Beyond labelling: What strategies do nut allergic individuals employ to make food choices? A qualitative study

This article is made available through the Brunel Open Access Publishing Fund. Copyright @ 2013 Barnett et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Objective: Food labelling is an important tool that assists people with peanut and tree nut allergies to avoid allergens. Nonetheless, other strategies are also developed and used in food choice decision making. In this paper, we examined the strategies that nut allergic individuals deploy to make safe food choices in addition to a reliance on food labelling. Methods: Three qualitative methods: an accompanied shop, in-depth semi-structured interviews, and the product choice reasoning task – were used with 32 patients that had a clinical history of reactions to peanuts and/or tree nuts consistent with IgE-mediated food allergy. Thematic analysis was applied to the transcribed data. Results: Three main strategies were identified that informed the risk assessments and food choice practices of nut allergic individuals. These pertained to: (1) qualities of product such as the product category or the country of origin, (2) past experience of consuming a food product, and (3) sensory appreciation of risk. Risk reasoning and risk management behaviours were often contingent on the context and other physiological and socio-psychological needs which often competed with risk considerations. Conclusions: Understanding and taking into account the complexity of strategies and the influences of contextual factors will allow healthcare practitioners, allergy nutritionists, and caregivers to advise and educate patients more effectively in choosing foods safely. Governmental bodies and policy makers could also benefit from an understanding of these food choice strategies when risk management policies are designed and developed.United Kingdom Food Standards Agenc

Association of child neurodevelopmental or behavioural problems with maternal unemployment in a population-based birth cohort

PurposeTo estimate associations between suspected or diagnosed neurodevelopmental or behavioural problems in 7-year-old children and maternal unemployment at child age 7 and 10, in a Portuguese birth cohort.MethodsWe evaluated 5754 mothers and their children of the population-based birth cohort Generation XXI in Porto, Portugal. Data on suspected and diagnosed child neurodevelopmental and behavioural problems (exposures)-learning, attention and language problems, externalising behaviours, developmental delay, autism spectrum disorders, and other neurodevelopmental problems-were retrieved at 7 years of age by interviewing caregivers. Maternal employment status (outcome) was collected at the 7- and 10-year follow-up waves. Robust Poisson regression models were used to estimate associations.ResultsAfter adjustment for maternal and household characteristics, women were more likely to be unemployed at child age 10 if the child had, up to age 7, any of the following suspected problems: an autism spectrum disorder (PR = 1.73; 95% CI 1.07, 2.79), developmental delay (PR = 1.58; 95% CI 1.20, 2.06), externalising behaviours (PR = 1.29; 95% CI 1.11, 1.50) or learning problems (PR = 1.26; 95% CI 1.07, 1.48). When the exposure was restricted to clinically diagnosed disorders, the magnitude of associations remained similar but estimates were less precise. Associations with unemployment were stronger at child age 10 (prospective analyses), than at child age 7 (cross-sectional).ConclusionHaving a child with learning, developmental or behavioural problems, or an autism spectrum disorder up to age 7 was associated with maternal unemployment three years later, even in a less affluent European economy where the dual-earner family structure is often necessary to make ends meet.This study was funded by European Regional Development Fund (ERDF) through the Operational Programme Competitiveness and Internationalization; national funding from Foundation for Science and Technology (FCT)-Portuguese Ministry of Science, Technology and Higher Education under the projects 'STEPACHE-Raizes pediatricas da resposta ampliada a dor: das influencias contextuais a estratificacao do risco' (POCI- 01- 0145FEDER-029087) [Ref. FCT PTDC/SAUEPI/29087/2017], 'HIneC: Quando se revelam as desigualdades em saude?' (POCI-01-0145FEDER-029567) [Ref. FCT PTDC/SAU-PUB/29567/2017]; Epidemiology Research Unit-Instituto de Saude Publica, Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; UID/DTP/04750/2019); Administracao Regional de Saude Norte (Regional Department of Ministry of Health) and Fundacao Calouste Gulbenkian; EEA Grants through the Work-life Balance and Gender Equality program operated by CIG (SGS3A2); ERDF, through the North Regional Operational Program in the framework of the project HEALTHUNORTE: Setting-up biobanks and regenerative medicine strategies to boost research in cardiovascular, musculoskeletal, neurological, oncological, immunological and infectious diseases (NORTE-01-0145FEDER-000039); PhD grant (Joana Amaro) co-funded by the FCT and the Human Capital Operating Program of the European Social Fund (POPH/ FSE Program) [PD/BD/128009/2016]; research grant from FOREUM Foundation for Research in Rheumatology (Career Research Grant). This study was based upon work from COST Action CA16216 (OMEGA-NET), supported by COST (European Cooperation in Science and Technology)

