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Advancing dysphagia-oriented multi-ingredient meal development: Optimising hydrocolloid incorporation in 3D printed nutritious meals
Get PDFDysphagia (DP) is a growing health concern in today's ageing population, leading to high demand for DP-oriented food. 3D printing is a promising novel technology for developing new attractive and appetising products. Therefore, we aimed to develop a 3D-printed shaped meal, to serve as a nutritious DP-oriented food. The texture was modified with the addition of different thickeners: 2.0% (w/w) k-carrageenan gum (KC) and 1.0 or 1.5% (w/w) guar gum (GG), xanthan gum (XG), locust bean gum (LBG), and gum arabic (GA). Upon characterising and mapping the rheological behaviour involved in extrusion-based 3D printing, the higher concentrations of GG, XG, LBG and GA were found to significantly increase the yield stress and apparent viscosities of the ink formulations. In addition, the colour attributes were examined, while a low population of total viable bacteria (TVC) was observed. The DP-oriented formulations had high fibre content, regulating bowel function and glucose metabolism in the elderly. According to the International dysphagia diet standardisation initiative (IDDSI), KC/XG1 and KC/LBG1 were classified as level 5 indicative of minced and moist dysphagia diet, while KC/GA1, KC/GA1.5, KC/XG1.5, and KC/GG1.5 were classified as level 4, that can be bitten or chewed if the tongue control is reduced. All ink formulations demonstrated high printing precision with excellent self-supporting capability and smooth surface texture that were easy to extrude and print complex samples. This study provides valuable insights into addressing dysphagia by developing a nutritious meal using 3D printing
A cognitive dissonance body image intervention ‘Free Being Me’ delivered by Guide leaders to adolescent Girl Guides in India: A pilot and acceptability trial
Get PDFThis pilot study assessed the acceptability and pre-post intervention effects of a cognitive dissonance-based body image intervention, Free Being Me, delivered by Guide leaders to adolescent girls in India. Girls aged 11–14 years (Mage = 12.6, N = 117), who were members of the national scouting and guiding association of India, received the intervention across five weekly 1-hour group sessions. The primary outcome (body esteem) and secondary outcomes (self-esteem, internalisation of appearance ideals, negative and positive affect, and life disengagement) were measured pre-intervention and immediately post-intervention. The intervention was acceptable. Adolescent girls reported high levels of comfort (89%), enjoyment (90%), and perceived importance (92%) with suggestions for improvement including more interactive activities. Facilitator adherence and competence delivering Free Being Me was rated good. Significant within-groups pre-post intervention improvements in body esteem (Cohen's d = 0.28) and reductions in internalisation of appearance ideals (Cohen's d = 0.49) were identified. No changes to self-esteem, negative or positive affect, or life disengagement were observed. This study suggests that Free Being Me is acceptable for community-based delivery and Guide leader format with promising pre-post intervention effects. Going forward, a randomised controlled trial is necessary to make confident interpretations on the effectiveness of Free Being Me
Implementation of the CHIldren with acute COugh (CHICO) intervention to improve antibiotics management: A qualitative study in primary care
Get PDFBACKGROUND: Childhood respiratory tract infections (RTIs) are common and can lead to unnecessary antibiotic use and antimicrobial resistance. The CHIldren with COugh (CHICO) intervention incorporates a clinician-focused algorithm (STARWAVe) to predict future hospitalisation risk, elicitation of carer concerns, and a carer-focused personalised leaflet recording treatment decisions and safety-netting information. AIM: To examine the implementation of the CHICO intervention by primary care clinicians. DESIGN AND SETTING: A qualitative study with primary care clinicians in England taking part in the CHICO randomised controlled trial. METHOD: Interviews explored the CHICO intervention's acceptability and use. Clinicians from a range of practices with high and low antibiotic dispensing rates were recruited. Normalisation process theory underpinned data collection and thematic analysis. RESULTS: Most clinicians liked the intervention because it was quick and easy to use, it helped elicit carer concerns, and reassured clinicians and carers of the appropriateness of treatment decisions. However, clinicians used it as a supportive aid for treatment decisions rather than as a tool for behaviour change. The accompanying advice leaflet helped explain treatment decisions and support self-care. The intervention did not always align with clinicians' usual processes, which could affect use. Increased familiarisation with the algorithm led to reduced intervention use, which was further reduced during the COVID-19 pandemic as a result of changes to practice and remote consultations. CONCLUSION: Clinicians found the CHICO intervention useful to support decision making around antibiotic prescribing and it helped discussions with carers about concerns and treatment decisions. The intervention may need to be adapted to align more with clinicians' consultation flow and remote consultations
Campaigning against workplace ‘sexual harassment’ in the UK: Law, discourse and the news press c. 1975–2005
