221 research outputs found

    Pain at the back of the heel

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    Elusive

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    Effects of maternal and sibling deprivation on basal and stress induced hypothalamic-pituitary-adrenal components in the infant rat.

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    Prolonged maternal deprivation during early infancy increases basal- and stress-induced corticosterone (CORT) levels, but the underlying mechanism is not clear. In general, stressors activate the hypothalamic-pituitary-adrenal (HPA) axis, with secretion and compensatory synthesis of hypothalamic cortcotropin-releasing hormone (CRH). In the infant rat, we have demonstrated that maximally tolerated acute cold stress induced a robust elevation of plasma CORT throughout the first 2 postnatal weeks. However CRH messenger RNA (CRH-mRNA) abundance 4 h subsequent to cold stress was enhanced only in rats aged 9 days or older. This suggests a developmental regulation of the CRH component of the HPA-response to this stressor. The present study examined whether increased basal and cold stress-induced CORT levels after 24 h of maternal deprivation were due to enhanced CRH-mRNA abundance in the hypothalamic paraventricular nucleus (PVN). CRH-mRNA abundance, and basal- and cold-induced plasma CORT levels were measured in maternally deprived 6 and 9-day-old pups compared to non-deprived controls. Maternal deprivation increased basal and cold-induced CORT levels on both 6 and 9-day-old rats. CRH-mRNA abundance in the PVN of deprived rats did not differ from that in non-deprived rats. Our results indicate that the enhanced basal and stress-induced plasma CORT observed after 24 h maternal deprivation is not due to increased CRH-mRNA abundance in the PVN

    Assessing global resource use and greenhouse emissions to 2050, with ambitious resource efficiency and climate mitigation policies

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    Achieving sustainable development requires the decoupling of natural resource use and environmental pressures from economic growth and improvements in living standards. G7 leaders and others have called for improved resource efficiency, along with inclusive economic growth and deep cuts in global greenhouse emissions. However, the outlooks for and interactions between global natural resource use, resource efficiency, economic growth and greenhouse emissions are not well understood. We use a novel multi-regional modeling framework to develop projections to 2050 under existing trends and three policy scenarios. We find that resource efficiency could provide pro-growth pro-environment policies with global benefits of USD $2.4 trillion in 2050, and ease the politics of shifting towards sustainability. Under existing trends, resource extraction is projected to increase 119% from 2015 to 2050, from 84 to 184 billion tonnes per annum, while greenhouse gas emissions increase 41%, both driven by the value of global economic activity more than doubling. Resource efficiency and greenhouse abatement slow the growth of global resource extraction, so that in 2050 it is up to 28% lower than in existing trends. Resource efficiency reduces greenhouse gas emissions by 15–20% in 2050, with global emissions falling to 63% below 2015 levels when combined with a 2 °C emissions pathway. In contrast to greenhouse abatement, resource efficiency boosts near-term economic growth. These economic gains more than offset the near-term costs of shifting to a 2 °C emissions pathway, resulting in emissions in 2050 well below current levels, slower growth in resource extractions, and faster economic growth

    The implausibility of ‘usual care’ in an open system: sedation and weaning practices in Paediatric Intensive Care Units (PICUs) in the United Kingdom (UK)

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    Background: The power of the randomised controlled trial depends upon its capacity to operate in a closed system whereby the intervention is the only causal force acting upon the experimental group and absent in the control group, permitting a valid assessment of intervention efficacy. Conversely, clinical arenas are open systems where factors relating to context, resources, interpretation and actions of individuals will affect implementation and effectiveness of interventions. Consequently, the comparator (usual care) can be difficult to define and variable in multi-centre trials. Hence outcomes cannot be understood without considering usual care and factors that may affect implementation and impact on the intervention. Methods: Using a fieldwork approach, we describe PICU context, ‘usual’ practice in sedation and weaning from mechanical ventilation, and factors affecting implementation prior to designing a trial involving a sedation and ventilation weaning intervention. We collected data from 23 UK PICUs between June and November 2014 using observation, individual and multi-disciplinary group interviews with staff. Results: Pain and sedation practices were broadly similar in terms of drug usage and assessment tools. Sedation protocols linking assessment to appropriate titration of sedatives and sedation holds were rarely used (9 % and 4 % of PICUs respectively). Ventilator weaning was primarily a medical-led process with 39 % of PICUs engaging senior nurses in the process: weaning protocols were rarely used (9 % of PICUs). Weaning methods were variably based on clinician preference. No formal criteria or use of spontaneous breathing trials were used to test weaning readiness. Seventeen PICUs (74 %) had prior engagement in multi-centre trials, but limited research nurse availability. Barriers to previous trial implementation were intervention complexity, lack of belief in the evidence and inadequate training. Facilitating factors were senior staff buy-in and dedicated research nurse provision. Conclusions: We examined and identified contextual and organisational factors that may impact on the implementation of our intervention. We found usual practice relating to sedation, analgesia and ventilator weaning broadly similar, yet distinctively different from our proposed intervention, providing assurance in our ability to evaluate intervention effects. The data will enable us to develop an implementation plan; considering these factors we can more fully understand their impact on study outcomes

