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Tang H, Spreckley M, van Sluijs E, Ahern AL, Smith AD. The impact of social media interventions on eating behaviours and diet in adolescents and young adults: a mixed methods systematic review protocol. BMJ Open 2024; 14:e083465. [PMID: 38670609 PMCID: PMC11057283 DOI: 10.1136/bmjopen-2023-083465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/12/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Adolescents and young adults are susceptible population when it comes to healthy eating and dietary behaviours. The increasing use of social media by this age group presents a unique opportunity to promote healthy eating habits. Social media has become a popular platform for promoting health interventions, particularly among young people. However, there is a lack of consensus on the effectiveness of social media interventions in this population. This mixed-method systematic review aims to synthesise the available evidence on the impact of social media interventions on healthy eating behaviours among young people, their qualitative views and user experiences, and the intervention characteristics, behaviour change theories and techniques used to promote healthy eating. METHODS AND ANALYSIS We will conduct a comprehensive search of seven electronic databases, including ASSIA, Cochrane Library, Embase, MEDLINE, PsycINFO, Scopus and Web of Science. The search strategy will use a combination of Medical Subject Headings terms and keywords covering three domains: social media, eating behaviours and young people. The search will be limited to peer-reviewed published papers in any language, published from 2000. Three independent reviewers will screen studies based on predetermined eligibility criteria. Data will be extracted and analysed using a convergent segregated mixed-method approach. We will use random-effect meta-analysis or Synthesis Without Meta-analysis for quantitative data and thematic synthesis for qualitative data. Finally, narrative synthesis using concurrent triangulation will be used to bring together the results of the mixed-method data analysis to provide a comprehensive and integrated understanding of the impact and other features of social media interventions. This systematic review will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. ETHICS AND DISSEMINATION Ethical approval is not required since this systematic review will not collect original data. The outcomes of this review will be shared through peer-reviewed publications and conference presentations and will contribute to the PhD thesis of the primary author. PROSPERO REGISTRATION NUMBER CRD42023414476.
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Affiliation(s)
- Hao Tang
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Marie Spreckley
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Esther van Sluijs
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Amy L Ahern
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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2
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Smith AD, Dodd HF, Ricardo L, van Sluijs E. Gender Differences in Caregivers' Attitudes to Risky Child Play in Britain: A Cross-Sectional Study. J Phys Act Health 2024; 21:365-374. [PMID: 38253052 DOI: 10.1123/jpah.2023-0676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/06/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024]
Abstract
BACKGROUND This study examines gender differences in parental attitudes toward risky play for 5- to 11-year-old boys and girls in Britain. METHODS Analyses use data from the cross-sectional, nationally representative British Child Play Survey. Survey respondents were caregivers of primary-school-aged children living in Britain. Parent self-reported their risk tolerance in play via the Tolerance for Risk in Play Scale (TRiPS) and the Risk Engagement and Protection Survey (REPS). The REPS includes subscales that assess caregiver attitudes around "Protection from Injury" (PFI) and "Engagement with Risk" (EWR) in relation to children's play. Multiple linear regression compared caregiver gender differences in TRiPS, REPS-PFI, and REPS-EWR at the item level, and overall. Associations between child gender and these scales were also examined. RESULTS Among 1919 caregivers, no significant gender differences emerged in mean TRiPS (P = .72), REPS-EWR (P = .58), and REPS-PFI (P = .34) scores. Activity-specific differences were evident in caregivers' tolerance for individual risky play activities (15/31 activities). Parents of boys exhibited higher risk tolerance (B = -4.48, P < .01) and willingness for their child to engage in risky play (B = -0.63, P < .01) than parents of girls. CONCLUSIONS While there was no difference between male and female caregivers overall attitudes, gender differences were prominent for specific play activities and attitudes, with male caregivers demonstrating higher tolerance for the riskiest activities. Parents of boys expressed more permissive attitudes toward engagement in risky play. Further work is needed to identify why there is gender-related variation in these attitudes and should be considered in interventions that support parents in enabling adventurous play opportunities for children.
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Affiliation(s)
- Andrea D Smith
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Helen F Dodd
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Luiza Ricardo
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
| | - Esther van Sluijs
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom
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Conway R, Ritchie I, Esser S, Steptoe A, Smith AD, Llewellyn C. Perceived influence of commercial milk formula labelling on mothers' feeding choices in Great Britain: a qualitative study. Arch Dis Child 2023; 108:1008-1013. [PMID: 37541681 PMCID: PMC10715500 DOI: 10.1136/archdischild-2023-325767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/19/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE To understand how mothers use commercial milk formula (CMF) labels to inform their feeding choices and explore mothers' understanding of differences between CMF products. DESIGN Qualitative study with recruitment via social media. Online semistructured interviews, including a product mapping exercise and thematic analysis. PARTICIPANTS Mothers (n=25) using CMF for children <3 years living in Great Britain (GB). RESULTS Mothers were drawn to brands they recognised from years of exposure to CMF advertising. CMF products were assumed to vary according to brand and stage, but participants found on-pack information did not explain how. This added to anxiety about choosing 'the best one' and mothers would have liked guidance from healthcare professionals (HCPs). Wide availability of CMF for older infants and children, and on-pack messaging suggesting progression from one product to the next, led many to believe these products were necessary. There was confusion over the appropriate use of specialist products. While mothers rarely mentioned on-pack health and nutrition claims, they were attracted to the overall appearance of packs and messaging relating to science, research and nature. References to breast milk and a logo perceived to represent a breastfeeding mother were taken as indicators of closer similarity to breast milk. CONCLUSIONS CMF legislation in GB should be updated to restrict brand advertising and the use of on-pack text and images that mothers perceive as indicating products have a closer similarity to breast milk. Greater input from HCPs was desired by new mothers and would support them to make more informed choices about CMF.
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Affiliation(s)
- Rana Conway
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Isabel Ritchie
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Sara Esser
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, London, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, University College London, London, UK
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Olwi DI, Day FR, Cheng TS, Olga L, Petry CJ, Hughes IA, Smith AD, Ong KK. Associations of appetitive traits with growth velocities from infancy to childhood. Sci Rep 2023; 13:16056. [PMID: 37749117 PMCID: PMC10520028 DOI: 10.1038/s41598-023-42899-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 09/15/2023] [Indexed: 09/27/2023] Open
Abstract
Several studies have reported associations between appetitive traits and weight gain during infancy or childhood, but none have directly compared these associations across both age periods. Here, we tested the associations between appetitive traits and growth velocities from birth to childhood. Appetitive trait data were collected using the Children's Eating Behaviour Questionnaire (CEBQ) in 149 children from the Cambridge Baby Growth Study at age 9-17 years. These participants also provided anthropometric measurements during infancy (birth, 3, 12, 18, and 24 months) and childhood (5 to 11 years). Standardized growth velocities (in weight, length/height, BMI, and body fat percentage) for 0-3 months, 3-24 months, and 24 months to childhood were estimated using individual linear-spline models. Associations between each of the eight CEBQ traits and each growth velocity were tested in separate multilevel linear regression models, adjusted for sex, age at CEBQ completion, and the corresponding birth measurement (weight, length, BMI, or body fat percentage). The three food-approach traits (food responsiveness, enjoyment of food and emotional overeating) were positively associated with infancy and childhood growth velocities in weight, BMI, and body fat percentage. By contrast, only one of the food-avoidant traits, satiety responsiveness, was negatively associated with all growth velocities. Significant associations were mostly of similar magnitude across all age periods. These findings reveal a broadly consistent relationship between appetitive traits with gains in weight and adiposity throughout infancy and childhood. Future interventions and strategies to prevent obesity may benefit from measuring appetitive traits in infants and children and targeting these as part of their programs.
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Affiliation(s)
- Duaa Ibrahim Olwi
- MRC Epidemiology Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge, CB2 0QQ, UK.
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
- King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
| | - Felix R Day
- MRC Epidemiology Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge, CB2 0QQ, UK
| | - Tuck Seng Cheng
- MRC Epidemiology Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge, CB2 0QQ, UK
| | - Laurentya Olga
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Clive J Petry
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Ieuan A Hughes
- Department of Paediatrics, University of Cambridge, Cambridge, UK
| | - Andrea D Smith
- MRC Epidemiology Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge, CB2 0QQ, UK
| | - Ken K Ong
- MRC Epidemiology Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, School of Clinical Medicine, Box 285, Cambridge, CB2 0QQ, UK
- Department of Paediatrics, University of Cambridge, Cambridge, UK
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Llewellyn CH, Kininmonth AR, Herle M, Nas Z, Smith AD, Carnell S, Fildes A. Behavioural susceptibility theory: the role of appetite in genetic susceptibility to obesity in early life. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220223. [PMID: 37482774 PMCID: PMC10363697 DOI: 10.1098/rstb.2022.0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023] Open
Abstract
Excess weight gained during the early years and, in particular, rapid weight gain in the first 2 years of life, are a major risk factors for adult obesity. The growing consensus is that childhood obesity develops from a complex interaction between genetic susceptibility and exposure to an 'obesogenic' environment. Behavioural susceptibility theory (BST) was developed to explain the nature of this gene-environment interaction, and why the 'obesogenic' environment does not affect all children equally. It hypothesizes that inherited variation in appetite, which is present from birth, determines why some infants and children overeat, and others do not, in response to environmental opportunity. That is, those who inherit genetic variants promoting an avid appetite are vulnerable to overeating and developing obesity, while those who are genetically predisposed to have a smaller appetite and lower interest in food are protected from obesity-or even at risk of being underweight. We review the breadth of research to-date that has contributed to the evidence base for BST, focusing on early life, and discuss implications and future directions for research and theory. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part I)'.
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Affiliation(s)
- C H Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK
| | - A R Kininmonth
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK
| | - M Herle
- Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Z Nas
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, WC1E 6BT, UK
| | - A D Smith
- MRC Epidemiology Unit, University of Cambridge, Cambridge, CB2 0SL, UK
| | - S Carnell
- Department of Psychiatry and Behavioural Sciences, Johns Hopkins University School of Medicine, Baltimore, MD21287, USA
| | - A Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
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Garcia L, Pearce M, Abbas A, Mok A, Strain T, Ali S, Crippa A, Dempsey PC, Golubic R, Kelly P, Laird Y, McNamara E, Moore S, de Sa TH, Smith AD, Wijndaele K, Woodcock J, Brage S. Non-occupational physical activity and risk of cardiovascular disease, cancer and mortality outcomes: a dose-response meta-analysis of large prospective studies. Br J Sports Med 2023; 57:979-989. [PMID: 36854652 PMCID: PMC10423495 DOI: 10.1136/bjsports-2022-105669] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 03/02/2023]
Abstract
OBJECTIVE To estimate the dose-response associations between non-occupational physical activity and several chronic disease and mortality outcomes in the general adult population. DESIGN Systematic review and cohort-level dose-response meta-analysis. DATA SOURCES PubMed, Scopus, Web of Science and reference lists of published studies. ELIGIBILITY CRITERIA Prospective cohort studies with (1) general population samples >10 000 adults, (2) ≥3 physical activity categories, and (3) risk measures and CIs for all-cause mortality or incident total cardiovascular disease, coronary heart disease, stroke, heart failure, total cancer and site-specific cancers (head and neck, myeloid leukaemia, myeloma, gastric cardia, lung, liver, endometrium, colon, breast, bladder, rectum, oesophagus, prostate, kidney). RESULTS 196 articles were included, covering 94 cohorts with >30 million participants. The evidence base was largest for all-cause mortality (50 separate results; 163 415 543 person-years, 811 616 events), and incidence of cardiovascular disease (37 results; 28 884 209 person-years, 74 757 events) and cancer (31 results; 35 500 867 person-years, 185 870 events). In general, higher activity levels were associated with lower risk of all outcomes. Differences in risk were greater between 0 and 8.75 marginal metabolic equivalent of task-hours per week (mMET-hours/week) (equivalent to the recommended 150 min/week of moderate-to-vigorous aerobic physical activity), with smaller marginal differences in risk above this level to 17.5 mMET-hours/week, beyond which additional differences were small and uncertain. Associations were stronger for all-cause (relative risk (RR) at 8.75 mMET-hours/week: 0.69, 95% CI 0.65 to 0.73) and cardiovascular disease (RR at 8.75 mMET-hours/week: 0.71, 95% CI 0.66 to 0.77) mortality than for cancer mortality (RR at 8.75 mMET-hours/week: 0.85, 95% CI 0.81 to 0.89). If all insufficiently active individuals had achieved 8.75 mMET-hours/week, 15.7% (95% CI 13.1 to 18.2) of all premature deaths would have been averted. CONCLUSIONS Inverse non-linear dose-response associations suggest substantial protection against a range of chronic disease outcomes from small increases in non-occupational physical activity in inactive adults. PROSPERO registration number CRD42018095481.
