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Prescribing of glucose-lowering medication to adults with type 2 diabetes by severe mental illness status in Scotland:a cohort study
No full textAim We aimed to determine whether glucose-lowering medication (GLM) prescribing differs by severe mental illness (SMI) status.Materials and methods We conducted a population-based cohort study using routinely collected linked data, including people in Scotland diagnosed with type 2 diabetes between Jan 2004 and March 2022. We used Cox proportional hazards models to compare time from diabetes diagnosis to first prescription of each of metformin and insulin in people with and without a hospital admission record of SMI (schizophrenia, bipolar disorder or depression prior to diabetes diagnosis). We adjusted for age, sex, area-based socio-economic deprivation, smoking status, and baseline HbA1c and estimated glomerular filtration rate.Results Among 317,761 people with type 2 diabetes, 14,600 (4.6%) had pre-existing SMI. During median follow-up of 1.6 years, 10,859 (74%) of those with SMI and 219,823 (73%) without SMI were prescribed metformin. After accounting for confounders, people with SMI received their first metformin (HR 1.09, 95% CI: 1.07–1.11) and insulin (HR 1.24, 95% CI: 1.18–1.31) prescriptions at a faster rate than people without SMI. Body mass index (BMI) was missing in 21% of participants, but similar estimates were obtained when we additionally adjusted for BMI in analyses that only included people with BMI data. Conclusions Among people with type 2 diabetes each of metformin and insulin are prescribed sooner in people with compared to without SMI. Further research is needed to understand the reasons for this, and to investigate the implications of these differences in prescribing patterns.<br/
Middle childhood social-emotional competencies mediate the effects of school-entry literacy and numeracy skills on secondary school reading and numeracy attainment
No full textThis research examined the extent to which students' social-emotional skills during middle childhood (age ∼ 11 years) mediated longitudinal associations between literacy and numeracy skills measured at school entry (age ∼ 5 years) and early secondary school (age ∼ 12 years). Among 20,814 Australian students from the New South Wales Child Development Study, multi-level mediation analyses examined the indirect effect of Language and Cognitive skills (school-based; from Kindergarten teacher-report on the Australian Early Development Census) on reading and numeracy attainment (standardised scores from the Year 7 National Assessment Program–Literacy and Numeracy), through students' self-reported Self-Awareness and Self-Management (from the Middle Childhood Survey–Social-Emotional Learning in Year 6). Significant, partial mediation by Self-Awareness accounted for 37–40 % of the effect of early skills on later attainment, suggesting early skills may inform students' academic confidence, which then supports their achievement. Independent contributions of cognitive and social-emotional skills to achievement endorses formal teaching of both domains.</p
Mind the gap:Formal kinship care and children’s participation in decision making
No full textKinship care is a historically persistent phenomenon that has been utilised as a form of alternative care across the world for centuries. It is increasingly being considered as the first choice in national and regional policies for alternative care of children. This paper will focus upon the literature surrounding the paradoxical position that formal kinship care holds in the public and private spheres of child welfare. Considering the added complexity of conceptualisations of family and familial dynamics, the potential added barriers to children and young people’s participation in kinship care decision-making will be discussed. The position of children’s participation in kinship care decision making will be compared to other types of placements for looked after children. Theoretical constructs and frameworks including adopting an ecological approach will underpin this discussion to elucidate the relationship between children’s participation and kinship care decision-making. Broader implications will be discussed for how children’s participation may be improved for kinship care decision-making, the link between children's participation in decision-making and placement outcomes and how future research may contribute to bridging the gap between policy and practice
Changes in microcirculation variables in an acute endotoxaemic equine mode
