Are all ulvans equal? A comparative assessment of the chemical and gelling properties of ulvan from blade and filamentous Ulva.

Green seaweeds of the genus Ulva are rich in the bioactive sulfated polysaccharide ulvan. Herein we characterise ulvan from Ulva species collected from the Bay of Plenty, Aotearoa New Zealand. Using standardised procedures, we quantified, characterised, and compared ulvans from blade (U. australis, U. rigida, U. sp. B, and Ulva sp.) and filamentous (U. flexuosa, U. compressa, U. prolifera, and U. ralfsii) Ulva species. There were distinct differences in composition and structure of ulvans between morphologies. Ulvan isolated from blade species had higher yields (14.0-19.3 %) and iduronic acid content (IdoA = 7-18 mol%), and lower molecular weight (Mw = 190-254 kDa) and storage moduli (G' = 0.1-6.6 Pa) than filamentous species (yield = 7.2-14.6 %; IdoA = 4-7 mol%; Mw = 260-406 kDa; G' = 22.7-74.2 Pa). These results highlight the variability of the physicochemical properties of ulvan from different Ulva sources, and identifies a morphology-based division within the genus Ulva.

Is there a role for patients and their relatives in escalating clinical deterioration in hospital? A systematic review.

BACKGROUND: Measures exist to improve early recognition of, and response to, deteriorating patients in hospital. However, deteriorating patients continue to go unrecognized. To address this, interventions have been developed that invite patients and relatives to escalate patient deterioration to a rapid response team (RRT). OBJECTIVE: To systematically review articles that describe these interventions and investigate their effectiveness at reducing preventable deterioration. SEARCH STRATEGY: Following PRISMA guidelines, four electronic databases and two web search engines were searched to identify literature investigating patient and relative led escalation. INCLUSION CRITERIA: Articles investigating the implementation or use of systems involving patients and relatives in the detection of clinical patient deterioration and escalation of patient care to address any clinical or non-clinical outcomes were included. Articles' eligibility was validated by a second reviewer (20%). DATA EXTRACTION: Data were extracted according to pre-defined criteria. DATA SYNTHESIS: Narrative synthesis was applied to included studies. MAIN RESULTS: Nine empirical studies and 36 grey literature articles were included in the review. Limited studies were conducted to establish the clinical effectiveness of patient and relative led escalation. Instead, studies investigated the impact of this intervention on health-care staff and available resources. Although appropriate, this reflects the infancy of research in this area. Patients and relatives did not overwhelm resources by activating the RRT. However, they did activate it to address concerns unrelated to patient deterioration. CONCLUSIONS: Activating a RRT may not be the most appropriate or cost-effective method of resolving non-life-threatening concerns.

Testing a workplace physical activity intervention: a cluster randomized controlled trial.

BACKGROUND: Increased physical activity levels benefit both an individuals' health and productivity at work. The purpose of the current study was to explore the impact and cost-effectiveness of a workplace physical activity intervention designed to increase physical activity levels. METHODS: A total of 1260 participants from 44 UK worksites (based within 5 organizations) were recruited to a cluster randomized controlled trial with worksites randomly allocated to an intervention or control condition. Measurement of physical activity and other variables occurred at baseline, and at 0 months, 3 months and 9 months post-intervention. Health outcomes were measured during a 30 minute health check conducted in worksites at baseline and 9 months post intervention. The intervention consisted of a 3 month tool-kit of activities targeting components of the Theory of Planned Behavior, delivered in-house by nominated facilitators. Self-reported physical activity (measured using the IPAQ short-form) and health outcomes were assessed. RESULTS AND DISCUSSION: Multilevel modelling found no significant effect of the intervention on MET minutes of activity (from the IPAQ) at any of the follow-up time points controlling for baseline activity. However, the intervention did significantly reduce systolic blood pressure (B=-1.79 mm/Hg) and resting heart rate (B=-2.08 beats) and significantly increased body mass index (B=.18 units) compared to control. The intervention was found not to be cost-effective, however the substantial variability round this estimate suggested that further research is warranted. CONCLUSIONS: The current study found mixed support for this worksite physical activity intervention. The paper discusses some of the tensions involved in conducting rigorous evaluations of large-scale randomized controlled trials in real-world settings.

Promoting adherence to antibiotics: a test of implementation intentions.

OBJECTIVE: This prospective study tested whether implementation intentions increased adherence to short-term antibiotics in a patient sample. Implementation intentions specify exactly when and where an individual will undertake an activity. They may help people achieve health behaviours, such as taking medicines. METHODS: A total of 220 patients with an antibiotics prescription were randomly assigned to four groups (control, Theory of Planned Behaviour (TPB) questionnaire, TPB questionnaire+formed own implementation intention for taking the medicine, TPB questionnaire+researcher formed implementation intention). Participants were telephoned at the end of the course to record adherence. Two hundred and seven participants completed the study. RESULTS: At follow-up, adherence was high (75.8% reported no tablets left). Analysis revealed no significant difference in adherence between groups. CONCLUSION: High adherence to antibiotics was achieved, but not improved by implementation intentions. PRACTICE IMPLICATIONS: Providing information and telephone follow-up may have been the unintended effective intervention in this study.