Nutrition management in the adult patient with Crohn’s disease

Malnutrition, nutrient deficiencies and osteoporosis are common in patients with Crohn’s disease, regardless of disease activity. While the role of diet in the pathogenesis of the disease remains inconclusive, upon diagnosis, nutrition therapy plays an integral role in patient care. Successful nutrition intervention involves appropriate nutritional assessment, supplemental nutrition and individualised counselling and support

“You are my rock and fortress”. Refuge metaphors in Psalm 31. a perspective from cognitive metaphor theory

The psalms of lamentation are prayers of a beleaguered individual or nation. The one under constant attack of the enemy has no other option but to implore the deity to intervene on his behalf. Yahweh is invoked to save the supplicant and to destroy the adversaries. Apart from this recurrent plea, Yahweh is often depicted as one providing refuge to those in need. Psalm 31 is no exception. The competent reader will identify various refuge metaphors being employed by the psalmist. Through the application of images from the natural world, the poet accentuates the notion that Yahweh acts as a refuge to his people. By taking recourse to the cognitive theory of metaphor, this study endeavours to explicate the cognitive world underlying the use of the refuge metaphors is Psalm 31

Effect of four-day psyllium supplementation on bowel preparation for colonoscopy:A prospective double blind randomized trial [ISRCTN76623768]

BACKGROUND: Patients with new onset constipation or presumed hemorrhoid bleeding frequently require the use of both fiber supplements and diagnostic colonoscopy. We sought to determine whether preliminary fiber supplementation would alter the tolerability or efficacy of a standard bowel preparation for colonoscopy METHODS: A prospective, double blind, randomized trial was designed to compare a short course of a psyllium-based supplement versus placebo prior to a colon lavage. Patients were given an unlabeled canister of powder, and instructed to take 1 tablespoon with 8 oz of water bid for 4 days before colonoscopy. A 4-liter polyethylene based glycol lavage was self-administered over 4 hours on the day prior to colonoscopy. A questionnaire on pre-study bowel habits and side effects was completed. Efficacy of the preparation was visually evaluated on a pre-determined scale. RESULTS: There were no significant differences between the two groups in gender, race, age, pre-study stool frequency or consistency. Tolerability was equivalent but efficacy of the bowel preparation was worse in the psyllium group compared to placebo (P < 0.05). CONCLUSIONS: In non-constipated patients psyllium based fiber supplementation should not be initiated in the few days prior to endoscopy using a polyethylene glycol preparation

The neuroanatomy of autism – a developmental perspective

Autism Spectrum Disorders (ASDs) are a heterogeneous group of neurodevelopmental disorders that are diagnosed solely on the basis of behaviour. A large body of work has reported neuroanatomical differences between individuals with ASD and neurotypical controls. Despite the huge clinical and genetic heterogeneity that typifies autism, some of these anatomical features appear to be either present in most cases or so dramatically altered in some that their presence is now reasonably well replicated in a number of studies. One such finding is the tendency towards overgrowth of the frontal cortex during the early postnatal period. Although these reports have been focused primarily on the presumed pathological anatomy, they are providing us with important insights into normal brain anatomy and are stimulating new ideas and hypotheses about the normal trajectory of brain development and the function of specific anatomical brain structures. The use of model systems that include genetic model organisms such as the mouse and, more recently, human induced pluripotent stem cell‐derived brain organoids to model normal and pathological human cortical development, is proving particularly informative. Here we review some of the neuroanatomical alterations reported in autism, with a particular focus on well‐validated findings and recent advances in the field, and ask what these observations can tell us about normal and abnormal brain development

ISO/IEC 15504 measurement applied to COBIT process maturity

Purpose: The assessment of COBIT process maturity levels is fraught with a number of problems regarding the objectivity of the assessment results. Unlike ISO/IEC 15504, COBIT does not define an assessment model. The purpose of this paper is to align the behavioural aspects of the six COBIT process attributes with achievement results defined for the nine process attributes associated with the ISO/IEC 15504-2 measurement scale. The authors believe that this alignment permits a translation of the ISO/IEC 15504 assessment data into an objective COBIT process maturity rating. Design/methodology/approach: The tables presented in the paper identify the COBIT process attributes, the applicable ISO/IEC 15504 process attribute achievement results and the aggregated rating that pertains to the selected achievement results. A final table lists the derived COBIT process maturity level in terms of the ratings for the ISO/IEC 15504 process attribute achievement results for an assessed process. Findings: The objectivity of the aggregated result (COBIT process maturity level) appeals strongly to end-users of this measurement result, particularly where contractual obligations must be satisfied. Practical implications: The method is useful where measurement rigour must be demonstrated in the computation of the COBIT process maturity levels. Originality/value: This assessment and computational method was developed and trialled in the second half of 2010 in the context of the assessment of 13 information technology (IT) service management processes at two different customer sites. The material is of special value to service managers in companies that have outsourced IT service management processes to external IT service providers. © Emerald Group Publishing Limited

