The Internet for weight control in an obese sample: results of a randomised controlled trial

Rising levels of obesity coupled with the limited success of currently available weight control methods highlight the need for investigation of novel approaches to obesity treatment. This study aims to determine the effectiveness and cost-effectiveness of an Internet-based resource for obesity management

Evaluation of lifestyle interventions to treat elevated cardiometabolic risk in primary care (E-LITE): a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Efficacy research has shown that intensive individual lifestyle intervention lowers the risk for developing type 2 diabetes mellitus and the metabolic syndrome. Translational research is needed to test real-world models of lifestyle interventions in primary care settings.</p> <p>Design</p> <p>E-LITE is a three-arm randomized controlled clinical trial aimed at testing the feasibility and potential effectiveness of two lifestyle interventions: information technology-assisted self-management, either alone or in combination with care management by a dietitian and exercise counselor, in comparison to usual care. Overweight or obese adults with pre-diabetes and/or metabolic syndrome (n = 240) recruited from a community-based primary care clinic are randomly assigned to one of three treatment conditions. Treatment will last 15 months and involves a three-month intensive treatment phase followed by a 12-month maintenance phase. Follow-up assessment occurs at three, six, and 15 months. The primary outcome is change in body mass index. The target sample size will provide 80% power for detecting a net difference of half a standard deviation in body mass index at 15 months between either of the self-management or care management interventions and usual care at a two-sided α level of 0.05, assuming up to a 20% rate of loss to 15-month follow-up.</p> <p>Secondary outcomes include glycemic control, additional cardiovascular risk factors, and health-related quality of life. Potential mediators (e.g., treatment adherence, caloric intake, physical activity level) and moderators (e.g., age, gender, race/ethnicity, baseline mental status) of the intervention's effect on weight change also will be examined.</p> <p>Discussion</p> <p>This study will provide objective evidence on the extent of reductions in body mass index and related cardiometabolic risk factors from two lifestyle intervention programs of varying intensity that could be implemented as part of routine health care.</p> <p>Trial registration</p> <p>NCT00842426</p

Determination of consensus among professionals for community safety terms through a Delphi study

This is a post-peer-review, pre-copyedit version of an article published in Crime Prevention and Community Safety. The definitive publisher-authenticated version 2013, 15(4), pp. 258-277 is available online at: http://dx.doi.org/10.1057/cpcs.2013.9This article reports the findings from a study of Community Safety professionals (Academics, Policymakers and Practitioners), using the Delphi method to determine common definitions, if any, for Community Safety terms in current usage. The study investigated the differences in the way that the terms were used and understood by the members of the three groups. The study was predicated on the view that the groups of Community Safety professionals probably use the language of Community Safety in different ways. It is suggested that work in the field would benefit from a shared terminology, where the same term has the same meaning for different professional groups

Veterans walk to beat back pain: study rationale, design and protocol of a randomized trial of a pedometer-based Internet mediated intervention for patients with chronic low back pain

<p>Abstract</p> <p>Background</p> <p>Chronic back pain is a significant problem worldwide and may be especially prevalent among patients receiving care in the U.S. Department of Veterans Affairs healthcare system. Back pain affects adults at all ages and is associated with disability, lost workplace productivity, functional limitations and social isolation. Exercise is one of the most effective strategies for managing chronic back pain. Yet, there are few clinical programs that use low cost approaches to help patients with chronic back pain initiate and maintain an exercise program.</p> <p>Methods/Design</p> <p>We describe the design and rationale of a randomized controlled trial to assess the efficacy of a pedometer-based Internet mediated intervention for patients with chronic back pain. The intervention uses an enhanced pedometer, website and e-community to assist these patients with initiating and maintaining a regular walking program with the primary aim of reducing pain-related disability and functional interference. The study specific aims are: 1) To determine whether a pedometer-based Internet-mediated intervention reduces pain-related functional interference among patients with chronic back pain in the short term and over a 12-month timeframe. 2) To assess the effect of the intervention on walking (measured by step counts), quality of life, pain intensity, pain related fear and self-efficacy for exercise. 3) To identify factors associated with a sustained increase in walking over a 12-month timeframe among patients randomized to the intervention.</p> <p>Discussion</p> <p>Exercise is an integral part of managing chronic back pain but to be effective requires that patients actively participate in the management process. This intervention is designed to increase activity levels, improve functional status and make exercise programs more accessible for a broad range of patients with chronic back pain.</p> <p>Trial Registration Number</p> <p>NCT00694018</p

Laparoscopic versus small-incision cholecystectomy: Health status in a blind randomised trial

Contains fulltext : 69536.pdf (publisher's version ) (Open Access)BACKGROUND: Gallstones are a major cause of morbidity, and cholecystectomy is a commonly performed procedure. Minimal invasive procedures, laparoscopic cholecystectomy (LC) and small-incision cholecystectomy (SIC), have replaced the classical open cholecystectomy. No differences have been found in primary outcome measures between LC and SIC, therefore secondary outcome measures have to be considered to determine preferences. The aim of our study was to examine health status applying evidence-based guidelines in LC and SIC in a randomised trial. METHODS: Patients with symptomatic cholecystolithiasis were included in a blind randomised trial. Operative procedures, anaesthesia, analgesics and postoperative care were standardised in order to limit bias. Questionnaires were filled in preoperatively, the first day postoperatively, and at outpatients follow-up at 2, 6 and 12 weeks. In accordance with evidence-based guidelines, the generic short form (SF-36) and the disease-specific gastrointestinal quality-of-life index (GIQLI) questionnaires were used in addition to the body image questionnaire (BIQ). RESULTS: A total of 257 patients were randomised between LC (120) and SIC (137). Analyses were performed according to intention-to-treat (converted procedures included) and also distinguishing converted from minimal invasive (nonconverted) procedures. Questionnaires were obtained with a response rate varying from 87.5% preoperatively to 77.4% three months postoperatively. Except for two time-specific measurements in one SF-36 subscale, there were no differences between LC and SIC. There were significant differences in several subscales in all three questionnaires comparing minimal invasive versus converted procedures. CONCLUSIONS: Applying adequate methodological quality and evidence-based guidelines (by using SF-36 and GIQLI), there are no significant differences in health status between LC and SIC

