The effect of exercise referral schemes upon health and wellbeing: Initial observational insights using individual patient data meta-analysis from The National Referral Database

Objectives: To examine if exercise referral schemes (ERS)s are associated with meaningful changes in health and wellbeing in a large cohort of individuals throughout England, Scotland, and Wales from The National Referral Database. Methods: Data were obtained from 23,731 participants from 13 different ERSs lasting 6 weeks to 3 months. Changes from pre- to post-ERS in health and wellbeing outcomes were examined including body mass index (BMI), blood pressure (SBP & DBP), resting heart rate (RHR), short Warwick Edinburgh Mental Wellbeing Scale (SWEMWBS), World Health Organization Well-Being Index (WHO-5), Exercise Related Quality of Life scale (ERQoL), and Exercise Self-Efficacy Scale (ESES). Two-stage individual patient data meta-analysis was used to generate effect estimates. Results: Estimates [95%CIs] revealed statistically significant changes occurred compared to point nulls for BMI (-0.55 kg.m2 [-0.69 to -0.41]), SBP (-2.95 mmHg [-3.97 to -1.92]), SWEMWBS (2.99 pts [1.61 to 4.36]), WHO-5 (8.78 pts [6.84 to 10.63]), ERQoL (15.26 pts [4.71 to 25.82]), ESES (2.58 pts [1.76 to 3.40]), but not RHR (0.22 fc [-1.57 to 1.12]), DBP (-0.93 mmHg [-1.51 to -0.35]). However, comparisons of estimates [95%CIs] against null intervals suggested the majority of outcomes may not improve meaningfully. Conclusions: We considered whether meaningful health and wellbeing changes occur in people who are undergoing ERSs? Regarding this broad question, these results demonstrate that, although many health and wellbeing outcomes improved, the changes be not achieve meaningful levels. This suggests the need to consider the implementation of ERSs more critically to discern how to maximize their effectiveness

Fire Spread in an Artificial Fuel

Paper published as Bulletin 32 in the UM Bulletin Forestry Series.https://scholarworks.umt.edu/umforestrybulletin/1016/thumbnail.jp

Awareness of lifestyle and colorectal cancer risk:findings from the BeWEL study

It is estimated that 47% of colorectal cancers (CRC) could be prevented by appropriate lifestyles. This study aimed to identify awareness of the causes of CRC in patients who had been diagnosed with a colorectal adenoma through the Scottish Bowel Screening Programme and subsequently enrolled in an intervention trial (using diet and physical activity education and behavioural change techniques) (BeWEL). At baseline and 12-month follow-up, participants answered an open-ended question on factors influencing CRC development. Of the 329 participants at baseline, 40 (12%) reported that they did not know any risk factors and 36 (11%) failed to identify specific factors related to diet and activity. From a potential knowledge score of 1 to 6, the mean score was 1.5 (SD 1.1, range 0 to 5) with no difference between intervention and control groups. At follow-up, the intervention group had a significantly greater knowledge score and better weight loss, diet, and physical activity measures than the control group. Awareness of relevant lifestyle factors for CRC remains low in people at increased risk of the disease. Opportunities within routine NHS screening to aid the capability (including knowledge of risk factors) of individuals to make behavioural changes to reduce CRC risk deserve exploration.Additional co-author: The BeWEL team. The BeWEL Team consists of Shaun Treweek, Fergus Daly, Jill Belch, Jackie Rodger, Alison Kirk, Anne Ludbrook, Petra Rauchhaus, Patricia Norwood, Joyce Thompson, and Jane Wardle

\u3ci\u3e Phenytoin reduces 5-ala mediated fluorescence in glioblastoma cells \u3c/i\u3e

Glioblastoma multiforme (GBM) is a devastating form of cancer, and essentially all GBM tumors recur causing fatality. A new surgical technique, fluorescence-guided resection of GBM using 5-aminolevulinic acid (5-ala), improves the extent of resection and positively impacts the length and quality of patient survival. The fluorescence achieved in neoplastic tissue depends directly on the accumulation of porphyrins derived from the metabolism of the 5-ala prodrug within the cancer cell. However, 5-ala induced fluorescence has been reported to be inconsistent. In an effort to determine the cause of the inconsistent fluorescence, the authors investigated the effect of medications commonly prescribed to brain tumor patients on 5-ala induced fluorescence. A model was developed to quantify intracellular porphyrin accumulation using a U87MG GBM cell line constitutively expressing yellow fluorescent protein (YFP-U87). 5-ala mediated fluorescence within the cells was standardized to cell number via the fluorescence emission spectra ratio of porphyrin (405 nm) to YFP (525 nm). 5-ala induced accumulation of porphyrins was measured after treating YFP-U87 cells with phenytoin, dexamethasone, or desipramine for 3 days. After a 6 hour incubation with 5-ala, no significant difference in porphyrin accumulation was observed in cells treated with dexamethasone or desipramine. Phenytoin, however, significantly reduced the accumulation of fluorescent porphyrins within the YFP-U87 cell line by nearly 30% compared to the control. To optimize fluorescence during surgery and improve patient survival these results suggest that further investigations are warranted to determine the effects of commonly administered medications on 5-ala fluorescence-guided resection of GBM

Meeting the challenges of recruitment to multicentre, community-based, lifestyle-change trials : a case study of the BeWEL trial

Peer reviewedPublisher PD

Genetic and Physiological Responses of \u3ci\u3eBifidobacterium animalis\u3c/i\u3e subsp. \u3ci\u3elactis\u3c/i\u3e to Hydrogen Peroxide Stress

Consumer interest in probiotic bifidobacteria is increasing, but industry efforts to secure high cell viability in foods is determined by these anaerobes’ sensitivity to oxidative stress. To address this limitation, we investigated genetic and physiological responses of two fully sequenced Bifidobacterium animalis subsp. lactis strains, BL-04 and DSM 10140, to hydrogen peroxide (H2O2) stress. Although the genome sequences for these strains are highly clonal, prior work showed they differ in both intrinsic and inducible H2O2 resistance. Transcriptome analysis of early stationary phase cells exposed to a sub-lethal H2O2 concentration detected significant (P2O2 stress resistance might be due to a mutation in a BL-04 gene encoding long chain fatty acid-coA ligase. To explore this possibility, membrane fatty acids were isolated and analyzed by GC-MS. Results confirmed the strains had significantly different lipid profiles; the BL-04 membrane contained higher percentages of C14:0 and C16:0, and lower percentages of C16:1n7 and C18:1n9. Alteration of the DSM 10140 membrane lipid composition using modified growth medium to more closely mimic that of BL-04 yielded cells that showed increased intrinsic resistance to lethal H2O2 challenge, but did not display an inducible H2O2 stress response. Results show deliberate stress induction or membrane lipid modification can be employed to significantly improve H2O2 resistance in B. animalis subsp. lactis strains