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Influence of turbulence on electric-field intensity variations in the earth’s atmosphere
No full textThe influence of turbulent mixing on the vertical profile of electric-field intensity in the atmospheric boundary layer is investigated. The effects of meteorological conditions and thermodynamic stratification on the electrical conductivity and structure of the electric field are analyzed. It is shown that the turbulent diffusion coefficient K(z), which determines the vertical transport of electric charge, can vary significantly with altitude depending on atmospheric stratification. Several models for describing K(z) are considered, including empirical and theoretically grounded approaches (the Monin–Obukhov model). Calculations based on radiosonde data from the Norderney station (WMO 10 113) for the winter and summer seasons have made it possible to trace seasonal differences in the distributions of the turbulent diffusion coefficient and electric-field intensity. Additionally, data from station 2TDJJ8J aboard the research vessel Polarstern RV, which operates near the Earth’s poles during polar summer, are analyzed. This makes it possible to compare changes in the electric field and the turbulent diffusion coefficient for high-latitude regions of both hemispheres. The similarity of exponential field decay with altitude is established, and differences indicating regional characteristics of atmospheric stratification are identified
Exploring the outcomes of community based dental interventions delivered by dental students for people experiencing homelessness: A scoping review
No full textBackground: People experiencing homelessness (PEH) have significantly poorer oral health compared to the general population, with barriers to dental care exacerbating health inequalities. Community-based dental interventions delivered by dental students offers a potential solution for improving oral health among PEH.
Objectives: This scoping review aims to map existing literature on community-based dental interventions provided by dental students to PEH and to explore the reported outcomes of these from the perspectives of PEH.
Methods: A scoping review was conducted using the PRISMA-ScR checklist. The comprehensive search was conducted across multiple databases and reference lists were hand searched. The Population, Concept, Context (PCC) framework using Joanna Briggs Institute (JBI) methodology was followed to guide the search strategy and eligibility criteria. Studies were screened against the eligibility criteria by two reviewers.
Results: Six studies met the inclusion criteria, originating from the UK, Australia, the USA, and Canada. Interventions included oral health education and clinical treatments. Thematic analysis identified two overarching themes: ‘experience of the intervention’ and ‘impact of the intervention.’ High levels of satisfaction were reported, with participants noting improved oral health knowledge and intentions to improve oral health behaviours.
Conclusions: Community-based dental interventions were well-received by PEH and led to improved oral health knowledge, oral health behaviour change and psychosocial wellbeing. The interventions fostered dignity and trust through respectful care, while also enriching dental education by promoting empathy and social accountability. Despite promising short-term outcomes, further inclusive and longitudinal research is needed to assess long-term impact and global relevance
Care within and across borders: introducing a transnational convoy of care
Get PDFAn increasingly diverse population of older people raises important challenges around how older migrants’ care needs are addressed. To deepen our understanding of migrants’ care relationships and experiences, we introduce a novel conceptual framework, ‘transnational care convoys’, which combines insights from convoys of care and transnational theories. Drawing on 77 qualitative interviews with older migrants in Spain and England, we demonstrate how the care networks (convoys) of older migrants involve the interplay of formal and informal relationships, physical and virtual co-presence, and socio-ethnic practices and relations, both across borders and within the country of settlement
Digital assessment of real-world walking in people with impaired mobility: How many hours and days are needed?
Get PDFBackground
Impaired mobility increases falls and mortality risk. However, guidelines to reliably assess real-world walking activity and gait remain undefined. We aimed to (i) determine the minimum daily wear time during waking hours (7:00–22:00) for a valid measurement day, (ii) identify the minimum number of valid days, and (iii) weekend days, to reliably assess weekly walking activity and gait parameters, and (iv) provide recommendations for reliable real-world walking assessments.
Methods
Participants with chronic obstructive pulmonary disease (n = 565), multiple sclerosis (n = 558), Parkinson’s disease (n = 543) or proximal femoral fracture (n = 487) from 10 countries were asked to wear a single wearable device on the lower back, 24 h/day for seven days, resulting in 13,191 measurement days. The Mobilise-D processing pipeline was used to obtain 24 daily walking activity and gait parameters. Minimum daily wear time was determined as the highest wear time category that did not statistically change parameter values. Intraclass correlation coefficients ≥ 0.80 determined the minimum number of valid measurement and weekend days.
Results
The minimum daily wear time varied between “no requirement” (13% of parameter-condition combinations) and > 14 h (19%), with higher requirements for walking activity than gait parameters. The minimum number of days ranged from 1 (17%) to > 7 days (6%), and was higher for parameters that are yet to be clinically validated. There was no evidence of a weekend nor health condition effect on parameter reliability.
