To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure email@example.com
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Despite the well-documented health benefits of physical activity in older adults, participation levels remain low. With rapid global population ageing, intensive efforts are needed to encourage higher levels of participation to ameliorate the negative effects of physical inactivity for older individuals and society as a whole. The aim of this qualitative study was to inform future physical activity promotion interventions by examining factors contributing to low activity levels among older people undertaking less than half the recommended level of moderate-to-vigorous physical activity (MVPA). Semi-structured interviews were conducted with 102 (65% female) community-dwelling Western Australians aged 60+ years (mean = 71.52, standard deviation = 6.26) who engaged in ⩽75 minutes of MVPA per week as measured by accelerometers. Several modifiable and unmodifiable barriers were identified, of which poor health featured most prominently. Lifetime physical inactivity, caring duties, low motivation, misperceptions of physical activity and ageing, and a lack of affordable and attractive options were the other barriers identified. The results suggest that strategies are needed to raise awareness of current physical activity guidelines, normalise engagement in MVPA throughout the lifespan, develop initiatives to motivate participation, improve the availability of affordable physical activity programmes that are attractive to this population segment, and facilitate participation among those with intensive caring responsibilities.
Whitehouse's theory on fusion can explain why suicide terrorists are willing to make the ultimate sacrifice for their groups, but the following questions on violent extremism remain: (a) Why are victims of suicide terrorism often innocent bystanders? (b) Why do terrorists seem motivated by ancient conflicts? We incorporate findings from the entitativity literature to provide insights into how perceptions of in-groups and out-groups are key processes influencing violent extremism.
CVD are the leading cause of death in women globally, with ageing associated with progressive endothelial dysfunction and increased CVD risk. Natural menopause is characterised by raised non-fasting TAG concentrations and impairment of vascular function compared with premenopausal women. However, the mechanisms underlying the increased CVD risk after women have transitioned through the menopause are unclear. Dietary fat is an important modifiable risk factor relating to both postprandial lipaemia and vascular reactivity. Meals rich in SFA and MUFA are often associated with greater postprandial TAG responses compared with those containing n-6 PUFA, but studies comparing their effects on vascular function during the postprandial phase are limited, particularly in postmenopausal women. The present review aimed to evaluate the acute effects of test meals rich in SFA, MUFA and n-6 PUFA on postprandial lipaemia, vascular reactivity and other CVD risk factors in postmenopausal women. The systematic search of the literature identified 778 publications. The impact of fat-rich meals on postprandial lipaemia was reported in seven relevant studies, of which meal fat composition was compared in one study described in three papers. An additional study determined the impact of a high-fat meal on vascular reactivity. Although moderately consistent evidence suggests detrimental effects of high-fat meals on postprandial lipaemia in postmenopausal (than premenopausal) women, there is insufficient evidence to establish the impact of meals of differing fat composition. Furthermore, there is no robust evidence to conclude the effect of meal fatty acids on vascular function or blood pressure. In conclusion, there is an urgent requirement for suitably powered robust randomised controlled trials to investigate the impact of meal fat composition on postprandial novel and established CVD risk markers in postmenopausal women, an understudied population at increased cardiometabolic risk.
To examine dietary Na and K intake at eating occasions in Australian adults and identify the contribution of major food sources to Na and K at different eating occasions.
Secondary analysis of 24 h recall diet data from the Australian Health Survey (2011–2013).
Nationally representative survey in Australia.
Male and female Australians aged 18–84 years (n 7818).
Dinner contributed the greatest proportion to total daily Na intake (33 %) and K intake (35 %). Na density was highest at lunch (380 mg/MJ) and K density highest at between-meal time eating occasions (401 mg/MJ). Between-meal time eating occasions provided 20 % of daily Na intake and 26 % of daily K intake. The major food group sources of Na were different at meal times (breads and mixed dishes) compared with between-meal times (cakes, muffins, scones, cake-type desserts). The top food group sources of K at meal times were potatoes and unprocessed meat products and dishes.
Foods which contributed to Na and K intake differed according to eating occasion. Major food sources of Na were bread and processed foods. Major food sources of K were potatoes and meat products and dishes. Public health messages that emphasise meal-based advice and diet patterns high in vegetables, fruits and unprocessed foods may also aid reduction in dietary Na intake and increase in dietary K intake.
Infants of diabetic mothers are at risk for transient hypertrophic cardiomyopathy. These infants are typically asymptomatic, but may develop signs of poor cardiac output from left ventricular outflow tract obstruction. This case illustrates the successful use of extracorporeal membrane oxygenation to support cardiac output in an infant of a diabetic mother with outflow tract obstruction until hypertrophy improved.
