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Eating at a faster speed is positively correlated with having a higher BMI. Modifying eating speed may offer a treatment opportunity for those with overweight and obesity. This review sought to understand the feasibility, acceptability, and benefit to using eating speed interventions in paediatric clinical weight-management settings. The PICO Framework was used. Clinical studies of eating speed interventions as a treatment for paediatric patients with overweight or obesity were included. No limits to search date were implemented. A systematic search of MEDLINE, PsychINFO and EMBASE via OVID, Web of Science and JBI, Database of systematic reviews and Implementation reports, along with trial registers NICE, ClinicalTrials.gov and Cochrane Central Register of Controlled Trials was conducted. Two authors were responsible for screening, extraction, and evaluation of the risk of bias. Fifteen papers reporting twelve interventions addressing eating-speed were identified, involving a total of 486 active participants (range 7–297). Study design was weak with only one full RCT and there were some concerns over quality and risk of bias (Cochrane RoB 2.0). Limited sample sizes and different measured outcomes did not allow powered evaluations of effect for all outcomes. There is some indication, overall, that addressing eating speed has the potential to be a beneficial adjunct to clinical obesity treatment, although the pooled effect estimate did not demonstrate a difference in BMISDS status following eating speed interventions compared to control [pooled mean difference (0.04, 95% CI -0.39 to 0.46, N = 3)]. Developments to improve the engagement to, and acceptability of, interventions are required, alongside rigorous high-quality trials to evaluate effectiveness.

Purpose Patients use mobile applications (apps) to obtain information about health, including contraception. Providers and health educators may also use apps designed for patients to aid in patient education during the clinical encounter or recommend apps for patient use. Individuals may have a difficult time remaining updated on the number and quality of available apps. The objective of this study is to identify and evaluate contraception apps for patient education and health promotion, so that providers and health educators may recommend accurate apps to patients. Methods We systematically searched the Apple iTunes Store using contraception search terms. A master list of apps was created and the apps were divided into categories and subcategories according to intended audience and purpose. Contraception apps for patient education and health promotion were selected and also checked for availability in the Google Play Store. We evaluated these identified apps using an adapted APPLICATIONS scoring system. Findings Forty-eight apps were identified from the original search. Nineteen of these were excluded because they did not open on an iPhone or iPad, were no longer available, or did not contain educational material on contraception. We excluded 11 additional apps that contained inaccurate information. We evaluated 18 apps. The mean score was 10.6 out of 17 possible points with a range of 7 to 15 points. Conclusions Many apps provide contraception information for patients, but some apps are inaccurate. Few apps provide comprehensive information on all available methods, including effectiveness, side effects, and contraindications.

Objective We aimed to identify mobile applications (apps) about contraception and to evaluate those targeted toward providers of family planning services in order to assess their quality and comprehensiveness. Methods We systematically searched the Apple iTunes Store using contraception search terms. We created a master list of relevant and unique apps and divided the apps into categories and subcategories according to intended audience and purpose. We then checked availability of contraception apps for providers in the Google Play Store. We scored apps on objective and subjective components using the APPLICATIONS scoring system, a tool developed to evaluate health-related mobile apps with a maximum score of 17 points. Results From a total of 1218 apps found using 41 contraception search terms, 113 were unique and relevant to contraception. We determined that six apps (5.3%) were potentially useful for providers of family planning services and evaluated them. Four apps received 12 points, one received 11 points and one received 8 points. The two free apps were among those with the highest scores. Three of these apps were also available in the Google Play Store. Conclusions A small number of contraception apps are targeted toward providers of family planning services. Available apps are variable in quality and comprehensiveness. Implications There is potential for further mobile resource development in the area of contraception, given the limited number and inconsistent quality of available apps.

Objective We aimed to explore current practices regarding screening for rape and response to disclosure of rape-related pregnancy in the abortion care setting. Methods We performed a cross-sectional, nonprobability survey of U.S. abortion providers. Individuals were recruited in person and via emailed invitations to professional organization member lists. Questions in this web-based survey pertained to providers' practice setting, how they identify rape-related pregnancy, the availability of support services, and their experiences with law enforcement. Providers were asked their perceptions of barriers to care for women who report rape-related pregnancy. Results Surveys were completed by 279 providers (21% response rate). Most respondents were female (93.1%), and the majority were physicians in a clinical role (69.4%). One-half (49.8%) reported their practice screens for pregnancy resulting from rape, although fewer (34.8%) reported that screening is the method through which most patients with this history are identified. Most (80.6%) refer women with rape-related pregnancy to support services such as rape crisis centers. Relatively few (19.7%) have a specific protocol for care of women who report rape-related pregnancy. Clinics that screen were 79% more likely to have a protocol for care than centers that do not screen. Although the majority (67.4%) reported barriers to identification of women with rape-related pregnancy, fewer (33.3%) reported barriers to connecting them to support services. Conclusion Practices for identifying and providing care to women with rape-related pregnancy in the abortion care setting are variable. Further research should address barriers to care provision, as well as identifying protocols for care.