Get PDFThis article examines how and in what ways workplace ‘sexual harassment’ achieved social and legal recognition in the UK news press following its importation from North America in the mid-1970s. It assesses the role of feminist campaigners working within institutions (trade unions, human rights advocacy, the Equal Opportunities Commission and journalism itself) in shifting public discourse and in using the media to educate and promote social change. We demonstrate that the trajectory was far from a linear progression. Initial hostility within the popular press in the early 1980s was replaced with sympathetic coverage across the party-political spectrum by 1990. However, this consensus broke down in the 1990s as a result of politicised and polarised coverage of a series of claims brought by women in the services and armed forces against the backdrop of debates about ‘compensation culture’ and membership of the European Union. Whilst change was effected at the level of employment law, formal practice and in the human resources policies of larger employers, ‘sexual harassment myths’ were resilient as a thread within ‘everyday cultural discourse’ and, by implication, within informal workplace cultures
A quantitative evaluation of aerosol generation during cardiopulmonary resuscitation
Get PDFIt is unclear if cardiopulmonary resuscitation is an aerosol-generating procedure and whether this poses a risk of airborne disease transmission to healthcare workers and bystanders. Use of airborne transmission precautions during cardiopulmonary resuscitation may confer rescuer protection but risks patient harm due to delays in commencing treatment. To quantify the risk of respiratory aerosol generation during cardiopulmonary resuscitation in humans, we conducted an aerosol monitoring study during out-of-hospital cardiac arrests. Exhaled aerosol was recorded using an optical particle sizer spectrometer connected to the breathing system. Aerosol produced during resuscitation was compared with that produced by control participants under general anaesthesia ventilated with an equivalent respiratory pattern tocardiopulmonary resuscitation. A porcine cardiac arrest model was used to determine the independent contributions of ventilatory breaths, chest compressions and external cardiac defibrillation to aerosol generation. Time-series analysis of participants with cardiac arrest (n = 18) demonstrated a repeating waveform of respiratory aerosol that mapped to specific components of resuscitation. Very high peak aerosol concentrations were generated during ventilation of participants with cardiac arrest with median (IQR [range]) 17,926 (5546–59,209 [1523–242,648]) particles.l-1, which were 24-fold greater than in control participants under general anaesthesia (744 (309–2106 [23–9099]) particles.l-1, p < 0.001, n = 16). A substantial rise in aerosol also occurred with cardiac defibrillation and chest compressions. In a complimentary porcine model of cardiac arrest, aerosol recordings showed a strikingly similar profile to the human data. Time-averaged aerosol concentrations during ventilation were approximately 270-fold higher than before cardiac arrest (19,410 (2307–41,017 [104–136,025]) vs. 72 (41–136 [23–268]) particles.l-1, p = 0.008). The porcine model also confirmed that both defibrillation and chest compressions generate high concentrations of aerosol independent of, but synergistic with, ventilation. In conclusion, multiple components of cardiopulmonary resuscitation generate high concentrations of respiratory aerosol. We recommend that airborne transmission precautions are warranted in the setting of high-risk pathogens, until the airway is secured with an airway device and breathing system with a filter
The AU free movement protocol: Challenges in its implementation
Get PDFOne of the major pillars of the African Union is the integration of peoples and the ability for them to move freely from one member country to another, with the right to reside and practise their trade or profession. This aspect of integration found full expression in the Protocol to the Treaty Establishing the African Economic Community Relating to the Free Movement of Persons, Right of Residence and Right of Establishment, adopted in 2018. Upon operationalization, it will remove obstacles to the movement of people, capital and resources in the region and give expression to aspiration 2 of the African Union Agenda 2063. However, significant challenges lie on the path of its implementation. This article doctrinally reviews the protocol, looking at its prospects for promoting African integration and development, and anticipates some of the problems that the protocol will face. It concludes with recommendations for achieving its lofty but desirable ends
A mixed methods systematic review on the effects of arts interventions for children and young people at-risk of offending, or who have offended on behavioural, psychosocial, cognitive and offending outcomes: A systematic review
Get PDFBackground: Young people who enter the justice system experience complex health and social needs, and offending behaviour is increasingly recognised as a public health problem. Arts interventions can be used with the aim of preventing or reducing offending or reoffending. Objectives: 1. To evaluate evidence on the effectiveness and impact of arts interventions on keeping children and young people safe from involvement in violence and crime. 2. To explore factors impacting the implementation of arts interventions, and barriers and facilitators to participation and achievement of intended outcomes. 3. To develop a logic model of the processes by which arts interventions might work in preventing offending behaviours. Search Methods: We searched AMED, Academic Search Complete; APA PsycInfo; CINAHL Plus; ERIC; SocIndex; SportDiscus, Medline, CENTRAL, Web of Science, Scopus, PTSDPubs and Performing Arts Periodicals Database, Sage, the US National Criminal Justice Reference Service, the Global Policing and British Library EThOS databases, and the National Police Library from inception to January 2023 without language restrictions. Selection Criteria: We included randomised and non-randomised controlled trials and quasi-experimental study designs. We included qualitative studies conducted alongside intervention trials investigating experiences and perceptions of participants, and offering insight into the barriers and facilitators to delivering and receiving arts interventions. We included qualitative and mixed methods studies focused on delivery of arts interventions. We included studies from any global setting. We included studies with CYP (8–25 years) who were identified as at-risk of offending behaviour (secondary