141 research outputs found
Return to competitive gymnastics training in the UK following the first COVID-19 national lockdown
Putting "space" on the agenda of sociocultural research in education
The global rescaling of the world, culture, and education has influenced how people experience their situationality, meaning-making, and learning in relation to the Other. This article explores the implications of spatial analysis for rethinking education in new conditions of cultural complexity. The experience of living and learning with difference is conceptualized as an open journey in which the very act of movement across spatial boundaries unlocks the fixity of meanings and identities and, hence, problematizes the spatial logic of bounded learning places. Explicating the tension between fixity and mobility, boundedness and flows, this article deploys the concepts of cultural-semiotic space, scale, and boundary to theorize locations of learning and meaning-making in new times. <br /
Hypoxia during maintenance hemodialysis; the critical role of pH
Background
The impact and management of subclinical hypoxia during hemodialysis is a significant medical challenge. As key determinants of O2 availability and delivery, proposed mechanisms contributing to hypoxia include ischemia, alkalemia and pulmonary leukocyte sequestration. However, no study has comprehensively investigated and compared these interrelated mechanisms throughout a typical hemodialysis treatment week. This study aimed to comprehensively assess the physiological mechanisms that contribute to hypoxia during hemodialysis.
Methods
In 76 patients, we measured arterial blood gases and pH at four time-points during hemodialysis (start, 15 min, 60 min, end) over the course of a standard treatment week. For the mid-week hemodialysis session, we additionally measured central hemodynamics (non-invasive cardiac output monitoring) and white blood cell count.
Results
Linear regression modelling identified changes in pH, but not central hemodynamics or white blood cell count, to be predictive of changes in PaO2 throughout hemodialysis (e.g. at 60 min, β standardized coefficient pH = 0.45, model R2 = 0.25, P < .001). Alkalemia, hypokalemia, decreased calcium and increased hemoglobin–O2 affinity (leftward shift in the oxyhemoglobin dissociation curve) were evident at the end of hemodialysis. pH and hemoglobin–O2 affinity at the start of hemodialysis increased incrementally over the course of a standard treatment week.
Conclusion
These data highlight the important role of pH in regulating O2 availability and delivery during hemodialysis. Findings support routine pH monitoring and personalized dialysate bicarbonate prescription to mitigate the significant risk of alkalemia and subclinical hypoxia
Coral record of Younger Dryas Chronozone warmth on the Great Barrier Reef
Author Posting. © American Geophysical Union, 2020. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Paleoceanography and Paleoclimatology 35(12), (2020): e2020PA003962, doi:10.1029/2020PA003962.The Great Barrier Reef (GBR) is an internationally recognized and widely studied ecosystem, yet little is known about its sea surface temperature (SST) evolution since the Last Glacial Maximum (LGM) (~20 kyr BP). Here, we present the first paleo‐application of Isopora coral‐derived SST calibrations to a suite of 25 previously published fossil Isopora from the central GBR spanning ~25–11 kyr BP. The resultant multicoral Sr/Ca‐ and δ18O‐derived SST anomaly (SSTA) histories are placed within the context of published relative sea level, reef sequence, and coralgal reef assemblage evolution. Our new calculations indicate SSTs were cooler on average by ~5–5.5°C at Noggin Pass (~17°S) and ~7–8°C at Hydrographer's Passage (~20°S) (Sr/Ca‐derived) during the LGM, in line with previous estimates (Felis et al., 2014, https://doi.org/10.1038/ncomms5102). We focus on contextualizing the Younger Dryas Chronozone (YDC, ~12.9–11.7 kyr BP), whose Southern Hemisphere expression, in particular in Australia, is elusive and poorly constrained. Our record does not indicate cooling during the YDC with near‐modern temperatures reached during this interval on the GBR, supporting an asymmetric hemispheric presentation of this climate event. Building on a previous study (Felis et al., 2014, https://doi.org10.1038/ncomms5102), these fossil Isopora SSTA data from the GBR provide new insights into the deglacial reef response, with near‐modern warming during the YDC, since the LGM.This work was funded by National Science Foundation (NSF) award OCE 13‐56948 to B. K. L, with NSF GRFP support DGE‐11‐44155 to L. D. B., and the Australian Research Council (grant no. DP1094001) and ANZIC IODP. Partial support for B. K. L's work on this project also came from the Vetlesen Foundation via a gift to the Lamont‐Doherty Earth Observatory. T. F. received funding from the Deutsche Forschungsgemeinschaft (DFG, German Research Foundation)—Project number 180346848, through Priority Program 527 “IODP.” A. T. received support from the UK Natural Environment Research Council (NE/H014136/1 and NE/H014268/1). M. T. thanks Ministry of Earth Sciences for support (NCPOR contribution no. J‐84/2020‐21). L. D. B. would also like to thank Kassandra Costa for her input regarding error analysis.2021-06-1
