Aims/hypothesis
Inverse associations between physical activity (PA) and type 2 diabetes mellitus are well known. However, the shape of the dose–response relationship is still uncertain. This review ...synthesises results from longitudinal studies in general populations and uses non-linear models of the association between PA and incident type 2 diabetes.
Methods
A systematic literature search identified 28 prospective studies on leisure-time PA (LTPA) or total PA and risk of type 2 diabetes. PA exposures were converted into metabolic equivalent of task (MET) h/week and marginal MET (MMET) h/week, a measure only considering energy expended above resting metabolic rate. Restricted cubic splines were used to model the exposure–disease relationship.
Results
Our results suggest an overall non-linear relationship; using the cubic spline model we found a risk reduction of 26% (95% CI 20%, 31%) for type 2 diabetes among those who achieved 11.25 MET h/week (equivalent to 150 min/week of moderate activity) relative to inactive individuals. Achieving twice this amount of PA was associated with a risk reduction of 36% (95% CI 27%, 46%), with further reductions at higher doses (60 MET h/week, risk reduction of 53%). Results for the MMET h/week dose–response curve were similar for moderate intensity PA, but benefits were greater for higher intensity PA and smaller for lower intensity activity.
Conclusions/interpretation
Higher levels of LTPA were associated with substantially lower incidence of type 2 diabetes in the general population. The relationship between LTPA and type 2 diabetes was curvilinear; the greatest relative benefits are achieved at low levels of activity, but additional benefits can be realised at exposures considerably higher than those prescribed by public health recommendations.
Summary Diabetic peripheral neuropathy is a prevalent, disabling disorder. The most common manifestation is distal symmetrical polyneuropathy (DSP), but many patterns of nerve injury can occur. ...Currently, the only effective treatments are glucose control and pain management. While glucose control substantially decreases the development of neuropathy in those with type 1 diabetes, the effect is probably much smaller in those with type 2 diabetes. Evidence supports the use of specific anticonvulsants and antidepressants for pain management in patients with diabetic peripheral neuropathy. However, the lack of disease-modifying therapies for diabetic DSP makes the identification of new modifiable risk factors essential. Growing evidence supports an association between components of the metabolic syndrome, including prediabetes, and neuropathy. Studies are needed to further explore this association, which has implications for the development of new treatments for this common disorder.
The development of the primarily women-of-color-led movement for transformative justice has also shed light on the fact that abolition requires not just the transformation of social relations and ...place, but the transformations of subjectivity itself. This movement recognizes that violence is not just enacted against oppressed communities but is enacted with them, and hence the line between those who harm and those who face harm is often illusory. The movement for transformative justice—for accountability without disposability—calls on us to create different systems of relationality, which, in turn, transform who we think we are as people. Essentially, we are required to embark on an uncharted journey that will result in the creation of new selves we would not now recognize. Abolition can be seen as a process and a methodology rather than a presumed destination. To identify abolitionist methodologies, it can be helpful to look at unexpected places rather than presume that some spaces and peoples are necessarily more abolitionist than others. Consequently, this essay will look at abolitionism in an unexpected place, Christian evangelicalism.
Purpose: To estimate the strength and shape of the dose-response relationship between sedentary behaviour and all-cause, cardiovascular disease (CVD) and cancer mortality, and incident type 2 ...diabetes (T2D), adjusted for physical activity (PA). Data Sources: Pubmed, Web of Knowledge, Medline, Embase, Cochrane Library and Google Scholar (through September-2016); reference lists. Study Selection: Prospective studies reporting associations between total daily sedentary time or TV viewing time, and ≥ one outcome of interest. Data Extraction: Two independent reviewers extracted data, study quality was assessed; corresponding authors were approached where needed. Data Synthesis: Thirty-four studies (1,331,468 unique participants; good study quality) covering 8 exposure-outcome combinations were included. For total sedentary behaviour, the PA-adjusted relationship was non-linear for all-cause mortality (RR per 1 h/day: were 1.01 (1.00-1.01) ≤ 8 h/day; 1.04 (1.03-1.05) > 8 h/day of exposure), and for CVD mortality (1.01 (0.99-1.02) ≤ 6 h/day; 1.04 (1.03-1.04) > 6 h/day). The association was linear (1.01 (1.00-1.01)) with T2D and non-significant with cancer mortality. Stronger PA-adjusted associations were found for TV viewing (h/day); non-linear for all-cause mortality (1.03 (1.01-1.04) ≤ 3.5 h/day; 1.06 (1.05-1.08) > 3.5 h/day) and for CVD mortality (1.02 (0.99-1.04) ≤ 4 h/day; 1.08 (1.05-1.12) > 4 h/day). Associations with cancer mortality (1.03 (1.02-1.04)) and T2D were linear (1.09 (1.07-1.12)). Conclusions: Independent of PA, total sitting and TV viewing time are associated with greater risk for several major chronic disease outcomes. For all-cause and CVD mortality, a threshold of 6-8 h/day of total sitting and 3-4 h/day of TV viewing was identified, above which the risk is increased.
In patients with diabetes, nerve injury is a common complication that leads to chronic pain, numbness and substantial loss of quality of life. Good glycemic control can decrease the incidence of ...diabetic neuropathy, but more than half of all patients with diabetes still develop this complication. There is no approved treatment to prevent or halt diabetic neuropathy, and only symptomatic pain therapies, with variable efficacy, are available. New insights into the mechanisms leading to the development of diabetic neuropathy continue to point to systemic and cellular imbalances in metabolites of glucose and lipids. In the PNS, sensory neurons, Schwann cells and the microvascular endothelium are vulnerable to oxidative and inflammatory stress in the presence of these altered metabolic substrates. This Review discusses the emerging cellular mechanisms that are activated in the diabetic milieu of hyperglycemia, dyslipidemia and impaired insulin signaling. We highlight the pathways to cellular injury, thereby identifying promising therapeutic targets, including mitochondrial function and inflammation.
