Female song in the hooded warbler

One female Hooded Warbler (Wilsonia citrina) was discovered singing in July 1993, and another in May 1996 among a color-banded breeding population under investigation. The first female\u27s song structurally resembled the typical male Hooded Warbler mixed-mode song in duration, frequency range, and number of syllables, although it had an atypical raspy quality. Males responded similarly to playbacks of the female song and a male song from the same population. We suggest that age and high breeding density may be explanatory factors for this rare behavior

Pharmacists’ Opinions on the Implementation of HIV and HepC Point-of-Care-Testing in a U.S. Pharmacy Chain

Background: The role of community pharmacists continues to expand with immunizations, medication therapy management, and point-of-care testing (POCT). Current guidelines recommend that Human Immunodeficiency Virus (HIV) and Hepatitis C (HCV) testing become integrated into routine care. Current guidelines recommend all people aged 13-64 be tested for HIV at least once in their lifetime, with those at higher risk for HIV tested at least annually.1 Regarding HCV, current guidelines recommend a one-time HCV test in persons born from 1945 to 1965, as well as other individuals based on exposures, behaviors, and conditions or circumstances that increase HCV infection risk.2 Currently available HIV and HCV treatment regimens are safe and highly effective. With HCV, successful treatment can halt disease progression to cirrhosis, end-stage liver disease, and hepatocellular carcinoma.3 POCT in community pharmacy offers an ideal location due to its accessibility, convenience, and lower cost to patients who might not otherwise be tested. However, HIV and HCV screenings are not routinely conducted by community pharmacists due to many barriers. Though many barriers to HIV and HCV POCT have been identified at the patient, provider, and institutional level, little is known about pharmacist-perceived barriers. It is worth noting that the barrier of state legislation limiting POCT in pharmacies has been resolved – currently 49 states have some form of statute that allows for delegation of prescriptive authority between a prescriber and community pharmacist.4 Though this removed barrier means increased availability of POCT, as the studies above have demonstrated, the mere availability of POCT is not enough for its implementation. Objective: The main objective of this study is to identify pharmacist-perceived barriers and their level of confidence in performing community pharmacy-based POCT for HIV and HCV. Methods: A cross-sectional survey was sent to all pharmacists working in a regional grocery store chain to evaluate their opinions and attitudes toward the implementation of POCT for HIV and HCV. The electronic survey questions consisted of Likert scale, select-all-that-apply, yes/no and no open-ended questions. Results: The perceived barriers to implementation of HIV and HCV POCT in a community setting identified by pharmacists include staffing, time to conduct test, patient out-of-pocket cost, and discussion of positive results. Pharmacists’ perceived level of confidence was greatest with providing basic education and incorporating HIV and HCV POCT into workflow; whereas discussion of a positive result was perceived as less confident.  Conclusions: While this survey determined pharmacist support for the implementation of HIV and HCV POCT, additional studies are needed before effective implementation of HIV and HCV POCT in a community pharmacy chain.   Article Type: Original Researc

The development of theory-informed participant-centred interventions to maximise participant retention in randomised controlled trials

Acknowledgements We would like to thank all of the participants who volunteered their time to contribute to this study. We would also like to thank all of the teams linked to the host trials we worked with to help identify potential participants. Funding This research is funded by the Chief Scientist Office of the Scottish Government’s Health and Social Care Department [HIPS/16/46]. KG held a Medical Research Council UK Methodology Fellowship during the delivery of this project [MR/L01193X/1]. The publication was supported through a Health Research Board Trials Methodology Research Network award. MDW acknowledges support from the NIHR Newcastle Biomedical Research Centre. MW acknowledges support from the NIHR Imperial Biomedical Research Centre (BRC). The Health Services Research Unit, Institute of Applied Health Sciences (University of Aberdeen), is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. The funders had no involvement in study design, collection, analysis and interpretation of data, reporting or the decision to publish.Peer reviewedPublisher PD

Systematic Techniques to Enhance rEtention in Randomised controlled trials: the STEER study protocol

Background Non-retention of participants seriously affects the credibility of clinical trial results and significantly reduces the potential of a trial to influence clinical practice. Non-retention can be defined as instances where participants leave the study prematurely. Examples include withdrawal of consent and loss to follow-up and thus outcome data cannot be obtained. The majority of existing interventions targeting retention fail to describe any theoretical basis for the observed improvement, or lack of improvement. Moreover, most of these interventions lack involvement of participants in their conception and/or design, raising questions about their relevance and acceptability. Many of the causes of non-retention involve people performing a behaviour (e.g. not returning a questionnaire). Behaviour change is difficult, and the importance of a strong theoretical basis for interventions that aim to change behaviour is increasingly recognised. This research aims to develop and pilot theoretically informed, participant-centred, evidence-based behaviour change interventions to improve retention in trials. Methods This research will generate data through semi-structured interviews on stakeholders’ perspectives of the reasons for trial non-retention. It will identify perceived barriers and enablers to trial retention using the Theoretical Domains Framework. The intervention development work will involve identification of behaviour change techniques, using recognised methodology, and co-production of retention interventions through discussion groups with end-users. An evaluation of intervention acceptability and feasibility will be conducted in focus groups. Finally, a ready-to-use evaluation framework to deploy in Studies Within A Trial as well as an explanatory retention framework will be developed for identifying and tackling modifiable issues to improve trial retention. Discussion We believe this to be one of the first studies to apply a theoretical lens to the development of interventions to improve trial retention that have been informed by, and are embedded within, participants’ experiential accounts. By developing and identifying priority interventions this study will support efforts to reduce research waste

Effects of Moderate-to-Vigorous Intensity Physical Activity on Overnight and Next-Day Hypoglycemia in Active Adolescents With Type 1 Diabetes

© 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.OBJECTIVE: Physical activity (PA) provides many benefits to adolescents with type 1 diabetes; however, these individuals tend to have lower fitness and PA levels than their disease-free counterparts. The purpose of this study was to examine the acute temporal associations between moderate-to-vigorous intensity PA (MVPA) and hypoglycemia (continuous glucose monitor [CGM] reading ≤70 mg/dL). RESEARCH DESIGN AND METHODS: Nineteen participants (53% females) 14-20 years old with type 1 diabetes were recruited. Participant fitness was evaluated via indirect calorimetry using a maximal exercise test; body composition was measured using air displacement plethysmography. An accelerometer was worn continuously (3-5 days) and acceleration data used to estimate MVPA (minutes per day). Blood glucose values were simultaneously tracked using CGM. Controlling for sex, percent body fat (%BF), fitness, and concurrent MVPA, the likelihood of nighttime and next-day hypoglycemia due to MVPA was examined using logistic regression. RESULTS: Participants were of average fitness (females: 43.9 mL/kg/min; males: 49.8 mL/kg/min) and adiposity (females: 26.2%; males: 19.2%); 63.2% met the U.S. federal guideline of accumulating 60 min/day of MVPA. Hypoglycemia was 31% more likely in those who accumulated 30 min/day more MVPA in the previous afternoon than those with less (95% CI 1.05-1.63; P = 0.017). CONCLUSIONS: The results suggest that participating in afternoon MVPA increases the risk of overnight and next-day hypoglycemia, independent of sex, %BF, fitness, and concurrent MVPA. While promoting PA as a healthy behavior, it is important to educate adolescents with type 1 diabetes on prevention of hypoglycemia following PA

Additional file 1: of Systematic Techniques to Enhance rEtention in Randomised controlled trials: the STEER study protocol

SPIRIT 2013 Checklist completed for STEER Protocol. (DOC 120 kb