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To determine whether there were changes in the prevalence or healthiness of products carrying claims post-implementation of Standard 1.2.7: Nutrition, Health and Related Claims in the Australia New Zealand Food Standards Code.
Observational survey of claims on food packages in three categories: non-alcoholic beverages, breakfast cereals and cereal bars. Nutrient profiling was applied to products to determine their eligibility to carry health claims under Standard 1.2.7. The Standard came into effect in 2013. The proportion of products carrying claims and the proportion of those not meeting the nutrient profiling criteria were calculated. A comparative analysis was conducted to determine changes between 2011 and 2016.
Three large metropolitan stores from the three major supermarket chains in Sydney, Australia were surveyed in 2011 and 2016.
All claims on all available products in 2016 (n 1737). Nutrition composition and ingredients were collected from the packaging.
Overall in 2016, 76 % of products carried claims and there were 7367 claims identified in the three food categories. Of products in 2016 with health claims, 34 % did not meet nutrient profiling criteria. These may breach Standard 1.2.7. Comparison of 2011–2016 showed a significant increase in the number of products carrying claims (66 v. 76 %, P < 0·001).
The proportion of products carrying claims that do not meet nutrient profiling and consumers’ tendency to infer health benefits from nutrition content claims warrants the regulation of all claims using the nutrient profiling. This will ensure consumers are not misled by claims on unhealthy food products.
On low-input smallholder farms of Kenyan upland landscapes, erosion of nutrient-rich topsoil strongly affects crop yields. Where maize (Zea mays) is intercropped on erosion-prone slopes, intercropping can potentially reduce soil erosion. The objective of this research was to quantify the contribution of crops and crop mixtures of different growth habits to erosion control and their influence on above-ground biomass and earthworm abundance as indicators of soil function in smallholder farming systems under a bimodal rainfall pattern in Western Kenya. The experiment involved five treatments, namely maize (Z. mays)/common bean (Phaseolus vulgaris) intercrop (maize intercrop), maize/common bean intercrop plus Calliandra (Calliandra calothyrsus) hedgerows and Calliandra mulch (Calliandra), sole Lablab (Lablab purpureus), sole Mucuna (Mucuna pruriens) and groundnut (Arachis hypogaea) intercropped with maize (during the short rains). The experiment was conducted over three consecutive cropping seasons and the cropping system had significant effects on soil loss, runoff, water infiltration, earthworm abundance and above-ground biomass and crop grain yield. The Calliandra treatment had the lowest runoff (11.6–17.2 mm ha−1) and soil erosion (31–446 kg ha−1 per season) in all the seasons, followed by the Mucuna treatment. Lablab was affected by disease and showed the highest soil erosion in the last two seasons. Infiltration was highest in Calliandra treatment, and earthworm abundance was higher under Mucuna and Calliandra treatments (229 and 165 earthworms per square metre, respectively) than under other crops. Our results suggest that including sole crops of herbaceous species such as Mucuna, or tree hedgerows with mixtures of maize and grain legumes has the potential to reduce runoff and soil erosion in smallholder farming. Additionally, these species provide a suitable habitat for earthworms which stabilise soil structure and macropores and thus potentially increase infiltration, further reducing soil erosion.
The dynamic model Nitrogen Dynamics in Crop rotations in Ecological Agriculture (NDICEA) was used to assess the nitrogen (N), phosphorus (P) and potassium (K) balance of long-term organic cropping trials and typical organic crop rotations on a range of soil types and rainfall zones in the UK. The measurements of soil N taken at each of the organic trial sites were also used to assess the performance of NDICEA. The modeled outputs compared well to recorded soil N levels, with relatively small error margins. NDICEA therefore seems to be a useful tool for UK organic farmers. The modeling of typical organic rotations has shown that positive N balances can be achieved, although negative N balances can occur under high rainfall conditions and on lighter soil types as a result of leaching. The analysis and modeling also showed that some organic cropping systems rely on imported sources of P and K to maintain an adequate balance and large deficits of both nutrients are apparent in stockless systems. Although the K deficits could be addressed through the buffering capacity of minerals, the amount available for crop uptake will depend on the type and amount of minerals present, current cropping and fertilization practices and the climatic environment. A P deficit represents a more fundamental problem for the maintenance of crop yields and the organic sector currently relies on mined sources of P which represents a fundamental conflict with the International Federation of Organic Agriculture Movements organic principles.