populations) or already in the criminal justice system (tertiary populations). We included studies of interventions involving arts participation as an intervention on its own or alongside other interventions. Primary outcomes were: (i) offending behaviour and (ii) anti-pro-social behaviours. Secondary outcomes were: participation/attendance at arts interventions, educational attainment, school attendance and engagement and exclusions, workplace engagement, wellbeing, costs and associated economic outcomes and adverse events. Data Collection and Analysis: We included 43 studies (3 quantitative, 38 qualitative and 2 mixed methods). We used standard methodological procedures expected by The Campbell Collaboration. We used GRADE and GRADE CERQual to assess the certainty of and confidence in the evidence for quantitative and qualitative data respectively. Main Results: We found insufficient evidence from quantitative studies to support or refute the effectiveness of arts interventions for CYP at-risk of or who have offended for any outcome. Qualitative evidence suggested that arts interventions may lead to positive emotions, the development of a sense of self, successful engagement in creative practices, and development of positive personal relationships. Arts interventions may need accessible and flexible delivery and are likely to be engaging if they have support from staff, family and community members, are delivered by professional artists, involve culturally relevant activity, a youth focus, regularity and a sustainable strategy. We found limited evidence that a lack of advocacy, low funding, insufficient wider support from key personnel in adjacent services could act as barriers to success. Methodological limitations resulted in a judgement of very low confidence in these findings. Authors' Conclusions: We found insufficient evidence from quantitative studies to support or refute the effectiveness of arts interventions for CYP at-risk of offending or who have offended for any outcome. We report very low confidence about the evidence for understanding the processes influencing the successful design and delivery of arts interventions in this population of CYP and their impact on behavioural, psychosocial, cognitive and offending outcomes
Factors affecting early retirement intentions with the mediating mechanism of job engagement
Get PDFThe main objective of this study is to empirically examine the associations between work goals (intrinsic and extrinsic) and early retirement intentions, with the mediating mechanism of work passion and the moderating role of flexible HR practices, spouse’s health, and position level (employees’ position level in organizations, e.g., junior manager at lower level, deputy manager at middle level, or senior manager at upper level etc.). Data for the study was collected through survey-based questionnaires distributed to a sample of 350 female employees from different public and private sector organizations in Pakistan. Testing of the hypotheses was conducted using structural equation modeling (SEM) with WarpPLS software. The findings indicate that employees’ work goals are positively related to the level of passion they feel about their work. However, this has a negative impact on their early retirement intentions. Besides, the results show that this work passion mediates the relationship between work goals and early retirement intentions. Furthermore, flexible HR practices, position level, and spouse’s health moderate the relationship between work passion and early retirement intentions. The study’s theoretical and managerial contributions and limitations are also discussed at the end of the article
Pavlovian reflex in colloids
Get PDFLiquid computers are devices that utilise the properties of liquid volumes or reactants to represent data and outputs. A recent development in this field is the emergence of colloid computers, which employ electromagnetic interactions among functional particles for computation. To assess the potential of colloid computers in implementing neuromorphic dynamical architectures, we have focused on realising Pavlovian reflexes within colloid mixtures. The Pavlovian reflex, a fundamental function of neurological systems in living organisms, enables learning capabilities. Our approach involves implementing Pavlovian learning by associating an increase in synaptic weight with a decrease in the resistance of the colloid mixture. Through experimental laboratory conditions, we have successfully demonstrated the feasibility of Pavlovian learning in colloid systems
A shock to the (health) system: Experiences of adults with rare disorders during the first COVID-19 wave
Get PDFBackground: Before COVID-19, people with rare diseases (RD) experienced numerous disparities in quality of life and healthcare access and quality, yet little is known about the experiences of this underserved group during the pandemic. Results: During the first wave of the COVID-19 pandemic in the United States, spring and summer of 2020, 759 participants representing 231 unique RDs responded to open-ended questions about the impact of the pandemic on life with a RD, healthcare access, and coping. Qualitative conventional content analysis was used to analyze responses. Identified themes represented positive and negative dimensions of change, including a shock to the (health) system, coping with uncertainty, and the value of social support while isolated. Conclusions: Limitations in healthcare access and quality were the most frequently described as impacts of COVID-19. Other major negative impacts included exacerbation of symptoms, psychological distress, and a lack of usual social support and reliable information. However, participants also noted silver linings, especially in healthcare. For some, expanded telehealth enhanced their ability to access medical and mental health providers and RD specialists. Finally, many participants hoped that, by highlighting social and health inequities faced by people with RDs and other minorities, the pandemic would prompt greater understanding and policies that could improve the quality of life of the RD community