    Eliminating the mystery from the concept of emergence

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    While some branches of complexity theory are advancing rapidly, the same cannot be said for our understanding of emergence. Despite a complete knowledge of the rules underlying the interactions between the parts of many systems, we are often baffled by their sudden transitions from simple to complex. Here I propose a solution to this conceptual problem. Given that emergence is often the result of many interactions occurring simultaneously in time and space, an ability to intuitively grasp it would require the ability to consciously think in parallel. A simple exercise is used to demonstrate that we do not possess this ability. Our surprise at the behaviour of cellular automata models, and the natural cases of pattern formation they mimic, is then explained from this perspective. This work suggests that the cognitive limitations of the mind can be as significant a barrier to scientific progress as the limitations of our senses

    Conservation implications of misidentification and killing of protected species

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    This is the final version. Available on open access from Wiley via the DOI in this recordData availability: All data supporting the results in this paper are available from Zenodo (digital repository).Killing protected species mistaken for morphologically similar quarry species, or species with weaker protection, can hinder their conservation. Despite policy aims to reduce threats from illegal killing, information is lacking on susceptible species, conservation impacts and the identification accuracy of hunters. We examined the ability of hunters (n = 232) in Arctic Russia to identify the endangered Northwest European Bewick's swan Cygnus columbianus bewickii using photographs. Only 14% (n = 33) identified this species correctly and distinguished it from sympatric and congeneric whooper swans C. cygnus and mute swans C. olor , with 15% of individuals admitting to accidentally hunting a Bewick's swan in the previous 3 years. We conclude that there is a risk of Bewick's swans being shot accidentally when mistaken for similar species with less legal protection. Improving hunters' skills in discerning protected from legitimate quarry species is likely to be an effective tool for conservation of morphologically similar species.Peter Smith Charitable Trust for NatureOlive Herbert Charitable Trus

    Uncovering the nutritional landscape of food

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    Recent progresses in data-driven analysis methods, including network-based approaches, are revolutionizing many classical disciplines. These techniques can also be applied to food and nutrition, which must be studied to design healthy diets. Using nutritional information from over 1,000 raw foods, we systematically evaluated the nutrient composition of each food in regards to satisfying daily nutritional requirements. The nutrient balance of a food was quantified herein as nutritional fitness, using the food's frequency of occurrence in nutritionally adequate food combinations. Nutritional fitness offers prioritization of recommendable foods within a global network of foods, in which foods are connected based on the similarities of their nutrient compositions. We identified a number of key nutrients, such as choline and alpha-linolenic acid, whose levels in foods can critically affect the foods' nutritional fitness. Analogously, pairs of nutrients can have the same effect. In fact, two nutrients can impact the nutritional fitness synergistically, although the individual nutrients alone may not. This result, involving the tendency among nutrients to show correlations in their abundances across foods, implies a hidden layer of complexity when exploring for foods whose balance of nutrients within pairs holistically helps meet nutritional requirements. Interestingly, foods with high nutritional fitness successfully maintain this nutrient balance. This effect expands our scope to a diverse repertoire of nutrient-nutrient correlations, integrated under a common network framework that yields unexpected yet coherent associations between nutrients. Our nutrient-profiling approach combined with a network-based analysis provides a more unbiased, global view of the relationships between foods and nutrients, and can be extended towards nutritional policies, food marketing, and personalized nutrition.Comment: Supplementary material is available at the journal websit

    Prediction of function in daily life following multidisciplinary rehabilitation for individuals with chronic musculoskeletal pain; a prospective study

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    Background: The prevalence of chronic musculoskeletal pain is high, with widespread negative economic, psychological, and social consequences for the individual. It is therefore important to find ways to predict the outcome of rehabilitation programmes in terms of function in daily life. The aims of this study were to investigate the improvements over time from multidisciplinary rehabilitation in terms of pain and function, and analyse the relative impact of individual and psychosocial factors as predictors of function in daily life in individuals with chronic musculoskeletal pain. Methods: A prospective study was conducted among one hundred and forty three (N = 143) musculoskeletal pain patients. Measures of pain, function, and functional health status were obtained at baseline, after 5 weeks of intensive training, at the end of the 57-week rehabilitation programme, and at a 1 year follow-up, using validated self-administrated measures. Linear regression analysis was applied to investigate the relative impact of musculoskeletal pain, individual- , and psychosocial factors in function. Results: The participants studied showed a significant increase in function during the 57 weeks rehabilitation period. There was also a significant increase in function from the end of the rehabilitation period (57th week) to the one year follow-up measures. Pain intensity associated significantly with pain experience over all measurement periods. High levels of pain intensity (β = .42**) and pain experience (β = .37*), and poor psychological capacity (β = -.68*) at baseline, as well as poor physiological capacity (β = -.44**) and high levels of anxiety (β = .48**) and depression (β = .58***) at the end of the rehabilitation program were the most important prognostic factors of variance in functioning over the 4 measurement periods. Conclusion: The data suggest that physical capacity, emotional distress and coping skills should be priority areas in rehabilitation programmes to improve functioning in daily life
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