Sequence variation in the haemagglutinin-neuraminidase gene of human parainfluenza virus type 3 isolates in the UK

The sequence variation in a 934 base-pair region of the gene encoding the haemagglutinin-neuraminidase of five human parainfluenza virus type 3 (HPIV3) isolates was determined together with that of a prototype UK strain. All of the clinical isolates were from the Manchester area of the UK and were obtained in 1990. 1991 and 1993. The gene segment was amplified by the polymerase chain reaction using HPIVB-specific oligonucleotide primers. The nucleotide homology of the strains was high, around 99% and specific differences in the UK sequences when compared with that of the US prototype strain were identified. In addition, a number of isolate-specific differences were seen. No correlation was detected between the observed nucleotide mutations and the year of isolation, which supports the hypothesis that HPIV3 shows cocirculation of a heterogeneous population of viruses rather than varying with time in a linear fashion. However, the data suggested that geographically-defined genetic lineages of HPIV3 may exist

Do women and men use language differently in spoken face-to-face interaction? A scoping review

Although the question of whether women and men speak differently is a topic of hot debate, an overview of the extent towhich empirical studies provide robust support for a relationship between sex/gender and language is lacking. Therefore, the aim of the current scoping review is to synthesize recent studies from various theoretical perspectives on the relationship between sex/gender and language use in spoken face-to-face dyadic interactions. Fifteen empirical studies were systematically selected for review, and were discussed according to four different theoretical perspectives and associated methodologies. More than thirty relevant linguistic variables were identified (e.g., interruptions and intensifiers). Overall, few robust differences between women and men in the use of linguistic variables were observed across contexts, although women seem to be more engaged in supportive turn-taking than men. Importantly, gender identity salience, institutionalized roles, and social and contextual factors such as interactional setting or conversational goal seem to play a key role in the relationship between speaker’s sex/gender and language used in spoken interaction

Feasibility of a real-time self-monitoring device for sitting less and moving more:A randomised controlled trial

Objectives: Time spent inactive and sedentary are both associated with poor health. Self-monitoring of walking, using pedometers for real-time feedback, is effective at increasing physical activity. This study evaluated the feasibility of a new pocket-worn sedentary time and physical activity real-time self-monitoring device (SitFIT™). Methods: Forty sedentary men were equally randomized into two intervention groups. For four weeks, one group received a SitFIT™ providing feedback on steps and time spent sedentary (lying/sitting); the other group received a SitFIT™ providing feedback on steps and time spent upright (standing/stepping). Change in sedentary time, standing time, stepping time and step count was assessed using activPAL™ monitors at baseline, and 4-week (T1) and 12-week (T2) follow-up. Semi-structured interviews were conducted after 4 and 12 weeks. Results: The SitFIT™ was reported as acceptable and usable, and seen as a motivating tool to reduce sedentary time by both groups. On average, participants reduced their sedentary time by 7.8 minutes/day (95%CI -55.4, 39.7) (T1) and by 8.2 minutes/day (95%CI -60.1, 44.3) (T2). They increased standing time by 23.2 minutes/day (95%CI 4.0, 42.5) (T1) and 16.2 minutes/day (95%CI -13.9, 46.2) (T2). Stepping time was increased by 8.5 minutes/day (95%CI 0.9, 16.0) (T1) and 9.0 minutes/day (95%CI 0.5, 17.5) (T2). There were no between-group differences at either follow-up time points. Conclusion: The SitFIT™ was perceived as a useful tool for self-monitoring of sedentary time. It has potential as a real-time self-monitoring device to reduce sedentary and increase upright time

The intervention process in the European Fans in Training (EuroFIT) trial: a mixed method protocol for evaluation

