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Anecdotal evidence suggests the use of bolus tube feeding is increasing in long term home enteral tube feed (HETF) patients. A cross-sectional survey to assess the prevalence of bolus tube feeding and to characterise these patients was undertaken. Dietitians from 10 centres across the UK collected data on all adult HETF patients on the dietetic caseload receiving bolus tube feeding, (n=604, 60% male, age 58years). Demographic data, reasons for tube and bolus feeding, tube and equipment types, feeding method and patients’ complete tube feeding regimens were recorded. Over a third of patients receiving HETF used bolus feeding (37%). Patients were long-term tube fed (4.1years tube feeding, 3.5years bolus tube feeding), living at home (71%) and sedentary (70%). The majority were head and neck cancer patients (22%) who were significantly more active (79%) and lived at home (97%), while those with cerebral palsy (12%) were typically younger (age 31years) but sedentary (94%). Most patients used bolus feeding as their sole feeding method (46%), because it was quick and easy to use, as a top up to oral diet or to mimic meal times. Importantly, oral nutritional supplements (ONS) were used for bolus feeding in 85% of patients, with 51% of these being compact-style ONS (2.4kcal/ml, 125ml). This survey shows that bolus tube feeding is common amongst UK HETF patients, is used by a wide variety of patient groups and can be adapted to meet the needs of a variety of patients, clinical conditions, nutritional requirements and lifestyles.
Swede midge (Contarinia nasturtii (Kieffer); Diptera: Cecidomyiidae) is a serious invasive pest of Brassica Linnaeus (Brassicaceae) oilseed and vegetable crops in Canada and the United States of America. Pheromone mating disruption is a promising new tactic for managing this difficult pest, but research is needed to determine how pheromone delivery can be optimised. With an understanding of swede midge diel mating patterns, pest managers could limit pheromone release to periods when midges are sexually active. We conducted a series of 24-hour trials to test whether swede midge exhibit diel periodicity of emergence, female calling, and male capture in pheromone traps. We found that females began releasing pheromones almost immediately following emergence within the first five hours after dawn. In the field, we found that males were most active from dawn until late morning, indicating that midges mate primarily during the first five hours of photophase. Low levels of reproductive activity during midday and nighttime hours present opportunities to turn off dispensers and reduce the cost of pheromone inputs in a swede midge mating disruption system.
The purpose of this article is to examine what was involved when the great linguist George Grierson framed the history of Indian bhakti in terms of ‘the four churches of the reformation’ in one of his most widely read publications, ‘Bhakti-Mārga’, an entry in the Encyclopaedia of Religion and Ethics (1910). This was his translation of the concept of catuḥ (or cār) sampradāy, which plays a significant role in Nābhādās's Hindi Bhaktamāl (circa 1600). The weight of the target language and its enveloping culture (‘church’, ‘reformation’) raise obvious red flags. Grierson did not submit them to the sort of self-critical scrutiny we might today, nor did he examine the adequacy of Nābhādās's historiography. But did he get it all wrong? I will suggest that there are in fact some intriguing, if distant, analogies between the early modern world out of which Nābhādās wrote and its contemporary Protestant European counterpart, and I will ask whether Nābhādās may have been encouraged to adopt the framework he did because of precedents established in contemporary Muslim historiographical practice. In outlining his four sampradāys, Nābhādas played a role in creating a set of assumptions that long survived his own time in North India—and not just because Grierson would later be listening.