No full textBackground: Microcirculation is the essential link between macrocirculation andcellular metabolism.Objectives: To test our hypotheses that microcirculation variables will show a heterogeneous flow pattern during experimental endotoxaemia, and that fluid therapy and noradrenaline (NA) infusion will normalise altered microcirculation variables.Study design: In vivo experimentsMethods: Six healthy adult horses were anaesthetised with dexmedetomidine, ketamine, and diazepam and were mechanically ventilated under isoflurane anaesthesia. Endotoxaemia was induced with 30 ng kg1 Escherichia coli lipopolysaccharide intravenously. One hundred and twenty minutes later fluid bolus and noradrenaline (NA) infusion were administered to producenormotension. Pulse rate (PR) and mean arterial blood pressure (MAP) were measured and microcirculation variables were obtained by side-stream darkfield technique (de Backer density (DBD), perfused de Backer density (PDBD), proportion of perfused vessels, microvascular flow index (MFI), heterogeneity index (HI)), laser Doppler flowmetry (blood flow) and white light spectrometry (tissue oxygen saturation (tSO2)) in sublingual, jejunal and genital area.Measurements were obtained at baseline, after endotoxin, at 60 and 120 min and during the normotensive phase. Data were analysed by mixed model variance analysis and Tukey–Kramer.Results: The PPV decreased significantly over time by 30% (p < 0.001) at the jejunum. MFI decreased from baseline to ET60 and from baseline to ET120 in sublingual and genital mucosa (2.9 vs. 1.4, p < 0.001 and 2.8 vs. 1.9, p < 0.01), respectively. The sublingual HI increased from baseline to ET60, ET120 and NA (0.1 vs. 0.9, p = 0.02; vs. 0.6, p = 0.01; vs. 0.3, p = 0.01), respectively. The genital HI increased from baseline to ET120 (0.2 vs. 1.1, p ≤ 0.01) and NA (0.16 vs. 0.53, p < 0.05, respectively). Moderate agreement between observers for MFI assessment was present (kappa = 0.4). The PR significantly increased, and MAP significantly decreased from baseline over time.Main limitations: The obtained data could be influenced by secretions, pressure artefacts, the experience of the examiner and the sampling location. Blood flow was not quantified and there was no control group.Conclusions: Overall, short-term experimental endotoxaemia did negatively alter MFI and HI; however, it did not alter tSO2, blood flow, DBD, PDBD or proportion of perfused vessels. Intravenous fluid therapy and NA did not restore MFI and HI to baseline values
The learnability of sign language morphology:An experimental study
No full textLinguistic features are adapted to their sociolinguistic ecologies (Lupyan & Dale, 2010). In this way, we posit that the morphological features of sign languages have evolved to be learnable and iconic, as many sign languages have a large proportion of second language learners and delayed first language learners. To test the learnability of sign language morphology, we conceptually replicate Smith (2024), teaching participants (hearing non-signers) British Sign Language (BSL) descriptions (lexical item plus classifier construction depicting the referent and movement) of scenes where animals perform movements. We test how accurately and how quickly participants perform in two conditions: a BSL condition pairing scenes with the BSL descriptions and a counter-iconic condition randomly pairing BSL descriptions to scenes. Following our pre-registered analysis, our pilot study suggests that BSL condition participants perform faster and more accurately than those in the counter-iconic condition. Data collection for our online learning study is underway
National, regional, and provincial prevalence of glaucoma in China in 2020:an updated systematic review and modelling analysis
No full textBACKGROUND: Glaucoma is the leading cause of irreversible blindness worldwide, with a significant disease burden in China. Accurate prevalence estimates are crucial for guiding public health strategies, but large-scale epidemiological investigations remain challenging due to the need for comprehensive ophthalmic assessments. Through a systematic review and modelling approach, we aimed to estimate the national, regional, and provincial prevalence of glaucoma in China in 2020.METHODS: We performed an updated systematic literature search of the China National Knowledge Infrastructure, Wanfang, the China Science and Technology Journal Database, PubMed, Embase, and MEDLINE for articles published from 19 August 2017 to 12 July 2024 that reported the prevalence of glaucoma in the general Chinese population. We also included articles from the 2017 China Glaucoma Study whose data collection period started in 2000 or later. We included articles that used optic disc examination and/or visual field assessment for diagnosis, and excluded those defining glaucoma solely by intraocular pressure measurement. We conducted age-sex splitting to enhance data availability for estimating the prevalence of primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). We applied a multi-level mixed-effects meta-regression to estimate the prevalence of POAG and PACG at national and regional levels, adjusting for age, sex and study year, while we used an associated factor-based model to derive provincial prevalence estimates. We estimated the prevalence of secondary glaucoma and congenital glaucoma through random-effects meta-analyses.RESULTS: We included 43 articles comprising 286 577 participants. We estimated that the national prevalence of POAG among those aged 20-99 years in 2020 was 0.73% (95% confidence interval (CI) = 0.51, 1.03), equivalent to 7.88 million (95% CI = 5.58, 11.13) affected individuals in the mainland of China. We estimated PACG to be 