The “secret” impact of population statistics on the metrics of diabetes

The accuracy of disease metrics is dependent on the quality of population-based data. Many diseases, including diabetes, are age and sex dependant. Accurate age- and sexspecific population survey data, population estimates and projections are required to assess the scale and trends in the burden of these diseases. No assessment of the quality of population data being used in the UAE diabetes metrics has been published. We provide insight into the availability and quality of published population data, which is currently being used to inform diabetes research and health services planning in the UAE. We show the absence of credible population-based data impedes the accurate assessment of disease prevalence, incidence and trends. This means that many statements about the burden of this disease in relative and absolute terms are not robust. There has been only one study of sufficient reliability of the prevalence of diabetes in the UAE and this was undertaken in 2000. Hence the calculation and reporting of trends is problematic. Population estimates for the UAE are based on out of date data and are extremely variable. Population projections for the UAE and other Middle East countries with large expatriate labour forces are improbable. The clinical and other implications of accurate population-based metrics are wide reaching. If prevalence rates are to be used to guide public policy and infrastructure planning, then we need to use valid data, including population and population-based data. Whilst specific reference is made to diabetes, and the issues affecting the United Arab Emirates and the Gulf Cooperation Council Countries of the Middle East; the impact of inaccurate population–based metrics have application in other regions, and other diseases

Pedagogy and Culture: An Educational Initiative in Supporting UAE Nursing Graduates Prepare for a High-stakes Nurse Licensing Examination

Graduates of an Abu Dhabi transnational nursing degree struggled with the mandatory national licensing examination. Poor pass rates undermine graduate career futures and impact on the workforce capacity building contributions of the partnering transnational educational providers. This paper describes how the design and delivery of an intensive examination preparation program dramatically reversed this trend. The objectives of this educational initiative involved the design, delivery and evaluation of a program that would align with cultural learning preferences and which improve the success rates of graduates attempting the national nurse licensing examination. To achieve these objectives, the program combined a range of teaching and assessment strategies developed to reflect the specific needs of Arabic learners, build on their existing knowledge and help them engage more effectively in the learning processes required for successful performance in a high stakes examination. Analysis of data collected during program evaluation provides useful insights into the preference and experiences of nursing graduates in the UAE Emirate of Abu Dhabi. The lessons learned are applicable to Arabic learners both regionally and globally

Biosynthesis of bile acids

Cholesterol, along with a number of its derivatives and very small quantities of its precursors, is the only sterol which can be identified in extracts of mammalian tissue. Cholesterol is eliminated from the body in the form of bile acids, the degradation products of the steroid hormones and by way of excretion of neutral sterols in the faeces. The formation of the bile acids is the major quantitative pathway, . In the rat, the major bile acids which have been identified in bile are the dihydroxy acid, chenodeoxycholic acid and the trihydroxy acid, cholic acid. Small quantities of the muricholic acids (trihydroxy acids) have also been identified. There is no interconversion of chenodeoxycholic acid and cholic acid in the rat. The bile acids are excreted in bile as conjugates, mainly with taurine and are reabsorbed from the small intestine and returned to the liver in the portal blood. The re-excretion of the bile acid conjugates in bile thus establishes an enterohepatic circulation. The total biliary content of bile acid conjugates represents both those conjugates which have been reabsorbed from the small intestine and a small quantity which have been newly synthesised. Thus direct measurement of the concentration of bile acid conjugates does not provide an estimate of the bile acid synthesis rates

Establishing What Constitutes a Healthy Human Gut Microbiome: State of the Science, Regulatory Considerations, and Future Directions.

