Application of the Theory of Planned Behaviour to weight control in an overweight cohort. Results from a pan-European dietary intervention trial (DiOGenes)

Using the Theory of Planned Behaviour (TPB), this study investigates weight control in overweight and obese participants (27 kg/m² ? BMI < 45 kg/m²) taking part in a dietary intervention trial targeted at weight loss maintenance (n = 932). Respondents completed TPB measures investigating “weight gain prevention” at three time points. Correlation and regression analyses were used to investigate the relationship between TPB variables and weight regain. The TPB explained up to 27% variance in expectation, 14% in intention and 20% in desire scores. No relationship was established between intention, expectation or desire and behaviour at Time 1 or Time 2. Perceived need and subjective norm were found to be significantly related to weight regain, however, the model explained a maximum of 11% of the variation in weight regain. Better understanding of overweight individuals’ trajectories of weight control is needed to help inform studies investigating people’s weight regain behaviours. Future research using the TPB model to explain weight control should consider the likely behaviours being sought by individuals.     

Effects of librarian-provided services in healthcare settings: a systematic review

Objective

To assess the effects of librarian-provided services in healthcare settings on patient, healthcare provider, and researcher outcomes.

Materials and methods

Medline, CINAHL, ERIC, LISA (Library and Information Science Abstracts), and the Cochrane Central Register of Controlled Trials were searched from inception to June 2013. Studies involving librarian-provided services for patients encountering the healthcare system, healthcare providers, or researchers were eligible for inclusion. All librarian-provided services in healthcare settings were considered as an intervention, including hospitals, primary care settings, or public health clinics.

Results

Twenty-five articles fulfilled our eligibility criteria, including 22 primary publications and three companion reports. The majority of studies (15/22 primary publications) examined librarians providing instruction in literature searching to healthcare trainees, and measured literature searching proficiency. Other studies analyzed librarian-provided literature searching services and instruction in question formulation as well as the impact of librarian-provided services on patient length of stay in hospital. No studies were found that investigated librarians providing direct services to researchers or patients in healthcare settings.

Conclusions

Librarian-provided services directed to participants in training programs (eg, students, residents) improve skills in searching the literature to facilitate the integration of research evidence into clinical decision-making. Services provided to clinicians were shown to be effective in saving time for health professionals and providing relevant information for decision-making. Two studies indicated patient length of stay was reduced when clinicians requested literature searches related to a patient''s case.     

Evaluation of sampling density on the accuracy of aortic pulse wave velocity from velocity‐encoded MRI in patients with Marfan syndrome

Purpose:

To evaluate the effect of spatial (ie, number of sampling locations along the aorta) and temporal sampling density on aortic pulse wave velocity (PWV) assessment from velocity‐encoded MRI in patients with Marfan syndrome (MFS).

Materials and Methods:

Twenty‐three MFS patients (12 men, mean age 36 ± 14 years) were included. Three PWV‐methods were evaluated: 1) reference PWV_i.p. from in‐plane velocity‐encoded MRI with dense temporal and spatial sampling; 2) conventional PWV_t.p. from through‐plane velocity‐encoded MRI with dense temporal but sparse spatial sampling at three aortic locations; 3) EPI‐accelerated PWV_t.p. with sparse temporal but improved spatial sampling at five aortic locations with acceleration by echo‐planar imaging (EPI).

Results:

Despite inferior temporal resolution, EPI‐accelerated PWV_t.p. showed stronger correlation (r = 0.92 vs. r = 0.65, P = 0.03) with reference PWV_i.p. in the total aorta, with less error (8% vs. 16%) and variation (11% vs. 27%) as compared to conventional PWV_t.p.. In the aortic arch, correlation was comparable for both EPI‐accelerated and conventional PWV_t.p. with reference PWV_i.p. (r = 0.66 vs. r = 0.67, P = 0.46), albeit 92% scan‐time reduction by EPI‐acceleration.

Conclusion:

Improving spatial sampling density by adding two acquisition planes along the aorta results in more accurate PWV assessment, even when temporal resolution decreases. For regional PWV assessment in the aortic arch, EPI‐accelerated and conventional PWV assessment are comparably accurate. Scan‐time reduction makes EPI‐accelerated PWV assessment the preferred method of choice. J. Magn. Reson. Imaging 2012; 36:1470–1476. © 2012 Wiley Periodicals, Inc.     

