Awareness of lifestyle and colorectal cancer risk:findings from the BeWEL study

It is estimated that 47% of colorectal cancers (CRC) could be prevented by appropriate lifestyles. This study aimed to identify awareness of the causes of CRC in patients who had been diagnosed with a colorectal adenoma through the Scottish Bowel Screening Programme and subsequently enrolled in an intervention trial (using diet and physical activity education and behavioural change techniques) (BeWEL). At baseline and 12-month follow-up, participants answered an open-ended question on factors influencing CRC development. Of the 329 participants at baseline, 40 (12%) reported that they did not know any risk factors and 36 (11%) failed to identify specific factors related to diet and activity. From a potential knowledge score of 1 to 6, the mean score was 1.5 (SD 1.1, range 0 to 5) with no difference between intervention and control groups. At follow-up, the intervention group had a significantly greater knowledge score and better weight loss, diet, and physical activity measures than the control group. Awareness of relevant lifestyle factors for CRC remains low in people at increased risk of the disease. Opportunities within routine NHS screening to aid the capability (including knowledge of risk factors) of individuals to make behavioural changes to reduce CRC risk deserve exploration.Additional co-author: The BeWEL team. The BeWEL Team consists of Shaun Treweek, Fergus Daly, Jill Belch, Jackie Rodger, Alison Kirk, Anne Ludbrook, Petra Rauchhaus, Patricia Norwood, Joyce Thompson, and Jane Wardle

Integrating agroecology and participatory action research (PAR): Lessons from Central America

The last decade has seen an increasing advancement and interest in the integration of agroecology and participatory action research (PAR). This article aims to: (1) analyze the key characteristics and principles of two case studies that integrated PAR and agroecology in Central America; and (2) learn from the lessons offered by these case studies, as well as others from the literature, on how to better integrate PAR and agroecology. Key principles identified for effective PAR agroecological processes include a shared interest in research by partners, a belief in collective power/action, a commitment to participation, practicing humility and establishing trust and accountability. Important lessons to consider for future work include: (1) research processes that did not start as PAR, can evolve into it; (2) farmer/stakeholder participation in setting the research agenda, from the outset, results in higher engagement and enhanced outcomes; (3) having the right partners for the desired outcomes is key; (4) intentional and explicit reflection is an essential component of PAR processes; and (5) cross-generational collaborations are crucial to long-term benefits. Key challenges that confront PAR processes include the need for time and resources over longer periods; the complexity of multi-actor process facilitation; and institutional barriers within the academy and development organizations, which prevent shifting investment towards integrated PAR agroecological processes

Meeting the challenges of recruitment to multicentre, community-based, lifestyle-change trials : a case study of the BeWEL trial

Peer reviewedPublisher PD

Detailed protocol for the lifestyle intervention in the BeWEL randomised controlled trial of weight loss in adults who have had a colorectal adenoma

Introduction: The BeWEL study is aimed at assessing the impact of a personalised lifestyle programme on body weight in people at risk of developing colorectal adenomas. The study is a two-arm multicentre randomised controlled trial comparing the BeWEL lifestyle programme against usual care. Over 12 months, 316 people who have had a colorectal adenoma removed through the national screening programme will be randomised to provide 80% power to detect a weight loss (primary outcome) of 7% over 12 months. Methods: The 12-month intervention will be delivered by lifestyle counsellors via three face-to-face visits followed by nine monthly telephone support calls. Consultant endorsement for the study will be stressed. An individualised caloric prescription based on estimates for weight maintenance -600 kcal will be calculated. Motivational interviewing techniques will be used to identify personal motivations for weight change and ways to improve perceived self-efficacy. The programme will utilise personalised diet and physical activity data from baseline measures to set behavioural goals. A range of behavioural strategies will be employed to support lifestyle change including goal setting, identifying specific implementation intentions, self-monitoring and feedback. Emphasis will be placed on self-monitoring body weight, and weighing scales will be provided. Programme acceptability will be explored postintervention with indepth interviews. Compliance and impact will be assessed by baseline and follow-up measures of diet by self-report, activity by accelerometry and anthropometry. Ethics and dissemination: Ethical approval has been obtained from the Tayside Committee on Medical Research Ethics. Dissemination of results will focus on publications in peer-reviewed journals, presentations at national/international cancer meetings and NHS groups. In addition, the work will be communicated to the public through forums such at The Scottish Cancer Prevention Network (http://www.cancerpreventionscotland.co.uk/). The trial is registered with Current Controlled Trials (International Standard Randomised Controlled Trials No: ISRCTN53033856)

