Development of a readiness ruler for use with alcohol brief interventions

Background A quick method of assessing readiness to change was needed for a major study of implementing screening and alcohol brief intervention in England. For this purpose, a Readiness Ruler that had been validated among a sample of male college students in the USA was adapted and applied to a sample of excessive drinkers in a general medical practice located in a deprived area of Gateshead, England. Methods 72 participants identified as excessive drinkers by health professionals completed a single-item Readiness Ruler, the 12-item Readiness to Change Questionnaire (RCQ) and the AUDIT questionnaire. Results In terms of concurrent validity, the relationships between the Readiness Ruler, on the one hand, and either stage of change allocation or a dimensional score derived from the RCQ, on the other hand, were highly significant but weaker than expected. When patients who endorsed the “maintenance” point on the Readiness Ruler were excluded from the analysis, the above relationships were considerably strengthened for reasons that are discussed. On this basis and with another small change, a final Readiness Ruler was developed. Conclusion If the validity of the Readiness Ruler is confirmed in subsequent research, a quick and simple way of measuring readiness to change will be available for research or clinical work with alcohol brief interventions

Will the NHS continue to function in an influenza pandemic? A survey of healthcare workers in the West Midlands, UK

If UK healthcare services are to respond effectively to pandemic influenza, levels of absenteeism amongst healthcare workers (HCWs) must be minimised. Current estimates of the likelihood that HCWs will continue to attend work during a pandemic are subject to scientific and predictive uncertainty, yet an informed evidence base is needed if contingency plans addressing the issues of HCW absenteeism are to be prepared

Decline in Methylmercury in Museum-Preserved Bivalves from San Francisco Bay, California

There are ongoing efforts to manage mercury and nutrient pollution in San Francisco Bay (California, USA), but historical data on biological responses are limited. We used bivalves preserved in formalin or ethanol from museum collections to investigate long-term trends in methylmercury (MeHg) concentrations and carbon and nitrogen isotopic signatures. In the southern reach of the estuary, South Bay, MeHg in the Asian date mussel (Musculista senhousia) significantly declined over the study duration (1970 to 2012). Mean MeHg concentrations were highest (218 ng/g dry weight, dw) in 1975 and declined 3.8-fold (to 57 ng/g dw) by 2012. This decrease corresponded with closure of the New Almaden Mercury Mines and was consistent with previously observed declines in sediment core mercury concentrations. In contrast, across all sites, MeHg in the overbite clam (Potamocorbula amurensis) increased 1.3-fold from 64 ng/g dw before 2000 to 81 ng/g dw during the 2000s and was higher than in M. senhousia. Pearson correlation coefficients of the association between MeHg and δ13C or δ15N provided no evidence that food web alterations explained changing MeHg concentrations. However, isotopic composition shifted temporally. South Bay bivalve δ15N increased from 12‰ in the 1970s to 18‰ in 2012. This increase corresponded with increasing nitrogen loadings from wastewater treatment plants until the late 1980s and increasing phytoplankton biomass from the 1990s to 2012. Similarly, a 3‰ decline in δ13C from 2002 to 2012 may represent greater utilization of planktonic food sources. In a complimentary 90 day laboratory study to validate use of these preserved specimens, preservation had only minor effects (\u3c 0.5‰) on δ13C and δ15N. MeHg increased following preservation but then stabilized. These are the first documented long-term trends in biota MeHg and stable isotopes in this heavily impacted estuary and support the utility of preserved specimens to infer contaminant and biogeochemical trends

Datos de composición de alimentos: obtención, gestión y utilización

RESUMEN La primera edición de este libro se utilizó proficuamente en la capacitación de los analistas y compiladores que se ocupan de composición de alimentos en todo el mundo durante el primer curso de capacitación sobre composición de alimentos celebrado en Wageningen (Países Bajos) en octubre de 1992. Posteriormente se impartieron otros cinco cursos más en Wageningen y otros en las regiones en desarrollo, a saber, se celebró un curso en Chile para los países de la Red latinoamericana de composición de alimentos (LATINFOODS), uno en Jamaica para los países del Centro regional de datos de la INFOODS para los países de la Comunidad del Caribe (CARICOMFOODS), uno en Tailandia para el Centro regional de datos de la INFOODS para los países de la Asociación de Naciones de Asia Sudoriental (ASEANFOODS) y de la Asociación del Asia Meridional para la Cooperación Regional (SAARCFOODS) y tres en Sudáfrica para el Centro subregional de datos del AFROFOODS para los países del África oriental, central y austral (ECAFOODS). La utilización del libro en los cursos de capacitación de la Universidad de las Naciones Unidas/INFOODS puso de manifiesto la necesidad de introducir cambios para actualizar el texto y las figuras, en particular para lograr una mayor facilidad de uso en ámbito internacional. A medida que pasaba el tiempo, la enorme proliferación de métodos de análisis hizo cada vez más patente que el libro estaba quedando anticuado con rapidez. Además, con el establecimiento de programas sobre la composición de alimentos en todo el mundo aumentó el acervo de experiencia disponible. Sin embargo, la revisión no era viable como proyecto comercial. Si bien el libro se utilizó en la enseñanza de algunos cursos de tercer ciclo, en su mayor parte en países industrializados, el costo prohibitivo de la primera edición hizo que adquirieran la obra sobre todo bibliotecas, y no particulares o programas locales sobre la composición de alimentos. Cuando se agotó la primera edición, los autores originales recuperaron los derechos de auto

