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To evaluate associations of demographic and socio-economic factors with diet quality among population subgroups in Bosnia and Herzegovina (B&H).
A cross-sectional analysis of 2017 B&H dietary survey data. Diet quality was assessed by the Prime Diet Quality Score (PDQS) utilizing data from two non-consecutive 24 h diet recalls. Socio-economic variables were extracted from the 2015 B&H Household Budget Survey. Homogeneity of means across population subgroups was evaluated using multivariable regression.
B&H population survey.
A population-based sample of 853 adults.
The mean PDQS was 15·8 (range 7–28 out of a possible 42 points). In general, Bosnian adults had low PDQS due to high intakes of refined grains, high-fat dairy and processed meats, and low intakes of whole grains, nuts and fish. The PDQS was significantly higher (P < 0·0001) among older individuals (17·0) compared with those in the youngest group (14·5), among individuals living in the central and northern regions (16·5) compared with those living in the south (15·1; P < 0·0001), and among people who are married/cohabitating (16·1) v. single (14·8; P = 0·02). In energy-adjusted models, socio-economic status (P = 0·04) and tertiles of household spending (P = 0·002) were inversely associated with the PDQS.
Diet quality in this population was low. Young and middle-aged individuals, singles and those living in the south had significantly lower quality diets compared with other subgroups. Public health action is needed to promote higher consumption of whole grains, nuts and fish, and a higher variety of fruits and vegetables.
The Beck’s Petrel Pseudobulweria beckii is a ‘Critically Endangered’ seabird whose breeding sites remain unknown. Historic observations suggest the species’ distribution is concentrated in the Bismarck Archipelago and particularly southern New Ireland. Over the course of two research expeditions in 2016 and 2017 we used on-land and at-sea observations, local interviews and satellite telemetry to understand the distribution of the species, its at-sea movements and potential breeding locations. Land-based and at-sea observations indicated that the area of Silur Bay in southern New Ireland was a significant site for Beck’s Petrel with numbers of birds increasing near shore prior to dusk and birds observed in spotlights over land. A local population is estimated to be in the low thousands. In 2017 a single Beck’s was captured at sea, fitted with a satellite transmitter and tracked for eight months. This bird maintained a core distribution off the south-east coast of New Ireland and north of Bougainville for 122 days. During the tracking period, the bird was located over land at night seven times; predominantly over southern New Ireland, where the signal was also lost for extended periods suggesting occupancy of an underground burrow. In August the bird migrated 1,400 km to a core pelagic habitat north of West Papua before the signal was eventually lost. Our combination of land- and sea-based observations and analysis of behaviour from satellite tracking supports the conclusion that a breeding site for Beck’s Petrel lies in the inland mountains of southern New Ireland and most likely in the high-altitude zone (> 2000 m) of the Hans Meyer Range. Further investigations are required to determine the exact location of breeding colonies in the mountains of southern New Ireland and the importance of a potential west Papuan non-breeding pelagic habitat for the species.
The aim of this study was to explore parental preparedness for discharge and their experiences of going home with their infant after the first-stage surgery for a functionally univentricular heart.
Technological advances worldwide have improved outcomes for infants with a functionally univentricular heart over the last 3 decades; however, concern remains regarding mortality in the period between the first and second stages of surgery. The implementation of home monitoring programmes for this group of infants has improved this initial inter-stage survival; however, little is known about parents’ experiences of going home, their preparedness for discharge, and parents’ recognition of deterioration in their fragile infant.
This study was conducted in 2011–2013; eight sets of parents were consulted in the research planning stage in September, 2011, and 22 parents with children aged 0–2 years responded to an online survey during November, 2012–March, 2013. Description of categorical data and deductive thematic analysis of the open-ended questions were undertaken.
Not all parents were taught signs of deterioration or given written information specific to their baby. The following three themes emerged from the qualitative data: mixed emotions about going home, knowledge and preparedness, and support systems.
Parents are not adequately prepared for discharge and are not well equipped to recognise deterioration in their child. There is a role for greater parental education through development of an early warning tool to address the gap in parents’ understanding of signs of deterioration, enabling appropriate contact and earlier management by clinicians.
The genus Diorhabda (Coleoptera: Chrysomelidae) was recently revised, using morphological characters, into five tamarisk-feeding species, four of which have been used in the tamarisk (Tamarix spp.) biological control program in North America and are the subject of these studies. The taxonomic revision is here supported using molecular genetic and hybridization studies. Four Diorhabda species separated into five clades using cytochrome c oxidase subunit 1 sequence data with Diorhabda elongata separating into two clades. Amplified fragment length polymorphism (AFLP) analysis using genomic DNA revealed only four clades, which corresponded to the four morphospecies. Hybridization between the four species yielded viable eggs in F1 crosses but viability was significantly lower than achieved with intraspecific crosses. Crosses involving Diorhabda carinulata and the other three species resulted in low F2 egg viability, whereas crosses between D. elongata, Diorhabda sublineata and Diorhabda carinata resulted in > 40% F2 egg viability. Crosses between D. carinulata and the other three species resulted in high mortality of D. carinulata females due to genital mismatch. AFLP patterns combined with principal coordinates analysis enabled effective separation between D. elongata and D. sublineata, providing a method to measure genetic introgression in the field.
