Moving Beyond the Stigma: Systematic Review of Video Games and Their Potential to Combat Obesity

Increasing epidemic proportions of overweight children in the United States presents formidable challenges for education and healthcare. Given the popularity and pervasiveness of video gaming culture in North American children, the perfect opportunity arises to investigate the potential of video games to promote healthful behaviour. Our objective was to systematically review the literature for possible benefits of active and educational video games targeting diet and physical activity in children. A review of English-language journal articles from 1998 to 2011 using EMBASE and PubMed was conducted. Thirty-four studies concerned with children, video games, physical, and/or nutritional outcomes were included. Results of these studies that showed some benefit (increased physical activity and nutritional knowledge as a result of gaming) demonstrate the possibility of video games to combat childhood obesity—looking beyond the stigma attached to gaming

Applying Knowledge Translation in Rehabilitation: An Exploration of What it Means to Change Clinical Practice

Health care providers are often required to implement evidence-based recommendations into the care they deliver. Resources that support health care providers’ efforts are a useful knowledge translation strategy. This thesis describes the development and usability evaluation of an evidence-informed clinical practice implementation toolkit to support implementation efforts. Two studies were undertaken to provide insight into what was needed to support health care providers, and to inform the development of the toolkit. A retrospective evaluation analyzed the performance of a team implementing a pressure ulcer risk assessment for patients with spinal cord injury. The rates of adherence to the risk assessment and action plan were low at both admission and reassessment. A phenomenology of practice study was conducted to understand the experiences of implementation by health care providers. This study identified five essential themes of the experience: decision making, implementation as a process, lived time, lived human relation, and lived space. The principles of integrated knowledge translation, the Knowledge Exchange Framework, and toolkit development resources were used in this study. This toolkit contains a simplified, phased implementation process based on the Active Implementation Frameworks, and is accompanied by tools. The toolkit received very positive usability ratings: 92% of respondents learned something new from reviewing the toolkit; 100% of respondents said the toolkit was well organized; 92% of respondents said the toolkit was easy to use; 92% of respondents would recommend the toolkit to a colleague; and 92% of respondents showed intention to use the toolkit. This body of work contributes to the fields of knowledge translation and implementation science by generating insight into and appreciation of the process, context, and stakeholders in relation to implementing evidence-based guidelines into routine care delivery practices

Player chronotype does not affect shooting accuracy at different times of the day in a professional, male basketball team: a pilot study

Athlete chronotype has been documented to underpin diurnal variations in skill execution across various team sports. However, no research has explored the effects of athlete chronotype on basketball-specific skills at different times of the day. Therefore, the aim of this study was to explore diurnal variations in basketball shooting accuracy according to chronotype. Professional, male basketball players (n = 13) completed a Morningness- Eveningness Questionnaire and were categorised into chronotypes using a tertile split technique (morning-types: n = 4; neither-types: n = 4; evening-types: n = 5). Players completed separate trials of a shooting accuracy test in the morning (08:00-09:30h) and afternoon (15:00-16:30h) with each trial consisting of 20 shots attempted from four court locations at either two- or three-point distances and one-shot location from the free-throw line (100 shots in total). Each shot attempt was scored using a 0-3-point scale with higher scores awarded to more accurate shots. Non-significant (p >0.05) differences in shooting scores were evident between morning and afternoon trials for each chronotype group, with small-large effects in shooting scores favouring the morning across groups. Moreover, non-significant (p >0.05) differences in shooting scores were apparent between chronotype groups in the morning (small-large effects) and afternoon (moderate-large effects). Shooting accuracy appears to remain consistent across morning and afternoon performances irrespective of player chronotype in a professional basketball team, suggesting coaches may not need to schedule training sessions involving shooting tasks at specific times of the day to optimise shooting accuracy in players

Curriculum Setting and Pre-Clinical Dental Students' Stress Level

Objectives: The first two years of Dental School are commonly known to be the most stressful in a student’s academic career. Very few studies, however, consider both the pressures of dental school and their causes. In order to understand the relationship between the curriculum and its stressful effects it has on the first (D1) and second-year (D2) dental students, a cross-sectional study was performed at the University of New England College of Dental Medicine (UNE-CDM) during the fall and spring semesters of the 2015-2016 academic year. Methods: 64 D1 and 63 D2 dental students were asked to voluntarily complete an anonymous 27-question survey regarding demographic characteristics and the curriculum-related stressors. Researchers utilized the modified Dental Environment Scale (DES) to rate the stress levels. Results: This study revealed that the D2 students felt more stress than the D1 students overall. D2 students experienced more anxiety in their Spring semester of their second year. In general, students who lived with their immediate family felt less stress. Students twenty-five and over experienced less stress than their younger classmates. Conclusions: The study provided valuable information about the current structure of the curriculum at a newly established dental school. This study could provide insight into curriculum-related stress among pre-clinical dental students, which could guide dental schools in making curricular changes that help alleviate stressors during particularly stressful semesters. Furthermore, the outcomes of this project could provide dental schools the information necessary to develop student support programs to help balance students’ lives and intense course loads

In search of the authentic nation: landscape and national identity in Canada and Switzerland

