A pilot study evaluating the effects of a 12 week exergaming programme on body mass, size and composition in postpartum females

Introduction: Pregnancy is associated with weight gain, the retention of which contributes to the prevalence of obesity and overweight in adult females. Many new mothers do not achieve the recommendations for physical activity (PA), citing factors such as a lack of time and access to childcare. Exergaming may address some of the barriers to PA and offer an alternative to traditional exercise, thus aiding in weight management. The aim of this pilot study was to evaluate the effects of an exergaming intervention on body composition in postpartum females. Methods: Eight females who had given birth within 1 year completed a 12 week exergaming intervention, which required them to exercise at home for 45 minutes on alternate days, using the Wii Fit. Participants self-reported their pre-pregnancy body weight, and visited the laboratory prior to and following the intervention for evaluation of body weight, size (height, regional circumferences, body mass index [BMI]) and composition (fat mass [FM], lean mass [LM] and bone mineral content [BMC]). Body composition was evaluated via full body full-body dual-energy x-ray absorptiometry scan. Participants completed a three-day weighed food intake at three time-points. Results: Baseline body mass was 8.2 kg greater than self-reported pre-pregnancy values (56.8 ± 5.1 kg). Following the intervention, body mass was significantly lower than baseline values and was similar to pre-pregnancy levels (59.9 ± 7.9 kg). Reductions in BMI (~2 kg·m2 ), waist, hip and bust circumference (3-6%) accompanied the loss of body mass. Food diaries confirmed participants had not altered their energy intake. Discussion: The results of this pilot study indicate that exergaming may offer an alternative to traditional exercise for preventing the retention of gestational weight gain and reducing associated health risks, whilst also maintaining lean mass and bone mineral content

An identification and brief advice programme for low-risk alcohol consumption in an acute medical setting: an implementation study.

OBJECTIVES: To implement an identification and brief advice (IBA) intervention to detect low-risk/hazardous alcohol consumption. DESIGN: Implementation was guided through the use of quality improvement tools and training. SETTING: This study was conducted over an 18-month period from April 2010 to September 2011 on a 42-bed acute medical unit at a central London acute hospital. PARTICIPANTS: All medical patients over the age of 18 admitted to the acute assessment unit were eligible; any patient unable to provide a medical history either through language barriers or due to illness was excluded. MAIN OUTCOME MEASURES: Percentage of medical patients admitted each week to the acute assessment unit who were screened for low-risk/hazardous alcohol consumption. RESULTS: Weekly data were analysed in time series run charts and cross-referenced to the date of educational sessions and their effect on the uptake of screening monitored. A demonstrable change in the mean percentage number of patients screened was observed in different time periods, 67.3-80.1%, following targeted teaching on the AAU. CONCLUSIONS: Our study demonstrates the successful use of quality improvement methodology to guide the implementation of Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), an IBA intervention, in the acute medical setting. The incorporation of the AUDIT-C into an admission document has been well accepted by the junior doctors, attaining an average (mean) of 80% of patients being screened using the tool. Targeted teaching of clinical staff involved in admitting patients appears to be the most effective method in improving uptake of IBA by junior doctors

Co-Design of an Integrated Intergenerational Model: Uniting Generations Through Shared Spaces

This report sets out the findings from a research project to develop an intergenerational model of care at Uniting Westmead. We review relevant literature to understand what is already known about the impact of intergenerational care models on wellbeing and development outcomes for young children, older adults, other community members, and staff, and distil the core elements of program implementation that are most influential in determining positive outcomes. The research uses a combination of focus groups followed by a co-design workshop. From the research data we develop principles of practice for intergenerational care. Then, the report presents a Theory of Change, developed using a co-design process, which brought together researcher knowledge of the existing evidence, the practice wisdom of Uniting, the lived experience of the young children attending the early learning centre, the older adult residents, and their families and staff members as co-designers

Exile Vol. XXII No. 1

PROSE Dust by Katie Tight 4-13 The Masculine Cure by Elizabeth Thomas 14-19 The Rats Still Sleep At Night by Wolfgang Borchert (translated from the German by Eric Fridman) 20-22 Largo for a Pelican by Morgan Wills 23-25 Role by Anne Tomfohrde 26-29 Goody Two-Shoes Meets the Cincinnati Kid by Kim McMullen 30-38 In the Final Analysis (Psychological or Otherwise): A Review of Carl Jung\u27s Theory of Art by Issa Christian Halabi 39-42 POETRY Here by Fayad Jamis (translated from the Spanish by Joseph R. deArmas) 44 No. 236 by Dawn Patnode 45 No. 237 by Dawn Patnode 46 In my Room by Ulf Miehe 47 Saturday Night Lament by Woodrow Jones 48-49 Basho\u27s Hut by Lenore Mayhew 50 From a Train: Ireland by Kim McMullen 51 Suggested by One Hundred Years Of Solitude by Martin Cloran 52 (to L. Martynov) by Yevgeny Yevtushenko 53 At Sea by Paul Bennett 54 Words In A Line by Lawrence Weber 55 a leave-taking by Debra Allbery 56 untitled by Alison Orleans 57 As The Water Whittles in Colour by Lawrence Weber 58-59 Falconsong or Falcon Song by The Man from Kurenben (translated from the German by John Kessler) 60 POUND Introduction 62 Response from Hugh Kenner 63 Response from Mary de Rachewiltz 64 The Cantos: The Vision of Ezra Pound by William McNaughton 65-78 CONTRIBUORS 79-80 Cover sketch by Lisa Rope Pound Photograph Courtesy of Bill McNaughto

