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Rats offered free access to sucrose solution in addition to a sucrose-free composite diet develop leptin resistance whereas those consuming a similar amount of sucrose from a dry diet remain leptin responsive. Here we tested whether rats consuming a complete high sucrose diet in liquid form also became leptin resistant. Female Sprague Dawley rats were offered a sucrose free diet (NS), a dry high sucrose diet (HS), NS diet plus 30% sucrose solution (LiqS), NS diet in liquid form (NSLiq) or HS diet in Liquid form (HSLiq). After 30 days LiqS rats were leptin resistant, but all other groups were leptin responsive even though HSLiq rats consumed as much sucrose as LiqS rats and NSLiq rats had the greatest amount of body fat. Therefore, development of leptin resistance is dependent upon the consumption of sucrose independent of any other nutrients. Because LiqS rats consume sucrose throughout the day and night we tested whether limiting sucrose solution access to either the light or dark period prevented development of leptin resistance. Leptin resistant LiqS rats were either given free access to sucrose, had access to sucrose only at night or had access only during the day. The intake of rats with limited access was supplemented to the level of those with free access by tube-feeding. The results of this study show that leptin resistance of LiqS rats is independent of when the sucrose is consumed and is unrelated to total energy intake, body fat mass or serum leptin concentration.

Background: There is growing attention in the UK and internationally to the representation of black and minority ethnic groups in healthcare education and the workplace. Although the NHS workforce is very diverse, ethnic minorities are unevenly spread across occupations, and considerably underrepresented in senior positions. Previous research has highlighted that this inequality also exists at junior levels with newly qualified nurses from non-White/British ethnic groups being less likely to get a job at graduation than their White/British colleagues. Although there is better national data on the scale of inequalities in the healthcare workforce, there is a gap in our understanding about the experience of job seeking, and the factors that influence disadvantage in nursing and other professions such as physiotherapy. Aim: This qualitative study seeks to fill that gap and explores the experience of student nurses (n=12) and physiotherapists (n=6) throughout their education and during the first 6-months post qualification to identify key experiences and milestones relating to successful employment particularly focusing on the perspectives from different ethnic groups. Participants: Participants were purposively sampled from one university to ensure diversity in ethnic group, age and gender. Methods: Using a phenomenological approach, in-depth semi-structured interviews were conducted at course completion and 6 months later. Results: Two main themes were identified. The ‘proactive self’ (‘It’s up to me’) theme included perceptions of employment success being due to student proactivity and resilience; qualities valued by employers. The second theme described the need to ‘fit in’ with organisational culture. Graduates described accommodating strategies where they modified aspects of their identity (clothing, cultural markers) to fit in. At one extreme, rather than fitting in, participants from minority ethnic backgrounds avoided applying to certain hospitals due to perceptions of discriminatory cultures, ‘I wouldn’t apply there ‘cos you know, it’s not really an ethnic hospital’. In contrast, some participants recognised that other graduates (usually white) did not need to change and aspects of their identity brought unsolicited rewards 'if your face fits then the barriers are reduced'. Conclusions: The findings indicate that success in getting work is perceived as determined by individual factors, and fitting in is enabled by strategies adopted by the individual rather than the workplace. Demands for change are more acute for graduates from black and minority ethnic backgrounds. This is an issue for healthcare organisations seeking to be inclusive and challenges employers and educators to acknowledge inequalities and take action to address them. Keywords: ethnicity; employability; nurses; physiotherapists; job seeking activities; equality of employment

