Association of Early Introduction of Solids With Infant Sleep: A Secondary Analysis of a Randomized Clinical Trial.

Importance: The World Health Organization recommends exclusive breastfeeding for 6 months. However, 75% of British mothers introduce solids before 5 months and 26% report infant waking at night as influencing this decision. Objective: To determine whether early introduction of solids influences infant sleep. Design, Setting, and Participants: The Enquiring About Tolerance study was a population-based randomized clinical trial conducted from January 15, 2008, to August 31, 2015, that included 1303 exclusively breastfed 3-month-old infants from England and Wales. Clinical visits took place at St Thomas' Hospital, London, England, and the trial studied the early introduction of solids into the infant diet from age 3 months. Interventions: The early introduction group (EIG) continued to breastfeed while nonallergenic and then 6 allergenic foods were introduced. The standard introduction group (SIG) followed British infant feeding guidelines (ie, exclusive breastfeeding to around age 6 months and to avoid any food consumption during this period). Main Outcomes and Measures: Secondary analysis of an a priori secondary outcome of the effect of early food introduction on infant sleep using the standardized Brief Infant Sleep Questionnaire. Results: Of the 1303 infants who were enrolled in the Enquiring About Tolerance study, 1225 participants (94%) completed the final 3-year questionnaire (618 SIG [95%] and 607 EIG [93%]). Randomization was effective and there were no significant baseline differences between the 2 groups. Following the early introduction of solids, infants in the EIG slept significantly longer and woke significantly less frequently than infants in the SIG. Differences between the 2 groups peaked at age 6 months. At this point, in the intention-to-treat analysis infants in the EIG slept for 16.6 (95% CI, 7.8-25.4) minutes longer per night and their night waking frequency had decreased from 2.01 to 1.74 wakings per night. Most clinically important, very serious sleep problems, which were significantly associated with maternal quality of life, were reported significantly more frequently in the SIG than in the EIG (odds ratio, 1.8; 95% CI, 1.22-2.61). Conclusions and Relevance: In a randomized clinical trial, the early introduction of solids into the infant's diet was associated with longer sleep duration, less frequent waking at night, and a reduction in reported very serious sleep problems. Trial Registration: isrctn.org Identifier: ISRCTN14254740

Door locks, wall stickers, fireplaces: Assemblage Theory and home (un)making in Lewisham’s temporary accommodation

This paper explores resident experiences of life in PLACE/Ladywell, a “pop‐up” social housing scheme in London providing temporary accommodation for homeless families. Specifically, we consider barriers to, and assertions of, homemaking in this temporary setting through fixtures and fittings—a door lock, wall stickers, and a fireplace. The paper utilises assemblage thinking to understand homemaking within these time‐limited and constrained circumstances. Despite their seeming banality, fixtures and fittings offer a material, politicised, and lively means of studying the attempted and thwarted production of home by residents living in PLACE/Ladywell. The absence of door locks reduces parents’ ability to maintain privacy and intimate relations; restrictions on hanging pictures and other decorative measures are circumvented by the use of wall stickers; and a defiant decorative fireplace establishes a sense of home in a temporary setting. Together, these objects constitute vital elements in negotiations between fixity and impermanence in temporary accommodation

Randomized Trial of Introduction of Allergenic Foods in Breast-Fed Infants.

