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Exercise has many health benefits for individuals with Type 1 Diabetes (T1D), however it carries the risk of hypoglycaemia. Research has indicated that intermittent high intensity exercise reduces this risk compared to steady state exercise, potentially via a greater anaerobic component inducing increased lactate and catecholamine response.Six physically active males aged 23 ± 5 years, BMI 24.9 ± 1.8 kg•m-2, Vo2 max 47.9 ± 10.1 ml•kg-1•min-1 diagnosed with Type 1 Diabetes for 9 ± 3 years and a HbA1c concentration of 8.6 ± 0.3% participated in a randomised counterbalanced trial. Participants exercised for 60 min on a cycle ergometer on two occasions separated by 7 days, which consisted of a moderate continuous steady state exercise session at 40% o2 max (CONT), or the same exercise intensity interspersed with 7 s high intensity sprints at 100% Vo2 max every 2 min (INT). Blood glucose concentration was assessed via capillary blood sampling every 10 min during exercise and at regular intervals in the 60 min post exercise (Accu-Chek Aviva, Roche, UK). Additional metabolic measures such as blood lactate concentration and carbohydrate oxidation rates were assessed during exercise. Participants ingested small quantities of a carbohydrate drink, if required, to avoid hypoglycaemia during exercise. Magnitude based inferences were used to compare the two exercise trials and Effect Sizes (ES) calculated using Cohen's d and results presented as mean ± SD.Average blood glucose concentration was lower on the INT trial compared to CONT during both the exercise phase (8.9 ± 1.7 mmol•l-1 vs 7.1 ± 1.1 mmol•l-1; ES 0.55) and the 60 min post-exercise recovery phase (8.1 ± 1.9 mmol•l-1 vs 7.0 ± 1.8 mmol•l-1; ES 0.56). Carbohydrate oxidation was greater on the INT trial compared to CONT (1.9 ± 1.4 g•min-1 vs 1.5 ± 0.6 g•min-1; ES 0.35). Capillary blood lactate concentration was markedly elevated on INT when compared to CONT (5.0 ± 1.4 mmol•l-1 vs 2.4 ± 1.1 mmol•l-1; ES 2.48). Carbohydrate ingestion during exercise was 13 ± 11 g and differed little between trials (ES 0.18).Despite greater anaerobic metabolic response, the addition of intermittent high intensity sprints to 60 min steady-state cycle exercise resulted in greater declines in blood glucose concentration during the exercise and post-exercise period, potentially by inhibition of the counter regulatory hormone response expected on the INT trial. These results would indicate that additional exogenous carbohydrate ingestion may be required for individuals with T1D when intermittent sprints are added to prolonged continuous exercise.
We describe the effectiveness of community outreach and engagement in supporting recruitment for the US National Children’s Vanguard Study between 2009 and 2012.
Thirty-seven study locations used 1 of 4 strategies to recruit 18–49-year-old pregnant or trying to conceive women: (1) Initial Vanguard Study used household-based recruitment; (2) Direct Outreach emphasized self-referral; (3) Enhanced Household-Based Recruitment enhanced Initial Vanguard Study strategies; and (4) Provider-Based Recruitment recruited through healthcare providers. Outreach and engagement included advance letters, interactions with healthcare providers, participation in community events, contacts with community organizations, and media outreach.
After 1–2 years, 41%–74% of 9844 study-eligible women had heard about the National Children’s Vanguard Study when first approached. Women who heard were 1.5–3 times more likely to consent. Hearing via word-of-mouth or the media most frequently predicted consent. The more sources women heard from the higher the odds of consent.
We conclude that tailored outreach and engagement facilitate recruitment in cohort studies.
During natural disasters, hospital evacuation may be necessary to ensure patient safety and care. We aimed to examine perceptions of stakeholders involved in these decisions throughout the Mid-Atlantic region of the United States during Hurricane Sandy in October 2012.
Semistructured interviews were conducted from March 2014 to February 2015 to characterize stakeholders’ perceptions about authority and responsibility for acute care hospital evacuation/shelter-in-place decision-making in Delaware, Maryland, New Jersey, and New York during Hurricane Sandy. Interviews were recorded, transcribed, and thematically analyzed using a framework approach.
