Viewpoints of adolescents with overweight and obesity attending lifestyle obesity treatment interventions: a qualitative systematic review.

BACKGROUND: Current UK guidance recommends that adolescents with obesity attend a family-based multi-component obesity intervention. However, these programmes suffer from low recruitment and high rates of attrition. Understanding the views of adolescents is necessary for developing future interventions. The aim of this systematic review was to synthesize and explore the views of adolescents who have attended an obesity intervention. METHODS: Published literature was identified by searching six databases. Studies of adolescents (12-17 years) who attended an obesity intervention were examined. Only studies that collected and analysed data qualitatively were included. Full texts were analysed using thematic synthesis. RESULTS: Twenty-eight studies were included. Thirty-five analytical themes were developed that were broadly divided into seven domains. Key themes included ensuring adolescents receive a 'tailored intervention' that involves 'active engagement'. Support from professionals, family and peers were valued highly. Adolescents expressed 'prior fears of attending interventions' and wanted 'longer term support'. 'Enjoyment of sport and physical activity' was evident, and adolescents were strongly motivated by improving body image and social desirability. DISCUSSION: Considering the views of adolescents attending obesity interventions may help to inform policy makers in the development of future interventions. This may lead to an improvement in recruitment and attrition rates.

Text-message reminders increase uptake of routine breast screening appointments: a randomised controlled trial in a hard-to-reach population.

BACKGROUND: There is a need for interventions to promote uptake of breast screening throughout Europe. METHODS: We performed a single-blind randomised controlled trial to test whether text-message reminders were effective. Two thousand two hundred and forty women receiving their first breast screening invitation were included in the study and randomly assigned in a 1 : 1 ratio to receive either a normal invitation only (n=1118) or a normal invitation plus a text-message reminder 48 h before their appointment (n=1122). FINDINGS: In the intention-to-treat analysis, uptake of breast screening was 59.1% among women in the normal invitation group and 64.4% in the text-message reminder group (χ(2)=6.47, odds ratio (OR): 1.26, 95% confidence intervals (CI): 1.05-1.48, P=0.01). Of the 1122 women assigned to the text-message reminder group, only 456 (41%) had a mobile number recorded by their GP and were thereby sent a text. In the per-protocol analysis, uptake by those in the control group who had a mobile number recorded on the GP system was 59.77% and by those in the intervention group who were sent a reminder 71.7% (χ(2)=14.12, OR=1.71, 95% CI=1.29-2.26, P<0.01). INTERPRETATION: Sending women a text-message reminder before their first routine breast screening appointment significantly increased attendance. This information can be used to allocate resources efficiently to improve uptake without exacerbating social inequalities.

Use of data from the Health Survey for England in obesity policy making and monitoring.

Health data and statistics are the foundation of health policy. Over the last 20 years, numerous government documents have been commissioned and published to inform obesity strategies in the UK. The Health Survey for England, an annual cross-sectional survey of a nationally representative random general population sample in England, collects information on health, lifestyle and socioeconomic factors, physical measurements and biological samples. Heights and weights measured by the Health Survey for England are believed to have played a major part in promoting, shaping and evaluating obesity strategies. A formal review of how these data have been used has not been conducted previously. This paper reviews government documents demonstrating the contribution of Health Survey for England examination data to every stage of the policy making process: quantifying the obesity problem in England (e.g. Chief Medical Officer's reports); identifying inequalities in the burden of obesity (Acheson report); modelling potential future scenarios (Foresight); setting and monitoring specific, measurable, attainable targets (calorie reduction challenge in manufacturers' Responsibility Deal); developing and informing strategies and clinical guidance; and evaluating the success of obesity strategies (Healthy Weights, Healthy Lives progress report). Measurement data are needed and used by governments to produce evidence-based strategies to combat obesity.

Effects of different fractions of Calliandra portoricensis root bark on isolated rat liver mitochondrial membrane permeability transition pore.

