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To validate digitally displayed photographic portion-size estimation aids (PSEA) against a weighed meal record and compare findings with an atlas of printed photographic PSEA and actual prepared-food PSEA in a low-income country.
Participants served themselves water and five prepared foods, which were weighed separately before the meal and again after the meal to measure any leftovers. Participants returned the following day and completed a meal recall. They estimated the quantities of foods consumed three times using the different PSEA in a randomized order.
Two urban and two rural communities in southern Malawi.
Women (n 300) aged 18–45 years, equally divided by urban/rural residence and years of education (≤4 years and ≥5 years).
Responses for digital and printed PSEA were highly correlated (>91 % agreement for all foods, Cohen’s κw = 0·78–0·93). Overall, at the individual level, digital and actual-food PSEA had a similar level of agreement with the weighed meal record. At the group level, the proportion of participants who estimated within 20 % of the weighed grams of food consumed ranged by type of food from 30 to 45 % for digital PSEA and 40–56 % for actual-food PSEA. Digital PSEA consistently underestimated grams and nutrients across foods, whereas actual-food PSEA provided a mix of under- and overestimates that balanced each other to produce accurate mean energy and nutrient intake estimates. Results did not differ by urban and rural location or participant education level.
Digital PSEA require further testing in low-income settings to improve accuracy of estimations.
To investigate preferences for and ease-of-use perceptions of different aspects of printed and digitally displayed photographic portion-size estimation aids (PSEA) in a low-resource setting and to document accuracy of portion-size selections using PSEA with different visual characteristics.
A convergent mixed-methods design and stepwise approach were used to assess characteristics of interest in isolation. Participants served themselves food and water, which were weighed before and after consumption to measure leftovers and quantity consumed. Thirty minutes later, data collectors administered a meal recall using a PSEA and then a semi-structured interview.
Blantyre and Chikwawa Districts in the southern region of Malawi.
Ninety-six women, aged 18–45 years.
Preferences and ease-of-use perceptions favoured photographs rather than drawings of shapes, three and five portion-size options rather than three with four virtual portion-size options, a 45° rather than a 90° photograph angle, and simultaneous rather than sequential presentation of portion-size options. Approximately half to three-quarters of participants found the portion-size options represented appropriate amounts of foods or water consumed. Photographs with three portion sizes resulted in more accurate portion-size selections (closest to measured consumption) than other format and number of portion-size option combinations. A 45° angle and simultaneous presentation were more accurate than a 90° angle and sequential presentation of images.
Results from testing PSEA visual characteristics separately can be used to generate optimal PSEA, which can improve participants’ experiences during meal recalls.
We used a survey to characterize contemporary infection prevention and antibiotic stewardship program practices across 64 healthcare facilities, and we compared these findings to those of a similar 2013 survey. Notable findings include decreased frequency of active surveillance for methicillin-resistant Staphylococcus aureus, frequent active surveillance for carbapenem-resistant Enterobacteriaceae, and increased support for antibiotic stewardship programs.
Low- and middle-income countries (LMIC) are increasingly experiencing the double burden of malnutrition. Studies to identify ‘double-duty’ actions that address both undernutrition and overweight in sub-Saharan Africa are needed. We aimed to identify acceptable behaviours to achieve more optimal feeding and physical activity practices among both under- and overweight children in Rwanda, a sub-Saharan LMIC with one of the largest recent increases in child overweight.
We used the Trials of Improved Practices (TIPs) method. During three household visits over 1·5 weeks, we used structured interviews and unstructured observations to collect data on infant and young child feeding practices and caregivers’ experiences with testing recommended practices.
An urban district and a rural district in Rwanda.
Caregivers with an under- or overweight child from 6 to 59 months of age (n 136).
We identified twenty-five specific recommended practices that caregivers of both under- and overweight children agreed to try. The most frequently recommended practices were related to dietary diversity, food quantity, and hygiene and food handling. The most commonly cited reason for trying a new practice was its benefits to the child’s health and growth. Financial constraints and limited food availability were common barriers. Nearly all caregivers said they were willing to continue the practices and recommend them to others.
