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Childhood obesity is a common concern across global cities and threatens sustainable urban development. Initiatives to improve nutrition and encourage physical exercise are promising but are yet to exert significant influence on prevention. Childhood obesity in London is associated with distinct ethnic and socio-economic patterns. Ethnic inequalities in health-related behaviour endure, underpinned by inequalities in employment, housing, access to welfare services, and discrimination. Addressing these growing concerns requires a clearer understanding of the socio-cultural, environmental and economic contexts of urban living that promote obesity. We explore opportunities for prevention using asset based-approaches to nutritional health and well-being, with a particular focus on adolescents from diverse ethnic backgrounds living in London. We focus on the important role that community engagement and multi-sectoral partnership play in improving the nutritional outcomes of London's children. London's children and adolescents grow up in the rich cultural mix of a global city where local streets are characterised by diversity in ethnicities, languages, religions, foods, and customs, creating complex and fluid identities. Growing up with such everyday diversity we argue can enhance the quality of life for London's children and strengthen their social capital. The Determinants of young Adult Social well-being and Health longitudinal study of about 6500 of London's young people demonstrated the positive impact of cultural diversity. Born to parents from over a hundred countries and exposed to multi-lingual households and religious practices, they demonstrated strong psychological resilience and sense of pride from cultural straddling, despite material disadvantage and discrimination. Supporting the potential contribution of such socio-cultural assets is in keeping with the values of social justice and equitable and sustainable development. Our work signals the importance of community engagement and multisectoral partnerships, involving, for example, schools and faith-based organisations, to improve the nutrition of London's children.
This study examined the response of forage crops to composted dairy waste (compost) applied at low rates and investigated effects on soil health. The evenness of spreading compost by commercial machinery was also assessed. An experiment was established on a commercial dairy farm with target rates of compost up to 5 t ha−1 applied to a field containing millet [Echinochloa esculenta (A. Braun) H. Scholz] and Pasja leafy turnip (Brassica hybrid). A pot experiment was also conducted to monitor the response of a legume forage crop (vetch; Vicia sativa L.) on three soils with equivalent rates of compost up to 20 t ha−1 with and without ‘additive blends’ comprising gypsum, lime or other soil treatments. Few significant increases in forage biomass were observed with the application of low rates of compost in either the field or pot experiment. In the field experiment, compost had little impact on crop herbage mineral composition, soil chemical attributes or soil fungal and bacterial biomass. However, small but significant increases were observed in gravimetric water content resulting in up to 22.4 mm of additional plant available water calculated in the surface 0.45 m of soil, 2 years after compost was applied in the field at 6 t ha−1 dried (7.2 t ha−1 undried), compared with the nil control. In the pot experiment, where the soil was homogenized and compost incorporated into the soil prior to sowing, there were significant differences in mineral composition in herbage and in soil. A response in biomass yield to compost was only observed on the sandier and lower fertility soil type, and yields only exceeded that of the conventional fertilizer treatment where rates equivalent to 20 t ha−1 were applied. With few yield responses observed, the justification for applying low rates of compost to forage crops and pastures seems uncertain. Our collective experience from the field and the glasshouse suggests that farmers might increase the response to compost by: (i) increasing compost application rates; (ii) applying it prior to sowing a crop; (iii) incorporating the compost into the soil; (iv) applying only to responsive soil types; (v) growing only responsive crops; and (vi) reducing weed burdens in crops following application. Commercial machinery incorporating a centrifugal twin disc mechanism was shown to deliver double the quantity of compost in the area immediately behind the spreader compared with the edges of the spreading swathe. Spatial variability in the delivery of compost could be reduced but not eliminated by increased overlapping, but this might represent a potential 20% increase in spreading costs.
Parkinson's disease (PD) is a neurodegenerative disorder characterised by the progressive loss of midbrain dopaminergic neurons, which causes motor impairments. Current treatments involve dopamine replacement to address the disease symptoms rather than its cause. Factors that promote the survival of dopaminergic neurons have been proposed as novel therapies for PD. Several dopaminergic neurotrophic factors (NTFs) have been examined for their ability to protect and/or restore degenerating dopaminergic neurons, both in animal models and in clinical trials. These include glial cell line-derived neurotrophic factor, neurturin, cerebral dopamine neurotrophic factor and growth/differentiation factor 5. Delivery of these NTFs via injection or infusion to the brain raises several practical problems. A new delivery approach for NTFs involves the use of recombinant viral vectors to enable long-term expression of these factors in brain cells. Vectors used include those based on adenoviruses, adeno-associated viruses and lentiviruses. Here we review progress to date on the potential of each of these four NTFs as novel therapeutic strategies for PD, as well as the challenges that have arisen, from pre-clinical analysis to clinical trials. We conclude by discussing recently-developed approaches to optimise the delivery of NTF-carrying viral vectors to the brain.
