Evobiopsychosocial Medicine

The biopsychosocial model remains the de facto framework of current healthcare, but lacks causational depth, scientific rigour, or any recognition of the importance of evolutionary theory for understanding health and disease. In this article it is updated to integrate Tinbergen’s four questions with the three biopsychosocial levels. This ‘evobiopsychosocial’ schema provides a more complete framework for understanding causation of medical conditions. Its application is exemplified by tabulating depression, rheumatoid arthritis and COVID-19 within its format, which highlights the direct research and practical applications uniquely offered by evolutionary medicine. An evobiopsychosocial framework can serve as a useful tool to introduce evolutionary concepts into mainstream medicine by highlighting the broad and specific contributions of evolutionary analysis to researching, treating and preventing health conditions, providing a suitable next step for the mainstream model of medicine

Effects of exercise and environmental complexity on deficits in trace and contextual fear conditioning produced by neonatal alcohol exposure in rats

In rodents, voluntary exercise and environmental complexity increases hippocampal neurogenesis and reverses spatial learning and long-term potentiation deficits in animals prenatally exposed to alcohol. The present experiment extended these findings to neonatal alcohol exposure and to delay, trace, and contextual fear conditioning. Rats were administered either 5.25g/kg/day alcohol via gastric intubation or received sham-intubations (SI) between Postnatal Day (PD) 4 and 9 followed by either free access to a running wheel on PD 30-41 and housing in a complex environment on PD 42-72 (wheel-running plus environmental complexity; WREC) or conventional social housing (SHSH) from PD 30 to 72. Adult rats (PD 80 +/- 5) received 5 trials/day of a 10-s flashing-light conditioned stimulus (CS) paired with .8mA footshock either immediately (delay conditioning) or after a 10-s trace interval (trace conditioning) for 2 days. Neonatal alcohol exposure impaired context and trace conditioning, but not short-delay conditioning. The WREC intervention did not reverse these deficits, despite increasing context-related freezing in ethanol-exposed and SI animals. (c) 2012 Wiley Periodicals, Inc. Dev Psychobiol 55: 483-495, 201

Grain refinement in a AlZnMgCuTi alloy by intensive melt shearing: A multi-step nucleation mechanism

This is a post-print version of the article. Copyright @ 2010 Elsevier B.V.Direct chill (DC) cast ingots of wrought Al alloys conventionally require the deliberate addition of a grain refiner to provide a uniform as-cast microstructure for the optimisation of both mechanical properties and processability. Grain refiner additions have been in widespread industrial use for more than half a century. Intensive melt shearing can provide grain refinement without the need for a specific grain refiner addition for both magnesium and aluminium based alloys. In this paper we present experimental evidence of the grain refinement in an experimental wrought aluminium alloy achieved by intensive melt shearing in the liquid state prior to solidification. The mechanisms for high shear induced grain refinement are correlated with the evolution of oxides in alloys. The oxides present in liquid aluminium alloys, normally as oxide films and clusters, can be effectively dispersed by intensive shearing and then provide effective sites for the heterogeneous nucleation of Al3Ti phase. As a result, Al3Ti particles with a narrow size distribution and hence improved efficiency as active nucleation sites of alpha-aluminium grains are responsible for the achieved significant grain refinement. This is termed a multi-step nucleation mechanism.Funding was obtained from the EPRSC

Men’s Perspectives of a Gender-Sensitized Health Promotion Program Targeting Healthy Eating, Active Living, and Social Connectedness

© The Author(s) 2018. Men in high income countries have poorer dietary habits and higher rates of overweight and obesity than women. A major challenge with engaging men in health promotion is the perception that attention to one’s health runs counter to masculine identities. Contemporary health promotion programs are believed to hold little “manly” appeal and often fail to engage and retain men. The HAT TRICK program was designed to engage men with their health by delivering an intervention in collaboration with a semi-professional ice hockey team. The program included 12 weekly sessions promoting healthy eating, active living, and social connectedness among men. Gender-sensitized elements were reflected in the program design, setting, content, and delivery. Semistructured telephone interviews were conducted with 23 men to explore perspectives of their participation in the gender-sensitized intervention. Participants were white (100%) with a mean age of 53 years (SD ± 9.9), Body Mass Index (BMI) of 37 kg/m2 (SD ± 6.8), and waist circumference of 127 centimeters (SD ± 14.5). Inductive thematic analysis revealed three overarching themes, including: (a) Harnessing nostalgia for past masculinities: “Closet athletes from 30 years ago,” (2) Offsetting resistance to change with sensible health advice: “Don’t give up drinking beer, just have less,” and (3) Gendered social spaces for doing health: “A night out with the guys,” The findings support the value of gender-sensitized approaches to men’s health promotion. Further research is needed to identify which gender-sensitized elements are critical to engaging men in healthy lifestyle changes

The influence of depression-PTSD comorbidity on health-related quality of life in treatment-seeking veterans

Objective: Posttraumatic stress disorder (PTSD) and depression substantially impair healthrelated quality of life (HRQOL) for many Canadian Armed Forces (CAF) veterans. Although PTSD and depression are highly comorbid, little is known about whether the disorders may interact in their association with HRQOL. We sought to investigate whether depressive symptoms modify the relation between PTSD and HRQOL in treatment-seeking veterans. Method: We accessed the clinical data of 545 CAF veterans aged 18 to 65 years who were seeking treatment at a specialized clinic in London, Ontario. We used hierarchical linear regression to assess the additive and multiplicative relations between depression and PTSD symptoms on HRQOL, controlling for age and alcohol/substance abuse. Simple slopes were examined to probe significant interactions. Results: Probable PTSD and major depression were present in 77.4% and 85.3% of the sample, respectively, and 73.0% of the sample presented with probable PTSD-depression comorbidity. Depression symptoms significantly modified the relation between PTSD symptoms and overall mental HRQOL (β = 0.12,

The HAT TRICK programme for improving physical activity, healthy eating and connectedness among overweight, inactive men: study protocol of a pragmatic feasibility trial.

