Persistent organic pollutants (POPs) are a diverse family of contaminants that show widespread global dispersion and bioaccumulation. Humans are continuously exposed to POPs through diet, air particles, and household and commercial products; POPs are consistently detected in human tissues, including the pancreas. Epidemiological studies show a modest but consistent correlation between exposure to POPs and increased diabetes risk. The goal of this review is to provide an overview of epidemiological evidence and an in-depth evaluation of the in vivo and in vitro evidence for POPs as potential b-cell toxins. We review evidence for 6 classes of POPs: dioxins, polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), organophosphate pesticides (OPPs), flame retardants, and per- and polyfluoroalkyl substances (PFAS). The available data provide convincing evidence implicating POPs as a contributing factor driving impaired glucose homeostasis, b-cell dysfunction, and altered metabolic and oxidative stress pathways in islets. These findings support epidemiological data showing that POPs increase diabetes risk and emphasize the need to consider the endocrine pancreas in toxicity assessments. However, our review also highlights significant gaps in the literature assessing islet-specific endpoints following both in vivo and in vitro POP exposure. In addition, most rodent studies do not consider the impact of biological sex or secondary metabolic stressors in mediating the effects of POPs on glucose homeostasis and b-cell function. We discuss key gaps and limitations that should be assessed in future studies.

Objective: Regular exercise constitutes an essential component of diabetes management. However, the compliance with exercise related advice is poor among patients. Our objectives were to assess the compliance with exercise recommendations and the barriers to exercise among patients with diabetes.Methods: 253 patients with type 2 diabetes treated in 3 different clinical settings; hospital diabetes clinic, hospital general medical clinics and general practitioners (GPs), were recruited for the study. Data were collected using an interviewer administered questionnaire.Results: Out of 253 patients, only 45.1% (n=114) were properly educated regarding exercise as part of diabetes management. A higher percentage of patients in diabetes clinics were educated (60.6%, n=63) compared to patients attending medical clinics (26.5%, n=26) and the GPs (49%, n=25) regarding exercise. However, the compliance with exercise recommendations is poor (11.5%) irrespective of the clinical setting. Walking is the commonest mode of exercise (72.4%, n=21) followed by exercise machines (13.8%, n=4) and running (13.8%, n=4). In the non-exercising group, majority (51.6%, n=48) think that the activities of daily living are adequate as daily exercise. 18.3% (n=17) claim that they do not have time to exercise and 14% (n=13) are not really interested.Conclusions: Adherence to regular exercise as part of diabetes management is poor among patients with diabetes. Current health promotional and health information delivering techniques have also failed to achieve the desired attitude change among patients towards regular exercise. This highlights the need for novel approaches to address this problem.

Objectives: Globally 10-20% of children and adolescents are suffering from mental health disorders. Improving mental health literacy (MHL) of teachers supports early detection and referral of children with mental health problems. In a background of no organized programs to improve teachers' MHL training, "Sisu Sitha Noridawa (SSN)" (not hurting students' feelings) was developed and conducted in central Sri Lanka to explore the effects of the intervention on teacher MHL.Method: There were 251 teachers participated in the study. To begin, Psychiatrist authors facilitated small group discussions on ten case vignettes of common child psychiatry problems and then large group discussions using mini lectures and a handbook. Pre and post-tests were conducted to assess knowledge and attitudes on mental health problems of school children. The scores were analyzed using, Paired T-test in SPSS 17. Results:A majority (73.7%) of teachers claimed to have encountered students with mental health issues. The mean score differences of pre and posttest in both knowledge and attitude components showed statistically significant differences with p values <0.001 and Cohen's d values >0.2 in each, indicating the training had a significant positive impact on improving both the knowledge and attitude about mental health. Conclusions:The training program had a significant positive impact on improving the MHL of participants on common child and adolescent mental health problems. The sustainability of achieved effects and their application in the classroom need exploration in a long-term study. SSN is a feasible and effective training program to be included in the existing teacher-training curriculum with in-service booster SSN programs, in a middle-income country like Sri Lanka.