Effect of a lipid-rich fraction from boiled coffee on serum cholesterol

Scandinavian-style boiled coffee, which raises serum cholesterol, was found to contain more lipid material than drip filter coffee, which does not. Ten volunteers consumed a lipid-enriched fraction from boiled coffee for six weeks: the supplement provided 77 g of water, 1?3 g of lipid, and 1?6 g of other solids per day. Serum cholesterol rose in every subject; the mean rise was 0?74 mmol/l after three weeks (range - 0?09 to 1?48 mmol/l) and 1 ?06 SD 0?37 mmol/l or 23% after six weeks (range 0?48 to 1?52 mmol/l). The increase was mainly due to low-density-lipoprotein cholesterol, which rose by 29%, but very-low-density lipoprotein cholesterol was also raised, as evidenced by a 55% rise in triglycerides. High-density-lipoprotein cholesterol was unchanged. After supplementation had ended, lipid levels returned to baseline. Boiled coffee thus contains a lipid that powerfully raises serum cholesterol

Response Conversion for Improving Comparability of International Physical Activity Data

Background: Many questionnaires for measuring physical activity (PA) exist. This complicates the comparison of outcomes. Methods: In 8 European countries, PA was measured in random samples of 600 persons, using the IPAQ as a 'bridge' to historical sets of country-specific questions. We assume that a unidimensional scale of PA ability exists on which items and respondents can be placed, irrespective of country, culture, background factors, or measurement instrument. Response Conversion (RC) based on Item Response Theory (IRT) was used to estimate such a common PA scale, to compare PA levels between countries, and to create a conversion key. Comparisons were made with Eurobarometer (IPAQ) data. Results: Appropriateness of IRT was supported by the existence of a strong first dimension established by principal component analysis. The IRT analysis resulted in 1 common PA scale with a reasonable fit and face validity. However, evidence for cultural bias (Differential Item Functioning, DIF) was found in all IPAQ items. This result made actual comparison between countries difficult. Conclusions: Response Conversion can improve comparability in the field of PA. RC needs common items that are culturally unbiased. Wide-scale use of RC awaits measures that are more culturally invariant (such as international accelerometer data). © 2012 Human Kinetics, Inc

In the Eye of the Beholder:Changes in Perceived Emotion Expression after Smile Reanimation

Background: Tools to quantify layperson assessments of facial palsy are lacking. In this study, artificial intelligence was applied to develop a proxy for layperson assessments, and compare sensitivity to existing outcome measures. Methods: Artificially intelligent emotion detection software was used to develop the emotionality quotient. The emotionality quotient was defined as the percentage probability of perceived joy over the percentage probability of perceived negative emotions during smiling, as predicted by the software. The emotionality quotient was used to analyze the emotionality of voluntary smiles of normal subjects and unilateral facial palsy patients before and after smile reanimation. The emotionality quotient was compared to oral commissure excursion and layperson assessments of facial palsy patients. Results: In voluntary smiles of 10 normal subjects, 100 percent joy and no negative emotion was detected (interquartile ranges, 0/1). Median preoperative emotionality quotient of 30 facial palsy patients was 15/-60 (interquartile range, 73/62). Postoperatively, median emotionality quotient was 84/0 (interquartile range, 28/5). In 134 smile reanimation patients, no correlation was found between postoperative oral commissure excursion and emotionality quotient score. However, in 61 preoperative patients, a moderate correlation was found between layperson-assessed disfigurement and negative emotion perception (correlation coefficient, 0.516; p <0.001). Conclusions: Computer vision artificial intelligence software detected less joy and more negative emotion in smiles of facial palsy patients compared with normal subjects. Following smile reanimation, significantly more joy and less negative emotion were detected. The emotionality quotient was correlated with layperson assessments. The simplicity, sensitivity, and objectivity of the emotionality quotient render it an attractive tool to serve as a potential proxy for layperson assessment, an ideal outcome measure in facial palsy

The effect of chronic quercetin supplementation on bone health in postmenopausal women: A double-blind placebo-controlled investigation

Currently, there is limited research investigating the effects of quercetin on bone turnover and density. Therefore, this study aimed to examine the efficacy of 90-day quercetin supplementation on bone turnover, inflammation, body composition, and physical function in postmenopausal women. Thirty-four healthy postmenopausal women (59.2 ± 7.0 yrs, 80.7 ± 15.6 kg, 29.8 ± 6.1 kg⸱m2) participated in the double-blind placebo-controlled investigation. Participants were randomly assigned to one of two groups: 500 mg of Q or 500 mg of fiber (placebo; PLB). Data collected during the pre-and post-supplementation assessments included: bone turnover (osteocalcin, P1NP, CTX), inflammation markers (IL-6, TNF-alpha, CRP), body composition, dominant handgrip strength, and timed up and go test. Independent samples t-tests were used for between-group comparisons of baseline values and the percent change for each dependent variable. A significant difference in percent change for osteocalcin (Q: 20.5±25.7; PLB: 1.3±17.2; p=0.016; d=0.89), P1NP (Q: 28.9 (6.0–57.3); PLB: 4.6 (-7.6 – 8.5); p=0.030; d=0.64), and CTX (Q: 39.0 (-10.0 – 84.6); PLB: -7.74 (-28.9 – 18.5); p=0.023; d=0.91) was found between Q and PLB, with greater increases in Q. Changes in the inflammation markers IL-6 (Q: -17.6±24.1; PLB: 2.90±31.1; p=0.045; d=0.73) and TNF-alpha (Q: -4.9± (-15.3 – [-3.2]); PLB: 1.9 (-7.8 – 4.0); p=0.021; d=0.90) between the two groups were significant. No significant changes were found between groups for CRP, body composition, and physical function (p\u3e0.05). The data suggest that Q may improve bone health status in postmenopausal women through its ability to decrease pro-inflammatory mediators and increase turnover markers

