Promoting Healthy Behaviour Choices: Understanding Patient Challenges by Undertaking a Personal Behaviour Change Task

INTRODUCTION: Unhealthy behaviours such as poor diet, smoking and physical inactivity contribute significantly to chronic disease. Our first year medical school project aims to increase student awareness of: the importance of these behaviours and their systematic measurement; recommended behaviour targets in health professional guidelines; challenges in achieving patient behaviour change; and psychological theories which aid behaviour change. METHODS: Students are provided with evidence-based health behaviour guidelines for prevention of heart disease. Students select whichever behaviour they would personally like to achieve improvement in, systematically record behaviour for one week (baseline), and then try to implement (healthy) behaviour change for the next two weeks, using psychological theory as an aide. Students report their results and discuss outcomes reflecting on explanations for the success or otherwise of their behaviour attempts. A virtual learning environment (Moodle) ensures project engagement and completion during the relevant timeframes. RESULTS: This assignment has been successfully completed by students over previous academic years. The use of deadlines for uploading sections of coursework to Moodle (e.g. baseline data) has increased the quality and completeness of the projects. Students learn to use standard instruments such as the Fagerstrom Test for Nicotine Dependence and also learn recommended professional guidelines on diet and physical activity at an early point in a medical training. Also, self-reported health behaviours improved over the course of the assignment. CONCLUSIONS: This project allows students to test the difficulty of adhering to professional advice they themselves will give to future patients. The assignment combines knowledge (e.g. education on chronic conditions, on the role of behaviour change and on professional guidelines), skills (e.g. documenting behaviours, planning and implementing change) and attitudes (e.g. on understanding the difficulties encountered by individuals when making and sustaining recommended behaviour change). The novel use of a virtual learning environment ensures high participation

Flattering to deceive: Why people misunderstand Benevolent Sexism

Perceptions of warmth play a central role in social cognition. Seven studies employ observational, correlational, and experimental methods to examine its role in concealing the functions of benevolent sexism. Together, Studies 1 (n = 297), 2 (n = 252) and 3 (n = 219) indicated that although women recall experiencing benevolent (vs. hostile) sexism more often, they protest it less often, because they see it as warm. In Studies 4 (n = 296) and 5 (n = 361), describing men as high in benevolent sexism caused them (via warmth) to be seen as lower in hostile sexism and more supportive of gender equality. In Study 6 (n = 283) these findings were replicated and extended, revealing misunderstanding of relationships between BS and a wide array of its correlates. In Study 7 (n = 211), men experimentally described as harboring warm (vs. cold) attitudes toward women were perceived as higher in benevolent sexism but lower in known correlates of benevolent sexism. These findings demonstrate that the warm affective tone of benevolent sexism, particularly when displayed by men, masks its ideological functions

Agenda for Translating Physical Activity, Nutrition, and Weight Management Interventions for Cancer Survivors into Clinical and Community Practice.

Evidence supporting physical activity, diet, and weight management for cancer survivors has grown, leading to the development of guidelines and interventions. The next step is to identify necessary practice and policy changes and to develop a research agenda to inform how interventions can be delivered to survivors most effectively and efficiently in health care settings and by community-based organizations. Here, an agenda is proposed for research, practice, and policy that incorporates recommendations for a range of programming options, a patient-centered, tailored screening and referral approach, and training needs for survivorship care providers and providers of exercise, nutrition, and weight management services. Research needs to focus on sustainability, dissemination, and implementation. Needed policy changes are presented, as well as opportunities to leverage current health care policies

MRI bone oedema scores are higher in the arthritis mutilans form of psoriatic arthritis and correlate with high radiographic scores for joint damage

10.1186/ar2586Arthritis Research and Therapy111R

HSPB1 facilitates ERK-mediated phosphorylation and degradation of BIM to attenuate endoplasmic reticulum stress-induced apoptosis

BIM, a pro-apoptotic BH3-only protein, is a key regulator of the intrinsic (or mitochondrial) apoptosis pathway. Here, we show that BIM induction by endoplasmic reticulum (ER) stress is suppressed in rat PC12 cells overexpressing heat shock protein B1 (HSPB1 or HSP27) and that this is due to enhanced proteasomal degradation of BIM. HSPB1 and BIM form a complex that immunoprecipitates with p-ERK1/2. We found that HSPB1-mediated proteasomal degradation of BIM is dependent on MEK-ERK signaling. Other studies have shown that several missense mutations in HSPB1 cause the peripheral neuropathy, Charcot-Marie-Tooth (CMT) disease, which is associated with nerve degeneration. Here we show that cells overexpressing CMT-related HSPB1 mutants exhibited increased susceptibility to ER stress-induced cell death and high levels of BIM. These findings identify a novel function for HSPB1 as a negative regulator of BIM protein stability leading to protection against ER stress-induced apoptosis, a function that is absent in CMT-associated HSPB1 mutants

Orbit image analysis machine learning software can be used for the histological quantification of acute ischemic stroke blood clots

