BMC Obesity - expanding the BMC series into an important area of research

This Editorial marks the launch of an important new journal to join the BMC series portfolio - BMC Obesity. BMC Obesity joins BMC Cancer as the second journal within the series to focus on a particular condition in the human body and the factors that contribute towards it

Pre-activation negativity (PrAN) : A neural index of predictive strength of phonological cues

We propose that a recently discovered event-related potential (ERP) component—the pre-activation negativity (PrAN)—indexes the predictive strength of phonological cues, including segments, word tones, and sentence-level tones. Specifically, we argue that PrAN is a reflection of the brain’s anticipation of upcoming speech (segments, morphemes, words, and syntactic structures). Findings from a long series of neurolinguistic studies indicate that the effect can be divided into two time windows with different possible brain sources. Between 136 and 200 ms from stimulus onset, it indexes activity mainly in the primary and secondary auditory cortices, reflecting disinhibition of neurons sensitive to the expected acoustic signal, as indicated by the brain regions’ response to predictive certainty rather than sound salience. After ~200 ms, PrAN is related to activity in Broca’s area, possibly reflecting inhibition of irrelevant segments, morphemes, words, and syntactic structures

Spinnaktiviteter i norsk politikk - en kvalitativ undersøkelse av strategisk mediehåndtering

Spinn i politikken er et tema som stadig blir omdiskutert i mediene, både i og utenfor Norge. I de fleste tilfeller blir spinn beskrevet som noe negativt og forbindes ofte med manipulering, spill og tåkelegging. Vi har imidlertid et inntrykk av at det ligger en del forvirring og spekulasjoner rundt spinndoktorenes arbeidsmetoder, og vi ønsket derfor å undersøke spinndoktorens verktøykasse nærmere. Temaer som politisk kommunikasjon, medialisering, profesjonalisering og relasjonen til mediene har vært viktige for å få en oversikt over fenomenet i sin helhet og for å forklare hvordan den strategiske mediehåndteringen utspiller seg i norsk politikk. Hensikten med denne bacheloroppgaven har vært å forske på om politisk spinn er et aktuelt fenomen i Norge. I den anledning valgte vi å forske på hvilke verktøy spinndoktorer i Norge bruker i møte med mediene. I tillegg til dette har oppgaven sett på spinndoktorens forhold til mediene. Vi benyttet oss av et kvalitativt forskningsdesign med tilhørende semistrukturerte dybdeintervjuer som datainnsamlingsmetode. Vårt strategiske utvalg har bestått av fire spinndoktorer som enten jobber, eller tidligere har jobbet på Stortinget. Vi har forsket med følgende problemstilling: Hvilke verktøy bruker spinndoktorer i Norge i møte med mediene? Funnene fra analysen viser at spinndoktorene i stor grad jobber med å påvirke mediene. I dette møte med mediene er det flere spinnverktøy som blir tatt aktivt i bruk. Det viste seg at hele fem av de syv undersøkte spinnverktøyene brukes av spinndoktorer i Norge. Vi kan dermed si at spinn er et fenomen som også preger den norske politikken. Selve relasjonen til mediene ble i hovedsak karakterisert god, men det viste seg at forholdet var svært personavhengig og kunne variere fra journalist til journalist

Electronic reminders and rewards to improve adherence to inhaled asthma treatment in adolescents:a non-randomised feasibility study in tertiary care

OBJECTIVE: To test the feasibility and acceptability of a short-term reminder and incentives intervention in adolescents with low adherence to asthma medications. METHODS: Mixed-methods feasibility study in a tertiary care clinic. Adolescents recruited to a 24-week programme with three 8-weekly visits, receiving electronic reminders to prompt inhaled corticosteroid (ICS) inhalation through a mobile app coupled with electronic monitoring devices (EMD). From the second visit, monetary incentives based on adherence of ICS inhalation: £1 per dose, maximum £2 /day, up to £112/study, collected as gift cards at the third visit. End of study interviews and questionnaires assessing perceptions of asthma and ICS, analysed using the Perceptions and Practicalities Framework. PARTICIPANTS: Adolescents (11-18 years) with documented low ICS adherence (<80% by EMD), and poor asthma control at the first clinic visit. RESULTS: 10 out of 12 adolescents approached were recruited (7 males, 3 females, 12-16 years). Eight participants provided adherence measures up to the fourth visits and received rewards. Mean study duration was 281 days, with 7/10 participants unable to attend their fourth visit due to COVID-19 lockdown. Only 3/10 participants managed to pair the app/EMD up to the fourth visit, which was associated with improved ICS adherence (from 0.51, SD 0.07 to 0.86, SD 0.05). Adherence did not change in adolescents unable to pair the app/EMD. The intervention was acceptable to participants and parents/guardians. Exit interviews showed that participants welcomed reminders and incentives, though expressed frustration with app/EMD technological difficulties. Participants stated the intervention helped through reminding ICS doses, promoting self-monitoring and increasing motivation to take inhalers. CONCLUSIONS: An intervention using electronic reminders and incentives through an app coupled with an EMD was feasible and acceptable to adolescents with asthma. A pilot randomised controlled trial is warranted to better estimate the effect size on adherence, with improved technical support for the EMD