Objective We conducted a systematic review to investigate the cross-sectional and prospective associations of accelerometer-measured total sedentary time and breaks in sedentary time with individual cardiometabolic biomarkers in adults ≥ 18 years of age. Methods Ovid Medline, Embase, Web of Science and the Cochrane Library were searched for studies meeting the inclusion criteria. Due to inconsistencies in the measurement and analysis of sedentary time, data was synthesised and presented narratively rather than as a meta-analysis. Results Twenty-nine studies were included in the review; twenty-eight reported on total sedentary time and six on breaks in sedentary time. There was consistent evidence from cross-sectional data of an unfavourable association between total sedentary time and insulin sensitivity. There was also some evidence that total sedentary time was unfavourably associated with fasting insulin, insulin resistance and triglycerides. Furthermore, there was some evidence from cross-sectional data of a favourable association between breaks in sedentary time and triglycerides. Conclusion Total sedentary time was consistently shown to be associated with poorer insulin sensitivity, even after adjusting for time spent in physical activity. This finding supports the proposed association between sedentary time and the development of Type 2 diabetes and reinforces the need to identify interventions to reduce time spent sedentary.

Background: Complementary medicine appears to be an increasingly popular option amongst both doctors and patients. General practitioners in more affluent parts of Britain have showed considerable interest in its use. Objectives: To ascertain use of and attitudes towards complementary medicine, amongst general practitioners working in a socioeconomically deprived urban area. Methods: A postal questionnaire survey of all general practice principles in Liverpool, using freepost envelopes and one reminder after 3 weeks. With respect to eight common complementary therapies, respondents were asked whether they treat with, refer to or endorse each therapy; for their views on NHS funding, effectiveness, adverse reactions, training needs, and theoretical validity, for each therapy. Results: The response rate was 131/252 (52%), higher amongst women and doctors aged under 40. During the previous week 74 (56%) of respondents had been involved in complementary medical activity with their patients: 13% had treated directly, 31% had referred to and 38% had endorsed one or more complementary therapies. Acupuncture was most popular as an NHS option, and along with osteopathy and chiropractic was the therapy most highly regarded by respondents in terms of effectiveness. Homeopathy and hypnotherapy received a mixed reaction, while medical herbalism, aromatherapy and reflexology were viewed more sceptically. Sixty-two per cent of respondents reported successful outcomes of complementary treatments, compared with 21% reporting adverse reactions. Knowledge and training desires were highest for homeopathy and acupuncture. Respondents were generally uncertain about the theoretical validity of these therapies: 50% though acupuncture had a valid basis, compared with only 23% for homeopathy and 8% for reflexology. Conclusions: The degree of support for complementary medicine therapies amongst general practitioners in this socioeconomically deprived urban area was similar to that found elsewhere in Britain. These general practitioners appeared to tolerate high levels of clinical uncertainty, endorsing a wide range of therapies, despite little knowledge of their content or conviction of their validity.

Summary The outer membrane protein (OMP) profiles from 8 Campylobacter jejuni and 5 Campylobacter coli fecal isolates grown under various conditions were compared by SDS-PAGE. The bacteria were grown under usual conditions, in iron-deficient medium (Dip) and on iron-supplemented medium (Fe). The OMP profiles of most bacterial strains grown under usual conditions, or in the Fe-supplemented medium, contained four major bands of approximately 31, 45, 63–66 and 97 kDa, and in addition, a number of minor bands. It was found that OMP from 10 of 13 strains tested and grown on iron deficient medium contained an intensive band of a protein in the molecular weight region of 76 kDa which was lacking in the OMP of bacteria grown in the presence of iron (iron-regulated protein). Sera from 11 children with C. jejuni infection analyzed by Western blot recognized the 76 kDa bands, in contrast to only one out of 10 control sera from healthy children. The Western-blot experiments demonstrated also various bands of other OMP components, both in OMP-Dip and OMP-Fe. The 45 kDa (porin protein) was recognized by all 11 serum samples from C. jejuni -infected patients and in 8 out of 10 control sera. The data suggested that the 76 kDa iron-regulated protein was expressed by bacteria during infection and it stimulated the immune response in children infected with C. jejuni .

Objectives: Almost 90% of United States counties lack an abortion provider. Given federal and state restrictions on abortion funding, many women lack true access to abortion. Some turn to online sources to obtain and self-administer abortion medications. This study explores online availability of medical abortion. Methods: Google was used to search for “mifepristone, ”“ misoprostol” and “medical abortion.” The top 100 hits and relevant sites reached from the hits were condensed into 90 unique sites. We evaluated each site for availability and cost of mifepristone and misoprostol as well as medical advice and gestational age recommendations for use. Results: Thirty-six of the 90 sites advertised or sold pharmaceuticals; 16 sold misoprostol, 3 sold mifepristone, and 3 sold kits containing both, costing $45–$60. The rest advertised pharmaceuticals but did not sell mifepristone or misoprostol. Twenty-two of the 36 sites advertising pharmaceuticals warned against using misoprostol during pregnancy. Five recommended gestational age limits for medical abortion: less than 9 weeks for three sites and during the first trimester for the others. Six sites gave appropriate warnings regarding bleeding, infection or failure. One Web site featured a “pharmacist” touting the products as “100% safe and effective” while warning that the medications are “not safe for use at home.” Conclusions: Deterrents such as waiting periods, funding restrictions and lack of nearby providers represent prohibitive barriers to abortion. As a result, some women seek abortion outside of clinical settings, even in the United States. Our research shows that medication abortion is available online but accompanied by advice of varying quality.