A paradigm shift in cystic fibrosis nutritional care: clinicians' views on the management of patients with overweight and obesity

Background Overweight and obesity among people with cystic fibrosis (pwCF) has become more prevalent since the widespread adoption of CF transmembrane conductance regulator (CFTR) modulator therapies and presents a new challenge for nutritional care. We aimed to explore how clinicians working in CF care approach the management of adults with overweight and obesity. Methods We conducted semi-structured interviews with n = 20 clinicians (n = 6 physiotherapists, n = 6 doctors and n = 8 dietitians) working in 15 adult CF centres in the United Kingdom. The interviews explored their perspectives and current practices caring for people with CF and overweight/obesity. Data were analysed using reflexive thematic analysis. Results Four main themes were identified: 1) challenges of raising the topic of overweight and obesity in the CF clinic (e.g., clinician-patient rapport and concerns around weight stigma); 2) the changing landscape of assessment due to CF-specific causes of weight gain: (e.g., impact of CFTR modulators and CF legacy diet) 3) presence of clinical equipoise for weight management due to the lack of CF-specific evidence on the consequences of obesity and intentional weight loss (e.g., unclear consequences on respiratory outcomes and risk of weight related co-morbidities) and 4) opportunities for a safe, effective, and acceptable weight management treatment for people with CF (e.g., working collaboratively with current multidisciplinary CF care). Conclusions Approaching weight management in the CF setting is complex. Trials are needed to assess the equipoise of weight management interventions in this group and CF-specific issues should be considered when developing such interventions

Determinants of student satisfaction with campus residence life at a South African University

Although there are a number of studies on the determinants of general quality of life among university students, these occur mainly in developed countries and do not focus specifically on campus-based residence life. It has long been accepted that factors outside the classroom (“the other curriculum”) can contribute to academic success, as well as the achievement of other important outcomes such as the appreciation of human diversity. Striving towards equality of residence life satisfaction across different racial and gender groups, for example, is thus important for academic outcomes and for the development of well-functioning citizens. This study is based on the 2011 Quality of Residence Life (QoRL) Survey, conducted at a South African university, comprising roughly 2 000 respondents. Based on descriptive analyses and ordered probit regressions, the study investigates the association between satisfaction with QoRL and (i) residence milieu and characteristics, (ii) direct and indirect discrimination, (iii) perceptions of drug and alcohol issues in residence, (iv) safety, and (v) individual student characteristics. One of the main findings is that there are no significant differences in satisfaction with QoRL across racial and gender groups; a finding that suggests significant progress in university transformation and equity goals. The general atmosphere and characteristics of residences are also important predictors of QoRL satisfaction.Economic Research Southern Africa (ERSA) is a research programme funded by the National Treasury of South Africa

Determinants of student satisfaction with campus residence life at a South African University

Publisher versionAlthough there are a number of studies on the determinants of general quality of life among university students, these occur mainly in developed countries and do not focus specifically on campus-based residence life. It has long been accepted that factors outside the classroom (“the other curriculum”) can contribute to academic success, as well as the achievement of other important outcomes such as the appreciation of human diversity. Striving towards equality of residence life satisfaction across different racial and gender groups, for example, is thus important for academic outcomes and for the development of well-functioning citizens. This study is based on the 2011 Quality of Residence Life (QoRL) Survey, conducted at a South African university, comprising roughly 2 000 respondents. Based on descriptive analyses and ordered probit regressions, the study investigates the association between satisfaction with QoRL and (i) residence milieu and characteristics, (ii) direct and indirect discrimination, (iii) perceptions of drug and alcohol issues in residence, (iv) safety, and (v) individual student characteristics. One of the main findings is that there are no significant differences in satisfaction with QoRL across racial and gender groups; a finding that suggests significant progress in university transformation and equity goals. The general atmosphere and characteristics of residences are also important predictors of QoRL satisfaction.Economic Research Southern Africa (ERSA) is a research programme funded by the National Treasury of South Africa

Sensitivity of the UK clinical practice research datalink to detect neurodevelopmental effects of medicine exposure in utero:comparative analysis of an antiepileptic drug-exposed cohort

Introduction: Electronic healthcare data have several advantages over prospective observational studies, but the sensitivity of data on neurodevelopmental outcomes and its comparability with data generated through other methodologies is unknown. Objectives: The objectives of this study were to determine whether data from the UK Clinical Practice Research Datalink (CPRD) produces similar risk estimates to a prospective cohort study in relation to the risk of neurodevelopmental disorders (NDDs) following prenatal antiepileptic drug (AED) exposure. Methods: A cohort of mother–child pairs of women with epilepsy (WWE) was identified in the CPRD and matched to a cohort without epilepsy. The study period ran from 1 January 2000 to 31 March 2007 and children were required to be in the CPRD at age 6 years. AED exposure during pregnancy was determined from prescription data and children with an NDD diagnosis by 6 years were identified from Read clinical codes. The prevalence and risk of NDDs was calculated for mother–child pairs in WWE stratified by AED regimen and for those without epilepsy. Comparisons were made with the results of the prospective Liverpool and Manchester Neurodevelopment Group study which completed assessment on 201 WWE and 214 without epilepsy at age 6 years. Results: In the CPRD, 1018 mother–child pairs to WWE and 6048 to women without epilepsy were identified. The CPRD identified a lower prevalence of NDDs than the prospective study. In both studies, NDDs were more frequently reported in children of WWE than women without epilepsy, although the CPRD risk estimate was lower (2.16 vs. 0.96%, p < 0.001 and 7.46 vs. 1.87%, p = 0.0128). NDD prevalence differed across AED regimens but the CPRD data did not replicate the significantly higher risk of NDDs following in utero monotherapy valproate exposure (adjusted odds ratio [ORadj] 2.02, 95% confidence interval [CI] 0.52–7.86) observed in the prospective study (ORadj 6.05, 95% CI 1.65–24.53). Conclusion: It was possible to identify NDDs in the CPRD; however, the CPRD appears to under-record these outcomes. Larger studies are required to investigate further