These practices show potential for addressing the double burden as part of a broader intervention. Still, further research is needed to determine whether caregivers can maintain the behaviours and their direct impact on both under- and overweight.
We examine whether early acquisition of a second language (L2) leads to native-like neural processing of phonemic contrasts that are absent in the L1. Four groups (adult and child monolingual speakers of English; adult and child early bilingual speakers of English and Spanish, exposed to both languages before 5 years of age) participated in a study comparing the English /ɪ/ - /ε/ contrast. Neural measures of automatic change detection (Mismatch Negativity, MMN) and attention (Processing Negativity, PN and Late Negativity, LN) were measured by varying whether participants tracked the stimulus stream or not. We observed no effect of bilingualism on the MMN, but adult bilinguals differed significantly from adult monolinguals on neural indices of attention. The child bilinguals were indistinguishable from their monolingual peers. This suggest that learning a L2 before five years of age leads to native-like phoneme discrimination, but bilinguals develop increased attentional sensitivity to speech sounds.
The present work investigates local flow structures and the downstream evolution of the core of helical tip vortices generated by a three-bladed rotor. Earlier experimental studies have shown that the core of a helical tip vortex exhibits a local helical symmetry with a simple relation between the axial and azimuthal velocities. In the present study, a self-similarity scaling argument further describes the downstream development of the vortex core. Self-similarity has up to now only been investigated for longitudinal vortices and it is the first time that helical vortices have become the subject of such an analysis. Combining symmetry arguments from previous studies on helical vortices with novel experiments and knowledge regarding the self-similarity evolution of the core of longitudinal vortices, a new model describing what is referred to as ‘helical self-similarity’ is proposed. The generality of the model is verified and supported by experimental data. The proposed model is important for fundamental understanding of the behaviour of helical vortices, with a range of applications in both industry and nature. Examples of this are tip vortices behind aerodynamic devices, such as vortex generators, and fixed and rotary aircraft, and in combustion chambers and cyclone separators.
Objective: Adults are at risk for unemployment following a moderate-severe traumatic brain injury (TBI). Less is known about employment patterns following mild TBI. This study aims to examine patterns of return to pre-injury job in adults following mild TBI over a 12-month post injury period, and to investigate factors associated with return to work. Methods: It is a prospective longitudinal study of 205 adults (aged ≥16 years at injury) identified as part of a larger population-based incidence study in the Waikato, New Zealand. In-person assessments were completed at baseline (within 14 days) and 1-, 6-, and 12-month post-injury. Results: A total of 159 (77.6%) adults returned to their pre-injury job at baseline and 185 (90.2%) returned within 12 months. Of those who did not return to their pre-injury job at baseline (n = 46), younger age at injury (≤30 years, p = .02) and poor overall neurocognitive functioning at 1-month (p = .02) was associated with non-return to pre-injury job at 12 months. Conclusion: In a sample of employed adults, the majority returned to their pre-injury job shortly after injury. Cognitive functioning and younger age at time of injury may be associated with delayed return to work. Interventions to support younger workers may facilitate their return to work.
Background: Social anxiety disorder (SAD) is a common and chronic mental health condition. Given the significant prevalence and impairment caused by SAD, it is important to investigate novel ways to improve the efficacy of cognitive behavioural therapy (CBT) for SAD. One approach may be to provide CBT in an accelerated fashion, which involves multiple sessions per week. Such accelerated treatments have been shown to be effective in other anxiety disorders, but in SAD this accelerated treatment has only been studied in a group treatment format. Aims: The aim of this study was to provide a preliminary investigation of the efficacy of individual accelerated CBT (aCBT) in the treatment of SAD. Method: The studied utilized an open trial design. Seventeen participants commenced the treatment, which consisted of 12 sessions delivered over 4 weeks. Results: The results indicated that participants obtained moderate to large effect sizes on measures of SAD at post-treatment (range d = 0.76–0.92) and 3-month follow-up (range d = 1.31–1.79). In addition, at post-treatment, 59% of participants no longer met criteria for SAD, and this number increased to 71% at 3-month follow-up. Conclusions: The results provide preliminary evidence to suggest that individual aCBT may be an important treatment option for individuals with SAD.
