Medical undergraduates' use of behaviour change talk: The example of facilitating weight management

BACKGROUND: Obesity, an increasing problem worldwide, is a leading cause of morbidity and mortality. Management principally requires lifestyle (i.e. behavioural) changes. An evidence-base exists of behaviour change techniques for weight loss; however, in routine practice doctors are often unsure about effective treatments and commonly use theoretically-unfounded communication strategies (e.g. information-giving). It is not known if communication skills teaching during undergraduate training adequately prepares future doctors to engage in effective behaviour change talk with patients. The aim of the study was to examine which behaviour change techniques medical undergraduates use to facilitate lifestyle adjustments in obese patients. METHODS: Forty-eight medical trainees in their clinical years of a UK medical school conducted two simulated consultations each. Both consultations involved an obese patient scenario where weight loss was indicated. Use of simulated patients (SPs) ensured standardisation of key variables (e.g. barriers to behaviour change). Presentation of scenario order was counterbalanced. Following each consultation, students assessed the techniques they perceived themselves to have used. SPs rated the extent to which they intended to make behavioural changes and why. Anonymised transcripts of the audiotaped consultations were coded by independent assessors, blind to student and SP ratings, using a validated behaviour change taxonomy. RESULTS: Students reported using a wide range of evidence-based techniques. In contrast, codings of observed communication behaviours were limited. SPs behavioural intention varied and a range of helpful elements of student’s communication were revealed. CONCLUSIONS: Current skills-based communication programmes do not adequately prepare future doctors for the growing task of facilitating weight management. Students are able to generalise some communication skills to these encounters, but are over confident and have limited ability to use evidence-based theoretically informed techniques. They recognise this as a learning need. Educators will need to tackle the challenges of integrating theoretically informed and evidence based behaviour change talk within medical training

Smart Street Lighting: Campus Pilot

Course Code: ENR/AEDE 4567This report details a proposed, pilot project for The Ohio State University. This pilot can be used as a real-world example, or "test-case", for the City of Columbus and its smart street lighting efforts. This report includes explanations of recommended technologies (computer vision, dimming capabilities, and air quality monitoring), a proposed pilot location, campus/city receptivity data, and a cost estimate.Academic Major: Environment, Economy, Development, and Sustainabilit

Selective Differential Expression Of The Ribosomal Protein Genes El14 And Us19 In A Well-Differentiated Epithelial Cell Line Of Nasopharyngeal Carcinoma

Besides ribosome biogenesis and protein synthesis, ribosomal proteins (RP) are associated with congenital diseases and cancers. A small subset of ribosomal protein genes has shown expression pattern indicative of their association with nasopharyngeal carcinoma (NPC). Nevertheless, the list of RP genes that are NPC-associated factors is largely incomplete. Herein we report the expression patterns of eL14 and uS19 in NPC normal nasopharyngeal epithelium cell lines. Expression levels of eL14 and uS19 in the NPC-HK1 cell line was comparatively analysed with a normal nasopharyngeal cell line (NP69) using Reverse Transcription – Polymerase Chain Reaction (RT-PCR). We revealed that the transcript level of eL14 was significantly down-regulated in HK1 when compared to NP69. The expression behaviour of eL14 is demonstrated for the first time in the NPC context. In contrast, the transcript level of uS19 was up-regulated in NPC/HK1 compared to NP69, but not to a statistically significant extent. This study provides new evidence of differential expression of the ribosomal protein gene, eL14 in an NPC cell line derived from well-differentiated squamous cell carcinoma of human nasopharynx. It adds to the list of NPC-associated ribosomal protein genes amenable for development of biomarkers for improved molecular diagnosis of nasopharyngeal cancer

Geriatric Oncology as an Unmet Workforce Training Need in the United Kingdom—A Narrative Review by the British Oncology Network for Undergraduate Societies (BONUS) and the International Society of Geriatric Oncology (SIOG) UK Country Group

Cancer is a disease associated with ageing. Managing cancer in older adults may prove challenging owing to pre-existing frailty, comorbidity, and wider holistic needs, as well as the unclear benefits and harms of standard treatment options. With the ongoing advances in oncology and the increasing complexity of treating older adults with cancer, the geriatric oncology field must be a priority for healthcare systems in education, research, and clinical practice. However, geriatric oncology is currently not formally taught in undergraduate education or postgraduate training programmes in the United Kingdom (UK). In this commentary, we outline the landscape of geriatric oncology undergraduate education and postgraduate training for UK doctors. We highlight current challenges and opportunities and provide practical recommendations for better preparing the medical workforce to meet the needs of the growing population of older adults with cancer. This includes key outcomes to be considered for inclusion within undergraduate and postgraduate curricula

Dermatological remedies in the traditional pharmacopoeia of Vulture-Alto Bradano, inland southern Italy