Implementation of a shared care guideline for back pain: effect on unnecessary referrals

Objective: To determine the effect of the implementation of a shared care guideline for the lumbosacral radicular syndrome (LRS) on unnecessary early referrals and the duration of the total diagnostic procedure. Design: Introduction of shared care guideline in November 2005. Pre-test in 2005 (April to October), a first post-test in 2006 (April to October) and a second post-test in 2007 (April to October). Setting and Intervention: The introduction of a shared care guideline derived from national guidelines for GPs and several medical/paramedical specialists in two Dutch regions. Three hundred and sixty GPs, 550 physiotherapists and two hospitals (9 neurologists and 18 radiologists) were involved. The essential component of the guideline was a trade-off: if the GP complied with the conservative management approach in the first 6 weeks, the hospital guaranteed a priority appointment with the neurologist after 6 weeks, if still required. Main Outcome Measures: The neurologists in both hospitals registered whether a patient had been unnecessarily referred during the first 6 weeks. The duration of the total diagnostic procedure was defined as the number of days between referral by the GP and the consultation when the neurologist made the final diagnosis. Results: The percentage of patients being unnecessarily referred within 6 weeks fell significantly from 15% in 2005 to 9% in 2006 and 8% in 2007. The duration of the total diagnostic procedure also fell significantly in both the long and short terms. Conclusions: The introduction of a shared care guideline for all care providers in a region reduces the number of unnecessary early referrals for patients with LRS. © The Author 2010. Published by Oxford University Press in association with the International Society for Quality in Health Care

Measuring determinants of implementation behavior: psychometric properties of a questionnaire based on the theoretical domains framework

BACKGROUND: To be able to design effective strategies to improve healthcare professionals’ implementation behaviors, a valid and reliable questionnaire is needed to assess potential implementation determinants. The present study describes the development of the Determinants of Implementation Behavior Questionnaire (DIBQ) and investigates the reliability and validity of this Theoretical Domains Framework (TDF)-based questionnaire. METHODS: The DIBQ was developed to measure the potential behavioral determinants of the 12-domain version of the TDF (Michie et al., 2005). We identified existing questionnaires including items assessing constructs within TDF domains and developed new items where needed. Confirmatory factor analysis was used to examine whether the predefined structure of the TDF-based questionnaire was supported by the data. Cronbach’s alpha was calculated to assess internal consistency reliability of the questionnaire, and domains’ discriminant validity was investigated. RESULTS: We developed an initial questionnaire containing 100 items assessing 12 domains. Results obtained from confirmatory factor analysis and Cronbach’s alpha resulted in the final questionnaire consisting of 93 items assessing 18 domains, explaining 63.3% of the variance, and internal consistency reliability values ranging from .68 to .93. Domains demonstrated good discriminant validity, although the domains ‘Knowledge’ and ‘Skills’ and the domains ‘Skills’ and ‘Social/professional role and identity’ were highly correlated. CONCLUSIONS: We have developed a valid and reliable questionnaire that can be used to assess potential determinants of healthcare professional implementation behavior following the theoretical domains of the TDF. The DIBQ can be used by researchers and practitioners who are interested in identifying determinants of implementation behaviors in order to be able to develop effective strategies to improve healthcare professionals’ implementation behaviors. Furthermore, the findings provide a novel validation of the TDF and indicate that the domain ‘Environmental context and resources’ might be divided into several environment-related domains

Low-dose folic acid supplementation does not influence plasma methionine concentrations in young non-pregnant women

Item does not contain fulltex

The association of health literacy with adherence in older 2 adults, and its role in interventions: a systematic meta-review

Background: Low health literacy is a common problem among older adults. It is often suggested to be associated with poor adherence. This suggested association implies a need for effective adherence interventions in low health literate people. However, previous reviews show mixed results on the association between low health literacy and poor adherence. A systematic meta-review of systematic reviews was conducted to study the association between health literacy and adherence in adults above the age of 50. Evidence for the effectiveness of adherence interventions among adults in this older age group with low health literacy was also explored. Methods: Eight electronic databases (MEDLINE, ERIC, EMBASE, PsycINFO, CINAHL, DARE, the Cochrane Library, and Web of Knowledge) were searched using a variety of keywords regarding health literacy and adherence. Additionally, references of identified articles were checked. Systematic reviews were included if they assessed the association between health literacy and adherence or evaluated the effectiveness of interventions to improve adherence in adults with low health literacy. The AMSTAR tool was used to assess the quality of the included reviews. The selection procedure, data-extraction, and quality assessment were performed by two independent reviewers. Seventeen reviews were selected for inclusion. Results: Reviews varied widely in quality. Both reviews of high and low quality found only weak or mixed associations between health literacy and adherence among older adults. Reviews report on seven studies that assess the effectiveness of adherence interventions among low health literate older adults. The results suggest that some adherence interventions are effective for this group. The interventions described in the reviews focused mainly on education and on lowering the health literacy demands of adherence instructions. No conclusions could be drawn about which type of intervention could be most beneficial for this population. Conclusions: Evidence on the association between health literacy and adherence in older adults is relatively weak. Adherence interventions are potentially effective for the vulnerable population of older adults with low levels of health literacy, but the evidence on this topic is limited. Further research is needed on the association between health literacy and general health behavior, and on the effectiveness of interventions