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Affiliation(s)
- Leandro Garcia
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Matthew Pearce
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Ali Abbas
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alexander Mok
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | - Tessa Strain
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Sara Ali
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Alessio Crippa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paddy C Dempsey
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Diabetes Research Centre, University of Leicester, Leicester, UK
| | - Rajna Golubic
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Paul Kelly
- Physical Activity for Health Research Centre, University of Edinburgh Institute for Sport, Physical Education and Health Sciences, Edinburgh, UK
| | - Yvonne Laird
- Sydney School of Public Health, Prevention Research Collaboration, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Eoin McNamara
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Economic and Social Research Institute, Dublin, Ireland
| | - Samuel Moore
- University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Thiago Herick de Sa
- Center for Epidemiological Research in Nutrition and Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Andrea D Smith
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Department of Behavioural Science and Health, University College London, London, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - James Woodcock
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Soren Brage
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK
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Conway R, Esser S, Steptoe A, Smith AD, Llewellyn C. Content analysis of on-package formula labelling in Great Britain: use of marketing messages on infant, follow-on, growing-up and specialist formula. Public Health Nutr 2023; 26:1696-1705. [PMID: 36710005 PMCID: PMC10427444 DOI: 10.1017/s1368980023000216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 12/19/2022] [Accepted: 01/23/2023] [Indexed: 01/31/2023]
Abstract
OBJECTIVE To explore on-package formula messaging with reference to legislation and government-issued guidance in Great Britain (GB). DESIGN Formula products were identified, pictures of all sides of packs collated and on-package text and images were coded. Compliance with both GB legislation and guidance issued by the Department of Health and Social Care (DHSC) was assessed. SETTING All formula packs that were available for sale over the counter in GB between April and October 2020. PARTICIPANTS Formula packs (n 71) including infant formula, follow-on formula, growing-up formula and specialist formula were identified, coded and analysed. RESULTS In total, 41 % of formula packs included nutrition claims, and 18 % included health claims that may be considered non-permitted, according to DHSC guidance. Additionally, 72 % of products showed images considered 'non-permitted'. Breast Milk Substitute (BMS) legislation states infant and follow-on formula packs should be clearly distinguishable but does not provide criteria to assess similarity. Based on DHSC guidance, 72 % of infant and follow-on formula packs were categorised as showing a high degree of similarity. Marketing practices not covered by current legislation were widespread, such as 94 % of infant formula packs including advertisements for follow-on or growing-up formula. CONCLUSIONS Text and images considered non-permitted according to DHSC guidance for implementing BMS legislation were widespread on formula products available in GB. As terms such as 'similarity' are not defined in BMS legislation, it was unclear if breaches had occurred. Findings support the WHO call for loopholes in domestic legislation to be closed as a matter of urgency.
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Affiliation(s)
- Rana Conway
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Sara Esser
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Andrew Steptoe
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Clare Llewellyn
- Research Department of Behavioural Science and Health, University College London, Gower Street, London, WC1E 6BT, UK
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Perchik JD, Smith AD, Elkassem AA, Park JM, Rothenberg SA, Tanwar M, Yi PH, Sturdivant A, Tridandapani S, Sotoudeh H. Artificial Intelligence Literacy: Developing a Multi-institutional Infrastructure for AI Education. Acad Radiol 2023; 30:1472-1480. [PMID: 36323613 DOI: 10.1016/j.acra.2022.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 09/23/2022] [Accepted: 10/01/2022] [Indexed: 11/17/2022]
Abstract
RATIONALE AND OBJECTIVES To evaluate the effectiveness of an artificial intelligence (AI) in radiology literacy course on participants from nine radiology residency programs in the Southeast and Mid-Atlantic United States. MATERIALS AND METHODS A week-long AI in radiology course was developed and included participants from nine radiology residency programs in the Southeast and Mid-Atlantic United States. Ten 30 minutes lectures utilizing a remote learning format covered basic AI terms and methods, clinical applications of AI in radiology by four different subspecialties, and special topics lectures on the economics of AI, ethics of AI, algorithm bias, and medicolegal implications of AI in medicine. A proctored hands-on clinical AI session allowed participants to directly use an FDA cleared AI-assisted viewer and reporting system for advanced cancer. Pre- and post-course electronic surveys were distributed to assess participants' knowledge of AI terminology and applications and interest in AI education. RESULTS There were an average of 75 participants each day of the course (range: 50-120). Nearly all participants reported a lack of sufficient exposure to AI in their radiology training (96.7%, 90/93). Mean participant score on the pre-course AI knowledge evaluation was 8.3/15, with a statistically significant increase to 10.1/15 on the post-course evaluation (p= 0.04). A majority of participants reported an interest in continued AI in radiology education in the future (78.6%, 22/28). CONCLUSION A multi-institutional AI in radiology literacy course successfully improved AI education of participants, with the majority of participants reporting a continued interest in AI in radiology education in the future.
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Affiliation(s)
- J D Perchik
- Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama.
| | - A D Smith
- Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - A A Elkassem
- Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - J M Park
- Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - S A Rothenberg
- Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - M Tanwar
- Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - P H Yi
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland Medical Intelligent Imaging Center, University of Maryland School of Medicine, Baltimore, Maryland
| | - A Sturdivant
- University of Alabama at Birmingham Heersink School of Medicine
| | - S Tridandapani
- Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - H Sotoudeh
- Department of Diagnostic Radiology, University of Alabama at Birmingham, Birmingham, Alabama
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Rhodes A, Pimprikar A, Baum A, Smith AD, Llewellyn CH. Using the Person-Based Approach to Develop a Digital Intervention Targeting Diet and Physical Activity in Pregnancy: Development Study. JMIR Form Res 2023; 7:e44082. [PMID: 37234026 PMCID: PMC10257111 DOI: 10.2196/44082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 01/19/2023] [Accepted: 04/26/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND In pregnancy, eating well, keeping active, and avoiding excessive weight gain are associated with better maternal and fetal health outcomes. Dietary and physical activity (PA) interventions can be effective in changing behaviors and managing weight gain. The comparatively lower cost and greater accessibility of digital interventions make them an attractive alternative to in-person interventions. Baby Buddy is a free pregnancy and parenting app from the charity Best Beginnings. Designed to support parents, improve health outcomes, and reduce inequalities, the app is actively used within the UK National Health Service. It offers an ideal platform for delivering and evaluating a new prenatal dietary and PA intervention. OBJECTIVE The aim of this study was to create a theory-based intervention within Baby Buddy to empower, encourage, and support expectant parents to develop healthier dietary and PA habits for pregnancy and parenthood. METHODS The intervention's development process was guided by the Behavior Change Wheel, with the person-based approach used to create and test its design. Three stages of qualitative research with pregnant and recently pregnant parents guided the intervention design. Study 1 (n=30), comprising 4 web-based focus groups and 12 telephone interviews, gauged response to the rudimentary concept and generated ideas for its development. Results were analyzed thematically. At this stage, the guiding principles for the intervention development were established, and regular team meetings ensured that the intervention design remained aligned with Best Beginnings' objectives, evidence-based approach, and feasibility criteria. Study 2 (n=29), comprising web-based individual and couple interviews, explored design ideas using wireframes and scripts and generated iterative feedback on the intervention content, branding, and tone. A table of changes analysis tracked design amendments. Study 3 (n=19) tested an app prototype using think-aloud interviews with current Baby Buddy users. A patient and public involvement and engagement activity (n=18) and other expert contributors (n=14) provided ad hoc input into the research process and design development. RESULTS Study 1 confirmed the appeal and relevance of the intervention concept and its novel approach of including partners. The identified themes underpinned the development of the intervention design. Iterative feedback from study 2, in conjunction with patient and public involvement and engagement and expert contributor input, helped refine the intervention design and ensure its relevance and appeal to a diverse target user group. Study 3 highlighted functionality, content, and design issues with the app prototype and identified ways of improving the user experience. CONCLUSIONS This study illustrates the value of combining a theoretical method for intervention development with the person-based approach to create a theory-based intervention that is also user-friendly, appealing, and engaging for its target audience. Further research is needed to evaluate the effectiveness of the intervention in improving diet, PA, and weight management in pregnancy.
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Affiliation(s)
- Alexandra Rhodes
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare, University College London, London, United Kingdom
| | - Arya Pimprikar
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare, University College London, London, United Kingdom
| | | | - Andrea D Smith
- Medical Research Council Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Clare H Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare, University College London, London, United Kingdom
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Hunot-Alexander C, Arellano-Gómez LP, Smith AD, Kaufer-Horwitz M, Vásquez-Garibay EM, Romero-Velarde E, Fildes A, Croker H, Llewellyn CH, Beeken RJ. Examining the validity and consistency of the Adult Eating Behaviour Questionnaire-Español (AEBQ-Esp) and its relationship to BMI in a Mexican population. Eat Weight Disord 2022; 27:651-663. [PMID: 33966254 PMCID: PMC8933343 DOI: 10.1007/s40519-021-01201-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 04/19/2021] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Appetitive traits in adults and their associations with weight can be measured using the Adult Eating Behaviour Questionnaire (AEBQ). The aim of this study was to confirm the factor structure of the Spanish AEBQ (AEBQ-Esp) in a Mexican sample and explore associations between the eight traits with body mass index (BMI). METHOD A sample of 1023 adults, mean age of 36.8 ± 12.8 years, was recruited from Guadalajara, Mexico. Researchers weighed and measured participants, and they completed the AEBQ-Esp either online or in paper format and reported sociodemographic data. To test two alternative factor structures (eight factors including Hunger; seven factors excluding Hunger), confirmatory factor analysis (CFA) was used. Internal reliability was assessed using Cronbach's alpha; test-retest reliability was assessed using intra-class correlation coefficients. Multivariate linear regressions were used to test for associations between the AEBQ subscales and BMI, adjusted for age, sex, format of AEBQ responses, education, marital and employment status. RESULTS A seven-factor structure was the best model fit using CFA, excluding the Hunger subscale but similar to the original AEBQ. Internal reliability was good for all subscales (Cronbach's α = 0.70-0.86), and the intra-class correlation coefficient (0.70-0.91) reflected good test-retest reliability. In the fully adjusted models, Satiety Responsiveness [β = - 0.61; (- 1.01, - 0.21)] and Slowness in Eating [β = - 0.70; (- 1.01, - 0.39)] were negatively associated with BMI, and Emotional Over-Eating [β = 0.94; (0.62, 1.27)] was positively associated with BMI. CONCLUSIONS The AEBQ-Esp (excluding Hunger) appears to be a valid and reliable psychometric questionnaire for measuring appetitive traits in a Mexican Spanish-speaking population. Some traits appear to be associated with BMI in adulthood and warrant further exploration. LEVEL OF EVIDENCE Level III evidence obtained from well-designed cohort or case-control analytic studies. Although this was just an observational study, it was well designed and provided new evidence.