OBJECTIVES: to evaluate accuracy, sensitivity, specificity and inter-rater agreement of AVPU (Alert, Voice, Pain, Unresponsive) when used by non-specialist nursing staff assessing consciousness, and to investigate users' views. METHODS: Video-recorded simulations of assessments of consciousness were developed and verified by an expert panel. Participants scored simulations using AVPU and completed questionnaires eliciting views on the scale. AVPU scores were compared with functional levels agreed by the panel. SETTING: A large urban teaching hospital. RESULTS: Fifty-one participants scored 255 simulations. Overall accuracy was 82.4% (95% CI=77.7-87.1%), sensitivity 0.94 (95% CI=0.90-0.98), specificity 0.74 (95% CI=0.66-0.82) and inter-rater agreement (un-weighted kappa) 0.782. Accuracy was low for simulations depicting an orientated patient whose eyes open to speech (49% correct) and a confused patient with spontaneous eye opening (61.5% correct). Sensitivity and agreement for levels corresponding to "Alert" and "Voice" were 0.81 (95% CI=0.69-0.93) and kappa=0.506. Participants expressed uncertainty about aspects of AVPU's use. CONCLUSIONS: AVPU had low rates of accuracy, sensitivity and agreement in distinguishing between "Alert" and "Voice", and low specificity overall, suggesting it may be unsuitable for early warning scoring. Participants expressed doubts about the use of AVPU.

Peer- and self-assessment (PASA) are student-led assessment practices with the potential to positively affect achievement. Case studies of three New Zealand classrooms were examined to explore teacher and student perspectives of and purposes for PASA. Four themes (i.e., improvement, accountability, social interaction, and accuracy) were identified. Teachers cited mainly improvement purposes for PASA, with students primarily focused on accuracy and social interaction concerns. Data indicated that these teachers and students needed deeper understanding of how to use PASA for improvement and self-regulation purposes. This suggests teachers must provide concrete instruction in PASA and carefully manage interpersonal issues for successful implementation.

Teachers’ understandings of feedback probably influence the type and quality of feedback that they provide. The beliefs of 518 New Zealand practicing teachers about feedback were evaluated with the Teachers’ Conceptions of Feedback (TCoF) inventory and related to practices these teachers considered to be feedback. Nine feedback factors and four practices factors were found and models were statistically invariant between primary and secondary teachers. New Zealand teachers’ understandings of feedback were strongly focused on improving learning instead of enhancing student well-being. Similar factors are expected in other contexts, though agreement rates should reflect local policy priorities and cultural values.

The use of chitosan for the encapsulation of active components has gained interest in the last years due to its mucous adhesiveness, non-toxicity, biocompatibility and biodegradability. The benefits of encapsulating active agents in a polymer matrix include their protection from the surrounding medium or processing conditions and their controlled release. In this study chitosan nanoparticles and microspheres were obtained for the encapsulation of yerba mate. Nanoparticles were prepared by ionic gelation of chitosan hydrochloride and sodium tripolyphosphate. The active components were added to the sodium tripolyphosphate solution and this was added dropwise to the chitosan hydrochloride solution while stirring. Microspheres were prepared by the spray-drying method. In this case, antioxidants were added to the chitosan solution and the mixture was spray-dried. The effect of the encapsulating systems on the active compound stability and its release properties was analyzed. The products obtained allowed to control the release of natural antioxidants and therefore these encapsulating methods are a promising technique for nutraceutical and cosmetic applications.

Teacher actions can influence how students engage at school, making it relevant to understand their conceptions of student engagement and how to facilitate it. Reviews of existing literature suggested that a distinction between engagement in schooling and engagement in learning might help differentiate between social and academic outcomes. Data from a phenomenographic study of 20 Australian teachers were analysed to show how teacher thinking related to this distinction. While some teachers held complex conceptions centred on promoting cognitive engagement and student learning, others aligned with engagement in schooling, focusing on generating participation and emphasising positive student affective experiences.

Phenomenographers have developed two frameworks to enhance the study of conceptions. The first framework creates a distinction between what and how aspects; the second level of this framework also includes the act, direct object, and indirect object. This framework allows the conception to be analysed separately from the actions and intentions related to it. The second framework creates a distinction between referential and structural aspects which allows the parts and contexts of the conception to be identified; its second level includes the internal and external horizons. This article traces the origins of these frameworks and reviews 56 studies that have utilised them, examining similarities and differences in their usage. The review found heterogeneous definitions and usages of these frameworks, often with weak links to theory. It concluded by evaluating the utility of these frameworks, identifying that while they may not be strongly grounded in theory, when clearly defined, they can provide a method to ‘think apart’ important distinctions within conceptions.

