Development and exploratory cluster-randomised opportunistic trial of a theory-based intervention to enhance physical activity among adolescents

Peer reviewedPostprin

Liver triacylglycerol content and gestational diabetes: effects of moderate energy restriction

Aims/hypothesis Women with a history of gestational diabetes mellitus (GDM) have raised liver triacylglycerol. Restriction of energy intake in type 2 diabetes can normalise glucose control and liver triacylglycerol concentration but it is not known whether similar benefits could be achieved in GDM. The aim of this work was to examine liver triacylglycerol accumulation in women with GDM and the effect of modest energy restriction. Methods Sixteen women with GDM followed a 4 week diet (5 MJ [1200 kcal]/day). Liver triacylglycerol, before and after diet and postpartum, was measured by magnetic resonance. Insulin secretion and sensitivity were assessed before and after diet. Twenty-six women who underwent standard antenatal care for GDM (matched for age, BMI, parity and ethnicity) were used as a comparator group. Results Fourteen women, who completed the study, achieved a weight loss of 1.6 ± 1.7 kg over the 4 week dietary period. Mean weight change was −0.4 kg/week in the study group vs +0.3 kg/week in the comparator group (p = 0.002). Liver triacylglycerol level was normal but decreased following diet (3.7% [interquartile range, IQR 1.2–6.1%] vs 1.8% [IQR 0.7–3.1%], p = 0.004). There was no change in insulin sensitivity or production. Insulin was required in six comparator women vs none in the study group (eight vs two required metformin). Blood glucose control was similar for both groups. The hypo-energetic diet was well accepted. Conclusions/interpretation Liver triacylglycerol in women with GDM was not elevated, unlike observations in non-pregnant women with a history of GDM. A 4 week hypo-energetic diet resulted in weight loss, reduced liver triacylglycerol and minimised pharmacotherapy. The underlying pathophysiology of glucose metabolism appeared unchanged

A description of interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England: a systematic mapping and evidence synthesis

Abstract Background Ready-to-eat meals (to eat in, to take away or to be delivered) sold by food outlets are often more energy dense and nutrient poor compared with meals prepared at home, making them a reasonable target for public health intervention. The aim of the research presented in this paper was to systematically identify and describe interventions to promote healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England. Methods A systematic search and sift of the literature, followed by evidence mapping of relevant interventions, was conducted. Food outlets were included if they were located in England, were openly accessible to the public and, as their main business, sold ready-to-eat meals. Academic databases and grey literature were searched. Also, local authorities in England, topic experts, and key health professionals and workers were contacted. Two tiers of evidence synthesis took place: type, content and delivery of each intervention were summarised (Tier 1) and for those interventions that had been evaluated, a narrative synthesis was conducted (Tier 2). Results A total of 75 interventions were identified, the most popular being awards. Businesses were more likely to engage with cost neutral interventions which offered imperceptible changes to price, palatability and portion size. Few interventions involved working upstream with suppliers of food, the generation of customer demand, the exploration of competition effects, and/or reducing portion sizes. Evaluations of interventions were generally limited in scope and of low methodological quality, and many were simple assessments of acceptability. Conclusions Many interventions promoting healthier ready-to-eat meals (to eat in, to take away, or to be delivered) sold by specific food outlets in England are taking place; award-type interventions are the most common. Proprietors of food outlets in England that, as their main business, sell ready-to-eat meals, can be engaged in implementing interventions to promote healthier ready-to-eat-food. These proprietors are generally positive about such interventions, particularly when they are cost neutral and use a health by stealth approach

Monitorização do vale e pico sérico de vancomicina em recém-nascidos de termo: comparação entre as técnicas de cromatografia líquida de alta eficácia e imunoensaio por fluorescência polarizada