With the renewed interest in perception–action coupling at the cerebral level, this idea of shared representations has rapidly been extended to non-motor domains as well, including somatosensory experiences. Indeed, in the last decades, a wealth of evidence has been produced suggesting that experience of somatosensory stimulations such as touch and pain share common neurophysiological and cognitive representations with the perception of the same experiences in others. However, it remains unclear what exactly is shared between an individual experiencing a state and someone observing this individual, and to what extent non-motor shared representations are supported by evidence. Here, we first review the different definitions of shared representations in the somatosensory domain proposed in the cognitive neuroscience literature. We then briefly describe the neurophysiological mechanisms underlying pain and touch perception and provide a critical review of the evidence for and against shared somatosensory representations for the different aspects of pain and touch experiences. Finally, we argue that these shared somatosensory representations can be modulated by individual, relational and contextual characteristics, and while most of these modulations occur implicitly, some can be deliberate, focused and meant to optimize subsequent social interactions.
This study explores the phenomenon of uvularization in the vowel systems of two Heishui County varieties of Qiang, a Sino-Tibetan language of Sichuan Province, China. Ultrasound imaging (one speaker) shows that uvularized vowels have two tongue gestures: a rearward gesture, followed by movement toward the place of articulation of the corresponding plain vowel. Time-aligned acoustic and articulatory data show how movement toward the uvula correlates with changes in the acoustic signal. Acoustic correlates of uvularization (taken from two speakers) are seen most consistently in raising of vowel F1, lowering of F2 and in raising of the difference F3-F2. Imaging data and the formant structure of [l] show that uvular approximation can begin during the initial consonant that precedes a uvularized vowel. Uvularization is reflected phonologically in the phonotactic properties of vowels, while vowel harmony aids in the identification of plain–uvularized vowel pairs. The data reported in this paper argue in favor of a revision of the catalog of secondary articulations recognized by the International Phonetic Alphabet, in order to include uvularization, which can be marked with the symbol [ʶ] in the case of approximation and [χ] for secondary uvular frication.
As scholars have rushed to either prove or refute cultural group selection (CGS), the debate lacks sufficient consideration of CGS's potential moderators. We argue that pressures for CGS are particularly strong when groups face ecological and human-made threat. Field, experimental, computational, and genetic evidence are presented to substantiate this claim.
To determine the prevalence of Pseudomonas aeruginosa colonization on intensive care unit (ICU) admission, risk factors for P. aeruginosa colonization, and the incidence of subsequent clinical culture with P. aeruginosa among those colonized and not colonized.
We conducted a cohort study of patients admitted to a medical or surgical intensive care unit of a tertiary care hospital. Patients had admission perirectal surveillance cultures performed. Risk factors analyzed included comorbidities at admission, age, sex, antibiotics received during current hospitalization before ICU admission, and type of ICU.
Of 1,840 patients, 213 (11.6%) were colonized with P. aeruginosa on ICU admission. Significant risk factors in the multivariable analysis for colonization were age (odds ratio, 1.02 [95% CI, 1.01–1.03]), anemia (1.90 [1.05–3.42]), and neurologic disorder (1.80 [1.27–2.54]). Of the 213 patients colonized with P. aeruginosa on admission, 41 (19.2%) had a subsequent clinical culture positive for P. aeruginosa on ICU admission and 60 (28.2%) had a subsequent clinical culture positive for P. aeruginosa in the current hospitalization (ICU period and post-ICU period). Of these 60 patients, 49 (81.7%) had clinical infections. Of the 1,627 patients not colonized on admission, only 68 (4.2%) had a subsequent clinical culture positive for P. aeruginosa in the current hospitalization. Patients colonized with P. aeruginosa were more likely to have a subsequent positive clinical culture than patients not colonized (incidence rate ratio, 6.74 [95% CI, 4.91–9.25]).
Prediction rules or rapid diagnostic testing will help clinicians more appropriately choose empirical antibiotic therapy for subsequent infections.
This article describes a review undertaken in 2012–2013 by Nutrition and Dietetics, Flinders University, to assess the Indigenous health curriculum of the Bachelor of Nutrition and Dietetics (BND) and Masters of Nutrition and Dietetics (MND). An action research framework was used to guide and inform inquiry. This involved four stages, each of which provided information to reach a final decision about how to progress forward. First, relevant information was collected to present to stakeholders. This included identification of acknowledged curriculum frameworks, a review of other accredited nutrition and dietetics courses in Australia, a review of Indigenous health topics at Flinders University, including liaison with the Poche Centre for Indigenous Health and Well-Being (Indigenous health teaching and research unit), and a review of BND and MND current curriculum related to Indigenous health. Second, input was sought from stakeholders. This involved a workshop with practising dietitians and nutritionists from South Australia and the Northern Territory and discussions with Flinders University Nutrition and Dietetics academic staff. Third, a new curriculum was developed. Nine areas were identified for this curriculum, including reflexivity, approach and role, history and health status, worldview, beliefs and values, systems and structures, relationship building and communication, food and food choice, appreciating and understanding diversity, and nutrition issues and health status. Fourth, a final outcome was achieved, which was the decision to introduce a core, semester-long Indigenous health topic for BND students. A secondary outcome was strengthening of Indigenous health teaching across the BND and MND. The process and findings will be useful to other university courses looking to assess and expand their Indigenous health curriculum.
