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Writing reflects some of the different characteristics of the language being used and of the people who are communicating. The present paper focusses on the internal written communication in international and inter-disciplinary research projects. Using a case study of an international public health research project, it argues that the authorship and the languages used in internal project communication are not neutral but help to generate or reinforce power hierarchies. Within research partnerships, language thus raises ethical issues that have so far been neglected. Current ethics guidelines often focus on interactions between scientists and participants of social research and clinical trials, with less attention paid to the interactions among the scientists themselves. Describing all the different project phases based on writing within a research project, the paper distinguishes different influences on the distribution of power that emerge through a focus on written communication. The focus of the present paper is to illuminate the issues of ethics, power and the dimensions of hierarchy, physical location and native versus non-native English speakers that arise from paying attention to such communications.

Background: Diabetes self-management education (DSME) is generally considered to be a key determinant of the treatment outcomes and related costs of diabetes mellitus. While DSME programmes generally have positive outcomes, their effects may depend on certain factors, such as the type of programmes provided and patients' level of health literacy (HL). Low HL has been associated with poorer self-management behaviours and poor medication adherence in diabetic patients, but its impact on the effects of DSME has not yet been systematically investigated. This study aimed to investigate the influence of HL on the self-reported effects of DSME programmes while taking the type of programme into consideration. Method: A total of 366 diabetic patients from nine countries completed a questionnaire measuring HL, self-management behaviours, problem perception, coping, perceived general health and well-being, before and after participating in a DSME programme. Results: DSME programmes were found to have positive effects on self-reported self-management behaviours and almost all psychological and health outcomes, regardless of HL level. Patients with high HL scored better on several diabetes outcomes than those with low HL, but all patients described benefiting from DSME. Individual and group-based programmes resulted in more positive effects on several diabetes outcomes than self-help groups, but no interaction with HL was found. Conclusion: Our findings confirm those of previous studies showing that DSME programmes have positive effects and that low HL is associated with lower diabetes outcomes but do not support the assumption that the effects of DSME programmes are influenced by the patient's HL. However, due to the limitations of this study, further investigation is necessary to support these findings and improve our understanding about the impact of HL on DSME programmes' effectiveness.

The fatty acids in the body fat of 41 British and 37 Dutch infants between birth and 1 year were determined. At birth linoleic acid contributed 1-3% of the total fatty acids of the body fat in infants in both countries. By one month its proportion in the fat of the Dutch infants was about 25% and by four months 32-37%; in the fat of the British infants it was never more than 3%. In the Dutch infants this large increase in the linoleic acid percentage was accompanied by a fall in the percentage contribution of others, particularly the saturated acids myristic, palmitic, and stearic. Infants born preterm showed changes in their fat after birth similar to those in fullterm infants. The difference between the composition of the fat of the infants in the two countries is attributed to the nature of the fat in the milk they received. Until recently most British infants who are not breast-fed have been given milks based on cow's milk with only minor modifications. For the past 10 years many Dutch infants have been given a milk in which all the cow's milk fat has been replaced by maize oil. Dutch infants also had a lower concentration of cholesterol in their serum than British infants, which was not unexpected. The results show that the triglycerides in the adipose tissue are profoundly influenced by the nature of the fat in the diet.