INTRODUCTION: Peak and trough serum concentrations of vancomycin were determined in term newborn infants with confirmed or suspected Staphylococcus sp sepsis by high performance liquid chromatography and flourescence polarization immunoassay. OBJECTIVE: To statistically compare the results of the high performance liquid chromatography and flourescence polarization immunoassay techniques for measuring serum vancomycin concentrations. METHODS: Eighteen peak and 20 trough serum samples were assayed for vancomycin concentrations using high performance liquid chromatography and flourescence polarization immunoassay from October 1995 to October 1997. RESULTS: The linear correlation coefficients for high performance liquid chromatography and flourescence polarization immunoassay were 0.27 (peak, P = 0.110) and 0.26 (trough, P = 0.1045) respectively, which were not statistically significant. CONCLUSION: There was wide variation in serum vancomycin concentrations determined by high performance liquid chromatography as compared with those determined by flourescence polarization immunoassay. There was no recognizable pattern in the variability; in an apparently random fashion, the high performance liquid chromatography measurement was sometimes substantially higher than the flourescence polarization immunoassay measurement, and at other times it was substantially lower.INTRODUÇÃO: Foi realizada monitorização dos níveis séricos de vancomicina em recém-nascidos de termo com sepse ou suspeita de sepse Staphylococcus sp., através da cromatografia líquida de alta eficácia (HPLC) e imunoensaio por fluorescência polarizada (FPIA). OBJETIVO: Verificar a existência de correlação estatística entre os resultados obtidos pelas duas técnicas. MÉTODO E CASUÍSTICA: Foram obtidas dezoito e vinte concentrações séricas de vancomicina no pico e vale respectivamente, em recém-nascidos de termo, no período de outubro de 1995 a outubro de 1997. RESULTADO: O coeficiente de correlação linear para pico sérico foi de 0,27, p=0,110 e para vale sérico 0,26, p= 0,1045 não sendo estatisticamente significativo, não sendo estatisticamente significativo. CONCLUSÃO: Apesar da pequena casuística, não houve correlação estatisticamente significante entre os resultados obtidos pelos duas técnicas

Application of behavior change techniques in a personalized nutrition Electronic Health intervention study: protocol for the web-based Food4Me randomized controlled trial

Background: In order to determine the efficacy of behavior change techniques (BCT) applied in dietary and physical activity intervention studies, it is first necessary to record and describe techniques which have been used during such interventions. Published frameworks used in dietary and smoking cessation interventions undergo continuous development and most are not adapted for online delivery. The Food4Me study (N=1607) provided the opportunity to use existing frameworks to describe standardized online techniques employed in a large-scale internet-based intervention to change dietary behaviour and physical activity. Objectives: To describe techniques embedded in the Food4Me study design and explain the selection rationale. To demonstrate the use of behaviour change technique taxonomies, develop standard operating procedures for training, and identify strengths and limitations of the Food4Me framework that will inform its use in future studies. Methods: The 6-month randomized controlled trial took place simultaneously in 7 European countries, with participants receiving one of 4 levels of personalized advice (generalized, intake-based, intake+phenotype-based and intake+phenotype+gene-based). A 3-phase approach was taken: (I), existing taxonomies were reviewed and techniques were identified a priori for possible inclusion in the Food4Me study; (II) a standard operating procedure was developed to maintain consistency in the use of methods and techniques across research centers; (III) the Food4Me BCT framework was reviewed and updated post intervention. An analysis of excluded techniques was also conducted. Results: Of 46 techniques identified a priori as being applicable to Food4Me, 17 were embedded in the intervention design. Eleven were from a dietary taxonomy and 6 from a smoking cessation taxonomy. In addition, the 4-category smoking cessation framework structure was adopted for clarity of communication. Smoking cessation texts were adapted for dietary use where necessary. A posteriori, a further 9 techniques were included. Examination of excluded items highlighted the distinction between techniques considered appropriate for face-to-face vs internet-based delivery. Conclusions: The use of existing taxonomies facilitated the description and standardization of techniques used in Food4Me. We recommend that for complex studies of this nature, technique analysis should be conducted a priori to develop standardized procedures and training, and reviewed a posteriori to audit the techniques actually adopted. The present framework description makes a valuable contribution to future systematic reviews and meta-analyses which explore technique efficacy and underlying psychological constructs. This was a novel application of the behavior change taxonomies, and was the first internet-based personalized nutrition intervention to use such a framework remotely

Structure of Hierridin C, Synthesis of Hierridins B and C, and Evidence for Prevalent Alkylresorcinol Biosynthesis in Picocyanobacteria

Small, single-celled planktonic cyanobacteria are ubiquitous in the world's oceans yet tend not to be perceived as secondary metabolite-rich organisms. Here we report the isolation and structure elucidation of hierridin C, a minor metabolite obtained from the cultured picocyanobacterium Cyanobium sp. LEGE 06113. We describe a simple, straightforward synthetic route to the scarcely produced hierridins that relies on a key regioselective halogenation step. In addition, we show that these compounds originate from a type III PKS pathway and that similar biosynthetic gene clusters are found in a variety of bacterial genomes, most notably those of the globally distributed picocyanobacteria genera Prochlorococcus, Cyanobium and Synechococcus.info:eu-repo/semantics/publishedVersio

