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We present the development of a regional dementia strategy in Southwestern Ontario, Canada. We worked with stakeholders in a regional health authority to develop a dementia strategy. We conducted interviews with persons with dementia and their care partners (n = 26) and health care administrators and policy makers (n = 33); and administered a priority-setting survey (n = 64). Both participant groups identified provider compassion, professionalism, and care in the early stages of dementia as system strengths. Both groups also highlighted a need for more integration and coordination, a need for more person-centred care, support for care partners, and more flexibility in the provision and receipt of services. The highest-ranked priorities were improving care partner support, improving access to care, and improving system-wide quality. We integrate these strengths, needs, and priorities in a strategic framework, “Whole Person, Whole Journey”. Organizations developing a dementia strategy may use this framework as a springboard for their own work.
Online dietary assessment tools can reduce administrative costs and facilitate repeated dietary assessment during follow-up in large-scale prospective studies. We developed an online 24-h recall (myfood24) with automated estimation of associated nutrient intake, and assessed validity against reference recovery, predictive and concentration biomarkers. Validity of the online tool was then compared with that of traditional interviewer-administered multiple-pass 24-h recalls and presented as the expected attenuation of any diet-disease associations estimated with the tool.
Metabolically stable adults were recruited and completed the new online dietary recall, a traditional interviewer-based multiple-pass recall and provided samples of blood and urine for a range of reference biomarkers. Longer-term dietary intake was estimated from up to three recalls taken two weeks apart. Estimated intakes of protein, total sugars, potassium and sodium were compared with urinary biomarker concentrations. Estimated energy intake was compared with energy expenditure measured by three-plane accelerometry and open-circuit indirect calorimetry. Validity against these biomarkers was also compared to that estimated for traditional interviewer-administered multiple-pass 24-hour recalls.
At least one biomarker sample was received from each of 212 participants. Compared to reference biomarkers, both the online 24-hour recall and interviewer-based recall led to attenuation of diet-disease associations. The online tool resulted in attenuation factors of around 0.2–0.3 which could have important effects on estimated risks. For example, if the true relative risk of a diet-disease association was 2.0, an attenuation factor of 0.3 would reduce the relative risk to 1.23. Ranking using intakes against repeated biomarkers as an estimate of truth, resulted in higher attenuation factors of approximately 0.3–0.4, with a smaller impact on risk estimates. Attenuation improved substantially on repeated application of the tool. Validity of the interviewer-based recall found similar attenuation factors, but it was more administratively burdensome and expensive to implement. The online tool typically provided 10–20% lower nutrient estimates compared to the interviewer-administered tool.
Our findings show that, whilst results from both automated online and traditional interviewer-based dietary recalls are attenuated compared to objective biomarker measures, the myfood24 online 24-hour recall is comparable to the more time-consuming and costly traditional interviewer-based 24-hour recall across a wide range of measures. The less burdensome implementation of the online tool, with automated nutrient coding and easy replication over a longer time period with associated gains in precision, makes it well-placed for repeated use in large-scale prospective studies.
Two chondrichthyan assemblages of Late Mississippian/Early Pennsylvanian age are now recognized from the western Grand Canyon of northern Arizona. The latest Serpukhovian Surprise Canyon Formation has yielded thirty-one taxa from teeth and dermal elements, which include members of the Phoebodontiformes, Symmoriiformes, Bransonelliformes, Ctenacanthiformes, Protacrodontoidea, Hybodontiformes, Neoselachii (Anachronistidae), Paraselachii (Gregoriidae, Deeberiidae, Orodontiformes, and Eugeneodontiformes), Petalodontiformes, and Holocephali. The euselachian grade taxa are remarkably diverse with four new taxa recognized here; the Protacrodontidae: Microklomax carrieae new genus new species and Novaculodus billingsleyi new genus new species, and the Anchronistidae: Cooleyella platera new species and Amaradontus santucii new genus new species The Surprise Canyon assemblage also has the youngest occurrence of the elasmobranch Clairina, previously only known from the Upper Devonian. The Surprise Canyon Formation represents a nearshore fluvial infilling of karstic channels, followed by a shallow marine bioherm reef, and finally deeper open water deposition. The early Bashkirian Watahomigi Formation represents open marine deposition and contains only two taxa: a new xenacanthiform, Hokomata parva new genus new species, and the holocephalan Deltodus. The relationship between the Surprise Canyon and Watahomigi chondrichthyan assemblages and other significant coeval chondrichthyan assemblages suggests that there may have been eastern and western distinctions among the Euamerican assemblages during the Serpukhovian due to geographic separation by the formation of Pangea.
