Impact of glass shape on time taken to drink a soft drink: A laboratory-based experiment.

BACKGROUND: Glassware design may affect drinking behaviour for alcoholic beverages, with glass shape and size influencing drinking speed and amount consumed. Uncertainty remains both about the extent to which these effects are restricted to alcohol and the underlying mechanisms. The primary aim of the current study was to examine the effect of differently shaped glasses on time taken to drink a soft drink. The secondary aim was to develop hypotheses about mechanisms concerning micro-drinking behaviours and perceptual effects. METHOD: In a single-session experiment, 162 participants were randomised to receive 330ml of carbonated apple juice in a glass that was either inward-sloped, straight-sided, or outward-sloped. The primary outcome measure was total drinking time. Secondary outcome measures included micro-drinking behaviours (sip size, sip duration, interval duration), and perceptual measures (midpoint bias, drink enjoyment). RESULTS: Participants drank 21.4% faster from the outward-sloped glass than from the straight-sided glass [95%CI: 0.2%,38.0%] in adjusted models. They were also 18.2% faster from the inward-sloped glass than the straight-sided glass, but this did not reach statistical significance with wide confidence intervals also consistent with slower drinking [95%CI: -3.8%,35.6%]. Larger sips were associated with faster drinking times (Pearson's r(162) = -.45, p < .001). The direction of effects suggested sips were larger from the outward-sloped and inward-sloped glasses, compared to the straight-sided glass (15.1%, 95%CI: -4.3%,38.0%; 19.4%, 95%CI: -0.5%,43.6%, respectively). There were no significant differences between glasses in mean sip or interval duration. Bias in midpoint estimation was greater for the outward-sloped glass (12.9ml, 95%CI: 6.6ml,19.2ml) than for the straight-sided glass, although the degree of bias was not associated with total drinking time (Pearson's r(162) = 0.01, p = .87). DISCUSSION: Individuals drank a soft drink more quickly from an outward-sloped glass, relative to a straight-sided glass. Micro-drinking behaviours, such as sip size, are promising candidates for underlying mechanisms

Glassware design and drinking behaviours: a review of impact and mechanisms using a new typology of drinking behaviours.

Much of the global burden of disease is attributable to unhealthy behaviour, including excessive consumption of alcohol and sugar-sweetened beverages. Developing effective methods to change these drinking behaviours could inform policies to improve population health. In line with an increasing interest in environmental-level interventions - i.e., changing the environment in which a behaviour occurs in order to change the behaviour of interest - this review first describes the existing evidence of the impact of glassware design (including capacity and shape) on drinking behaviours (e.g., at the 'micro' level - including sip size, as well as at the macro level - including amount consumed). The roles of two sets of possible underlying mechanisms - perception and affordance - are also explored. Finally, this review sets out a provisional typology of drinking behaviours to enable more systematic approaches to the study of these behaviours. While there is a paucity of evidence - in particular on measures of consumption - this growing evidence base suggests promising targets for novel interventions involving glassware design to reduce the consumption of drinks that harm health.Trial registration: ISRCTN.org identifier: ISRCTN10456720

The theoretical and practical determination of clinical cut-offs for the British Sign Language versions of PHQ-9 and GAD-7.

BACKGROUND: The PHQ-9 and the GAD-7 assess depression and anxiety respectively. There are standardised, reliability-tested versions in BSL (British Sign Language) that are used with Deaf users of the IAPT service. The aim of this study is to determine their appropriate clinical cut-offs when used with Deaf people who sign and to examine the operating characteristics for PHQ-9 BSL and GAD-7 BSL with a clinical Deaf population. METHODS: Two datasets were compared: (i) dataset (n = 502) from a specialist IAPT service for Deaf people; and (ii) dataset (n = 85) from our existing study of Deaf people who self-reported having no mental health difficulties. Parameter estimates, with the precision of AUC value, sensitivity, specificity, positive predicted value (ppv) and negative predicted value (npv), were carried out to provide the details of the clinical cut-offs. Three statistical choices were included: Maximising (Youden: maximising sensitivity + specificity), Equalising (Sensitivity = Specificity) and Prioritising treatment (False Negative twice as bad as False Positive). Standard measures (as defined by IAPT) were applied to examine caseness, recovery, reliable change and reliable recovery for the first dataset. RESULTS: The clinical cut-offs for PHQ-9 BSL and GAD-7 BSL are 8 and 6 respectively. This compares with the original English version cut-offs in the hearing population of 10 and 8 respectively. The three different statistical choices for calculating clinical cut-offs all showed a lower clinical cut-off for the Deaf population with respect to the PHQ-9 BSL and GAD-7 BSL with the exception of the Maximising criteria when used with the PHQ-9 BSL. Applying the new clinical cut-offs, the percentage of Deaf BSL IAPT service users showing reliable recovery is 54.0 % compared to 63.7 % using the cut-off scores used for English speaking hearing people. These compare favourably with national IAPT data for the general population. CONCLUSIONS: The correct clinical cut-offs for the PHQ-9 BSL and GAD-7 BSL enable meaningful measures of clinical effectiveness and facilitate appropriate access to treatment when required

Translation, validity and reliability of the British Sign Language (BSL) version of the EQ-5D-5L.

