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Anne Sophie Mathiesen,1 Ingrid Egerod,2 Tonny Jensen,1 Gudrun Kaldan,3 Henning Langberg,4 Thordis Thomsen3 1Department of Endocrinology, Abdominal Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 2Intensive Care Unit 4131, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 3Abdominal Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark; 4CopenRehab, Section of Social Medicine, Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark Abstract: Diabetes distress (DD) disproportionately affects vulnerable people with type 2 diabetes mellitus and interventions targeting this population are therefore relevant. A systematic review and meta-analysis was performed to assess the evidence for an effect of psychosocial interventions for reducing DD, and, secondly HbA1c, depression, and health-related quality of life in vulnerable people with type 2 diabetes mellitus. Vulnerability encompasses poor glycemic control (HbA1c >7.5%) and at least one additional risk factor for poor diabetes outcomes such as low educational level, comorbidity, and risky lifestyle behavior. The interventions should be theoretically founded and include cognition- or emotion-focused elements. We systematically searched four databases for articles published between January 1995 and March 2018. Eighteen studies testing a variety of psychosocial interventions in 4,066 patients were included. We adhered to the Cochrane methodology and PRISMA guidelines. Review Manager 5.3 was used for data extraction and risk of bias assessment, and Grades of Recommendation, Assessment, Development and Evaluation for assessing the quality of the evidence. Data were pooled using the fixed or random effects method as appropriate. We investigated effects of individual vs group, intensive vs brief interventions, and interventions with and without motivational interviewing in subgroup analyses. To assess the robustness of effect estimates, sensitivity analyses excluding studies with high risk of bias and attrition >20% were conducted. We found low to moderate quality evidence for a significant small effect of psychosocial interventions on DD, and very low to moderate quality evidence for no effect on HbA1c, both outcomes assessed at 3, 6, 12, and 24 months follow-up. The effect on depression was small, while there was no effect on health-related quality of life. Exploratory subgroup analyses suggested that interventions using motivational interviewing and individual interventions were associated with incremental effects on DD. Likewise, intensive interventions were associated with significant reductions in both DD and HbA1c. Keywords: diabetes distress, HbA1c, meta-analysis, psychosocial interventions, type 2 diabetes, vulnerable populations

Critique can be defined as disciplinary feedback, analysis, or assessment provided to an individual or within a group, be it a classroom or a team. At a fundamental level, it is an exchange of ideas, impressions, evaluations, opinions, reflections, judgments, speculations, or suggestions to oneself or between two or more participants in a defined context. Scholars describe critique as a signature pedagogy in many disciplines, a cornerstone of the educational experience. There has been scant critical analysis of how critique also represents a performance of power with roots in positions of authority, expertise, or assigned roles. Such power dynamics have been explored in some areas within SoTL, for example in scholarship on assessment, epistemic disobedience, social justice, feminist pedagogies, and critical race theory. However, this has not been the case generally within the scholarship on critique. To better understand the dimensions of power in the context of critique we developed a conceptual framework that can be applied at the individual level (teacher to student, student to student) as well as the systemic level (critique as a construct of cultural hegemony in a specific episteme). Drawing from theoretical and pedagogical literature in areas such as cultural studies, whiteness studies, design education, and assessment, the conceptual framework defines power in three main expressions: power as inequity, power as authority, and power as cultural hegemony. The framework can be used to identify and define power within the critique context and to also inform reflection and shift perspectives at various academic levels.

Introduction: Although direct oral anticoagulants' (DOACs) prescriptions have experienced immense growth in the last decade, the proportion of discontinuers is still common yielding an increased risk of ischemic stroke (IS) onset. Aims: We aimed to estimate the association between DOACs discontinuation and risk of IS among patients with non‐valvular atrial fibrillation (NVAF). Methods: We used data from a cohort of new DOACs users, followed patients from the first DOAC prescription date up to IS (index date) and conducted a nested case–control analysis using conditional logistic regression. Adjusted odds ratios, 95% confidence intervals were calculated for discontinuation of DOACs (current use compared with past use). The latter, subdivided among those stopping treatment 3 to 2 months and 6 and 3 months prior to index date. The effect of naïve current users against IS onset compared with non‐naïve current users was also evaluated. Results: DOACs discontinuation showed an OR of IS of 1.47 (95% CI: 1.02–2.12); estimates were 2.51 (95% CI: 1.84–3.42) for whom discontinued treatment within months 3 and 2 and 1.43 (95% CI: 0.96–2.13) for those between months 6 and 3 prior to index date. Analyzing DOACs individually, risk of IS associated with past users compared with current users: 1.98 (95% CI: 1.25–3.12) for apixaban, 1.38 (95% CI: 0.40–4.72) for edoxaban, 1.98 (95% CI: 1.24–2.65) for dabigatran and 1.87 (95% CI: 1.26–2.76) for rivaroxaban. Similar results were found when stratified by naïve and non‐naïve users. Conclusions: DOACs' discontinuation is associated with higher risk of IS, especially in the second and third months following interruption. [ABSTRACT FROM AUTHOR]