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Affiliation(s)
- Claudia Hunot-Alexander
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Edificio anexo al Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", 3ª piso ala norte. Salvador Quevedo y Zubieta No. 750, C.P. 44340, Guadalajara, Jalisco, Mexico
| | - Laura Patricia Arellano-Gómez
- Licenciatura en Nutrición y Ciencias de los Alimentos, Departamento de Psicología, Educación y Salud (DPES), Instituto Tecnológico de Estudios Superiores de Occidente (ITESO), Periférico Sur Manuel Gómez Morín #8585, C.P. 45604, Tlaquepaque, Jalisco, Mexico
| | - Andrea D Smith
- Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK
| | - Martha Kaufer-Horwitz
- Clínica de Obesidad y Trastornos de la Conducta Alimentaria, Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Avenida Vasco de Quiroga No.15, Colonia Belisario Domínguez Sección XVI, Delegación Tlalpan, C.P.14080, Ciudad de México, Mexico
| | - Edgar M Vásquez-Garibay
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Edificio anexo al Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", 3ª piso ala norte. Salvador Quevedo y Zubieta No. 750, C.P. 44340, Guadalajara, Jalisco, Mexico
| | - Enrique Romero-Velarde
- Instituto de Nutrición Humana, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Edificio anexo al Nuevo Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", 3ª piso ala norte. Salvador Quevedo y Zubieta No. 750, C.P. 44340, Guadalajara, Jalisco, Mexico
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Helen Croker
- Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK
| | - Clare H Llewellyn
- Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK
| | - Rebecca J Beeken
- Leeds Institute of Health Sciences, University of Leeds, Leeds, LS2 9NL, UK.
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11
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Maltais M, de Souto Barreto P, Bowman GL, Smith AD, Cantet C, Andrieu S, Rolland Y. Omega-3 Supplementation for the Prevention of Cognitive Decline in Older Adults: Does It Depend on Homocysteine Levels? J Nutr Health Aging 2022; 26:615-620. [PMID: 35718871 DOI: 10.1007/s12603-022-1809-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Recent evidence point towards an interaction between omega-3 (n-3) polyunsaturated fatty acids (PUFA) and plasma homocysteine (Hcy). OBJECTIVES This study tested the hypothesis that effects of red blood cell n-3 PUFA are modified according to baseline plasma Hcy in the large Mulit-domain Alzheimer Prevention Trial (MAPT) throughout the 3-years of treatment with an additional 2 years of observational follow-up. DESIGN Experimental study. PARTICIPANTS From the 1680 participants that were randomized in the four groups of the MAPT study (two of which received n-3 PUFA, the other two without n-3 PUFA), 782 were selected because they had baseline data on both Hcy and n-3 PUFA. MEASUREMENTS Cognitive performance was measured with a broad set of cognitive tests including free and total recall of the cued selective reminding test, digit symbol substitution test, category naming test and Trail-making tests (TMT-A and B) and Clinical dementia rating scale. RESULTS We found a significant association between TMT-A and red blood cell n-3 PUFA levels in participants with Hcy values ≤16.8 µMol/L after adjustments at baseline (Estimate: -1.3, 95% CI: -2.3; -0.3, p=0.01). Additionally, participants with high Hcy values had a significant worsening after adjustments in TMT-B after a 5-year n-3 PUFA supplementation, compared to low levels of Hcy (Mean difference: 34.8, 95% CI: 7.8;61.7). CONCLUSION This study shows that Hcy levels could modify the association between red blood cell n-3 PUFA and executive function. People with high Hcy may benefit less from a n-3 PUFA supplementation to prevent cognitive decline.
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Affiliation(s)
- M Maltais
- Mathieu Maltais, PhD, Faculté des Sciences de l'Activité Physique, Université de Sherbrooke, 2500 Boulevard de l'Université, Sherbrooke QC, +1 873-662-2510 E-mail : , @mathieu_maltais
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12
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Abstract
We have reviewed the literature and have identified more than 100 diseases or conditions that are associated with raised concentrations of plasma total homocysteine. The commonest associations are with cardiovascular diseases and diseases of the central nervous system, but a large number of developmental and age-related conditions are also associated. Few other disease biomarkers have so many associations. The clinical importance of these associations becomes especially relevant if lowering plasma total homocysteine by B vitamin treatment can prevent disease and so improve health. Five diseases can at least in part be prevented by lowering total homocysteine: neural tube defects, impaired childhood cognition, macular degeneration, primary stroke, and cognitive impairment in the elderly. We conclude from our review that total homocysteine values in adults of 10 μmol/L or below are probably safe, but that values of 11 μmol/L or above may justify intervention. Homocysteine is more than a disease biomarker: it is a guide for the prevention of disease.
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Affiliation(s)
- A D Smith
- From the, University Department of Pharmacology, Oxford, UK
| | - H Refsum
- From the, University Department of Pharmacology, Oxford, UK.,Department Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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13
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Rhodes A, Smith AD, Llewellyn CH, Croker H. Investigating partner involvement in pregnancy and identifying barriers and facilitators to participating as a couple in a digital healthy eating and physical activity intervention. BMC Pregnancy Childbirth 2021; 21:450. [PMID: 34182953 PMCID: PMC8237776 DOI: 10.1186/s12884-021-03917-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Maternal obesity and excessive gestational weight gain are associated with adverse maternal and foetal health outcomes. Interventions targeting dietary and physical activity behaviours during pregnancy have typically been directed at women only. A digital intervention targeting couples could encourage expectant parents to support each other in improving energy balance (dietary and physical activity) behaviours. AIMS This study aimed to investigate the role partners play in pregnant women's energy balance behaviours, and to identify barriers and facilitators to participating as a couple in a digital intervention to encourage healthy eating and physical activity in pregnancy. METHODS A qualitative design combined online focus groups and telephone interviews. Three focus groups were held with men (n = 15) and one mini focus group (n = 3) and 12 telephone interviews were conducted with women. Participants were either in the last trimester of pregnancy or had a baby under 18 months old. Most were from more deprived population groups where prevalence of maternal obesity is higher. Data were analysed thematically. Barriers and facilitators to participating as a couple in a digital intervention were mapped to the COM-B model and the Theoretical Domains Framework. RESULTS Four main themes were identified; partner involvement and support; partner understanding of good energy balance behaviours; couple concordance of energy balance behaviours; partner influence on her energy balance behaviours. Most facilitators to participating in a digital intervention as a couple fell within the Reflective Motivation domain of COM-B. Men were motivated by the desire to be supportive partners and good role models. Women were motivated by their belief that partner involvement would improve their success in achieving goals and enhance couple-bonding. Other facilitators included concordance in dietary behaviours (Physical Opportunity), healthcare practitioner recommendation, perceptions of pregnancy as 'ours' (Social Opportunity) and feeling supported and involved (Automatic Motivation). Barriers were rarely mentioned but included potential for partner conflict, perceptions of pregnancy as 'hers' and economic constraints. CONCLUSIONS An opportunity exists to harness partner support to improve maternal energy balance behaviours. Barriers and facilitators to participating in a digital intervention as a couple indicate its potential to benefit emotional and relationship wellbeing in addition to physical health.
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Affiliation(s)
- Alexandra Rhodes
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare, University College London, Gower Street, WC1E 6BT, London, UK.
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare, University College London, Gower Street, WC1E 6BT, London, UK
| | - Clare H Llewellyn
- Research Department of Behavioural Science and Health, Institute of Epidemiology and Healthcare, University College London, Gower Street, WC1E 6BT, London, UK
| | - Helen Croker
- Population, Policy and Practice Department, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, WC1N 1EH, London, UK
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14
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Herle M, Smith AD, Bu F, Steptoe A, Fancourt D. Trajectories of eating behavior during COVID-19 lockdown: Longitudinal analyses of 22,374 adults. Clin Nutr ESPEN 2021; 42:158-165. [PMID: 33745572 PMCID: PMC7871880 DOI: 10.1016/j.clnesp.2021.01.046] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/20/2021] [Accepted: 01/30/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND & AIMS The COVID-19 pandemic has led to the implementation of stay-at-home and lockdown measures. It is currently unknown if the experience of lockdown leads to long term changes in individual's eating behaviors. The objectives of this study were: i) to derive longitudinal trajectories of change in eating during UK lockdown, and ii) to identify risk factors associated with eating behavior trajectories. METHOD Data from 22,374 UK adults from the UCL COVID-19 Social study (a panel study collecting weekly data during the pandemic) were analyzed from 28th March to 29th May 2020. Latent Class Growth Analysis was used to derive trajectories of change in eating. These were then associated with prior socio-economic, health-related and psychological factors using multinomial regression models. RESULTS Analyses suggested five trajectories, with the majority (64%) showing no change in eating. In contrast, one trajectory was marked by persistently eating more, whereas another by persistently eating less. Overall, participants with greater depressive symptoms were more likely to report any change in eating. Loneliness was linked to persistently eating more (OR = 1.07), whereas being single or divorced, as well as stressful life events, were associated with consistently eating less (OR = 1.69). Overall, higher education status was linked to lower odds of changing eating behavior (OR = 0.54-0.77). Secondary exploratory analyses suggest that participants self-reported to have overweight were more commonly categorised into the group consistently eating more, whereas participants with underweigh persistently ate less. CONCLUSION In this study, we found that one third of the sample report changes in quantities eaten throughout the first UK lockdown period. Findings highlight the importance of adjusting public health programs to support eating behaviors in future lockdowns both in this and potential future pandemics. This is particularly important as part of on-going preventive efforts to prevent nutrition-related chronic diseases.
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Affiliation(s)
- Moritz Herle
- Department of Biostatistics & Health Informatics, King's College London, London, UK
| | - Andrea D Smith
- Department of Behavioural Science and Health, University College London, London, UK
| | - Feifei Bu
- Department of Behavioural Science and Health, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK.
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15
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Abstract
Background: Our understanding of how the coronavirus disease 2019 (COVID-19) pandemic has impacted decision-making for women planning to conceive is unclear. We aimed to investigate how the COVID-19 pandemic has influenced pregnancy planning behaviors. Methods: An online questionnaire of closed- and open-ended questions was utilized to capture pregnancy planning behaviors and reported behavioral changes during the COVID-19 pandemic in women planning pregnancy between January and July 2020. Closed-ended questions were analyzed quantitatively, and thematic framework analysis was utilized for open-ended responses. Results: A total of 504 questionnaires were included for analysis. The majority of respondents lived in the United Kingdom. Ninety-two percent of the women were still planning a pregnancy but over half (n = 267) reported that COVID-19 had affected their plans, with 72% of these (n = 189) deliberately postponing pregnancy. Concerns were predominantly over changes in antenatal care, but also fear of adverse effects of the virus on mother and baby. From the thematic analysis (n = 37), lack of services to remove contraceptive devices and provide fertility treatment were also cited. In contrast, 27% (n = 71) reported bringing their pregnancy plans forward; common themes included recalibration of priorities and cancelled or changed plans. Conclusions: The COVID-19 pandemic influenced pregnancy-planning behaviors with many women reporting postponement of pregnancy. These alterations in behavior could impact the health and wellbeing of women planning pregnancy while having important implications for health care services worldwide. Continued provision of family planning and fertility services should be ensured to mitigate the effect of future outbreaks or pandemics.
