Educators' Perspectives on the Teaching and Learning of Type 2 Diabetes Content in Physiotherapy Programmes across Canada.

Purpose: This qualitative descriptive study researched educators' perspectives of type 2 diabetes (T2D) Teaching and learning, in physiotherapy (PT) programmes across Canada. Methods: Faculty members and clinical instructors from the 15 PT programmes in Canada were contacted. Online surveys collected data on the educators' professional background and perspectives on T2D in the PT curriculum. One-on-one telephone interviews were conducted and thematic analysis was used to generate themes and codes from the interview transcripts. Results: Ten educators from 10 universities completed the survey. Seven of the 10 educators also participated in a telephone interview. Survey responses revealed that T2D content is taught predominantly through case studies and lectures. Of the 10 respondents, six reported that the curriculum does not devote adequate time to T2D content, and nine reported they "strongly agree" or "agree" that T2D is an essential component of the PT curriculum. The interviews revealed that T2D content varies across PT programmes. The educators agreed that T2D is a common condition seen in practice, there is a role for PT intervention, and T2D content is limited by classroom time. Conclusions: Educators noted challenges integrating more T2D content in the curriculum and said that PT clinical contributions for people living with T2D are underutilized. Additional evidence-informed rationale is needed to explore optimal integration of T2D content in PT programmes.

Objectif: étude descriptive qualitative sur le point de vue des éducateurs à l'égard de l'enseignement et de l'apprentissage sur le diabète de type 2 (DT2) dans les programmes de physiothérapie du Canada. Méthodologie: prise de contact avec les professeurs et éducateurs cliniques de 15 programmes de physiothérapie au Canada. Au moyen de sondages en ligne, les chercheurs ont recueilli des données sur l'expérience professionnelle des éducateurs et leurs points de vue au sujet du DT2 dans le programme de physiothérapie. Ils ont réalisé des entrevues individuelles et procédé à une analyse thématique pour dégager des thèmes et des codes à partir des transcriptions d'entrevue. Résultats: dix éducateurs de dix universités ont rempli le sondage. Sept d'entre eux ont également participé à une entrevue téléphonique. Les réponses au sondage ont révélé que la matière sur le DT2 est surtout enseignée dans le cadre d'études de cas et d'exposés.Six des dix répondants ont déclaré que le programme ne prévoit pas assez de temps sur la matière liée au DT2 et neuf ont affirmé qu'ils étaient « fortement d'accord ¼ ou « d'accord ¼ avec le fait que le DT2 est un élément essentiel du programme de physiothérapie. Les entrevues ont révélé que la matière sur le DT2 varie selon les programmes. Les éducateurs ont convenu que le DT2 est une affection courante en pratique, qu'il y a un rôle pour une intervention en physiothérapie et que la matière sur le DT2 est limitée par le temps en classe. Conclusions: les éducateurs ont souligné les difficultés à intégrer plus de matière sur le DT2 au programme et ont affirmé que l'apport clinique est sous-utilisé en physiothérapie auprès des personnes qui vivent avec le DT2. Il faudra obtenir plus d'explications fondées sur des données probantes pour explorer la manière optimale d'intégrer de la matière sur le DT2 aux programmes de physiothérapie.

Learnings from nursing bridging education programs: A scoping review.

AIM: The aim of this scoping review is to summarize and critically evaluate research focused on nursing bridging education programs internationally. Specifically, this review addresses bridging from a: (1) Personal Support Worker (or similar) to a Registered Practical Nurse (or similar); and (2) Registered Practical Nurse (or similar) to a Registered Nurse. BACKGROUND: Nursing bridging education programs support learners to move from one level of educational preparation or practice to another. These programs can therefore increase nursing workforce capacity. Global healthcare systems have faced nursing shortages for decades. Moreover, the presently insufficient nursing workforce is confronting an ever-increasing volume of needed healthcare that is rising with the global ageing demographic shift. DESIGN: The Joanna Briggs Institute methods for scoping reviews, combined with Arksey and O'Malley's (2005) guidelines, were used with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). METHODS: MEDLINE (Ovid), CINAHL, EMBASE and SCOPUS databases were searched. Articles published in English that included Personal Support Workers, Registered Practical Nurses, Registered Nurses and/or nurses in similar categories who were studied through the process of a nursing bridging education program were included in the review. The study search was limited to papers published after 2005 (i.e., the beginning of nurse workload "overload" according to the Canadian Nurses Association). Braun and Clarke's (2006) thematic analysis was used in a content analysis of the included studies. RESULTS: A total of 15 articles published between 2005 and 2022 were included. Four themes were generated: (1) participating in bridging education programs fuels both professional and personal development; (2) nursing bridging education programs enhance diversity in the nursing workforce; (3) student nurses do not anticipate the challenges associated with participating in a bridging program; and (4) mentor-mentee connection promotes academic learning and successful completion of nursing bridging education programs. CONCLUSIONS: Despite experiencing challenges, participation in/completion of nursing bridging education programs leads to successful role transitioning and self-reported fulfillment of personal and professional aspirations. This review revealed the need for bridging programs to accommodate the unique needs of student nurses. Incorporation of support services, mentorship and faculty familiarity with varying nursing educational backgrounds facilitates role transitions by reducing the perceived challenges of bridging and promoting connection to foster learning. Nursing bridging education programs allow greater numbers of nurses to be trained to build workforce capacity and enable care for the world's rapidly ageing population.

Assessing physical function after completing a supervised education and exercise program in adults with type 2 diabetes and exploring exercise motivation at one-year follow up: A case series study.

