilot randomised controlled trial.

Author

Halliday, JA, Russell-Green, S, Hagger, V, O, E, Morris, A, Sturt, J, Speight, J, Hendrieckx, C, Halliday, JA, Russell-Green, S, Hagger, V, O, E, Morris, A, Sturt, J, Speight, J, and Hendrieckx, C

Abstract

BACKGROUND: Diabetes distress is a commonly experienced negative emotional response to the ongoing burden of diabetes. Holistic diabetes care, including attention to diabetes distress, is recommended in clinical guidelines, yet not routinely implemented. Diabetes health professionals have highlighted lack of training as a barrier to implementation of psychological care. Therefore, we developed an e-learning: 'Diabetes distress e-learning: A course for diabetes educators' to address this need. This pilot study aimed to examine the feasibility of evaluating the e-learning in a randomised controlled trial study, the acceptability of the e-learning to credentialled diabetes educators (CDEs); and preliminary evidence of its effect upon CDEs' diabetes distress-related knowledge, motivation, confidence, behavioural skills, and barriers to implementation. METHODS: A pilot, unblinded, 2-armed, parallel group randomised controlled trial. Participants were recruited during a 4-month timeframe. Eligible participants were CDEs for ≥ 1 year providing care to ≥ 10 adults with type 1 or type 2 diabetes per week. Participants were randomly allocated (1:1 computer automated) to 1 of 2 learning activities: diabetes distress e-learning (intervention) or diabetes distress chapter (active control). They had 4 weeks to access the activity. They completed online surveys at baseline, 2-week and 12-week follow-up. RESULTS: Seventy-four eligible CDEs (36 intervention, 38 active control) participated. At baseline, recognition of the clinical importance of diabetes distress was high but knowledge and confidence to provide support were low-to-moderate. Engagement with learning activities was high (intervention: 83%; active control: 92%). Fifty-five percent returned at least 1 follow-up survey. All 30 intervention participants who returned the 2-week follow-up survey deemed the e-learning high quality and relevant. Systemic barriers (e.g., financial limitations and access to mental health profess

Published
2022

36. Hypo-METRICS: Hypoglycaemia-MEasurement, ThResholds and ImpaCtS-A multi-country clinical study to define the optimal threshold and duration of sensor-detected hypoglycaemia that impact the experience of hypoglycaemia, quality of life and health economic outcomes: The study protocol

Author

Divilly, P, Zaremba, N, Mahmoudi, Z, Soholm, U, Pollard, DJ, Broadley, M, Abbink, EJ, de Galan, B, Pedersen-Bjergaard, U, Renard, E, Evans, M, Speight, J, Brennan, A, McCrimmon, RJ, Mullenborn, M, Heller, S, Seibold, A, Mader, JK, Amiel, SA, Pouwer, F, Choudhary, P, Divilly, P, Zaremba, N, Mahmoudi, Z, Soholm, U, Pollard, DJ, Broadley, M, Abbink, EJ, de Galan, B, Pedersen-Bjergaard, U, Renard, E, Evans, M, Speight, J, Brennan, A, McCrimmon, RJ, Mullenborn, M, Heller, S, Seibold, A, Mader, JK, Amiel, SA, Pouwer, F, and Choudhary, P

Abstract

INTRODUCTION: Hypoglycaemia is a significant burden to people living with diabetes and an impediment to achieving optimal glycaemic outcomes. The use of continuous glucose monitoring (CGM) has improved the capacity to assess duration and level of hypoglycaemia. The personal impact of sensor-detected hypoglycaemia (SDH) is unclear. Hypo-METRICS is an observational study designed to define the threshold and duration of sensor glucose that provides the optimal sensitivity and specificity for events that people living with diabetes experience as hypoglycaemia. METHODS: We will recruit 600 participants: 350 with insulin-treated type 2 diabetes, 200 with type 1 diabetes and awareness of hypoglycaemia and 50 with type 1 diabetes and impaired awareness of hypoglycaemia who have recent experience of hypoglycaemia. Participants will wear a blinded CGM device and an actigraphy monitor to differentiate awake and sleep times for 10 weeks. Participants will be asked to complete three short surveys each day using a bespoke mobile phone app, a technique known as ecological momentary assessment. Participants will also record all episodes of self-detected hypoglycaemia on the mobile app. We will use particle Markov chain Monte Carlo optimization to identify the optimal threshold and duration of SDH that have optimum sensitivity and specificity for detecting patient-reported hypoglycaemia. Key secondary objectives include measuring the impact of symptomatic and asymptomatic SDH on daily functioning and health economic outcomes. ETHICS AND DISSEMINATION: The protocol was approved by local ethical boards in all participating centres. Study results will be shared with participants, in peer-reviewed journal publications and conference presentations.