Adrift upon a salinity-stratified sea

The structure and variability of upper-ocean properties in the Bay of Bengal (BoB) modulate air-sea interactions, which profoundly influence the pattern and intensity of monsoonal precipitation across the Indian subcontinent. In turn, the bay receives a massive amount of freshwater through river input at its boundaries and from heavy local rainfall, leading to a salinity-stratified surface ocean and shallow mixed layers. Small-scale oceanographic processes that drive variability in near-surface BoB waters complicate the tight coupling between ocean and atmosphere implicit in this seasonal feedback. Unraveling these ocean dynamics and their impact on air-sea interactions is critical to improving the forecasting of intraseasonal variability in the southwest monsoon. To that end, we deployed a wave-powered, rapidly profiling system capable of measuring the structure and variability of the upper 100 m of the BoB. The evolution of upper-ocean structure along the trajectory of the instrument’s roughly two-week drift, along with direct estimates of vertical fluxes of salt and heat, permit assessment of the contributions of various phenomena to temporal and spatial variability in the surface mixed layer depth. Further, these observations suggest that the particular “barrier-layer” stratification found in the BoB may decrease the influence of the wind on mixing processes in the interior, thus isolating the upper ocean from the interior below, and tightening its coupling to the atmosphere abov

The political economy of competitiveness and social mobility

Social mobility has become a mainstream political and media issue in recent years in the United Kingdom. This article suggests that part of the reason for this is that it can serve as a mechanism to discuss policy concerns that appear to be about social justice without questioning important aspects of neo-liberal political economy. The article charts the policy rhetoric on social mobility under both New Labour and the current Coalition Government. It is argued first that under New Labour the apparent commitment to social mobility was in fact subsumed beneath the pursuit of neo-liberal competitiveness, albeit imperfectly realised in policy. Second, the article suggests that under the Coalition Government the commitment to raising levels of social mobility has been retained and the recently published Strategy for Social Mobility promises that social mobility is what the Coalition means when it argues that the austerity programme is balanced with ‘fairness’. Third, however, the Strategy makes clear that the Coalition define social mobility in narrower terms than the previous government. It is argued here that in narrowing the definition the connection with the idea of competitiveness, while still clearly desirable for the Coalition, is weakened. Fourth, a brief analysis of the Coalition's main policy announcements provides little evidence to suggest that even the narrow definition set out in the Strategy is being seriously pursued. Fifth, the international comparative evidence suggests that any strategy aimed at genuinely raising the level of social mobility would need to give much more serious consideration to narrowing levels of inequality. Finally, it is concluded that when considered in the light of the arguments above, the Strategy for Social Mobility – and therefore ‘Fairness’ itself – is merely a discursive legitimation of the wider political economy programme of austerity

Simpson's Paradox, Lord's Paradox, and Suppression Effects are the same phenomenon – the reversal paradox

This article discusses three statistical paradoxes that pervade epidemiological research: Simpson's paradox, Lord's paradox, and suppression. These paradoxes have important implications for the interpretation of evidence from observational studies. This article uses hypothetical scenarios to illustrate how the three paradoxes are different manifestations of one phenomenon – the reversal paradox – depending on whether the outcome and explanatory variables are categorical, continuous or a combination of both; this renders the issues and remedies for any one to be similar for all three. Although the three statistical paradoxes occur in different types of variables, they share the same characteristic: the association between two variables can be reversed, diminished, or enhanced when another variable is statistically controlled for. Understanding the concepts and theory behind these paradoxes provides insights into some controversial or contradictory research findings. These paradoxes show that prior knowledge and underlying causal theory play an important role in the statistical modelling of epidemiological data, where incorrect use of statistical models might produce consistent, replicable, yet erroneous results