Objective: To identify the systems available to sub-classify mild traumatic brain injury (TBI) and to determine their utility in predicting 1-year outcome.
Methods: A systematic review to identify mild-TBI sub-classification systems was conducted until March 2016. The identified systems were applied to a cohort of N = 290 adults who had experienced a mild-TBI, and who had been assessed for post-concussion symptoms 1-year post injury. ANOVAs and regression models were used to determine whether each sub-classification system could distinguish between outcomes and to explore their contribution to explaining variance in post-concussion symptoms 1-year post injury.
Results: Nineteen sub-classification systems for mild-TBI met the inclusion criteria for this review. The Saal (1991) classification system significantly differentiated the experience of post-concussion symptoms in our cohort 1-year post injury (F = 2.39, p = 0.05). However, the findings did not remain significant following correction for multiple comparisons and inclusion of socio-demographic and contextual factors in the regression model.
Conclusions: Current sub-classification systems fail to explain much of the variance in post-concussion symptoms 1 year following mild-TBI. Further research is needed to identify the factors (including socio-demographic and contextual factors) to determine, who may be at risk of developing persistent post-concussion symptoms.
It is known that n-Si solar cells have higher efficiency than p-Si solar cells. One of the problems connected with n-Si application for solar cell production is the difficulty of using Czochralski method for growing n-Si ingots, uniform in structure. The present paper examines the possibility of production of n-Si ingots, uniform in resistance, by neutron transmutation doping (NTD) for photovoltaics using the mathematical modeling method. The provided calculation data are obtained by MCU-RFFI/A accounting code with DLC/MCUDAT-1.0 constant library developed by «Kurchatov Institute» Russian Research Center. The MCU accounting code is used for solution of the neutron-transport equation by Monte-Carlo procedure on the basis of estimated nuclear data for arbitrary three-dimensional geometry systems.
The present paper provides the estimation of uniformity of neutron-flux density along the ingot length and radius; dependence of silicon resistance on duration of irradiation. These studies established the neutron flux density distribution along the ingot length and radius; regularities of silicon resistance changes on duration and intensity of irradiation.
Airline companies, the Director of the International Paris Airport, and sanitary and administrative authorities of the Seine-Saint-Denis Dpt of SAMU were asked to organize a simulation of an aircraft crash on the site of the Charles-de-Gaulle airport. The two main purposes of this simulation were to check the efficiency of the rescue means from a technical point of view, the delays in the organization, and the coordination of services.
The scenario was an accident during take-off of a big jet. The fuselage of the plane was in three parts. There was an intense fire in the middle one. The crash happened at the end of the runway, on soft ground which was normally unapproachable for ordinary vehicles. The casualties were distributed according to aircraft accidents statistics; 200 military personnel and 30 volunteers of Civil Security participated. The victims were classified into 5 groups: 1) uninjured (30 in front and 40 in rear); 2) slightly injured (15 in frontand 15 in rear); 3) severely wounded (8 in front 4 in center, and 8 in rear); 4) critically injured (5 in front, 6 in center, and 4 in rear)); and 5) dead (95 in center).
The injured were simulated by first aid workers who had been trained and made up so as to be seen by the rescuers. Besides, they were given a tag on which was indicated the group, the types of injuries, the delay of survival without care, the necessary time for the diagnosis, and the appreciation of the victims.
The self-similarity law for axisymmetric wakes has for the first time been examined and verified in a complex helical vortex in the far part of an asymmetric wake by means of direct numerical simulation (DNS). The helical vortex is the main coherent flow structure in the transitional non-axisymmetric wake behind an inclined 6:1 prolate spheroid at Reynolds number 3000 based on the minor axis. The gradual development of the complex helical vortex structure has been described in detail all the way from its inception at the spheroid and into the far wake. We observed a complex vortex composition in the generation stage, a rare jet-like wake pattern in the near wake and an abrupt change of helical symmetry in the vortex core without an accompanying change in flow topology, i.e. with no recirculation bubble.