BACKGROUND: Exercise programs for adults with type 2 diabetes (T2D) improve glycemic control and physical function. However, diabetes complications, disability, and motivation pose challenges for exercise participation. OBJECTIVE: The purpose of the study was to: 1) measure change in fasting blood glucose, blood pressure, anthropometrics (i.e. BMI and waist circumference), and physical function (i.e. endurance, agility and balance, upper and lower-body strength and flexibility) after completing an eight-week education and exercise program for adults with T2D; and 2) explore the experience of exercise continuation in people living with T2D at one-year follow-up. METHODS: A mixed methods case series design was conducted. Participants were ≥ 18 years and had a clinical diagnosis of T2D (glycated hemoglobin (A1C) ≥ 6.5%). Participants completed two one-hour exercise sessions and one one-hour education session per week for eight weeks. Blood glucose, blood pressure, body mass index (BMI), waist circumference, and physical function were measured at baseline and after completing the program. Follow-up telephone interviews were conducted at one, six, and 12-months and thematic analysis was employed to analyze interviews. RESULTS: Twelve participants completed the program. Clinically significant improvements were observed for waist circumference, systolic blood pressure, six-minute walk test (6MWT), timed up-and-go test (TUG), 30-second chair stand test (CST) and arm curls. Three themes emerged from the interviews that described participant reflections and experiences with a supervised education and exercise program for management of their T2D: 1) medical management; 2) lifestyle management; and 3) finding what works. Conclusion: Supervised programming improves physical function and may mitigate disability. Physiotherapists are qualified to assess and treat physical function through education and exercise.

Isoform-specific Roles of Prolyl Hydroxylases in the Regulation of Pancreatic ß-Cell Function.

Pancreatic ß-cells can secrete insulin via 2 pathways characterized as KATP channel -dependent and -independent. The KATP channel-independent pathway is characterized by a rise in several potential metabolic signaling molecules, including the NADPH/NADP+ ratio and α-ketoglutarate (αKG). Prolyl hydroxylases (PHDs), which belong to the αKG-dependent dioxygenase superfamily, are known to regulate the stability of hypoxia-inducible factor α. In the current study, we assess the role of PHDs in vivo using the pharmacological inhibitor dimethyloxalylglycine (DMOG) and generated ß-cell-specific knockout (KO) mice for all 3 isoforms of PHD (ß-PHD1 KO, ß-PHD2 KO, and ß-PHD3 KO mice). DMOG inhibited in vivo insulin secretion in response to glucose challenge and inhibited the first phase of insulin secretion but enhanced the second phase of insulin secretion in isolated islets. None of the ß-PHD KO mice showed any significant in vivo defects associated with glucose tolerance and insulin resistance except for ß-PHD2 KO mice which had significantly increased plasma insulin during a glucose challenge. Islets from both ß-PHD1 KO and ß-PHD3 KO had elevated ß-cell apoptosis and reduced ß-cell mass. Isolated islets from ß-PHD1 KO and ß-PHD3 KO had impaired glucose-stimulated insulin secretion and glucose-stimulated increases in the ATP/ADP and NADPH/NADP+ ratio. All 3 PHD isoforms are expressed in ß-cells, with PHD3 showing the most distinct expression pattern. The lack of each PHD protein did not significantly impair in vivo glucose homeostasis. However, ß-PHD1 KO and ß-PHD3 KO mice had defective ß-cell mass and islet insulin secretion, suggesting that these mice may be predisposed to developing diabetes.

The effects of exercise interventions on physical function tests and glycemic control in adults with type 2 diabetes: A systematic review.

INTRODUCTION: Regular exercise improves glycemic control and helps to mitigate the decline in strength, mobility, and balance. The 6-min walk test (6MWT), timed up-and-go test (TUG) and the sit-to-stand test (STS) are reliable measures of physical function in adults with type 2 diabetes (T2D). Outcome measures allow physiotherapists to monitor changes in physical function with exercise prescription. METHODS: PubMed, CINAHL, EMBASE and Scopus databases and reference lists of relevant reviews were searched for randomized controlled trials (RCTs) relating to exercise and T2D published until June 2020. Studies were included when: (a) participants were adults diagnosed with T2D, (b) exercise was a main intervention and compared to controls, and (c) at least one clinical physical function measure was used to detect changes in aerobic capacity, mobility or strength. RESULTS: Eight of 10 RCTs reported either statistically significant between-group (p < 0.05) or within-group (p < 0.05) differences in 6MWT scores. Nonsignificant between-group differences were found in two resistance training RCTs that utilized the TUG test. Three of five RCTs utilizing the STS test reported significant between groups differences (p < 0.05). Seven of 11 RCTs reported statistically significant between-group (p < 0.05) or within-group (p < 0.05) differences in glycated hemoglobin (HbA1c) levels. CONCLUSION: Physical function measures may be useful for monitoring aerobic capacity, lower extremity strength and mobility with exercise in patients with T2D. Improvements in 6MWT scores may depend on total volume of exercise (minutes/week ∗ weeks of intervention). However, changes in HbA1c with exercise were variable and may depend on type of exercise.

Role of n-3 Polyunsaturated Fatty Acids and Exercise in Breast Cancer Prevention: Identifying Common Targets.

Diet and exercise are recognized as important lifestyle factors that significantly influence breast cancer risk. In particular, dietary n-3 polyunsaturated fatty acids (PUFAs) have been shown to play an important role in breast cancer prevention. Growing evidence also demonstrates a role for exercise in cancer and chronic disease prevention. However, the potential synergistic effect of n-3 PUFA intake and exercise is yet to be determined. This review explores targets for breast cancer prevention that are common between n-3 PUFA intake and exercise and that may be important study outcomes for future research investigating the combined effect of n-3 PUFA intake and exercise. These lines of evidence highlight potential new avenues for research and strategies for breast cancer prevention.