| 1. |
- Gangannagaripalli, J., et al.
(author)
-
A Standard Set of Value-Based Patient-Centered Outcomes and Measures of Overall Health in Adults
- 2022
-
In: Patient-Patient Centered Outcomes Research. - : Springer Science and Business Media LLC. - 1178-1653 .- 1178-1661. ; 15:3, s. 341-351
-
Journal article (peer-reviewed)abstract
- Background The definition of population-specific outcomes is an essential precondition for the implementation of value-based health care. We developed a minimum standard outcome set for overall adult health (OAH) to facilitate the implementation of value-based health care in tracking, comparing, and improving overall health care outcomes of adults across multiple conditions, which would be of particular relevance for primary care and public health populations. Methods The International Consortium for Health Outcomes Measurement (ICHOM) convened an international panel (patients, clinicians, and topic experts). Following the development of a conceptual framework, a modified Delphi method (supported by public consultations) was implemented to identify, in sequence, the relevant domains, the best instruments for measuring them, the timing of measurement, and the relevant adjustment variables. Findings Outcomes were identified in relation to overall health status and the domains of physical, mental, and social health. Three instruments covering these domains were identified: PROMIS Scale v1.2-Global Health (10 items), WHO Wellbeing Index (5 items), and the WHO Disability Assessment Schedule 2.0 (12 items). Case-mix variables included a range of sociodemographic and biometric measures. Yearly measurement was proposed for all outcomes and most case-mix variables. Interpretation The ICHOM OAH Standard Set has been developed through consensus-based methods based on predefined criteria following high standards for the identification and selection of high-quality measures The involvements of a wide range of stakeholders supports the acceptability of the set, which is readily available for use and feasibility testing in clinical settings.
|
|
| 2. |
- Goulson, D., et al.
(author)
-
Social learning drives handedness in nectar-robbing bumblebees
- 2013
-
In: Behavioral Ecology and Sociobiology. - 0340-5443 .- 1432-0762. ; 67:7, s. 1141-1150
-
Journal article (peer-reviewed)abstract
- Bumblebees have been found to observe and copy the behaviour of others with regard to floral choices, particularly when investigating novel flower types. They can also learn to make nectar-robbing holes in flowers as a result of encountering them. Here, we investigate handedness in nectar-robbing bumblebees feeding on Rhinanthus minor, a flower that can be robbed from either the right-hand side or the left-hand side. We studied numerous patches of R. minor spread across an alpine landscape; each patch tended to be robbed on either the right or the left. The intensity of side bias increased through the season and was strongest in the most heavily robbed patches. We suggest that bees within patches learn robbing strategies (including handedness) from one another, either by direct observation or from experience with the location of holes, leading to rapid frequency-dependent selection for a common strategy. Primary robbing was predominantly carried out not only by a specialist robbing species, Bombus wurflenii, but also by Bombus lucorum, a widespread generalist. Both species adopted the same handedness within particular flower patches, providing the first evidence for social learning crossing the species boundary in wild insects.
|
|
| 3. |
|
|
| 4. |
- Asker, Mohammed, et al.
(author)
-
Peripherally restricted oxytocin is sufficient to reduce food intake and motivation, while CNS entry is required for locomotor and taste avoidance effects
- 2023
-
In: Diabetes Obesity & Metabolism. - : Wiley. - 1462-8902 .- 1463-1326. ; 25:3, s. 856-877
-
Journal article (peer-reviewed)abstract
- ObjectivesOxytocin (OT) has a well-established role in reproductive behaviours; however, it recently emerged as an important regulator of energy homeostasis. In addition to central nervous system (CNS), OT is found in the plasma and OT receptors (OT-R) are found in peripheral tissues relevant to energy balance regulation. Here, we aim to determine whether peripheral OT-R activation is sufficient to alter energy intake and expenditure.Methods and ResultsWe first show that systemic OT potently reduced food intake and food-motivated behaviour for a high-fat reward in male and female rats. As it is plausible that peripherally, intraperitoneally (IP) injected OT crosses the blood-brain barrier (BBB) to produce some of the metabolic effects within the CNS, we screened, with a novel fluorescently labelled-OT (fAF546-OT, Roxy), for the presence of IP-injected Roxy in CNS tissue relevant to feeding control and compared such with BBB-impermeable fluorescent OT-B-12 (fCy5-OT-B-12; BRoxy). While Roxy did penetrate the CNS, BRoxy did not. To evaluate the behavioural and thermoregulatory impact of exclusive activation of peripheral OT-R, we generated a novel BBB-impermeable OT (OT-B-12), with equipotent binding at OT-R in vitro. In vivo, IP-injected OT and OT-B-12 were equipotent at food intake suppression in rats of both sexes, suggesting that peripheral OT acts on peripheral OT-R to reduce feeding behaviour. Importantly, OT induced a potent conditioned taste avoidance, indistinguishable from that induced by LiCl, when applied peripherally. Remarkably, and in contrast to OT, OT-B-12 did not induce any conditioned taste avoidance. Limiting the CNS entry of OT also resulted in a dose-dependent reduction of emesis in male shrews. While both OT and OT-B-12 proved to have similar effects on body temperature, only OT resulted in home-cage locomotor depression.ConclusionsTogether our data indicate that limiting systemic OT CNS penetrance preserves the anorexic effects of the peptide and reduces the clinically undesired side effects of OT: emesis, taste avoidance and locomotor depression. Thus, therapeutic targeting of peripheral OT-R may be a viable strategy to achieve appetite suppression with better patient outcomes.
|
|