BACKGROUND: The age at which allergenic foods should be introduced into the diet of breast-fed infants is uncertain. We evaluated whether the early introduction of allergenic foods in the diet of breast-fed infants would protect against the development of food allergy. METHODS: We recruited, from the general population, 1303 exclusively breast-fed infants who were 3 months of age and randomly assigned them to the early introduction of six allergenic foods (peanut, cooked egg, cow's milk, sesame, whitefish, and wheat; early-introduction group) or to the current practice recommended in the United Kingdom of exclusive breast-feeding to approximately 6 months of age (standard-introduction group). The primary outcome was food allergy to one or more of the six foods between 1 year and 3 years of age. RESULTS: In the intention-to-treat analysis, food allergy to one or more of the six intervention foods developed in 7.1% of the participants in the standard-introduction group (42 of 595 participants) and in 5.6% of those in the early-introduction group (32 of 567) (P=0.32). In the per-protocol analysis, the prevalence of any food allergy was significantly lower in the early-introduction group than in the standard-introduction group (2.4% vs. 7.3%, P=0.01), as was the prevalence of peanut allergy (0% vs. 2.5%, P=0.003) and egg allergy (1.4% vs. 5.5%, P=0.009); there were no significant effects with respect to milk, sesame, fish, or wheat. The consumption of 2 g per week of peanut or egg-white protein was associated with a significantly lower prevalence of these respective allergies than was less consumption. The early introduction of all six foods was not easily achieved but was safe. CONCLUSIONS: The trial did not show the efficacy of early introduction of allergenic foods in an intention-to-treat analysis. Further analysis raised the question of whether the prevention of food allergy by means of early introduction of multiple allergenic foods was dose-dependent. (Funded by the Food Standards Agency and others; EAT Current Controlled Trials number, ISRCTN14254740.)

HICS: Highly charged ion collisions with surfaces

The layout of a new instrument designed to study the interaction of highly charged ions with surfaces, which consists of an ion source, a beamline including charge separation and a target chamber, is presented here. By varying the charge state and impact velocity of the projectiles separately, the dissipation of potential and kinetic energy at or below the surface can be studied independently. The target chamber offers the use of tunable metal-insulator-metal devices as detectors for internal electronic excitation, a timeof-flight system to study the impact induced particle emission and the possibility to transfer samples in situ to a UHV scanning probe microscope. Samples and detectors can be prepared in situ as well. As a first example data on graphene layers on SrTiO3 which have been irradiated with Xe36+ are presented. Key words: highly charged ions, sputtering, AFM, grapheneComment: 4 pages, 4 figures, conference proceeding to 17th Internat. Workshop for Ion Surf. Collision

Relativistic quantum dynamics in strong fields: Photon emission from heavy, few-electron ions

Recent progress in the study of the photon emission from highly-charged heavy ions is reviewed. These investigations show that high-$Z$ ions provide a unique tool for improving the understanding of the electron-electron and electron-photon interaction in the presence of strong fields. Apart from the bound-state transitions, which are accurately described in the framework of Quantum Electrodynamics, much information has been obtained also from the radiative capture of (quasi-) free electrons by high-$Z$ ions. Many features in the observed spectra hereby confirm the inherently relativistic behavior of even the simplest compound quantum systems in Nature.Comment: Version 18/11/0

Living with severe allergy: an Anaphylaxis Campaign national survey of young people

<p>Abstract</p> <p>Background</p> <p>The transition to adulthood can be particularly challenging for young people with severe allergies, who must learn to balance personal safety with independent living. Information and support for young people and their families are crucial to successfully managing this transition. We sought to: gather insights into the impact of severe allergies on the lives of young people; explore where young people go for information about anaphylaxis and what information they want and need; identify areas where further support is needed.</p> <p>Methods</p> <p>An online questionnaire survey of young people aged 15–25 years with severe allergies in the United Kingdom (UK) was conducted on behalf of the Anaphylaxis Campaign, the main patient support organisation. Participants were recruited mainly from the Anaphylaxis Campaign membership database and also via allergy clinics and social media. The study was funded by the Anaphylaxis Campaign’s In Memoriam Fund.</p> <p>Results</p> <p>A total of 520 young people responded to the survey. The majority had lived with severe allergies since they were young children; 59% reported having attended Accident and Emergency units as a consequence of their allergies. Only 66% of respondents reported always carrying their epinephrine auto-injectors; only 23% had ever used these. Few were currently receiving specialist allergy care; younger respondents were more likely to be under specialist care (34%) than those 18 years and above (23%). Respondents wanted more information about eating out (56%), travelling (54%) and food labelling (43%). Almost a quarter of respondents (23%) reported needing more information on managing their allergies independently without parental help. Managing allergies in the context of social relationships was a concern for 22% of respondents.</p> <p>Conclusions</p> <p>This survey has identified the information and support needs and gaps in service provision for young people with severe allergies. Healthcare professionals and patient support organisations, with the support of the food industry, can help to meet these needs.</p