The aim of this study was to investigate the challenges that nurse unit managers (NUMs) face while working in acute care settings, the strategies they use to deal with these challenges, and the effectiveness of these strategies from the perspectives of NUMs and their supervisors. NUMs (N = 22) and directors of nursing (N = 3) were interviewed for this study. Thematic analysis revealed 14 challenges relating primarily to NUMs interactions with others, both within and outside of their wards/units. These challenges related to the managerial, but not clinical, aspects of their roles; 16 strategies for managing these challenges were identified, the effectiveness of which seemed dependent on how well they were executed. The strategies are: seeking assistance and support; trial and error; satisficing; taking responsibility for own professional development; scheduling of time; working longer hours; delegation; adaptive staffing and rostering; being a visible presence on the ward; team development; facilitating professional development for staff; being available for staff; negotiation and collaboration; communication; working with the processes of a large organisation; and complying with the demands of others, The findings make a strong case for NUMs to be supported in undertaking comprehensive management education.
Hume's critique of religion and religious belief is, as a whole, subtle, profound, and damaging to religion in ways that have no philosophical antecedents and few successors. Some of the damage and a little of the subtlety will, I trust, become evident in Part II of this essay, where Hume's seminal discussions of the design argument for the existence of God, miracles, morality, and natural belief are examined. Before this, however, certain preliminaries need attention. First, there is the difficulty caused by the old-fashioned or unfamiliar terminology used by Hume and his commentators in describing and assessing what he has to say. Second, although the scale of Hume's writing on religion is reasonably obvious (it exceeds his output concerning any other subject except history), the fact that it is dispersed over a number of publications and partly embedded (sometimes none too clearly) in several more, as well as having to be drawn from essays, letters, and minor writings, needs to be understood before any informed discussion is possible. Third, there is the problem of seeing what he wrote not as ad hoc criticisms turned out piecemeal, but as a comprehensive critical strategy. Finally, a problem of interpretation results from Hume's “abundant prudence” in covering his real opinions with ambiguous irony and even, on occasions, with denials of his own apparent conclusions.
The separate evolution, or differential diffusion, of high-Schmidt-number passive scalars in a turbulent jet is studied experimentally. The two scalars under consideration are disodium fluorescein (Sc ≡ ν/D = 2000) and sulforhodamine 101 (Sc = 5000). The objectives of the research are twofold: to determine (i) the Reynolds-number-dependence, and (ii) the radial distribution of differential diffusion effects in the self-similar region of the jet. Punctual laser-induced fluorescence (LIF) measurements were obtained 50 jet diameters downstream of the nozzle exit for five Reynolds numbers (Re ≡ uod/ν = 900, 2100, 4300, 6700 and 10600, where u0 is the jet exit velocity, d is the jet diameter, and ν is the kinematic viscosity) and for radial positions extending from the centreline to the edges of the jet cross-section (0 ≤ r/d ≤ 7.5). Statistics of the normalized concentration difference, Z, were used to quantify the differential diffusion. The latter were found to decay slowly with increasing Reynolds number, with the root mean square of Z scaling as Zrms ≡ 〈Z2〉1/2 ∝ Re−0.1, (or alternatively 〈Z2〉 ∝ Re−0.2). Regardless of Reynolds number, differential diffusion effects were found to increase away from the centreline. The increase in differential diffusion effects with radial position, along with their increase with decreasing Reynolds number, support the hypothesis of increased differential diffusion at interfaces between the jet and ambient fluids. Power spectral densities of Z were also studied. These spectra decreased with increasing wavenumber – an observation attributed to the decay of the scalar fluctuations in a turbulent jet. Furthermore, these spectra showed that significant differential diffusion effects persist at scales larger than the Kolmogorov scale, even for moderately high Reynolds numbers.
The authors of a recent systematic review concluded that the use of non-pharmacological containment methods, excluding restraint and seclusion, was not supported by evidence. Their focus on randomised, controlled trials, however, does not reflect the research that has been, or could be, conducted.
To find empirically supported interventions that allow reduction in the use of seclusion in psychiatric facilities.
We reviewed English-language, peer-reviewed literature on interventions that allow reduction in the use of seclusion.
Staff typically used multiple interventions, including state-level support, state policy and regulation changes, leadership, examinations of the practice contexts, staff integration, treatment plan improvement, increased staff to patient ratios, monitoring seclusion episodes, psychiatric emergency response teams, staff education, monitoring of patients, pharmacological interventions, treating patients as active participants in seclusion reduction interventions, changing the therapeutic environment, changing the facility environment, adopting a facility focus, and improving staff safety and welfare.
Reducing seclusion rates is challenging and generally requires staff to implement several interventions.