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Affiliation(s)
- Angela C Flynn
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom
| | - Kimberley Kavanagh
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom
| | - Andrea D Smith
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Lucilla Poston
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom
| | - Sara L White
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, United Kingdom
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16
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Tommerup K, Smith AD, Evans EH, Croker H, Steptoe A, Tovee MJ, Fildes A, Llewellyn C. The acceptability and feasibility of using a 3D body size scale to initiate conversations about weight in toddlerhood: a mixed-methods study. Pediatr Obes 2021; 16:e12715. [PMID: 32820620 DOI: 10.1111/ijpo.12715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/28/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Health Care Professionals struggle to initiate conversations about overweight in toddlerhood. A novel 3D body size scale (3D BSS) may facilitate engagement with this topic during pediatric appointments. OBJECTIVES To explore barriers and facilitators to using the 3D BSS through a mixed-methods design. METHODS For the qualitative phase, parents of toddlers (n = 38) participated in semi-structured interviews introducing the 3D BSS of 4-5-year-old children. For the quantitative phase, pre- and post-interview questionnaires were administered to ascertain the acceptability of the 3D BSS. RESULTS Parents rated the 3D BSS as "very" (n = 20, 52.6%) to "moderately" (n = 12, 31.6%) acceptable. Thematic analysis revealed four barriers to acceptability: i) the sensitive nature of child weight, ii) the belief that weight does not determine health, iii) the visual normalisation of overweight and iv) the need to account for individual variation in growth patterns. However, these barriers could be overcome through three facilitators: i) the provision of expert guidance ii) the value of simple tools, and iii) tailoring conversations to familial needs. CONCLUSIONS Parents considered the 3D BSS an acceptable visual resource to discuss child weight during routine appointments. However, the acceptability of the tool was conditional on a sensitive, collaborative, and tailored delivery approach.
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Affiliation(s)
- Kristiane Tommerup
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| | - Andrea D Smith
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| | | | - Helen Croker
- Great Ormond Street Institute of Child Health, Faculty of Population Health Sciences, University College London (UCL), London, UK
| | - Andrew Steptoe
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
| | - Martin J Tovee
- Department of Psychology, Northumbria University, Newcastle upon Tyne, UK
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, UK
| | - Clare Llewellyn
- Obesity Research Group, Department of Behavioural Science and Health, University College London (UCL), London, UK
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17
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Kininmonth AR, Smith AD, Llewellyn CH, Dye L, Lawton CL, Fildes A. The relationship between the home environment and child adiposity: a systematic review. Int J Behav Nutr Phys Act 2021; 18:4. [PMID: 33407598 PMCID: PMC7788808 DOI: 10.1186/s12966-020-01073-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/14/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Extensive research has demonstrated the role of the Home Environment (HE) in shaping children's energy balance behaviours. Less is known about direct relationships with bodyweight. This review examines associations between the social and physical aspects of three pre-defined Home Environment domains (food, physical activity and media) and adiposity measures in children ≤12 years. METHODS Six electronic databases (PubMed, Medline, EBSCO CINAHL, EMBASE, Web of Science, PsycInfo) were systematically searched up to October 2020. Studies reporting at least one physical and/or social aspect of the food, physical activity and/or media domains of the Home Environment in relation to child adiposity outcomes were included (n = 62). RESULTS Most studies examined one (n = 41) or two domains (n = 16). Only five studies assessed all three domains of the Home Environment. Most consistent relationships were observed for physical aspects of the home media environment; with greater availability of electronic devices associated with higher child adiposity (21/29 studies). Findings were less consistent for the smaller number of studies examining physical aspects of the home food or physical activity environments. 8/15 studies examining physical food environments reported null associations with adiposity. Findings were similarly mixed for physical activity environments; with 4/7 reporting null associations, 2/7 reporting negative associations and 1/7 reporting positive associations between access to physical activity equipment/garden space and adiposity. Fewer studies assessed social aspects (e.g. caregiver modelling or limit setting) of the Home Environment in relation to child adiposity and findings were again mixed; 9/16 media environment, 7/11 food environment and 9/13 physical activity environment studies reported null associations with child adiposity outcomes. CONCLUSIONS The home media environment was most consistently associated with adiposity in childhood. Findings were less consistent for the home food and physical activity environments. Greater agreement on definitions and the measurement of the obesogenic home environment is required in order to clarify the strength and direction of relationships with child adiposity. Robust longitudinal research using comprehensive measures of the holistic home environment is needed to better identify which aspects contribute to excess weight gain in childhood. TRIAL REGISTRATION PROSPERO Systematic review registration number: CRD42018115139 .
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Affiliation(s)
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Clare H Llewellyn
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Louise Dye
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Clare L Lawton
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
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18
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Wu Y, Smith AD, Refsum H, Kwok T. Effectiveness of B Vitamins and Their Interactions with Aspirin in Improving Cognitive Functioning in Older People with Mild Cognitive Impairment: Pooled Post-Hoc Analyses of Two Randomized Trials. J Nutr Health Aging 2021; 25:1154-1160. [PMID: 34866142 DOI: 10.1007/s12603-021-1708-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND OBJECTIVES A randomized placebo-controlled trial found a significant negative interaction between aspirin and B vitamins in cognitive functioning in older people with mild cognitive impairment (MCI). To validate this finding, we pooled data of this trial with that of a similar B-vitamin trial (VITACOG) to examine the effectiveness of B vitamins and their interactions with aspirin in improving global cognitive functioning and slowing brain atrophy in older people with MCI. DESIGN Pooled post-hoc analyses of two randomized placebo-controlled trials. PARTICIPANTS In total, 545 older people with MCI were included in the study. INTERVENTION Placebo or B-vitamin supplements (vitamin B12, folic acid with or without vitamin B6) for 24 months. MEASUREMENTS The primary outcome was the Clinical Dementia Rating scale-global score (CDR-global). The secondary outcomes were CDR-sum of box score (CDR-SOB), memory Z-score, executive function Z-score, and whole brain atrophy rate. RESULTS 71 (26.2%) and 83 (30.3%) subjects in the active and placebo group respectively were aspirin users. Overall, B vitamins reduced whole brain atrophy rate significantly (P = 0.003), but did not have significant effect on CDR-global, CDR-SOB, memory and executive function. Aspirin use had significant negative interaction effects on B vitamins in CDR-global and CDR-SOB (Beta = 0.993, P = 0.038, and Beta = 0.583, P = 0.009, respectively), but not in memory or executive function Z-scores. Among aspirin non-users, B-vitamin group subjects had more favourable changes in CDR-global and CDR-SOB (P = 0.019 and 0.057, respectively). B vitamins significantly slowed brain atrophy in aspirin non-users (P = 0.001), but not in aspirin users, though the interaction term was not significant (Beta = 0.192, P = 0.276). CONCLUSION In older people with MCI, B vitamins had significantly favourable effects on global cognitive functioning and whole brain atrophy rate in those who were not taking aspirin, but not in aspirin users.
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Affiliation(s)
- Y Wu
- Professor Timothy Kwok, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China, Tel: (852) 3505 3145; Fax: (852) 2637 3852.
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19
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Rhodes A, Kheireddine S, Smith AD. Experiences, Attitudes, and Needs of Users of a Pregnancy and Parenting App (Baby Buddy) During the COVID-19 Pandemic: Mixed Methods Study. JMIR Mhealth Uhealth 2020; 8:e23157. [PMID: 33264100 PMCID: PMC7732354 DOI: 10.2196/23157] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/08/2020] [Accepted: 10/19/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic has impacted the lives of expectant parents and parents of young babies, with disruptions in health care provision and loss of social support. OBJECTIVE This study investigated the impact of the COVID-19 pandemic and its associated lockdown on this population through the lens of users of the UK National Health Service-approved pregnancy and parenting smartphone app, Baby Buddy. The study aims were threefold: to gain insights into the attitudes and experiences of expectant and recent parents (with babies under 24 weeks of age) during the COVID-19 pandemic; to investigate whether Baby Buddy is meeting users' needs during this time; and to identify ways to revise the content of Baby Buddy to better support its users now and in future. METHODS A mixed methods study design combining a web-based survey with semistructured telephone interviews among Baby Buddy users in the United Kingdom was applied. Data were collected from April 15 to mid-June 2020, corresponding to weeks 4-13 of the lockdown in the United Kingdom. RESULTS A total of 436 expectant (n=244, 56.0%) and recent (n=192, 44.0%) parents responded to the web-based survey, of which 79.1% (n=345) were aged 25-39 years and 17.2% (n=75) spoke English as their second language. Of the 436 respondents, 88.5% (386/436) reported increased levels of anxiety around pregnancy, birth, and being a new parent, and 58.0% (253/436) were concerned about their emotional and mental health. Of the 244 pregnant respondents, 43.4% (n=106) were concerned about their physical health. Telephone interviews with 13 pregnant women and 19 recent parents revealed similarly increased levels of anxiety due to reduced health care provision and loss of support from friends and family. Although a minority of respondents identified some positive outcomes of lockdown, such as family bonding, many telephone interviewees reported feeling isolated, disregarded, and overwhelmed. Recent parents were particularly anxious about the impact of the lockdown on their baby's development and socialization. Many interviewees were also concerned about their physical health as a consequence of both limited access to face-to-face medical appointments and their own poorer dietary and physical activity behaviors. Across both samples, 97.0% (423/436) of respondents reported that Baby Buddy was currently helping them, with many commenting that its role was even more important given the lack of face-to-face support from health care and parenting organizations. Greater speed in updating digital content to reflect changes due to the pandemic was suggested. CONCLUSIONS The COVID-19 pandemic has created heightened anxiety and stress among expectant parents and those with a young baby, and for many, lockdown has had an adverse impact on their physical and mental well-being. With reductions in health care and social support, expectant and new parents are increasingly relying on web-based resources. As a free, evidence-based app, Baby Buddy is well positioned to meet this need. The app could support its users even more by actively directing them to the wealth of existing content relevant to their concerns and by adding content to give users the knowledge and confidence to meet new challenges.
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Affiliation(s)
- Alexandra Rhodes
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Sara Kheireddine
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
| | - Andrea D Smith
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom
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20
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Abstract
PURPOSE OF REVIEW Eating behaviours are hypothesised to be the behavioural expression of genetic risk of obesity. In this review, we summarise findings from behavioural genetic research on the association between genetic risk for obesity and validated psychometrics measures of eating behaviours in children and adults (published in the past 10 years). RECENT FINDINGS Twin studies have produced some evidence for a shared genetic aetiology underlying body mass index and eating behaviours. Studies using measured genetic susceptibility to obesity have suggested that increased genetic liability for obesity is associated with variation in obesogenic eating behaviours such as emotional and uncontrolled eating. More research on this topic is needed. Especially longitudinal studies using genetically sensitive designs to investigate the direction of genetic pathways between genetic liability of eating behaviours to weight and vice versa, as well as the potential subsequent link to eating disorders.
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Affiliation(s)
- Moritz Herle
- Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, London, UK
| | | | - Clare Llewellyn
- Research Department of Behavioural Science and Health, University College London, London, UK
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McGowan CP, Angeli NF, Beisler WA, Snyder C, Rankin NM, Woodrow JO, Wilson JK, Rivenbark E, Schwarzer A, Hand CE, Anthony R, Griffin RK, Barrett K, Haverland AA, Roach NS, Schnieder T, Smith AD, Smith FM, Tolliver JDM, Watts BD. Linking monitoring and data analysis to predictions and decisions for the range-wide eastern black rail status assessment. ENDANGER SPECIES RES 2020. [DOI: 10.3354/esr01063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The US Fish and Wildlife Service (USFWS) has initiated a re-envisioned approach for providing decision makers with the best available science and synthesis of that information, called the Species Status Assessment (SSA), for endangered species decision making. The SSA report is a descriptive document that provides decision makers with an assessment of the current and predicted future status of a species. These analyses support all manner of decisions under the US Endangered Species Act, such as listing, reclassification, and recovery planning. Novel scientific analysis and predictive modeling in SSAs could be an important part of rooting conservation decisions in current data and cutting edge analytical and modeling techniques. Here, we describe a novel analysis of available data to assess the current condition of eastern black rail Laterallus jamaicensis jamaicensis across its range in a dynamic occupancy analysis. We used the results of the analysis to develop a site occupancy projection model where the model parameters (initial occupancy, site persistence, colonization) were linked to environmental covariates, such as land management and land cover change (sea-level rise, development, etc.). We used the projection model to predict future status under multiple sea-level rise and habitat management scenarios. Occupancy probability and site colonization were low in all analysis units, and site persistence was also low, suggesting low resiliency and redundancy currently. Extinction probability was high for all analysis units in all simulated scenarios except one with significant effort to preserve existing habitat, suggesting low future resiliency and redundancy. With the results of these data analyses and predictive models, the USFWS concluded that protections of the Endangered Species Act were warranted for this subspecies.
