A Community Jury on initiating weight management conversations in primary care.

BACKGROUND: Current guidelines recommend that patients attending general practice should be screened for excess weight, and provided with weight management advice. OBJECTIVE: This study sought to elicit the views of people with overweight and obesity about the role of GPs in initiating conversations about weight management. METHODS: Participants with a body mass index ≥25 were recruited from a region in Australia to take part in a Community Jury. Over 2 days, participants (n = 11) deliberated on two interconnected questions: 'Should GPs initiate discussions about weight management?' And 'if so, when: (a) opportunistically, (b) in the context of disease prevention, (c) in the context of disease management or (d) other?' The jury deliberations were analysed qualitatively to elicit their views and recommendations. RESULTS: The jury concluded GPs should be discussing weight management, but within the broader context of general health. The jury were divided about the utility of screening. Jurors felt GPs should initiate the conversation if directly relevant for disease prevention or management, otherwise GPs should provide opportunities for patients to consent to the issue being raised. CONCLUSION: The jury's verdict suggests informed people affected by overweight and obesity believe GPs should discuss weight management with their patients. GPs should feel reassured that discussions are likely to be welcomed by patients, particularly if embedded within a more holistic focus on person-centred care. PUBLIC CONTRIBUTION: Members of the public took part in the conduct of this study as jurors, but were not involved in the design, analysis or write-up.

Facilitating personal development for public involvement in health-care education and research: A co-produced pilot study in one UK higher education institute.

BACKGROUND: Public involvement in the education of students enrolled on higher education programmes has gained impetus. For students enrolled on professional health-care programmes and health-related modules in the UK, there is also a requirement by professional bodies to include "service user" involvement in preparation for entry to a professional health-care register and continuing professional development. Actively involving patients and members of the public in research is also a requirement by many research funders. In this article, the term Patient and Public Involvement (PPI) will be used throughout to include lay members, volunteers, user and carers. OBJECTIVES: A unique pilot study was introduced across a health faculty to integrate PPI in a deliberate way. It aimed to provide an educational, focused programme of events that was meaningful to develop and inform peoples' knowledge, skills and confidence for their involvement in the health faculty. DESIGN: PPI members volunteered to sit on a steering group to determine the educational journey; the outcomes of three focus groups with PPI members (N = 32) and academics informed the programme content which included a range of workshops covering the exploration of public roles and barriers to involvement, introduction to research and interviewing skills. RESULTS: The workshops were well attended, and outcomes indicated the importance of co-production when designing, delivering and evaluating programmes. DISCUSSION: Co-production underpinned this pilot study, resulting in a programme which was meaningfully received by public contributors. RECOMMENDATIONS: Co-production was seen as integral to this research to ensure that outcomes were indeed "fit for purpose".

Fluoride content of powdered infant formula meets Australian Food Safety Standards.

OBJECTIVES: To identify the fluoride content of powdered formula for infants 0-12 months in products available from Brisbane stores in 2006/07 and compare this with the fluoride content of infant formula products available in Australia 10 years earlier. METHODS: A range of available infant formula powders were collected from major supermarkets and chemists in Brisbane, Queensland. The fluoride levels in infant formula powder samples were determined using a modification of the micro-diffusion method of Silva and Reynolds(1) utilising perchloric acid and silver sulphate and measured with an ion selective (fluoride) electrode/meter. Fluoride content both prior to and after reconstitution, as well as estimated daily intake according to age was calculated. RESULTS: Formula samples contained an average of 0.49 microg F/g of powder (range 0.24-0.92 microg F/g). After reconstitution with water containing 0 mg/L fluoride, the fluoride content averaged 7.09 microg F/100mL (range 3.367-22.72 microg F/100mL). Estimated infant fluoride intakes ranged from 0.0039 mg/kg/day for a 6-12 month old infant when reconstituting milk-based formula with non-fluoridated water (0 mg/L), to 0.1735 mg/kg/day for a 0-3 month old infant when reconstituting soy-based formula with fluoridated water (1.0 mg/L). CONCLUSIONS: Infant formula powders contain lower levels of fluoride than previously found in Australia in 1996. IMPLICATIONS: This confirms that infants consume only a small amount of fluoride from milk-based powdered infant formula. Although soy-based infant formulas contain more fluoride than milk-based products, the levels still comply with national food standards.