Meal and food preferences of nutritionally at-risk inpatients admitted to two Australian tertiary teaching hospitals

Aim: To determine preferences for meals and snack of long-stay patients and hospitalised patients with increased energy and protein requirements.----- Methods: Using consistent methodology across two tertiary teaching hospitals, a convenience sample of adult public hospital inpatients with increased energy and protein requirements or longer stays (seven days or more) were interviewed regarding meal and snack preferences. Descriptive reporting of sample representativeness, preferred foods and frequency of meals and between meal snacks.----- Results: Of 134 respondents, 55% reported a decreased appetite and 28% rated their appetite as 'poor'. Most felt like eating either nothing (42%) or soup (15%) when unwell. The most desired foods were hot meal items, including eggs (31%), meat dishes (20%) and soup (69%). Of items not routinely available, soft drink (7.6%) and alcohol (6.7%) were most commonly desired during admission. Almost half (49%) reported difficulty opening packaged food and a majority (81%) indicated finger foods were easy to eat.----- Conclusion: Appetites during admission were frequently lower than usual. Responses encourage consideration of eggs, meat dishes and soups for long-stayers or those with high-energy, high-protein needs. Easy to consume but not routinely offered, between meal items, such as soup, juice, cake, soft drink or Milo could be explored further to enhance oral intakes

Baseline T cell dysfunction by single cell network profiling in metastatic breast cancer patients.

BackgroundWe previously reported the results of a multicentric prospective randomized trial of chemo-refractory metastatic breast cancer patients testing the efficacy of two doses of TGFβ blockade during radiotherapy. Despite a lack of objective responses to the combination, patients who received a higher dose of TGFβ blocking antibody fresolimumab had a better overall survival when compared to those assigned to lower dose (hazard ratio of 2.73, p = 0.039). They also demonstrated an improved peripheral blood mononuclear cell (PBMC) counts and increase in the CD8 central memory pool. We performed additional analysis on residual PBMC using single cell network profiling (SCNP).MethodsThe original trial randomized metastatic breast cancer patients to either 1 or 10 mg/kg of fresolimumab, every 3 weeks for 5 cycles, combined with radiotherapy to a metastatic site at week 1 and 7 (22.5 Gy given in 3 doses of 7.5 Gy). Trial immune monitoring results were previously reported. In 15 patients with available residual blood samples, additional functional studies were performed, and compared with data obtained in parallel from seven healthy female donors (HD): SCNP was applied to analyze T cell receptor (TCR) modulated signaling via CD3 and CD28 crosslinking and measurement of evoked phosphorylation of AKT and ERK in CD4 and CD8 T cell subsets defined by PD-1 expression.ResultsAt baseline, a significantly higher level of expression (p < 0.05) of PD-L1 was identified in patient monocytes compared to HD. TCR modulation revealed dysfunction of circulating T-cells in patient baseline samples as compared to HD, and this was more pronounced in PD-1+ cells. Treatment with radiotherapy and fresolimumab did not resolve this dyfunctional signaling. However, in vitro PD-1 blockade enhanced TCR signaling in patient PD-1+ T cells and not in PD-1- T cells or in PD-1+ T cells from HD.ConclusionsFunctional T cell analysis suggests that baseline T cell functionality is hampered in metastatic breast cancer patients, at least in part mediated by the PD-1 signaling pathway. These preliminary data support the rationale for investigating the possible beneficial effects of adding PD-1 blockade to improve responses to TGFβ blockade and radiotherapy.Trial registrationNCT01401062

Quantitative multidimensional phenotypes improve genetic analysis of laterality traits

The UK Medical Research Council and Wellcome (Grant ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and SP and JS will serve as guarantors for the analysis of the ALSPAC data presented in this paper. GWAS data were generated by Sample Logistics and Genotyping Facilities at Wellcome Sanger Institute and LabCorp (Laboratory Corporation of America) using support from 23andMe. Support to the genetic analysis was provided by the St Andrews Bioinformatics Unit funded by the Wellcome Trust [grant 105621/Z/14/Z]. The Hong Kong sample was funded through a Collaborative Research Fund from the Hong Kong Special Administrative Region Research Grants Council (CUHK8/CRF/13G, and C4054-17WF). JS is funded by the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation, 418445085) and supported by the Wellcome Trust [Institutional Strategic Support fund, Grant number 204821/Z/16/Z]. SP is funded by the Royal Society (UF150663).Handedness is the most commonly investigated lateralised phenotype and is usually measured as a binary left/right category. Its links with psychiatric and neurodevelopmental disorders prompted studies aimed at understanding the underlying genetics, while other measures and side preferences have been less studied. We investigated the heritability of hand, as well as foot, and eye preference by assessing parental effects (n ≤ 5028 family trios) and SNP-based heritability (SNP-h2, n ≤ 5931 children) in the Avon Longitudinal Study of Parents and Children (ALSPAC). An independent twin cohort from Hong Kong (n = 358) was used to replicate results from structural equation modelling (SEM). Parental left-side preference increased the chance of an individual to be left-sided for the same trait, with stronger maternal than paternal effects for footedness. By regressing out the effects of sex, age, and ancestry, we transformed laterality categories into quantitative measures. The SNP-h2 for quantitative handedness and footedness was 0.21 and 0.23, respectively, which is higher than the SNP-h2 reported in larger genetic studies using binary handedness measures. The heritability of the quantitative measure of handedness increased (0.45) compared to a binary measure for writing hand (0.27) in the Hong Kong twins. Genomic and behavioural SEM identified a shared genetic factor contributing to handedness, footedness, and eyedness, but no independent effects on individual phenotypes. Our analysis demonstrates how quantitative multidimensional laterality phenotypes are better suited to capture the underlying genetics than binary traits.Publisher PDFPeer reviewe