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Affiliation(s)
- CP McGowan
- U.S. Geological Survey, Alabama Cooperative Fish and Wildlife Research Unit, Auburn University, Auburn, AL 36849, USA Addresses for other authors are given in Supplement 1 at www.int-res.com/articles/suppl/n043p209_supp/
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Rhodes A, Smith AD, Chadwick P, Croker H, Llewellyn CH. Exclusively Digital Health Interventions Targeting Diet, Physical Activity, and Weight Gain in Pregnant Women: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2020; 8:e18255. [PMID: 32673251 PMCID: PMC7382015 DOI: 10.2196/18255] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/30/2020] [Accepted: 05/14/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Interventions to promote a healthy diet, physical activity, and weight management during pregnancy are increasingly embracing digital technologies. Although some interventions have combined digital with interpersonal (face-to-face or telephone) delivery, others have relied exclusively on digital delivery. Exclusively digital interventions have the advantages of greater cost-effectiveness and broader reach and as such can be a valuable resource for health care providers. OBJECTIVE This systematic review aims to focus on exclusively digital interventions to determine their effectiveness, identify behavior change techniques (BCTs), and investigate user engagement. METHODS A total of 6 databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulated Index to Nursing and Allied Health Literature [CINAHL] Plus, Web of Science, and ProQuest) were searched for randomized controlled trials or pilot control trials of exclusively digital interventions to encourage healthy eating, physical activity, or appropriate weight gain during pregnancy. The outcome measures were gestational weight gain (GWG) and changes in physical activity and dietary behaviors. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Where possible, pooled effect sizes were calculated using a random effects meta-analysis. RESULTS In total, 11 studies met the inclusion criteria. The risk of bias was mostly high (n=5) or moderate (n=3). Of the 11 studies, 6 reported on GWG as the primary outcome, 4 of which also measured changes in physical activity and dietary behaviors, and 5 studies focused either on dietary behaviors only (n=2) or physical activity only (n=3). The meta-analyses showed no significant benefit of interventions on total GWG for either intention-to-treat data (-0.28 kg; 95% CI -1.43 to 0.87) or per-protocol data (-0.65 kg; 95% CI -1.98 to 0.67). Substantial heterogeneity in outcome measures of change in dietary behaviors and physical activity precluded further meta-analyses. BCT coding identified 7 BCTs that were common to all effective interventions. Effective interventions averaged over twice as many BCTs from the goals and planning, and feedback and monitoring domains as ineffective interventions. Data from the 6 studies reporting on user engagement indicated a positive association between high engagement with key BCTs and greater intervention effectiveness. Interventions using proactive messaging and feedback appeared to have higher levels of engagement. CONCLUSIONS In contrast to interpersonal interventions, there is little evidence of the effectiveness of exclusively digital interventions to encourage a healthy diet, physical activity, or weight management during pregnancy. In this review, effective interventions used proactive messaging, such as reminders to engage in BCTs, feedback on progress, or tips, suggesting that interactivity may drive engagement and lead to greater effectiveness. Given the benefits of cost and reach of digital interventions, further research is needed to understand how to use advancing technologies to enhance user engagement and improve effectiveness.
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Affiliation(s)
| | | | | | - Helen Croker
- University College London, London, United Kingdom
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23
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Kininmonth AR, Smith AD, Llewellyn CH, Fildes A. Socioeconomic status and changes in appetite from toddlerhood to early childhood. Appetite 2020; 146:104517. [DOI: 10.1016/j.appet.2019.104517] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/14/2019] [Accepted: 11/13/2019] [Indexed: 12/12/2022]
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Smith AD, Li Q, Vyas A, Haque MM, Wang K, Velasco A, Zhang X, Thurakkal S, Quellmalz A, Niklaus F, Gylfason K, Lundgren P, Enoksson P. Carbon-Based Electrode Materials for Microsupercapacitors in Self-Powering Sensor Networks: Present and Future Development. Sensors (Basel) 2019; 19:s19194231. [PMID: 31569477 PMCID: PMC6806280 DOI: 10.3390/s19194231] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 11/25/2022]
Abstract
There is an urgent need to fulfill future energy demands for micro and nanoelectronics. This work outlines a number of important design features for carbon-based microsupercapacitors, which enhance both their performance and integration potential and are critical for complimentary metal oxide semiconductor (CMOS) compatibility. Based on these design features, we present CMOS-compatible, graphene-based microsupercapacitors that can be integrated at the back end of the line of the integrated circuit fabrication. Electrode materials and their interfaces play a crucial role for the device characteristics. As such, different carbon-based materials are discussed and the importance of careful design of current collector/electrode interfaces is emphasized. Electrode adhesion is an important factor to improve device performance and uniformity. Additionally, doping of the electrodes can greatly improve the energy density of the devices. As microsupercapacitors are engineered for targeted applications, device scaling is critically important, and we present the first steps toward general scaling trends. Last, we outline a potential future integration scheme for a complete microsystem on a chip, containing sensors, logic, power generation, power management, and power storage. Such a system would be self-powering.
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Affiliation(s)
- A D Smith
- Micro and Nanosystems Group, Department of Microtechnology and Nanoscience, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Qi Li
- Micro and Nanosystems Group, Department of Microtechnology and Nanoscience, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Agin Vyas
- Micro and Nanosystems Group, Department of Microtechnology and Nanoscience, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Mohammad Mazharul Haque
- Micro and Nanosystems Group, Department of Microtechnology and Nanoscience, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Kejian Wang
- Micro and Nanosystems Group, Department of Microtechnology and Nanoscience, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Andres Velasco
- Micro and Nanosystems Group, Department of Microtechnology and Nanoscience, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Xiaoyan Zhang
- Chemistry on 2D Materials Group, Department of Chemistry and Chemical Engineering, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Shameel Thurakkal
- Chemistry on 2D Materials Group, Department of Chemistry and Chemical Engineering, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Arne Quellmalz
- Department of Micro and Nanosystems, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, SE-10044 Stockholm, Sweden.
| | - Frank Niklaus
- Department of Micro and Nanosystems, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, SE-10044 Stockholm, Sweden.
| | - Kristinn Gylfason
- Department of Micro and Nanosystems, School of Electrical Engineering and Computer Science, KTH Royal Institute of Technology, SE-10044 Stockholm, Sweden.
| | - Per Lundgren
- Micro and Nanosystems Group, Department of Microtechnology and Nanoscience, Chalmers University of Technology, 41296 Gothenburg, Sweden.
| | - Peter Enoksson
- Micro and Nanosystems Group, Department of Microtechnology and Nanoscience, Chalmers University of Technology, 41296 Gothenburg, Sweden.
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25
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Affiliation(s)
- A D Smith
- Prof. A. David Smith, Department of Pharmacology, Mansfield Rd. Oxford OX1 3QT. Tel: +44-1865-271617; Fax: +44-1865-271853.
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26
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Christou N, Rashid A, Gorissen KJ, Ris F, Gosselink MP, Shorthouse JR, Smith AD, Pandit JJ, Lindsey I, Crabtree NA. Response to Hamid et al., 'The role of laparoscopic-guided transversus abdominis plane block in laparoscopic colorectal surgery'. Colorectal Dis 2019; 21:605-606. [PMID: 30875447 DOI: 10.1111/codi.14609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/12/2019] [Indexed: 02/08/2023]
Affiliation(s)
- N Christou
- University Hospital of Limoges, Limoges, France.,Service of Visceral Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - A Rashid
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K J Gorissen
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - F Ris
- Service of Visceral Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - M P Gosselink
- Service of Visceral Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - J R Shorthouse
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - A D Smith
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - J J Pandit
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - I Lindsey
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - N A Crabtree
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Schrempft S, van Jaarsveld CHM, Fisher A, Herle M, Smith AD, Fildes A, Llewellyn CH. Variation in the Heritability of Child Body Mass Index by Obesogenic Home Environment. JAMA Pediatr 2018; 172:1153-1160. [PMID: 30285028 PMCID: PMC6396810 DOI: 10.1001/jamapediatrics.2018.1508] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/23/2018] [Indexed: 12/24/2022]
Abstract
Importance The early obesogenic home environment is consistently identified as a key influence on child weight trajectories, but little research has examined the mechanisms of that influence. Such research is essential for the effective prevention and treatment of overweight and obesity. Objective To test behavioral susceptibility theory's hypothesis that the heritability of body mass index (BMI) is higher among children who live in more obesogenic home environments. Design, Setting, and Participants This study was a gene-environment interaction twin study that used cross-sectional data from 925 families (1850 twins) in the Gemini cohort (a population-based prospective cohort of twins born in England and Wales between March and December 2007). Data were analyzed from July to October 2013 and in June 2018. Exposures Parents completed the Home Environment Interview, a comprehensive measure of the obesogenic home environment in early childhood. Three standardized composite scores were created to capture food, physical activity, and media-related influences in the home; these were summed to create an overall obesogenic risk score. The 4 composite scores were split on the mean, reflecting higher-risk and lower-risk home environments. Main Outcomes and Measures Quantitative genetic model fitting was used to estimate heritability of age-adjusted and sex-adjusted BMI (BMI SD score, estimated using British 1990 growth reference data) for children living in lower-risk and higher-risk home environments. Results Among 1850 twins (915 [49.5%] male and 935 [50.5%] female; mean [SD] age, 4.1 [0.4] years), the heritability of BMI SD score was significantly higher among children living in overall higher-risk home environments (86%; 95% CI, 68%-89%) compared with those living in overall lower-risk home environments (39%; 95% CI, 21%-57%). The findings were similar when examining the heritability of BMI in the separate food and physical activity environment domains. Conclusions and Relevance These findings support the hypothesis that obesity-related genes are more strongly associated with BMI in more obesogenic home environments. Modifying the early home environment to prevent weight gain may be particularly important for children genetically at risk for obesity.
