Outcomes of an Education and Exercise Program for Adults with Type 2 Diabetes,and Comorbidities that Limit their Mobility: A Preliminary Project Report

Purpose: Some adults with type 2 diabetes mellitus (T2DM) have comorbidities and mobility impairments that limit their exercise capacity. In consideration of this, we developed and piloted a program called Active Steps for Diabetes for people with T2DM, comorbidities, and mobility impairments. The purpose of this paper was to report outcomes for the pilot program. Methods: Active Steps for Diabetes, an 8-week program, included instruction on diabetes self-care andgroup and home exercise programs. Twenty-two females (62.7 ± 6.1yrs) with T2DM and self-reported mobility impairments completed the program. Six participants used a walking aid. Outcome measures included two risk factors for coronary artery disease [daily physical activity and body mass index (BMI)], cardiovascular fitness (6-minute walk distance), and knowledge of diabetes-specific exercise guidelines. A two-way repeated measures ANOVA was used to compare outcomes before and after the program and between participants who did and did not use a walking aid. Results: Active Steps for Diabetes was effective in increasing daily physical activity in both groups of subjects (walking aid group: 2.6 days/week [95% confidence interval (CI) = 2.1 to 3.3]; no walking aid group: 1.9 days/week [95% CI=1.2 to 2.5]). This was accompanied by increases in 6-minute walk distances (walking aid group: 54.0 m [95% CI = 36.4 to 71.6]; no walking aid group: 62.6 m [95% CI=55.7 to 69.4]). Changes in BMI were not significant (walking aid group: −0.4 [95% CI = −1.2 to 0.4]; no walking aid group: −.24[95% CI = −.91 to .44]). Increases in knowledge of diabetes-specific exercise guidelines were observed in both groups (walking aid group: 18.8% [95% CI = 11.3 to 26.4]; no walking aid group: 19.3% [95% CI = 16.1 to 22.5]). Discussion:: Physical inactivity and low cardiovascular fitness are predictors of CAD morbidity and mortality in adults with T2DM. This pilot program suggests that a model for diabetes education, incorporating exercise programs developed by a physical therapist, may increase physical activity, improve endurance, and thereby potentially reduce CAD risk in people with T2DM and mobility impairments from comorbidities.Key Words: type 2 diabetes, physical activity     

Social and interactional practices for disseminating current awareness information in an organisational setting

Current awareness services are designed to keep users informed about recent developments based around user need profiles. In organisational settings, they may operate through both electronic and social interactions aimed at delivering information that is relevant, pertinent and current. Understanding these interactions can reveal the tensions in current awareness dissemination and help inform ways of making services more effective and efficient. We report an in-depth, observational study of electronic current awareness use within a large London law firm. The study found that selection, re-aggregation and forwarding of information by multiple actors gives rise to a complex sociotechnical distribution network. Knowledge management staff act as a layer of “intelligent filters” sensitive to complex, local information needs; their distribution decisions address multiple situational relevance factors in a situation fraught with information overload and restrictive time-pressures. Their decisions aim to optimise conflicting constraints of recall, precision and information quantity. Critical to this is the use of dynamic profile updates which propagate back through the network through formal and informal social interactions. This supports changes to situational relevance judgements and so allows the network to ‘self-tune’. These findings lead to design requirements, including that systems should support rapid assessment of information items against an individual’s interests; that it should be possible to organise information for different subsequent uses; and that there should be back-propagation from information consumers to providers, to tune the understanding of their information needs.     

Development of a sex education programme for 12‐year‐old to 14‐year‐old Turkish adolescents

Previous research has documented a need for the development of a sex education programme in Turkish schools in terms of adolescence readiness and the presence of misconceptions regarding critical aspects of sexual issues. Currently no school‐based sex education is available for Turkish adolescents. This paper presents the development of a contemporary sex education programme for 12‐year‐old to 14‐year‐old adolescents, entitled ‘The Human Development Program for 12–14 Year Old Adolescents’. A five‐step programme development model was used including reviewing internationally recognised sex education programmes for this age group. Sexuality Information and Education Council of United States guidelines were chosen as an educational framework, and Turkish cultural values were integrated into the curriculum. The sex curriculum consists of an eight‐session interactive programme in which parental permission and involvement is required. Five units are presented: human development, relationships, sexual behaviour, sexual health, and society/culture. The programme and a related knowledge assessment tool were reviewed by a group of Turkish professionals and the validity of the educational content was received. The programme was piloted with a group of Turkish adolescents with positive results. Future recommendations include school counsellors implementing this sex educational programme into Turkish schools.     

Chronic flexibility gains: effect of isometric contraction duration during proprioceptive neuromuscular facilitation stretching techniques

The aim of this study was to assess the effect of to isometic contraction durations during propiceptive neuromuscular facilitation stretching on gains inflexion at the hip. Forty-three women (M age = 20.0 years, SD = 1.3) were assigned to one of three groups: 5-s isometric contraction (5-IC), 10-IC, and control. Flexibility was assessed at baseline and Weeks 3 and 6. Analysis of covariance, controlling for pretest differences, showed a significant interaction, F(2, 33) = 44.1, p < .001. Flexibility was significant lower in the control group relative to the 5-IC and 10-IC groups and in the 5-IC group relative to the 10-IC group at 3 and 6 weeks (3 weeks = 101.2 +/- 1.4 degrees, 114.3 +/- 1.5 degrees, 120.5 +/- 1.3 degrees; 6 weeks = 103.0 +/- 1.4 degrees, 126.1 +/- 1.6 degrees, 133.3 +/- 1.4 degrees for control, 5-IC and 10-IC groups, respectively). A longer contraction time led to greater increases in flexibility.     

International trends in health science librarianship: part 1 - the English speaking world

This is the second in a series of articles exploring international trends in health science librarianship in the first decade of the 21st century. The invited authors were asked to reflect on developments in their country - viz. Australia, Canada, New Zealand and the United States. Future issues will track trends in Northern Europe, the Nordic countries, Southern Europe and Latin America. JM.     

Book reviews

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