Evaluation of indigenous Trichoderma isolates from Manipur as biocontrol agent against Pythium aphanidermatum on common beans

Pythium aphanidermatum is one of the common causal pathogen of damping-off disease of beans (Phaseolus vulgaris L.) grown in Manipur. A total of 110 indigenous Trichoderma isolates obtained from North east India were screened for their biocontrol activity which can inhibit the mycelial growth of P. aphanidermatum, the causal organism of damping-off in beans. Out of the total isolates, 32% of them showed strong antagonistic activity against P. aphanidermatum under in vitro condition and subsequently 20 best isolates were selected based on their mycelial inhibition capacity against P. aphanidermatum for further analysis. Different biocontrol mechanisms such as protease, chitinase, β-1,3-glucanase activity, cellulase and production of volatile and non-volatile compounds were also assayed. Based on their relative biocontrol potency, only three indigenous Trichoderma isolates (T73, T80 and T105) were selected for pot culture experiment against damping-off diseases in common beans. In greenhouse experiment, Trichoderma isolates T-105 significantly reduced the pre- and post-emergence damping-off disease incidence under artificial infection with P. aphanidermatum and showed highest disease control percentage

Heterologous Overexpression and Mutagenesis of the Human Bile Salt Export Pump (ABCB11) Using DREAM (Directed REcombination-Assisted Mutagenesis)

Homologous recombination in Saccharomyces cerevisiae is a well-studied process. Here, we describe a yeast-recombination-based approach to construct and mutate plasmids containing the cDNA of the human bile salt export pump (BSEP) that has been shown to be unstable in E. coli. Using this approach, we constructed the necessary plasmids for a heterologous overexpression of BSEP in the yeast Pichia pastoris. We then applied a new site-directed mutagenesis method, DREAM (Directed REcombination-Assisted Mutagenesis) that completely bypasses E. coli by using S. cerevisiae as the plasmid host with high mutagenesis efficiency. Finally, we show how to apply this strategy to unstable non-yeast plasmids by rapidly turning an existing mammalian BSEP expression construct into a S. cerevisiae-compatible plasmid and analyzing the impact of a BSEP mutation in several mammalian cell lines

The Glasgow Outcome Scale -- 40 years of application and refinement

The Glasgow Outcome Scale (GOS) was first published in 1975 by Bryan Jennett and Michael Bond. With over 4,000 citations to the original paper, it is the most highly cited outcome measure in studies of brain injury and the second most-cited paper in clinical neurosurgery. The original GOS and the subsequently developed extended GOS (GOSE) are recommended by several national bodies as the outcome measure for major trauma and for head injury. The enduring appeal of the GOS is linked to its simplicity, short administration time, reliability and validity, stability, flexibility of administration (face-to-face, over the telephone and by post), cost-free availability and ease of access. These benefits apply to other derivatives of the scale, including the Glasgow Outcome at Discharge Scale (GODS) and the GOS paediatric revision. The GOS was devised to provide an overview of outcome and to focus on social recovery. Since the initial development of the GOS, there has been an increasing focus on the multidimensional nature of outcome after head injury. This Review charts the development of the GOS, its refinement and usage over the past 40 years, and considers its current and future roles in developing an understanding of brain injury

Comparing the Effect of Naturally Restored Forest and Grassland on Carbon Sequestration and Its Vertical Distribution in the Chinese Loess Plateau

Vegetation restoration has been conducted in the Chinese Loess Plateau (CLP) since the 1950s, and large areas of farmland have been converted to forest and grassland, which largely results in SOC change. However, there has been little comparative research on SOC sequestration and distribution between secondary forest and restored grassland. Therefore, we selected typical secondary forest (SF-1 and SF-2) and restored grassland (RG-1 and RG-2) sites and determined the SOC storage. Moreover, to illustrate the factors resulting in possible variance in SOC sequestration, we measured the soil δ13C value. The average SOC content was 6.8, 9.9, 17.9 and 20.4 g kg−1 at sites SF-1, SF-2, RG-1 and RG-2, respectively. Compared with 0–100 cm depth, the percentage of SOC content in the top 20 cm was 55.1%, 55.3%, 23.1%, and 30.6% at sites SF-1, SF-2, RG-1 and RG-2, suggesting a higher SOC content in shallow layers in secondary forest and in deeper layers in restored grassland. The variation of soil δ13C values with depth in this study might be attributed to the mixing of new and old carbon and kinetic fractionation during the decomposition of SOM by microbes, whereas the impact of the Suess effect (the decline of 13C atmospheric CO2 values with the burning of fossil fuel since the Industrial Revolution) was minimal. The soil δ13C value increased sharply in the top 20 cm, which then increased slightly in deeper layers in secondary forest, indicating a main carbon source of surface litter. However the soil δ13C values exhibited slow increases in the whole profile in the restored grasslands, suggesting that the contribution of roots to soil carbon in deeper layers played an important role. We suggest that naturally restored grassland would be a more effective vegetation type for SOC sequestration due to higher carbon input from roots in the CLP