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Affiliation(s)
- Stephanie Schrempft
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Cornelia H. M. van Jaarsveld
- Departments for Health Evidence and Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Abigail Fisher
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Moritz Herle
- University College London Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Andrea D. Smith
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Clare H. Llewellyn
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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28
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Smith AD, Bradley W, Reilly S, Barrett JA, Hunt Smith JJ. Medical Emergency Team calls within 24 hours of surgery and strategy for reduction. Anaesth Intensive Care 2018; 46:343-344. [PMID: 29716501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | - Wpl Bradley
- Senior Lecturer, Monash University, Melbourne, Victoria
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Patterson R, McNamara E, Tainio M, de Sá TH, Smith AD, Sharp SJ, Edwards P, Woodcock J, Brage S, Wijndaele K. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur J Epidemiol 2018; 33:811-829. [PMID: 29589226 PMCID: PMC6133005 DOI: 10.1007/s10654-018-0380-1] [Citation(s) in RCA: 649] [Impact Index Per Article: 108.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 03/12/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE To estimate the strength and shape of the dose-response relationship between sedentary behaviour and all-cause, cardiovascular disease (CVD) and cancer mortality, and incident type 2 diabetes (T2D), adjusted for physical activity (PA). Data Sources: Pubmed, Web of Knowledge, Medline, Embase, Cochrane Library and Google Scholar (through September-2016); reference lists. Study Selection: Prospective studies reporting associations between total daily sedentary time or TV viewing time, and ≥ one outcome of interest. Data Extraction: Two independent reviewers extracted data, study quality was assessed; corresponding authors were approached where needed. Data Synthesis: Thirty-four studies (1,331,468 unique participants; good study quality) covering 8 exposure-outcome combinations were included. For total sedentary behaviour, the PA-adjusted relationship was non-linear for all-cause mortality (RR per 1 h/day: were 1.01 (1.00-1.01) ≤ 8 h/day; 1.04 (1.03-1.05) > 8 h/day of exposure), and for CVD mortality (1.01 (0.99-1.02) ≤ 6 h/day; 1.04 (1.03-1.04) > 6 h/day). The association was linear (1.01 (1.00-1.01)) with T2D and non-significant with cancer mortality. Stronger PA-adjusted associations were found for TV viewing (h/day); non-linear for all-cause mortality (1.03 (1.01-1.04) ≤ 3.5 h/day; 1.06 (1.05-1.08) > 3.5 h/day) and for CVD mortality (1.02 (0.99-1.04) ≤ 4 h/day; 1.08 (1.05-1.12) > 4 h/day). Associations with cancer mortality (1.03 (1.02-1.04)) and T2D were linear (1.09 (1.07-1.12)). CONCLUSIONS Independent of PA, total sitting and TV viewing time are associated with greater risk for several major chronic disease outcomes. For all-cause and CVD mortality, a threshold of 6-8 h/day of total sitting and 3-4 h/day of TV viewing was identified, above which the risk is increased.
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Affiliation(s)
- Richard Patterson
- Public Health Policy Evaluation Unit, School of Public Health, Imperial College London, London, W6 8RP, UK.
| | - Eoin McNamara
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Marko Tainio
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Thiago Hérick de Sá
- Centre for Epidemiological Research in Nutrition and Health, University of São Paulo, São Paulo, Brazil
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, London, WC1E 6BT, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Phil Edwards
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - James Woodcock
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Søren Brage
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, School of Clinical Medicine, University of Cambridge, Cambridge, CB2 0QQ, UK
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Smith AD, Fildes A, Forwood S, Cooke L, Llewellyn C. The individual environment, not the family is the most important influence on preferences for common non-alcoholic beverages in adolescence. Sci Rep 2017; 7:16822. [PMID: 29203875 PMCID: PMC5715117 DOI: 10.1038/s41598-017-17020-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 11/13/2017] [Indexed: 11/09/2022] Open
Abstract
Beverage preferences are an important driver of consumption, and strong liking for beverages high in energy (e.g. sugar-sweetened beverages [SSBs]) and dislike for beverages low in energy (e.g. non-nutritive sweetened beverages [NNSBs]) are potentially modifiable risk factors contributing to variation in intake. Twin studies have established that both genes and environment play important roles in shaping food preferences; but the aetiology of variation in non-alcoholic beverage preferences is unknown. 2865 adolescent twins (18-19-years old) from the Twins Early Development Study were used to quantify genetic and environmental influence on variation in liking for seven non-alcoholic beverages: SSBs; NNSBs; fruit cordials, orange juice, milk, coffee, and tea. Maximum Likelihood Structural Equation Modelling established that beverage preferences have a moderate to low genetic basis; from 18% (95% CI: 10%, 25%) for orange juice to 42% (36%, 43%) for fruit cordials. Aspects of the environment that are not shared by twin pairs explained all remaining variance in drink preferences. The sizeable unique environmental influence on beverage preferences highlights the potential for environmental modification. Policies and guidelines to change preferences for unhealthy beverages may therefore be best directed at the wider environment.
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Affiliation(s)
- Andrea D Smith
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Alison Fildes
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- School of Psychology, University of Leeds, Leeds, United Kingdom
| | - Suzanna Forwood
- Department of Psychology, Anglia Ruskin University, Cambridge, United Kingdom
| | - Lucy Cooke
- Department of Behavioural Science and Health, University College London, London, United Kingdom
- Great Ormond Street Hospital, Children NHS Foundation Trust, London, United Kingdom
| | - Clare Llewellyn
- Department of Behavioural Science and Health, University College London, London, United Kingdom.
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Rashid A, Gorissen KJ, Ris F, Gosselink MP, Shorthouse JR, Smith AD, Pandit JJ, Lindsey I, Crabtree NA. No benefit of ultrasound-guided transversus abdominis plane blocks over wound infiltration with local anaesthetic in elective laparoscopic colonic surgery: results of a double-blind randomized controlled trial. Colorectal Dis 2017; 19:681-689. [PMID: 27943522 DOI: 10.1111/codi.13578] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Accepted: 09/12/2016] [Indexed: 02/08/2023]
Abstract
AIM Advances in laparoscopic techniques combined with enhanced recovery pathways have led to faster recuperation and discharge after colorectal surgery. Peripheral nerve blockade using transversus abdominis plane (TAP) blocks reduce opioid requirements and provide better analgesia for laparoscopic colectomies than do inactive controls. This double-blind randomized study was performed to compare TAP blocks using bupivacaine with standardized wound infiltration with local anaesthetic (LA). METHOD Seventy-one patients were randomized to receive either TAP block or wound infiltration. The TAP blocks were performed by experienced anaesthetists who used ultrasound guidance to deliver 40 ml of 0.25% bupivacaine post-induction into the transverse abdominis plane. In the control group, 40 ml of 0.25% bupivacaine was injected around the trocar and the extraction site by the surgeon. Both groups received patient-controlled analgesia (PCA) with intravenous morphine. Patients and nursing staff assessed pain scores 6, 12, 24 and 48 h after surgery. The primary outcome was overall morphine use in the first 48 h. RESULTS Of the 71 patients, 20 underwent a right hemicolectomy and 51 a high anterior resection. The modified intention-to-treat analysis showed no significant differences in overall morphine use [47.3 (36.2-58.5) mg vs 46.7 (36.2-57.3) mg; mean (95% CI), P = 0.8663] in the first 48 h. Pain scores were similar at 6, 12, 24 and 48 h. No differences were found regarding time to mobilization, resumption of diet and length of hospital stay. CONCLUSION In elective laparoscopic colectomies, standardized wound infiltration with LA has the same analgesic effect as TAP blocks post-induction using bupivacaine at 48 h.
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Affiliation(s)
- A Rashid
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - K J Gorissen
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - F Ris
- Service of Visceral Surgery, Geneva University Hospitals, Geneva, Switzerland
| | - M P Gosselink
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - J R Shorthouse
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - A D Smith
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - J J Pandit
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - I Lindsey
- Department of Colorectal Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - N A Crabtree
- Nuffield Department of Anaesthetics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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Horke DA, Watts HM, Smith AD, Jager E, Springate E, Alexander O, Cacho C, Chapman RT, Minns RS. Publisher's Note: Hydrogen Bonds in Excited State Proton Transfer [Phys. Rev. Lett. 117, 163002 (2016)]. Phys Rev Lett 2017; 118:139902. [PMID: 28409949 DOI: 10.1103/physrevlett.118.139902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Indexed: 06/07/2023]
Abstract
This corrects the article DOI: 10.1103/PhysRevLett.117.163002.
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Smith AD, Herle M, Fildes A, Cooke L, Steinsbekk S, Llewellyn CH. Food fussiness and food neophobia share a common etiology in early childhood. J Child Psychol Psychiatry 2017; 58:189-196. [PMID: 27739065 PMCID: PMC5298015 DOI: 10.1111/jcpp.12647] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/15/2016] [Indexed: 11/30/2022]
Abstract
BACKGROUND 'Food fussiness' (FF) is the tendency to be highly selective about which foods one is willing to eat, and emerges in early childhood; 'food neophobia' (FN) is a closely related characteristic but specifically refers to rejection of unfamiliar food. These behaviors are associated, but the extent to which their etiological architecture overlaps is unknown. The objective of this study was to quantify the relative contribution of genetic and environmental influences to variation in FF and FN in early childhood; and to establish the extent to which they share common genetic and environmental influences. METHOD Participants were 1,921 families with 16-month-old twins from the Gemini birth cohort. Parents completed the Child Eating Behaviour Questionnaire which included three FF items and four FN items. Bivariate quantitative genetic modeling was used to quantify: (a) genetic and environmental contributions to variation in FF and FN; and (b) the extent to which genetic or environmental influences on FF and FN are shared across the traits. RESULTS Food fussiness and FN were strongly correlated (r = .72, p < .001). Proportions of variation in FF were equally explained by genetic (.46; 95% CI: 0.41-0.52) and shared environmental influences (.46; 95% CI: 0.41-0.51). Shared environmental effects accounted for a significantly lower proportion of variation in FN (.22; 95% CI: 0.14-0.30), but genetic influences were not significantly different from those on FF (.58, 95% CI: 0.50-0.67). FF and FN largely shared a common etiology, indicated by high genetic (.73; 95% CI: 0.67-0.78) and shared environmental correlations (.78; 95% CI: 0.69-0.86) across the two traits. CONCLUSIONS Food fussiness and FN both show considerable heritability at 16 months but shared environmental factors, for example the home environment, influenced more interindividual differences in the expression of FF than in FN. FF and FN largely share a common etiology.
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Affiliation(s)
- Andrea D. Smith
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
| | - Moritz Herle
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
| | - Alison Fildes
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
| | - Lucy Cooke
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
| | - Silje Steinsbekk
- Department of PsychologyNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Clare H. Llewellyn
- Department of Epidemiology and Public HealthHealth Behaviour Research CentreUniversity College LondonLondonUK
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Smith AD, Crippa A, Woodcock J, Brage S. Physical activity and incident type 2 diabetes mellitus: a systematic review and dose-response meta-analysis of prospective cohort studies. Diabetologia 2016; 59:2527-2545. [PMID: 27747395 PMCID: PMC6207340 DOI: 10.1007/s00125-016-4079-0] [Citation(s) in RCA: 212] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 07/28/2016] [Indexed: 12/21/2022]
Abstract
AIMS/HYPOTHESIS Inverse associations between physical activity (PA) and type 2 diabetes mellitus are well known. However, the shape of the dose-response relationship is still uncertain. This review synthesises results from longitudinal studies in general populations and uses non-linear models of the association between PA and incident type 2 diabetes. METHODS A systematic literature search identified 28 prospective studies on leisure-time PA (LTPA) or total PA and risk of type 2 diabetes. PA exposures were converted into metabolic equivalent of task (MET) h/week and marginal MET (MMET) h/week, a measure only considering energy expended above resting metabolic rate. Restricted cubic splines were used to model the exposure-disease relationship. RESULTS Our results suggest an overall non-linear relationship; using the cubic spline model we found a risk reduction of 26% (95% CI 20%, 31%) for type 2 diabetes among those who achieved 11.25 MET h/week (equivalent to 150 min/week of moderate activity) relative to inactive individuals. Achieving twice this amount of PA was associated with a risk reduction of 36% (95% CI 27%, 46%), with further reductions at higher doses (60 MET h/week, risk reduction of 53%). Results for the MMET h/week dose-response curve were similar for moderate intensity PA, but benefits were greater for higher intensity PA and smaller for lower intensity activity. CONCLUSIONS/INTERPRETATION Higher levels of LTPA were associated with substantially lower incidence of type 2 diabetes in the general population. The relationship between LTPA and type 2 diabetes was curvilinear; the greatest relative benefits are achieved at low levels of activity, but additional benefits can be realised at exposures considerably higher than those prescribed by public health recommendations.