The Clinical Teaching Fellow role:exploring expectations and experiences

BackgroundMany UK junior doctors are now taking a year out of the traditional training pathway, usually before specialty training, and some choose to work as a clinical teaching fellow (CTF). CTFs primarily have responsibility for delivering hospital-based teaching to undergraduate medical students. Only a very small amount of literature is available regarding CTF posts, none of which has explored why doctors choose to undertake the role and their expectations of the job. This study aimed to explore the expectations and experiences of CTFs employed at NHS hospital Trusts in the West Midlands.MethodsCTFs working in Trusts in the West Midlands region registered as students on the Education for Healthcare Professionals Post Graduate Certificate course at the University of Birmingham in August 2019 took part in a survey and a focus group.ResultsTwenty-eight CTFs participated in the survey and ten participated in the focus group. In the survey, participants reported choosing a CTF role due to an interest in teaching, wanting time out of training, and being unsure of which specialty to choose. Expectations for the year in post were directly related to reasons for choosing the role with participants expecting to develop teaching skills, and have a break from usual clinical work and rotations. The focus group identified five main themes relating to experiences starting their job, time pressures and challenges faced in post, how CTF jobs differed between Trusts, and future career plans. Broadly, participants reported enjoying their year in a post at a mid-year point but identified particular challenges such as difficulties in starting the role and facing time pressures in their day-to-day work.ConclusionThis study has provided a valuable insight into the CTF role and why doctors choose a CTF post and some of the challenges experienced, adding to the sparse amount of literature. Understanding post holders’ experiences may contribute to optimisation of the role. Those employing CTFs should consider ensuring a formal handover process is in place between outgoing and incoming CTFs, having a lead person at their Trust responsible for evaluating changes suggested by CTFs, and the balance of contractual duties and personal development time

Dietary Manipulation for Therapeutic Effect in Prostate Cancer

Given that there is a wealth of literature on the potential effect of a wide variety of phytochemicals on the growth of prostate cancer cells, we have limited our discussion to arguably four of the most important: isoflavones, lycopene, resveratrol, and curcumin. The focus of this review is on the clinical pharmacology of these compounds, as there are already an extensive number of reviews in the literature on all of these compounds for various cancers, including our previous review of isoflavones in prostate cancer (de Souza et al., 2009). Here, we use the loose term “phytochemicals” to describe this group of plant–based compounds with biological activity in vitro, for simplicity. Like other phytochemicals, isoflavones, lycopene, resveratrol and curcumin have a wide variety of potential mechanisms of action in many different cancer cell lines. Many of these biological effects involve key components of signal transduction pathways within cancer cells, but in this review, we will be focusing on studies specifically in prostate cancer

Vitamin D3 and 25-Hydroxyvitamin D3 Content of Retail White Fish and Eggs in Australia

Dietary vitamin D may compensate for inadequate sun exposure; however, there have been few investigations into the vitamin D content of Australian foods. We measured vitamin D3 and 25-hydroxyvitamin D3 (25(OH)D3) in four species of white fish (barramundi, basa, hoki and king dory), and chicken eggs (cage and free-range), purchased from five Australian cities. Samples included local, imported and wild-caught fish, and eggs of varying size from producers with a range of hen stocking densities. Raw and cooked samples were analysed using high performance liquid chromatography with photodiode array. Limits of reporting were 0.2 and 0.1 µg/100 g for vitamin D3 and 25(OH)D3, respectively. The vitamin D3 content of cooked white fish ranged from <0.1 to 2.3 µg/100 g, and the 25(OH)D3 content ranged from 0.3 to 0.7 µg/100 g. The vitamin D3 content of cooked cage eggs ranged from 0.4 to 0.8 µg/100 g, and the 25(OH)D3 content ranged from 0.4 to 1.2 µg/100 g. The vitamin D3 content of cooked free-range eggs ranged from 0.3 to 2.2 µg/100 g, and the 25(OH)D3 content ranged from 0.5 to 0.8 µg/100 g. If, as has been suggested, 25(OH)D3 has five times greater bioactivity than vitamin D3, one cooked serve (100 g) of white fish, and one cooked serve of cage or free-range eggs (120 g) may provide 50% or 100%, respectively, of the current guidelines for the adequate intake of vitamin D (5 µg) for Australians aged 1-50 years

Adapting and testing a brief intervention to reduce maternal anxiety during pregnancy (ACORN): study protocol for a randomised controlled trial.