Neural Substrates of Mounting Temporal Expectation

A cognitive and neuroanatomical perspective on how timing and expectation are represented in the human brain

Artemisinin derivatives versus quinine in treating severe malaria in children: a systematic review

<p>Abstract</p> <p>Background</p> <p>The efficacy of intravenous quinine, which is the mainstay for treating severe malaria in children, is decreasing in South East Asia and Africa. Artemisinin derivatives are a potential alternative to quinine. However, their efficacy compared to quinine in treating severe malaria in children is not clearly understood. The objective of this review was to assess the efficacy of parenteral artemisinin derivatives versus parenteral quinine in treating severe malaria in children.</p> <p>Methods</p> <p>All randomized controlled studies comparing parenteral artemisinin derivatives with parenteral quinine in treating severe malaria in children were included in the review. Data bases searched were: The Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2007), MEDLINE (1966 to February 2008), EMBASE (1980 to February 2008), and LILACS (1982 to February 2008). Dichotomous variables were compared using risk ratios (RR) and the continuous data using weighted mean difference (WMD).</p> <p>Results</p> <p>Twelve trials were included (1,524 subjects). There was no difference in mortality between artemisinin derivatives and quinine (RR = 0.90, 95% CI 0.73 to 1.12). The artemisinin derivatives resolved coma faster than quinine (WMD = -4.61, 95% CI: -7.21 to -2.00, fixed effect model), but when trials with adequate concealment only were considered this differences disappeared. There was no statistically significant difference between the two groups in parasite clearance time, fever clearance time, incidence of neurological sequelae and 28^thday cure rate. One trial reported significantly more local reactions at the injection site with intramuscular quinine compared to artemether. None of the trials was adequately powered to demonstrate equivalence.</p> <p>Conclusion</p> <p>There was no evidence that treatment of children with severe malaria with parenteral artemisinin derivatives was associated with lower mortality or long-term morbidity compared to parenteral quinine. Future studies require adequately powered equivalence trial design to decide whether both drugs are equally effective.</p

Outsourcing and structural change: shifting firm and sectoral boundaries

The paper aims at investigating the structural change implications of outsourcing. In trying to bridge the organizational/industrial and the sectoral/structural analysis of outsourcing, it discusses the rational and the methodological pros and cons of a “battery” of outsourcing measurements for structural change analysis. Their functioning is then illustrated through a concise application of them to the OECD area over the ’80s and the early ’90s. A combined used of them emerges as recommendable in checking for the role of outsourcing with respect to that of other structural change determinants

Communication about colorectal cancer screening in Britain:public preferences for an expert recommendation

BACKGROUND: Informed decision-making approaches to cancer screening emphasise the importance of decisions being determined by individuals' own values and preferences. However, advice from a trusted source may also contribute to autonomous decision-making. This study examined preferences regarding a recommendation from the NHS and information provision in the context of colorectal cancer (CRC) screening. METHODS: In face-to-face interviews, a population-based sample of adults across Britain (n=1964; age 50–80 years) indicated their preference between: (1) a strong recommendation to participate in CRC screening, (2) a recommendation alongside advice to make an individual decision, and (3) no recommendation but advice to make an individual decision. Other measures included trust in the NHS and preferences for information on benefits and risks. RESULTS: Most respondents (84%) preferred a recommendation (47% strong recommendation, 37% recommendation plus individual decision-making advice), but the majority also wanted full information on risks (77%) and benefits (78%). Men were more in favour of a recommendation than women (86% vs 81%). Trust in the NHS was high overall, but the minority who expressed low trust were less likely to want a recommendation. CONCLUSION: Most British adults want full information on risks and benefits of screening but they also want a recommendation from an authoritative source. An ‘expert' view may be an important part of autonomous health decision-making

You Can’t Always Get What You Want: Trade-size Clustering and Quantity Choice in Liquidity”,

Abstract This paper examines whether investors care more about trading their exact quantity demands at some times than at others. Using a new data set of foreign-exchange transactions, I find that customers trade more precise quantities at quarter-end, as evidenced by less trade-size clustering. Customers trade more odd lots and fewer round lots, while the number of trades and total volume are not significantly changed. I also find that the price impact of order flow is greater when customers care more about trading precise quantities. This work sheds new light on trade-size clustering and offers a potential explanation for time-series and cross-sectional variations in common liquidity measures. JEL classification: D4; G12; G1