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Affiliation(s)
- Andrea D Smith
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
- Institute of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
| | - Alessio Crippa
- Institute of Environmental Medicine, Karolinska Institutet, Solna, Sweden
| | - James Woodcock
- UKCRC Centre for Diet and Activity Research (CEDAR), University of Cambridge, Institute of Metabolic Science, Cambridge, UK
| | - Søren Brage
- MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Cambridge, UK
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Horke DA, Watts HM, Smith AD, Jager E, Springate E, Alexander O, Cacho C, Chapman RT, Minns RS. Hydrogen Bonds in Excited State Proton Transfer. Phys Rev Lett 2016; 117:163002. [PMID: 27792360 DOI: 10.1103/physrevlett.117.163002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Indexed: 06/06/2023]
Abstract
Hydrogen bonding interactions between biological chromophores and their surrounding protein and solvent environment significantly affect the photochemical pathways of the chromophore and its biological function. A common first step in the dynamics of these systems is excited state proton transfer between the noncovalently bound molecules, which stabilizes the system against dissociation and principally alters relaxation pathways. Despite such fundamental importance, studying excited state proton transfer across a hydrogen bond has proven difficult, leaving uncertainties about the mechanism. Through time-resolved photoelectron imaging measurements, we demonstrate how the addition of a single hydrogen bond and the opening of an excited state proton transfer channel dramatically changes the outcome of a photochemical reaction, from rapid dissociation in the isolated chromophore to efficient stabilization and ground state recovery in the hydrogen bonded case, and uncover the mechanism of excited state proton transfer at a hydrogen bond, which follows sequential hydrogen and charge transfer processes.
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Affiliation(s)
- D A Horke
- Center for Free-Electron Laser Science, DESY, Notkestrasse 85, 22607 Hamburg, Germany
| | - H M Watts
- Chemistry, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
| | - A D Smith
- Chemistry, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
| | - E Jager
- Chemistry, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
| | - E Springate
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - O Alexander
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - C Cacho
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - R T Chapman
- Central Laser Facility, STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - R S Minns
- Chemistry, University of Southampton, Highfield, Southampton SO17 1BJ, United Kingdom
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Patel D, Lunn AD, Smith AD, Lehmann DJ, Dorrington KL. Cognitive decline in the elderly after surgery and anaesthesia: results from the Oxford Project to Investigate Memory and Ageing (OPTIMA) cohort. Anaesthesia 2016; 71:1144-52. [PMID: 27501155 PMCID: PMC5213281 DOI: 10.1111/anae.13571] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 11/30/2022]
Abstract
Concerns have been raised about the effects on cognition of anaesthesia for surgery, especially in elderly people. We recorded cognitive decline in a cohort of 394 people (198 women) with median (IQR) age at recruitment of 72.6 (66.6–77.8) years, of whom 109 had moderate or major surgery during a median (IQR) follow‐up of 4.1 (2.0–7.6) years. Cognitive decline was more rapid in people who on recruitment were: older, p = 0.0003; male, p = 0.027; had worse cognition, p < 0.0001; or carried the ε4 allele of apoliprotein E (APOEε4), p = 0.008; and after an operation if cognitive impairment was already diagnosed, p = 0.0001. Cognitive decline appears to accelerate after surgery in elderly patients diagnosed with cognitive impairment, but not other elderly patients. ☛ CPD available at http://www.learnataagbi.org
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Affiliation(s)
- D Patel
- Northwick Park Hospital, Harrow, UK
| | - A D Lunn
- Department of Statistics, University of Oxford, Oxford, UK
| | - A D Smith
- Oxford Project to Investigate Memory and Ageing, Department of Pharmacology, University of Oxford, Oxford, UK
| | - D J Lehmann
- Oxford Project to Investigate Memory and Ageing, Department of Pharmacology, University of Oxford, Oxford, UK
| | - K L Dorrington
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK. .,Nuffield Department of Anaesthetics, John Radcliffe Hospital, Oxford, UK.
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Smith AD, Fildes A, Cooke L, Herle M, Shakeshaft N, Plomin R, Llewellyn C. Genetic and environmental influences on food preferences in adolescence. Am J Clin Nutr 2016; 104:446-53. [PMID: 27385609 PMCID: PMC4962164 DOI: 10.3945/ajcn.116.133983] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 05/31/2016] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Food preferences vary substantially among adults and children. Twin studies have established that genes and aspects of the shared family environment both play important roles in shaping children's food preferences. The transition from childhood to adulthood is characterized by large gains in independence, but the relative influences of genes and the environment on food preferences in late adolescence are unknown. OBJECTIVE The aim of this study was to quantify the contribution of genetic and environmental influences on food preferences in older adolescents. DESIGN Participants were 2865 twins aged 18-19 y from the TEDS (Twins Early Development Study), a large population-based cohort of British twins born during 1994-1996. Food preferences were measured by using a self-report questionnaire of 62 individual foods. Food items were categorized into 6 food groups (fruit, vegetables, meat or fish, dairy, starch foods, and snacks) by using factor analysis. Maximum likelihood structural equation modeling established genetic and environmental contributions to variations in preferences for each food group. RESULTS Genetic factors influenced a significant and substantial proportion of the variation in preference scores of all 6 food groups: vegetables (0.54; 95% CI: 0.47, 0.59), fruit (0.49; 95% CI: 0.43, 0.55), starchy foods (0.32; 95% CI: 0.24, 0.39), meat or fish (0.44; 95% CI: 0.38, 0.51), dairy (0.44; 95% CI: 0.37, 0.50), and snacks (0.43; 95% CI: 0.36, 0.49). Aspects of the environment that are not shared by 2 twins in a family explained all of the remaining variance in food preferences. CONCLUSIONS Food preferences had a moderate genetic basis in late adolescence, in keeping with findings in children. However, by this older age, the influence of the shared family environment had disappeared, and only aspects of the environment unique to each individual twin influenced food preferences. This finding suggests that shared environmental experiences that influence food preferences in childhood may not have effects that persist into adulthood.
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Affiliation(s)
- Andrea D Smith
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Alison Fildes
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Lucy Cooke
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom; Great Ormond Street Hospital, Children's NHS Foundation Trust, London, United Kingdom; and
| | - Moritz Herle
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Nicholas Shakeshaft
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Robert Plomin
- Medical Research Council Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom
| | - Clare Llewellyn
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, United Kingdom;
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Keeley J, Jarvis P, Smith AD, Judd SJ. Coagulant recovery and reuse for drinking water treatment. Water Res 2016; 88:502-509. [PMID: 26521220 DOI: 10.1016/j.watres.2015.10.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/13/2015] [Accepted: 10/18/2015] [Indexed: 06/05/2023]
Abstract
Coagulant recovery and reuse from waterworks sludge has the potential to significantly reduce waste disposal and chemicals usage for water treatment. Drinking water regulations demand purification of recovered coagulant before they can be safely reused, due to the risk of disinfection by-product precursors being recovered from waterworks sludge alongside coagulant metals. While several full-scale separation technologies have proven effective for coagulant purification, none have matched virgin coagulant treatment performance. This study examines the individual and successive separation performance of several novel and existing ferric coagulant recovery purification technologies to attain virgin coagulant purity levels. The new suggested approach of alkali extraction of dissolved organic compounds (DOC) from waterworks sludge prior to acidic solubilisation of ferric coagulants provided the same 14:1 selectivity ratio (874 mg/L Fe vs. 61 mg/L DOC) to the more established size separation using ultrafiltration (1285 mg/L Fe vs. 91 mg/L DOC). Cation exchange Donnan membranes were also examined: while highly selective (2555 mg/L Fe vs. 29 mg/L DOC, 88:1 selectivity), the low pH of the recovered ferric solution impaired subsequent treatment performance. The application of powdered activated carbon (PAC) to ultrafiltration or alkali pre-treated sludge, dosed at 80 mg/mg DOC, reduced recovered ferric DOC contamination to <1 mg/L but in practice, this option would incur significant costs. The treatment performance of the purified recovered coagulants was compared to that of virgin reagent with reference to key water quality parameters. Several PAC-polished recovered coagulants provided the same or improved DOC and turbidity removal as virgin coagulant, as well as demonstrating the potential to reduce disinfection byproducts and regulated metals to levels comparable to that attained from virgin material.
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Affiliation(s)
- James Keeley
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK; Yorkshire Water Services Limited, Western House, Halifax Road, Bradford BD6 2SZ, UK
| | - Peter Jarvis
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK
| | - Andrea D Smith
- Severn Trent Water LTD., Severn Trent Centre, PO Box 5309, Coventry CV3 9FH, UK
| | - Simon J Judd
- Cranfield Water Science Institute, Cranfield University, Bedfordshire MK43 0AL, UK; Department of Chemical Engineering, Qatar University, Doha, Qatar.
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Keeley J, Smith AD, Judd SJ, Jarvis P. Acidified and ultrafiltered recovered coagulants from water treatment works sludge for removal of phosphorus from wastewater. Water Res 2016; 88:380-388. [PMID: 26517789 DOI: 10.1016/j.watres.2015.10.039] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/09/2015] [Accepted: 10/18/2015] [Indexed: 06/05/2023]
Abstract
This study used a range of treated water treatment works sludge options for the removal of phosphorus (P) from primary wastewater. These options included the application of ultrafiltration for recovery of the coagulant from the sludge. The treatment performance and whole life cost (WLC) of the various recovered coagulant (RC) configurations have been considered in relation to fresh ferric sulphate (FFS). Pre-treatment of the sludge with acid followed by removal of organic and particulate contaminants using a 2kD ultrafiltration membrane resulted in a reusable coagulant that closely matched the performance FFS. Unacidified RC showed 53% of the phosphorus removal efficiency of FFS, at a dose of 20 mg/L as Fe and a contact time of 90 min. A longer contact time of 8 h improved performance to 85% of FFS. P removal at the shorter contact time improved to 88% relative to FFS by pre-acidifying the sludge to pH 2, using an acid molar ratio of 5.2:1 mol H(+):Fe. Analysis of the removal of P showed that rapid phosphate precipitation accounted for >65% of removal with FFS. However, for the acidified RC a slower adsorption mechanism dominated; this was accelerated at a lower pH. A cost-benefit analysis showed that relative to dosing FFS and disposing waterworks sludge to land, the 20 year WLC was halved by transporting acidified or unacidified sludge up to 80 km for reuse in wastewater treatment. A maximum inter-site distance was determined to be 240 km above the current disposal route at current prices. Further savings could be made if longer contact times were available to allow greater P removal with unacidified RC.
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Affiliation(s)
- James Keeley
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - Andrea D Smith
- Severn Trent Water LTD., Severn Trent Centre, PO Box 5309, Coventry CV3 9FH, UK
| | - Simon J Judd
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, MK43 0AL, UK
| | - Peter Jarvis
- Cranfield Water Science Institute, Cranfield University, Bedfordshire, MK43 0AL, UK.
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Vaziri S, Belete M, Dentoni Litta E, Smith AD, Lupina G, Lemme MC, Östling M. Bilayer insulator tunnel barriers for graphene-based vertical hot-electron transistors. Nanoscale 2015; 7:13096-13104. [PMID: 26176739 DOI: 10.1039/c5nr03002a] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Vertical graphene-based device concepts that rely on quantum mechanical tunneling are intensely being discussed in the literature for applications in electronics and optoelectronics. In this work, the carrier transport mechanisms in semiconductor-insulator-graphene (SIG) capacitors are investigated with respect to their suitability as electron emitters in vertical graphene base transistors (GBTs). Several dielectric materials as tunnel barriers are compared, including dielectric double layers. Using bilayer dielectrics, we experimentally demonstrate significant improvements in the electron injection current by promoting Fowler-Nordheim tunneling (FNT) and step tunneling (ST) while suppressing defect mediated carrier transport. High injected tunneling current densities approaching 10(3) A cm(-2) (limited by series resistance), and excellent current-voltage nonlinearity and asymmetry are achieved using a 1 nm thick high quality dielectric, thulium silicate (TmSiO), as the first insulator layer, and titanium dioxide (TiO2) as a high electron affinity second layer insulator. We also confirm the feasibility and effectiveness of our approach in a full GBT structure which shows dramatic improvement in the collector on-state current density with respect to the previously reported GBTs. The device design and the fabrication scheme have been selected with future CMOS process compatibility in mind. This work proposes a bilayer tunnel barrier approach as a promising candidate to be used in high performance vertical graphene-based tunneling devices.
