Eye-tracking evidence shows that non-fit messaging impacts attention, attitudes and choice

When patients have strong initial attitudes about a medical intervention, they might not be open to learning new information when choosing whether or not to receive the intervention. We aim to show that non-fit messaging (messages framed in a manner that is incongruent with recipients’ motivational orientation) can increase attention to the message content, thereby de-intensifying an initial attitude bias and reducing the influence of this bias on choice. In this study, 196 students received information about the pros and cons of a vaccine, framed in either a fit or non-fit manner with their motivational orientation. The results show that when information was presented in a non-fit (vs. fit) manner, the strength of participants’ initial attitude was reduced. An eye-tracking procedure indicated that participants read information more thoroughly (measured by the average length of fixation time while reading) in the non-fit condition versus fit condition. This average time of fixation mediated the effect of message framing on the strength of people’s attitudes. A reduction in attitude was associated with participants’ ability to recall the given information correctly and make a choice consistent with the provided information. Non-fit messaging increases individuals’ willingness to process information when individuals’ pre-existing attitude biases might otherwise cause them to make uninformed decisions

Reproducibility of Dietary Intake Measurement From Diet Diaries, Photographic Food Records, and a Novel Sensor Method

Objective: No data currently exist on the reproducibility of photographic food records compared to diet diaries, two commonly used methods to measure dietary intake. Our aim was to examine the reproducibility of diet diaries, photographic food records, and a novel electronic sensor, consisting of counts of chews and swallows using wearable sensors and video analysis, for estimating energy intake. Method: This was a retrospective analysis of data from a previous study, in which 30 participants (15 female), aged 29 ± 12 y and having a BMI of 27.9 ± 5.5, consumed three identical meals on different days. Four different methods were used to estimate total mass and energy intake on each day: (1) weighed food record; (2) photographic food record; (3) diet diary; and (4) novel mathematical model based on counts of chews and swallows (CCS models) obtained via the use of electronic sensors and video monitoring system. The study staff conducted weighed food records for all meals, took pre- and post-meal photographs, and ensured that diet diaries were completed by participants at the end of each meal. All methods were compared against the weighed food record, which was used as the reference method. Results: Reproducibility was significantly different between the diet diary and photographic food record for total energy intake (p = 0.004). The photographic record had greater reproducibility vs. the diet diary for all parameters measured. For total energy intake, the novel sensor method exhibited good reproducibility (repeatability coefficient (RC) of 59.9 (45.9, 70.4), which was better than that for the diet diary [RC = 79.6 (55.5, 103.3)] but not as repeatable as the photographic method [RC = 43.4 (32.1, 53.9)]. Conclusion: Photographic food records offer superior precision to the diet diary and, therefore, would be valuable for longitudinal studies with repeated measures of dietary intake. A novel electronic sensor also shows promise for the collection of longitudinal dietary intake data.Fil: Fontana, Juan Manuel. Universidad Nacional de Río Cuarto. Instituto para el Desarrollo Agroindustrial y de la Salud. - Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto para el Desarrollo Agroindustrial y de la Salud; ArgentinaFil: Pan, Zhaoxing. University of Colorado; Estados UnidosFil: Sazonov, Edward S.. University of Alabama; Estados UnidosFil: McCrory, Megan A.. Boston University; Estados UnidosFil: Thomas, J. Graham. University Brown; Estados UnidosFil: McGrane, Kelli S.. University of Colorado; Estados UnidosFil: Marden, Tyson. University of Colorado; Estados UnidosFil: Higgins, Janine A.. University of Colorado; Estados Unido

Statistical models for meal-level estimation of mass and energy intake using features derived from video observation and a chewing sensor

Accurate and objective assessment of energy intake remains an ongoing problem. We used features derived from annotated video observation and a chewing sensor to predict mass and energy intake during a meal without participant self-report. 30 participants each consumed 4 different meals in a laboratory setting and wore a chewing sensor while being videotaped. Subject-independent models were derived from bite, chew, and swallow features obtained from either video observation or information extracted from the chewing sensor. With multiple regression analysis, a forward selection procedure was used to choose the best model. The best estimates of meal mass and energy intake had (mean ± standard deviation) absolute percentage errors of 25.2% ± 18.9% and 30.1% ± 33.8%, respectively, and mean ± standard deviation estimation errors of −17.7 ± 226.9 g and −6.1 ± 273.8 kcal using features derived from both video observations and sensor data. Both video annotation and sensor-derived features may be utilized to objectively quantify energy intake.DK10079604 - Foundation for the National Institutes of Health (Foundation for the National Institutes of Health, Inc.); DK10079604 - Foundation for the National Institutes of Health (Foundation for the National Institutes of Health, Inc.); DK10079604 - Foundation for the National Institutes of Health (Foundation for the National Institutes of Health, Inc.); DK10079604 - Foundation for the National Institutes of Health (Foundation for the National Institutes of Health, Inc.); DK10079604 - Foundation for the National Institutes of Health (Foundation for the National Institutes of Health, Inc.); DK10079604 - Foundation for the National Institutes of Health (Foundation for the National Institutes of Health, Inc.)Published versio

Incidence, management, and outcomes of cardiovascular insufficiency in critically ill term and late preterm newborn infants

