2,487 research outputs found
Outcomes of a specialist weight management programme in the UK national health service: prospective study of 1838 patients
Objectives There is limited evidence on the effectiveness of weight management programmes provided within routine healthcare and inconsistent use of outcome measures. Our aim was to evaluate a large National Health Service (NHS) weight management service and report absolute and proportional weight losses over 12â
months.<p></p>
Design Prospective observational study.<p></p>
Setting Glasgow and Clyde Weight Management Service (GCWMS), which provides care for residents of NHS Greater Glasgow and Clyde area (population 1.2 million).<p></p>
Participants All patients who began GCWMS between 1 October 2008 and 30 September 2009.<p></p>
Interventions Structured educational lifestyle programme employing cognitive behavioural therapy, 600â
kcal deficit diet, physical activity advice, lower calorie diet and pharmacotherapy.<p></p>
Primary and secondary outcomes measures Baseline observation carried forward (BOCF), last observation carried forward (LOCF) and changes in programme completers reported using outcomes of absolute 5â
kg and 5% weight losses and mean weight changes at a variety of time points.<p></p>
Results 6505 referrals were made to GCWMS, 5637 were eligible, 3460 opted in and 1916 (34%) attended a first session. 78 patients were excluded from our analysis on 1838 patients. 72.9% of patients were women, mean age of all patients at baseline was 49.1â
years, 43.3% lived in highly socioeconomically deprived areas and mean weights and body mass indices at baseline were 118.1â
kg and 43.3â
kg/m2, respectively. 26% lost â„5â
kg by the end of phase 1, 30% by the end of phase 2 and 28% by the end of phase 3 (all LOCF). Weight loss was more successful among men, particularly those â€29â
years old.<p></p>
Conclusions Routine NHS weight management services may achieve moderate weight losses through a comprehensive evidence-based dietary, activity and behavioural approach including psychological care. Weight losses should be reported using a range of outcome measures so that the effectiveness of different services can be compared
Twistor-Inspired Construction of Electroweak Vector Boson Currents
We present an extension of the twistor-motivated MHV vertices and
accompanying rules presented by Cachazo, Svrvcek and Witten to the construction
of vector-boson currents coupling to an arbitrary source. In particular, we
give rules for constructing off-shell vector-boson currents with one fermion
pair and n gluons of arbitrary helicity. These currents may be employed
directly in the computation of electroweak amplitudes. The rules yield
expressions in agreement with previously-obtained results for Z,W,\gamma^* -->
qbar q + n gluons (analytically up to n=3, beyond via the Berends--Giele
recursion relations). We also confirm that the contribution to a seven-point
amplitude containing the non-abelian triple vector-boson coupling obtained
using the next-to-MHV currents matches the previous result in the literature.Comment: 22 pages, 4 figures, v2 minor corrections and added commentary on
multiple vector boson
Bootstrapping One-Loop QCD Amplitudes with General Helicities
The recently developed on-shell bootstrap for computing one-loop amplitudes
in non-supersymmetric theories such as QCD combines the unitarity method with
loop-level on-shell recursion. For generic helicity configurations, the
recursion relations may involve undetermined contributions from non-standard
complex singularities or from large values of the shift parameter. Here we
develop a strategy for sidestepping difficulties through use of pairs of
recursion relations. To illustrate the strategy, we present sets of recursion
relations needed for obtaining n-gluon amplitudes in QCD. We give a recursive
solution for the one-loop n-gluon QCD amplitudes with three or four
color-adjacent gluons of negative helicity and the remaining ones of positive
helicity. We provide an explicit analytic formula for the QCD amplitude
A_{6;1}(1^-,2^-,3^-,4^+,5^+,6^+), as well as numerical results for
A_{7;1}(1^-,2^-,3^-,4^+,5^+,6^+,7^+), A_{8;1}(1^-,2^-,3^-,4^+,5^+,6^+,7^+,8^+),
and A_{8;1}(1^-,2^-,3^-,4^-,5^+,6^+,7^+,8^+). We expect the on-shell bootstrap
approach to have widespread applications to phenomenological studies at
colliders.Comment: 77 pages, 17 figures; v2, corrected minor typos in text and small
equation
The practical management of emergencies in primary care: Taking simulation out of the classroom and into real-life environments
