Implementation of a 2-for-1 Price Incentive for Fruits and Vegetables in a Grocery Retail Setting.

BACKGROUND AND PURPOSE: There is growing interest in expanding healthy eating interventions in the retail setting. The purpose of this study was to evaluate the implementation of a successful 2-for-1 price incentive for fruits and vegetables (F&V), including frozen and canned, that took place in partnership with a large chain grocery retailer in Maine. Intervention Approach. A randomized controlled trial (RCT) pilot study was conducted in 2015-2016, followed by a larger RCT in 2016-2017, to assess whether a supermarket double-dollar F&V incentive increased purchases of these items. EVALUATION METHODS: A convergent, parallel mixed-methods design was used to examine barriers and facilitators to implementing the interventions, using six implementation outcomes: acceptability, adoption, appropriateness, feasibility, implementation fidelity, and perceived cost. RESULTS: The intervention was deemed highly acceptable, appropriate, and feasible by shoppers, retailers, and researchers. The F&V discount had a high rate of initial adoption. There was a moderate degree of fidelity, which improved over time based on lessons learned from the pilot and applied to the subsequent RCT. Specific costs associated with implementation from the research perspective are reported. Implications for Practice, Policy, and Research. Partnerships between academic researchers and retailers can be an effective model for improving healthful purchases among shoppers. These findings are relevant for investigators, public health advocates, and retailers interested in implementing similar grocery retail-based interventions.

The profile of patients referred to an outreach restorative dentistry clinic over the last 10 years has changed.

The aim of the study was to compare the profile of the patients referred to a Restorative Dentistry consultant clinic at Scarborough General Hospital (SGH) in 1991 and 2001. The clinical records from 80% of a cohort of the new patients referred for consultation and who attended in 1991 and 2001 were examined. In total 55 clinical records were examined from 1991 and 84 from 2001. Data on reason for referral, time of wait before assessment and outcome of the consultation was recorded. The number of patients seen for consultation increased considerably between 1991 and 2001. Mean waiting times from the date of referral to the date when assessed trebled (p = 0.016). Referral for denture problems (notably complete dentures) was the main reason for referral in 2001 (25%). Tooth wear was the most common reason for referral in 1991 (22%). It was concluded that the demand for the services of a Restorative Dentistry consultant at Scarborough General Hospital increased considerably between 1991 and 2001. This resulted in considerably longer waiting times for a consultation. In 2001 there was a greater percentage of referrals for appearance, complete dentures and implants. A higher percentage of patients in this study were referred back to their GDP for treatment as compared to other studies.

Heat-labile proteases in molecular biology applications.

Thermolabile proteases were identified in three Gram-negative psychrotrophic bacteria. The protease from the psychrotrophic strain A9 was purified and its application to common molecular biology techniques was demonstrated. Heat-stable molecular biology enzymes (Taq polymerase and PvuII) were digested by a heat-labile protease, which was then inactivated by a mild heat treatment. The clear benefit of using heat-labile proteases arises in situations where further reactions may be accomplished without an intermediate purification step, thereby saving time and avoiding the possibility of product loss.

Assessment of the serodiagnostic potential of nine novel proteins from Mycobacterium tuberculosis.

To identify antigens that would improve the accuracy of serological diagnosis of active tuberculosis, we cloned the genes encoding nine potentially immunogenic secreted or surface-associated proteins of Mycobacterium tuberculosis. Recombinant proteins were reacted with sera from HIV-negative individuals with extrapulmonary tuberculosis (EP-TB) or HIV-positive individuals with pulmonary tuberculosis (TBH). Specific and high level antibody responses were obtained for four recombinant proteins, of which antigen GST-822 was recognized by 60% of EP-TB and 42% of TBH and antigen MBP-506 was recognized by 45% of EP-TB and 61% of TBH. These results suggest that these proteins are strong candidates as subunits in a polyvalent serodiagnostic test.

Health inequalities and mental illness in women.

Stereotyped views of a woman's role lead to inequalities in health for women. Women may be particularly vulnerable to mental health problems at certain ages and in certain social circumstances. Nurses can work with women to combat health inequalities.

Identification of novel immunogenic Mycobacterium tuberculosis peptides that stimulate mononuclear cells from immune donors.