Wellness Recovery Action Planning (WRAP) is a cross-diagnostic, patient-centred, self-management intervention for psychiatric illness. WRAP utilises an individualised Wellness Toolbox, a six part structured monitoring and response system, and a crisis and post-crisis plan to promote recovery. The objective of this study was to evaluate the effect of WRAP on personal recovery, quality of life, and self-reported psychiatric symptoms.
A prospective randomised controlled trial, based on the CONSORT principles was conducted using a sample of 36 inpatients and outpatients with a diagnosis of a mental disorder. Participants were randomly allocated to Experimental Group or Waiting List Control Group conditions in a 1:1 ratio. Measures of personal recovery, personal recovery life areas, quality of life, anxiety, and depression were administered at three time points: (i) pre-intervention, (ii) post-Experimental Group intervention delivery, and (iii) 6-month follow-up. Data was analysed by available case analysis using univariate and bivariate methodologies.
WRAP had a significant effect on two personal recovery life areas measured by the Mental Health Recovery Star: (i) addictive behaviour and (ii) identity and self-esteem. WRAP did not have a significant effect on personal recovery (measured by the Mental Health Recovery Measure), quality of life, or psychiatric symptoms.
Findings indicate that WRAP improves personal recovery in the areas of (i) addictive behaviour and (ii) identity and self-esteem. Further research is required to confirm WRAP efficacy in other outcome domains. Efforts to integrate WRAP into recovery-orientated mental health services should be encouraged and evaluated.
1.1 The background to the production of this paper is somewhat involved, but is necessary for an understanding of why it contains what it does. Readers who are familiar with recent developments in the valuation field may proceed straight to Section 2.
1.2 Statutory valuations of long-term insurance business under the Insurance Companies Act 1982 (“the Act”, which superseded the 1974 and 1981 Acts) and the Insurance Companies Regulations 1981 (“the current Regulations”) have now been prepared by actuaries for some years. Similarly the guidance issued by the profession to Appointed Actuaries, specifically GN1 and GN8, has also remained substantially unchanged over that period. The time was opportune for valuation practice to be reviewed in the light of recent experience.
The paper considers the valuation for solvency purposes of traditional long-term insurance business. It concentrates on without-profit business, and discusses the reserves that are required to protect against the contingency of sudden adverse changes in asset values (the ‘mismatching’ or ‘resilience’ test). The details of a suitable test, and a method of applying it in practice using a ‘matching rectangle’, are described. Investigations into the effectiveness of such a test, using both deterministic and stochastic methods, are followed by concluding remarks on the underlying philosophical issues raised.
Full numerical results are presented in the Appendices.
Attention deficit hyperactivity disorder (ADHD) persists into adulthood in ∼2/3 of patients, yet services for adults are lacking in Ireland. This may involve negative attitudes and beliefs as to the validity of ADHD or lack of knowledge and training in its treatment. The objectives of this study are to explore the views of Adult Psychiatrists regarding ADHD knowledge and the treatment options available and pursued in Ireland.
A questionnaire was constructed based on the stated aims of the study, and was either posted, emailed or handed to 400 Consultants and Senior Registrars throughout the Republic of Ireland between February and December 2011. A total of 92 questionnaires were returned (23%); one was excluded from analysis due to insufficient information entered by the respondent.
Seventy-five per cent of respondents correctly estimated the prevalence rates of adult ADHD to be under 3%, but stated it is currently under-diagnosed (77%). Seventy-four per cent indicated that Adult ADHD should be a diagnostic category in the Diagnostic and Statistical Manual, 5th Edition (DSM V). Sixty-six per cent of respondents were willing to accept referrals of childhood ADHD for ongoing care and a similar number for new ADHD assessments (61%). Less than half (42%) surveyed had actually diagnosed ADHD and of these, only 33% felt confident in managing ADHD in their patients.
Although there is a general willingness to offer services for new and existing ADHD cases and a recognition that Adult ADHD is valid and under-diagnosed, the low confidence levels when treating ADHD and the perception of under-diagnosis suggests a role for further training and links between child and adult services.