While the study of nationalism and national identity has flourished in the last decade, little attention has been devoted to the conditions under which natural environments acquire significance in definitions of nationhood. This article examines the identity-forming role of landscape depictions in two polyethnic nation-states: Canada and Switzerland. Two types of geographical national identity are identified. The first – what we call the ‘nationalisation of nature’– portrays zarticular landscapes as expressions of national authenticity. The second pattern – what we refer to as the ‘naturalisation of the nation’– rests upon a notion of geographical determinism that depicts specific landscapes as forces capable of determining national identity. The authors offer two reasons why the second pattern came to prevail in the cases under consideration: (1) the affinity between wild landscape and the Romantic ideal of pure, rugged nature, and (2) a divergence between the nationalist ideal of ethnic homogeneity and the polyethnic composition of the two societies under consideration

A comparison of the pharmacokinetics of Aspen Ceftriaxone and Rocephin in community-acquired meningitis

BACKGROUND. Community-acquired bacterial meningitis (CABM) is a life-threatening condition that is common among immunocompromised individuals. Intravenous ceftriaxone, of which Rocephin (ROC) is the originator brand, is recommended as first-line therapy in South Africa. Despite concerns regarding therapeutic equivalence with generic agents, this is the first study that has been conducted comparing clinical pharmacokinetics (PK) of a generic ceftriaxone formulation with the originator. OBJECTIVE. To compare the PK and safety of Aspen Ceftriaxone (AC) and ROC in the treatment of adult CABM. METHODS. A total of 63 eligible patients were randomised 1:1 to receive 2 g of either medication twice daily for a duration based on the identity of the causative organism and their physician’s clinical judgment. The primary endpoint of this study was the comparison of clinical PK, specifically the concentrations of each drug in the cerebrospinal fluid with corresponding paired plasma samples. While this study was underpowered to assess efficacy, safety could be evaluated on the basis of reported adverse events. RESULTS. The two patient groups were epidemiologically similar. There were no statistically significant differences in PK between either agent, nor any difference with regard to safety. CONCLUSION. AC can be considered as equivalent to ROC with regard to PK and safety in patients with CABM.Aspen Pharmacare Ltd, SA.http://www.samj.org.zaam2014ay201

A comparison of the pharmacokinetics of Aspen Ceftriaxone and Rocephin in community-acquired meningitis

Background. Community-acquired bacterial meningitis (CABM) is a life-threatening condition that is common among immunocompromised individuals. Intravenous ceftriaxone, of which Rocephin (ROC) is the originator brand, is recommended as first-line therapy in South Africa. Despite concerns regarding therapeutic equivalence with generic agents, this is the first study that has been conducted comparing clinical pharmacokinetics (PK) of a generic ceftriaxone formulation with the originator. Objective. To compare the PK and safety of Aspen Ceftriaxone (AC) and ROC in the treatment of adult CABM.Methods. A total of 63 eligible patients were randomised 1:1 to receive 2 g of either medication twice daily for a duration based on the identity of the causative organism and their physician’s clinical judgment. The primary endpoint of this study was the comparison of clinical PK, specifically the concentrations of each drug in the cerebrospinal fluid with corresponding paired plasma samples. While this study was underpowered to assess efficacy, safety could be evaluated on the basis of reported adverse events.Results. The two patient groups were epidemiologically similar. There were no statistically significant differences in PK between either agent, nor any difference with regard to safety.Conclusion. AC can be considered as equivalent to ROC with regard to PK and safety in patients with CABM.

Whole Slide Imaging Versus Microscopy for Primary Diagnosis in Surgical Pathology: A Multicenter Blinded Randomized Noninferiority Study of 1992 Cases (Pivotal Study)

Most prior studies of primary diagnosis in surgical pathology using whole slide imaging (WSI) versus microscopy have focused on specific organ systems or included relatively few cases. The objective of this study was to demonstrate that WSI is noninferior to microscopy for primary diagnosis in surgical pathology. A blinded randomized noninferiority study was conducted across the entire range of surgical pathology cases (biopsies and resections, including hematoxylin and eosin, immunohistochemistry, and special stains) from 4 institutions using the original sign-out diagnosis (baseline diagnosis) as the reference standard. Cases were scanned, converted to WSI and randomized. Sixteen pathologists interpreted cases by microscopy or WSI, followed by a wash-out period of ≥4 weeks, after which cases were read by the same observers using the other modality. Major discordances were identified by an adjudication panel, and the differences between major discordance rates for both microscopy (against the reference standard) and WSI (against the reference standard) were calculated. A total of 1992 cases were included, resulting in 15,925 reads. The major discordance rate with the reference standard diagnosis was 4.9% for WSI and 4.6% for microscopy. The difference between major discordance rates for microscopy and WSI was 0.4% (95% confidence interval, -0.30% to 1.01%). The difference in major discordance rates for WSI and microscopy was highest in endocrine pathology (1.8%), neoplastic kidney pathology (1.5%), urinary bladder pathology (1.3%), and gynecologic pathology (1.2%). Detailed analysis of these cases revealed no instances where interpretation by WSI was consistently inaccurate compared with microscopy for multiple observers. We conclude that WSI is noninferior to microscopy for primary diagnosis in surgical pathology, including biopsies and resections stained with hematoxylin and eosin, immunohistochemistry and special stains. This conclusion is valid across a wide variety of organ systems and specimen types