A systematic review of nudge interventions to optimize medication prescribing

Background: The benefits of medication optimization are largely uncontroversial but difficult to achieve. Behavior change interventions aiming to optimize prescriber medication-related decisions, which do not forbid any option and that do not significantly change financial incentives, offer a promising way forward. These interventions are often referred to as nudges. Objective: The current systematic literature review characterizes published studies describing nudge interventions to optimize medication prescribing by the behavioral determinants they intend to influence and the techniques they apply. Methods: Four databases were searched (MEDLINE, Embase, PsychINFO, and CINAHL) to identify studies with nudge-type interventions aiming to optimize prescribing decisions. To describe the behavioral determinants that interventionists aimed to influence, data were extracted according to the Theoretical Domains Framework (TDF). To describe intervention techniques applied, data were extracted according to the Behavior Change Techniques (BCT) Taxonomy version 1 and MINDSPACE. Next, the recommended TDF-BCT mappings were used to appraise whether each intervention applied a sufficient array of techniques to influence all identified behavioral determinants. Results: The current review located 15 studies comprised of 20 interventions. Of the 20 interventions, 16 interventions (80%) were effective. The behavior change techniques most often applied involved prompts (n = 13). The MINDSPACE contextual influencer most often applied involved defaults (n = 10). According to the recommended TDF-BCT mappings, only two interventions applied a sufficient array of behavior change techniques to address the behavioral determinants the interventionists aimed to influence. Conclusion: The fact that so many interventions successfully changed prescriber behavior encourages the development of future behavior change interventions to optimize prescribing without mandates or financial incentives. The current review encourages interventionists to understand the behavioral determinants they are trying to affect, before the selection and application of techniques to change prescribing behaviors. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/], identifier [CRD42020168006]

Identity change and the human dissection experience over the first year of medical training

The aim of this study is to explore identity change in medical students over their first year of medical training, particularly in relation to their experience of human dissection. Each of our four participants completed two repertory grids at the end of term one and, again, towards the end of term three. One grid tapped their identity construction, and the other, their experience of human dissection. Our participants were optimistic about becoming similar to a doctor they admired and, towards the end of term three, began to develop a stable identity as a medical student. Their identity constructs involved three common themes: dedication, competence, and responsibility. However, the data also revealed negative reactions to the demands of training, such as feeling driven and stressed. Three major themes were apparent in their experience of human dissection: involvement, emotional coping, and ability. Our participants’ dedication to their studies was reflected in their appreciation of the need to become involved actively in the process of dissection but some experienced an erosion of their self-confidence and perceived some of their colleagues to have lost much of their enthusiasm for learning. Emotional coping could be an additional challenge within this context and their reaction tended to reflect distancing processes previously identified in the literature. In all, we see a development of a vulnerable sense of professionalism alongside a frustration of losing out potentially on wider aspects of personal development due to the high work demands

Challenges in lifestyle and community interventions research

Earlier this year the BMC portfolio was enriched by a new journal BMC Obesity. Here, we present the aims and objectives of the section on Lifestyle and Community Interventions. Innovative research is needed. Preventing or managing obesity requires addressing different determinants across multiple levels where diverse levers and stakeholders can play a critical role. Interactions of these determinants within and between systems need to be studied. How to leverage, manage and measure this complexity underlies the innovation that is needed in the next generation of obesity interventions. The ambition of the Lifestyle and Community Interventions section is to provide a space for innovative research, including research that falls outside the traditional comfort zone. We welcome studies of heterogeneous designs, including those of qualitative, quantitative, mixed and systems methodologies. Studies of interest include not only outcomes research of interventions but also process evaluation, cost effectiveness or cost-benefit analysis, and implementation and dissemination research. Innovations that integrate diverse intervention levers or combine primary and secondary levels of prevention are particularly encouraged. The general aim of BMC Obesity&rsquo; s Lifestyle and Community Interventions section is to advance our ability to decide on what combinations of approaches will be required to effectively and equitably prevent obesity