Improving management of type 1 diabetes in the UK: the Dose Adjustment For Normal Eating (DAFNE) programme as a research test-bed. A mixed-method analysis of the barriers to and facilitators of successful diabetes self-management, a health economic analysis, a cluster randomised controlled trial of different models of delivery of an educational intervention and the potential of insulin pumps and additional educator input to improve outcomes

Mood congruent psychotic symptoms and specific cognitive deficits in carriers of the novel schizophrenia risk variant at MIR-137, Neuroscience Letters (2010Letters ( ), doi:10.1016Letters ( /j.neulet.2012 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Page 1 of 17A c c e p t e d M a n u s c r i p t  We investigated the clinical symptom profiles of carriers of the schizophrenia mir137 risk allele. The sample included 821 patients with schizophrenia, schizoaffective disorder and bipolar I disorder. Risk allele carriers had lower scores for positive symptoms and less psychosis incongruity.  On neurocognitive testing in a subset, there were more cognitive deficits in risk allele carriers *Highlights (for review)

Mental state decoding difficulties are significant in BD. An important direction for further research will be to establish to what extent these deficits affect social and occupational functioning as a potential target for therapeutic intervention.

The term frailty is increasingly used in gerontological literature and in practice. However, indicators differentiating frail from nonfrail are not well delineated. Identifying factors discriminating between frail and nonfrail older community-residing adults may lead to more comprehensive clinical assessments and targeted interventions to minimize or prevent frailty. Eighty-four adults, ages 60 to 88 (mean = 74) living independently in the community completed a functional performance questionnaire and a perceived health questionnaire that were combined as measures of frailty. Predictor variables of frailty included four measures of balance and three measures of lower leg strength. Discriminant analysis revealed that one balance score and dorsiflexion correctly classified 65% of group membership, with better prediction of the nonfrail than frail group. This study clarifies that the predictors of frailty include the combination of dorsiflexion strength and balance, specifically the contribution of vision to balance when the support surface is compliant. Recommendations are proposed for conceptualizing and operationalizing frailty and adding variables to enhance discrimination between frailty and nonfrailty. Nursing implications include adding clinical assessments of specific components of balance and ankle strength to develop a more comprehensive evaluation of frailty.

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Background Psychosocial risk factors are known to impact quality of life, treatment adherence, and health outcomes. No standardized comprehensive psychosocial risk screener is routinely utilized in cystic fibrosis (CF) care. The objectives of the study were to describe the range and severity of psychosocial risk within this CF population, investigate the reliability of a comprehensive psychosocial screener in pediatric CF clinical care, and explore relationships between psychosocial risk and key factors affecting health outcomes. It was hypothesized that the PAT‐CF total and subscale α coefficients would be similar to those found in other pediatric medical populations. Method Parents of 154 children with CF completed a CF‐specific version of the Psychosocial Assessment Tool_All‐lit (PAT‐CF), an empirically‐based psychosocial risk assessment, during routine CF clinical care. Results The internal consistency of the PAT‐CF Total score was 0.71. Total score and subscale reliabilities reflect findings in other pediatric populations. Total risk scores fell in the following categories: 7% (Clinical‐highest risk), 41% (Targeted), and 52% (Universal‐lowest risk), respectively. Increased psychosocial risk was associated with Medicaid status and lower parent education, whereas having private insurance was associated with decreased psychosocial risk. Conclusions The PAT‐CF can feasibly be used as an empirically‐based comprehensive psychosocial risk tool in routine CF care and is acceptable by parents. In addition to providing universal anticipatory guidance regarding child and family wellness, early identification of risk factors allows care teams to proactively provide targeted support and intervention for specific psychosocial risk factors to promote improved quality of life and ability to sustain daily care.

The common variant rs1344706 within the zinc-finger protein gene ZNF804A has been strongly implicated in schizophrenia (SZ) susceptibility by a series of recent genetic association studies. Although associated with a pattern of altered neural connectivity, evidence that increased risk is mediated by an effect on cognitive deficits associated with the disorder has been equivocal. This study investigated whether the same ZNF804A risk allele was associated with variation in the P300 auditory-evoked response, a cognitively relevant putative endophenotype for SZ. We compared P300 responses in carriers and noncarriers of the ZNF804A risk allele genotype groups in Irish patients and controls (n=97). P300 response was observed to vary according to genotype in this sample, such that risk allele carriers showed relatively higher P300 response compared with noncarriers. This finding accords with behavioural data reported by our group and others. It is also consistent with the idea that ZNF804A may have an impact on cortical efficiency, reflected in the higher levels of activations required to achieve comparable behavioural accuracy on the task used.

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