The influence of friends and siblings on the physical activity and screen viewing behaviours of children aged 5-6 years: a qualitative analysis of parent interviews.

OBJECTIVES: The present study uses qualitative data to explore parental perceptions of how their young child's screen viewing and physical activity behaviours are influenced by their child's friends and siblings. DESIGN: Telephone interviews were conducted with parents of year 1 children (age 5-6 years). Interviews considered parental views on a variety of issues related to their child's screen viewing and physical activity behaviours, including the influence that their child's friends and siblings have over such behaviours. Interviews were transcribed verbatim and analysed using deductive content analysis. Data were organised using a categorisation matrix developed by the research team. Coding and theme generation was iterative and refined throughout. Data were entered into and coded within N-Vivo. SETTING: Parents were recruited through 57 primary schools located in Bristol and the surrounding area that took part in the B-ProAct1v study. PARTICIPANTS: Fifty-three parents of children aged 5-6 years. RESULTS: Parents believe that their child's screen viewing and physical activity behaviours are influenced by their child's siblings and friends. Friends are considered to have a greater influence over the structured physical activities a child asks to participate in, whereas the influence of siblings is more strongly perceived over informal and spontaneous physical activities. In terms of screen viewing, parents suggest that their child's friends can heavily influence the content their child wishes to consume, however, siblings have a more direct and tangible influence over what a child watches. CONCLUSIONS: Friends and siblings influence young children's physical activity and screen viewing behaviours. Child-focused physical activity and screen viewing interventions should consider the important influence that siblings and friends have over these behaviours.

An improved quantitative assay of galactose-1-phosphate uridyltransferase activity in erythrocytes based on the determination of glucose 1-phosphate generation.

An improved quantitative method for measuring galactose-1-phosphate uridyltransferase (EC 2.7.7.12, Gal-PUT) activity in erythrocytes was developed based on the detection of glucose 1-phosphate generated under the catalytic influence of the enzyme. This is achieved by incubating the enzyme with galactose 1-phosphate and uridyldiphosphoglucose during 15 min, followed by deproteinisation. The glucose 1-phosphate generated is quantitated subsequently by measuring NADPH formation from added NADP+ in a second incubation step with added phosphoglucomutase (EC 2.7.5.1) and glucose-6-phosphate dehydrogenase (EC 1.1.1.49). Gal-PUT activity is calculated from the increment in absorption at 340 nm. Because it is technically a simple assay that is sensitive, specific and not affected by UDPgalactose-4-epimerase (EC 5.1.3.2) activity in the erythrocytal lysates it is suggested to be the method of choice for measuring Gal-PUT activity. Activities in erythrocytes of controls varied from 264 to 556 U/kg hemoglobin; in obligate heterozygotes from 53 to 190 U/kg Hb and in homozygous deficient patients less than 5 U/kg Hb was measured at 37 degrees C.

Informed consent for medical research: common discrepancies and readability.

OBJECTIVE: To identify common discrepancies and average reading grade levels for informed consent forms (ICFs) as submitted to institutional review boards (IRBs) by medical researchers. METHODS: A retrospective evaluation of ICFs as submitted to IRBs of 3 university-affiliated hospitals during a 1-year period. ICF content was evaluated using a checklist of 23 requirements specified in the federal regulations governing human research. Documents then were computer-analyzed to determine the readability scores using 2 common indexes of comprehension. A discrepancy was defined as any instance in which an ICF did not address an applicable requirement in the Code of Federal Regulations. RESULTS: Eighty-two ICFs representing 16 medical specialties were evaluated; 8 (10%) were from emergency medicine. Eighteen ICFs (22%) were conspicuously incomplete, lacking > or = 9 federal requirements. The mean number of discrepancies was 4.7 (95% CI, 3.9-5.5) Common omissions included: a statement about who is doing the research, number of subjects in the study, circumstances when a subject's participation may be terminated, disclosure of alternative procedures, and notice to subjects regarding new findings. The mean Flesch grade level required to read all ICFs was 13.8 (95% CI, 13.5-14.2), implying that the majority of the U.S. adult population would be unable to comprehend these forms. CONCLUSION: Designing a consent form to meet all of the federal requirements while maintaining a level of reading comprehension suitable for the general population is a difficult task for investigators.