Our aim was to assess the utility of a novel machine learning software (Orbit Image Analysis) in the histological quantification of acute ischemic stroke (AIS) clots. We analyzed 50 AIS blood clots retrieved using mechanical thrombectomy procedures. Following HandE staining, quantification of clot components was performed by two different methods: a pathologist using a reference standard method (Adobe Photoshop CC) and an experienced researcher using Orbit Image Analysis. Following quantification, the clots were categorized into 3 types: RBC dominant (\u3e/=60% RBCs), Mixed and Fibrin dominant ( \u3e /=60% Fibrin). Correlations between clot composition and Hounsfield Units density on Computed Tomography (CT) were assessed. There was a significant correlation between the components of clots as quantified by the Orbit Image Analysis algorithm and the reference standard approach (rho = 0.944**, p \u3c 0.001, n = 150). A significant relationship was found between clot composition (RBC-Rich, Mixed, Fibrin-Rich) and the presence of a Hyperdense artery sign using the algorithmic method (X2(2) = 6.712, p = 0.035*) but not using the reference standard method (X2(2) = 3.924, p = 0.141). Orbit Image Analysis machine learning software can be used for the histological quantification of AIS clots, reproducibly generating composition analyses similar to current reference standard methods

Cancer and stroke : commonly encountered by clinicians, but little evidence to guide clinical approach

The association between stroke and cancer is well-established. Because of an aging population and longer survival rates, the frequency of synchronous stroke and cancer will become even more common. Different pathophysiologic mechanisms have been proposed how cancer or cancer treatment directly or via coagulation disturbances can mediate stroke. Increased serum levels of D-dimer, fibrin degradation products, and CRP are more often seen in stroke with concomitant cancer, and the clot retrieved during thrombectomy has a more fibrin- and platelet-rich constitution compared with that of atherosclerotic etiology. Multiple infarctions are more common in patients with active cancer compared with those without a cancer diagnosis. New MRI techniques may help in detecting typical patterns seen in the presence of a concomitant cancer. In ischemic stroke patients, a newly published cancer probability score can help clinicians in their decision-making when to suspect an underlying malignancy in a stroke patient and to start cancer-screening studies. Treating stroke patients with synchronous cancer can be a delicate matter. Limited evidence suggests that administration of intravenous thrombolysis appears safe in non-axial intracranial and non-metastatic cancer patients. Endovascular thrombectomy is probably rather safe in these patients, but probably futile in most patients placed on palliative care due to their advanced disease. In this topical review, we discuss the epidemiology, pathophysiology, and prognosis of ischemic and hemorrhagic strokes as well as cerebral venous thrombosis and concomitant cancer. We further summarize the current evidence on acute management and secondary preventive therapy.Peer reviewe

Serotonergic modulation of the ventral pallidum by 5HT1A, 5HT5A, 5HT7 AND 5HT2C receptors

Introduction: Serotonin's involvement in reward processing is controversial. The large number of serotonin receptor sub-types and their individual and unique contributions have been difficult to dissect out, yet understanding how specific serotonin receptor sub-types contribute to its effects on areas associated with reward processing is an essential step. Methods: The current study used multi-electrode arrays and acute slice preparations to examine the effects of serotonin on ventral pallidum (VP) neurons. Approach for statistical analysis: extracellular recordings were spike sorted using template matching and principal components analysis, Consecutive inter-spike intervals were then compared over periods of 1200 seconds for each treatment condition using a student’s t test. Results and conclusions: Our data suggests that excitatory responses to serotonin application are pre-synaptic in origin as blocking synaptic transmission with low-calcium aCSF abolished these responses. Our data also suggests that 5HT1a, 5HT5a and 5HT7 receptors contribute to this effect, potentially forming an oligomeric complex, as 5HT1a antagonists completely abolished excitatory responses to serotonin application, while 5HT5a and 5HT7 only reduced the magnitude of excitatory responses to serotonin. 5HT2c receptors were the only serotonin receptor sub-type tested that elicited inhibitory responses to serotonin application in the VP. These findings, combined with our previous data outlining the mechanisms underpinning dopamine's effects in the VP, provide key information, which will allow future research to fully examine the interplay between serotonin and dopamine in the VP. Investigation of dopamine and serotonins interaction may provide vital insights into our understanding of the VP's involvement in reward processing. It may also contribute to our understanding of how drugs of abuse, such as cocaine, may hijack these mechanisms in the VP resulting in sensitization to drugs of abuse

Galaxy Zoo: Passive Red Spirals

We study the spectroscopic properties and environments of red spiral galaxies found by the Galaxy Zoo project. By carefully selecting face-on, disk dominated spirals we construct a sample of truly passive disks (not dust reddened, nor dominated by old stellar populations in a bulge). As such, our red spirals represent an interesting set of possible transition objects between normal blue spirals and red early types. We use SDSS data to investigate the physical processes which could have turned these objects red without disturbing their morphology. Red spirals prefer intermediate density regimes, however there are no obvious correlations between red spiral properties and environment - environment alone is not sufficient to determine if a spiral will become red. Red spirals are a small fraction of spirals at low masses, but are a significant fraction at large stellar masses - massive galaxies are red independent of morphology. We confirm that red spirals have older stellar popns and less recent star formation than the main spiral population. While the presence of spiral arms suggests that major star formation cannot have ceased long ago, we show that these are not recent post-starbursts, so star formation must have ceased gradually. Intriguingly, red spirals are ~4 times more likely than normal spirals to host optically identified Seyfert or LINER, with most of the difference coming from LINERs. We find a curiously large bar fraction in the red spirals suggesting that the cessation of star formation and bar instabilities are strongly correlated. We conclude by discussing the possible origins. We suggest they may represent the very oldest spiral galaxies which have already used up their reserves of gas - probably aided by strangulation, and perhaps bar instabilities moving material around in the disk.Comment: MNRAS in press, 20 pages, 15 figures (v3