Barriers and facilitators to implementing a patient-centered model of contraceptive provision in community health centers.

Background: The Contraceptive CHOICE Project developed a patient-centered model for contraceptive provision including: (1) structured, evidence-based counseling; (2) staff and health care provider education; and (3) removal of barriers such as cost and multiple appointments to initiate contraception. In preparation for conducting a research study of the CHOICE model in three community health settings, we sought to identify potential barriers and facilitators to implementation.

Methods: Using a semi-structured interview guide guided by a framework of implementation research, we conducted 31 qualitative interviews with female patients, staff, and health care providers assessing attitudes, beliefs, and barriers to receiving contraception.

Implementing and Evaluating Environmental and Policy Interventions for Promoting Physical Activity in Rural Schools.

Background: Schools are an important setting for improving behaviors associated with obesity, including physical activity. However, within schools there is often a tension between spending time on activities promoting academic achievement and those promoting physical activity.

Methods: A community-based intervention provided administrators and teachers with a training on evidence-based public health and then collaborated with them to identify and implement environmental (walking track) and local school policy interventions (brain breaks).

The pollen of metaphor: Box, cage, and trap as containment in the eighteenth century.

This article uses the concept of "the pollen of metaphor" to discuss three forms of non-human animal containment in the eighteenth century: François Huber's Leaf or Book Hive bee box first described in his Nouvelles Observations sur les Abeilles (1792, English translation 1806), Sarah Trimmer's bird cages in her didactic children's book, Fabulous Histories; Or, The Story of the Robins (1786), and a mouse trap in Anna Letitia Barbauld's 1773 poem, "The Mouse's Petition, found in the trap where he had been confined all night by Dr. Priestley, for the sake of making experiments with different kinds of air." All three works highlight the eighteenth-century art of observation.

Protein and energy supplementation in elderly people at risk from malnutrition.

Background: Evidence for the effectiveness of nutritional supplements containing protein and energy, often prescribed for older people, is limited. Malnutrition is more common in this age group and deterioration of nutritional status can occur during illness. It is important to establish whether supplementing the diet is an effective way of improving outcomes for older people at risk from malnutrition.

Randomised trial of glutamine and selenium supplemented parenteral nutrition for critically ill patients. Protocol Version 9, 19 February 2007 known as SIGNET (Scottish Intensive care Glutamine or seleNium Evaluative Trial).

Background: Mortality rates in the Intensive Care Unit and subsequent hospital mortality rates in the UK remain high. Infections in Intensive Care are associated with a 2-3 times increased risk of death. It is thought that under conditions of severe metabolic stress glutamine becomes "conditionally essential".

Effect of multivitamin and multimineral supplementation on cognitive function in men and women aged 65 years and over: a randomised controlled trial.

Background: Observational studies have frequently reported an association between cognitive function and nutrition in later life but randomised trials of B vitamins and antioxidant supplements have mostly found no beneficial effect. We examined the effect of daily supplementation with 11 vitamins and 5 minerals on cognitive function in older adults to assess the possibility that this could help to prevent cognitive decline.

Methods: The study was carried out as part of a randomised double blind placebo controlled trial of micronutrient supplementation based in six primary care health centres in North East Scotland.

Does enteral nutrition affect clinical outcome? A systematic review of the randomized trials.

Background: Both parenteral nutrition (PN) and enteral nutrition (EN) are widely advocated as adjunctive care in patients with various diseases. A systematic review of 82 randomized controlled trials (RCTs) of PN published in 2001 found little, if any, effect on mortality, morbidity, or duration of hospital stay; in some situations, PN increased infectious complication rates.

Objective: The objective was to assess the effect of EN or volitional nutrition support (VNS) in individual disease states from available RCTs.

A cost-utility analysis of multivitamin and multimineral supplements in men and women aged 65 years and over.

Background & Aims: As people age there is a progressive dysregulation of the immune system that may lead to an increased risk of infections, which may precipitate hospital admission in people with chronic heart or respiratory diseases. Mineral and vitamin supplementation in older people could therefore influence infections in older people. However, the evidence from the available randomised controlled trials (RCTs) is mixed.

Meta-analysis: protein and energy supplementation in older people.

Background: Protein and energy undernutrition is common in older people, and further deterioration may occur during illness.

Purpose: To assess whether oral protein and energy supplementation improves clinical and nutritional outcomes for older people in the hospital, in an institution, or in the community.

Data Sources: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, HealthStar, CINAHL, BIOSIS, and CAB abstracts.

Effect of multivitamin and multimineral supplements on morbidity from infections in older people (MAVIS trial): pragmatic, randomised, double blind, placebo controlled trial.

Objective: To examine whether supplementation with multivitamins and multiminerals influences self reported days of infection, use of health services, and quality of life in people aged 65 or over.

Design: Randomised, placebo controlled trial, with blinding of participants, outcome assessors, and investigators.

Setting: Communities associated with six general practices in Grampian, Scotland.