The Hanging/hanged Patient and Relevance to Pre-hospital Care

Death and injury from hanging is a complex situation, which requires careful and appropriate assessment and management in the pre-hospital environment. It is arguably an area of limited understanding and therefore may not be assessed and managed in the most effective manner. Most hanged/hanging patients will be found in their homes, rather than in institutions. It could be argued that due to prevalence as a suicide method, the majority of pre-hospital ambulance service staff will be responded to at least one hanged or hanging patient within their careers, thus a greater understanding will benefit both clinician and patient. Patients who attempt or achieve suicide will rarely achieve fracturing the spine and severing the spinal cord, bringing into question the requirement for the traditional cervical collar and spinal immobilisation techniques. Death from asphyxiation and carotid/vagal reflex require consideration and management as does raised ICP, which is likely to occur

Perspective: Measuring Sweetness in Foods, Beverages, and Diets: Toward Understanding the Role of Sweetness in Health.

Various global public health agencies recommend minimizing exposure to sweet-tasting foods or beverages. The underlying rationale is that reducing exposure to the perception of sweet tastes, without regard to the source of sweetness, may reduce preferences for sweetness, added sugar intake, caloric intake, and body weight. However, the veracity of this sequence of outcomes has yet to be documented, as revealed by findings from recent systematic reviews on the topic. Efforts to examine and document the effects of sweetness exposure are needed to support evidence-based recommendations. They require a generally agreed-upon methodology for measuring sweetness in foods, beverages, and the overall diet. Although well-established sensory evaluation techniques exist for individual foods in laboratory settings, they are expensive and time-consuming, and agreement on the optimal approach for measuring the sweetness of the total diet is lacking. If such a measure could be developed, it would permit researchers to combine data from different studies and populations and facilitate the design and conduct of new studies to address unresolved research questions about dietary sweetness. This narrative review includes an overview of available sensory techniques, their strengths and limitations, recent efforts to measure the sweetness of foods and diets across countries and cultures, and a proposed future direction for improving methods for measuring sweetness toward developing the data required to support evidence-based recommendations around dietary sweetness

Software Sustainability: Research and Practice from a Software Architecture Viewpoint

Context: Modern societies are highly dependent on complex, large-scale, software-intensive systems that increasingly operate within an environment of continuous availability, which is challenging to maintain and evolve in response to the inevitable changes in stakeholder goals and requirements of the system. Software architectures are the foundation of any software system and provide a mechanism for reasoning about core software quality requirements. Their sustainability – the capacity to endure in changing environments – is a critical concern for software architecture research and practice. Problem: Accidental software complexity accrues both naturally and gradually over time as part of the overall software design and development process. From a software architecture perspective, this allows several issues to overlap including, but not limited to: the accumulation of technical debt design decisions of individual components and systems leading to coupling and cohesion issues; the application of tacit architectural knowledge resulting in unsystematic and undocumented design decisions; architectural knowledge vaporisation of design choices and the continued ability of the organization to understand the architecture of its systems; sustainability debt and the broader cumulative effects of flawed architectural design choices over time resulting in code smells, architectural brittleness, erosion, and drift, which ultimately lead to decay and software death. Sustainable software architectures are required to evolve over the entire lifecycle of the system from initial design inception to end-of-life to achieve efficient and effective maintenance and evolutionary change. Method: This article outlines general principles and perspectives on sustainability with regards to software systems to provide a context and terminology for framing the discourse on software architectures and sustainability. Focusing on the capacity of software architectures and architectural design choices to endure over time, it highlights some of the recent research trends and approaches with regards to explicitly addressing sustainability in the context of software architectures. Contribution: The principal aim of this article is to provide a foundation and roadmap of emerging research themes in the area of sustainable software architectures highlighting recent trends, and open issues and research challenges