The CuInSe2 and CuSbSe2 ternary compounds and alloys of the (CuSbSe2)1-x·(CuInSe2)x system with the mole fraction of CuInSe2 (x) equal to 0.05, 0.15, 0.25, 0.375, 0.50, 0.625, 0.75, 0.85, and 0.95 were prepared and the phase relations in this system were investigated by X-ray powder diffraction, optical microscopy, and scanning electron microscopy. It was shown that the alloys of the CuSbSe2-CuInSe2 system are biphasic at room temperature in the whole range of compositions, and the limits of solubility for CuSbSe2 in CuInSe2 and for CuInSe2 in CuSbSe2 do not exceed 0.001 mole fraction.
Frontotemporal brain sagging syndrome is a dementia associated with hypersomnolence, personality changes, and features of intracranial hypotension on magnetic resonance imaging. The literature is sparse with respect to treatment options; many patients simply worsen. We present a case in which this syndrome responded to lumbar dural reduction surgery. Postoperative magnetic resonance imaging indicated normalization of brain sagging and lumbar intrathecal pressure. Although no evidence of cerebrospinal leak was found, extremely thin dura was noted intraoperatively, suggesting that a thin and incompetent dura could result in this low-pressure syndrome. Clinicians who encounter this syndrome should consider dural reduction surgery as a treatment strategy.
Introduction: The current study examined the level of agreement in expired-air carbon monoxide (CO) values, focusing especially on those confirming abstinence, between the two most commonly used CO monitors, the Vitalograph BreathCO and the Bedfont piCO+ Smokerlyzer.
Methods: Expired-air samples were collected via both monitors from adult dependent smokers (44 M, 34 F) participating in studies using CO values to confirm abstinence durations of: 24 hours, 12 hours, or no abstinence. All met DSM-IV nicotine dependence criteria and had a mean (SD) Fagerström Test of Cigarette Dependence score of 5.1 (1.8). Paired data collected across multiple visits were analyzed by regression-based Bland–Altman method of Limits of Agreement (LoA).
Findings: Analysis indicated a lack of agreement in CO measurement between monitors. Overall, the Bedfont monitor gave mean (±SEM) readings 3.83 (±0.23) ppm higher than the Vitalograph monitor. Mean differences between monitors were larger for those ad lib smoking (5.65 ± 0.38 ppm) than those abstaining 12–24 hours (1.71 ± 0.13 ppm). Yet, there also was not consistent agreement in classification of 24-hour abstinence between monitors.
Conclusions: Systematic differences in CO readings demonstrate these two very common monitors may not result in interchangeable values, and reported outcomes in smoking research based on CO values may depend on the monitor used.
Recent studies suggest that sand can serve as a vehicle for exposure of humans to pathogens at beach sites, resulting in increased health risks. Sampling for microorganisms in sand should therefore be considered for inclusion in regulatory programmes aimed at protecting recreational beach users from infectious disease. Here, we review the literature on pathogen levels in beach sand, and their potential for affecting human health. In an effort to provide specific recommendations for sand sampling programmes, we outline published guidelines for beach monitoring programmes, which are currently focused exclusively on measuring microbial levels in water. We also provide background on spatial distribution and temporal characteristics of microbes in sand, as these factors influence sampling programmes. First steps toward establishing a sand sampling programme include identifying appropriate beach sites and use of initial sanitary assessments to refine site selection. A tiered approach is recommended for monitoring. This approach would include the analysis of samples from many sites for faecal indicator organisms and other conventional analytes, while testing for specific pathogens and unconventional indicators is reserved for high-risk sites. Given the diversity of microbes found in sand, studies are urgently needed to identify the most significant aetiological agent of disease and to relate microbial measurements in sand to human health risk.