GRANADA consensus on analytical approaches to assess associations with accelerometer-determined physical behaviours (physical activity, sedentary behaviour and sleep) in epidemiological studies
The inter-relationship between physical activity, sedentary behaviour and sleep (collectively defined as physical behaviours) is of interest to researchers from different fields. Each of these physical behaviours has been investigated in epidemiological studies, yet their codependency and interactions need to be further explored and accounted for in data analysis. Modern accelerometers capture continuous movement through the day, which presents the challenge of how to best use the richness of these data. In recent years, analytical approaches first applied in other scientific fields have been applied to physical behaviour epidemiology (eg, isotemporal substitution models, compositional data analysis, multivariate pattern analysis, functional data analysis and machine learning). A comprehensive description, discussion, and consensus on the strengths and limitations of these analytical approaches will help researchers decide which approach to use in different situations. In this context, a scientific workshop and meeting were held in Granada to discuss: (1) analytical approaches currently used in the scientific literature on physical behaviour, highlighting strengths and limitations, providing practical recommendations on their use and including a decision tree for assisting researchers’ decision-making; and (2) current gaps and future research directions around the analysis and use of accelerometer data. Advances in analytical approaches to accelerometer-determined physical behaviours in epidemiological studies are expected to influence the interpretation of current and future evidence, and ultimately impact on future physical behaviour guidelines
Equine obesity: current perspectives
Foreword Equine obesity is now so common that is has become accepted by many as the norm ( Owers and Chubbock, 2012 ). Rates of obesity may be as high as 70% in some populations and obesity is often associated with morbidities that may ultimately result in mortality. Obesity is a common feature in animals diagnosed with equine metabolic syndrome, a conflation of metabolic disturbances including insulin dysregulation, which may lead to laminitis. Obesity is a risk factor for insulin dysregulation and is therefore implicated in laminitis risk. In addition to laminitis, adverse consequences of obesity include orthopaedic disease, hyperlipaemia, hyperthermia, infertility and poor performance. Over time, perception of what constitutes a healthy body condition in horses has shifted, with the result that potentially harmful excess adiposity may not be recognised by owners or those working in the equine industry ( Owers and Chubbock, 2012 ). In addition, increasing numbers of equines are kept as companions rather than athletes and live relatively inactive lifestyles favouring the development of obesity. Finally, owners of leisure horses often think their horses are working hard when, in reality, their exertions have minimal impact on their energy requirements. Despite increasing awareness within the veterinary profession and equine industry of the impact of obesity on equine welfare, little progress seems to have been made in tackling it. This document was commissioned in order to provide veterinary surgeons with up-to-date information on equine obesity and to equip them to tackle it within their own practices. Recommendations were developed using an informal two-round Delphi process, considering published and unpublished research relating to equine obesity using a round table forum and online discussion. Where research evidence was conflicting or absent, collective expert opinion based on the clinical experience of the group was applied. The opinions expressed are the consensus of views expressed by the authors. Where agreement was not reached, opposing views are presented such that readers can understand the arguments fully. The document is focused on the management of horses and ponies; while much of the information herein is applicable to donkeys it is important to recognise that the metabolism and management of donkeys are different and further research is required before specific recommendations can be made. The expert group was organised by UK-Vet Equine with sponsorship from Baileys Horse Feeds. </jats:sec