BACKGROUND: National guidelines in the UK, United States of America, Canada, and Australia have recently stressed the importance of identifying and treating antenatal anxiety and depression. However, there is little research into the most effective and acceptable ways of helping women manage their symptoms of anxiety and stress during pregnancy. Research indicates the necessity to consider the unique needs and concerns of perinatal populations to ensure treatment engagement, highlighting the need to develop specialised treatments which could be integrated within routine antenatal healthcare services. This trial aims to develop a brief intervention for antenatal anxiety, with a focus on embedding the delivery of the treatment within routine antenatal care. METHODS/DESIGN: This study is a two-phase feasibility trial. In phase 1 we will develop and pilot a brief intervention for antenatal anxiety, blended with group support, to be led by midwives. This intervention will draw on cognitive behavioural principles and wider learning from existing interventions that have been used to reduce anxiety in expectant mothers. The intervention will then be tested in a pilot randomised controlled trial in phase 2. The following outcomes will be assessed: (1) number of participants meeting eligibility criteria, (2) number of participants consenting to the study, (3) number of participants randomised, (4) number of sessions completed by those in the intervention arm, and (5) number of participants completing the post-intervention outcome measures. Secondary outcomes comprise: detailed feedback on acceptability, which will guide further development of the intervention; and outcome data on symptoms of maternal and paternal anxiety and depression, maternal quality of life, quality of couple relationship, mother-child bonding, infant temperament and infant sleep. DISCUSSION: The study will provide important data to inform the design of a future full-scale randomised controlled trial of a brief intervention for anxiety during pregnancy. This will include information on its acceptability and feasibility regarding implementation within current antenatal services, which will inform whether ultimately this provision could be rolled out widely in healthcare settings. TRIAL REGISTRATION: Current Controlled Trials ISRCTN95282830 . Registered on 29 October 2014

Influence of body composition, muscle strength, diet and physical activity on total body and forearm bone mass in Chinese adolescent girls

The aim of the present study was to determine association between body composition, muscle strength, diet and physical exercise with bone mineral content (BMC) and bone area (BA) in 283 Chinese adolescent girls aged 15 years in Beijing, China. Body composition, pubertal stage, physical activity and dietary intakes were assessed using standard validated protocols. Total body and forearm bone, lean body mass (LBM) and fat body mass (FBM) were determined by dual X-ray absorptiometry. Multivariate linear regression analyses were carried out to examine the predictors of BMC and BA, after controlling for potential confounders. The subjects had a mean age of 15·0 (SD 0·9) years and 99·6% of them had reached menarche. Multivariate analyses showed that LBM, FBM, handgrip muscle strength and milk intake were significant independent determinants of BMC and BA of the total body and/or forearm sites. LBM was found to be a stronger independent determinant than FBM of BMC and BA, whereas handgrip muscle strength was only found as significant determinant of BMC and BA at the forearm sites than in total body BMC and BA. Further, total physical activity level had a significant positive association with handgrip and LBM. This suggested that greater muscle strength and higher LBM may reflect higher levels of physical activity. Therefore, continuous healthy lifestyle practices such as adequate intake of milk and continuous participation in physical activity should be encouraged throughout adolescence to optimise bone growth during this period

Vitamin D3 and 25-hydroxyvitamin D3 content of retail white fish and eggs in Australia

Dietary vitamin D may compensate for inadequate sun exposure; however, there have been few investigations into the vitamin D content of Australian foods. We measured vitamin D3 and 25-hydroxyvitamin D3 (25(OH)D3) in four species of white fish (barramundi, basa, hoki and king dory), and chicken eggs (cage and free-range), purchased from five Australian cities. Samples included local, imported and wild-caught fish, and eggs of varying size from producers with a range of hen stocking densities. Raw and cooked samples were analysed using high performance liquid chromatography with photodiode array. Limits of reporting were 0.2 and 0.1 μg/100 g for vitamin D3 and 25(OH)D3, respectively. The vitamin D3 content of cooked white fish ranged from <0.1 to 2.3 μg/100 g, and the 25(OH)D3 content ranged from 0.3 to 0.7 μg/100 g. The vitamin D3 content of cooked cage eggs ranged from 0.4 to 0.8 μg/100 g, and the 25(OH)D3 content ranged from 0.4 to 1.2 μg/100 g. The vitamin D3 content of cooked free-range eggs ranged from 0.3 to 2.2 μg/100 g, and the 25(OH)D3 content ranged from 0.5 to 0.8 μg/100 g. If, as has been suggested, 25(OH)D3 has five times greater bioactivity than vitamin D3, one cooked serve (100 g) of white fish, and one cooked serve of cage or free-range eggs (120 g) may provide 50% or 100%, respectively, of the current guidelines for the adequate intake of vitamin D (5 µg) for Australians aged 1–50 years. View Full-Text Keywords: food composition data; vitamin D3; 25-hydroxyvitamin D3; fish; eggsSample purchase, preparation and analysis was funded by the Western Australia Department of Health. L.J.B is funded by a Curtin University Research Fellowship; R.M.L is funded by a NHMRC Senior Research Fellowship