Behavioural counselling to increase consumption of fruit and vegetables in low income adults : randomised trial

Objective To measure the effect of brief behavioural counselling in general practice on patients’ consumption of fruit and vegetables in adults from a low income population. Design Parallel group randomised controlled trial. Setting Primary health centre in a deprived, ethnically mixed inner city area. Participants 271 patients aged 18-70 years without serious illness. Intervention Brief individual behavioural counselling based on the stage of change model; time matched nutrition education counselling. Main outcome measures Self reported number of portions of fruit and vegetables eaten per day, plasma β carotene, α tocopherol, and ascorbic acid concentrations, and 24 hour urinary potassium excretion. Assessment at baseline, eight weeks, and 12 months. Results Consumption of fruit and vegetables increased from baseline to 12 months by 1.5 and 0.9 portions per day in the behavioural and nutrition groups (mean difference 0.6 portions, 95% confidence interval 0.1 to 1.1). The proportion of participants eating five or more portions a day increased by 42% and 27% in the two groups (mean difference 15%, 3% to 28%). Plasma β carotene and α tocopherol concentrations increased in both groups, but the rise in β carotene was greater in the behavioural group (mean difference 0.16 μmol/l, 0.001 μmol/l to 1.34 μmol/l). There were no changes in plasma ascorbic acid concentrations or urinary potassium excretion. Differences were maintained when analysis was restricted to the 177 participants with incomes ≤ £400 (€596, $640) a week. Conclusions Brief individual counselling in primary care can elicit sustained increases in consumption of fruit and vegetables in low income adults in the general population

ASD, Employment and Mental Health

Factsheet for HR Departments (and employers more generally). This leaflet is designed to help Human Resources departments understand Autism Spectrum Disorder (ASD) and the impact of mental health on individuals with ASD in the workplace. It provides information on how HR can help, and 'Top Tips' to support employees with ASD & mental health difficulties

A systematic review and meta-analysis comparing mortality in pre-hospital tracheal intubation to emergency department intubation in trauma patients

Background Pre-hospital endotracheal intubation is frequently used for trauma patients in many emergency medical systems. Despite a wide range of publications in the field, it is debated whether the intervention is associated with a favourable outcome, when compared to more conservative airway measures. Methods A systematic literature search was conducted to identify interventional and observational studies where the mortality rates of adult trauma patients undergoing pre-hospital endotracheal intubation were compared to those undergoing emergency department intubation. Results Twenty-one studies examining 35,838 patients were included. The median mortality rate in patients undergoing pre-hospital intubation was 48% (range 8–94%), compared to 29% (range 6–67%) in patients undergoing intubation in the emergency department. Odds ratios were in favour of emergency department intubation both in crude and adjusted mortality, with 2.56 (95% CI: 2.06, 3.18) and 2.59 (95% CI: 1.97, 3.39), respectively. The overall quality of evidence is very low. Twelve of the twenty-one studies found a significantly higher mortality rate after pre-hospital intubation, seven found no significant differences, one found a positive effect, and for one study an analysis of the mortality rate was beyond the scope of the article. Conclusions The rationale for wide and unspecific indications for pre-hospital intubation seems to lack support in the literature, despite several publications involving a relatively large number of patients. Pre-hospital intubation is a complex intervention where guidelines and research findings should be approached cautiously. The association between pre-hospital intubation and a higher mortality rate does not necessarily contradict the importance of the intervention, but it does call for a thorough investigation by clinicians and researchers into possible causes for this finding.publishedVersio

Reaching and understanding

Individuals with Asperger syndrome, part of the autism spectrum, experience particular difficulties with social interaction and communication. Despite having average (or above average) intellectual ability, the vast majority of these individuals fail to secure, or maintain, long term employment. Furthermore, high rates of anxiety are common in this group and this further compounds employment difficulties. In this article we outline some of the difficulties experienced by those with Asperger syndrome in the workplace, as well as the role and responsibility of those working in HR Departments to support those with Asperger syndrome according to the Equality Act (2010). We provide specific ideas for interventions and support that may be appropriate to this group. The article links to the HR Factsheet also available (see http://eprints.gold.ac.uk/5624/)