A New Young Galactic Supernova Remnant Containing a Compact Object: G15.9+0.2

We identify the radio-emitting shell-type supernova remnant G15.9+0.2 as a relatively young remnant containing an X-ray point source that may be its associated neutron star. The integrated spectrum of the remnant shell obtained from our 30 ks exploratory Chandra observation shows very strong lines that require elevated element abundances from ejecta, in particular of sulfur. A plane-shock model fit gives a temperature $kT = 0.9 (0.8, 1.0)$ keV, an ionization timescale $n_et = 6 (4, 9) \times 10^{10}$ cm$^{-3}$ s, and a sulfur abundance of 2.1 (1.7, 2.7) times solar (90% confidence limits). Two-component models with one solar and one enriched component are also plausible, but are not well constrained by the data. Various estimates give a remnant age of order $10^3$ yr, which would make G15.9+0.2 among the dozen or so youngest remnants in the Galaxy. The sparse point source spectrum is consistent with either a steep $\Gamma \sim$ 4 power law or a $kT \sim$ 0.4 keV blackbody. The spectrum is absorbed by a H column density $N_H \sim 4 \times 10^{22}$ cm$^{-2}$ similar to that required for the remnant shell. The implied 2--9.5 keV source luminosity is about $10^{33}$ ergs s$^{-1}$ for an assumed distance of 8.5 kpc consistent with the high absorption column. We suggest that the point source is either a rotation-powered pulsar or a compact central object (CCO)

Autoregulation of the Escherichia coli melR promoter: repression involves four molecules of MelR

The Escherichia coli MelR protein is a transcription activator that autoregulates its own promoter by repressing transcription initiation. Optimal repression requires MelR binding to a site that overlaps the melR transcription start point and to upstream sites. In this work, we have investigated the different determinants needed for optimal repression and their spatial requirements. We show that repression requires a complex involving four DNA-bound MelR molecules, and that the global CRP regulator plays little or no role

Ecological equivalence: a realistic assumption for niche theory as a testable alternative to neutral theory

Hubbell's 2001 neutral theory unifies biodiversity and biogeography by modelling steady-state distributions of species richness and abundances across spatio-temporal scales. Accurate predictions have issued from its core premise that all species have identical vital rates. Yet no ecologist believes that species are identical in reality. Here I explain this paradox in terms of the ecological equivalence that species must achieve at their coexistence equilibrium, defined by zero net fitness for all regardless of intrinsic differences between them. I show that the distinction of realised from intrinsic vital rates is crucial to evaluating community resilience. An analysis of competitive interactions reveals how zero-sum patterns of abundance emerge for species with contrasting life-history traits as for identical species. I develop a stochastic model to simulate community assembly from a random drift of invasions sustaining the dynamics of recruitment following deaths and extinctions. Species are allocated identical intrinsic vital rates for neutral dynamics, or random intrinsic vital rates and competitive abilities for niche dynamics either on a continuous scale or between dominant-fugitive extremes. Resulting communities have steady-state distributions of the same type for more or less extremely differentiated species as for identical species. All produce negatively skewed log-normal distributions of species abundance, zero-sum relationships of total abundance to area, and Arrhenius relationships of species to area. Intrinsically identical species nevertheless support fewer total individuals, because their densities impact as strongly on each other as on themselves. Truly neutral communities have measurably lower abundance/area and higher species/abundance ratios. Neutral scenarios can be parameterized as null hypotheses for testing competitive release, which is a sure signal of niche dynamics. Ignoring the true strength of interactions between and within species risks a substantial misrepresentation of community resilience to habitat los