BACKGROUND: Mitochondrial membrane permeability transition (MMPT) pore ha s emerged as a promisingtarget for various pharmacological interventions because of the consequent release of cytochrome c upon the opening of the pore which is the point of no return for apoptosis, a form of programed cell death that is down regulated in cancercells. AIM: To evaluate the modulatory effects of fractions (Chloroform fraction of calliandra portoricensis( CFCP), Aqueous fraction of calliandra portoricensis (AFCP), and Ethylacetate fraction of Calliandra portoricensis (EFCP) of methanol extracts of the root bark of Calliandra portoricensis (MECP), a medicinal plant used in the traditional treatment of prostate tumour, on mitochondrial membrane permeability transition (MMPT) pore. METHODOLOGY: Opening of the pore was assessed as mitochondrial swelling and was monitored spectrophotometrically as changes in absorbance at 540nm. RESULTS: Varying concentrations of MECP (10microg/ml, 20microg/ml, 40microg/ml, and 60microg/ml) induced opening of the pore, in the absence of calcium, by 1.1, 2.8, 4.5, 13.8 folds, respectively while spermine reversed this inductive effect. Interestingly, unlike MECP, EFCP and AFCP did not have any effect at lower concentrations (<40microg/ml) but induced pore opening at 60microg/ml, 80microg/ ml, 100microg/ml and 120microg/ml by 1.6, 3.1, 12.7, 16.7folds, respectively for EFCP and 1.4, 5.4, 7 and 10 folds respectively, for AFCP. In the presence ofcalcium, the pore was slightly further opened by MECP, EFCP andAFCP. The CFCP however did not have any significant effect on the pore either in the presence or absence of calcium. CONCLUSION: These findings suggest that the bioactive agents that induced the opening of the pore are present in the most potent ethylacetate fraction of the root bark of C. portoricensis. This fraction will therefore be useful for the structural elucidation of the bioactive principle in the plant and for further studies in diseases that require increased apoptosis such as cancer.

Differential protection of neuromuscular sensory and motor axons and their endings in Wld(S) mutant mice.

Orthograde Wallerian degeneration normally brings about fragmentation of peripheral nerve axons and their sensory or motor endings within 24-48 h in mice. However, neuronal expression of the chimaeric, Wld(S) gene mutation extends survival of functioning axons and their distal endings for up to 3 weeks after nerve section. Here we studied the pattern and rate of degeneration of sensory axons and their annulospiral endings in deep lumbrical muscles of Wld(S) mice, and compared these with motor axons and their terminals, using neurone-specific transgenic expression of the fluorescent proteins yellow fluorescent protein (YFP) or cyan fluorescent protein (CFP) as morphological reporters. Surprisingly, sensory endings were preserved for up to 20 days, at least twice as long as the most resilient motor nerve terminals. Protection of sensory endings and axons was also much less sensitive to Wld(S) gene-copy number or age than motor axons and their endings. Protection of γ-motor axons and their terminals innervating the juxtaequatorial and polar regions of the spindles was less than sensory axons but greater than α-motor axons. The differences between sensory and motor axon protection persisted in electrically silent, organotypic nerve-explant cultures suggesting that residual axonal activity does not contribute to the sensory-motor axon differences in vivo. Quantitative, Wld(S)-specific immunostaining of dorsal root ganglion (DRG) neurones and motor neurones in homozygous Wld(S) mice suggested that the nuclei of large DRG neurones contain about 2.4 times as much Wld(S) protein as motor neurones. By contrast, nuclear fluorescence of DRG neurones in homozygotes was only 1.5 times brighter than in heterozygotes stained under identical conditions. Thus, differences in axonal or synaptic protection within the same Wld(S) mouse may most simply be explained by differences in expression level of Wld(S) protein between neurones. Mimicry of Wld(S)-induced protection may also have applications in treatment of neurotoxicity or peripheral neuropathies in which the integrity of sensory endings may be especially implicated.