The practice of extended family and friends helping to care for children when their parents are unable to is an enduring tradition in many cultures. Kinship care provides the largest proportion of out of home care in Western society but many of these carers experience poverty and deprivation, and do not receive comparable levels of support, financial or professional, to other placement types. This study provides UK evidence for the relationship between kinship care and deprivation and examines how the welfare state frames kinship care in policy and practice.
CVD is the leading cause of death worldwide. Diet is a key modifiable component in the development of CVD. No official UK diet quality index exists for use in UK nutritional epidemiological studies. The aims of this study are to: (i) develop a diet quality index based on components of UK dietary reference values (DRV) and (ii) determine the association between the index, the existing UK nutrient profile (NP) model and a comprehensive range of cardiometabolic risk markers among a British adult population. A cross-sectional analysis was conducted using data from the Airwave Health Monitoring Study (n 5848). Dietary intake was measured by 7-d food diary and metabolic risk using waist circumference, BMI, blood lipid profile, glycated Hb (HbA1c) and blood pressure measurements. Diet quality was assessed using the novel DRV index and NP model. Associations between diet and cardiometabolic risk were analysed via multivariate linear models and logistic regression. A two-point increase in NP score was associated with total cholesterol (β −0·33 mmol/l, P<0·0001) and HbA1c (β −0·01 %, P<0·0001). A two-point increase in DRV score was associated with waist circumference (β −0·56 cm, P<0·0001), BMI (β −0·15 kg/m2, P<0·0001), total cholesterol (β −0·06 mmol/l, P<0·0001) and HbA1c (β −0·02 %, P=0·002). A one-point increase in DRV score was associated with type 2 diabetes (T2D) (OR 0·94, P=0·01) and obesity (OR 0·95, P<0·0001). The DRV index is associated with overall diet quality and risk factors for CVD and T2D, supporting its application in nutritional epidemiological studies investigating CVD risk in a UK population.
Prospective cohort studies have shown inverse associations between fibre intake and CVD, possibly mediated by blood pressure (BP). However, little is known about the impact of types of fibre on BP. We examined cross-sectional associations with BP of total, insoluble and soluble fibre intakes. Data were used from the INTERnational study on MAcro/micronutrients and blood Pressure (INTERMAP) study, including 2195 men and women aged between 40 and 59 years from the USA. During four visits, eight BP, four 24 h dietary recalls and two 24 h urine samples were collected. Linear regression models adjusted for lifestyle and dietary confounders to estimate BP differences per 2 sd higher intakes of total and individual types of fibre were calculated. After multivariable adjustment, total fibre intake higher by 6·8 g/4184 kJ (6·8 g/1000 kcal) was associated with a 1·69 mmHg lower systolic blood pressure (SBP; 95 % CI −2·97, −0·41) and attenuated to −1·01 mmHg (95 % CI −2·35, 0·34) after adjustment for urinary K. Insoluble fibre intake higher by 4·6 g/4184 kJ (4·6 g/1000 kcal) was associated with a 1·81 mmHg lower SBP (95 % CI −3·65, 0·04), additionally adjusted for soluble fibre and urinary K excretion, whereas soluble fibre was not associated with BP. Raw fruit was the main source of total and insoluble fibre, followed by whole grains and vegetables. In conclusion, higher intakes of fibre, especially insoluble, may contribute to lower BP, independent of nutrients associated with higher intakes of fibre-rich foods.