Self-screening using an electronic version of the Malnutrition Universal Screening Tool (‘MUST’) has been developed but its implementation requires investigation. A total of 100 outpatients (mean age 50 (sd 16) years; 57 % male) self-screened with an electronic version of ‘MUST’ and were then screened by a healthcare professional (HCP) to assess concurrent validity. Ease of use, time to self-screen and prevalence of malnutrition were also assessed. A further twenty outpatients (mean age 54 (sd 15) years; 55 % male) examined preference between self- screening with paper and electronic versions of ‘MUST’. For the three-category classification of ‘MUST’ (low, medium and high risk), agreement between electronic self-screening and HCP screening was 94 % (κ=0·74, se 0·092; P<0·001). For the two-category classification (low risk; medium+high risk) agreement was 96 % (κ=0·82, se 0·085; P<0·001), comparable with the previously reported paper-based self-screening. In all, 15 % of patients categorised themselves ‘at risk’ of malnutrition (5 % medium, 10 % high). Electronic self-screening took 3 min (sd 1·2 min), 40 % faster than previously reported for the paper-based version. Patients found the tool easy or very easy to understand (99 %) and complete (98 %). Patients that assessed both tools found the electronic tool easier to complete (65 %) and preferred it (55 %) to the paper version. Electronic self-screening using ‘MUST’ in a heterogeneous group of hospital outpatients is acceptable, user-friendly and has ‘substantial to almost-perfect’ agreement with HCP screening. The electronic format appears to be as agreeable and often the preferred format when compared with the validated paper-based ‘MUST’ self-screening tool.
The emergence of separate cemeteries for disposal of the dead represents a profound shift in mortuary practice in the Late Neolithic of southeast Europe, with a new emphasis on the repeated use of a specific space distinct from, though still often close to, settlements. To help to time this shift more precisely, this paper presents 25 dates from 21 burials in the large cemetery at Cernica, in the Lower Danube valley in southern Romania, which are used to formally model the start, duration of use and end of the cemetery. A further six dates were obtained from four contexts for the nearby settlement. Careful consideration is given to the possibility of environmental and dietary offsets. The preferred model, without freshwater reservoir offsets, suggests that use of the Cernica cemetery probably began in 5355–5220 cal BC (95% probability) and ended in 5190–5080 cal BC (28% probability) or 5070–4940 (67% probability). The implications of this result are discussed, including with reference to other cemeteries of similar age in the region, the nature of social relations being projected through mortuary ritual, and the incorporation of older, Mesolithic, ways of doing things into Late Neolithic mortuary practice.
This work presents a study of the region of nanoparticle growth in an atmospheric pressure carbon arc. The nanoparticles are detected using the planar laser-induced incandescence technique. The measurements revealed large clouds of nanoparticles in the arc periphery bordering the region with a high density of diatomic carbon molecules. Two-dimensional computational fluid dynamic simulations of the arc combined with thermodynamic modeling show that this is due to the interplay of the condensation of carbon molecular species and the convection flow pattern. These results show that the nanoparticles are formed in the colder, peripheral regions of the arc and describe the parameters necessary for coagulation.
Low resting respiratory sinus arrhythmia (RSA), and to a lesser extent excessive RSA reactivity to emotion evocation, are observed in many psychiatric disorders characterized by emotion dysregulation, including syndromes spanning the internalizing and externalizing spectra, and other conditions such as nonsuicidal self-injury. Nevertheless, some inconsistencies exist. For example, null outcomes in studies of RSA–emotion dysregulation relations are sometimes observed among younger participants. Such findings may derive from use of age inappropriate frequency bands in calculating RSA. We combine data from five published samples (N = 559) spanning ages 4 to 17 years, and reanalyze RSA data using age-appropriate respiratory frequencies. Misspecifying respiratory frequencies results in overestimates of resting RSA and underestimates of RSA reactivity, particularly among young children. Underestimates of developmental shifts in RSA and RSA reactivity from preschool to adolescence were also observed. Although correlational analyses revealed weak negative associations between resting RSA and aggression, those with clinical levels of externalizing exhibited lower resting RSA than their peers. No associations between RSA reactivity and externalizing were observed. Results confirm that age-corrected frequency bands should be used when estimating RSA, and that literature-wide overestimates of resting RSA, underestimates of RSA reactivity, and underestimates of developmental shifts in RSA and RSA reactivity may exist.