Body sprays and perfumes are commonly worn by patients attending ENT out-patients clinics. Their effect on performance in olfactory testing is unknown. The aim of this study was to determine whether olfactory thresholds are altered by the presence of such fragrances.
Materials and methods:
One hundred and sixty healthy volunteers, aged 18 to 65 years, underwent olfactory thresholds testing. Each was then exposed to one of four strong perfumes, applied in a facemask for two minutes, and the thresholds were retested.
Results and analysis:
All olfactory thresholds worsened after being exposed to the strong perfumes of LynxTM and ImpulseTM body sprays, with the strongest effect being on olfactory detection of phenylethyl alcohol (p<0.001).
Strong perfumes can have a negative effect on olfactory thresholds.
Patients attending olfactory threshold testing need to be advised not to wear body sprays or perfumes.
Seasonal regression of testes and epididymides is described for 161 mature harbour porpoises Phocoena phocoena, L. from the Bay of Fundy and Gulf of Maine from June to December 1984–1995. Based on histological appearance and size of gonads, testes are fully active from late June until at least the end of July, spanning the estimated period of conceptions. During testicular regression, spermatocytes and round spermatids disappeared first from the lumina of seminiferous tubules, followed by the gradual disappearance of spermatozoa. Ultimately, all signs of spermatogenesis were absent, but tubules retained an alternating lining of Sertoli cells and spermatogonia. Testicular and epididymal mass, testicular length and seminiferous tubular diameter decreased approximately 3.5, 1.5 and 1.5 times, respectively, from peak production to full regression and this decrease was best described by a quadratic function. During early July when most females are ovulating, all males had active testes; variation in the degree of regression among males increased as the season progressed. This may reflect a trade-off between the costs of maintaining active testes at 4% body mass and the probability of successful fertilization. Testes are completely regressed during the winter, suggesting that few reproductive opportunities exist during this season. Unlike some other odontocete species, testicular mass of porpoises is a good indicator of breeding season.
A device for the collection of discrete blood samples from large animals has been developed to allow studies of physiology to be undertaken without the confounding effect of restraint. A microprocessor controlled unit (measuring 180 × 110 × 90 mm), weighing less than 1-2 kg, is mounted on the back of the experimental subject using a simple harness. A sampling line is connected to a previously inserted jugular vein catheter. Samples of blood (approx. 5 ml) are collected at pre-determined times following a start time which can be delayed by up to 48 h to allow the subject to recover from any effects of attachment of the sampler. The results from three studies suggest that the device offers a novel way to overcome a number of difficulties which occur when conventional methods are used to collect blood in experiments.
In an article in Philosophy (1968, pp. 199–211) R. G. Swinburne set out to argue that none of Hume's formal objections to the design argument ‘have any validity against a carefully articulated version of the argument’ (p. 199). This, he maintained, is largely because Hume's criticisms ‘are bad criticisms of the argument in any form’ (p. 206). The ensuing controversy between Swinburne and Olding1 has focused upon the acceptable/unacceptable aspects of the dualism presupposed in Swinburne's defence of the design argument; upon whether any simplification is achieved by reducing scientific explanation to agent explanation; and upon the problems which arise from taking a man's acting upon his body (or the material universe within his reach) as the analogy for understanding a disembodied agent acting upon matter. In this article I shall refer to the Swinburne-Olding controversy when appropriate but my main concern is to return to Swinburne's original article and argue, seriatim, that Hume's individual criticisms of the design argument are for the most part a great deal more powerful than Swinburne allowed. I shall contend that cumulatively they destroy the design argument as any sort of rational foundation for theistic belief. But first I shall indicate briefly the character of the argument together with one or two of the distinctions and refinements in terms of which it has been found helpful to carry on the discussion in recent years.
Hume's doctrine of natural belief allows that certain beliefs are justifiably held by all men without regard to the quality of the evidence which may be produced in their favour. Examples are belief in an external world and belief in the veracity of our senses. According to R. J. Butler, Hume argues in the Dialogues that belief in God is of this sort. More recently John Hick has argued that for some people it is as natural (and as rational) to believe in God as to believe in an external world. I shall first inquire what Hume understands by reasonable belief and by natural belief. I shall then use the results of this investigation to argue, against Butler, that belief in God is not a natural belief; and against Hick, more briefly, that his thesis is not viable in as far as it depends upon Hume's doctrine of natural belief. These discussions are important to the philosophy of religion since by means of natural beliefs it could be urged that belief in God is something justifiable without reference to reason or evidence: a position which would be of immense value to the theist.
Dr Ian Ramsey has made considerable use of the word ‘disclosure’ in what he has to say about religion and in his attempts to give an account of the meaning of religious language. He sometimes (e.g. in Religious Language) speaks of ‘discernment’ or ‘insight’ but ‘disclosure’ is the word he normally favours. In what follows I shall ask: what a disclosure is, to what extent Dr Ramsey's use of the notion leads to confusions, and what questions have to be faced in order to resolve these confusions.
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