Structure and practice of institutional review boards in the United States.

OBJECTIVE: The institutional review board (IRB) is a critical element in the protection of patients' and subjects' rights with regard to their participation in research protocols. The purpose of this study was to describe the structure and current practices of IRBs in the United States. METHODS: A self-administered questionnaire was mailed to the IRB chair of each U.S. hospital with a capacity of at least 400 beds (n = 907). The survey contained 21 questions outlining committee size and structure, review of research proposals, and policies concerning scientific misconduct. Chairs also were asked what advice they would offer a young investigator preparing a proposal for submission. RESULTS: A total of 488 surveys (54%) were returned; 447 of the responding institutions had an IRB committee. Committees had an average of 14 members, representing 27 medical specialties. Orthopedics had the least IRB representation (10% of committees), followed by emergency medicine (12%) and ophthalmology (15%). The majority of research proposals go through 5 specific steps once submitted for review. Common reasons for proposal rejection were improperly designed consent form (54%), poor study design (44%), unacceptable risk to subjects (34%), ethical or legal reasons (24%), and scientific merit (14%). When a research proposal is rejected, 86% of the responding IRBs assist the investigator in making appropriate revisions. Although a number of IRBs (17%) have dealt with scientific misconduct allegations, only 58% have a written policy regarding research integrity. CONCLUSION: Despite variations in committee structure and representation, IRBs have similar procedures for governing research. Investigators should be familiar with these procedures and are encouraged to discuss their proposal with an IRB representative prior to formal review.

Treatment of jejunoileal bypass failure by reanastomosis and gastroplasty in a single-stage procedure. Review of 47 cases.

Jejunoileal bypass (JIB) for morbid obesity has resulted in a variety of metabolic complications requiring reanastomosis. Although reversal of JIB is usually effective in resolving the metabolic problems, weight gain to pre-JIB levels is common. A single-stage operation combining JIB reversal with gastroplasty (RGP) was performed on 47 patients to correct metabolic complications associated with JIB and reduce recurrence of morbid obesity. Mean follow-up time was 20 months with a range of 6 to 37 months. Average weight at the time of revision was 81 kg, 16.6 kg above the mean ideal weight. Approximately 96 per cent of complications leading to reversal were resolved. Mean postoperative weights showed a gradual increase up to 2 years, at which time weight gain stabilized. Patients 2 to 3 years postsurgery average 36.4 kg above ideal weight and 19.8 kg above weight at the time of reversal. Approximately 79 per cent of patients remained below morbid obesity levels. Complications included eight cases of stomal obstruction; two required reoperation. Stomal dilatation was identified in two patients. There were no mortalities. RGP was found to be ineffective in producing weight loss in patients who had not lost significant weight following JIB. This study suggests that JIB reversal with gastroplasty as a single procedure is safe and effective in resolving nearly all JIB complications. RGP is associated with gradual increase in weight for 2 years, after which weight gain appears to plateau. However, return to morbid obesity levels can be prevented in 70 per cent of patients undergoing RGP.

Jejunal loop interposition: a remedy for failed jejunoileal bypass.

A jejunal loop interposition procedure has been developed for selected post-jejunoileal bypass patients who require repeated hospitalizations for electrolyte imbalance and malnutrition. Twelve patients have undergone interposition of an additional 6 inches of jejunum into the functional segment of bowel with excellent results. Deficiencies in serum albumin, calcium, magnesium and potassium were rapidly corrected following this operation. Desired weight was maintained, and rapid, dramatic improvement in general state of well-being was observed. No intraoperative complications were encountered and the procedure is easily performed.