The present study aimed to assess nutritional status, dietary diversity and lifestyle risk factors associated with undernutrition in an institutionalised Sri Lankan elderly population.
The study was of cross-sectional design followed by a stratified sampling method.
Twelve homes for the elderly recruited from six provinces in Sri Lanka.
A total of 311 institutionalised elderly aged ≥60 years.
The mean age of the study population was 75 (sd 8) years. Prevalence of undernutrition was 30 %. Mean food variety score, dietary diversity score and dietary serving score of the study population were 8·7 (sd 1·5), 7·3 (sd 1·2) and 10·9 (sd 2·0), respectively. Mean daily intakes of fruit, vegetables, meat, fish, eggs and pulses and dairy portions were below the national recommendations, whereas the mean consumption of sugar exceeded the national recommendation. Only the mean intake of starch was within the recommendation. Food allergies (OR=8·0; 95 % CI 3·9, 16·2), skipping meals (OR=3·8; 95 % CI 2·0, 7·5) and lack of leisure activities (OR=3·1; 95 % CI 1·5, 6·7) significantly increased the risk of undernutrition, whereas the use of dentures decreased the risk (OR=0·20; 95 % CI 0·06, 0·69).
High prevalence of undernutrition and low dietary diversity were observed in an institutionalised elderly Sri Lankan population. Therefore, there is an urgent need to implement nutrition interventions as part of geriatric care to reduce undernutrition and improve the diets of the institutionalised elderly population in Sri Lanka.
Stormwater catch basins form part of artificial drainage systems in urban areas and can provide larval habitat for mosquito vector species of West Nile virus (WNv), such as Culex pipiens Linnaeus (Diptera: Culicidae). We evaluated the impact of management techniques and targeted applications of larvicide on larval populations of this potential WNv mosquito vector species in catch basins from the Lower Mainland of Vancouver and on Vancouver Island of British Columbia, Canada. A mixed effects logistic regression model described the relationship between larval presence and larvicide treatment while controlling for other parameters. Parameter estimates showed that larvicide treatment reduced the odds of larvae presence by a factor of ∼7.23. The model also revealed relationships between larval presence and water temperature and adjacent land use but larvicide treatment consistently reduced the presence of larvae regardless of these other factors. This knowledge can now be used to prioritise and target control efforts to most efficiently reduce WNv mosquito vector populations, and most effectively reduce the risk of WNv transmission to humans. A similar research strategy could be applied to emerging threats from other potential mosquito vectors of disease around the world, to help lower the incidence of mosquito-borne disease.
Incentives used to encourage local residents to support conservation range from integrated conservation and development projects (ICDPs), which indirectly connect improved livelihoods with biodiversity protection, to direct payments for ecosystem services (PES). A unique hybrid between these two strategies, the Arabuko-Sokoke Schools and Ecotourism Scheme (ASSETS), provides secondary-school bursaries to encourage stewardship of a biodiverse highly-imperiled Kenyan forest. Household surveys and semi-structured interviews were used to assess the effectiveness of ASSETS by comparing attitudes and perceptions toward the forest among scheme beneficiaries and non-beneficiaries. The most commonly identified benefit of the forest was resource extraction (for example fuelwood), followed by ecosystem services (such as source of rain). Those in favour of forest clearing tended not to be ASSETS beneficiaries, were less-educated, and were less likely to mention ecosystem services and tourism as forest benefits. ASSETS appears to shape pro-conservation attitudes among beneficiaries and foster a sense of responsibility toward the forest. Challenges for ASSETS are similar to those faced by many conservation and development projects, namely unsteady funding and the risk that the extremely poor may be overlooked. ASSETS may serve as an effective hybrid between the PES and ICDP approaches, and such educational support provides a promising conservation incentive.
Vascular dysfunction is recognised as an integrative marker of CVD. While dietary strategies aimed at reducing CVD risk include reductions in the intake of SFA, there are currently no clear guidelines on what should replace SFA. The purpose of this review was to assess the evidence for the effects of total dietary fat and individual fatty acids (SFA, MUFA and n-6 PUFA) on vascular function, cellular microparticles and endothelial progenitor cells. Medline was systematically searched from 1966 until November 2010. A total of fifty-nine peer-reviewed publications (covering fifty-six studies), which included five epidemiological, eighteen dietary intervention and thirty-three test meal studies, were identified. The findings from the epidemiological studies were inconclusive. The limited data available from dietary intervention studies suggested a beneficial effect of low-fat diets on vascular reactivity, which was strongest when the comparator diet was high in SFA, with a modest improvement in measures of vascular reactivity when high-fat, MUFA-rich diets were compared with SFA-rich diets. There was consistent evidence from the test meal studies that high-fat meals have a detrimental effect on postprandial vascular function. However, the evidence for the comparative effects of test meals rich in MUFA or n-6 PUFA with SFA on postprandial vascular function was limited and inconclusive. The lack of studies with comparable within-study dietary fatty acid targets, a variety of different study designs and different methods for determining vascular function all confound any clear conclusions on the impact of dietary fat and individual fatty acids on vascular function.