The new very small angle neutron scattering spectrometer at Laboratoire Leon Brillouin

The design and characteristics of the new very small angle neutron scattering spectrometer under construction at the Laboratoire Leon Brillouin is described. Its goal is to extend the range of scattering vectors magnitudes towards 2x10{-4} /A. The unique feature of this new spectrometer is a high resolution two dimensional image plate detector sensitive to neutrons. The wavelength selection is achieved by a double reflection supermirror monochromator and the collimator uses a novel multibeam design

A Systematic Review of the Efficacy of Motivational Interviewing on Occupational Performance

This systematic review aims to review the efficacy of MI to address such performance goals falling within the occupational therapy scope of practice

Caesarean Section among Referred and Self-Referred Birthing Women: A Cohort Study from a Tertiary Hospital, Northeastern Tanzania.

The inequity in emergency obstetric care access in Tanzania is unsatisfactory. Despite an existing national obstetric referral system, many birthing women bypass referring facilities and go directly to higher-level care centres. We wanted to compare Caesarean section (CS) rates among women formally referred to a tertiary care centre versus self-referred women, and to assess the effect of referral status on adverse outcomes after CS. We used data from 21,011 deliveries, drawn from the birth registry of a tertiary hospital in northeastern Tanzania, during 2000-07. Referral status was categorized as self-referred if the woman had bypassed or not accessed referral, or formally-referred if referred by a health worker. Because CS indications were insufficiently registered, we applied the Ten-Group Classification System to determine the CS rate by obstetric group and referral status. Associations between referral status and adverse outcomes after CS delivery were analysed using multiple regression models. Outcome measures were CS, maternal death, obstetric haemorrhage ≥ 750 mL, postpartum stay > 9 days, neonatal death, Apgar score < 7 at 5 min and neonatal ward transfer. Referral status contributed substantially to the CS rate, which was 55.0% in formally-referred and 26.9% in self-referred birthing women. In both groups, term nulliparous singleton cephalic pregnancies and women with previous scar(s) constituted two thirds of CS deliveries. Low Apgar score (adjusted OR 1.42, 95% CI 1.09-1.86) and neonatal ward transfer (adjusted OR 1.18, 95% CI 1.04-1.35) were significantly associated with formal referral. Early neonatal death rates after CS were 1.6% in babies of formally-referred versus 1.2% in babies of self-referred birthing women, a non-significant difference after adjusting for confounding factors (adjusted OR 1.37, 95% CI 0.87-2.16). Absolute neonatal death rates were > 2% after CS in breech, multiple gestation and preterm deliveries in both referral groups. Women referred for delivery had higher CS rates and poorer neonatal outcomes, suggesting that the formal referral system successfully identifies high-risk birth, although low volume suggests underutilization. High absolute rates of post-CS adverse outcomes among breech, multiple gestation and preterm deliveries suggest the need to target self-referred birthing women for earlier professional intrapartum care

Autonomy supportive environments and mastery as basic factors to motivate physical activity in children: a controlled laboratory study

<p>Abstract</p> <p>Background</p> <p>Choice promotes the experience of autonomy, which enhances intrinsic motivation. Providing a greater choice of traditional active toys may increase children's activity time. Mastery also increases intrinsic motivation and is designed into exergames, which may increase play time of a single exergame, reducing the need for choice to motivate activity compared to traditional active toys. Providing both choice and mastery could be most efficacious at increasing activity time. The energy expenditure (EE) of an active play session is dependent on the duration of play and the rate of EE during play. The rate of EE of exergames and the same game played in traditional fashion is not known. The purpose was to test the basic parameters of choice and mastery on children's physical activity time, activity intensity, and energy expenditure.</p> <p>Methods</p> <p>44 children were assigned to low (1 toy) or high (3 toys) choice groups. Children completed 60 min sessions with access to traditional active toys on one visit and exergame versions of the same active toys on another visit.</p> <p>Results</p> <p>Choice had a greater effect on increasing girls' (146%) than boys' (23%) activity time and on girls' (230%) than boys' (minus 24%) activity intensity. When provided choice, girls' activity time and intensity were no longer lower than boys' activity time and intensity. The combination of choice and mastery by providing access to 3 exergames produced greater increases in physical activity time (1 toy 22.5 min, 3 toys 41.4 min) than choice alone via access to 3 traditional games (1 toy 13.6 min, 3 toys 19.5 min). Energy expenditure was 83% greater when engaging in traditional games than exergames.</p> <p>Conclusions</p> <p>Boys and girls differ in their behavioral responses to autonomy supportive environments. By providing girls with greater autonomy they can be motivated to engage in physical activity equal to boys. An environment that provides both autonomy and mastery is most efficacious at increasing physical activity time. Though children play exergames 87% longer than traditional games, the rate of energy expenditure is 83% lower for exergames than traditional indoor versions of the same games.</p

Study profile: the Durban Diabetes Study (DDS): a platform for chronic disease research.