A comparison of the neuroprotective efficacy of newly developed oximes (K117, K127) and currently available oxime (obidoxime) in tabun-poisoned rats

The potency of newly developed bispyridinium compounds (K117, K127) to reduce tabun-induced acute neurotoxic signs and symptoms was compared with currently available oxime (obidoxime) using functional observational battery. The neuroprotective effects of atropine alone and atropine combined with one of three bispyridinium oximes (K117, K127, obidoxime) on rats poisoned with tabun at a sublethal dose (180 μg/kg i.m.; 80% of LD50 value) were studied. Tabun-induced neurotoxicity was monitored using a functional observational battery and automatic measurement of motor activity at 24 h following tabun challenge. The results indicated that all tested oximes combined with atropine enabled tabun-poisoned rats to survive 24 h following tabun challenge while one tabun-poisoned rats died within 24 h after tabun poisoning when the rats were treated with atropine alone. Newly developed oxime K127 combined with atropine was the most effective in decreasing tabun-induced neurotoxicity in the case of sublethal poisonings among all oximes tested. Nevertheless, the differences of neuroprotective efficacy between K127 and obidoxime are not sufficient to replace obidoxime by K127 for the treatment of acute tabun poisonings

Patients’ ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial

BACKGROUND: Previous work has shown patients commonly misuse adrenaline autoinjectors (AAI). It is unclear whether this is due to inadequate training, or poor device design. We undertook a prospective randomized controlled trial to evaluate ability to administer adrenaline using different AAI devices. METHODS: We allocated mothers of food‐allergic children prescribed an AAI for the first time to Anapen or EpiPen using a computer‐generated randomization list, with optimal training according to manufacturer's instructions. After one year, participants were randomly allocated a new device (EpiPen, Anapen, new EpiPen, JEXT or Auvi‐Q), without device‐specific training. We assessed ability to deliver adrenaline using their AAI in a simulated anaphylaxis scenario six weeks and one year after initial training, and following device switch. Primary outcome was successful adrenaline administration at six weeks, assessed by an independent expert. Secondary outcomes were success at one year, success after switching device, and adverse events. RESULTS: We randomized 158 participants. At six weeks, 30 of 71 (42%) participants allocated to Anapen and 31 of 73 (43%) participants allocated to EpiPen were successful – RR 1.00 (95% CI 0.68–1.46). Success rates at one year were also similar, but digital injection was more common at one year with EpiPen (8/59, 14%) than Anapen (0/51, 0%, P = 0.007). When switched to a new device without specific training, success rates were higher with Auvi‐Q (26/28, 93%) than other devices (39/80, 49%; P < 0.001). CONCLUSIONS: AAI device design is a major determinant of successful adrenaline administration. Success rates were low with several devices, but were high using the audio‐prompt device Auvi‐Q

Learn before Lecture: A Strategy That Improves Learning Outcomes in a Large Introductory Biology Class

Actively engaging students in lecture has been shown to increase learning gains. To create time for active learning without displacing content we used two strategies for introducing material before class in a large introductory biology course. Four to five slides from 2007/8 were removed from each of three lectures in 2009 and the information introduced in preclass worksheets or narrated PowerPoint videos. In class, time created by shifting lecture material to learn before lecture (LBL) assignments was used to engage students in application of their new knowledge. Learning was evaluated by comparing student performance in 2009 versus 2007/8 on LBL-related question pairs, matched by level and format. The percentage of students who correctly answered five of six LBL-related exam questions was significantly higher (p < 0.001) in 2009 versus 2007/8. The mean increase in performance was 21% across the six LBL-related questions compared with <3% on all non-LBL exam questions. The worksheet and video LBL formats were equally effective based on a cross-over experimental design. These results demonstrate that LBLs combined with interactive exercises can be implemented incrementally and result in significant increases in learning gains in large introductory biology classes