A Test of Multisession Automatic Action Tendency Retraining to Reduce Alcohol Consumption Among Young Adults in the Context of a Human Laboratory Paradigm.

BACKGROUND: Young adult heavy drinking is an important public health concern. Current interventions have efficacy but with only modest effects, and thus, novel interventions are needed. In prior studies, heavy drinkers, including young adults, have demonstrated stronger automatically triggered approach tendencies to alcohol-related stimuli than lighter drinkers. Automatic action tendency retraining has been developed to correct this tendency and consequently reduce alcohol consumption. This study is the first to test multiple iterations of automatic action tendency retraining, followed by laboratory alcohol self-administration. METHODS: A total of 72 nontreatment-seeking, heavy drinking young adults ages 21 to 25 were randomized to automatic action tendency retraining or a control condition (i.e., sham training ). Of these, 69 (54% male) completed 4 iterations of retraining or the control condition over 5 days with an alcohol drinking session on Day 5. Self-administration was conducted according to a human laboratory paradigm designed to model individual differences in impaired control (i.e., difficulty adhering to limits on alcohol consumption). RESULTS: Automatic action tendency retraining was not associated with greater reduction in alcohol approach tendency or less alcohol self-administration than the control condition. The laboratory paradigm was probably sufficiently sensitive to detect an effect of an experimental manipulation given the range of self-administration behavior observed, both in terms of number of alcoholic and nonalcoholic drinks and measures of drinking topography. CONCLUSIONS: Automatic action tendency retraining was ineffective among heavy drinking young adults without motivation to change their drinking. Details of the retraining procedure may have contributed to the lack of a significant effect. Despite null primary findings, the impaired control laboratory paradigm is a valid laboratory-based measure of young adult alcohol consumption that provides the opportunity to observe drinking topography and self-administration of nonalcoholic beverages (i.e., protective behavioral strategies directly related to alcohol use)

Genetic diversity from proviral DNA as a proxy for time since HIV-1 infection.

HIV-1 RNA genetic diversity predicts time since infection which is important for clinical care and research. It's unclear, however, whether proviral DNA genetic diversity sampled under suppressive antiretroviral therapy can be used for this purpose. We tested whether proviral genetic diversity from NGS sequences predicts time since infection and recency in 221 people with HIV-1 with known infection time. Proviral diversity was significantly associated with time since infection (p<5*10-07, R2 up to 25%) and predictive of treatment initiation during recent infection (AUC-ROC up to 0.85). This shows the utility of proviral genetic diversity as a proxy for time since infection

The Perioperative Quality Improvement Programme (PQIP patient study): protocol for a UK multicentre, prospective cohort study to measure quality of care and outcomes after major surgery

INTRODUCTION: Major surgery accounts for a substantial proportion of health service activity, due not only to the primary procedure, but the longer-term health implications of poor short-term outcome. Data from small studies or from outside the UK indicate that rates of complications and failure to rescue vary between hospitals, as does compliance with best practice processes. Within the UK, there is currently no system for monitoring postoperative complications (other than short-term mortality) in major non-cardiac surgery. Further, there is variation between national audit programmes, in the emphasis placed on quality assurance versus quality improvement, and therefore the principles of measurement and reporting which are used to design such programmes. METHODS AND ANALYSIS: The PQIP patient study is a multi-centre prospective cohort study which recruits patients undergoing major surgery. Patient provide informed consent and contribute baseline and outcome data from their perspective using a suite of patient-reported outcome tools. Research and clinical staff complete data on patient risk factors and outcomes in-hospital, including two measures of complications. Longer-term outcome data are collected through patient feedback and linkage to national administrative datasets (mortality and readmissions). As well as providing a uniquely granular dataset for research, PQIP provides feedback to participating sites on their compliance with evidence-based processes and their patients' outcomes, with the aim of supporting local quality improvement. ETHICS AND DISSEMINATION: Ethical approval has been granted by the Health Research Authority in the UK. Dissemination of interim findings (non-inferential) will form a part of the improvement methodology and will be provided to participating centres at regular intervals, including near-real time feedback of key process measures. Inferential analyses will be published in the peer-reviewed literature, supported by a comprehensive multi-modal communications strategy including to patients, policy makers and academic audiences as well as clinicians

