The variation in pressures exerted by commercially available compression garments

Commercially available compression garments (CGs) demonstrate the enhanced recovery from exercise in some, but not all studies. It is possible that in some cases the degree of compression pressure (ComP) exerted is not sufficient to produce any physiological benefit. The aim of this investigation was to identify the levels of ComP exerted by commercially available CGs. This study was composed of two parts. In part A 50 healthy, physically active individuals (n=26 male, n=24 female) were fitted with CGs according to manufacturer’s guidelines. ComP was measured in participants standing in the anatomical position with a pressure measurement device inserted between the skin and the garment. Data were compared to ‘ideal’ pressure values proposed in the literature. In part B ComP in three different brands of CG were compared in a population of 29 men who all wore a medium sized garment. A one way ANOVA indicated that there was a significant difference (P0.05) between observed and ideal pressures in the calf of the male population. No significant differences in pressure (P>0.05) were observed between CG brands at the quadriceps or calf. In conclusion a large number of individuals may not be experiencing an adequate ComP from CG, and this is true for all 3 of the major brands of CGs tested in this investigation

Microscopic heat from the energetics of stochastic phenomena

The energetics of the stochastic process has shown the balance of energy on the mesoscopic level. The heat and the energy defined there are, however, generally different from their macroscopic counterpart. We show that this discrepancy can be removed by adding to these quantities the reversible heat associated with the mesoscopic free energy.Comment: 4 pages, 0 figur

N-of-1 randomized trials for psychological and health behavior outcomes: a systematic review protocol

Background Randomized controlled trials are the sine qua non of causal inference; however, heterogeneity of treatment effects for many chronic conditions and for many symptoms often limits their utility. Single-patient studies in which patients select a treatment after trying a randomized sequence of treatments (i.e., multiple crossover trials) offer an alternative to traditional randomized controlled trials by providing scientifically valid results in a practical manner that can be used by patients and their providers to decide upon their personally optimal treatment. Although N-of-1 trials have been used in the medical literature, their use for interventions that consist of psychological or health behavior outcomes is unknown. This systematic review thus aims to describe the interventions and outcomes and assess the quality of N-of-1 trials for psychological or health behavior outcomes. Methods/Design Electronic databases (Ovid MEDLINE, EMBASE, CINAHL, PsycINFO, and the six databases in the Cochrane Library) will be searched using all relevant subject headings and free-text terms to represent N-of-1 trials and psychological or behavioral interventions. Full text review and bibliography searching will be conducted. Unpublished studies will be sought by searching trial registries and contacting authors of included studies. Eligibility criteria are the following: population, all human participants for whom N-of-1 trials with psychological or health behavior outcomes have been conducted; interventions, all interventions for which N-of-1 trials have been conducted; comparison, placebo or active treatment control; and outcome, psychological and health behavior outcomes including self-perceived disease severity and psychological phenomena such as mood and affect. Studies that do not contain sufficient trial detail, describe only design or statistical analytic issues in N-of-1 trials without presentation of an N-of-1 trial itself, and/or are not written in the English language are ineligible. Screening, data extraction, and quality assessment will be conducted by two independent reviewers with disagreements resolved through discussion. Discussion This systematic review will describe the interventions and outcomes and assess the quality of N-of-1 trials for psychological or health behavior outcomes. The results will clarify the use of this research methodology in the health psychology and behavioral medicine literature and may pave the way for additional N-of-1 trials to be conducted

Exploring Meaningful Patient Engagement in ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness).

BackgroundGenuine patient engagement can improve research relevance, impact and is required for studies using the National Patient-Centered Clinical Research Network including major multicenter research projects. It is unclear, however, how best to integrate patients into governance of such projects.MethodsADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness) is the first major multicenter research project to be conducted in National Patient-Centered Clinical Research Network. Here, we provide a description of how we implemented patient engagement in ADAPTABLE thus far, including a description of committee structures and composition, first-hand patient testimonials, specific contributions, and lessons learned during the planning and early implementation of ADAPTABLE.ResultsWe recruited 1 patient leader from 6 of the 7 enrolling networks to serve on a Patient Review Board for ADAPTABLE, supported the Board with an experienced patient engagement team including an "investigator-advocate" not otherwise involved in the trial, and facilitated bidirectional communication between the Board and ADAPTABLE Coordinating Center. The Board has reviewed and provided substantial input on the informed consent procedure, recruitment materials, patient portal design, and study policy including compensation of participants. Although it was "too late" for some suggested modifications, most modifications suggested by the patient leaders have been implemented, and they are enthusiastic about the study and their role. The patient leaders also attend Steering and Executive Committee calls; these experiences have been somewhat less productive.ConclusionsWith adequate support, a cadre of committed patient leaders can provide substantial value to design and implementation of a major multicenter clinical trial

Career development and good practice in the retail sector in England: A national study to investigate the barriers to women's promotion to senior positions in retail management

