Floral temperature and optimal foraging: is heat a feasible floral reward for pollinators?

As well as nutritional rewards, some plants also reward ectothermic pollinators with warmth. Bumble bees have some control over their temperature, but have been shown to forage at warmer flowers when given a choice, suggesting that there is some advantage to them of foraging at warm flowers (such as reducing the energy required to raise their body to flight temperature before leaving the flower). We describe a model that considers how a heat reward affects the foraging behaviour in a thermogenic central-place forager (such as a bumble bee). We show that although the pollinator should spend a longer time on individual flowers if they are warm, the increase in total visit time is likely to be small. The pollinator's net rate of energy gain will be increased by landing on warmer flowers. Therefore, if a plant provides a heat reward, it could reduce the amount of nectar it produces, whilst still providing its pollinator with the same net rate of gain. We suggest how heat rewards may link with plant life history strategies

Exploring Well-being as a Tourism Product Resource

This study employs a qualitative research approach where focus groups (n ¼ 11) with key stakeholders were used to understand how tourism investors view the concept of well-being in relation to tourism and the potential to use it as a tourism product resource. Findings validated by a wider group (n ¼ 50) exposed the barriers and enablers of implementing well-being in this way. The potential for businesses and policymakers to transform these barriers into enablers was also identified. In addition, study findings were mapped onto a robust model extracted from the public health sector and applied in a tourism context using a systems theory approach. This further highlighted the potential offered to the fields of public health and tourism in the concept of well-being, and demonstrated the well-being value of tourism. Data from this research will aid tourism business practice and development by embedding a well-being philosophy for tourism destinations' strategies

Case Study: Wellness, tourism and small business development in a UK coastal resort: Public engagement in practice

This article examines the scope of well-being as a focus for tourism and its potential as a tool for small business development, particularly the opportunities for tourism entrepreneurs in coastal resorts. The study reports an example of public engagement by a research team and the co-creation of research knowledge with businesses to assist in business development by adapting many existing features of tourist resorts and extending their offer to wider markets. The synergy between well-being and public health interests also brings potential benefits for the tourism workforce and the host community. The Case Study outlines how these ideas were tested in Bournemouth, a southern coastal resort in the UK, in a study ultimately intended to be adopted nationally and with more wide reaching implications for global development of the visitor economy. Local changes ascribed to the study are assessed and its wider potential is evaluated

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Novel targets and future strategies for acute cardioprotection: Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart

Ischaemic heart disease and the heart failure that often results, remain the leading causes of death and disability in Europe and worldwide. As such, in order to prevent heart failure and improve clinical outcomes in patients presenting with an acute ST-segment elevation myocardial infarction and patients undergoing coronary artery bypass graft surgery, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury. During the last three decades, a wide variety of ischaemic conditioning strategies and pharmacological treatments have been tested in the clinic - however, their translation from experimental to clinical studies for improving patient outcomes has been both challenging and disappointing. Therefore, in this Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart, we critically analyse the current state of ischaemic conditioning in both the experimental and clinical settings, provide recommendations for improving its translation into the clinical setting, and highlight novel therapeutic targets and new treatment strategies for reducing acute myocardial ischaemia/reperfusion injury

Parents’ Experiences of Feeding, Swallowing, and Nutrition in Children Receiving Palliative Care

Thesis (Ph.D.)--University of Rochester. School of Nursing. Dept. of Health Practice Research, 2020.Objectives:  Describe the experience of parents providing nutrition to children with chronic life-threatening conditions receiving palliative care.  Characterize strategies employed by parents in coping with distress when they are unable to, or struggle to, feed their child. Background: Very little is known about how parents experience nutrition concerns amidst the stress and uncertainty of a child’s chronic life-threatening condition. Description: The purpose of this study was to explore and characterize parents’ experiences with, and responses to, providing nutrition when oral feeding was difficult or impossible for their child. Method(s): A qualitative descriptive design was used. There were 22 children, 19 mothers, and 3 fathers. The children ranged in age from 11 days to 5 years (mean 18 months). The children’s diagnoses included neurological conditions (11), congenital heart malformations (6), mitochondrial disorders (2), prematurity (9), and cancer (3). Race/Ethnicity: White 82% (36), African American 9% (4), Other 9% (4). Inclusion criteria for parents: English-speaking and having a child with nutrition difficulty receiving palliative care (PC). Recruitment occurred through pediatric PC services at a university hospital and home-care agency. Data from parents: interviews, field observations, and distress levels. Data from children: medical record abstraction. Distress levels were used to describe the parents. Interviews were transcribed verbatim, entered into Atlas.ti for data management, and were in analyzed using open and process coding. Within case analysis was used to find unique qualities in cases while across case analysis identified commonalities amongst the cases. Result(s): There were 3 key findings: 1. Guilt and grief are prominent for parents with feelings of failure as a parent and high levels of distress around the altered ability to provide nutrition to their child. 2. Parents cope by normalizing their experiences, taking it day-by-day, maintaining optimism, and modifying their role to meet the needs of the child. 3. The child’s projected illness trajectory affects the parents’ experiences with feeding. Conclusions: Having a child with a chronic life-threatening condition impacting nutrition is fraught with grief and distress. Parents expressed a need for support in coping with the distress associated with being unable to, or struggling to, feed their child