We interviewed 42 individuals from 32 organizations. Hospital executives from all states reported having authority and responsibility for evacuation/shelter-in-place decision-making. In New York and Maryland, government officials stated that they could order hospital evacuation, whereas officials in Delaware and New Jersey said the government lacked enforcement capacity and therefore could not mandate evacuation.
Among government officials, perceived authority for hospital evacuation/shelter-in-place decision-making was viewed as a prerequisite to ordering evacuation. When both hospital executives and government officials perceive themselves to possess decision-making authority, there is the potential for inaction. Future work should examine whether a single entity bearing ultimate responsibility or regional emergency response coalitions would improve decision-making. (Disaster Med Public Health Preparedness. 2016;10:320–324)
Despite the potential of declared serving size to encourage appropriate portion size consumption, most countries including Australia have not developed clear reference guidelines for serving size. The present study evaluated variability in manufacturer-declared serving size of discretionary food and beverage products in Australia, and how declared serving size compared with the 2013 Australian Dietary Guideline (ADG) standard serve (600 kJ). Serving sizes were obtained from the Nutrition Information Panel for 4466 packaged, discretionary products in 2013 at four large supermarkets in Sydney, Australia, and categorised into fifteen categories in line with the 2013 ADG. For unique products that were sold in multiple package sizes, the percentage difference between the minimum and the maximum serving size across different package sizes was calculated. A high variation in serving size was found within the majority of food and beverage categories – for example, among 347 non-alcoholic beverages (e.g. soft drinks), the median for serving size was 250 (interquartile range (IQR) 250, 355) ml (range 100–750 ml). Declared serving size for unique products that are available in multiple package sizes also showed high variation, particularly for chocolate-based confectionery, with median percentage difference between minimum and maximum serving size of 183 (IQR 150) %. Categories with a high proportion of products that exceeded the 600 kJ ADG standard serve included cakes and muffins, pastries and desserts (≥74 % for each). High variability in declared serving size may confound interpretation and understanding of consumers interested in standardising and controlling their portion selection. Future research is needed to assess if and how standardising declared serving size might affect consumer behaviour.
While more and more long-period giant planets are discovered by direct imaging, the distribution of planets at these separations (≳5 AU) has remained largely uncertain, especially compared to planets in the inner regions of solar systems probed by RV and transit techniques. The low frequency, the detection challenges, and heterogeneous samples make determining the mass and orbit distributions of directly imaged planets at the end of a survey difficult. By utilizing Monte Carlo methods that incorporate the age, distance, and spectral type of each target, we can use all stars in the survey, not just those with detected planets, to learn about the underlying population. We have produced upper limits and direct measurements of the frequency of these planets with the most recent generation of direct imaging surveys. The Gemini NICI Planet-Finding Campaign observed 220 young, nearby stars at a median H-band contrast of 14.5 magnitudes at 1”, representing the largest, deepest search for exoplanets by the completion of the survey. The Gemini Planet Imager Exoplanet Survey is in the process of surveying 600 stars, pushing these contrasts to a few tenths of an arcsecond from the star. With the advent of large surveys (many hundreds of stars) using advanced planet-imagers we gain the ability to move beyond measuring the frequency of wide-separation giant planets and to simultaneously determine the distribution as a function of planet mass, semi-major axis, and stellar mass, and so directly test models of planet formation and evolution.
In February 2013, the LEECH (LBTI Exozodi Exoplanet Common Hunt) survey began its 100-night campaign from the Large Binocular Telescope atop Mount Graham in Arizona. LEECH neatly complements other high-contrast planet imaging efforts by observing stars in L' band (3.8 microns) as opposed to the shorter wavelength near-infrared bands (1–2.3 microns). This part of the spectrum offers deeper mass sensitivity for intermediate age (several hundred Myr-old) systems, since their Jovian-mass planets radiate predominantly in the mid-infrared. In this proceedings, we present the science goals for LEECH and a preliminary contrast curve from some early data.
We have carried out high contrast imaging of 70 young, nearby B and A stars to search for brown dwarf and planetary companions as part of the Gemini NICI Planet-Finding Campaign. Our survey represents the largest, deepest survey for planets around high-mass stars (≈1.5–2.5 M⊙) conducted to date and includes the planet hosts β Pic and Fomalhaut. Despite detecting two new brown dwarfs, our observations did not detect new planets around our target stars, and we present upper limits on the fraction of high-mass stars that can host giant planets that are consistent with our null result.