Conclusions
For studies involving multiple walking activity and gait parameters or health conditions, expert consensus recommends a minimum of > 12 h of daily wear time across ≥ 3 days. For studies that involve specific parameters or health conditions, individual recommendations are provided within the manuscript
Carbohydrate Counting/Bolus Calculator Mobile Application Improves Time in Range in Adults with Type 1 Diabetes Subjects
Get PDFObjective: To evaluate the effectiveness and safety of a mobile application for carbohydrate counting and bolus calculation (CHOC-BC) in adults with type 1 diabetes mellitus (T1DM).
Research Design and Methods: A 12-week randomized controlled trial was conducted at King Fahad Medical City, Riyadh, Saudi Arabia. Adults with T1DM on multiple daily insulin injections and using Libre 2 glucose monitors were randomized to either CHOC-BC or conventional treatment. The primary endpoint was time in range (TIR; 70–180 mg/dL).
Results: A total of 127 participants (70 females) were included: 64 in the intervention group and 63 in the control group with a mean age of 26.56 ± 4.8 and 26.74 ± 6.52 years, respectively. After 3 months, the intervention group achieved better TIR than the control group (51.20% ± 11.61% vs. 46.17% ± 13.02%; mean difference [MD], 5.03; 95% confidence interval [CI], 0.70–9.36; P = 0.023). Application users showed a significant reduction in level 2 time above range (17.25% ± 11.61% vs. 24.10% ± 15.74%; MD, −6.85; 95% CI, −11.70 to −1.99; P = 0.006). No significant differences were observed in body weight or time below range.
Conclusions: The CHOC-BC mobile application empowered users to achieve better glycemic control while maintaining a safe profile that avoids hypoglycemia and weight gain
Use of adjunctive glycaemic agents with vascular protective properties in individuals with type 1 diabetes: Potential benefits and risks
Get PDFGlycaemic therapy in type 1 diabetes (T1D) is focused on insulin, with the majority of studies investigating different insulin preparations, delivery devices and dosing accuracy methods. While insulin deficiency is the key mechanism for hyperglycaemia in T1D, individuals with this condition can also develop insulin resistance (IR), making optimisation of glycaemia more challenging. Importantly, IR in T1D increases the risk of both microvascular and macrovascular complications; yet, it is rarely targeted in routine clinical care. In this narrative review, we briefly discuss the mechanistic pathways for diabetes complications in individuals with T1D, emphasising the adverse role of IR. We subsequently cover the use of adjunctive glycaemic therapies for improving the metabolic profile in T1D, focusing on therapies that have possible or definite cardiovascular or renal protective properties in individuals with type 2 diabetes. These include metformin and agents in the thiazolidinedione, Sodium-Glucose Cotransporter-2 inhibitor (SGLT2i) and Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RA) groups. In addition to reviewing the role of these agents in improving metabolic parameters, we address their potential vascular and renal protective effects in individuals with T1D. We suggest a pragmatic approach for using these agents in T1D, based on current knowledge of their benefits and risks, while also highlighting gaps in knowledge and areas that require further research. It is hoped that the review raises awareness of the role of adjunctive therapies in T1D and offers healthcare professionals simple guidance on using such agents for the management of high-risk individuals with T1D
Management of cardiac adverse effects of clozapine
No full textClozapine remains the only evidence-based treatment for treatment-resistant schizophrenia, supported by guidelines from the National Institute for Health and Care Excellence (NICE) and other authorities. However, clozapine is still underutilised for treatment-resistant schizophrenia, despite its proven benefits, including reduced all-cause mortality. This is attributed mainly to its association with adverse effects, including cardiac adverse effects. This review focuses on the latter, with a detailed exploration of clozapine-induced myocarditis – a potentially fatal acute hypersensitivity reaction – and cardiomyopathy, tachycardia and conduction deficits. Among other things, we discuss their pathophysiology, diagnosis and management, with signposting to international diagnostic criteria and monitoring protocols
Japan's new prime minister revives Abe's economic vision - with a twist
No full textSanae Takaichi, a hardline conservative with nationalist views, was elected as Japan’s first ever female prime minister on October 21. Known as a protege of the assassinated former Japanese prime minister, Shinzo Abe, she is assertive on defence, hawkish on China and is keen to bolster Japan’s regional role. This media article compares 'Sanaenomics' (Takaichi's economic policy) with Abenomics
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