Effect of human chorionic gonadotropin on luteal function and reproductive performance of high-producing lactating Holstein dairy cows.

The objectives were to evaluate effects of human chorionic gonadotropin (hCG) (3,300 IU i.m.) administered on d 5 after AI on CL number, plasma progesterone concentration, conception rate, and pregnancy loss in high-producing dairy cows. Following the synchronization of estrus and AI, 406 cows were injected with either hCG or saline on d 5 after AI in a randomized complete block design. Blood sampling and ovarian ultrasonography were conducted once between d 11 and 16 after AI. Pregnancy diagnoses were performed on d 28 by ultrasonography and on d 45 and 90 after AI by rectal palpation. Treatment with hCG on d 5 resulted in 86.2% of the cows with more than one CL compared with 23.2% in controls. Plasma progesterone concentrations were increased by 5.0 ng/mL in hCG-treated cows. The presence of more than one CL increased progesterone concentration in hCG-treated cows but not in controls. Conception rates were higher for hCG-treated cows on d 28 (45.8 > 38.7%), 45 (40.4 > 36.3%), and 90 (38.4 > 31.9%) after AI. Treatment with hCG improved conception rate in cows losing body condition between AI and d 28 after Al. Pregnancy losses were similar between treatment groups. Treatment with hCG on d 5 after AI induces accessory CL, enhances plasma progesterone concentration, and improves conception rate of high-producing dairy cows.

The effect of a honey based gel and silver sulphadiazine on bacterial infections of in vitro burn wounds.

Bacterial contamination remains a constant threat in burn wound care. Topical treatments to combat contaminations have good bactericidal effects but can have detrimental effects for the healing process. Treatments with for example silver can increase healing times. Honey based products can be a good alternative as it is antibacterial and patient-friendly. We evaluated the bactericidal and cytotoxic effects of a honey based gel and silver sulphadiazine in a human burn wound model with Pseudomonas aeruginosa. After adding 10(5)colony forming units of P. aeruginosa, topical treatments were applied on the burn wound models. After 2, 12, 24, 28 and 70 h, bacteria were dislodged and counted by plating dilutions. Cytotoxic effects were evaluated histologically in samples of burn wound models treated topically for 3 weeks, without bacteria. L-Mesitran Soft significantly reduced the bacterial load (5-log reduction) up to 24h but did not completely eliminate bacteria from the burn wounds. After Flammazine(®) treatment, only a few colony forming units were observed at all time points. In contrast, re-epithelialization was significantly reduced after application of Flammazine(®) compared to L-Mesitran Soft or control. This in vitro model of burn wound infection can be used to evaluate topical treatments. L-Mesitran Soft is a good alternative for treating burn wounds but the slightly lower bactericidal activity in the burn wound model warrants a higher frequency of application.

The cytochrome bc1 complex of yeast mitochondria. Isolation and partial characterization of the cytochrome bc1 complex and cytochrome b.

We have isolated the cytochrome bc1 complex and some of its constituent polypeptides from bakers yeast and have studied its spectroscopy, electrophoresis and amino acid analysis. The isolated complex contained 6 mumol of b heme and approximately 3 mumol of c1 heme per g of protein. The electron paramagnetic resonance spectrum was similar to that of the beef-heart preparation. The complex consisted of 7 polypeptides with mobilities on sodium dodecylsulphate polyacrylamide gel electrophoresis corresponding to Mr 44,000, 40,000, 32,000, 32,000, 17,000, 14,000 and 11,000. One of the polypeptides with Mr 32,000 was identified on sodium dodecylsulphate gels as cytochrome c1 by porphyrin fluorescence. Cytochrome b was isolated from the complex by treating it with guanidine hydrochloride; it had a purity of 20 mumol per g of protein and consisted of a polypeptide with Mr 32,000 plus two minor bands with Mr 14,000 and 11,000. We have isolated the polypeptide of Mr 32,000 from cytochrome b and the polypeptides of Mr 44,000 and 40,000 ("core proteins") from the complex, both by preparative sodium dodecylsulphate gel electrophoresis and determined their amino acid composition. Only the b polypeptide of Mr 32,000 shows the low proportion of polar amino acid residues that is considered typical of membrane proteins.