Proteins which are secreted or associated with the cell envelope of Mycobacterium tuberculosis may contain protective T-cell epitopes. Prior to this study, a recombinant clone bank of enzymatically active M. tuberculosis-alkaline phosphatase fusions, were screened for immunogenicity in a murine T-cell model. Five of these were selected for further study, and the IFN-gamma secretion and proliferation of human PBMC from purified protein derivative- (PPD)-positive and PPD-negative donors were measured in response to oligopeptides, Mtb-PhoA fusions and one full-length protein. Epitopes from four of the five selected antigens were immunoreactive in the human model and corresponded to cytochrome d ubiquinol oxidase, cytochrome c oxidase subunit II, MTV005.02 and MTV033.08. Thus, this strategy identified novel human immunogenic peptides as possible candidates for a subunit vaccine.

An unusual case of trauma: a toothbrush embedded in the buccal mucosa.

Severe trauma from a toothbrush is unusual in childhood. This case report illustrates a case where a toothbrush was so embedded in the buccal soft tissues that it needed to be removed under a general anaesthetic. Other cases are outlined where life-threatening conditions rapidly arose following toothbrush trauma to the oro-pharynx, both patients having been initially discharged without treatment from a casualty department. Apparently minor oro-pharyngeal lacerations should be approached with caution when a penetrating injury from a toothbrush or any object has occurred.

Mycobacterium tuberculosis efpA encodes an efflux protein of the QacA transporter family.

The Mycobacterium tuberculosis H37Rv efpA gene encodes a putative efflux protein, EfpA, of 55,670 Da. The deduced EfpA protein was similar in secondary structure to Pur8, MmrA, TcmA, LfrA, EmrB, and other members of the QacA transporter family (QacA TF) which mediate antibiotic and chemical resistance in bacteria and yeast. The predicted EfpA sequence possessed all transporter motifs characteristic of the QacA TF, including those associated with proton-antiport function and the motif considered to be specific to exporters. The 1,590-bp efpA open reading frame was G+C rich (65%), whereas the 40-bp region immediately upstream had an A+T bias (35% G+C). Reverse transcriptase-PCR assays indicated that efpA was expressed in vitro and in situ. Putative promoter sequences were partially overlapped by the A+T-rich region and by a region capable of forming alternative secondary structures indicative of transcriptional regulation in analogous systems. PCR single-stranded conformational polymorphism analysis demonstrated that these upstream flanking sequences and the 231-bp, 5' coding region are highly conserved among both drug-sensitive and multiply-drug-resistant isolates of M. tuberculosis. The efpA gene was present in the slow-growing human pathogens M. tuberculosis, Mycobacterium leprae, and Mycobacterium bovis and in the opportunistic human pathogens Mycobacterium avium and Mycobacterium intracellular. However, efpA was not present in 17 other opportunistically pathogenic or nonpathogenic mycobacterial species.

Automatic digitization and analysis of moiré topograms on a personal computer for clinical use.

Moiré topography is a non-invasive optical technique which may be used for the detection and follow up of spinal deformities such as scoliosis. The moiré technique produces interference patterns (moiré fringes) which are very good at showing up differences in symmetry on the patient's back. The moiré fringes follow lines of constant height and can therefore be considered analogous to contour lines on an ordinance survey map. The moiré technique is already being used as a tool for qualitative diagnosis but widespread use will wait until the task of interpreting the moiré patterns quantitatively has been automated. An automated process means extracting the third dimension from the moiré topogram to produce 3D representations from which various deformity indices may be calculated. Image processing of moiré topograms is not trivial due to the difficulty of producing distinct good contrast fringes. The contrast problem is addressed with an interactive contrast enhancing algorithm. The approach to extracting 3D information from the fringes is to tackle 'real world' problems head on; fringes are first detected using edge detection techniques and assigning heights to the fringes is accomplished with algorithms designed to cope with noisy and broken fringes.

Six cases of severe head injury treated by exercise in addition to other therapies.

Six cases of severe head injury treated with vigorous early morning exercise in addition to more orthodox therapies are presented. Observations on behaviour and psychometric testing have been used to assess results. Discussion is centred round the benefits of early morning exercise.