Ethnic inequalities in older adults bowel cancer awareness: findings from a community survey conducted in an ethnically diverse region in England
Background To date, research exploring the public’s awareness of bowel cancer has taken place with predominantly white populations. To enhance our understanding of how bowel cancer awareness varies between ethnic groups, and inform the development of targeted interventions, we conducted a questionnaire study across three ethnically diverse regions in Greater London, England. Methods Data were collected using an adapted version of the bowel cancer awareness measure. Eligible adults were individuals, aged 60+ years, who were eligible for screening. Participants were recruited and surveyed, verbally, by staff working at 40 community pharmacies in Northwest London, the Harrow Somali association, and St. Mark’s Bowel Cancer Screening Centre. Associations between risk factor, symptom and screening awareness scores and ethnicity were assessed using multivariate regression. Results 1013 adults, aged 60+ years, completed the questionnaire; half were of a Black, Asian or Minority ethnic group background (n = 507; 50.0%). Participants recognised a mean average of 4.27 of 9 symptoms and 3.99 of 10 risk factors. Symptom awareness was significantly lower among all ethnic minority groups (all p’s less than 0.05), while risk factor awareness was lower for Afro-Caribbean and Somali adults, specifically (both p's less than 0.05). One in three adults (n = 722; 29.7%) did not know there is a Bowel Cancer Screening Programme. Bowel screening awareness was particularly low among Afro-Caribbean and Somali adults (both p's less than 0.05). CONCLUSION: Awareness of bowel cancer symptoms, risk factors and screening varies by ethnicity. Interventions should be targeted towards specific groups for whom awareness of screening and risk factors is low
What shape do UK trainees want their training to be? Results of a cross-sectional study
OBJECTIVES: The British Government is acting on recommendations to overhaul postgraduate training to meet the needs of the changing population, to produce generalist doctors undergoing shorter broad-based training (Greenaway Review). Only 45 doctors in training were involved in the consultation process. This study aims to obtain a focused perspective on the proposed reforms by doctors in training from across specialities. DESIGN: Prospective, questionnaire-based cross-sectional study. SETTING/PARTICIPANTS: Following validation, a 31-item electronic questionnaire was distributed via trainee organisations and Postgraduate Local Education and Training Board (LETB) mailing lists. Throughout the 10-week study period, the survey was publicised on several social media platforms. RESULTS: Of the 3603 demographically representative respondents, 69% knew about proposed changes. Of the respondents, 73% expressed a desire to specialise, with 54% keen to provide general emergency cover. A small proportion (12%) stated that current training pathway length is too long, although 86% felt that it is impossible to achieve independent practitioner-level proficiency in a shorter period of time than is currently required. Opinions regarding credentialing were mixed, but tended towards disagreement. The vast majority (97%) felt credentialing should not be funded by doctors in training. Respondents preferred longer placement lengths with increasing career progression. Doctors in training value early generalised training (65%), with suggestions for further improvement. CONCLUSIONS: This is the first large-scale cross-specialty study regarding the Shape of Training Review. Although there are recommendations which trainees support, it is clear that one size does not fit all. Most trainees are keen to provide a specialist service on an emergency generalist background. Credentialing is a contentious issue; however, we believe removing aspects from curricula into post-Certificate of Completion of Training (CCT) credentialing programmes with shortened specialty training routes only degrades the current consultant expertise, and does not serve the population. Educational needs, not political winds, should drive changes in postgraduate medical education and all stakeholders should be involved
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