7 research outputs found
What makes a good clinical conversation on physical activity? A Scoping review exploring what is known to inform the development of physical activity resources to support healthcare professionals in routine practice
No full textThis scoping review aims to gain a broad insight into the makeup and delivery of effective physical activity conversations in healthcare. We identified two research questions (1) What is known about the effectiveness and acceptability of physical activity consultations in healthcare? (2) What is known about strategies to implement routine physical activity conversations in healthcare?
The results will inform the development of resources to support healthcare professionals having routine conversations on physical activity in their day-to-day practice
Interventions to achieve long-term weight loss in obese older people
No full textThis is a pre-copy-editing, author-produced PDF of an article accepted for publication in Age and Ageing following peer review. The definitive publisher-authenticated version Witham, M. & Avenell, A. (2010). 'Interventions to achieve long-term weight loss in obese older people.' Age and Ageing 39(2) pp. 176-184 is available online at: http://dx.doi.org/10.1093/ageing/afp251.Peer reviewe
Do UK based weight management programmes cause weight loss maintenance in adults? A systematic review
No full textThe aim of this dissertation was to examine whether UK based weight management programmes promote weight loss maintenance (follow up of 12 months to assess effectiveness of intervention in weight loss) in adults through the process of a systematic review. The World Health Organisation (WHO) has described obesity as a "global epidemic". Weight management comprises two phases; weight loss and weight loss maintenance. The latter phase is the true goal for obesity and the most difficult element of weight management to achieve. However much less is know about this as compared with the weight loss phase. There is little purpose in committing time and money to reducing obesity if the weight is regained. This is counter-productive and weight loss maintenance is essential to combat the obesity epidemic. Searches were made for relevant information from a variety of scientific online databases and journals,. Seven articles met the inclusion criteria and were analysed in the review. All studies incorporated a multi-component (diet, exercise, behaviur modification) intervention approach. All control and internvetion groups reported weight loss at 12 months when compared with baseline. All groups recieved an intervention. One study reported a significant difference (P<0.05) between groups. Four studies reported on at least one component (diet, physical activity, behaviour modification) however there was not enough information to conclude whether they complied with national guidelines (NICE CG43 and SIGN 115). High attrition rates and loss to follow up are problematic for each study except one. Analysis on an intention to treat basis was common however this is problematic and there are alternative methods which may be more suitable for dealing with missing data
Healthy built environments: A review of the literature
No full textThe Healthy Built Environments Program has completed a major scholarly literature review examining the role of the built environment in supporting human health as part of everyday living. The principal aim of the Review is to establish an evidence base that supports the development, prioritisation and implementation of healthy built environment policies and practices. The Review identifies current gaps in the evidence to inform future research directions. It includes an annotated bibliography of key research articles and a glossary of terms to assist practitioners, policy makers and researchers working in this interdisciplinary realm.
The focus of the Review is on the three key built environment domains that support human health:
The Built Environment and Getting People Active.
The Built Environment and Connecting and Strengthening Communities.
The Built Environment and Providing Healthy Food Options.
These built environment domains address three of the major risk factors for contemporary chronic disease - physical inactivity, social isolation and obesity.
The Literature Review is available for download as the whole document or its individual sections.
Whole document (12MB)
Cover and Acknowledgements (1.11MB)List of Abbreviations and Contents (2.11MB)The Healthy Built Environments Program Overview (291KB)Executive Summary (295KB)1.0 Introduction (255KB)2.0 Structure of this Review (2.46MB)3.0 Aims and Parameters (2.99MB)4.0 Scope and Methodology (3.20MB)5.0 The Evidence (200KB)5.1 The Built Environment and Getting People Active (653KB)5.2 The Built Environment and Connecting and Strengthening Communities (546KB)5.3 The Built Environment and Providing Healthy Food Options (416KB)6.0 Professional Development (284KB)7.0 Conclusion (114KB)References (490KB)Appendix 1: Diary of Database Searches (202KB)Appendix 2: Glossary (282KB)Appendix 3: Annotated Bibliography (2.57MB
Stem cell expansion and bioreactor development
No full textPhDA major challenge to the clinical success of cell-based tissue engineering strategies is the ability to obtain sufficient numbers of cells within an acceptable time frame. The expansion of cells on microcarriers within spinner flask bioreactor has shown promise in meeting that challenge. Spinner flask microcarrier technology is space-saving and media utilisation efficient. However, further optimisation in terms of, for example, seeding efficiency, expansion rates and harvest efficiency is necessary to realise the clinical potential of this technology. The present work is designed to improve cell expansion rates. It involves investigation of microcarrier composition and surface structure and spinner flask shear stress on cell growth.
BMSC growth on PHBV microcarriers was superior to PCL and PLGA microcarriers and comparable to Cytodex 1 microcarriers. Lower density PHBV microcarriers showed promise as a superior alternative to Cytodex 1. Two different impeller designs employed in the w/o/w method of microcarrier synthesis resulted in smoother and rougher PCL microcarriers with Ra = 1.77 ± 0.42 μm to 6.4 ± 1.48 μm respectively. Superior BMSC growth was observed on the rougher PCL microcarriers. Differentiation potential along the osteogenic and adipogenic lineages of BMSCs expanded on the microcarrier types was retained.