Background - EuroFIT is a gender-sensitised, health and lifestyle program targeting physical activity, sedentary time and dietary behaviours in men. The delivery of the program in football clubs, led by the clubs’ community coaches, is designed to both attract and engage men in lifestyle change through an interest in football or loyalty to the club they support. The EuroFIT program will be evaluated in a multicentre pragmatic randomised controlled trial (RCT), for which ~1000 overweight men, aged 30–65 years, will be recruited in 15 top professional football clubs in the Netherlands, Norway, Portugal and the UK. The process evaluation is designed to investigate how implementation within the RCT is achieved in the various football clubs and countries and the processes through which EuroFIT affects outcomes. Methods - This mixed methods evaluation is guided by the Medical Research Council (MRC) guidance for conducting process evaluations of complex interventions. Data will be collected in the intervention arm of the EuroFIT trial through: participant questionnaires (n = 500); attendance sheets and coach logs (n = 360); observations of sessions (n = 30); coach questionnaires (n = 30); usage logs from a novel device for self-monitoring physical activity and non-sedentary behaviour (SitFIT); an app-based game to promote social support for physical activity outside program sessions (MatchFIT); interviews with coaches (n = 15); football club representatives (n = 15); and focus groups with participants (n = 30). Written standard operating procedures are used to ensure quality and consistency in data collection and analysis across the participating countries. Data will be analysed thematically within datasets and overall synthesis of findings will address the processes through which the program is implemented in various countries and clubs and through which it affects outcomes, with careful attention to the context of the football club. Discussion - The process evaluation will provide a comprehensive account of what was necessary to implement the EuroFIT program in professional football clubs within a trial setting and how outcomes were affected by the program. This will allow us to re-appraise the program’s conceptual base, optimise the program for post-trial implementation and roll out, and offer suggestions for the development and implementation of future initiatives to promote health and wellbeing through professional sports clubs. Trial Registration - ISRCTN81935608. Registered on 16 June 2015

Orthotopic liver transplantation for acute and subacute hepatic failure in adults

The role of liver transplantation in 29 patients with fulminant and subacute hepatic failure due to a variety of different causes was examined by comparing the outcome and a variety of “hospitalization” variables. Transplanted patients (n = 13) were more likely to survive (p < 0.05), were younger (p < 0.05) and spent more time in the hospital (p < 0.025) than did those who were not transplanted (n = 16). Despite spending a much longer time in the hospital, transplanted patients spent less time in the intensive care unit (p < 0.05) in coma (p < 0.01) and on a respirator (p < 0.01) than did those not transplanted. Most importantly, the survival rate for transplanted patients was significantly improved (p < 0.05) as compared to those not transplanted. We conclude that liver transplantation can be applied successfully to the difficult clinical problem of fulminant and subacute hepatic failure. Copyright © 1987 American Association for the Study of Liver Disease

How European Fans in Training (EuroFIT), a lifestyle change program for men delivered in football clubs, achieved its effect : a mixed methods process evaluation embedded in a randomised controlled trial

Funding This project has received funding from the European Union’s Seventh Framework Program for research, technological development, and demonstration under grant agreement number 602170. The Health Services Research Unit, University of Aberdeen, receives core funding from the Chief Scientist Office of the Scottish Government Health Directorates. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Acknowledgements We are grateful to participants who took part in the research, coaches and club managers at fifteen football clubs and UEFA’s Football and Social Responsibility department for supporting the proposal at bidding stage. Ciaran Clissman of Pintail Ltd managed the project and provided invaluable editorial input into the funding application and delivery of the program. Prof Nanette Mutrie was substantially involved in the development of the EuroFIT program. Dr Lisa Macauley administered the UK data collection in the UK and Alan Pollok supported some UK data collection. Dr Mattias Rost and Prof Mathew Chalmers were substantially involved in the development of MatchFIT and Drs Douglas Maxwell and Nikos Mourselas of PAL Technologies in the technical development of the SitFIT. Views and opinions expressed are those of the authors and do not necessarily reflect those of the European Union.Peer reviewedPublisher PD

EEG Reactivity Predicts Individual Efficacy of Vagal Nerve Stimulation in Intractable Epileptics.