Role for primary cilia in the regulation of mouse ovarian function

Ift88 is a component of the intraflagellar transport complex required for formation and maintenance of cilia. Disruption of Ift88 results in depletion of cilia. The goal of the current study was to determine the role of primary cilia in ovarian function. Deletion of Ift88 in ovary using Cre-Lox recombination in mice resulted in a severe delay in mammary gland development including lack of terminal end bud structures, alterations in the estrous cycle, and impaired ovulation. Because estrogen drives the formation of end buds and Cre was expressed in the granulosa cells of the ovary, we tested the hypothesis that addition of estradiol to the mutant mice would compensate for defects in ovarian function and rescue the mammary gland phenotype. Mammary gland development including the formation of end bud structures resumed in mutant mice that were injected with estradiol. Together the results suggest that cilia are required for ovarian function.     

Visceral leishmaniasis--surgical aspects

Visceral Leishmaniasis is a multi-organic parasitic disease caused by an intracellular protozoon named Leishmania Donovani; the mean signs are: weight loss, cough, fever, hepatosplenomegaly, adenopathy and cutaneous lesions; death without treatment is the rule. The main treatment is a conservative one. Surgical treatment is necessary for complications, especially for those intra-abdominally. We wish to present a young female patient who underwent two subsequent interventions due to an unclear diagnosis. We emphasize the difficulties in achieving a certain diagnostic, because of the rarity of disease in Romania; there are also revealed surgical aspects, which are important because of very few available data in the literature.     

Considerations regarding the treatment with total dentures for patients with hyposalivation. A clinical case

The reduction of the saliva volume leads to a number of difficulties in wearing the total dentures and favours the appearance of the denture stomatitis. For this reason, the treatment of edentulous patients with xerostomia must begin with a complete clinical examination, in order to evaluate the conditions for prosthetic replacement and the amount of the saliva volume. One can appreciate the aetiology and the degree of the saliva volume's alteration trough subjective methods (questionnaires) and objective methods (a few clinical tests, i.e. the mirror test, the pH evaluation, the examination of the saliva). During the treatment, we must pay attention to the preprosthetic measures (the oral rehabilitation), to the treatment stages (special types of impressions, the correct determination of the occlusal and intermaxillary relationships, the aspect of the internal denture's surface), and to the after-treatment phase (the patient's instructions regarding denture's wearing and hygiene, the patient's monitoring). Respecting this rules we may increase the quality of total dentures for patients with xerostomia.     

Conformational disturbance in Abl kinase upon mutation and deregulation

Protein dynamics are inextricably linked to protein function but there are few techniques that allow protein dynamics to be conveniently interrogated. For example, mutations and translocations give rise to aberrant proteins such as Bcr-Abl where changes in protein conformation and dynamics are believed to result in deregulated kinase activity that provides the oncogenic signal in chronic myelogeous leukemia. Although crystal structures of the down-regulated c-Abl kinase core have been reported, the conformational impact of mutations that render Abl resistant to small-molecule kinase inhibitors are largely unknown as is the allosteric interplay of the various regulatory elements of the protein. Hydrogen exchange mass spectrometry (HX MS) was used to compare the conformations of wild-type Abl with a nonmyristoylated form and with 3 clinically relevant imatinib resistance mutants (T315I, Y253H and E255V). A HX-resistant core localized to the interface between the SH2 and kinase domains, a region known to be important for maintaining the down-regulated state. Conformational differences upon demyristoylation were consistent with the SH2 domain moving to the top of the small lobe of the kinase domain as a function of activation. There were conformational changes in the T315I mutant but, surprisingly, no major changes in conformation were detected in either the Y253H or the E255V mutants. Taken together, these results provide evidence that allosteric interactions and conformational changes play a major role in Abl kinase regulation in solution. Similar analyses could be performed on any protein to provide mechanistic details about conformational changes and protein function.     

Clinical controversy in orbitary cholesteatoma

Cholesterol granulomas are tumor-like lesions very rarely encountered in the orbital, frontal sinus, and maxillary sinus sites but with higher frequency in the middle-ear and petrous apex. Theoretically, cholesterol granulomas develop as a reaction to localized hemorrhages, often occurring in bony sites with no blood and blood products drainage. We present 5 cases with exophthalmoses, namely, 3 cases with granuloma and 2 cases with cholesteatoma, all being characterized by the presence of cholesterol spikes at the histologic examination. Henderson (Orbital tumors. 3rd ed. New York: Raven Press; 1994) reports cholesterol spikes in medical literature as structures with different histologic names as hematic cyst, intraorbital hematoma, subperiostal hemorrhages, chocolate cyst, and xanthomatosis reactive lesions of bone. In fact, cholesterol granuloma is the term for the pocket of hematogenous debris found in the frontal bone at surgery. We try to review the spectrum of clinical-pathological and radiographic features that characterize cholesterol granuloma but with the same surgical way management.