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Affiliation(s)
- S Vaziri
- KTH Royal Institute of Technology, School of Information and Communication Technology, Isafjordsgatan 22, 16440 Kista, Sweden.
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Bower WR, Smith AD, Pattrick RAD, Pimblott SM. Note: Establishing α-particle radiation damage experiments using the Dalton Cumbrian Facility's 5 MV tandem pelletron. Rev Sci Instrum 2015; 86:046105. [PMID: 25933903 DOI: 10.1063/1.4917348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Evaluating the radiation stability of mineral phases is a vital research challenge when assessing the performance of the materials employed in a Geological Disposal Facility for radioactive waste. This report outlines the setup and methodology for efficiently allowing the determination of the dose dependence of damage to a mineral from a single ion irradiated sample. The technique has been deployed using the Dalton Cumbrian Facility's 5 MV tandem pelletron to irradiate a suite of minerals with a controlled α-particle ((4)He(2+)) beam. Such minerals are proxies for near-field clay based buffer material surrounding radioactive canisters, as well as the sorbent components of the host rock.
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Affiliation(s)
- W R Bower
- Research Centre for Radwaste Disposal, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - A D Smith
- Dalton Cumbrian Facility, Westlakes Science and Technology Park, University of Manchester, Cumbria CA24 3HA, United Kingdom
| | - R A D Pattrick
- Research Centre for Radwaste Disposal, University of Manchester, Oxford Road, Manchester M13 9PL, United Kingdom
| | - S M Pimblott
- Dalton Cumbrian Facility, Westlakes Science and Technology Park, University of Manchester, Cumbria CA24 3HA, United Kingdom
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Mahadwar G, Chauhan KR, Bhagavathy GV, Murphy C, Smith AD, Bhagwat AA. Swarm motility of Salmonella enterica serovar Typhimurium is inhibited by compounds from fruit peel extracts. Lett Appl Microbiol 2015; 60:334-40. [PMID: 25422036 DOI: 10.1111/lam.12364] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/28/2014] [Accepted: 11/17/2014] [Indexed: 01/02/2023]
Abstract
UNLABELLED Controlling spread of human pathogens on fresh produce is a top priority for public health reasons. Isolation of compounds from agricultural waste that would control spread of human pathogens was explored using Salmonella enterica serovar Typhimurium as a model organism. In the environment, micro-organisms migrate as a 'community' especially when they move on moist surfaces. This type of motility is characterized as swarming motility. We examined extracts from agricultural waste such as soya bean husk, peels of orange, pineapple, avocado and pomegranate for antiswarming activity. Avocado and pineapple peels showed moderate (~40%) inhibition of swarming motility while pomegranate peel extract had high antiswarming activity (~85% inhibition) and was examined in further detail. Although the pomegranate peel extract was acidic, swarm-inhibitory activity was not due to low pH and the peel extract did not inhibit growth of Salmonella. Among the key swarm motility regulatory genes, class II (fliF, fliA, fliT and fliZ) and class III (fliC and fliM) regulators were downregulated upon exposure to pomegranate peel extract. Pomegranate peels offer great potential as a bioactive repellent for pathogenic micro-organisms on moist surfaces. SIGNIFICANCE AND IMPACT OF THE STUDY Controlling the spread of food-borne pathogens in moist environments is an important microbial food safety issue. Isolation of compounds from agricultural waste (such as fruit peels) that would control spread of human pathogens was explored using Salmonella enterica serovar Typhimurium as a model organism. Pomegranate peels offer great potential as a bioactive repellent for pathogenic micro-organisms.
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Affiliation(s)
- G Mahadwar
- Environmental Microbial & Food Safety Laboratory, Henry A. Wallace Beltsville Agricultural Research Center, Agricultural Research Service, USDA, Beltsville, MD, USA
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Smith AD, Olson C, Lyons B, Tran D, Blackburn DF. Adherence to abiraterone among the first 86 recipients after release in Saskatchewan. ACTA ACUST UNITED AC 2015; 22:64-7. [PMID: 25684990 DOI: 10.3747/co.22.2219] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Metastatic castration-resistant prostate cancer is now commonly treated with abiraterone, an orally administered chronic medication. Although abiraterone has certain advantages over docetaxel-based therapy, patients are now responsible for ensuring optimal adherence to their medication. To our knowledge, adherence to abiraterone in a real-world setting has never been described. The objective of the present study was to measure adherence to abiraterone among the first patients to receive the drug in Saskatchewan. Electronic pharmacy claims were obtained from the Saskatchewan Cancer Agency after removal of patient names and identifiers. All patients with at least 1 dispensation for abiraterone between August 2011 and October 2013 were eligible. The primary endpoint was the percentage of patients achieving optimal adherence at 6 months, defined as a medication possession ratio (mpr) of 80% or better. During the study period, 141 patients received abiraterone, among whom 86 could be followed for at least 6 months. Optimal adherence was achieved in 82.6% of patients (71 of 86) at 6 months, with 79.1% achieving a mpr of at least 90%. Of patients with available follow-up to 1 year, 81.6% (31 of 38) maintained optimal adherence during the entire period.
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Affiliation(s)
- A D Smith
- The Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON
| | - C Olson
- Saskatoon Cancer Centre, Saskatoon, SK
| | - B Lyons
- Saskatoon Cancer Centre, Saskatoon, SK
| | - D Tran
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
| | - D F Blackburn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
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Keeley J, Smith AD, Judd SJ, Jarvis P. Reuse of recovered coagulants in water treatment: An investigation on the effect coagulant purity has on treatment performance. Sep Purif Technol 2014. [DOI: 10.1016/j.seppur.2014.04.033] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Smith AD, Niklaus F, Paussa A, Vaziri S, Fischer AC, Sterner M, Forsberg F, Delin A, Esseni D, Palestri P, Östling M, Lemme MC. Electromechanical piezoresistive sensing in suspended graphene membranes. Nano Lett 2013; 13:3237-42. [PMID: 23786215 DOI: 10.1021/nl401352k] [Citation(s) in RCA: 132] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Monolayer graphene exhibits exceptional electronic and mechanical properties, making it a very promising material for nanoelectromechanical devices. Here, we conclusively demonstrate the piezoresistive effect in graphene in a nanoelectromechanical membrane configuration that provides direct electrical readout of pressure to strain transduction. This makes it highly relevant for an important class of nanoelectromechanical system (NEMS) transducers. This demonstration is consistent with our simulations and previously reported gauge factors and simulation values. The membrane in our experiment acts as a strain gauge independent of crystallographic orientation and allows for aggressive size scalability. When compared with conventional pressure sensors, the sensors have orders of magnitude higher sensitivity per unit area.
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Affiliation(s)
- A D Smith
- KTH Royal Institute of Technology , Isafjordsgatan 22, 16440 Kista, Sweden
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Hubach RD, Dodge B, Zimet G, Davis A, Smith AD, Pol BVD. P4.017 Bacterial STD Rates and Preferred Methods of STD Service Delivery Among a Sample of Underserved Midwestern Men. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pol BVD, Davis A, Smith AD, Williams JA, Zimet G. P3.074 Men’s Preferences For STD Screening Programs: Initial Prevalence of STD in the Study Population. Br J Vener Dis 2013. [DOI: 10.1136/sextrans-2013-051184.0534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Dent AJ, Cibin G, Ramos S, Parry SA, Gianolio D, Smith AD, Scott SM, Varandas L, Patel S, Pearson MR, Hudson L, Krumpa NA, Marsch AS, Robbins PE. Performance of B18, the Core EXAFS Bending Magnet beamline at Diamond. ACTA ACUST UNITED AC 2013. [DOI: 10.1088/1742-6596/430/1/012023] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Elshorbagy AK, Valdivia-Garcia M, Graham IM, Palma Reis R, Sales Luis A, Smith AD, Refsum H. The association of fasting plasma sulfur-containing compounds with BMI, serum lipids and apolipoproteins. Nutr Metab Cardiovasc Dis 2012; 22:1031-1038. [PMID: 21550220 DOI: 10.1016/j.numecd.2011.01.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Revised: 11/27/2010] [Accepted: 01/04/2011] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM Sulfur amino acids are recognized as potent modulators of lipid metabolism. Plasma total cysteine (tCys) is associated with fat mass, obesity and serum LDL-cholesterol and apolipoprotein (Apo)-B in large population studies. It is not known how fasting plasma concentrations of cysteine precursors and products relate to these associations in humans, given that sulfur-containing compounds (SCC) influence rodent weight gain and serum lipids. METHODS AND RESULTS We investigated the cross-sectional associations of fasting plasma SCC (methionine, total homocysteine, cystathionine, tCys, taurine and total glutathione) with BMI and fasting serum lipids and apolipoproteins in 854 men and women with and without cardiovascular disease (CVD). In multiple linear regression analysis adjusted for age, gender, CVD and other SCC, neither methionine, taurine, nor total glutathione was associated with BMI. Plasma taurine was, however, inversely related to HDL-cholesterol (partial r = -0.12, p = 0.004) and its associated apoA1 (partial r = -0.18, p < 0.001). Plasma cystathionine correlated positively with triglycerides and BMI, while tCys positively correlated with total cholesterol, LDL-cholesterol (partial r = 0.20, p < 0.001) and its associated apoB. The associations of SCC with serum lipids were independent of BMI. tCys was also independently associated with BMI (partial r = 0.20, p < 0.001) after adjustment for other SCC, glucose, lipids and apolipoproteins. CONCLUSIONS Fasting tCys is associated with BMI independently of metabolically related SCC. Elevation of plasma SCC is generally associated with an unfavorable lipid profile. The negative relations of plasma taurine with HDL-C and apoA1 deserve further investigation.
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Watson RS, Broome TA, Levings PP, Rice BL, Kay JD, Smith AD, Gouze E, Gouze JN, Dacanay EA, Hauswirth WW, Nickerson DM, Dark MJ, Colahan PT, Ghivizzani SC. scAAV-mediated gene transfer of interleukin-1-receptor antagonist to synovium and articular cartilage in large mammalian joints. Gene Ther 2012; 20:670-7. [PMID: 23151520 PMCID: PMC3577988 DOI: 10.1038/gt.2012.81] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
With the long-term goal of developing a gene-based treatment for osteoarthritis (OA), we performed studies to evaluate the equine joint as a model for adeno-associated virus (AAV)-mediated gene transfer to large, weight-bearing human joints. A self-complementary AAV2 vector containing the coding regions for human interleukin-1-receptor antagonist (hIL-1Ra) or green fluorescent protein was packaged in AAV capsid serotypes 1, 2, 5, 8 and 9. Following infection of human and equine synovial fibroblasts in culture, we found that both were only receptive to transduction with AAV1, 2 and 5. For these serotypes, however, transgene expression from the equine cells was consistently at least 10-fold higher. Analyses of AAV surface receptor molecules and intracellular trafficking of vector genomes implicate enhanced viral uptake by the equine cells. Following delivery of 1 × 10(11) vector genomes of serotypes 2, 5 and 8 into the forelimb joints of the horse, all three enabled hIL-1Ra expression at biologically relevant levels and effectively transduced the same cell types, primarily synovial fibroblasts and, to a lesser degree, chondrocytes in articular cartilage. These results provide optimism that AAV vectors can be effectively adapted for gene delivery to large human joints affected by OA.
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Affiliation(s)
- R S Watson
- Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL 32608-0137, USA
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