Paramedic confidence in estimating external blood loss

Introduction: Studies have identifed that visual estimation of blood loss is highly inaccurate, however no research has investigated therelationship between this practice and the confdence of estimation by paramedics. The aim of this study was to determineparamedic confdence in the estimation of, and reporting of external blood loss due to medical or trauma aetiology, within an Australasian paramedic context. Methods: Between July and September 2015, a cross-sectional survey was distributed through Australasian paramedic professional bodies to determine confdence in estimating and documentation of external blood loss. Using Likert scale and free text responses, participants provided demographic information and their self-perceived confdence in estimating and documenting external blood loss. Results: Five thousand six hundred paramedics were invited to participate in an online survey. Two hundred and eight responses were received (3.8% response rate). A total of 86.6% of participants reported documenting blood loss in clinical reports, however only 47.8% of participants believed their estimation of external blood loss was accurate with 13% reporting underestimation and 33.5% reporting overestimation of blood loss. Additionally, only 51.6% of participants agreed to strongly agreed that they were confdent in their estimation of blood loss. Conclusion: This research demonstrates the majority of paramedics estimate and document external blood loss, yet nearly half do not feel confdent in doing so, despite indicating its importance. Educational and organisational changes are recommended to refect the clear evidence against this practice. Further research is recommended to identify appropriate physiological parameters and practical assessment tools to replace this inaccurate form of clinical assessment

Designing a physical activity parenting course : parental views on recruitment, content and delivery

Background Many children do not engage in sufficient levels of physical activity (PA) and spend too much time screen-viewing (SV). High levels of SV (e.g. watching TV, playing video games and surfing the internet) and low levels of PA have been associated with adverse health outcomes. Parenting courses may hold promise as an intervention medium to change children’s PA and SV. The current study was formative work conducted to design a new parenting programme to increase children’s PA and reduce their SV. Specifically, we focussed on interest in a course, desired content and delivery style, barriers and facilitators to participation and opinions on control group provision. Methods In-depth telephone interviews were conducted with thirty two parents (29 female) of 6–8 year olds. Data were analysed thematically. An anonymous online survey was also completed by 750 parents of 6–8 year old children and descriptive statistics calculated. Results Interview participants were interested in a parenting course because they wanted general parenting advice and ideas to help their children be physically active. Parents indicated that they would benefit from knowing how to quantify their child’s PA and SV levels. Parents wanted practical ideas of alternatives to SV. Most parents would be unable to attend unless childcare was provided. Schools were perceived to be a trusted source of information about parenting courses and the optimal recruitment location. In terms of delivery style, the majority of parents stated they would prefer a group-based approach that provided opportunities for peer learning and support with professional input. Survey participants reported the timing of classes and the provision of childcare were essential factors that would affect participation. In terms of designing an intervention, the most preferred control group option was the opportunity to attend the same course at a later date. Conclusions Parents are interested in PA/SV parenting courses but the provision of child care is essential for attendance. Recruitment is likely to be facilitated via trusted sources. Parents want practical advice on how to overcome barriers and suggest advice is provided in a mutually supportive group experience with expert input

Theory of Star Formation

We review current understanding of star formation, outlining an overall theoretical framework and the observations that motivate it. A conception of star formation has emerged in which turbulence plays a dual role, both creating overdensities to initiate gravitational contraction or collapse, and countering the effects of gravity in these overdense regions. The key dynamical processes involved in star formation -- turbulence, magnetic fields, and self-gravity -- are highly nonlinear and multidimensional. Physical arguments are used to identify and explain the features and scalings involved in star formation, and results from numerical simulations are used to quantify these effects. We divide star formation into large-scale and small-scale regimes and review each in turn. Large scales range from galaxies to giant molecular clouds (GMCs) and their substructures. Important problems include how GMCs form and evolve, what determines the star formation rate (SFR), and what determines the initial mass function (IMF). Small scales range from dense cores to the protostellar systems they beget. We discuss formation of both low- and high-mass stars, including ongoing accretion. The development of winds and outflows is increasingly well understood, as are the mechanisms governing angular momentum transport in disks. Although outstanding questions remain, the framework is now in place to build a comprehensive theory of star formation that will be tested by the next generation of telescopes.Comment: 120 pages, to appear in ARAA. No changes from v1 text; permission statement adde

A Case-base Approach to Workforces’ Satisfaction Assessment

It is well known that human resources play a valuable role in a sustainable organizational development. Indeed, this work will focus on the development of a decision support system to assess workers’ satisfaction based on factors related to human resources management practices. The framework is built on top of a Logic Programming approach to Knowledge Representation and Reasoning, complemented with a Case Based approach to computing. The proposed solution is unique in itself, once it caters for the explicit treatment of incomplete, unknown, or even self-contradictory information, either in terms of a qualitative or quantitative setting. Furthermore, clustering methods based on similarity analysis among cases were used to distinguish and aggregate collections of historical data or knowledge in order to reduce the search space, therefore enhancing the cases retrieval and the overall computational process