INTRODUCTION: Physical activity, healthy eating and maintaining a healthy weight are associated with reduced risk of cardiovascular disease, type 2 diabetes and cancer and with improved mental health. Despite these benefits, many men do not meet recommended physical activity guidelines and have poor eating behaviours. Many health promotion programmes hold little appeal to men and consequently fail to influence men's health practices. HAT TRICK was designed as a 12-week face-to-face, gender-sensitised intervention for overweight and inactive men focusing on physical activity, healthy eating and social connectedness and was delivered in collaboration with a major junior Canadian ice hockey team (age range 16-20 years). The programme was implemented and evaluated to assess its feasibility. This article describes the intervention design and study protocol of HAT TRICK. METHODS AND ANALYSIS: HAT TRICK participants (n=60) were men age 35 years, residing in the Okanagan Region of British Columbia, who accumulate 150 min of moderate to vigorous physical activity a week, with a body mass index of >25 kg/m2 and a pant waist size of >38'. Each 90 min weekly session included targeted health education and theory-guided behavioural change techniques, as well as a progressive (ie, an increase in duration and intensity) group physical activity component. Outcome measures were collected at baseline, 12 weeks and 9 months and included the following: objectively measured anthropometrics, blood pressure, heart rate, physical activity and sedentary behaviour, as well as self-reported physical activity, sedentary behaviour, diet, smoking, alcohol consumption, sleep habits, risk of depression, health-related quality of life and social connectedness. Programme feasibility data (eg, recruitment, satisfaction, adherence, content delivery) were assessed at 12 weeks via interviews and self-report. ETHICS AND DISSEMINATION: Ethical approval was obtained from the University of British Columbia Okanagan Behavioural Research Ethics Board (reference no H1600736). Study findings will be disseminated through academic meetings, peer-reviewed publication, web-based podcasts, social media, plain language summaries and co-delivered community presentations. TRIAL REGISTRATION NUMBER: ISRCTN43361357,Pre results

An Intervention to Increase Condom Use Among Users of Chlamydia Self-Sampling Websites (Wrapped): Intervention Mapping and Think-Aloud Study.

BACKGROUND: Young people aged 16-24 years are disproportionately affected by sexually transmitted infections (STIs). STIs can have serious health consequences for affected individuals and the estimated annual cost of treatment to the National Health Service is £620 million. Accordingly, the UK government has made reducing the rates of STIs among this group a priority. A missed opportunity to intervene to increase condom use is when young people obtain self-sampling kits for STIs via the internet. OBJECTIVE: Our aim was to develop a theory-based tailored intervention to increase condom use for 16-24-years-olds accessing chlamydia self-sampling websites. METHODS: The intervention, Wrapped, was developed using Intervention Mapping and was co-designed with young people. The following steps were performed: (1) identification of important determinants of condom use and evidence of their changeability using computer and digital interventions; (2) setting the intervention goal, performance objectives, and change objectives; (3) identification of Behavior Change Principles (BCPs) and practical strategies to target these determinants; and (4) development of intervention materials able to deliver the BCPs and practical strategies. RESULTS: Users of existing chlamydia self-sampling websites are signposted to Wrapped after placing an order for a sampling kit. Salient barriers to condom use are identified by each user and relevant intervention components are allocated to target these. The components include the following: (1) a sample box of condoms, (2) an online condom distribution service, (3) a product for carrying condoms, (4) a condom demonstration video, (5) a series of videos on communication about condom use, and (6) erotic films of real couples discussing and demonstrating condom use. CONCLUSIONS: This intervention will be directed at young people who may be particularly receptive to messages and support for behavior change due to their testing status

Rare Disease Interest Group (rareDIG) at McGill University: A Medical Education Pilot Project

One in 12 Canadians have a rare disease, yet medical education continues to espouse Dr. Woodward’s aphorism “when you hear hoofbeats think horses, not zebras.” This produces physician attitudes which are deleterious to the care of people with rare diseases. The McGill University Rare Disease Interest Group (rareDIG) has created programming which sensitizes medical students to the extent and reality of rare diseases.rareDIG helps them to develop attitudes and approaches which shorten the diagnostic odyssey and improve care of people with rare diseases. Success stems from drawing attention to the realities of rare disease through direct patient interaction, creating a strong social media presence, and building collaborations with rare disease advocacy groups and networks. Our inaugural Rare Disease Day event was attended by over 100 attendees including medical students, patients and their families, and a variety of health professionals.Other successes include a Patient Perspective Series addressing the holistic approach to rare disease, shadowing opportunities, “n = rare” journal clubs, and a “Humans of Rare Disease” advocacy project. Medical students represent an important cohort to target with rare disease awareness campaigns that has largely been overlooked by current advocacy efforts. By exposing medical students early in their education to the realities of rare diseases, student-run interest groups can improve medical students’ understanding and perception of rare diseases and ultimately improve patient care in the future. rareDIG strives to continue achieving its objectives in rare disease education and aide other medical schools in creating their own rare disease student groups.