PURPOSE: To translate the health questionnaire EuroQol EQ-5D-5L into British Sign Language (BSL), to test its reliability with the signing Deaf population of BSL users in the UK and to validate its psychometric properties. METHODS: The EQ-5D-5L BSL was developed following the international standard for translation required by EuroQol, with additional agreed features appropriate to a visual language. Data collection used an online platform to view the signed (BSL) version of the tests. The psychometric testing included content validity, assessed by interviewing a small sample of Deaf people. Reliability was tested by internal consistency of the items and test-retest, and convergent validity was assessed by determining how well EQ-5D-5L BSL correlates with CORE-10 BSL and CORE-6D BSL. RESULTS: The psychometric properties of the EQ-5D-5L BSL are good, indicating that it can be used to measure health status in the Deaf signing population in the UK. Convergent validity between EQ-5D-5L BSL and CORE-10 BSL and CORE-6D BSL is consistent, demonstrating that the BSL version of EQ-5D-5L is a good measure of the health status of an individual. The test-retest reliability of EQ-5D-5L BSL, for each dimension of health, was shown to have Cohen's kappa values of 0.47-0.61; these were in the range of moderate to good and were therefore acceptable. CONCLUSIONS: This is the first time EQ-5D-5L has been translated into a signed language for use with Deaf people and is a significant step forward towards conducting studies of health status and cost-effectiveness in this population

Clinical assessment, investigation, diagnosis and initial management of cerebral visual impairment: a consensus practice guide

Cerebral Visual Impairment (CVI) is a common condition in the UK. Patients with conditions associated with CVI are frequently seen in paediatric ophthalmology clinics offering eye care professionals an opportunity to identify children proactively. In most cases CVI occurs as part of a neurodevelopmental condition or as a feature of multiple and complex disabilities. However, CVI can also be seen in children with apparently typical development. In some cases, high contrast visual acuity is normal and in other cases severely impaired. As such, identification of CVI requires evaluation of aspects of visual performance beyond high contrast acuity and consideration that visual function of those with CVI may fluctuate. Few paediatric ophthalmologists have received formal training in CVI. The detection and diagnosis of CVI varies across the UK and patients report hugely different experiences. A diagnosis of CVI is made based on professional clinical judgement and it is recognised that individual perspectives and local practice in the specific methodologies of assessment will vary. A systematic review and survey of professionals is underway to attempt to reach agreement on diagnostic criteria. Nonetheless, established pathways and published protocols can offer guidance on how a paediatric ophthalmology service can approach assessment of the child with suspected CVI. The purpose of this paper is to present a summary of research and clinical practice methods for detecting and diagnosing CVI in a paediatric ophthalmology outpatient setting. It represents current understanding of the topic and acknowledges the evolving nature of both practice and the evidence-base. A rapid literature review was undertaken to identify articles relating to clinical investigation of children with CVI. A focus group of QTVI and subject matter experts from sight loss charities was undertaken to address areas which were not covered by the literature review

Wine glass size and wine sales: four replication studies in one restaurant and two bars

Funder: National Institute for Health Research; doi: http://dx.doi.org/10.13039/501100000272Abstract: Objective: Previous research suggests that wine glass size affects sales of wine in bars, with more wine purchased when served in larger glasses. The current four studies, conducted in one restaurant (Studies 1 and 2) and two bars (Studies 3 and 4) in Cambridge, England, aim to establish the reproducibility of this effect of glass size on sales. A multiple treatment reversal design was used, involving wine being served in sequential fortnightly periods in different sized glasses of the same design (290 ml, 350 ml, and 450 ml). The primary outcome was daily wine volume (ml) sold. Results: Restaurant: Daily wine volume sold was 13% (95% CI 2%, 24%) higher when served with 350 ml vs. 290 ml glasses in Study 1. A similar direction of effect was seen in Study 2 (6%; 95% CI − 1%, 15%). Bars: Daily wine volume sold was 21% (95% CI 9%, 35%) higher when served with 450 ml vs. 350 ml glasses in Study 3. This effect was not observed in Study 4 (− 7%, 95% CI − 16%, 3%). Meaningful differences were not demonstrated with any other glass comparison. These results partially replicate previous studies showing that larger glasses increase wine sales. Considerable uncertainty remains about the magnitude of any effect and the contexts in which it might occur. Trial registration Study 1: ISRCTN17958895 (21/07/2017), Study 2: ISRCTN17097810 (29/03/2018), Study 3 and 4: ISRCTN39401124 (10/05/2018

What is the impact of increasing the prominence of calorie labelling? A stepped wedge randomised controlled pilot trial in worksite cafeterias.