Life threatening emergencies in the community are relatively infrequent and therefore provide a challenge for doctors in keeping up-to-date and maintaining confidence. Training in managing emergencies typically takes place through role play and classroom based simulation. In this project, we took simulation out of the classroom and into community environments where emergencies actually occur creating 'real-life' scenarios. These included the practical management of meningitis, anaphylaxis, hypoglycaemia, convulsions and cardiac arrest. Doctors had to find and utilize the equipment in their surgeries and were asked to physically draw up the appropriate medication. The simulation training was led by a GP and a Consultant in Intensive Care Medicine. Participants' confidence in managing emergencies significantly increased after the workshops. Qualitative feedback illustrated the need for more simulation based learning: "I hope this can be done regularly as it will make a huge difference to patient care", "Excellent - life like to make more memorable", "Good to use the actual surgery equipment". Many of the participants knew the theory of what to do but lacked the practical skills to efficiently manage emergency scenarios. Training doctors through simulation needs to be taken out of the classroom and into real life environments. This is particularly important for 'time critical illnesses' where delays can have a direct impact on morbidity and mortality
Welfare of Pigs in the Farrowing Environment
In the U.S.A., housing for the lactating sow and her piglets can be divided into five main areas. Total confinement, defined as the farrowing crate, houses the highest number of at 83.4 plus or minus 4.0%. Remaining operations house fewer sows with open buildings that have outside access at 12.4 plus or minus 4.1%, open building with no outside access, 2.9 plus or minus 0.5%, lot with hut or no building, 0.6 plus or minus 0.2% and pasture with hut or no building the lowest at 0.7 plus or minus 0.3% (. In the U.K., it is estimated that around 70% of sows farrow in crates, 27% farrow outdoors in farrowing arks and only 3% farrow in loose-housed indoor systems
Managing emergencies in primary care: does real-world simulation-based training have any lasting impact?
General Practitioners (GPs) have a responsibility to provide prompt and effective care when attending to life threatening emergencies in their GP surgeries. Primary care staff undertake mandatory, annual basic life support training. However, most emergencies are peri-arrest situations, and this is an area where GPs lack confidence and competence [1, 2]. The importance of effective, early intervention in peri-arrest scenarios was highlighted by the NCEPOD report âTime to Intervene (2012)â [3]. This report suggested that better early assessment and intervention may have prevented progression to cardiorespiratory arrest. GPs need to be equipped to manage âtime criticalâ emergencies, particularly as GP surgeries are deemed a place of safety and 999 ambulances can be redirected to other emergencies, thereby delaying transfer to secondary care for patients in GP settings. In previous work, we demonstrated that GPsâ confidence in managing time critical emergencies was initially low, and significantly improved immediately after attending âreal-worldâ, simulation based workshops [1]. The value of real-world, in-house simulation based training has also been shown to increase âpractical preparednessâ in the context of resuscitation training (4). However, there is relatively little data regarding the long term value of simulation based training in primary care (5). In the current paper, we assessed whether our workshops had any longer-term benefit on participantsâ confidence in managing emergencies and if it led to any changes in clinical practice
DNA molecules and human therapeutics
Nucleic acid molecules are championing a new generation of reverse engineered biopharmaceuticals. In terms of potential application in gene medicine, plasmid DNA (pDNA) vectors have exceptional therapeutic and immunological profiles as they are free from safety concerns associated with viral vectors, display non-toxicity and are simpler to develop. This review addresses the potential applications of pDNA molecules in vaccine design/development and gene therapy via recombinant DNA technology as well as a staged delivery mechanism for the introduction of plasmid-borne gene to target cells via the nasal route
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