0.81% (95% CI = 0.60, 1.10), equivalent to 8.79 million (95% CI = 6.50, 11.88) affected population. The prevalence of POAG and PACG both increased with age. The POAG prevalence was higher in males than in females across 20-99 years, while the PACG prevalence was higher in females. The POAG and PACG prevalence varied by region and province; the former was the highest in northeast China (0.77%, 95% CI = 0.55, 1.09) and the lowest in west China (0.71%, 95% CI = 0.50, 1.00), whereas the latter was the highest in central China (0.87%, 95% CI = 0.64, 1.17) and the lowest in east China (0.76%, 95% CI = 0.56, 1.02). Among 31 provinces or municipalities, Shanghai had the highest POAG prevalence (0.80%, 95% CI = 0.56, 1.12) and Tibet showed the lowest (0.56%, 95% CI = 0.40, 0.80). Regarding PACG, Sichuan had the highest prevalence (0.92%, 95% CI = 0.68, 1.25), whereas Beijing exhibited the lowest (0.56%, 95% CI = 0.42, 0.76). The pooled prevalence of secondary glaucoma and congenital glaucoma was 0.22% (95% CI = 0.16, 0.29) and 0.03% (95% CI = 0.00, 0.10), respectively.CONCLUSIONS: The prevalence of glaucoma in China varied significantly across regions and provinces in our study period, highlighting the need for targeted screening programmes, early detection, and resource allocation. The modelling approach used here provides a valuable framework for estimating glaucoma prevalence in settings with limited large-scale epidemiological data.REGISTRATION: PROSPERO: CRD420251005269.</p
Sites of halal consumption:Hui and Chinese Muslim restaurants in Malaysia
No full textWhile halal has become a contentious issue in China, it remains a popular standard of consumption and a marketing trend in Malaysia. This paper aims to explore how Chinese and Hui Muslims navigate their business and religious interests, as well as articulate halalness in Malaysia. Over the past decade, there has been a rise in Chinese halal restaurants operated by Hui migrants. These restaurants serve as important sites for them to uphold their identity, preach Islam, and earn a livelihood. Many of these claim to offer “authentic Muslim cuisine from China”; therefore, this paper investigates how culinary practices are traveled and refashioned to project a unique Muslim identity from China and to cater to local tastes. At the same time, an increasing number of restaurants are run by Chinese converts. Most serve halal versions of various Chinese dishes, many originating from Southeastern China (particularly Cantonese and Fujian cuisines), with no lack of local fusions. Based on informal interviews and ethnographic fieldwork, this paper examines how and under what conditions these restaurants act as sites for culinary dakwah (Islamic preaching), identity formation, cultural interaction, and halal consumption. While most of these restaurants claim to serve halal and authentic Chinese food, there are contested ideas and processes of halalizing and authenticatin
Public redress in UK competition enforcement:A study of rationales and techniques
No full textCompetition authorities’ potential role in providing redress for victims of competition infringements has attracted growing interest in Europe. This is attributed to the perceived lack of compensation for victims and the attendant deterrent effect due to the continued shortcomings of private enforcement. The increasing use of alternative regulatory techniques in certain fields has also contributed to this discourse. This article discusses and puts forward a typology of possible public redress mechanisms, from compulsive disgorgement to voluntary redress, drawing on lessons from the USA and other fields. Public redress aligns with competition authorities’ role, helps promote access to justice, fills deterrence gaps, and cultivates a competition culture. While the article focuses on the UK and how public redress might be implemented in that jurisdiction, the analysis may also apply to European Union Member States, especially those with less developed collective proceedings regimes.</p
Podcasting comparative and international education:Reflecting, reframing, or reorienting the field?
No full textPodcasts have increased in popularity in recent years as a form of knowledge production and dissemination, but scant research has examined how academic podcasts relate to their cognate fields. This study analysed in detail one academic podcast–FreshEd–to examine its content and how it may reflect, reframe, and/or reorient the field of comparative and international education (CIE). Data were collected on 294 podcast episodes, first analysed descriptively by mapping key information about the researchers featured on each, then thematically by inductively coding their focal content. The study is significant because it (1) examines how an academic podcast reflects or reframes a field (i.e. CIE); (2) explores the possibilities for academic podcasting to reorient the types of knowledge produced, and our relationships to them; and (3) exemplifies innovative methodological avenues for analysing new forms of knowledge dissemination beyond traditional scholarly boundaries.</p
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