Fyraåringars kostvanor och fysiska aktivitet

Övervikt och fetma bland barn är ett snabbt växande hälsoproblem i västvärlden, problemet är bland annat minskad fysisk aktivitet och kost med ett stort fett- och sockerinnehåll Den som varit överviktig som barn kan i större utsträckning få hälsoproblem i vuxen ålder Eftersom detta grundläggs redan i barndomen har distriktssköterskan på barnavårdscentralen en viktig roll att fylla. För att distriktssköterskan skall kunna hjälpa och stötta familjen bör de veta hur fyråringar äter och hur de rör sig. De Svenska näringsrekommendationerna kan vara stöd i samtal med föräldrar. Syftet var att kartlägga fyraåringars kostvanor och fysiska aktivitet och undersöka samband i en regional population i Mellansverige. Kostvanorna hos den regionala populationen av fyraåringar jämfördes med kostvanor hos en nationell population fyraåringar. En postenkät skickades ut till 96 föräldrar angående deras fyraåringars kostvanor och fysiska aktivitet. Frågorna hämtades ur SLV:s tidigare undersökningar om kost och fysisk aktivitet. Svarsfrekvensen var 59 %. Databearbetning gjordes med SPSS (Statistical package for social science). Resultaten visar att majoriteten av barnen åt en allsidig kost och rörde sig mer än 60 minuter per dag som rekommenderas. I jämförelser med den nationella populationen sågs signifikant skillnad i konsumtion av färdiglagad mat och snabbmat. På grund av att övervikt och fetma är ett vanligt förekommande problem så hade i aktuellt examensarbete förväntats att se något samband mellan kostvanor, fysisk aktivitet och tid vid TV/dator, men inga samband sågs

Utilisation of Backscattered Gamma Photons in Tc-99m SPECT Imaging

A number of report have suggested that some Comptom-scattered gamma-photons do carry true spatial information even after multiple deflections in the imaged object, and scattered data have been used for the enhancement of image quality. This study attempts to examine that conclusion via the use of simple energy windowing technique. In the work reported here, data straddling the 81-154 keV range were segmented into three disjoints energy windows: photopeak, backscaterring, and angle-scattered regions. It is shown how image quality may be manipulated by appropriate combination of the sub-images derived from this data sets. Image were compared with those reconstructed from the data acquired within the conventional energy window (126-154 keV). It is found that the conventional view is the more correct one: scattered gamma-photons do, in general, reduce image quality . This conclusion is reinforced by the demonstration that some of the image enhancements claimed when scattered data is incorporated, may in fact be mimicked by processing the photopeak image alone

Very brief, web-based interventions for reducing alcohol use and related problems among college students: A review

Very brief, web-based alcohol interventions have great potential due to their convenience, ease of dissemination, and college students’ stated preference for this intervention modality. To address the efficacy of these interventions, we conducted a review of the literature to identify randomized, controlled trials (RCTs). Fifteen published reports were included. All RCTs meeting criteria for inclusion tested an intervention that featured personalized feedback on students’ patterns of alcohol consumption. This review found some evidence to support the efficacy of very brief, web-based interventions among college students for alcohol use reduction. Several trials, however, reported no evidence of efficacy and it is possible that methodological limitations of some of the studies could have had an impact on their results. This review did not yield evidence to support the efficacy of very-brief, web-based interventions for reduction of alcohol-related problems among college students. We found evidence to support the efficacy of two main types of intervention content: (a) focused solely on personalized normative feedback designed to correct misconceptions about peer alcohol consumption and (b) multi-component interventions. Future research is needed to test enhancements to very brief, web-based interventions that feature personalized feedback on patterns of alcohol use and to determine for which types of college drinkers (e.g., heavier or lighter drinkers) these interventions are most efficacious. In addition, future studies are needed to test novel, very brief, web-based interventions featuring approaches other than personalized feedback. In summary, this review yielded some evidence supporting very brief, web-based interventions in reducing alcohol use but not related problems in college students. Very brief, web-based interventions are worth pursuing given their convenience, privacy and potential public health benefit

Randomized controlled trial of a very brief, multicomponent web-based alcohol intervention for undergraduates with a focus on protective behavioral strategies

Objective: THRIVE (Kypri et al., 2009; 2013; 2014), a very brief, freely-available, multi-component web-based alcohol intervention originally developed and tested among students in Australia and New Zealand, was tested in the United States. We also evaluated effects of systematically varying the protective behavioral strategies (PBS) component of the intervention to include shorter, focused lists of Direct (e.g., alternating alcoholic with non-alcoholic drinks) or Indirect (e.g., looking out for friends) strategies. Method: Undergraduates with past-month heavy drinking (N=208) were randomized to education/assessment Control or 1 of 3 US-THRIVE variants including Direct PBS only, Indirect PBS only, or Full (Direct and Indirect PBS). Results: After 1 month, compared to the Control condition, Full condition participants reported fewer drinks per week (rate ratio [RR]=.62) and lower peak drinking (RR=.74). The Indirect-only condition reported reduced peak drinking (RR=.74) and a trend toward fewer drinks per week (RR=.78). Changes in drinking relative to Control were significant through 6 months for the Full and Indirect-only conditions. There were no significant differences between the Direct-only and Control conditions. US-THRIVE was not associated with decreased heavy drinking or alcohol-related problems relative to Control. Conclusions: To our knowledge this was the first study to systematically vary the types of PBS provided in an intervention. Initial results suggest US-THRIVE is efficacious. Compared to Control, presenting Indirect PBS only as part of US-THRIVE was associated with lower drinks per week and peak past 30-day drinking. Targeting Indirect PBS may be more appropriate for non-treatment-seeking young adults receiving a brief intervention