Quality and availability of consumer information on heart failure in Australia

<p>Abstract</p> <p>Background</p> <p>Provision of consumer information and patient education are considered an essential part of chronic disease management programmes developed for patients with heart failure. This study aimed to review the quality and availability of consumer information materials for people with heart failure in Australia.</p> <p>Methods</p> <p>The availability of consumer information was assessed through a questionnaire-based survey of the major organisations in Australia known, or thought, to be producing or using consumer materials on heart failure, including hospitals. The questionnaire was designed to explore issues around the use, production and dissemination of consumer materials. Only groups that had produced consumer information on heart failure were asked to complete the totality of the questionnaire.</p> <p>The quality of information booklets was assessed by using a standardised checklist.</p> <p>Results</p> <p>Of 101 organisations which were sent a questionnaire, 33 had produced 61 consumer resources on heart failure including 21 information booklets, 3 videos, 5 reminder fridge magnets, 7 websites, 15 self-management diaries and 10 self-management plans. Questionnaires were completed for 40 separate information resources. Most had been produced by hospitals or health services. Two information booklets had been translated into other languages. There were major gaps in the availability of these resources as more than half of the resources were developed in 2 of the 8 Australian states and territories, New South Wales and Victoria.</p> <p>Quality assessment of 19 information booklets showed that most had good presentation and language. Overall eight high quality booklets were identified. There were gaps in terms of topics covered, provision of references, quantitative information about treatment outcomes and quality and level of scientific evidence to support medical recommendations. In only one case was there evidence that consumers had been involved in the production of the booklets.</p> <p>Conclusion</p> <p>Key findings arising from the study included the need to develop a nationally coordinated approach for increasing the dissemination of information resources on heart failure. While the more recent publication of a booklet by the National Heart Foundation may have improved the situation, dissemination of written information materials may remain sub-optimal, especially among patients who are not enrolled in chronic heart failure management programmes.</p

What is a 4-connected matroid?

The breadth of a tangle $\mathcal{T}$ in a matroid is the size of the largest spanning uniform submatroid of the tangle matroid of $\mathcal{T}$. The matroid $M$ is weakly 4-connected if it is 3-connected and whenever $(X,Y)$ is a partition of $E(M)$ with $|X|,|Y|>4$, then $\lambda(X)\geq 3$. We prove that if $\mathcal{T}$ is a tangle of order $k\geq 4$ and breadth $l$ in a matroid $M$, then $M$ has a weakly 4-connected minor $N$ with a tangle $\mathcal{T}_N$ of order $k$, breadth $l$ and has the property that $\mathcal{T}$ is the tangle in $M$ induced by $\mathcal{T}_N$. A set $Z$ of elements of a matroid $M$ is 4-connected if $\lambda(A)\geq\min\{|A\cap Z|,|Z-A|,3\}$ for all $A\subseteq E(M)$. As a corollary of our theorems on tangles we prove that if $M$ contains an $n$-element 4-connected set where $n\geq 7$, then $M$ has a weakly $4$-connected minor that contains an $n$-element $4$-connected set.Comment: 34 page

'They only smoke in the house when I'm not in': Understanding the limited effectiveness of a smoke-free homes intervention

Background: Children’s second-hand smoke (SHS) exposure in the home is highest in socio-economically disadvantaged areas. Personalised household air quality measurements can promote changes in smoking that reduce SHS exposure. The ‘First Steps 2 Smoke-free’ (FS2SF) intervention is the first to trial this approach delivered as part of health professionals’ routine work. This paper reports the findings of qualitative interviews with participants that explored their experiences of the intervention and why outcomes varied. Methods: 120 women were recruited from the NHS First Steps Programme, which supports disadvantaged mothers. They received either personalised feedback on their home air quality and advice on reducing SHS or standard SHS advice. Qualitative interviews with 15 mothers were analysed thematically using the COM-B (Capability, Opportunity, Motivation, Behaviour) model. Results: The intervention increased women’s capability to change home smoking behaviour, through increasing awareness and salience of SHS risks to their children, and motivation to act. However, taking effective action was constrained by their limited social and environmental opportunities, including others’ smoking in the home. Conclusions: The FS2SF intervention was ineffective as it was unable to fully address the precarious, complex life circumstances that make creating a smoke-free home particularly difficult for women experiencing intersecting dimensions of disadvantage.

Sestrins are evolutionarily conserved mediators of exercise benefits.

Exercise is among the most effective interventions for age-associated mobility decline and metabolic dysregulation. Although long-term endurance exercise promotes insulin sensitivity and expands respiratory capacity, genetic components and pathways mediating the metabolic benefits of exercise have remained elusive. Here, we show that Sestrins, a family of evolutionarily conserved exercise-inducible proteins, are critical mediators of exercise benefits. In both fly and mouse models, genetic ablation of Sestrins prevents organisms from acquiring metabolic benefits of exercise and improving their endurance through training. Conversely, Sestrin upregulation mimics both molecular and physiological effects of exercise, suggesting that it could be a major effector of exercise metabolism. Among the various targets modulated by Sestrin in response to exercise, AKT and PGC1α are critical for the Sestrin effects in extending endurance. These results indicate that Sestrin is a key integrating factor that drives the benefits of chronic exercise to metabolism and physical endurance

Emerging Roles of Primary Cilia in Glioma

Primary cilia are microtubule-based organelles that are typically present on cells during the G0 or G1-S/G2 phases of the cell cycle. Recent studies of glioblastoma (GBM) biopsies, a brain tumor that is notorious for its aggressive growth and resistance to treatment, show that many cells in the tumor lack cilia. At this point, it remains unclear whether primary cilia promote or suppress glioma tumorigenesis. In this review, we will discuss the different roles that have been proposed for primary cilia in glioma and how cilia may contribute to the resistance of these tumors to current therapies

Expression of GCAP 1 and GCAP2 in the retinal degeneration (rd) mutant chicken retina

AbstractWe cloned the guanylate cyclase activating proteins, GCAP1 and GCAP2, from chicken retina and examined their expression in normal and predegenerate rd/rd chicken retina. Northern analyses show that the amounts of the single transcripts encoding GCAPI and GCAP2 are reduced to about 70% of normal levels in rdlrd retina. Western analyses reveal that GCAP2 levels appear normal in this retina, while GCAPI levels are reduced by more than 90%. The specific downregulation of GCAPI in rd/rd retina is consistent with a model for this disease in which activation of guanylate cyclase in the photoreceptors is abnormal, resulting in low levels of cGMP and an absence of phototransduction