Coeliac disease (CD) results from immunologically mediated inflammation of the small intestinal mucosa precipitated by ingestion of gluten in wheat and other cereals in genetically susceptible people. There is a broad spectrum of clinical and histological features associated with gluten sensitivity. Overt clinical malabsorption is uncommon, and clinical symptoms are often non-specific. This is particularly true of older people and the diagnosis of CD may be delayed or missed as a result. The incidence of metabolic bone disease, neurological symptoms and nutritional deficiencies are high in older people with CD and respond well to treatment. Sensitive and specific serological tests are now available and these have improved ease of detection of CD in patients without classical symptoms. Hence, a high index of suspicion is warranted in older people with potential symptoms of CD.
Evidence for a new microcrystalline precipitate in CZ Si annealed for 256 hrs at 635°C is presented by electron microdiffraction. This may be a precursor phase for the formation of amorphous platelets . Multiple scattering microdiffraction calculations which distinguish the symmetries of two models for the thermal donor are also given.
We have used a first principles molecular dynamics technique to find the relaxed atomic geometry and the corresponding electronic structure of a simple novel form of threecoordinated solid carbon, which we name polybenzene. The polybenzene structure is found to have a substantially lower energy per atom (by 0.23 eV) than C60, yet contains only 24 atoms per unit cell. In addition we have calculated the zero wavevector vibrational spectrum for this novel carbon structure.
Reaction of silver(I) nitrate and hexamethylenetetramine (HMTA) gives crystals of Ag2(HMTA)(NO3)2, which was formulated by elemental microanalysis and a single crystal x-ray study. Its Ag2(HMTA) open-framework is the first example of a decorated CdSO4net. The relative orientation of the tetrahedral HMTA building blocks in this structure point to numerous opportunities toward constructing novel chiral and polar porous frameworks.
We describe the development of a new deposition method for thin oriented films of GaN on basal plane sapphire using an exclusively inorganic single-source precursor free of carbon and hydrogen, Cl2GaN3. The films have been characterized by Rutherford backscattering spectroscopy (RBS) and cross sectional transmission electron microscopy (TEM) for composition morphology and structure. RBS analysis confirmed stoichiometric GaN and TEM observations of the highly conformal films revealed heteroepitaxial columnar growth of crystalline wurrtzite material on sapphire. Auger and RBS oxygen and carbon resonance profiles indicated that the films were pure and highly homogeneous. We also report the reactions of Cl2GaN3 with organometallic nitriles to yield a crystalline, novel gallium carbon nitride of composition GaC3N3. Quantitative X-ray powder diffraction has been used to refine the cubic structure of this material which consists of Ga atoms octahedrally surrounded by on the average three C and three N atoms. The structurally analogous LiGaC4N4 phase has also been prepared and characterized.
Two types of silicon clathrates, NaxSi136 (0≤ × ≤ 24) and Na8Si46 and a mixed clathrate (Na,Ba)Si46 were synthesized and characterized by X-ray diffraction, 23Na NMR and high resolution TEM. Systematic changes in X-ray diffraction intensities enabled the sodium content and site occupancy in the NaxSi136 series to be followed and then refined by Rietveld profile analysis. 23Na NMR spectra of Na8Si46 and NaxSi136 samples reveals two peaks with large paramagnetic shifts (1600-2000 ppm) for each phase, associated with the presence of Na atoms in two different environments. High resolution electron microscopy reveals the clathrate structures of these samples, and allows classes of defects to be characterized.
For food intakes to be converted into nutrient intakes a measure or estimate of the amount of food consumed is required. A number of methods have been developed to assist subjects in providing an estimate of portion size. Children's ability to use perception, conceptualisation and memory skills to estimate food portion size has not been investigated systematically. The aim of the present study was to test the effect of the timing of a dietary interview on the accuracy of estimates of food portion sizes made by children, using food photographs, food models and an interactive portion size assessment system, developed for use with children and based on portion sizes of foods consumed by children. Children (n 108) aged 4–14 years were supplied with known quantities of foods and asked to estimate the portion size of each food using each of the three portion size assessment tools. Interviews took place (a) with the food in view, (b) just after the child had eaten the food or (c) 24 h after the child had eaten the food. There were no significant differences in children's ability to estimate food portion size (either as served or as eaten) with timing of interview. That is, children were as accurate in their estimates of portion size 24 h after consuming the food as when the food was in view. Under these conditions many children were able to estimate food portion size utilising perception, conceptualisation and memory skills.