What's the best way to motivate patients to exercise?

There is no single best strategy to motivate patients to exercise, given the lack of data from rigorous comparison studies. There are, however, several interventions for adults that are effective. They include: writing a patient-specific behavioral health ���green�۝ prescription, encouraging patients to join forces with accountability partners or support groups, recommending the use of pedometers (strength of recommendation [SOR]: A, meta-analyses). In children and adolescents, multi-component strategies that include school-based interventions combined with either family or community involvement increase physical activity (SOR: A, systematic review)

Book Reviews [ October 2014]

Reviews of the following four recent books: The Muslims are coming!: Islamophobia, extremism and the domestic war on terror by Arun Kundnani reviewed by Nasima Hassan, Senior Lecturer, University of East London; Beyond early reading by David Waugh and Sally Neaum (eds.) reviewed by Fran Paffard, Senior Lecturer in Early Years and Primary Education, University of East London; Action research in education by Mary McAteer, reviewed by Adrian Copping, Senior Lecturer, University of Cumbria; and Leading professional practice in education by Christine Wise, Pete Bradshaw and Marion Cartwright (eds.), reviewed by Michele J. Burns, Deputy Headteacher, The Sandon School, Essex

Advances in methods for determining fecundity: application of the new methods to some marine fishes

17 pages, 9 figures, 6 tables.Estimation of individual egg production (realized fecundity) is a key step either to understand the stock and recruit relationship or to carry out fisheries-independent assessment of spawning stock biomass using egg production methods. Many f ish are highly fecund and their ovaries may weigh over a kilogram; therefore the work time can be consuming and require large quantities of toxic fixative. Recently it has been shown for Atlantic cod (Gadus morhua) that image analysis can automate fecundity determination using a power equation that links follicles per gram ovary to the mean vitellogenic follicular diameter (the autodiametric method). In this article we demonstrate the precision of the autodiametric method applied to a range of species with different spawning strategies during maturation and spawning. A new method using a solid displacement pipette to remove quantitative fecundity samples (25, 50, 100, and 200 milligram [mg]) is evaluated, as are the underlying assumptions to effectively fix and subsample the ovary. Finally, we demonstrate the interpretation of dispersed formaldehyde-fixed ovarian samples (whole mounts) to assess the presence of atretic and postovulatory follicles to replace labor intensive histology. These results can be used to estimate down regulation (production of atretic follicles) of fecundity during maturation.T his study was jointly funded under Eu ropean Union Frame Work V Q5RS -2002 - 01825 and the Institutes in England (Department of the Environment, Food, and Rural Affairs), Norway (Institute of Marine Research), and Spain (Consejo Superior de Investigaciones Científ icas, and A ZTI Tecnalia (publication number 424))Peer reviewe

A study of the significance of photoparoxysmal responses and spontaneous epileptiform discharges in the EEG in childhood epilepsy

Aim: In clinical practice, there is a prevailing notion that photosensitivity mostly occurs in children with epilepsy (CWE) with idiopathic generalized epilepsy. We investigated the distribution of epilepsy types and etiology in photosensitive children and the associations with specific clinical and electroencephalogram (EEG) variables. Methods: In this retrospective cohort study, clinical data were acquired from all children that showed photosensitivity during systematic intermittent photic stimulation (IPS), over a 10-year interval at a tertiary level Children\u27s Hospital, Winnipeg. Patient demographics, EEG findings, and clinical data and symptoms during IPS were abstracted. Classification of diagnoses using the International League Against Epilepsy (ILAE) 2017 guidelines was done by an expert panel. Results: Seventy-eight photosensitive children were identified. Forty (51.3%) had generalized epilepsy (idiopathic: 27, structural: 2, other: 11) compared with 19 (24.4%) focal (idiopathic: 1, structural: 2, other: 16), 8 (10.3%) combined focal and generalized (structural: 4, other: 4), and 11 (14.1%) unknown epilepsy (other: 11); (χ2 (3) = 32.1, p = .000). Self-sustaining or outlasting photoparoxysmal responses (PPRs) occurred in association with all epilepsy types; however, the EEGs of focal CWE without treatment comprised almost solely of PPRs which outlasted the stimulus (8/10), in contrast to only 8/17 of focal CWE with treatment and to 13/26 of generalized epilepsy without treatment. Most frequency intervals in individual patients were less under treatment: a decrease in standardized photosensitivity range (SPR) was seen in 5 CWE, an increase in 2, and no change in 1 during treatment. Both CWE with focal and generalized epilepsy showed abnormal activity on EEG during hyperventilation (40% vs 65.7%). Thirteen out of 14 CWE with clinical signs during IPS had independent spontaneous epileptiform discharges (SEDs) in the EEG recording. Conclusion: Photosensitivity occurs in all types of epilepsy rather than in idiopathic generalized epilepsy alone. Surprisingly, there is a tendency for focal epilepsy to be associated with self-sustaining PPRs, especially when no treatment is used. Treatment tends to make the PPR more self-limiting and decrease the SPR. There is a tendency that clinical signs during IPS occur in EEGs in individuals with SEDs