Selecting Grassland Species for Saline Environments

In Australia, around 5.7 million hectares of agricultural land are currently affected by dryland salinity or at risk from shallow water tables and this figure is expected to increase over the next 50 years (LWRA, 2001). Most improved grassland species cannot tolerate the combined effects of salt and waterlogging and, therefore, the productivity of sown grasslands in salt-affected areas is low. However, there is potential to overcome the lack of suitably adapted fodder species by introducing new, salt and waterlogging-tolerant species and by diversifying the gene pool of proven species. Potential species include exotic, naturalised and native Australian grass, legumes, herb and shrub species that are halophytes and non-halophytes. A collaborative national project in southern Australia commenced in 2004 with the objective of evaluating a range of forage species for saline environments

Evolution of the solar irradiance during the Holocene

Aims. We present a physically consistent reconstruction of the total solar irradiance for the Holocene. Methods. We extend the SATIRE models to estimate the evolution of the total (and partly spectral) solar irradiance over the Holocene. The basic assumption is that the variations of the solar irradiance are due to the evolution of the dark and bright magnetic features on the solar surface. The evolution of the decadally averaged magnetic flux is computed from decadal values of cosmogenic isotope concentrations recorded in natural archives employing a series of physics-based models connecting the processes from the modulation of the cosmic ray flux in the heliosphere to their record in natural archives. We then compute the total solar irradiance (TSI) as a linear combination of the jth and jth + 1 decadal values of the open magnetic flux. Results. Reconstructions of the TSI over the Holocene, each valid for a di_erent paleomagnetic time series, are presented. Our analysis suggests that major sources of uncertainty in the TSI in this model are the heritage of the uncertainty of the TSI since 1610 reconstructed from sunspot data and the uncertainty of the evolution of the Earth's magnetic dipole moment. The analysis of the distribution functions of the reconstructed irradiance for the last 3000 years indicates that the estimates based on the virtual axial dipole moment are significantly lower at earlier times than the reconstructions based on the virtual dipole moment. Conclusions. We present the first physics-based reconstruction of the total solar irradiance over the Holocene, which will be of interest for studies of climate change over the last 11500 years. The reconstruction indicates that the decadally averaged total solar irradiance ranges over approximately 1.5 W/m2 from grand maxima to grand minima

Semiology, clustering, periodicity and natural history of seizures in an experimental occipital cortical epilepsy model

Focal neocortical epilepsy is a common form of epilepsy and there is a need to develop animal models that allow the evaluation of novel therapeutic strategies to treat this type of epilepsy. Tetanus toxin (TeNT) injection into the rat visual cortex induces focal neocortical epilepsy without preceding status epilepticus. The latency to first seizure ranged from 3 to 7 days. Seizure duration was bimodal, with both short (approximately 30 s) and long-lasting (>100 s) seizures occurring in the same animals. Seizures were accompanied by non-motor features such as behavioural arrest, or motor seizures with or without evolution to generalized tonic-clonic seizures. Seizures were more common during the sleep phase of a light-dark cycle. Seizure occurrence was not random, and tended to cluster with significantly higher probability of recurrence within 24 h of a previous seizure. Across animals, the number of seizures in the first week could be used to predict the number of seizures in the following 3 weeks. The TeNT model of occipital cortical epilepsy is a model of acquired focal neocortical epilepsy that is well-suited for preclinical evaluation of novel anti-epileptic strategies. We provide here a detailed analysis of the epilepsy phenotypes, seizure activity, electrographic features and the semiology. In addition, we provide a predictive framework that can be used to reduce variation and consequently animal use in preclinical studies of potential treatments

Systematic study of charged-pion and kaon femtoscopy in Au++Au collisions at sNN\sqrt{s_{_{NN}}}=200 GeV

We present a systematic study of charged pion and kaon interferometry in Au$+$Au collisions at $\sqrt{s_{_{NN}}}$=200 GeV. The kaon mean source radii are found to be larger than pion radii in the outward and longitudinal directions for the same transverse mass; this difference increases for more central collisions. The azimuthal-angle dependence of the radii was measured with respect to the second-order event plane and similar oscillations of the source radii were found for pions and kaons. Hydrodynamic models qualitatively describe the similar oscillations of the mean source radii for pions and kaons, but they do not fully describe the transverse-mass dependence of the oscillations.Comment: 499 authors, 27 pages, 13 figures, and 11 tables. v2 is the version accepted for publication in Phys. Rev. C. Plain text data tables for the points plotted in figures for this and previous PHENIX publications are (or will be) publicly available at http://www.phenix.bnl.gov/papers.htm