Dermatological remedies make up at least one-third of the traditional pharmacopoeia in southern Italy. The identification of folk remedies for the skin is important both for the preservation of traditional medical knowledge and in the search for novel antimicrobial agents in the treatment of skin and soft tissue infection (SSTI). Our goal is to document traditional remedies from botanical, animal, mineral and industrial sources for the topical treatment of skin ailments. In addition to SSTI remedies for humans, we also discuss certain ethnoveterinary applications. Field research was conducted in ten communities in the Vulture-Alto Bradano area of the Basilicata province, southern Italy. We randomly sampled 112 interviewees, stratified by age and gender. After obtaining prior informed consent, we collected data through semi-structured interviews, participant-observation, and small focus groups techniques. Voucher specimens of all cited botanic species were deposited at FTG and HLUC herbaria located in the US and Italy. We report the preparation and topical application of 116 remedies derived from 38 plant species. Remedies are used to treat laceration, burn wound, wart, inflammation, rash, dental abscess, furuncle, dermatitis, and other conditions. The pharmacopoeia also includes 49 animal remedies derived from sources such as pigs, slugs, and humans. Ethnoveterinary medicine, which incorporates both animal and plant derived remedies, is addressed. We also examine the recent decline in knowledge regarding the dermatological pharmacopoeia. The traditional dermatological pharmacopoeia of Vulture-Alto Bradano is based on a dynamic folk medical construct of natural and spiritual illness and healing. Remedies are used to treat more than 45 skin and soft tissue conditions of both humans and animals. Of the total 165 remedies reported, 110 have never before been published in the mainland southern Italian ethnomedical literature

“I Think That’s the Most Beneficial Change That WIC Has Made in a Really Long Time”: Perceptions and Awareness of an Increase in the WIC Cash Value Benefit

During the COVID-19 pandemic, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Cash Value Benefit (CVB) for fruits and vegetables increased by roughly USD 25/month/person. We sought to understand WIC participant perceptions of this change and barriers and facilitators to using the CVB. We conducted 10 virtual focus groups (5 rural, 5 urban/suburban) with WIC participants (n = 55) in North Carolina in March 2022. Focus groups were recorded and transcribed. We open-coded the content and used thematic analysis to uncover consistencies within and between sampled groups. Participants expressed favorable perceptions of the CVB increase and stated the pre-pandemic CVB amount was insufficient. Barriers to using the increased CVB were identifying WIC-approved fruits and vegetables in stores and insufficient supply of fruits and vegetables. Barriers were more pronounced in rural groups. Facilitators of CVB use were existing household preferences for fruits and vegetables and the variety of products that can be purchased with CVB relative to other components of the WIC food package. Participants felt the CVB increase allowed their families to eat a wider variety of fruits and vegetables. The CVB increase may improve fruit and vegetable intake, particularly if made permanent, but barriers to CVB and WIC benefit use may limit the potential impact

Which States Matter? An Application of an Intelligent Discretization Method to Solve a Continuous POMDP in Conservation Biology

When managing populations of threatened species, conservation managers seek to make the best conservation decisions to avoid extinction. Making the best decision is difficult because the true population size and the effects of management are uncertain. Managers must allocate limited resources between actively protecting the species and monitoring. Resources spent on monitoring reduce expenditure on management that could be used to directly improve species persistence. However monitoring may prevent sub-optimal management actions being taken as a result of observation error. Partially observable Markov decision processes (POMDPs) can optimize management for populations with partial detectability, but the solution methods can only be applied when there are few discrete states. We use the Continuous U-Tree (CU-Tree) algorithm to discretely represent a continuous state space by using only the states that are necessary to maintain an optimal management policy. We exploit the compact discretization created by CU-Tree to solve a POMDP on the original continuous state space. We apply our method to a population of sea otters and explore the trade-off between allocating resources to management and monitoring. We show that accurately discovering the population size is less important than management for the long term survival of our otter population

The care of older cancer patients in the United Kingdom

The ageing population poses new challenges globally. Cancer care for older patients is one of these challenges, and it has a significant impact on societies. In the United Kingdom (UK), as the number of older cancer patients increases, the management of this group has become part of daily practice for most oncology teams in every geographical area. Older cancer patients are at a higher risk of both under- and over-treatment. Therefore, the assessment of a patient’s biological age and effective organ functional reserve becomes paramount. This may then guide treatment decisions by better estimating a prognosis and the risk-to-benefit ratio of a given therapy to anticipate and mitigate against potential toxicities/difficulties. Moreover, older cancer patients are often affected by geriatric syndromes and other issues that impact their overall health, function and quality of life. Comprehensive geriatric assessments offer an opportunity to identify and address health problems which may then optimise one’s fitness and well-being. Whilst it is widely accepted that older cancer patients may benefit from such an approach, resources are often scarce, and access to dedicated services and research remains limited to specific centres across the UK. The aim of this project is to map the current services and projects in the UK to learn from each other and shape the future direction of care of older patients with cancer