BACKGROUND: Calorie labelling may help to reduce energy consumption, but few well-controlled experimental studies have been conducted in real world settings. In a previous randomised controlled pilot trial we did not observe an effect of calorie labelling on energy purchased in worksite cafeterias. In the present study we sought to enhance the effect by making the labels more prominent, and to address the operational challenges reported previously by worksites. METHODS: Three worksite cafeterias were randomised in a stepped wedge design to start the intervention at one of three fortnightly periods between March and July 2018. The intervention comprised introducing prominent calorie labelling for all cafeteria products for which calorie information was available (on average 87% of products offered across the three sites were labelled). Calorie content was displayed in bold capitalised Verdana typeface with a minimum font size of 14 e.g.120 CALORIES. Feasibility and acceptability were assessed using post-intervention surveys with cafeteria patrons and semi-structured interviews with managers. Effectiveness was assessed using total daily energy (kcal) purchased from intervention items across the three sites, analysed using semi-parametric GAMLSS models. RESULTS: Recruitment and retention of worksite cafeterias proved feasible: all three randomised sites successfully completed the study. Post-intervention feedback suggested high levels of intervention acceptability: 87% of responding patrons wanted calorie labelling to remain in place. No effect of the intervention on daily energy purchased was observed: -0.6% (95%CI -2.5 to 1.2, p = .487). By-site analyses showed similar null effects at each of the three sites, all ps > .110. CONCLUSIONS: There was no evidence that prominent calorie labelling changed daily energy purchased across three English-based worksite cafeterias. The intervention was feasible to implement and acceptable to patrons and managers

CCAAT-enhancer-binding protein-beta expression in vivo is associated with muscle strength

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.Declining muscle strength is a core feature of aging. Several mechanisms have been postulated, including CCAAT/enhancer-binding protein-beta (C/EBP-β)-triggered macrophage-mediated muscle fiber regeneration after micro-injury, evidenced in a mouse model. We aimed to identify in vivo circulating leukocyte gene expression changes associated with muscle strength in the human adult population. We undertook a genome-wide expression microarray screen, using peripheral blood RNA samples from InCHIANTI study participants (aged 30 and 104). Logged expression intensities were regressed with muscle strength using models adjusted for multiple confounders. Key results were validated by real-time PCR. The Short Physical Performance Battery (SPPB) score tested walk speed, chair stand, and balance. CEBPB expression levels were associated with muscle strength (β coefficient = 0.20560, P = 1.03*10(-6), false discovery rate q = 0.014). The estimated handgrip strength in 70-year-old men in the lowest CEBPB expression tertile was 35.2 kg compared with 41.2 kg in the top tertile. CEBPB expression was also associated with hip, knee, ankle, and shoulder strength and the SPPB score (P = 0.018). Near-study-wide associations were also noted for TGF-β3 (P = 3.4*10(-5) , q = 0.12) and CEBPD expression (P = 9.7*10(-5) , q = 0.18) but not for CEBPA expression. We report here a novel finding that raised CEBPB expression in circulating leukocyte-derived RNA samples in vivo is associated with greater muscle strength and better physical performance in humans. This association may be consistent with mouse model evidence of CEBPB-triggered muscle repair: if this mechanism is confirmed, it may provide a target for intervention to protect and enhance aging muscle

Increasing the proportion of healthier foods available with and without reducing portion sizes and energy purchased in worksite cafeterias:protocol for a stepped-wedge randomised controlled trial

BACKGROUND: Overconsumption of energy from food contributes to high rates of overweight and obesity in many populations. A promising set of interventions tested in pilot studies in worksite cafeterias, suggests energy intake may be reduced by increasing the proportion of healthier - i.e. lower energy - food options available, and decreasing portion sizes. The current study aims to assess the impact on energy purchased of i. increasing the proportion of lower energy options available; ii. combining this with reducing portion sizes, in a full trial. METHODS: A stepped-wedge randomised controlled trial in 19 worksite cafeterias, where the proportion of lower energy options available in targeted food categories (including main meals, snacks, and cold drinks) will be increased; and combined with reduced portion sizes. The primary outcome is total energy (kcal) purchased from targeted food categories using a pooled estimate across all sites. Follow-up analyses will test whether the impact on energy purchased varies according to the extent of intervention implementation. DISCUSSION: This study will provide the most reliable estimate to date of the effect sizes of two promising interventions for reducing energy purchased in worksite cafeterias. TRIAL REGISTRATION: The study was prospectively registered on ISRCTN (date: 24.05.19; TRN: ISRCTN87225572; doi: https://doi.org/10.1186/ISRCTN87225572)