Extending myocardial viability during heart preservation with cyclosporine A.

BACKGROUND AND AIM OF STUDY: Hypothermic preservation (PRES) of donor hearts is limited to 12-14 hours for complete functional recovery after reperfusion. In a canine heterotopic heart transplant model, 50% to 60% functional recovery returned after 18 hours of PRES with University of Wisconsin (UW) solution. Concomitant with functional changes were marked increases in apoptotic cells at 2 (2.69%) and 6 (5.98%) hours of reperfusion with a concomitant decrease in lamin B1 (2% and 7.6%, respectively) with no evidence of necrotic cells. These results suggested that blockade of apoptosis may prolong myocardial viability during PRES and reperfusion. METHODS: Donor hearts were subjected to 18 and 24 hours of PRES (2 degrees C to 4 degrees C) with and without cyclosporine A (CyS) treatment (apoptosis blocker). CyS was given to the donor animal (10 mg/kg), in the PRES solution (10(-5) mol/L), slowly infused during the PRES period (1 mL/min), and also to the recipient animal (2.5 mg/kg). RESULTS: After 18 hours of PRES with CyS, function returned to 100% within 1 hour and stayed at this level throughout a 6-hour recovery period. Apoptotic myocytes were reduced (55%) after 18 hours PRES with CyS treatment, and 6-hour reperfusion lamin B1 was reduced to only 3.7%. Twenty-four hour PRES in UW resulted in no functional recovery. However, after CyS treatment, functional recovery returned to 100% after 4 hours of reperfusion. Adenosine triphosphate (ATP) and creatine phosphate (CP) concentrations were surprisingly the same with or without CyS treatment at 18 hours and lower with 24 hours. CONCLUSIONS: Use of CyS in the PRES solution prolongs myocardial viability during donor heart PRES. The mechanism of action may be associated with the mitochondrial permeability transition (MPT) pore via cyclophilin D binding.

Flow quantification using fast cine phase-contrast MR imaging, conventional cine phase-contrast MR imaging, and Doppler sonography: in vitro and in vivo validation.

OBJECTIVE: Our purpose was to assess the accuracy of measurements of flow velocity and volume flow rate in an in vitro phantom and in healthy human volunteers using a cardiac-gated, segmented K-space, fast cine phase-contrast (PC) MR imaging technique with view sharing (fast PC). We compared this method with conventional cine PC MR imaging and Doppler sonography. SUBJECTS AND METHODS: Pulsatile flow was generated in a flow phantom that consisted of a cylindric tube having various degrees of tapered stenosis. Phase-encoded velocity maps were obtained using cine PC and fast PC MR imaging. Doppler sonography was also performed. Measurements of aortic and pulmonary artery peak systolic and minimum diastolic velocity and volume flow rate were then compared in eight healthy volunteers using the three imaging techniques. RESULTS: We found excellent agreement between fast PC and cine PC measurements of peak systolic velocity when regions of interest were drawn to exclude vessel margins (r > .99 for phantom studies, and r = .80 for human studies). Correlation between minimum diastolic velocity measurements by MR imaging was limited by noise that resulted from high encoding velocity settings. However, such correlation improved with signal averaging. When compared with predicted values of volume flow rates, both cine PC (r > .99) and fast PC (r = .97) MR imaging were more accurate than Doppler sonography (r = .78) in vitro. Measurements of cardiac output were adversely affected by low signal to noise, especially during diastole; estimates based on systolic forward flow resulted in better agreement between the two MR imaging methods. CONCLUSION: Fast PC MR flow quantification may prove to be a useful adjunct to routine MR studies for measurements of peak flow velocity. However, estimates of volume flow rate using fast PC MR imaging are limited because of increased noise during low diastolic flow as well as edge artifacts.