Particle Image Velocimetry was used to quantify shear stress within a spinner flask bioreactor. It was found that 80% of the shear stress was localised within the impeller region which occupied 55% of the bioreactor working volume. Shear stress increased as Cytodex 1 microcarrier concentration and impeller rotational speed increased. Superior BMSC growth rates on microcarriers were observed for the lowest shear stress experimental group (3.4 x 10-3 N/m2 ≤ impeller region mean shear stress ≤ 4.6 x 10-3 N/m2) as compared to the three higher shear stress groups (5.5 x 10-3 N/m2 ≤ mean shear stress ≤ 1.3 x 10-2 N/m2). Expanded BMSCs on the cytodex 1 microcarriers retained multipotentiality for the range of shear stresses investigated
Whole-genome sequencing reveals host factors underlying critical COVID-19
No full textAltres ajuts: Department of Health and Social Care (DHSC); Illumina; LifeArc; Medical Research Council (MRC); UKRI; Sepsis Research (the Fiona Elizabeth Agnew Trust); the Intensive Care Society, Wellcome Trust Senior Research Fellowship (223164/Z/21/Z); BBSRC Institute Program Support Grant to the Roslin Institute (BBS/E/D/20002172, BBS/E/D/10002070, BBS/E/D/30002275); UKRI grants (MC_PC_20004, MC_PC_19025, MC_PC_1905, MRNO2995X/1); UK Research and Innovation (MC_PC_20029); the Wellcome PhD training fellowship for clinicians (204979/Z/16/Z); the Edinburgh Clinical Academic Track (ECAT) programme; the National Institute for Health Research, the Wellcome Trust; the MRC; Cancer Research UK; the DHSC; NHS England; the Smilow family; the National Center for Advancing Translational Sciences of the National Institutes of Health (CTSA award number UL1TR001878); the Perelman School of Medicine at the University of Pennsylvania; National Institute on Aging (NIA U01AG009740); the National Institute on Aging (RC2 AG036495, RC4 AG039029); the Common Fund of the Office of the Director of the National Institutes of Health; NCI; NHGRI; NHLBI; NIDA; NIMH; NINDS.Critical COVID-19 is caused by immune-mediated inflammatory lung injury. Host genetic variation influences the development of illness requiring critical care or hospitalization after infection with SARS-CoV-2. The GenOMICC (Genetics of Mortality in Critical Care) study enables the comparison of genomes from individuals who are critically ill with those of population controls to find underlying disease mechanisms. Here we use whole-genome sequencing in 7,491 critically ill individuals compared with 48,400 controls to discover and replicate 23 independent variants that significantly predispose to critical COVID-19. We identify 16 new independent associations, including variants within genes that are involved in interferon signalling (IL10RB and PLSCR1), leucocyte differentiation (BCL11A) and blood-type antigen secretor status (FUT2). Using transcriptome-wide association and colocalization to infer the effect of gene expression on disease severity, we find evidence that implicates multiple genes-including reduced expression of a membrane flippase (ATP11A), and increased expression of a mucin (MUC1)-in critical disease. Mendelian randomization provides evidence in support of causal roles for myeloid cell adhesion molecules (SELE, ICAM5 and CD209) and the coagulation factor F8, all of which are potentially druggable targets. Our results are broadly consistent with a multi-component model of COVID-19 pathophysiology, in which at least two distinct mechanisms can predispose to life-threatening disease: failure to control viral replication; or an enhanced tendency towards pulmonary inflammation and intravascular coagulation. We show that comparison between cases of critical illness and population controls is highly efficient for the detection of therapeutically relevant mechanisms of disease
Stratified analyses refine association between TLR7 rare variants and severe COVID-19
No full textSummary: Despite extensive global research into genetic predisposition for severe COVID-19, knowledge on the role of rare host genetic variants and their relation to other risk factors remains limited. Here, 52 genes with prior etiological evidence were sequenced in 1,772 severe COVID-19 cases and 5,347 population-based controls from Spain/Italy. Rare deleterious TLR7 variants were present in 2.4% of young (<60 years) cases with no reported clinical risk factors (n = 378), compared to 0.24% of controls (odds ratio [OR] = 12.3, p = 1.27 × 10−10). Incorporation of the results of either functional assays or protein modeling led to a pronounced increase in effect size (ORmax = 46.5, p = 1.74 × 10−15). Association signals for the X-chromosomal gene TLR7 were also detected in the female-only subgroup, suggesting the existence of additional mechanisms beyond X-linked recessive inheritance in males. Additionally, supporting evidence was generated for a contribution to severe COVID-19 of the previously implicated genes IFNAR2, IFIH1, and TBK1. Our results refine the genetic contribution of rare TLR7 variants to severe COVID-19 and strengthen evidence for the etiological relevance of genes in the interferon signaling pathway
