Can the delivery of behavioural support be improved in the NHS England Low-Calorie Diet Programme? An observational study of behaviour change techniques

Background Previous research has illustrated a drift in the fidelity of behaviour change techniques (BCTs) during the design of the pilot NHS England Low-Calorie Diet (NHS-LCD) Programme. This study evaluated a subsequent domain of fidelity, intervention delivery. Two research questions were addressed: (1) To what extent were BCTs delivered with fidelity to providers programme plans? (2) What were the observed barriers and facilitators to delivery? Methods A mixed-methods sequential explanatory design was employed. Remote delivery of one-to-one and group-based programmes were observed. A BCT checklist was developed using the BCT Taxonomy v1; BCTs were coded as present, partially delivered, or absent during live sessions. Relational content analysis of field notes identified observed barriers and facilitators to fidelity. Results Observations of 122 sessions across eight samples and two service providers were completed. Delivery of the complete NHS-LCD was observed for five samples. Fidelity ranged from 33% to 70% across samples and was higher for group-based delivery models (64%) compared with one-to-one models (46%). Barriers and facilitators included alignment with the programme's target behaviours and outcomes, session content, time availability and management, group-based remote delivery, and deviation from the session plan. Conclusions Overall, BCTs were delivered with low-to-moderate fidelity. Findings indicate a dilution in fidelity during the delivery of the NHS-LCD and variation in the fidelity of programmes delivered across England. Staff training could provide opportunities to practice the delivery of BCTs. Programme-level changes such as structured activities supported by participant materials and with sufficient allocated time, might improve the delivery of BCTs targeting self-regulation

Investigating Collaborative Exploration of Design Alternatives on a Wall-Sized Display

International audienceIndustrial design review is an iterative process which mainly relies on two steps involving many stakeholders: design discussion and CAD data adjustment. We investigate how a wall-sized display could be used to merge these two steps by allowing multidisciplinary collaborators to simultaneously generate and explore design alternatives. We designed Shape-Compare based on the feedback from a usability study. It enables multiple users to compute and distribute CAD data with touch interaction. To assess the benefit of the wall-sized display in such context, we ran a controlled experiment which aims to compare ShapeCompare with a visualization technique suitable for standard screens. The results show that pairs of participants performed a constraint solving task faster and used more deictic instructions with ShapeCompare. From these findings, we draw generic recommendations for collaborative exploration of alternatives

Supplementary Material for: Discrepancies between Perceived and Measured Cognition in Kidney Transplant Recipients: Implications for Clinical Management

<p><b><i>Background:</i></b> Cognitive impairment is common in kidney transplant (KT) recipients and affects quality of life, graft survival, morbidity, and mortality. Failure to identify patients with cognitive impairment can withhold appropriate and timely intervention. This study determines whether measured cognition with standard screening tools offers any advantage over perceived cognition in screening transplant patients for cognitive impairment. <b><i>Methods:</i></b> Cognition was assessed in 157 KT recipients using the Montreal Cognitive Assessment (MoCA; measured cognition). In addition, transplant physicians and nurse coordinators were asked to rate transplant recipients' level of cognition after routine clinical interactions (perceived cognition). Physicians and nurses were blind to MoCA scores. Perceived cognition scores were compared to MoCA scores. <b><i>Results:</i></b> Perceived cognition scores fairly correlated with MOCA scores (γ = 0.24, <i>p</i> = 0.001 for physicians and γ = 0.33, <i>p</i> < 0.0001 for nurses). Physician scores moderately correlated with nurses scores (κ = 0.44, <i>p</i> < 0.0001). Clinical perception had a low accuracy for identifying patients with cognitive impairment (sensitivity 66% for physicians, 65% for nurses), and those without cognitive impairment (specificity 67% for physicians, 76% for nurses). <b><i>Conclusion:</i></b> Clinical perception is inaccurate at detecting cognitive impairment in KT recipients. Objective tests should be considered to screen KT recipients for cognitive impairment.</p

Trypanosoma cruzi, cancer and the Cold War Trypanosoma cruzi, câncer e a Guerra Fria

In the summer of 1946, the international community of cancer researchers was inspired by the announcement that two Soviet scientists, Nina Kliueva and Grigorii Roskin, had discovered anticancer properties in culture extracts made from the South American protozoan, Trypanosoma cruzi, and had produced a preparation - named after its discoverers KR - which showed clear therapeutic effects on cancer patients. Research teams from various countries enthusiastically pursued the promising new line of investigation. The story of the rise and fall of interest in the anticancer properties of T. cruzi in different countries suggests that during the second half of the twentieth century, the Cold War competition between the superpowers played an important role in shaping the research agendas of cancer studies.<br>No verão de 1946, a comunidade internacional que desenvolve pesquisas sobre o câncer, inspirou-se no anúncio de que dois cientistas soviéticos, Nina Kliueva e Grigorii Roskin, descobriram propriedades anticancerígenas em cultura extraída do protozoário existente na América Latina, o Trypanosoma cruzi e produziram um preparado que foi denominado com as iniciais KR - em sua homenagem. Grupos de pesquisadores de diversos países buscaram com entusiasmo as promessas dessa nova linha de investigação. A história da ascensão e queda do interesse nas propriedades anticâncer do T. cruzzi em diferentes países sugere que durante a segunda metade do século 20, a Guerra Fria teve um papel importante na definição das agendas de pesquisas sobre o câncer