Alcohol health literacy in young adults with type 1 diabetes and its impact on diabetes management.

AIMS: To investigate the knowledge of alcohol and carbohydrate content of commonly consumed alcoholic drinks among young adults with Type 1 diabetes and to explore alcohol consumption while identifying diabetes self-management strategies used to minimize alcohol-associated risk. METHOD: We conducted an open-access, multiple-choice web survey to investigate knowledge of alcohol and carbohydrate content of typical alcoholic drinks using images. Respondents to the survey also recorded their current alcohol consumption and diabetes self-management strategies when drinking. RESULTS: A total of 547 people aged 18-30 years responded to the survey (341 women; 192 men; mean (sd) age 24.5 (3.7) years), of whom 365 (66.7%) drank alcohol. In all, 84 (32.9%) women and 31 (22.6%) men scored higher than the cut-off score for increased-risk drinking. Knowledge accuracy of alcohol units was poor: only 7.3% (n = 40) correctly identified the alcohol content of six or more out of 10 drinks. Knowledge of carbohydrate content was also poor: no respondent correctly identified the carbohydrate content of six or more out of 10 drinks. Various and inconsistent strategies to minimize alcohol-associated risk were reported. CONCLUSIONS: Alcohol consumption was common among the survey respondents, but knowledge of alcohol and carbohydrate content was poor. Greater alcohol-related health literacy is required to minimize alcohol-associated risk. Further research should help develop effective strategies to improve health literacy and support safe drinking for young adults with Type 1 diabetes.

Perceptions of current and recent military internal medicine residents on operational medicine, managed care, graduate medical education, and continued military service.

Current and recent internal medicine residents were surveyed on their level of confidence in practicing operational medicine, satisfaction with graduate medical education, the impact of TRICARE, the military managed care plan, on their patients and education, and intentions on remaining in uniformed service. Their sentiments were recorded on a five-point Likert scale (1 = strongly agree, 3 = neutral, 5 = strongly disagree). Two hundred twenty-one of the 294 surveys were returned (75.2%). Most physicians felt unprepared to perform duties in a nuclear, biological, or chemical warfare environment, or handle administrative aspects of operational medicine (mean scores, 3.2-3.7). A majority of respondents felt satisfied with the quality of their residency experience (mean score, 1.9). Although more than half of those surveyed (53.6%) listed the opportunity to teach residents as a top factor influencing their retention decision, most felt skeptical that graduate medical education would remain important in the future (mean score, 3.6). Most physicians agreed that restriction of TRICARE to patients less than 65 years old may degrade the quality of military internal medicine residencies (mean score, 1.6). Previous service, Reserve Officer Training Corps experience, and graduation from the Uniformed Services University of the Health Sciences were factors associated with increased physician intention to remain beyond their obligated service. The most common factors inducing physicians to leave the military included frequent deployments, relocations, and financial compensation. Factors cited most frequently as influencing physicians to stay on active duty included high-quality colleagues, opportunities for teaching residents, and freedom from malpractice and office management details.

Maximal height scaling of kinetically growing surfaces.

The scaling properties of the maximal height of a growing self-affine surface with a lateral extent L are considered. In the late-time regime its value measured relative to the evolving average height scales like the roughness: h*(L) approximately L alpha. For large values its distribution obeys logP(h*(L)) approximately (-)A(h*(L)/L(alpha))(a). In the early-time regime where the roughness grows as t(beta), we find h*(L) approximately t(beta)[lnL-(beta/alpha)lnt+C](1/b), where either b = a or b is the corresponding exponent of the velocity distribution. These properties are derived from scaling and extreme-value arguments. They are corroborated by numerical simulations and supported by exact results for surfaces in 1D with the asymptotic behavior of a Brownian path.

Elucidation of the minimal sequence required to imprint H19 transgenes.

The imprinted mouse H19 gene exhibits maternal allele-specific expression and paternal allele-specific hypermethylation. We previously demonstrated that a 14-kb H19 minitransgene possessing 5' differentially methylated sequence recapitulates the endogenous H19 imprinting pattern when present as high-copy arrays. To investigate the minimal sequences that are sufficient for H19 transgene imprinting, we have tested new transgenes in mice. While transgenes harboring limited or no 3' H19 sequence indicate that multiple elements within the 8-kb 3' fragment are required for appropriate imprinting, transgenes incorporating 1.7 kb of additional 5' sequence mimic the endogenous H19 pattern, including proper imprinting of low-copy arrays. One of these imprinted lines had a single 15.7-kb transgene integrant. This is the smallest H19 transgene identified thus far to display imprinting properties characteristic of the endogenous gene, suggesting that all cis-acting elements required for H19 imprinting in endodermal tissues reside within the 15.7-kb transgenic sequence.

Role of a 461-bp G-rich repetitive element in H19 transgene imprinting.

The molecular mechanism leading to the imprinted expression of genes is poorly understood. While no conserved cis-acting elements have been identified within the known loci, many imprinted genes are located near directly repetitive sequence elements, suggesting that such repeats might play a role in imprinted gene expression. The maternally expressed mouse H19 gene is located approximately 1.5 kb downstream from a 461-bp G-rich repetitive element. We have used a transgenic model to investigate whether this element is essential for H19 imprinting. Previous results demonstrated that a transgene, which contains 14 kb of H19 sequence, exhibits parent-of-origin specific expression and methylation analogous to the endogenous H19 imprinting pattern. Here, we have generated transgenes lacking the G-rich repeat. One transgene, containing a deletion of the G-rich repetitive element but which includes an additional 1.7 kb of 5' H19 sequence, is imprinted similarly to the endogenous H19 gene. To determine whether the G-rich repeat is conserved in other imprinted mammalian H19 homologues, additional 5' flanking sequences were cloned from the rat and human. This element is conserved in the rat but not in human DNA. These results suggest that the 461-bp G-rich repetitive element is not essential for H19 imprinting.