An analysis of directly observed weight communication processes between primary care practitioners and overweight patients

This research was funded by a University of St Andrews 600th Anniversary Doctoral Scholarship.Objective To analyse weight-related communication prevalence and processes (content/context) between primary care practitioners (PCPs) and overweight patients within routine primary healthcare consultations. Methods Consultations between 14 PCPs and 218 overweight patients (BMI ≥25 kg/m2) were video recorded. Weight communication was coded using the Roter Interaction Analysis System (RIAS) and the novel St Andrews Issue Response Analysis System (SAIRAS). Communication code frequencies were analysed. Results Weight discussion occurred in 25% of consultations with overweight patients; 26% of these had weight-related consultation outcomes (e.g. weight-related counselling and referrals, stated weight-related intention from patients). Weight discussions were more likely to occur if PCPs provided space to patient attempts to discuss weight (p = 0.013). Longer weight discussions (p < 0.001) and contextualising weight as problematic when PCP/patient-initiated weight discussion (p < 0.001) were associated with weight-related consultation outcomes. Conclusion Weight was rarely discussed with overweight patients, however PCP space provision to patient weight-discussion initiation attempts increased weight discussion. When weight was discussed, increased time and/or contextualising weight as a problem increased the likelihood of weight-related consultation outcomes. Practical implication PCP use of specific communication approaches when discussing, contextualising and responding to patient weight may facilitate weight-related discussion and consultation outcomes and could lead to more effective patient weight management.PostprintPeer reviewe

Topography driven spreading

Roughening a hydrophobic surface enhances its nonwetting properties into superhydrophobicity. For liquids other than water, roughness can induce a complete rollup of a droplet. However, topographic effects can also enhance partial wetting by a given liquid into complete wetting to create superwetting. In this work, a model system of spreading droplets of a nonvolatile liquid on surfaces having lithographically produced pillars is used to show that superwetting also modifies the dynamics of spreading. The edge speed-dynamic contact angle relation is shown to obey a simple power law, and such power laws are shown to apply to naturally occurring surfaces

Advanced atomization concept for CWF burning in small combustors, Phase 2

The program describes a concept referred to as opposed-jet atomization, which is particularly applicable to coal-water fuel (CWF). In the present atomizer design, two opposed jets of CWF are directed at each other and externally encounter a perpendicular blast of air at the collision point to create a spray of much finer droplets. The present Phase 2 program involved further evaluation of the opposed-jet atomizer performance and related tasks

Passive water control at the surface of a superhydrophobic lichen

Some lichens have a super-hydrophobic upper surface, which repels water drops, keeping the surface dry but probably preventing water uptake. Spore ejection requires water and is most efficient just after rainfall. This study was carried out to investigate how super-hydrophobic lichens manage water uptake and repellence at their fruiting bodies, or podetia. Drops of water were placed onto separate podetia of Cladonia chlorophaea and observed using optical microscopy and cryo-scanning-electron microscopy (cryo-SEM) techniques to determine the structure of podetia and to visualise their interaction with water droplets. SEM and optical microscopy studies revealed that the surface of the podetia was constructed in a three-level structural hierarchy. By cryo-SEM of water-glycerol droplets placed on the upper part of the podetium, pinning of the droplet to specific, hydrophilic spots (pycnidia/apothecia) was observed. The results suggest a mechanism for water uptake, which is highly sophisticated, using surface wettability to generate a passive response to different types of precipitation in a manner similar to the Namib Desert beetle. This mechanism is likely to be found in other organisms as it offers passive but selective water control

Shapes, contact angles, and line tensions of droplets on cylinders

Using an interface displacement model we calculate the shapes of nanometer-size liquid droplets on homogeneous cylindrical surfaces. We determine effective contact angles and line tensions, the latter defined as excess free energies per unit length associated with the two contact lines at the ends of the droplet. The dependences of these quantities on the cylinder radius and on the volume of the droplets are analyzed.Comment: 26 pages, RevTeX, 10 Figure

Mechanical tuning of the evaporation rate of liquid on crossed fibers

We investigate experimentally the drying of a small volume of perfectly wetting liquid on two crossed fibers. We characterize the drying dynamics for the three liquid morphologies that are encountered in this geometry: drop, column and a mixed morphology, in which a drop and a column coexist. For each morphology, we rationalize our findings with theoretical models that capture the drying kinetics. We find that the evaporation rate depends significantly on the liquid morphology and that the drying of liquid column is faster than the evaporation of the drop and the mixed morphology for a given liquid volume. Finally, we illustrate that shearing a network of fibers reduces the angle between them, changes the morphology towards the column state, and so enhances the drying rate of a volatile liquid deposited on it

Health ‘Brexternalities’: The Brexit effect on health and health care outside the UK

The principal effects of Brexit on health and health care will fall within the United Kingdom, and all forms of Brexit have overwhelmingly negative implications for health care and health within the UK. This article focuses on the external effects of Brexit (‘Brexternalities’) for health and health care. The EU is a particularly powerful institutional and legal arrangement for managing economic and political externalities, in health policy as in any other policy. Equally, when a state leaves the EU, the manner of leaving will result in better or worse management of relevant externalities. ‘Brexternalities’ thus involve questions about policy legitimacy and accountability. Health ‘Brexternalities’ do not fall equally in all EU countries. They are felt more distinctly in the context of those elements of health policy that are most closely entwined with the UK’s health policy: for instance, on the island of Ireland; certain areas of Spain and other parts of southern Europe. Some health ‘Brexternalities’, such as in medicines safety, will be imposed on the whole population of the EU. And some health ‘Brexternalities’, such as communicable disease control, will be felt globally