Numerical simulation of steady and unsteady viscous flow in turbomachinery using pressure based algorithm

The objective of this research is to simulate steady and unsteady viscous flows, including rotor/stator interaction and tip clearance effects in turbomachinery. The numerical formulation for steady flow developed here includes an efficient grid generation scheme, particularly suited to computational grids for the analysis of turbulent turbomachinery flows and tip clearance flows, and a semi-implicit, pressure-based computational fluid dynamics scheme that directly includes artificial dissipation, and is applicable to both viscous and inviscid flows. The values of these artificial dissipation is optimized to achieve accuracy and convergency in the solution. The numerical model is used to investigate the structure of tip clearance flows in a turbine nozzle. The structure of leakage flow is captured accurately, including blade-to-blade variation of all three velocity components, pitch and yaw angles, losses and blade static pressures in the tip clearance region. The simulation also includes evaluation of such quantities of leakage mass flow, vortex strength, losses, dominant leakage flow regions and the spanwise extent affected by the leakage flow. It is demonstrated, through optimization of grid size and artificial dissipation, that the tip clearance flow field can be captured accurately. The above numerical formulation was modified to incorporate time accurate solutions. An inner loop iteration scheme is used at each time step to account for the non-linear effects. The computation of unsteady flow through a flat plate cascade subjected to a transverse gust reveals that the choice of grid spacing and the amount of artificial dissipation is critical for accurate prediction of unsteady phenomena. The rotor-stator interaction problem is simulated by starting the computation upstream of the stator, and the upstream rotor wake is specified from the experimental data. The results show that the stator potential effects have appreciable influence on the upstream rotor wake. The predicted unsteady wake profiles are compared with the available experimental data and the agreement is good. The numerical results are interpreted to draw conclusions on the unsteady wake transport mechanism in the blade passage

The significance of subthreshold symptoms of anxiety in the aetiology of bruxism

Magister Artium (Psychology) - MA(Psych)Bruxism is an oral parafunctional habit involving clenching and grinding of the teeth that occurs mainly unconsciously, diurnally and nocturnally. It is considered an important contributory factor in the aetiology of myofascial pain (MFP) and temporomandibular disorders (TMD). The aetiology of bruxism is considered to be multifactorial, involving physiological and psychological factors. The aim of this study was to examine the relationship between the subthreshold symptoms (subtle, prodromal, atypical and subclinical symptoms of which the severity precludes diagnosis as a disorder) of anxiety and bruxism in a sample of subjects using a spectrum model.South Afric

Identification of the Anti Listerial

Partially purified fractions of the n-hexane extract of Garcinia kola seeds were obtained through column chromatography and their constituents were identified through the use of gas chromatography coupled to mass spectrometry (GC-MS). Three fractions were obtained by elution with benzene as the mobile phase and silica gel 60 as the stationery phase and these were named Benz1, Benz2, and Benz3 in the order of their elution. The antiListerial activities of these fractions were assessed through MIC determination and only Benz2 and Benz3 were found to be active with MIC’s ranging from 0.625 to 2.5 mg/mL. The results of the GC-MS analysis showed Benz2 to have 9 compounds whilst Benz3 had 7 compounds, with the major compounds in both fractions being 9,19-Cyclolanost-24-en-3-ol, (3.β.) and 9,19-Cyclolanostan-3-ol,24-methylene-, (3.β.). The Benz2 fraction was found to have mainly indifferent interactions with ampicillin and penicillin G whilst mainly additive interactions were observed with ciprofloxacin. The Benz3 fraction’s interactions were found to be 50% synergistic with penicillin G and 25% synergistic with ciprofloxacin and ampicillin. A commercially available 9,19-Cyclolanost-24-en-3-ol, (3.β.) was found not to exhibit any antiListerial activities at maximum test concentrations of 5 mg/mL, suggesting that the compound could be acting in synergy with the other compounds in the eluted fractions of Garcinia kola seeds