OBJECTIVE: The objective of this study was to characterize the incidence, management, and short-term outcomes of cardiovascular insufficiency (CVI) in mechanically ventilated newborns, evaluating four separate prespecified definitions. STUDY DESIGN: Multicenter, prospective cohort study of infants ≥34 weeks gestational age (GA) and on mechanical ventilation during the first 72 hours. CVI was prospectively defined as either (1) mean arterial pressure (MAP) < GA; (2) MAP < GA + signs of inadequate perfusion; (3) any therapy for CVI; or (4) inotropic therapy. Short-term outcomes included death, days on ventilation, oxygen, and to full feedings and discharge. RESULTS: Of 647 who met inclusion criteria, 419 (65%) met ≥1 definition of CVI. Of these, 98% received fluid boluses, 36% inotropes, and 17% corticosteroids. Of treated infants, 46% did not have CVI as defined by a MAP < GA ± signs of inadequate perfusion. Inotropic therapy was associated with increased mortality (11.1 vs. 1.3%; p < 0.05). CONCLUSION: More than half of the infants met at least one definition of CVI. However, almost half of the treated infants met none of the definitions. Inotropic therapy was associated with increased mortality. These findings can help guide the design of future studies of CVI in newborn

A phenomenological exploration of transgender people's experiences of mental health services in Ireland

AIM: This study sought to explore the personal experiences of transgender people with Irish mental health services. BACKGROUND: The transgender community have been identified as an underserved, under-researched community in Ireland and abroad. While there has been a surge in research carried out with the community in recent years, there is little known about the personal experiences of Irish transgender people with mental health services. METHOD: Interpretative phenomenological analysis was used to inform data collection and analysis of semi-structured interviews carried out with four research participants all identifying as transgender and having experienced accessing Irish mental health services. RESULTS: Three themes emerged: affirmative experiences, non-affirmative experiences and clinician relationship. CONCLUSION: Lack of information and non-affirmative experiences are contributing to poor clinician-patient relationships with transgender populations and impacting attrition. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers have a central role in supporting a transgender-positive organisational approach to care by ensuring policies, care practices and the environment are supportive of sexual and gender expression by role modelling attitudes of respect and inclusivity. In order to provide appropriate and responsive services to transgender people, there needs to be in place strategies to enable the development of confident, competent and knowledgeable staff

Body mass index and variability in meal duration and association with rate of eating

BackgroundA fast rate of eating is associated with a higher risk for obesity but existing studies are limited by reliance on self-report and the consistency of eating rate has not been examined across all meals in a day. The goal of the current analysis was to examine associations between meal duration, rate of eating, and body mass index (BMI) and to assess the variance of meal duration and eating rate across different meals during the day.MethodsUsing an observational cross-sectional study design, non-smoking participants aged 18–45 years (N = 29) consumed all meals (breakfast, lunch, and dinner) on a single day in a pseudo free-living environment. Participants were allowed to choose any food and beverages from a University food court and consume their desired amount with no time restrictions. Weighed food records and a log of meal start and end times, to calculate duration, were obtained by a trained research assistant. Spearman's correlations and multiple linear regressions examined associations between BMI and meal duration and rate of eating.ResultsParticipants were 65% male and 48% white. A shorter meal duration was associated with a higher BMI at breakfast but not lunch or dinner, after adjusting for age and sex (p = 0.03). Faster rate of eating was associated with higher BMI across all meals (p = 0.04) and higher energy intake for all meals (p &lt; 0.001). Intra-individual rates of eating were not significantly different across breakfast, lunch, and dinner (p = 0.96).ConclusionShorter beakfast and a faster rate of eating across all meals were associated with higher BMI in a pseudo free-living environment. An individual's rate of eating is constant over all meals in a day. These data support weight reduction interventions focusing on the rate of eating at all meals throughout the day and provide evidence for specifically directing attention to breakfast eating behaviors

Coordinated Defects in Hepatic Long Chain Fatty Acid Metabolism and Triglyceride Accumulation Contribute to Insulin Resistance in Non-Human Primates

Non-Alcoholic fatty liver disease (NAFLD) is characterized by accumulation of triglycerides (TG) in hepatocytes, which may also trigger cirrhosis. The mechanisms of NAFLD are not fully understood, but insulin resistance has been proposed as a key determinant

Developmental Outcomes of Very Preterm Infants with Tracheostomies

Objectives To evaluate the neurodevelopmental outcomes of very preterm (<30 weeks) infants who underwent tracheostomy. Study design Retrospective cohort study from 16 centers of the NICHD Neonatal Research Network over 10 years (2001-2011). Infants who survived to at least 36 weeks (N=8,683), including 304 infants with tracheostomies, were studied. Primary outcome was death or neurodevelopmental impairment (NDI, a composite of one or more of: developmental delay, neurologic impairment, profound hearing loss, severe visual impairment) at a corrected age of 18-22 months. Outcomes were compared using multiple logistic regression. We assessed impact of timing, by comparing outcomes of infants who underwent tracheostomy before and after 120 days of life. Results Tracheostomies were associated with all neonatal morbidities examined, and with most adverse neurodevelopmental outcomes. Death or NDI occurred in 83% of infants with tracheostomies and 40% of those without [odds ratio (OR) adjusted for center 7.0 (95%CI, 5.2-9.5)]. After adjustment for potential confounders, odds of death or NDI remained higher [OR 3.3 (95%CI, 2.4-4.6)], but odds of death alone were lower [OR 0.4 (95%CI, 0.3-0.7)], among infants with tracheostomies. Death or NDI was lower in infants who received their tracheostomies before, rather than after, 120 days of life [adjusted OR 0.5 (95%CI, 0.3-0.9)]. Conclusions Tracheostomy in preterm infants is associated with adverse developmental outcomes, and cannot mitigate the significant risk associated with many complications of prematurity. These data may inform counseling about tracheostomy in this vulnerable population