Objective : In order to determine whether post-acute intermediate care in nursing-led inpatient units (NLUs) is effective in preparing patients for discharge from hospital we conducted a systematic review of the evidence. Review methods : The Cochrane Library, Effective Practice and Organisation of Care specialist register, Medline, Cinahl, Embase, British Nursing Index and the HMIC databases were searched for all available dates up to mid-2003. The science and social science citation indices were searched for papers that cited key works. Authors of papers were asked to identify additional research. Randomised controlled trials, controlled clinical trials, controlled before and after studies and interrupted time-series designs that compared the NLU to usual post-acute inpatient care for adults were included in the review. Studies were assessed for quality. Statistical meta-analysis on the results of controlled trials was performed. Sensitivity analyses were conducted to determine the impact of methodological quality on conclusions. Outcomes : Outcomes considered were mortality, institutionalisation after discharge, functional status early readmission, length of inpatient stay and cost. Results : Nine random or quasi-random controlled trials involving 1669 patients were reviewed. Quality was variable. The mean age of patients in all studies was over 70 years. There was no statistically significant difference in inpatient mortality between NLU and usual inpatient care (OR 1.10, 95% CI 0.56–2.16). The NLU was associated with reduced odds of discharge to institutional care (OR 0.44 95% CI 0.22–0.89), better functional status at discharge (SMD 0.37, 95% CI 0.20–0.54) and reduced odds of early readmission (OR 0.52 95% CI 0.34–0.80). Length of stay until discharge home was increased by 5.13 days (WMD) (95% CI–0.5–10.76 days). At longest follow up (3–6 months) there was no statistically significant difference in the proportion of patients in institutional care (OR 0.97, 95% CI 0.60–1.58). The results were not generally sensitive to study quality. Conclusions : The NLU successfully functions as a form of intermediate care, so far there is no evidence of adverse outcome from the lower level of routine medical care. However, more research is required to confirm safety. Patients discharged from NLUs have higher levels of function although it is unclear if the benefit is simply a product of an increased stay. There is no evidence of benefit over the longer term.

Chitosan microspheres cross-linked with genipin were prepared by a spray-drying method and were characterized in terms of morphology, loading efficiency, zeta potential and X-ray diffraction. The model drug used in this study was tramadol hydrochloride. In vitro drug release was also evaluated and microspheres showed controlled release kinetics.

To investigate the possibility that Hodgkin's disease (H.D.) may be transmitted from person to person, a case-control study was conducted among 87 of the 97 H.D. patients diagnosed under the age of 40 years in the period 1962-71, resident at the time of diagnosis in a defined area around Oxford. For each of the 87 H.D. patients a matched control patient was selected with a diagnosis other than that of a chronic or malignant disease. H.D. patients and controls were interviewed to determine their places of schooling and work and attempts were made to link pairs of patients who had attended the same school or work place at the same time. The findings do not support the hypothesis that H.D. patients may pass on the disease to others. Among the H.D. patients, links between 40 pairs were established, compared with 40·75 links expected, based upon the experience of all 174 persons studied. The only finding which was statistically significant (P≃0·04) arose when H.D. patients were considered to be "susceptible" from 10 to 5 years before diagnosis and "infective" from diagnosis to 2 years after diagnosis: 7 pairs of links were found against 2·75 expected. However, since 7 postulated periods of susceptibility and 9 postulated periods of infectivity were examined, this one "statistically significant" finding might easily have arisen by chance.

The EEGs of twenty-three patients and five asymptomatic siblings with Wilson's disease were correlated with their clinical states and biochemical studies related to liver function and copper metabolism. In uncomplicated cases of the disease the EEG may be normal or abnormal. When the EEG is abnormal there does not appear to be a clear correlation with a clinical or biochemical state. Severely abnormal EEGs are seen with severe complications of the disease and are appropriate to the complication. These EEGs show improvement parallel with clinical improvement. Asymptomatic siblings with the characteristic biochemical defect of copper metabolism may also show normal or abnormal EEGs, a feature which seems to have a familial tendency. The abnormal EEGs of asymptomatic siblings show improvement with treatment, supporting the argument for prophylaxis in such cases.