Messy Europe Loftsdóttir, Kristín; Smith, Andrea L; Hipfl, Brigitte
2018., 2018, 2018-02-15, Letnik:
32
eBook
Using the economic crisis as a starting point, Messy Europe offers a critical new look at the issues of race, gender, and national understandings of self and other in contemporary Europe. It ...highlights and challenges historical associations of Europe with whiteness and modern civilization, and asks how these associations are re-envisioned, re-inscribed, or contested in an era characterized by crises of different kinds. This important collection provides a nuanced exploration of how racialized identities in various European regions are played out in the crisis context, and asks what work “crisis talk” does, considering how it motivates public feelings and shapes bodies, boundaries and communities.
This article summarizes the findings from a systematic literature review to examine how social media may impact HPV vaccine uptake and HPV and HPV vaccine related awareness, knowledge, and attitudes. ...Study inclusion criteria was original data collection of at least one data point about social media and HPV and/or HPV vaccination, such that the study provided insight into how social media content may influence HPV and HPV vaccine related knowledge, attitudes, and/or behaviors. A total of 44 relevant articles were identified using the following databases: PubMed, PsycINFO, Communication Source, Sociological Abstracts, Business Source Elite, and the Educational Resources Information Center (ERIC). Most studies analyzed the valence, type, and frequency of social media content about HPV vaccination, and some found associations between potential exposure to negative, anti-vacc`11qine content and lower vaccination rates. Some studies that included primary human subject data collection found that engagement with HPV related social media content was associated with improved awareness and knowledge but not with increased vaccine uptake. The literature overall is lacking in systematic and rigorous research examining the effects of social media on HPV related knowledge, attitudes, and behaviors and needs further examination as social media increasingly becomes a source of health information.
The process of successful quitting, and the personal and social conditions required to support it, remain poorly understood.
This qualitative grounded theory study used in-depth interviews with 37 ...Australian adult ex-smokers (24–68 years; 15 men and 22 women) who quit in the past 6–24 months to explore how ex-smokers explain their quitting success.
This analysis provides a framework for understanding the personal, social and structural factors critical to successful quitting. The key analytic finding was the core concept ‘being serious’. Three factors contributed to ‘being serious’: (1) prior experiences of quitting; (2) an identity (or existential) threat; and (3) timing and circumstances. The analysis indicated that the concept ‘being serious’ rather than the oft-cited psychological constructs motivation and willpower more accurately captures how participants talked about and explained their quitting success, how they accounted for their success when previous apparently similar attempts had failed, and the advice they would offer would-be quitters about achieving quitting success. An explanation is provided for why some participants battled with quitting for years, while others quit unexpectedly, even effortlessly. The social and structural factors that made the state of ‘being serious’ easier or harder for the participant to attain are also discussed.
‘Being serious’ was a term that resonated with participants. Participants’ accounts of quitting indicate that quitting is a complex and gradual process and that social and structural influences have a key role in determining how easy or difficult it was to become serious about quitting.
To explore on-package formula messaging with reference to legislation and government-issued guidance in Great Britain (GB).
Formula products were identified, pictures of all sides of packs collated ...and on-package text and images were coded. Compliance with both GB legislation and guidance issued by the Department of Health and Social Care (DHSC) was assessed.
All formula packs that were available for sale over the counter in GB between April and October 2020.
Formula packs (
71) including infant formula, follow-on formula, growing-up formula and specialist formula were identified, coded and analysed.
In total, 41 % of formula packs included nutrition claims, and 18 % included health claims that may be considered non-permitted, according to DHSC guidance. Additionally, 72 % of products showed images considered 'non-permitted'. Breast Milk Substitute (BMS) legislation states infant and follow-on formula packs should be clearly distinguishable but does not provide criteria to assess similarity. Based on DHSC guidance, 72 % of infant and follow-on formula packs were categorised as showing a high degree of similarity. Marketing practices not covered by current legislation were widespread, such as 94 % of infant formula packs including advertisements for follow-on or growing-up formula.
Text and images considered non-permitted according to DHSC guidance for implementing BMS legislation were widespread on formula products available in GB. As terms such as 'similarity' are not defined in BMS legislation, it was unclear if breaches had occurred. Findings support the WHO call for loopholes in domestic legislation to be closed as a matter of urgency.
To understand how mothers use commercial milk formula (CMF) labels to inform their feeding choices and explore mothers' understanding of differences between CMF products.
Qualitative study with ...recruitment via social media. Online semistructured interviews, including a product mapping exercise and thematic analysis.
Mothers (n=25) using CMF for children <3 years living in Great Britain (GB).
Mothers were drawn to brands they recognised from years of exposure to CMF advertising. CMF products were assumed to vary according to brand and stage, but participants found on-pack information did not explain how. This added to anxiety about choosing 'the best one' and mothers would have liked guidance from healthcare professionals (HCPs). Wide availability of CMF for older infants and children, and on-pack messaging suggesting progression from one product to the next, led many to believe these products were necessary. There was confusion over the appropriate use of specialist products. While mothers rarely mentioned on-pack health and nutrition claims, they were attracted to the overall appearance of packs and messaging relating to science, research and nature. References to breast milk and a logo perceived to represent a breastfeeding mother were taken as indicators of closer similarity to breast milk.
CMF legislation in GB should be updated to restrict brand advertising and the use of on-pack text and images that mothers perceive as indicating products have a closer similarity to breast milk. Greater input from HCPs was desired by new mothers and would support them to make more informed choices about CMF.
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