Of all the Celtic countries, Scotland has lacked the kind of scholarly attention that has been lavished fruitfully on Wales, Ireland, Cornwall and Brittany. And yet of all of them, Scotland offers the widest range of interfaces with broader work on the cult of saints. The papers presented here cover this territory very effectively.... [the book] brings together excellent studies that successfully explore the wide ramifications of the topic. Anyone with an interest in saints' cults will want this book. DAUVIT BROUN, Professor of Scottish History, University of Glasgow. This volume examines the phenomena of the cult of saints and Marian devotion as they were manifested in Scotland, ranging from the early medieval period to the sixteenth century. It combines general surveys of the development of the study of saints in the early and later middle ages with more focused articles on particular subjects, including St Waltheof of Melrose, the obscure early medieval origins of the cult of St Munnu, the short-lived martyr cult of David, duke of Rothsay, and the Scottish saints included in the greatest liturgical compendium produced in late medieval Scotland, the Aberdeen breviary. The way in which Marian devotion permeated late medieval Scottish society is discussed in terms of the church dedications of the twelfth and thirteenth-century aristocracy, the ecclesiastical landscape of Perth, the depiction of Mary in Gaelic poetry, and the pervasive influence of the familial bond between holy mother and son in representations of the Scottish royal family. Dr Steve Boardman is Reader in History, University of Edinburgh; Eila Williamson gained her PhD from the University of Glasgow. Contributors: Helen Birkett, Steve Boardman, Rachel Butter, Thomas Owen Clancy, David Ditchburn, Audrey-Beth Fitch, Mark A. Hall, Matthew H. Hammond, Sim Innes, Alan Macquarrie
In this chapter, the focus is primarily on the problems that beset investigating saints' cults in the early medieval period, something approached also in Rachel Butter's incisive case-study of St Munnu. The Survey of Dedications to Saints in Medieval Scotland is one of the most welcome developments in such investigations. First, it will help us understand the dynamism and evolution of saints' cults during the later medieval period, a period for which there remains a great deal of work to do, and much headway to be gained in refining and opening out our understanding of medieval Scottish piety and the nexus between society and religion. Second, and more importantly for this contribution, it will help to clarify for us what we do and do not know about the later medieval position of the cult of those saints already present in the Scottish landscape in the period before the twelfth century. It has become increasingly apparent in recent studies that no real progress can be made in our understanding of early medieval saints' cults without a firm grasp of the nature of the later medieval evidence for those cults. This is especially so, given the paucity of clear documentation cited for the likes of church dedications or fair days by key secondary sources like Mackinlay's Ancient Church Dedications and Watson's Celtic Place-Names of Scotland. This chapter primarily addresses the evidence provided by one source which has had to remain largely outwith the remit of the Survey: place-name evidence.
In 1968 The Innes Review published an article by David McRoberts which was (to use a word often overused in recent years) seminal. Its influence is visible in much, indeed in almost everything, that has been written since 1968 about the Church and about religion in later medieval Scotland. The thesis which it presented was relatively straightforward. McRoberts argued that the fifteenth century witnessed a new and what he called ‘nationalist’ trend in Scottish religious observation. There were several dimensions to this development – but it was especially apparent, McRoberts argued, in the veneration of saints. Before the fifteenth century the Church had neglected Scotland's early saints; thereafter leading clergymen began to look anew at these forgotten worthies. In the earlier part of the century Prior James Haldenstone of St Andrews had coordinated a campaign to have St Duthac officially canonised. Elsewhere there were efforts to relocate the relics and to promote the cults of St Kentigern (at Glasgow and Culross), St Ninian (at Whithorn) and St Triduana (at Restalrig). We find the chronicler Walter Bower lauding St Columba and Archbishop Schevez of St Andrews mounting a search for the relics of St Palladius. This ‘devotional nationalism’ reached its culmination, according to McRoberts, in the early sixteenth century with the work of Bishop William Elphinstone and a team of collaborators in Old Aberdeen, who produced a new martyrology and a new breviary.