Methane Emissions from Grazing Holstein-Friesian Heifers at Different Ages Estimated Using the Sulfur Hexafluoride Tracer Technique

Publication history: Accepted - 9 May 2017; Published online - 17 May 2017Although the effect of animal and diet factors on enteric methane (CH4) emissions from confined cattle has been extensively examined, less data is available regarding CH4 emissions from grazing young cattle. A study was undertaken to evaluate the effect of the physiological state of Holstein-Friesian heifers on their enteric CH4 emissions while grazing a perennial ryegrass sward. Two experiments were conducted: Experiment 1 ran from May 2011 for 11 weeks and Experiment 2 ran from August 2011 for 10 weeks. In each experiment, Holstein-Friesian heifers were divided into three treatment groups (12 animals/group) consisting of calves, yearling heifers, and in-calf heifers (average ages: 8.5, 14.5, and 20.5 months, respectively). Methane emissions were estimated for each animal in the final week of each experiment using the sulfur hexafluoride tracer technique. Dry matter (DM) intake was estimated using the calculated metabolizable energy (ME) requirement divided by the ME concentration in the grazed grass. As expected, live weight increased with increasing animal age (P < 0.001); however, there was no difference in live weight gain among the three groups in Experiment 1, although in Experiment 2, this variable decreased with increasing animal age (P < 0.001). In Experiment 1, yearling heifers had the highest CH4 emissions (g·d–1) and in-calf heifers produced more than calves (P < 0.001). When expressed as CH4 emissions per unit of live weight, DM intake, and gross energy (GE) intake, yearling heifers had higher emission rates than calves and in-calf heifers (P < 0.001). However, the effects on CH4 emissions were different in Experiment 2, in which CH4 emissions (g·d–1) increased linearly with increasing animal age (P < 0.001), although the difference between yearling and in-calf heifers was not significant. The CH4/live weight ratio was lower in in-calf heifers than in the other two groups (P < 0.001), while CH4 energy output as a proportion of GE intake was lower in calves than in yearling and in-calf heifers (P < 0.05). All data were then pooled and used to develop prediction equations for CH4 emissions. All relationships are significant (P < 0.001), with R2 values ranging from 0.630 to 0.682. These models indicate that CH4 emissions could be increased by 0.252 g·d–1 with an increase of 1 kg live weight or by 14.9 g·d–1 with an increase of 1 kg·d–1 of DM intake; or, the CH4 energy output could be increased by 0.046 MJ·d–1 with an increase of 1 MJ·d–1 of GE intake. These results provide an alternative approach for estimating CH4 emissions from grazing dairy heifers when actual CH4 emission data are not availableThe study was funded by the Department for Environment Food & Rural Affairs, the Scottish Government, the Department of Agriculture and Rural Development for Northern Ireland, and the Welsh Government, as part of the UK’s Agricultural GHG Research Platform initiativ

Honneth, Butler and the Ambivalent Effects of Recognition

This paper examines the ambivalent effects of recognition by critically examining Axel Honneth’s theory of recognition. I argue that his underlying perfectionist account and his focus on the psychic effects of recognition cause him to misrepresent or overlook significant connections between recognition and power. These claims are substantiated by (1) drawing from Butler’s theory of gender performativity, power and recognition; and (2) exploring issues arising from the socio-institutional recognition of trans identities. I conclude by suggesting that certain problems with Butler’s own position can corrected by drawing more from the Foucauldian aspects of her work. I claim that this is the most promising way to conceptualise recognition and its complex, ambivalent effects

Identifying the science and technology dimensions of emerging public policy issues through horizon scanning

Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique [1]. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security.Public policy requires public support, which in turn implies a need to enable the public not just to understand policy but also to be engaged in its development. Where complex science and technology issues are involved in policy making, this takes time, so it is important to identify emerging issues of this type and prepare engagement plans. In our horizon scanning exercise, we used a modified Delphi technique [1]. A wide group of people with interests in the science and policy interface (drawn from policy makers, policy adviser, practitioners, the private sector and academics) elicited a long list of emergent policy issues in which science and technology would feature strongly and which would also necessitate public engagement as policies are developed. This was then refined to a short list of top priorities for policy makers. Thirty issues were identified within broad areas of business and technology; energy and environment; government, politics and education; health, healthcare, population and aging; information, communication, infrastructure and transport; and public safety and national security

living and learning a new identity for student housing in city suburbs

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Effective practices of international volunteering for health : perspectives from partner organizations

Abstract: The demand for international volunteer experiences to promote global health and nutrition is increasing and numerous studies have documented the experiences of the international volunteers who travel abroad; however, little is known about effective practices from the perspective of partner organizations. This study aims to understand how variables such as the skill-level of volunteers, the duration of service, cultural and language training, and other key variables affect partner organizations’ perceptions of volunteer effectiveness at promoting healthcare and nutrition..