The University of Bolton and The Centre for Diversity and Work Psychology, Manchester Business School, The University of Manchester, conducted an important, ground-breaking national study co-financed by the European Social Fund. This study investigated career development issues and generated examples of good practice for women and men in middle and senior management positions in the retail industry (store managers to senior executives to board level). The results and recommendations from this study will be developed into guidelines for the Government and will be of value to the UK retail sector in ensuring the full utilisation of talents of both female and male employees

Aircraft/island/ship/satellite intercomparison: Preliminary results from July 16, 1987

The First ISCCP Regional Experiment (FIRE) objective of validating and improving satellite algorithms for inferring cloud properties from satellite radiances was one of the central motivating factors in the design of the specific field experimental strategies used in the July, 1987 marine stratocumulus intensive field observations (IFO). The in situ measuring platforms were deployed to take maximum advantage of redundant measurements (for intercomparison of the in situ sensors) and to provide optimal coverage within satellite images. One of the most ambitious of these strategies was the attempt to coordinate measurements from San Nicolas Island (SNI), the R/V Pt. Sur, the meteorological aircraft, and the satellites. For the most part, this attempt was frustrated by flight restrictions in the vicinity of SNI. The exception was the mission of July 16, 1987, which achieved remarkable success in the coordination of the platforms. This presentation concerns operations conducted by the National Center for Atmospheric Research (NCAR) Electra and how data from the Electra can be integrated with and compared to data from the Pt. Sur, SNI, and the satellites. The focus is on the large-scale, integrated picture of the conditions on July 16 from the perspective of the Electra's flight operations

Enhancing the Evidence for Behavioral Counseling A Perspective From the Society of Behavioral Medicine

U.S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. As a result, the broad integration of behavioral counseling interventions in primary care remains elusive. Thus, there is an urgent need for novel perspectives on how to generate the highest-quality and -certainty evidence for primary care–focused behavioral counseling interventions. As members of the Society of Behavioral Medicine (SBM)—a multidisciplinary scientific organization committed to improving population health through behavior change—we review the USPSTF mandate and current recommendations for behavioral counseling interventions and provide a perspective for the future that calls for concerted and coordinated efforts among SBM, USPSTF, and other organizations invested in the rapid and wider uptake of beneficial, feasible, and referable primary care–focused behavioral counseling interventions. This perspective highlights five areas for further development, including (1) behavioral counseling–focused practice-based research networks; (2) promotion of USPSTF evidence standards and the increased use of pragmatic RCT design; (3) quality control and improvement procedures for behavioral counseling training; (4) systematic research on effective primary care–based collaborative care models; and (5) methodologic innovations that capitalize on disruptive technologies and healthcare transformation. Collective efforts to improve the health of all Americans in the 21st century and beyond must ensure that effective, feasible, and referable behavioral counseling interventions are embedded in modern primary care practice

Generalized Geologic Map for Land-Use Planning: Boone County, Kentucky

This map is not intended to be used for selecting individual sites. Its purpose is to inform land-use planners, government officials, and the public in a general way about geologic bedrock conditions that affect the selection of sites for various purposes. The properties of thick soils may supercede those of the underlying bedrock and should be considered on a site-to-site basis. At any site, it is important to understand the characteristics of both the soils and the underlying rock

Second generation catalytic enantioselective nucleophilic desymmetrization at P(V): improved generality, efficiency and modularity

A broadly improved second generation catalytic two-phase strategy for the enantioselective synthesis of chiral at phosphorus (V) compounds is described. This protocol, consisting of a bifunctional iminophosphorane (BIMP) catalyzed nucleophilic desymmetrization of prochiral, bench stable P(V) precursors and subsequent enantiospecific substitution allows for divergent access to a wide range of C-, N-, O- and S- substituted P(V) containing compounds from a handful of enantioenriched precursors. A new ureidopeptide BIMP catalyst/thiaziolidinone leaving group combination allowed for a far wider substrate scope and increased reaction efficiency and practicality over previously established protocols. The resulting enantioenriched intermediates could then be transformed into an even greater range of distinct classes of P(V) compounds by displacement of the remaining leaving group as well as allowing for even further diversification downstream. Density functional theory (DFT) calculations were performed to pinpoint the origin of enantioselectivity for the BIMP-catalyzed desymmetrization, to rationalize how a superior catalyst/leaving group combination leads to increased generality in our second-generation catalytic system, as well as to shed light onto observed retention and inversion pathways when performing late-stage enantiospecific SN2@P reactions with Grignard reagents

Generalized Geologic Map for Land-Use Planning: Wolfe County, Kentucky

This map is not intended to be used for selecting individual sites. Its purpose is to inform land-use planners, government officials, and the public in a general way about geologic bedrock conditions that affect the selection of sites for various purposes. The properties of thick soils may supercede those of the underlying bedrock and should be considered on a site-to-site basis. At any site, it is important to understand the characteristics of both the soils and the underlying rock