Maroon Archaeology Beyond the Americas: A View From Kenya

Archaeological research on Maroons—that is, runaway slaves—has been largely confined to the Americas. This essay advocates a more global approach. It specifically uses two runaway slave communities in 19th-century coastal Kenya to rethink prominent interpretive themes in the field, including “Africanisms,” Maroons’ connections to indigenous groups, and Maroon group cohesion and identity. This article’s analysis demonstrates that the comparisons enabled by a more globalized perspective benefit the field. Instead of eliding historical and cultural context, these comparisons support the development of more localized and historically specific understandings of individual runaway slave communities both in Kenya and throughout the New World

The prevalence of malnutrition in spinal cord injuries patients:a UK multicentre study

Data on the prevalence of malnutrition among patients with spinal cord injuries (SCI) are lacking. The aim of the present study was to assess nutritional risk at admission, and the status of nutritional support in the UK SCI Centres (SCIC); a cross-sectional, multicentre study in four SCIC. A standardised questionnaire was used and distributed to the participating SCIC. After obtaining informed consent, baseline demographic data, nutritional risk score by the 'Malnutrition Universal Screening Tool', BMI and routine blood biochemistry were collected from every patient admitted to an SCIC. The four SCIC, comprising 48·2 % of the total UK SCI beds, contributed data from 150 patients. On admission, 44·3 % of patients were malnourished or at risk of undernutrition. Nutritional risk was more common in patients with acute high cervical SCI than those with lower SCI (60·7 v. 34·5 %), and nutritional risk was more common in those with additional complications including ventilatory support (with tracheostomy, 56·3 v. 38·7 %). Also, 45 % of patients were at risk of overnutrition (BMI ≥ 25 kg/m2). The prevalence of malnutrition in SCI patients admitted to SCIC is higher than national figures focused on general hospitalised patients, indicating that SCI patients are particularly vulnerable to malnutrition. Patients with SCI who have a tracheostomy may need additional attention. Given the potential negative impact of malnutrition on clinical outcomes, an emphasis on mandatory nutrition screening, followed by detailed assessment for at-risk individuals should be in place in the SCIC

A Lactobacillus casei Shirota probiotic drink reduces antibiotic-associated diarrhoea in patients with spinal cord injuries:a randomised controlled trial

Certain probiotics may prevent the development of antibiotic-associated diarrhoea (AAD) and Clostridium difficile-associated diarrhoea (CDAD), but their effectiveness depends on both strain and dose. There are few data on nutritional interventions to control AAD/CDAD in the spinal cord injury (SCI) population. The present study aimed to assess (1) the efficacy of consuming a commercially produced probiotic containing at least 6·5 × 10⁹ live Lactobacillus casei Shirota (LcS) in reducing the incidence of AAD/CDAD, and (2) whether undernutrition and proton pump inhibitors (PPI) are risk factors for AAD/CDAD. A total of 164 SCI patients (50·1 (sd 17·8) years) with a requirement for antibiotics (median 21 d, range 5-366) were randomly allocated to receive LcS (n 76) or no probiotic (n 82). LcS was given once daily for the duration of the antibiotic course and continued for 7 days thereafter. Nutritional risk was assessed by the Spinal Nutrition Screening Tool. The LcS group had a significantly lower incidence of AAD (17·1 v. 54·9%,