The Derby Arboretum and Loudon's publications encouraged the planting of greater varieties of trees and shrubs and the provision of arboretums in public parks and gardens and the formation of public arboretums. Public arboretums were partly inspired by the discourse of rational recreation as expressed by the Select Committee on Public Walks of 1833 and partly intended to ameliorate the problems of urban industrial expansion and to provide a taste of rural pleasures in urban settings. Like Ruskin's intentions for architecture, arboretums were an attempt to restore the ‘loss of fellowship with nature’, to bring a piece of the countryside into towns and provide an opportunity to experience the foreign and exotic. As the Walsall Observer put it after the formation of a local arboretum, the ‘tendency of the age is towards the creation of an artificiality … incompatible with natural and real life’; the park would help ‘restore that balance’ which ‘busy commercial and industrial life has rendered artificial and unnatural’. Arboretums were places for urban refreshment where, as Charles Kinglsey observed of galleries, town dwellers could escape the grim smoky ‘city-world of stone and iron’ by taking country walks and wandering ‘beneath mountain peaks, blushing sunsets … broad woodlands … green meadows … overhanging rocks [and] rushing brooks’. Rational recreational objectives help to explain similarities between arboretums as ‘living museums’ and other nineteenth-century civic institutions such as galleries, museums, libraries and mechanics’ institutions.
Late seventeenth-century Britain was one of the least wooded countries in Europe. In broad terms woodland had fallen to less than 5 per cent of the land area compared to the 10 per cent estimated to have existed at the time of Domesday. Moreover, compared to many European counties, the number of trees that could be classed as native to Britain was very low with less than thirty broadleaved species and as few as five evergreens. The geography of tree species resulted from a complicated mixture of environmental conditions and past human activities. Although of small acreage, the woods found in different parts of the country varied considerably: intensively managed oak coppice grown for tannin in Cornwall and Devon; strips of coppiced alder along brooks and rivers in the Midlands; pollarded oaks and ashes and stripped elms found in many hedgerows; while significant areas of native Scots pine were only to be found in Scotland. Partly as a consequence of the small area of woodland, Britain was largely dependent on imported rather than home-produced timber and wood products. In addition, there was very little publicly owned forest apart from some small remnants of Crown forests, such as parts of the Forest of Dean and the New Forest.
He faced, across half an acre of lawn, what the previous owners had called their ‘arboretum’. Ludovic thought of it merely as ‘the trees’. Some were deciduous and had now been stripped bare by the east wind that blew from the sea, leaving the holm oaks, yews, and conifers in carefully contrived patterns, glaucous, golden and of a green so deep as to be almost black at that sunless noon.
Evelyn Waugh, Unconditional Surrender
By the mid-twentieth century the term arboretum was relatively commonplace. It referred to a place where collections of trees were grown and displayed systematically, sometimes planted according to botanical taxonomies, labelled and catalogued. For some, such as Evelyn Waugh, arboretums had become hackneyed; the quotation above describes an arboretum in the garden of a ‘large, requisitioned villa in a still desolate area of Essex’, in 1943. Here the term is consciously pompous and affected, describing the remnant of a small tree collection in the garden of a modest house; but as we have seen, in the nineteenth century arboretums were perceived as innovative and exciting places.
This study has explored the development of arboretums in the period, arguing that there was a close relationship between botany and arboriculture and that the latter encouraged the adoption of the natural system in Britain. It has examined the emergence of tree collections intended to provide botanical education including botanical gardens, private estates and public sites where collections were displayed.
Botany became one of the most fashionable and popular British Georgian pursuits, particularly after the translation and publication of the works of Carl Linnaeus. The Linnaean system helped to make botany accessible for men, women and children alike by providing a key through which plants in flower could be identified easily without requiring a profound knowledge of botanical characteristics. There were, however, other important aspects to British botany inspired by the economic, patriotic, cultural and fashionable emphasis upon horticultural and agricultural improvement. During the later Georgian period, and inspired by French botany and British arboriculture, increasing importance was attached to the interconnectedness of taxonomy, vegetable physiology and anatomy. The popularity of botany is exemplified by the number of natural historical works that were published and disseminated, the development of private gardens and commercial nurseries, creation of herbariums, practice of flower painting and formation of botanical societies. Introductions to the Linnaean system, intended for both sexes, sold widely and there were various attempts to translate key Linnaean works into English, whilst Erasmus Darwin's Loves of the Plants (1789), a poetical representation of the Linnaean world personified, proved especially popular during the 1790s. Although various botanical systems competed internationally in the period between 1760 and 1820, Linnaean taxonomy was dominant, particularly in Britain. The greatest challenge came from those who proffered what they claimed to be more ‘natural’ systems, especially French botanists such as Antoine-Laurent de Jussieu, although their work was partly inspired by suggestions offered by Linnaeus.