Published
2022

37. Personality and weight management in adults with type 2 diabetes: A systematic review.

Author

Geerling, R, Kothe, EJ, Anglim, J, Emerson, C, Holmes-Truscott, E, Speight, J, Geerling, R, Kothe, EJ, Anglim, J, Emerson, C, Holmes-Truscott, E, and Speight, J

Abstract

AIMS: Managing weight in the context of type 2 diabetes presents unique hormonal, medicinal, behavioural and psychological challenges. The relationship between weight management and personality has previously been reviewed for general and cardiovascular disease populations but is less well understood in diabetes. This systematic review investigated the relationship between personality constructs and weight management outcomes and behaviours among adults with type 2 diabetes. METHODS: Medline, PubMed, Embase, PsycINFO and SPORTDiscus databases were searched to July 2021. Eligibility: empirical quantitative studies; English language; adults with type 2 diabetes; investigation of personality-weight management association. Search terms included variants of: diabetes, physical activity, diet, body mass index (BMI), adiposity, personality constructs and validated scales. A narrative synthesis, with quality assessment, was conducted. RESULTS: Seventeen studies were identified: nine cross-sectional, six cohort and two randomised controlled trials (N=6,672 participants, range: 30-1,553). Three studies had a low risk of bias. Personality measurement varied. The Big Five and Type D personality constructs were the most common measures. Higher emotional instability (neuroticism, negative affect, anxiety, unmitigated communion and external locus of control) was negatively associated with healthy diet and physical activity, and positively associated with BMI. Conscientiousness had positive associations with healthy diet and physical activity and negative associations with BMI and anthropometric indices. CONCLUSIONS: Among adults with type 2 diabetes, evidence exists of a relationship between weight management and personality, specifically, negative emotionality and conscientiousness. Consideration of personality may be important for optimising weight management and further research is warranted. SYSTEMATIC REVIEW REGISTRATION: www.crd.york.ac.uk/prospero/, identifier CRD4201911100

Published
2022

39. Changes in attitudes to awareness of hypoglycaemia during a hypoglycaemia awareness restoration programme are associated with avoidance of further severe hypoglycaemia episodes within 24 months: the A2A in HypoCOMPaSS study

Author

Sepúlveda, E, Jacob, P, Poínhos, Rui, Carvalho, D, Selene Vicente, Smith, EL, Shaw, JAM, Speight, J, Choudhary, P, de Zoysa, N, Amiel, SA, Faculdade de Ciências da Nutrição e Alimentação, and Faculdade de Psicologia e de Ciências da Educação

Subjects
Endocrinology, Diabetes and Metabolism, Health sciences, Medical and Health sciences, Internal Medicine, Ciências médicas e da saúde, Medical and Health sciences, Ciências da Saúde, Ciências médicas e da saúde
Abstract

Aims/hypothesis The aims of this study were to assess cognitions relating to hypoglycaemia in adults with type 1 diabetes and impaired awareness of hypoglycaemia before and after the multimodal HypoCOMPaSS intervention, and to determine cognitive predictors of incomplete response (one or more severe hypoglycaemic episodes over 24 months). Methods This analysis included 91 adults with type 1 diabetes and impaired awareness of hypoglycaemia who completed the Attitudes to Awareness of Hypoglycaemia (A2A) questionnaire before, 24 weeks and 24 months after the intervention, which comprised a short psycho-educational programme with optimisation of insulin therapy and glucose monitoring. Results The age and diabetes duration of the participants were 48±12 and 29±12 years, respectively (mean±SD). At baseline, 91% reported one or more severe hypoglycaemic episodes over the preceding 12 months; this decreased to p=0.001). The attitudinal barrier ‘hyperglycaemia avoidance prioritised’ (η2p=0.250, p=0.001) decreased from baseline to 24 weeks, and this decrease was maintained at 24 months (mean±SD=5.3±0.3 vs 4.3±0.3 vs 4.0±0.3). The decrease in ‘asymptomatic hypoglycaemia normalised’ from baseline (η2p=0.113, p=0.045) was significant at 24 weeks (1.5±0.3 vs 0.8±0.2). Predictors of incomplete hypoglycaemia response (one or more further episodes of severe hypoglycaemia) were higher baseline rates of severe hypoglycaemia, higher baseline scores for ‘asymptomatic hypoglycaemia normalised’, reduced change in ‘asymptomatic hypoglycaemia normalised’ scores at 24 weeks, and lower baseline ‘hypoglycaemia concern minimised’ scores (all p Conclusions/interpretation Participation in the HypoCOMPaSS RCT was associated with improvements in hypoglycaemia-associated cognitions, with ‘hyperglycaemia avoidance prioritised’ most prevalent. Incomplete prevention of subsequent severe hypoglycaemia episodes was associated with persistence of the cognition ‘asymptomatic hypoglycaemia normalised’. Understanding and addressing cognitive barriers to hypoglycaemia avoidance is important in individuals prone to severe hypoglycaemia episodes. Clinical trials registration www.isrctn.org: ISRCTN52164803 and https://eudract.ema.europa.eu: EudraCT2009-015396-27. Graphical abstract