The Durban Diabetes Study (DDS) is a population-based cross-sectional survey of an urban black population in the eThekwini Municipality (city of Durban) in South Africa. The survey combines health, lifestyle and socioeconomic questionnaire data with standardised biophysical measurements, biomarkers for non-communicable and infectious diseases, and genetic data. Data collection for the study is currently underway and the target sample size is 10 000 participants. The DDS has an established infrastructure for survey fieldwork, data collection and management, sample processing and storage, managed data sharing and consent for re-approaching participants, which can be utilised for further research studies. As such, the DDS represents a rich platform for investigating the distribution, interrelation and aetiology of chronic diseases and their risk factors, which is critical for developing health care policies for disease management and prevention. For data access enquiries please contact the African Partnership for Chronic Disease Research (APCDR) at [email protected] or the corresponding author.The study was supported by the Wellcome Trust (grant number 098051), the African Partnership for Chronic Disease Research (Medical Research Council UK partnership grant number MR/K013491/1), the National Institute for Health Research Cambridge Biomedical Research Centre (UK), the Gates Cambridge Scholarship programme (UK), Novo-Nordisk (South Africa), Sanofi-Aventis (South Africa), and MSD Pharmaceuticals (Pty) Ltd (Southern Africa).This is the final version of the article. It first appeared from Cambridge University Press via http://dx.doi.org/10.1017/gheg.2015.

Removing Barriers to Tecovirimat for Mpox-infected Individuals via Novel Models of Care Delivery

Problem Statement During the 2022 mpox outbreak, the CDC’s expanded access Investigational New Drug (IND) protocol created a practical barrier to the outpatient provision of tecovirimat. We rapidly implemented a tecovirimat prescription program for individuals infected with mpox to improves access to care. Project AIM Primary aim: describe how we rapidly implemented a program for increasing tecovirimat distribution in a metropolitan area. Secondary aims: describe the patient population who received tecovirimat as treatment for mpox at our clinic and analyze several clinically relevant time intervals along the continuum of care delivery.https://jdc.jefferson.edu/didemposters/1004/thumbnail.jp

Area-level deprivation and adiposity in children: is the relationship linear?

OBJECTIVE: It has been suggested that childhood obesity is inversely associated with deprivation, such that the prevalence is higher in more deprived groups. However, comparatively few studies actually use an area-level measure of deprivation, limiting the scope to assess trends in the association with obesity for this indicator. Furthermore, most assume a linear relationship. Therefore, the aim of this study was to investigate associations between area-level deprivation and three measures of adiposity in children: body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). DESIGN: This is a cross-sectional study in which data were collected on three occasions a year apart (2005-2007). SUBJECTS: Data were available for 13,333 children, typically aged 11-12 years, from 37 schools and 542 lower super-output areas (LSOAs). MEASURES: Stature, mass and WC. Obesity was defined as a BMI and WC exceeding the 95th centile according to British reference data. WHtR exceeding 0.5 defined obesity. The Index of Multiple Deprivation affecting children (IDACI) was used to determine area-level deprivation. RESULTS: Considerable differences in the prevalence of obesity exist between the three different measures. However, for all measures of adiposity the highest probability of being classified as obese is in the middle of the IDACI range. This relationship is more marked in girls, such that the probability of being obese for girls living in areas at the two extremes of deprivation is around half that at the peak, occurring in the middle. CONCLUSION: These data confirm the high prevalence of obesity in children and suggest that the relationship between obesity and residential area-level deprivation is not linear. This is contrary to the 'deprivation theory' and questions the current understanding and interpretation of the relationship between obesity and deprivation in children. These results could help make informed decisions at the local level