Several studies demonstrating that central line–associated bloodstream infections (CLABSIs) are preventable prompted a national initiative to reduce the incidence of these infections.
We conducted a collaborative cohort study to evaluate the impact of the national “On the CUSP: Stop BSI” program on CLABSI rates among participating adult intensive care units (ICUs). The program goal was to achieve a unit-level mean CLABSI rate of less than 1 case per 1,000 catheter-days using standardized definitions from the National Healthcare Safety Network. Multilevel Poisson regression modeling compared infection rates before, during, and up to 18 months after the intervention was implemented.
A total of 1,071 ICUs from 44 states, the District of Columbia, and Puerto Rico, reporting 27,153 ICU-months and 4,454,324 catheter-days of data, were included in the analysis. The overall mean CLABSI rate significantly decreased from 1.96 cases per 1,000 catheter-days at baseline to 1.15 at 16–18 months after implementation. CLABSI rates decreased during all observation periods compared with baseline, with adjusted incidence rate ratios steadily decreasing to 0.57 (95% confidence intervals, 0.50–0.65) at 16–18 months after implementation.
Coincident with the implementation of the national “On the CUSP: Stop BSI” program was a significant and sustained decrease in CLABSIs among a large and diverse cohort of ICUs, demonstrating an overall 43% decrease and suggesting the majority of ICUs in the United States can achieve additional reductions in CLABSI rates.
Background: People with anxiety disorders occasionally report fears about losing control of basic bodily functions in public. These anxieties often occur in the absence of physical disorder and have previously been recognized as “obsessive” anxieties reflecting a preoccupation with loss of bowel/bladder control. Motivated by our observations of the non-trivial occurrence of such anxieties in our clinical practice we sought to fill a gap in the current understanding of “bowel/bladder-control anxieties”. Method: Eligible participants completed an internet survey. Results: Bowel/bladder-control anxieties (n = 140) tended to emerge in the mid to late 20s and were associated with high levels of avoidance and functional impairment. There was a high prevalence of panic attacks (78%); these were especially prevalent among those with bowel-control anxiety. Of those with panic attacks, 62% indicated that their main concern was being incontinent during a panic attack. Significantly, a proportion of respondents (~16%) reported actually being incontinent during a panic attack. Seventy percent of participants reported intrusive imagery related to loss of bowel/bladder control. Intrusion-related distress was correlated with agoraphobic avoidance and general role impairment. Some differences were noted between those with predominantly bowel-, predominantly bladder- and those with both bowel and bladder-control anxieties. Conclusion: This preliminary characterization indicates that even in a non-treatment seeking community sample, bowel/bladder-control anxieties are associated with high levels of distress and impairment. Further careful characterization of these anxieties will clarify their phenomenology and help us develop or modify treatment protocols in a way that takes account of any special characteristics of such viscerally-centred phobic syndromes.
Under Maltese law, a person can only exercise the profession of advocate if he or she has a warrant granted by the president of Malta. A person is only entitled to obtain this warrant if he is of good conduct and good morals; is a citizen of Malta or of a Member State of the European Union or is otherwise permitted to work in Malta under any law; has obtained the academic degree of doctor of law from the University of Malta or a comparable degree from another competent authority, having studied law in Malta or in a Member State; has regularly attended, for a period of not less than one year, at the office of a practising advocate of the Bar of Malta, and at the sittings of the superior courts; possesses a full knowledge of the Maltese language which is the language of the courts; and has been duly examined and approved by two judges who shall issue a certificate attesting that they have found him to possess the qualifications above-mentioned and that he is competent to exercise the profession of advocate in the courts of Malta.
To evaluate the impact of a multifaceted intervention on compliance with evidence-based therapies and ventilator-associated pneumonia (VAP) rates.
Collaborative cohort before-after study.
Intensive care units (ICUs) predominantly in Michigan.