On December 17, 2018, the North American branch of the International Life Sciences Institute (ILSI North America) convened a workshop "Can We Begin to Define a Healthy Gut Microbiome Through Quantifiable Characteristics?" with >40 invited academic, government, and industry experts in Washington, DC. The workshop objectives were to 1) develop a collective expert assessment of the state of the evidence on the human gut microbiome and associated human health benefits, 2) see if there was sufficient evidence to establish measurable gut microbiome characteristics that could serve as indicators of "health," 3) identify short- and long-term research needs to fully characterize healthy gut microbiome-host relationships, and 4) publish the findings. Conclusions were as follows: 1) mechanistic links of specific changes in gut microbiome structure with function or markers of human health are not yet established; 2) it is not established if dysbiosis is a cause, consequence, or both of changes in human gut epithelial function and disease; 3) microbiome communities are highly individualized, show a high degree of interindividual variation to perturbation, and tend to be stable over years; 4) the complexity of microbiome-host interactions requires a comprehensive, multidisciplinary research agenda to elucidate relationships between gut microbiome and host health; 5) biomarkers and/or surrogate indicators of host function and pathogenic processes based on the microbiome need to be determined and validated, along with normal ranges, using approaches similar to those used to establish biomarkers and/or surrogate indicators based on host metabolic phenotypes; 6) future studies measuring responses to an exposure or intervention need to combine validated microbiome-related biomarkers and/or surrogate indicators with multiomics characterization of the microbiome; and 7) because static genetic sampling misses important short- and long-term microbiome-related dynamic changes to host health, future studies must be powered to account for inter- and intraindividual variation and should use repeated measures within individuals

Improving Response Rates to an Alumni Survey in East Africa

Feedback from students and graduates is essential to inform ongoing quality improvement in higher education. However, African universities often face implementation issues in alumni surveys, including technological barriers and difficulties in tracking graduates, particularly those from earlier cohorts and rural alumni. Innovative strategies are needed to locate alumni and obtain a good response rate across widely dispersed, rural and remote areas. This paper reports on strategies used to increase response rates in an East African online alumni survey in a context of limited computer/Internet access. The survey aimed to assess the impact of nursing graduates over a 15 year period (2001–2016). Strategies focused on locating and communicating with graduates and providing solutions to barriers associated with computer/Internet access. Better engagement with alumni was achieved using mobile technologies and social media networks. Facilitating access to online surveys by taking technology to alumni or providing hubs for online access encouraged survey participation. The strategies discussed in this study are particularly relevant for clustered or networked alumni populations (e.g. nurses) in low income and limited resource settings

Dendritic glycopolymers based on dendritic polyamine scaffolds: view on their synthetic approaches, characteristics and potential for biomedical applications

In this review we highlight the potential for biomedical applications of dendritic glycopolymers based on polyamine scaffolds. The complex interplay of the molecular characteristics of the dendritic architectures and their specific interactions with various (bio)molecules are elucidated with various examples. A special role of the individual sugar units attached to the dendritic scaffolds and their density is identified, which govern ionic and H-bond interactions, and biological targeting, but to a large extent are also responsible for the significantly reduced toxicity of the dendritic glycopolymers compared to their polyamine scaffolds. Thus, the application of dendritic glycopolymers in drug delivery systems for gene transfection but also as therapeutics in neurodegenerative diseases has great promisePublikacja w ramach programu Royal Society of Chemistry "Gold for Gold" 2014 finansowanego przez Uniwersytet Łódzk

Self- Assessed Level of Competence of Experienced Expatriate Nurses in Rural and Remote Settings

We aimed to measure the self-assessed level of competence among nurses working in the public hospitals of Al-Gharbia Region, a remote rural region of United Arab Emirates, and to explore the factors associated with the nurses’ self-perceived competency. The Nurse Competency Scale, which measures the self-assessed level of competency of nurses, has been validated in a variety of clinical settings, in facilities of various sizes, and in small and large cohorts. However, its application among an expatriate nursing workforce working in small hospitals and health facilities in remote and rural areas has not been examined. We used the Nurse Competency Scale to survey the nursing workforce in Al-Gharbia’s public hospitals in United Arab Emirates. All 435 practicing registered nurses with more than 3 months clinical experience in the network were invited to participate. Data were collected electronically and analyzed by international collaborators. Statistical analysis included analysis of variance, Kruskal–Wallis, multiple linear regression, 2 test of independence, and Cronbach’s a. Totally, 189 responses were analyzed (43.4% response rate). Overall self-assessed levels of competence were uniformly ‘‘very good’’ across all competence categories. The overall score (84.3) was higher than those found in most other studies. Frequency of use was the most outstanding variable influencing self-assessed competence. Total years of experience were the next significant variable. Some items of the scale were not yet applicable to activities in the region, particularly those relating to supervision of students. The high scores achieved by expatriate nurses in the small hospitals of Al-Gharbia reflect well on the rigor of the recruitment process, ongoing cross-training and functional competency assessment. Policies and practices aimed at recruiting experienced expatriate nurses and providing opportunities to use competencies continue to be critical in providing a quality nursing service in a rural and remote region

