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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.
Human reasoning is richer than Lake et al. acknowledge, and the emphasis on theories of how images and scenes are synthesized is misleading. For example, the world knowledge used in vision presumably involves a combination of geometric, physical, and other knowledge, rather than just a causal theory of how the image was produced. In physical reasoning, a model can be a set of constraints rather than a physics engine. In intuitive psychology, many inferences proceed without detailed causal generative models. How humans reliably perform such inferences, often in the face of radically incomplete information, remains a mystery.
Motions of nearby elliptical galaxies reveal a large-scale velocity flow relative to cosmic rest towards the point 1=307±10, b = 9±10. The data are fit best by a two-component flow model. The smaller component is due to Virgo, which induces a velocity at the Local Group of 250 km/s. The main flow is due to a more massive concentration located a distance of 4350±350 km/s towards 1=307, b=9, which induces a local velocity here of 570±60 km/s. This larger component falls off away from the mass concentration roughly as r−1. The Centaurus double cluster and its neighbors are in the direction of the mass concentration but are in the foreground and are falling into it. Galaxy counts, radial velocity surveys, and the motions of nearby spirals are consistent with the above model. The IRAS dipole results are less clear but may also be consistent. There is evidence that the distant mass concentration is non-spherical, with the Centaurus cloud a substantial sub-condensation in the foreground. The formal agreement of the large-scale flow with biased (b=2) cold dark matter is low, but the simple methods used so far to assess this are uncertain. The main weakness of the present data in comparing to theory is the fact that they do not penetrate far enough to show the velocity field on all sides of the mass concentration. Sphericity and total extent of the flow are therefore still unknown.
The peculiar motions for spiral galaxies and elliptical galaxies within V = 3500 km/s are compared to the model predictions of the mass concentration (MC) velocity field model of Lynden-Bell et al. The large-scale motions defined by over 600 galaxies from three independent sets of data (Aaronson et al.; de Vaucouleurs and Peters and elliptical galaxies) are in substantial agreement with this model.
We have used a new distance estimator for elliptical galaxies to determine the peculiar velocities, with respect to a uniform Hubble flow, of approximately 400 galaxies. The relative distances of five clusters in common with those of Aaronson et al. (1981, 1986), based on the infrared Tully-Fisher relation for spirals, are in good agreement.
We do not see the reflex of the Local Group motion with respect to the microwave background out to recession velocities of 6000 km s−1. Rather, the frame of elliptical galaxies appears to be moving with respect to the microwave background with a velocity of 600 km s−1 towards 1 = 312°, b = +6°. This motion is consistent with a re-analysis of the Rubin et al. (1976) data on the magnitude-diameter relation for ScI galaxies and with the nearby and cluster samples of Aaronson et al. (1982, 1986).