We implemented a multifaceted intervention to improve compliance with 5 evidence-based recommendations for mechanically ventilated patients and to prevent VAP. A standardized CDC definition of VAP was used and maintained at each site, and data on the number of VAPs and ventilator-days were obtained from the hospital's infection preventionists. Baseline data were reported and postimplementation data were reported for 30 months. VAP rates (in cases per 1,000 ventilator-days) were calculated as the proportion of ventilator-days per quarter in which patients received all 5 therapies in the ventilator care bundle. Two interventions to improve safety culture and communication were implemented first.
One hundred twelve ICUs reporting 3,228 ICU-months and 550,800 ventilator-days were included. The overall median VAP rate decreased from 5.5 cases (mean, 6.9 cases) per 1,000 ventilator-days at baseline to 0 cases (mean, 3.4 cases) at 16–18 months after implementation (P < .001) and 0 cases (mean, 2.4 cases) at 28-30 months after implementation (P < .001). Compared to baseline, VAP rates decreased during all observation periods, with incidence rate ratios of 0.51 (95% confidence interval, 0.41–0.64) at 16–18 months after implementation and 0.29 (95% confidence interval, 0.24–0.34) at 28–30 months after implementation. Compliance with evidence-based therapies increased from 32% at baseline to 75% at 16–18 months after implementation (P < .001) and 84% at 28–30 months after implementation (P < .001).
A multifaceted intervention was associated with an increased use of evidence-based therapies and a substantial (up to 71%) and sustained (up to 2.5 years) decrease in VAP rates.
Background: Acceptance and Commitment Therapy advocates use of cognitive defusion techniques to reduce the distress evoked by negative thoughts, including verbal repetition (VR). In VR, a negative word is repeated until its semantic meaning is diluted (i.e. until semantic satiation is achieved). The present two studies examined whether VR is more effective than brief imaginal exposure (IE) and no intervention (CONT) in the reappraisal of contamination-related thoughts. Method: Participants high in contamination fears identified their most distressing thoughts and were randomly assigned to VR, IE, or CONT. A category membership decision task was also conducted to determine if VR produced semantic satiation. Results: In Study 1, there was no evidence of semantic satiation. Significant reductions in negative response to the thoughts was observed immediately following VR, but not IE or CONT; however, at one-week follow-up, both VR and IE groups reported similar reductions. In Study 2, the effects of VR and IE practice between post-intervention and follow-up were examined, as well as changes in behavioural avoidance. VR was found to produce semantic satiation of contamination thoughts, and VR was associated with less negative response at follow-up relative to IE and CONT, but the degree of satiation was not associated with the decreases in negative response. Only IE produced decreases in behavioural avoidance and vigilance monitoring. Conclusions: Taken together, these results suggest that VR may have potential as an additional strategy for managing obsessional thoughts, but more research is warranted.
This paper examined the fundamental frequency variation in the narratives of individuals with high-functioning autism (HFA) and typical controls matched on age, IQ, and verbal abilities. Study 1 found increased fundamental frequency variation in the speech of 21 children and adolescents with HFA when compared to 21 typical controls. Study 2 replicated the findings from Study 1 with a younger sample of 17 children with HFA and 17 typical controls. In addition, Study 1 found evidence that acoustic measurements of prosody were related to clinical judgments of autism-specific communication impairments, although this was not replicated in Study 2. Taken together, these studies provide evidence for differences in expressive prosody in individuals with HFA that can be measured objectively.
To determine the reliability and validity of scales measuring low-fat milk consumption self-efficacy and norms during school lunch among a cohort of 5th graders.
Two hundred and seventy-five students completed lunch food records and a psychosocial questionnaire measuring self-efficacy and norms for school lunch low-fat milk consumption during the fall and spring semesters of the 1998–1999 academic year. Test–retest reliability was assessed in participants who also completed the questionnaire in the spring semester (n = 262). Principal component analyses identified and confirmatory factor analyses confirmed latent variables. Bivariate correlations measured construct validity.
Houston-area middle school.
Fifth graders (n = 275) from one middle school in southeast Texas.
