Adolescents with diabetes have unique health needs, which impact upon their transition from children's health care services into adult health care services. These health needs result from the precarious period in their lives, when they have to cope with the stresses of being a maturing person. This coincides with their move from the children's into the adult health care service. Whilst coping with these pressures they must also keep their diabetes under control. The impact of emotional and physical demands upon the adolescent means that they are more susceptible to non-adherence, which may result in reduced diabetic control. This literature review identifies some of the many barriers erected to the transition into the adult health care system; these barriers may be constructed by any one of the parties involved: the children's health care team, adult health care team, the adolescent or their family. Principles of a successful transition are explored, along with the prerequisite qualities required of health care providers and the health care service.

The findings also suggested that participants in this study might have felt that the control of their chronic condition had been externalized to the health care professionals responsible for their care.

South Asian people are often perceived as a homogenous group whose culture is prescriptive and constraining. A metasynthesis of how culture influences diabetes self-management in the context of a South Asian population was undertaken. Theory explication was used to deconstruct and reconceptualize the findings of the studies. Eleven publications reported themes of health beliefs, individuality, context, and shared experiences. The results indicate that culture does not influence diabetes self-management in a rigid and prescriptive way; instead, individuals negotiate and interpret culture in a shifting and diverse context. An individualized approach to delivering culturally appropriate nursing care should be taken.

Background: Complex and expensive treatment options have increased the frequency and emphasis of ethical decision making in healthcare. In order to meet these challenges effectively we need to identify how nurses contribute the resolution of these dilemmas. Aims:To identify the values, beliefs and contextual influences that inform decision making.To identify the contribution made by nurses in achieving the resolution of ethical dilemmas in practice.Design: An interpretive exploratory study was undertaken, eleven registered acute care nurses, working in a district general hospital in England were interviewed, using semi-structured interviews. In-depth content analysis of the data was undertaken via NVivo coding and thematic identification.

Tel: 07747654280Key points:1. Type 2 diabetes can be preventable.2. Diagnosis of pre-diabetes or at risk status may enable behaviour change.3. Increased provision of education and support is required to motivate lifestyle change in the person with pre-diabetes.Key words: Type 2 diabetes; pre-diabetes; motivation; lifestyle; education; support Abstract Type 2 diabetes is a growing global problem that not only affects individuals but has an impact upon the economic health of countries 1 . The number of people developing type 2 diabetes can be reduced by up to by 80%; this can be achieved by targeting those who are "at risk" 2. This reduction can be achieved by appropriate lifestyle changes to diet and physical activity 3. It is not known what the impact of being informed that you have prediabetes has on a patients motivation to make appropriate lifestyle changes.The aim of this study was to assess whether having the diagnosis of pre-diabetes encourages or empowers people to make appropriate lifestyle changes to prevent progression to a diagnosis of type 2 diabetes.Using a systematic approach, an integrative literature review was undertaken, using a standard retrieval and appraisal method. The studies demonstrated that pre-diabetes was found to be a challenging concept by patients and nurse alike. Lack of knowledge and support, along with patient's perceived barriers had an impact upon the various motivation and self-efficacy behaviours towards lifestyle changes.