High Local Diversity of Trypanosoma in a Common Bat Species, and Implications for the Biogeography and Taxonomy of the T. cruzi Clade

The Trypanosoma cruzi clade is a group of parasites that comprises T. cruzi sensu lato and its closest relatives. Although several species have been confirmed phylogenetically to belong to this clade, it is uncertain how many more species can be expected to belong into this group. Here, we present the results of a survey of trypanosome parasites of the bat Artibeus jamaicensis from the Panama´ Canal Zone, an important seed disperser. Using a genealogical species delimitation approach, the Poisson tree processes (PTP), we tentatively identified five species of trypanosomes – all belonging to the T. cruzi clade. A small monophyletic group of three putative Trypanosoma species places at the base of the clade phylogeny, providing evidence for at least five independent colonization events of these parasites into the New World. Artibeus jamaicensis presents a high diversity of these blood parasites and is the vertebrate with the highest number of putative trypanosome species reported from a single locality. Our results emphasize the need for continued efforts to survey mammalian trypanosomes

Hemiptera records from Lake Spechtensee and from Southern Styria (Austria)

Hemiptera records gained in July 2015 in course of the 7th European Hemiptera Congress in Styria are presented. In total, 144 Auchenorrhyncha, 143 Heteroptera, 13 Psylloidea and 2 Aphididae species were collected. Ribautodelphax imitans (Delphacidae), Eurhadina saageri (Cicadellidae), Notonecta maculata (Notonectidae), Notonecta meridionalis (Notonectidae) and Polymerus cognatus (Miridae) are new records for Styria

Visual and olfactory associative learning in the malaria vector Anopheles gambiae sensu stricto

<p>Abstract</p> <p>Background</p> <p>Memory and learning are critical aspects of the ecology of insect vectors of human pathogens because of their potential effects on contacts between vectors and their hosts. Despite this epidemiological importance, there have been only a limited number of studies investigating associative learning in insect vector species and none on Anopheline mosquitoes.</p> <p>Methods</p> <p>A simple behavioural assays was developed to study visual and olfactory associative learning in <it>Anopheles gambiae</it>, the main vector of malaria in Africa. Two contrasted membrane qualities or levels of blood palatability were used as reinforcing stimuli for bi-directional conditioning during blood feeding.</p> <p>Results</p> <p>Under such experimental conditions <it>An. gambiae </it>females learned very rapidly to associate visual (chequered and white patterns) and olfactory cues (presence and absence of cheese or Citronella smell) with the reinforcing stimuli (bloodmeal quality) and remembered the association for up to three days. Associative learning significantly increased with the strength of the conditioning stimuli used. Importantly, learning sometimes occurred faster when a positive reinforcing stimulus (palatable blood) was associated with an innately preferred cue (such as a darker visual pattern). However, the use of too attractive a cue (e.g. Shropshire cheese smell) was counter-productive and decreased learning success.</p> <p>Conclusions</p> <p>The results address an important knowledge gap in mosquito ecology and emphasize the role of associative memory for <it>An. gambiae</it>'s host finding and blood-feeding behaviour with important potential implications for vector control.</p

The Consumption of Khat and Other Drugs in Somali Combatants: A Cross-Sectional Study

Having interviewed military personnel in Somali, Michael Odenwald and colleagues conclude that drug-related problems, mainly relating to the use of khat, have reached proportions formerly unknown to the country

On the notion of home and the goals of palliative care

The notion of home is well known from our everyday experience, and plays a crucial role in all kinds of narratives about human life, but is hardly ever systematically dealt with in the philosophy of medicine and health care. This paper is based upon the intuitively positive connotation of the term “home.” By metaphorically describing the goal of palliative care as “the patient’s coming home,” it wants to contribute to a medical humanities approach of medicine. It is argued that this metaphor can enrich our understanding of the goals of palliative care and its proper objectives. Four interpretations of “home” and “coming home” are explored: (1) one’s own house or homelike environment, (2) one’s own body, (3) the psychosocial environment, and (4) the spiritual dimension, in particular, the origin of human existence. Thinking in terms of coming home implies a normative point of view. It represents central human values and refers not only to the medical-technical and care aspects of health care, but also to the moral context