Loudon's Arboretum Britannicum has had a profound impact on the history of British arboriculture ever since its publication, unavoidably obscuring arboricultural works published prior to this and shaping subsequent interpretations of nineteenth-century tree collections. To fully contextualize Loudon's magnum opus and to appreciate its significance in the history of natural history we will examine some preceding arboretums and arboricultural works. This chapter argues that botanical society gardens were the first type of public and semi-public urban institutions with significant tree and shrub collections prior to the 1820s and that the challenges of applying Linnaean botany to arboriculture were first confronted leading to experiments with natural arrangements. Newly imported trees and shrubs were eagerly sought and presented but challenged taxonomic ideas and gardening practices, underscoring tensions between practical botany, education, popular natural history and publications. From the late eighteenth century, British botanical gardens began to present natural alongside Linnaean arrangements which impacted upon arboricultural publications such as Aylmer Bourke Lambert's Genus Pinus (1802–24) and Peter William Watson's Dendrologia Britannica (1825).
Older purposes of physic gardens were not entirely forgotten and, aided by active patronage from medical men, the potential to exploit plants for medicinal uses remained important, rhetorically if not often in practice. However, British botanical gardens and arboretums helped to develop and satisfy a new audience for botanical and arboricultural education. Private and semi-private institutions relied upon income from members, patrons and visitors whose expectations of the gardens had to be satisfied.
This study explores the science and culture of nineteenth-century British arboretums, or tree collections. The development of arboretums was fostered by a variety of factors, each of which is explored in detail: global trade and exploration, the popularity of collecting, the significance to the British economy and society, developments in Enlightenment science, changes in landscape gardening aesthetics and agricultural and horticultural improvement.Arboretums were idealized as microcosms of nature, miniature encapsulations of the globe and as living museums. This book critically examines different kinds of arboretum in order to understand the changing practical, scientific, aesthetic and pedagogical principles that underpinned their design, display and the way in which they were viewed. It is the first study of its kind and fills a gap in the literature on Victorian science and culture.
Loudon's Arboretum Britannicum is the most important systematic study of hardy British trees and shrubs to have been published in the past two centuries, and arguably ever. Its greatest significance lies in the fact that it combined a comprehensive study of trees and shrubs with geographically founded histories of arboriculture, analysis of the importance of trees and shrubs in landscape gardening and full-length portraits of trees at different growth stages. Loudon's ideas concerning arboretums developed in various ways during the 1820s and 1830s in response to his experience of trees in various contexts, including private gardens such as his Bayswater villa, botanical and horticultural society gardens, and country estate collections. The significance of the Arboretum Britannicum and arboretum concept, manifest in various changing forms, can only be fully appreciated if examined in the context of British scientific culture and particularly cultures of natural history. The book must also be judged in terms of Loudon's other efforts to promote botany within gardening and horticulture, encouraging new audiences and practitioners amongst all social classes in the British Isles and Ireland. Scientifically-informed arboriculture and landscape gardening should not be merely the preserve of aristocracy, gentry and their agents as in the days of Humphry Repton.
This book was motivated by recent work in the history of science and cultural and historical geography and a belief that arboretums have had a profound impact on British cultural and scientific history. We embark upon an exploration of the historical and cultural geographies of nineteenth-century arboretums in order to try to understand the various principles and practices underpinning their design and the management and consumption of tree collections, particularly tensions between naturalistic and geometric aesthetics and botanical taxonomies. This book traces interconnections between horticulture, botany and forestry, the role of institutions and the relationships between arboretums and their various social and cultural contexts including the horticultural trade, scientific development of forestry and importance of international networks, exploration, trade and imperialism in tree collecting. Although the principal focus is British arboretums (with some reference to the Republic of Ireland), just as John Claudius Loudon's Arboretum et Fruticetum Britannicum (1838, hereafter Arboretum Britannicum) was something of an international collaboration, and like nineteenth-century planted arboretums, any study of British arboretums is inherently both national and international.
This book is the result of a major project on the cultural and historical geographies of the arboretum begun at the School of Geography, Nottingham University and funded between 2004 and 2007.