Developing a Health Needs Assessment for people living with neurological conditions in Lincolnshire

The Healthy Ageing Research Group (HARG) from the School of Health and Social Care at the University of Lincoln were commissioned by Lincolnshire County Council to undertake an independent health needs assessment for people living with neurological conditions in the county in September 2017. The purpose of this work is to establish the distribution of neurological conditions within the county; the level of service activity; gaps and limitations in service provision as well as examples of effective provision and good practice. The review focuses on adults over the age of 18, and young adults transitioning into adult services, with a range of neurological conditions, including stroke. The report does not include data on people with dementia

Provider reported implementation of nutrition-related practices in childcare centers and family childcare homes in rural and urban Nebraska

Approximately 15 million children under age 6 are in childcare settings, offering childcare providers an opportunity to influence children’s dietary intake. Childcare settings vary in organizational structure – childcare centers (CCCs) vs. family childcare homes (FCCHs) – and in geographical location – urban vs. rural. Research on the nutrition-related best practices across these childcare settings is scarce. The objective of this study is to compare nutrition-related best practices of CCCs and FCCHs that participate in the Child and Adult Care Food Program (CACFP) in rural and urban Nebraska. Nebraska providers (urban n = 591; rural n = 579) reported implementation level, implementation difficulty and barriers to implementing evidence-informed food served and mealtime practices. Chi-square tests comparing CCCs and FCCHs in urban Nebraska and CCCs and FCCHs in rural Nebraska showed sub-optimal implementation for some practices across all groups, including limiting fried meats and high sugar/ high fat foods, using healthier foods or non-food treats for celebrations and serving meals family style. Significant differences (p \u3c .05) between CCCs and FCCHs also emerged, especially with regard to perceived barriers to implementing best practices. For example, CCCs reported not having enough money to cover the cost of meals for providers, lack of control over foods served and storage problems, whereas FCCHs reported lack of time to prepare healthier foods and sit with children during mealtimes. Findings suggest that policy and public health interventions may need to be targeted to address the unique challenges of implementing evidence-informed practices within different organizational structures and geographic locations

The accuracy of chromosomal microarray testing for identification of embryonic mosaicism in human blastocysts

A dança é uma forma ancestral de magia, invenção dos deuses que a ensinaram aos homens, diz-nos a mitologia hindu. Envolvido no mistério e movimento da dança, o dançarino pode encantar; porém, antes de tudo é preciso que encante a si mesmo. Não seria este também o caminho do professor? Fazer para si para poder fazer ou propor aos educandos, encantar-se para poder encantar; criar para poder seguir com as crianças a aventura da criação; ousar para poder encorajar? Nesta direção, a pergunta que percorre o presente artigo é assim formulada: como contribuir com o processo de encantamento dos professores, como alimentar a sensibilidade, nos percursos da formação universitária? Buscando respostas no processo de pesquisa, identifica-se na experiência com as danças circulares, tradição de diferentes povos, um profícuo caminho pelo qual aquele espaço de encantamento, de inteireza, de educação estética, igualmente, pode ser provocado

How can I thank you? Highlighting the benefactor’s responsiveness or costs when expressing gratitude

Despite growing evidence that showing gratitude plays a powerful role in building social connections, little is known about how to best express gratitude to maximize its relational benefits. In this research, we examined how two key ways of expressing gratitude—conveying that the benefactor’s kind action met one’s needs (responsiveness-highlighting) and acknowledging how costly the action was (cost-highlighting)—impact benefactors’ reactions to the gratitude and feelings about their relationship. Using observer ratings of gratitude expressions during couples’ live interactions (N = 111 couples), and benefactors’ self-reports across a 14-day experience sampling study (N = 463 daily reports), we found that responsiveness-highlighting was associated with benefactors’ positive feelings about the gratitude expression and the relationship. In contrast, cost-highlighting had no such effect. These findings suggest that expressing gratitude in a way that highlights how responsive benefactors were may be critical to reaping the relational benefits of gratitude and have practical implications for improving couples’ well-being

Provider reported implementation of nutrition-related practices in childcare centers and family childcare homes in rural and urban Nebraska

Approximately 15 million children under age 6 are in childcare settings, offering childcare providers an opportunity to influence children’s dietary intake. Childcare settings vary in organizational structure – childcare centers (CCCs) vs. family childcare homes (FCCHs) – and in geographical location – urban vs. rural. Research on the nutrition-related best practices across these childcare settings is scarce. The objective of this study is to compare nutrition-related best practices of CCCs and FCCHs that participate in the Child and Adult Care Food Program (CACFP) in rural and urban Nebraska. Nebraska providers (urban n = 591; rural n = 579) reported implementation level, implementation difficulty and barriers to implementing evidence-informed food served and mealtime practices. Chi-square tests comparing CCCs and FCCHs in urban Nebraska and CCCs and FCCHs in rural Nebraska showed sub-optimal implementation for some practices across all groups, including limiting fried meats and high sugar/ high fat foods, using healthier foods or non-food treats for celebrations and serving meals family style. Significant differences (p \u3c .05) between CCCs and FCCHs also emerged, especially with regard to perceived barriers to implementing best practices. For example, CCCs reported not having enough money to cover the cost of meals for providers, lack of control over foods served and storage problems, whereas FCCHs reported lack of time to prepare healthier foods and sit with children during mealtimes. Findings suggest that policy and public health interventions may need to be targeted to address the unique challenges of implementing evidence-informed practices within different organizational structures and geographic locations

Connective Tissue Activation. I. The Nature, Specificity, Measurement and Distribution of Connective Tissue Activating Peptide

A polypeptide which induces hypermetabolism in normal synovial fibroblasts in tissue culture is described. The metabolic changes induced included a marked increase in hyaluronate formation, lactate formation and glucose uptake; formation of soluble and fibrous collagen was depressed. An assay method is presented which permits quantitative comparisons of samples for connective tissue activating peptide (CTAP) activity. The CTAP appeared to be widely distributed in human tissues, the amount of activity being a function of cell density. A role for CTAP in rheumatoid inflammation is proposed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/37716/1/1780140107_ftp.pd

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570