Reducing the Intake of Sodium in Community Settings: Evaluation of Year One Activities in the Sodium Reduction in Communities Program, Arkansas, 2016-2017.

PURPOSE AND OBJECTIVES: The Centers for Disease Control and Prevention's Sodium Reduction in Communities Program (SRCP) aims to reduce dietary sodium intake through policy, systems, and environmental approaches. The objective of this study was to evaluate and document the progress of the first year of a 5-year SRCP project in northwest Arkansas. INTERVENTION APPROACH: In collaboration with 30 partner schools and 5 partner community meals programs, we sought to reduce dietary sodium intake through increased implementation of 1) food service guidelines, 2) procurement practices, 3) food preparation practices, and 4) environmental strategies. EVALUATION METHODS: We collected daily menus, information on nutritional content of meals, and procurement records and counted the number of people served in partnering schools and community meals programs. We used a pretest-posttest quantitative evaluation design to analyze changes in the sodium content of meals from baseline to Year 1 follow-up. RESULTS: From baseline to Year 1 follow-up, participating schools lowered the mean sodium content served per lunch diner from 1,103 mg to 980 mg (-11.2%). The schools also reduced the mean sodium content of entrées offered (ie, entrées listed on the menu) from 674 mg to 625 mg (-7.3%) and entrées served from 615 mg to 589 mg (-4.2%). From baseline to follow-up, participating community meals programs reduced the mean sodium content of meals offered (ie, meals listed on the menu) from 1,710 mg to 1,053 mg (-38.4%). The community meals programs reduced the mean sodium content of meals served from 1,509 mg to 1,258 mg (-16.6%). IMPLICATIONS FOR PUBLIC HEALTH: In both venues, our evaluation findings showed reductions in sodium served during the 1-year evaluation period. These results highlight the potential effectiveness of sodium reduction interventions focused on food service guidelines, procurement practices, food preparation practices, and environmental strategies for schools and community meals programs.

Action Identity in Style Simulation Systems: Do Players Consider Machine-Generated Music As of Their Own Style?

The generation of musical material in a given style has been the subject of many studies with the increased sophistication of artificial intelligence models of musical style. In this paper we address a question of primary importance for artificial intelligence and music psychology: can such systems generate music that users indeed consider as corresponding to their own style? We address this question through an experiment involving both performance and recognition tasks with musically naïve school-age children. We asked 56 children to perform a free-form improvisation from which two kinds of music excerpt were created. One was a mere recording of original performances. The other was created by a software program designed to simulate the participants' style, based on their original performances. Two hours after the performance task, the children completed the recognition task in two conditions, one with the original excerpts and one with machine-generated music. Results indicate that the success rate is practically equivalent in two conditions: children tended to make correct attribution of the excerpts to themselves or to others, whether the music was human-produced or machine-generated (mean accuracy = 0.75 and = 0.71, respectively). We discuss this equivalence in accuracy for machine-generated and human produced music in the light of the literature on memory effects and action identity which addresses the recognition of one's own production.

Conservative management of midportion Achilles tendinopathy: a mixed methods study, integrating systematic review and clinical reasoning.

BACKGROUND: Clinicians manage midportion Achilles tendinopathy (AT) using complex clinical reasoning underpinned by a rapidly developing evidence base. OBJECTIVES: The objectives of the study were to develop an inclusive, accessible review of the literature in combination with an account of expert therapists' related clinical reasoning to guide clinical practice and future research. METHODS: Searches of the electronic databases, PubMed, ISI Web of Science, PEDro, CINAHL, EMBASE, and Google Scholar were conducted for all papers published from inception to November 2011. Reference lists and citing articles were searched for further relevant articles. Inclusion required studies to evaluate the effectiveness of any conservative intervention for midportion AT. Exclusion criteria included in vitro, animal and cadaver studies and tendinopathies in other locations (e.g. patella, supraspinatus). From a total of 3497 identified in the initial search, 47 studies fulfilled the inclusion criteria. Studies were scored according to the PEDro scale, with a score of ≥ 8/10 considered of excellent quality, 5-7/10 good, and ≤ 4/10 poor. The strength of evidence supporting each treatment modality was then rated as 'strong', 'moderate', 'limited', 'conflicting' or 'no evidence' according to the number and quality of articles supporting that modality. Additionally, semi-structured interviews were conducted with physiotherapists to explore clinical reasoning related to the use of various interventions with and without an evidence base, and their perceptions of available evidence. RESULTS: Evidence was strong for eccentric loading exercises and extracorporeal shockwave therapy; moderate for splinting/bracing, active rest, low-level laser therapy and concentric exercises (i.e. inferior to eccentric exercise). In-shoe foot orthoses and therapeutic ultrasound had limited evidence. There was conflicting evidence for topical glycerin trinitrate. Taping techniques and soft-tissue mobilization were not yet examined but featured in case studies and in the interview data. Framework analysis of interview transcripts yielded multiple themes relating to physiotherapists' clinical reasoning and perceptions of the evidence, including the difficulty in causing pain while treating the condition and the need to vary research protocols for specific client groups--such as those with the metabolic syndrome as a likely etiological factor. Physiotherapists were commonly applying the modality with the strongest evidence base, eccentric loading exercises. Barriers to research being translated into practice identified included the lack of consistency of outcome measures, excessive stringency of some authoritative reviews and difficulty in accessing primary research reports. The broad inclusion criteria meant some lower quality studies were included in this review. However, this was deliberate to ensure that all available research evidence for the management of midportion AT, and all studies were evaluated using the PEDro scale to compensate for the lack of stringent inclusion criteria. CONCLUSION: Graded evidence combined with qualitative analysis of clinical reasoning produced a novel and clinically applicable guide to conservative management of midportion AT. This guide will be useful to novice clinicians learning how to manage this treatment-resistant condition and to expert clinicians reviewing their evidence-based practice and developing their clinical reasoning. Important areas requiring future research were identified including the effectiveness of orthoses, the effectiveness of manual therapy, etiological factors, optimal application of loading related to stage of presentation and how to optimize protocols for different types of patients such as the older patient with the metabolic syndrome as opposed to the athletically active.