Published
2022

40. Changes in quality of life following hypoglycaemia in adults with type 2 diabetes: A systematic review of longitudinal studies

Author

Matlock, K.A., Broadley, M., Hendrieckx, C., Clowes, M., Sutton, A., Heller, S.R., de Galan, B.E., Pouwer, F., Speight, J., and Hypo-RESOLVE consortium

Abstract

Aim\ud \ud To conduct a systematic review of published studies reporting on the longitudinal impacts of hypoglycaemia on quality of life (QoL) in adults with type 2 diabetes.\ud \ud \ud Method\ud \ud Database searches with no restrictions by language or date were conducted in MEDLINE, Cochrane Library, CINAHL and PsycINFO. Studies were included for review if they used a longitudinal design (e.g. cohort studies, randomised controlled trials) and reported on the association between hypoglycaemia and changes over time in patient-reported outcomes related to QoL.\ud \ud \ud Results\ud \ud In all, 20 longitudinal studies published between 1998 and 2020, representing 50,429 adults with type 2 diabetes, were selected for review. A descriptive synthesis following Synthesis Without Meta-analysis guidelines indicated that self-treated symptomatic hypoglycaemia was followed by impairments in daily functioning along with elevated symptoms of generalised anxiety, diabetes distress and fear of hypoglycaemia. Severe hypoglycaemic events were associated with reduced confidence in diabetes self-management and lower ratings of perceived health over time. Frequent hypoglycaemia was followed by reduced energy levels and diminished emotional well-being. There was insufficient evidence, however, to conclude that hypoglycaemia impacted sleep quality, depressive symptoms, general mood, social support or overall diabetes-specific QoL.\ud \ud \ud Conclusions\ud \ud Longitudinal evidence in this review suggests hypoglycaemia is a common occurrence among adults with type 2 diabetes that impacts key facets in the physical and psychological domains of QoL. Nonetheless, additional longitudinal research is needed—in particular, studies targeting diverse forms of hypoglycaemia, more varied facets of QoL and outcomes assessed using hypoglycaemia-specific measures.

Published
2021

44. A comparison of the acceptability and psychometric properties of scales assessing the impact of type 1 diabetes on quality of life – Results of ‘YourSAY: Quality of Life’

Author

Holmes‐Truscott, E., Cooke, D.D., Hendrieckx, C., Coates, E.J., Heller, S.R., and Speight, J.

Abstract

Aims\ud \ud To compare the acceptability, reliability and validity of five contemporary diabetes‐specific quality of life (QoL) scales among adults with type 1 diabetes in the UK and Australia.\ud \ud \ud Methods\ud \ud dults with type 1 diabetes (UK=1139, Australia=439) completed a cross‐sectional, online survey including: ADDQoL, DCP, DIDP, DSQOLS and Diabetes QoL‐Q, presented in randomised order. After completing each scale, participants rated it for clarity, relevance, ease of completion, length, and comprehensiveness. We examined scale acceptability (scale completion and user ratings), response patterns, structure (exploratory and confirmatory factor analyses), and validity (convergent, confirmatory, divergent, and known‐groups). To assess cross‐country reproducibility, analyses conducted on the UK dataset were replicated in the Australian dataset.\ud \ud \ud Results\ud \ud Findings were largely consistent between countries. All scales were acceptable to participants: ≥90% completing all items, and ≥80% positive user ratings, except for DSQOLS’ length. Scale structure was not supported for the DCP. Overall, in terms of acceptability and psychometric evaluation, the DIDP was the strongest performing scale, while the ADDQoL and Diabetes QoL‐Q scales also performed well.\ud \ud \ud Conclusions\ud \ud These findings suggest that the recently developed brief (7‐item), neutrally‐worded DIDP scale is acceptable to adults with type 1 diabetes and has the strongest psychometric performance. However, questionnaire selection should always be considered in the context of the research aims, study design and population, as well as the wider published evidence regarding both the development and responsiveness of the scales.

Published
2021

Catalog

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