Two scales measuring psychosocial influences of low-fat milk consumption were identified and proved reliable in this population: milk self-efficacy and milk norms. Milk self-efficacy and norms were positively correlated with milk consumption and negatively correlated with consumption of sweetened beverages.
These questionnaires can be used in similar interventions to measure the impact of self-efficacy and norms for drinking low-fat milk during school lunch.
Attention Training (ATT) is an auditory attention-focusing technique that attempts to reduce the perseverative self-focused processing characteristic of anxiety and mood disorders. The present study investigated the effects of one session of ATT in the reduction and reappraisal of intrusive thoughts in a university sample reporting high levels of obsessive-compulsive symptoms. One-hundred and eight participants identified their most distressing intrusive thought and spent 7 minutes monitoring their stream of consciousness while recording occurrences of the identified thought. They then rated the unpleasantness of the intrusive thought, their attempts to dismiss the thought from consciousness, and their perceived success in reducing the frequency of the thought. Participants were then randomly assigned to receive one session of ATT, thought replacement instructions (TR), distraction instructions (DI), or no intervention (CONT). Participants then repeated the thought monitoring interval and ratings. ATT was expected to be the most effective in decreasing the frequency and unpleasantness of intrusive thoughts. However, contrary to hypotheses, all groups reported similar decreases across intervals. Implications of these findings are discussed.
During pregnancy, there is a massive increase in the number of luminal epithelial cells in the breast, which are destined to become the milk factories after birth. These cells are no longer required when the young are weaned, and are removed in a carefully orchestrated event called involution. In this process, the secretory epithelial cells die and are replaced by adipocytes, which redifferentiate as the epithelium is removed. It is essential that the gland is properly remodelled to a pre-pregnant state so that successful lactation can occur following a subsequent pregnancy. Furthermore, failure to remove unnecessary lactational alveoli during weaning could result in inflammation and tissue damage. Recently, it has been shown that components in the fatty stroma in involuting breast can promote metastasis. Thus, it is important to understand the molecular mechanisms that regulate involution, how these can fail, the consequences of the remodelling process, and how this knowledge can inform us about breast cancer. In this review, I discuss the roles of the JAK–STAT, NF-κB and other signalling pathways in the regulation of apoptosis and tissue remodelling during involution.
We have investigated the low-temperature epitaxial growth of thin silicon films by hotwire chemical vapor deposition (HWCVD). Using reflection high energy electron diffraction (RHEED) and transmission electron microscopy (TEM), we have found conditions for epitaxial growth at low temperatures achieving twinned epitaxial growth up to 6.8 μm on Si(100) substrates at a substrate temperature of 230°C. This opens the possibility of growing high quality films on low cost substrates. The H2:SiH4 dilution ratio was set to 50:1 for all growths. Consistent with previous results, the epitaxial thickness is found to decrease with an increase in the substrate temperature.
The possible relationship between psychological responses among breast cancer patients and discase outcome continues to be an area of controversy and debate. Two parallel findings are reported separately in the literature: first, that emotional control is more common among women with breast cancer than in women with benign breast disease or in healthy controls and second, that a helpless attitude towards the disease is related to a poor prognosis.
These previously unrelated psychological responses are examined here in a group of women (N = 359) with early stage breast cancer, who were seen one to three months after diagnosis. The relationships between emotional control, adjustment to cancer and psychological morbidity were examined. Prevalence levels of 16 and 6% were observed for anxiety and depression respectively, which are lower than reported more generally in the literature. The results indicated a highly significant association between scores for the tendency to control emotional reactions and a fatalistic attitude toward cancer. A significant association was observed between anger control and a helpless attitude. Psychological morbidity was also linked to type of adjustment to cancer. The data are interpreted in terms of a process model of psychological responses which suggests that emotional control (an important component of the Type C behaviour pattern) fatalism, helplessness and psychological morbidity are linked.
An exploratory factor analysis of the HAD was carried out in 568 cancer patients. Two distinct, but correlated, factors emerged which corresponded to the questionnaire's anxiety and depression subscales. The factor structure proved stable when subsamples of the total sample were investigated. The internal consistency of the two subscales was also high. These results provide support for the use of the separate subscales of the HAD in studies of emotional disturbance in cancer patients.
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