Greenstone belt dynamics are a key to understanding the formation and evolution of continental crust but the scarcity, commonly poor exposure, strong deformation, and high metamorphic grades of many Archaean supracrustal rocks preserved in greenstone belts often hinder geological insights. Exceptionally, the largely siliciclastic Palaeoarchaean (ca. 3.22 Ga) Moodies Group, uppermost unit of the Barberton Greenstone Belt (BGB) in South Africa and Eswatini, allows a detailed understanding of regional depositional processes and stratigraphic architecture due to its low degree of deformation, considerable thickness, generally good exposure, and diverse sedimentary facies. We here investigate the Powerline Road Syncline (PRS) and the adjacent Maid-of-the-Mists Syncline (MMS), two east-west-trending, tightly to isoclinally folded, locally northwardly overturned synclines in Moodies Group strata in the central BGB. The northern and southeastern margins of the PRS and the southern to southwestern margin of MMS are bounded by the bedding-parallel 24-Hour-Camp Fault. Along this fault, Moodies Group strata and stratigraphically underlying units of the Auber Villiers Formation of the upper Fig Tree Group structurally overlie lower Fig Tree strata above Onverwacht Group strata. Stratigraphic architecture and palaeocurrent analysis of Moodies Group strata in both synclines document a northeastward (depositionally downdip) facies transition from proximal fan delta conglomerates to fluvial- to coastal-plain and estuarine sandstones in which thick foresets likely represent subtidal channel fills. The overall deepening-and fining-upward trend in this sequence, corresponding to an increasing mineralogical maturity of sandstones, is partially obscured by local hydrothermal alteration which was contemporaneous with sedimentation, minor volcanism, and sill intrusion. Moodies Group conglomerates and sandstones were largely shed from the rising Onverwacht Anticline to the southwest. Lithologies and stratigraphy in the PRS-MMS region closely resemble strata of the lower Moodies Group in the Sadddleback Syncline, located nearby to the north but across the Inyoka Fault. If the 24-Hour-Camp Fault was part of a group of extensional faults accompanying the rise of the Onverwacht Anticline and of tonalitic-trondhjemitic-granodioritic plutons around the BGB margins at ca. 3 224 Ma, it would have acted as one of numerous basin-bounding normal faults during early Moodies time. This would place the deposition of Moodies Group strata in the PRS-MMS region in a supra-detachment fault environment which was subsequently tightly folded. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the impact of routine follow-up consultations versus standard of care for intensive care unit (ICU) survivors. Methods Systematic literature review from five databases (Cochrane CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL), reference lists, citation tracking, and ongoing/unpublished trials. Randomized controlled trials investigating post-ICU consultations in adults with outcomes such as quality of life (QOL), anxiety, depression, posttraumatic stress disorder (PTSD), physical ability, cognitive function, and return to work were included. Two reviewers extracted data and assessed quality independently. The mean differences, risk ratios, and 95 % confidence intervals were calculated depending on outcome measures. Results From 1544 citations, five trials were included (855 patients). The overall risk of bias was low in two trials, unclear in two trials, and high in one trial. The overall quality of evidence was low. The trials assessed follow-up interventions defined as consultations informing survivors about their ICU stay. One trial found no effect on QOL. Pooling data from two trials (n = 374) showed a protective effect on risk of new onset PTSD at 3-6 months after ICU (risk ratio 0.49, 95 % CI 0.26-0.95). There was no effect on other outcomes. Conclusions The evidence indicates that follow-up consultations might reduce symptoms of PTSD at 3-6 months after ICU discharge in ICU survivors, but without affecting QOL and other outcomes investigated. This review highlights that planning of future RCTs should aim to standardize interventions and outcome measures to allow for comparisons across studies., Author(s): J. F. Jensen [sup.1], T. Thomsen [sup.2], D. Overgaard [sup.3], M. H. Bestle [sup.4], D. Christensen [sup.4], I. Egerod [sup.5] Author Affiliations: (1) grid.5254.6, 000000010674042X, Department of Anesthesiology, Nordsjællands [...]

A randomized controlled trial [Joint Resources – Sedentary Behaviour (JR-SB) intervention] aimed to reduce sedentary behaviour and increase light-intensity physical activity in patients with rheumatoid arthritis (RA) through motivational counselling and text messages. Since a large proportion of invited patients declined to participate, this study aims to compare sociodemographic, clinical, and lifestyle factors between included patients and patients declining to participate (non-participants) in the JR-SB study and to investigate which characteristics were associated with participation. A register-based cross-sectional study was conducted. All patients invited to participate in the JR-SB study were identified in the DANBIO registry, from which patients' clinical and lifestyle data were also retrieved. Data on sociodemography and comorbidity were extracted from national registers. Differences between participants and non-participants were determined by an independent t-test or a chi-squared test. Logistic regression analyses adjusted for various confounders tested the association of patient characteristics with the likelihood of participation in the JR-SB study. A total of 467 (58%) declined participation in the JR-SB study. Non-participants were older and less educated, more were smokers, fewer performed regular physical activity, and more had comorbidity compared to participants. Regression analyses showed that a higher educational level and absence of comorbidity in particular were associated with participation in the JR-SB study. Patients with RA who are less educated and with certain types of comorbidity are less motivated to participate in a physical activity intervention. The findings may inform the recruitment process and implementation of physical activity interventions in rheumatology clinical practice. [ABSTRACT FROM AUTHOR]