Nodal Structure of Unconventional Superconductors Probed by the Angle Resolved Thermal Transport Measurements

Over the past two decades, unconventional superconductivity with gap symmetry other than s-wave has been found in several classes of materials, including heavy fermion (HF), high-T_c, and organic superconductors. Unconventional superconductivity is characterized by anisotropic superconducting gap functions, which may have zeros (nodes) along certain directions in the Brillouin zone. The nodal structure is closely related to the pairing interaction, and it is widely believed that the presence of nodes is a signature of magnetic or some other exotic, rather than conventional phonon-mediated, pairing mechanism. Therefore experimental determination of the gap function is of fundamental importance. However, the detailed gap structure, especially the direction of the nodes, is an unresolved issue in most unconventional superconductors. Recently it has been demonstrated that the thermal conductivity and specific heat measurements under magnetic field rotated relative to the crystal axes are a powerful method for determining the shape of the gap and the nodal directions in the bulk. Here we review the theoretical underpinnings of the method and the results for the nodal structure of several unconventional superconductors, including borocarbide YNi$_2$B$_2$C, heavy fermions UPd$_2$Al$_3$, CeCoIn$_5$, and PrOs$_4$Sb$_{12}$, organic superconductor, $\kappa$-(BEDT-TTF)$_2$Cu(NCS)$_2$, and ruthenate Sr$_2$RuO$_4$, determined by angular variation of the thermal conductivity and heat capacity.Comment: topical review, 55 pages, 35 figures. Figure quality has been reduced for submission to cond-mat, higher quality figures available from the authors or from the publishe

Snap evaporation of droplets on smooth topographies

Droplet evaporation on solid surfaces is important in many applications including printing, micro-patterning and cooling. While seemingly simple, the configuration of evaporating droplets on solids is difficult to predict and control. This is because evaporation typically proceeds as a “stick-slip” sequence—a combination of pinning and de-pinning events dominated by static friction or “pinning”, caused by microscopic surface roughness. Here we show how smooth, pinning-free, solid surfaces of non-planar topography promote a different process called snap evaporation. During snap evaporation a droplet follows a reproducible sequence of configurations, consisting of a quasi-static phase-change controlled by mass diffusion interrupted by out-of-equilibrium snaps. Snaps are triggered by bifurcations of the equilibrium droplet shape mediated by the underlying non-planar solid. Because the evolution of droplets during snap evaporation is controlled by a smooth topography, and not by surface roughness, our ideas can inspire programmable surfaces that manage liquids in heat- and mass-transfer applications

Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football

IMPORTANCE: Players of American football may be at increased risk of long-term neurological conditions, particularly chronic traumatic encephalopathy (CTE). OBJECTIVE: To determine the neuropathological and clinical features of deceased football players with CTE. DESIGN, SETTING, AND PARTICIPANTS: Case series of 202 football players whose brains were donated for research. Neuropathological evaluations and retrospective telephone clinical assessments (including head trauma history) with informants were performed blinded. Online questionnaires ascertained athletic and military history. EXPOSURES: Participation in American football at any level of play. MAIN OUTCOMES AND MEASURES: Neuropathological diagnoses of neurodegenerative diseases, including CTE, based on defined diagnostic criteria; CTE neuropathological severity (stages I to IV or dichotomized into mild [stages I and II] and severe [stages III and IV]); informant-reported athletic history and, for players who died in 2014 or later, clinical presentation, including behavior, mood, and cognitive symptoms and dementia. RESULTS: Among 202 deceased former football players (median age at death, 66 years [interquartile range, 47-76 years]), CTE was neuropathologically diagnosed in 177 players (87%; median age at death, 67 years [interquartile range, 52-77 years]; mean years of football participation, 15.1 [SD, 5.2]), including 0 of 2 pre–high school, 3 of 14 high school (21%), 48 of 53 college (91%), 9 of 14 semiprofessional (64%), 7 of 8 Canadian Football League (88%), and 110 of 111 National Football League (99%) players. Neuropathological severity of CTE was distributed across the highest level of play, with all 3 former high school players having mild pathology and the majority of former college (27 [56%]), semiprofessional (5 [56%]), and professional (101 [86%]) players having severe pathology. Among 27 participants with mild CTE pathology, 26 (96%) had behavioral or mood symptoms or both, 23 (85%) had cognitive symptoms, and 9 (33%) had signs of dementia. Among 84 participants with severe CTE pathology, 75 (89%) had behavioral or mood symptoms or both, 80 (95%) had cognitive symptoms, and 71 (85%) had signs of dementia. CONCLUSIONS AND RELEVANCE: In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football.This study received support from NINDS (grants U01 NS086659, R01 NS078337, R56 NS078337, U01 NS093334, and F32 NS096803), the National Institute on Aging (grants K23 AG046377, P30AG13846 and supplement 0572063345-5, R01 AG1649), the US Department of Defense (grant W81XWH-13-2-0064), the US Department of Veterans Affairs (I01 CX001038), the Veterans Affairs Biorepository (CSP 501), the Veterans Affairs Rehabilitation Research and Development Traumatic Brain Injury Center of Excellence (grant B6796-C), the Department of Defense Peer Reviewed Alzheimer’s Research Program (grant 13267017), the National Operating Committee on Standards for Athletic Equipment, the Alzheimer’s Association (grants NIRG-15-362697 and NIRG-305779), the Concussion Legacy Foundation, the Andlinger Family Foundation, the WWE, and the NFL