Background: Chronic vagal nerve stimulation (VNS) is a well-established non-pharmacological treatment option for drug-resistant epilepsy. This study sought to develop a statistical model for prediction of VNS efficacy. We hypothesized that reactivity of the electroencephalogram (EEG) to external stimuli measured during routine preoperative evaluation differs between VNS responders and non-responders. Materials and Methods: Power spectral analyses were computed retrospectively on pre-operative EEG recordings from 60 epileptic patients with VNS. Thirty five responders and 25 non-responders were compared on the relative power values in four standard frequency bands and eight conditions of clinical assessment—eyes opening/closing, photic stimulation, and hyperventilation. Using logistic regression, groups of electrodes within anatomical areas identified as maximally discriminative by n leave-one-out iterations were used to classify patients. The reliability of the predictive model was verified with an independent data-set from 22 additional patients. Results: Power spectral analyses revealed significant differences in EEG reactivity between responders and non-responders; specifically, the dynamics of alpha and gamma activity strongly reflected VNS efficacy. Using individual EEG reactivity to develop and validate a predictive model, we discriminated between responders and non-responders with 86% accuracy, 83% sensitivity, and 90% specificity. Conclusion: We present a new statistical model with which EEG reactivity to external stimuli during routine presurgical evaluation can be seen as a promising avenue for the identification of patients with favorable VNS outcome. This novel method for the prediction of VNS efficacy might represent a breakthrough in the management of drug-resistant epilepsy, with wide-reaching medical and economic implications

Striking variations in consultation rates with general practice reveal family influence

BACKGROUND: The reasons why patients decide to consult a general practitioner vary enormously. While there may be individual reasons for this variation, the family context has a significant and unique influence upon the frequency of individuals' visits. The objective of this study was to explore which family factors can explain the differences between strikingly high, and correspondingly low, family consultation rates in families with children aged up to 21. METHODS: Data were used from the second Dutch national survey of general practice. This survey extracted from the medical records of 96 practices in the Netherlands, information on all consultations with patients during 2001. We defined, through multilevel analysis, two groups of families. These had respectively, predominantly high, and low, contact frequencies due to a significant family influence upon the frequency of the individual's first contacts. Binomial logistic regression analyses were used to analyse which of the family factors, related to shared circumstances and socialisation conditions, can explain the differences in consultation rates between the two groups of families. RESULTS: In almost 3% of all families, individual consultation rates decrease significantly due to family influence. In 11% of the families, individual consultation rates significantly increase due to family influence. While taking into account the health status of family members, family factors can explain family consultation rates. These factors include circumstances such as their economic status and number of children, as well as socialisation conditions such as specific health knowledge and family beliefs. The chance of significant low frequencies of contact due to family influences increases significantly with factors such as, paid employment of parents in the health care sector, low expectations of general practitioners' care for minor ailments and a western cultural background. CONCLUSION: Family circumstances can easily be identified and will add to the understanding of the health complaints of the individual patient in the consulting room. Family circumstances related to health risks often cannot be changed but they can illuminate the reasons for a visit, and mould strategies for prevention, treatment or recovery. Health beliefs, on the other hand, may be influenced by providing specific knowledge

Using conversation analysis to explore feedback on resident performance

Feedback on clinical performance of residents is seen as a fundamental element in postgraduate medical education. Although literature on feedback in medical education is abundant, many supervisors struggle with providing this feedback and residents experience feedback as insufciently constructive. With a detailed analysis of real-world feedback conversations, this study aims to contribute to the current literature by deepening the understanding of how feedback on residents’ performance is provided, and to formulate recommendations for improvement of feedback practice. Eight evaluation meetings between program directors and residents were recorded in 2015–2016. These meetings were analyzed using conversation analysis. This is an ethno-methodological approach that uses a data-driven, iterative procedure to uncover interactional patterns that structure naturally occurring, spoken interaction. Feedback in our data took two forms: feedback as a unidirectional activity and feedback as a dialogic activity. The unidirectional feedback activities prevailed over the dialogic activities. The two diferent formats elicit diferent types of resident responses and have diferent implications for the progress of the interaction. Both feedback format