Passive interventions in primary healthcare waiting rooms are effective in promoting healthy lifestyle behaviours: an integrative review.

Primary healthcare waiting rooms have the potential to provide health-promoting environments to support healthy lifestyle behaviours such as smoking cessation, weight management and safe contraception. Passive interventions are cost-effective and continually available within an environment or setting, allowing individuals to interact, engage and learn about topics. The aim of this study was to undertake an integrative review to investigate the effectiveness of passive health-related waiting room interventions in improving healthy lifestyle behaviours, as well as precursors to behaviour change. The integrative review encompassed five phases: problem identification, literature search, data evaluation, data analysis and presentation of results. Quantitative, qualitative and mixed methods studies were included. Of the 9205 studies originally identified, 33 publications were included and grouped under four areas: knowledge about a health condition or behaviour, attitudes and intentions towards a health condition or behaviour, healthcare use and interactions, and health-related behaviours. Overall, the passive interventions had a general positive influence on knowledge, intentions, healthcare use and behaviours. Variable outcomes were reported regarding attitude towards a health topic. Few studies were assessed as both high quality and the highest suitability to assess effectiveness of interventions. Consideration of the clinical significance of improvements is warranted before implementation of future interventions. Overall, passive waiting room interventions appear to be effective in promoting healthy lifestyle behaviours.

Effect of nutrition care provided by primary health professionals on adults' dietary behaviours: a systematic review.

BACKGROUND: 'Nutrition care' refers to any practice conducted by a health professional to support a patient to improve their dietary behaviours. Better understanding about the effectiveness of nutrition care is required to identify ways to enhance success of future interventions. OBJECTIVE: Systematically review literature that investigated the effect of nutrition care provided by primary health professionals on adult patients' dietary behaviours. METHODS: The systematic review included all studies published between January 2000 and January 2015 that involved nutrition care by one or more primary health professionals to adult patients and incorporated at least one quantified food-related outcome measure (e.g. daily intake of vegetables in grams, weekly servings of lean meats). After data extraction, the methodological quality of each study was appraised using the Mixed Methods Appraisal Tool. RESULTS: Twenty-one studies, totalling 12497 participants were included. The design, intensity, theoretical underpinning and follow-up period of interventions were diverse. Twelve studies found significant improvements in participants' dietary behaviours, such as increased daily consumption of fruit, vegetables, high-fibre bread and fish. However, seven studies did not identify any improvement in dietary behaviours; one observed equal improvements among participants in the intervention and control groups and one found a reduction in participants' daily fruit and vegetable intake. CONCLUSION: Interventions involving nutrition care provided by primary health professionals have the potential to improve patients' dietary behaviours. However, the consistency and clinical significance of intervention outcomes are unclear. Further consideration of factors that may influence the effectiveness of interventions, but not traditionally measured, are required.

Australian practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease.

Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses' perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term 'basic' varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.

Histologic evaluation of mandibular and medial retropharyngeal lymph nodes during staging of oral malignant melanoma and squamous cell carcinoma in dogs.

OBJECTIVE: To assess histologic evaluation of mandibular lymph nodes (MLNs) and medial retropharyngeal lymph nodes (MRLNs) for metastatic disease during tumor staging for dogs with oral malignant melanoma (OMM) and oral squamous cell carcinoma (OSCC). DESIGN: Retrospective multi-institutional study. ANIMALS: 27 dogs with OMM and 21 dogs with OSCC. PROCEDURES: Medical record databases of 8 institutions were searched to identify dogs with OMM or OSCC that underwent unilateral or bilateral extirpation of the MLNs and MRLNs during the same procedure between January 2004 and April 2016. Information extracted from the records included signalment, primary mass location and size, diagnostic imaging results, histologic results for the primary tumor and all lymph nodes evaluated, and whether distant metastasis developed. RESULTS: Prevalence of lymph node metastasis did not differ significantly between dogs with OMM (10/27 [37%]) and dogs with OSCC (6/21 [29%]). Distant metastasis was identified in 11 (41%) dogs with OMM and was suspected in 1 dog with OSCC. The MRLN was affected in 13 of 16 dogs with lymph node metastasis, and 3 of those dogs had metastasis to the MRLN without concurrent metastasis to an MLN. Metastasis was identified in lymph nodes contralateral to the primary tumor in 4 of 17 dogs that underwent contralateral lymph node removal. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated histologic evaluation of only 1 MLN was insufficient to definitively rule out lymph node metastasis in dogs with OMM or OSCC; therefore, bilateral lymphadenectomy of the MLN and MRLN lymphocentra is recommended for such dogs.

Repression of G1/S transcription is mediated via interaction of the GTB motifs of Nrm1 and Whi5 with Swi6.

In Saccharomyces cerevisiae, G1/S transcription factors MBF and SBF regulate a large family of genes important for entry to the cell cycle and DNA replication and repair. Their regulation is crucial for cell viability, and it is conserved throughout evolution. MBF and SBF consist of a common component, Swi6, and a DNA-specific binding protein, Mbp1 and Swi4, respectively. Transcriptional repressors bind to and regulate the activity of both transcription factors. Whi5 binds to SBF and represses its activity at the beginning of the G1 phase to prevent early activation. Nrm1 binds to MBF to repress transcription as cells progress through S phase. Here, we describe a protein motif, the GTB motif (for G1/S transcription factor binding), in Nrm1 and Whi5 that is required to bind to the transcription factors. We also identify a region of the carboxy terminus of Swi6 that is required for Nrm1 and Whi5 binding to their target transcription factors and show that mutation of this region overrides the repression of MBF- and SBF-regulated genes by Nrm1 and Whi5. Finally, we show that the GTB motif is the core of a functional module that is necessary and sufficient for targeting of the transcription factors by their cognate repressors.