Experience of, awareness of and help-seeking for potential cancer symptoms in smokers and non-smokers: A cross-sectional study

Background Presenting to primary care with potential cancer symptoms is contingent on one’s ability to recognize potentially serious symptoms. We investigated differences between smokers and non-smokers in symptoms experienced, awareness and consulting of potential respiratory, head and neck cancer symptoms. Methods Smokers and non-smokers aged over 50 from Yorkshire general practice lists were sent a postal questionnaire asking about symptoms, consulting and awareness of cancer symptoms. Data were analysed using STATA14. Results Response rate after one reminder was 30.5% (1205/3954). Smoking status was associated with experience of cough (p<0.001), breathlessness (p = 0.002) and tiredness (p = 0.004) with smokers (25.8% of population) more likely than never-smokers (53.6% of population) to experience all three symptoms (cough OR = 2.56;95%CI[1.75–3.75], breathlessness OR = 2.39;95%CI[1.43–4.00], tiredness OR = 1.57;95%CI[1.12–2.19]). Smoking status was associated with awareness of breathlessness as a potential cancer symptom (p = 0.035) and consulting for cough (p = 0.011) with smokers less likely to consult than never-smokers (OR = 0.37;95% CI[0.17–0.80]). Conclusion Our findings suggest that current smokers are more likely to experience cough, breathlessness and tiredness, but are less likely to consult for cough than never-smokers. To increase cancer awareness and promote consulting among smokers, innovative interventions improving symptom recognition and empowering smokers to seek help are required

Small molecules, big targets: drug discovery faces the protein-protein interaction challenge.

Protein-protein interactions (PPIs) are of pivotal importance in the regulation of biological systems and are consequently implicated in the development of disease states. Recent work has begun to show that, with the right tools, certain classes of PPI can yield to the efforts of medicinal chemists to develop inhibitors, and the first PPI inhibitors have reached clinical development. In this Review, we describe the research leading to these breakthroughs and highlight the existence of groups of structurally related PPIs within the PPI target class. For each of these groups, we use examples of successful discovery efforts to illustrate the research strategies that have proved most useful.JS, DES and ARB thank the Wellcome Trust for funding.This is the author accepted manuscript. The final version is available from Nature Publishing Group via http://dx.doi.org/10.1038/nrd.2016.2

Diversity of Staphylococcus aureus Isolates in European Wildlife

Staphylococcus aureus is a well-known colonizer and cause of infection among animals and it has been described from numerous domestic and wild animal species. The aim of the present study was to investigate the molecular epidemiology of S. aureus in a convenience sample of European wildlife and to review what previously has been observed in the subject field. 124 S. aureus isolates were collected from wildlife in Germany, Austria and Sweden; they were characterized by DNA microarray hybridization and, for isolates with novel hybridization patterns, by multilocus sequence typing (MLST). The isolates were assigned to 29 clonal complexes and singleton sequence types (CC1, CC5, CC6, CC7, CC8, CC9, CC12, CC15, CC22, CC25, CC30, CC49, CC59, CC88, CC97, CC130, CC133, CC398, ST425, CC599, CC692, CC707, ST890, CC1956, ST2425, CC2671, ST2691, CC2767 and ST2963), some of which (ST2425, ST2691, ST2963) were not described previously. Resistance rates in wildlife strains were rather low and mecA-MRSA isolates were rare (n = 6). mecC-MRSA (n = 8) were identified from a fox, a fallow deer, hares and hedgehogs. The common cattle- associated lineages CC479 and CC705 were not detected in wildlife in the present study while, in contrast, a third common cattle lineage, CC97, was found to be common among cervids. No Staphylococcus argenteus or Staphylococcus schweitzeri-like isolates were found. Systematic studies are required to monitor the possible transmission of human- and livestock- associated S. aureus/MRSA to wildlife and vice versa as well as the possible transmission, by unprotected contact to animals. The prevalence of S. aureus/MRSA in wildlife as well as its population structures in different wildlife host species warrants further investigation