Inclusão, democracia e novo-desenvolvimentismo : um balanço histórico

Este trabalho analisa o processo do desenvolvimentismo brasileiro compreendido entre a fase clássica dos anos 1950 até a perspectiva atual do novo-desenvolvimentismo, privilegiando o papel e a função desempenhadas pelo tema da democracia e da inclusão distributiva em cada arranjo. Na primeira seção, analisa-se a constelação semântica que envolve os termos progresso e desenvolvimento, procurando separá-los do processo/projeto denominado desenvolvimentismo. Na segunda seção, discutem-se as fases e características centrais do velho e do novo-desenvolvimentismo brasileiro e a perspectiva de sua subdivisão em três ondas históricas, separadas pelo aspecto político democrático e pelo tema da redistribuição. Por último, apresentam-se algumas considerações sobre o novo-desenvolvimentismo em seu arranjo democrático-inclusivo.This paper analyzes the process of the Brazilian developmentalism between the classical phase of the 1950s to the current perspective of new developmentalism, emphasizing the role and function played by the theme of democracy and distributive inclusion in every arrangement. In the first section, it is analyzed the semantic constellation involving the terms progress and development, seeking to separate them from the process / project called developmentalism. In the second section, it is discussed the phases and the central features of the old and the new Brazilian developmentalism and the prospect of their subdivision into three historical waves, separated by the political democratic aspect and by the theme of redistribution. Finally it presents some considerations about the new developmentalism in its democratic-inclusive arrangement

Enfermeira: a construção de um modelo de comportamento a partir dos discursos médicos do início do século

El objetivo es trazar un paralelo entre el contenido de los discursos medicos y el comportamiento esperado y esteriotipado de las enfermeras del inicio del siglo. Tiene un abordaje hsitórico-social que utilizó como fuentes los discursos médicos y de enfermeras proferidos en las escuela de enfermagen y de medicina. El analisis de los discursos médicos comparada a los discursos de las enfermeras reflejan la formación de una mentalidad intrinsecamente modelada y socilizada por el poder médico que las deseaba santas y sometidas y sirvientes.O objetivo é traçar um paralelo entre o conteúdo dos discursos médicos e o comportamento esperado e estereotipado das enfermeiras do início do século. É uma abordagem histórico-social que utilizou como fontes os discursos médicos e de enfermeiras proferidos nas escolas de enfermagem e de medicina. A análise dos discursos médicos comparada aos discursos das enfermeiras refletem a formação de uma mentalidade intrinsecamente modelada e docilizada pelo poder médico que as desejava santas e subservientes.The purpose of this study is to trace a parallel between the medical discourse content and the expected and stereotyped nurses behavior at the beginning of the twentieth century. It is a historic-social approach in which authors analysed the speeches used by nurses and physicians at nursing and medicine schools. The analysis of the physicians discourse compared to nurses discourse revealed the formation of a mentality shaped by the medical power that wanted them "holy" and servile

Using qualitative and co-design methods to inform the development of an intervention to support and improve physical activity in childhood cancer survivors: a study protocol for BEing Active after ChildhOod caNcer (BEACON)

Introduction: Childhood cancer survivors (CCSs) treated with cardiotoxic cancer treatments are at increased risk of developing cardiometabolic complications. This risk is further exacerbated by poor health behaviours. In particular, CCSs are less active than non-cancer comparators. Existing interventions aiming to improve physical activity (PA) levels in CCSs are methodologically weak. The aim of this study is to rigorously and systematically develop an evidence-based and theoretically-informed intervention to promote, support, improve and sustain PA levels in CCSs, with the long-term goal of reducing CCSs’ cardiovascular morbidity and mortality. Methods and analysis: The BEing Active after ChildhOod caNcer (BEACON) study involves two workpackages at two National Health Service sites in England, UK. Participants will be CCSs and their parents, and healthcare professionals (HCPs) involved in their care. Workpackage one (WP1) will use qualitative methods to explore and understand the barriers and facilitators to PA in CCSs. Two sets of semistructured interviews will be conducted with (1) CCSs (aged 10–24 years) and (2) parents of CCSs. WP2 will use co-design methods to bring together stakeholders (CCSs; their parents; HCPs; researchers) to develop a prototype intervention. Where possible, all data will be audio recorded and transcribed. Data from WP1 will be analysed using a thematic approach. Analysis of WP2 data will involve content analysis, and analysis of formative output and procedures. Ethics and dissemination: The study was approved by North East-Tyne & Wear South Research Ethics Committee (REC ref: 18/NE/0274). Research findings will be disseminated primarily via national and international conferences and publication in peer-reviewed journals. Patient and public involvement will inform further dissemination activities