Decreased STARD10 expression is associated with defective insulin secretion in humans and mice

Genetic variants near ARAP1 (CENTD2) and STARD10 influence type 2 diabetes (T2D) risk. The risk alleles impair glucose-induced insulin secretion and, paradoxically but characteristically, are associated with decreased proinsulin:insulin ratios, indicating improved proinsulin conversion. Neither the identity of the causal variants nor the gene(s) through which risk is conferred have been firmly established. Whereas ARAP1 encodes a GTPase activating protein, STARD10 is a member of the steroidogenic acute regulatory protein (StAR)-related lipid transfer protein family. By integrating genetic fine-mapping and epigenomic annotation data and performing promoter-reporter and chromatin conformational capture (3C) studies in β cell lines, we localize the causal variant(s) at this locus to a 5 kb region that overlaps a stretch-enhancer active in islets. This region contains several highly correlated T2D-risk variants, including the rs140130268 indel. Expression QTL analysis of islet transcriptomes from three independent subject groups demonstrated that T2D-risk allele carriers displayed reduced levels of STARD10 mRNA, with no concomitant change in ARAP1 mRNA levels. Correspondingly, β-cell-selective deletion of StarD10 in mice led to impaired glucose-stimulated Ca2+ dynamics and insulin secretion and recapitulated the pattern of improved proinsulin processing observed at the human GWAS signal. Conversely, overexpression of StarD10 in the adult β cell improved glucose tolerance in high fat-fed animals. In contrast, manipulation of Arap1 in β cells had no impact on insulin secretion or proinsulin conversion in mice. This convergence of human and murine data provides compelling evidence that the T2D risk associated with variation at this locus is mediated through reduction in STARD10 expression in the β cell

Post hoc depression analysis from a pharmacist-led diabetes trial

Introduction: Diabetes and depression may present concurrently, and clinical pharmacists are well equipped to manage these conditions. Clinical pharmacists were grant funded to implement a diabetes-focused randomized controlled trial in a Federally Qualified Health Center. The objective of this analysis is to evaluate if glycemic control and depressive symptoms improve for patients with diabetes and depression with additional management from clinical pharmacists compared with those receiving the standard of care. Methods: This is a post hoc subgroup analysis of a diabetes-focused randomized controlled trial. Pharmacists enrolled patients with type 2 diabetes mellitus (T2DM) and a glycated hemoglobin (A1C) greater than 8% and randomly assigned them to 1 of 2 cohorts, one managed by the primary care provider alone and one with additional care from the pharmacist. Pharmacists completed encounters with patients who have T2DM with or without depression to comprehensively optimize pharmacotherapy while tracking glycemic and depressive outcomes throughout the study. Results: A1C improved from baseline to 6 months in patients with depressive symptoms who received additional care from pharmacists by -2.4 percentage points (SD, 2.41) compared with a -0.1 percentage point (SD, 1.78) reduction in the control arm (P .0081), and there was no change in depressive symptoms. Discussion: Patients with T2DM and depressive symptoms experienced better diabetes outcomes with additional pharmacist management compared with a similar cohort of patients with depressive symptoms, managed independently by primary care providers. These patients with diabetes and comorbid depression received a higher level of engagement and care from the pharmacists, which led to more therapeutic interventions

The inevitable youthfulness of known high-redshift radio galaxies

Radio galaxies can be seen out to very high redshifts, where in principle they can serve as probes of the early evolution of the Universe. Here we show that for any model of radio-galaxy evolution in which the luminosity decreases with time after an initial rapid increase (that is, essentially all reasonable models), all observable high-redshift radio-galaxies must be seen when the lobes are less than 10^7 years old. This means that high-redshift radio galaxies can be used as a high-time-resolution probe of evolution in the early Universe. Moreover, this result helps to explain many observed trends of radio-galaxy properties with redshift [(i) the `alignment effect' of optical emission along radio-jet axes, (ii) the increased distortion in radio structure, (iii) the decrease in physical sizes, (iv) the increase in radio depolarisation, and (v) the increase in dust emission] without needing to invoke explanations based on cosmology or strong evolution of the surrounding intergalactic medium with cosmic time, thereby avoiding conflict with current theories of structure formation.Comment: To appear in Nature. 4 pages, 2 colour figures available on request. Also available at http://www-astro.physics.ox.ac.uk/~km