Beyond labelling: What strategies do nut allergic individuals employ to make food choices? A qualitative study

This article is made available through the Brunel Open Access Publishing Fund. Copyright @ 2013 Barnett et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Objective: Food labelling is an important tool that assists people with peanut and tree nut allergies to avoid allergens. Nonetheless, other strategies are also developed and used in food choice decision making. In this paper, we examined the strategies that nut allergic individuals deploy to make safe food choices in addition to a reliance on food labelling. Methods: Three qualitative methods: an accompanied shop, in-depth semi-structured interviews, and the product choice reasoning task – were used with 32 patients that had a clinical history of reactions to peanuts and/or tree nuts consistent with IgE-mediated food allergy. Thematic analysis was applied to the transcribed data. Results: Three main strategies were identified that informed the risk assessments and food choice practices of nut allergic individuals. These pertained to: (1) qualities of product such as the product category or the country of origin, (2) past experience of consuming a food product, and (3) sensory appreciation of risk. Risk reasoning and risk management behaviours were often contingent on the context and other physiological and socio-psychological needs which often competed with risk considerations. Conclusions: Understanding and taking into account the complexity of strategies and the influences of contextual factors will allow healthcare practitioners, allergy nutritionists, and caregivers to advise and educate patients more effectively in choosing foods safely. Governmental bodies and policy makers could also benefit from an understanding of these food choice strategies when risk management policies are designed and developed.United Kingdom Food Standards Agenc

The relation between sustainability performance and stock market returns: An Empirical analysis of the Dow Jones Sustainability Index Europe

This paper investigates the relation between corporate financial performance (CFP) and corporate sustainability performance (CSP). This is done by first analyzing a sample of European stocks that were added to or deleted from the Dow Jones Sustainability Europe Index (DJSI Europe) over the period 2009–2013, and second by analyzing a sample of European stocks that were recognized as industry group leaders in CSP by the DJSI Europe over the same period. The impacts are measured in terms of (abnormal) stock returns. For the first analysis no strong evidence could be found that the announcement of the inclusion and exclusion events has any significant impact on stock return. However, on the day of change (CD) and in the period following CD, index inclusion (exclusion) stocks experience a significant but temporary increase (decrease) in stock return. These results seem to support Harris and Eitan’s (1986) price pressure hypothesis, which postulates that event announcement does not carry information and any shift in demand and hence the corresponding price change is temporary. From the second analysis, on industry group leaders, it can be concluded that the market rewards firms with high CSP. In the period after the day of change, industry group leader stocks experience a permanent and significant positive growth in stock returns. This conclusion can be supported by the resource based perspective, which posits that firms capable of investing heavily in CSP have greater underlying resources which in turn should produce higher financial performance (Alexander and Bucholz, 1978; Waddock and Graves, 1997; Clarkson et al., 2006)

A rare case of bilateral supernumerary heads of sternocleidomastoid muscle and its clinical impact

The sternocleidomastoid muscle (SCM) functions as a landmark for physicians such as anatomists, orthopaedic surgeons, neurosurgeons, and anaesthesiologists, who intervene in the minor supraclavicular fossa located at the base of the neck. The variability of SCM anatomy may cause complications while trying to access the vital elements that are located in the minor supraclavicular fossa. This study aims to present a case of supernumerary heads of the sternocleidomastoid muscle and to discuss its clinical significance. The cervical region of an elderly male cadaver was dissected and the findings were recorded and photographed. On both sides, the SCM muscle had an additional sternal head, and simultaneously there were three additional clavicular heads, four in total. These additional heads, the sternal and the clavicular, reduced the interval between them causing significant stenosis of the minor supraclavicular fossa. Sternocleidomastoid muscle variations with regard to the number of its heads are very rare in the literature, but this variation may cause severe complications. The minor supraclavicular fossa is important for anaesthesiologists because of the anterior central venous catheterization approach. Physicians should be aware of this anatomical variation in order to prevent complication

Experience of loneliness associated with being an informal caregiver: A qualitative investigation.

ArticleThis is the author accepted manuscript. The final version is available from Frontiers Media via the DOI in this record.Although providing care to a family member or friend may provide psychological benefits, informal (i.e. unpaid) caregivers also encounter difficulties which may negatively affect their quality of life as well as their mental and physical health. Loneliness is one important challenge that caregivers face, with this psychological state being associated with morbidity and premature mortality. Although previous research has identified loneliness as an issue associated with being an informal caregiver, there is a paucity of evidence that attempts to understand this phenomenon in depth. This study aimed to examine informal caregivers' reflections on, and accounts of, experiences of loneliness linked to their caregiving situation. A cross-sectional, qualitative study was designed. Sixteen semi-structured interviews were conducted with 8 spousal caregivers, 4 daughters caring for a parent, 3 mothers caring for a child (or children) and 1 woman looking after her partner. The cared-for persons were suffering from a range of mental and physical health conditions (e.g. dementia, frailty due to old age, multiple sclerosis, depression, autism). Data were analyzed using an inductive thematic analysis. Experiences of loneliness were described by reference to a context of shrunken personal space and diminished social interaction caused by the restrictions imposed by the caregiving role. Loneliness was also articulated against a background of relational deprivations and losses as well as sentiments of powerlessness, helplessness and a sense of sole responsibility. Social encounters were also seen to generate loneliness when they were characterized by some form of distancing. Though not all sources or circumstances of loneliness in caregivers are amenable to change, more opportunities for respite care services, as well as a heightened sensibility and social appreciation of caregivers' valued contributions could help caregivers manage some forms of loneliness.This study is part of a larger research project, titled Loneliness in the Digital Age (LiDA): Developing Strategies for Empathy and Trust. LiDA is financially supported from the Economic and Social Research Council (ESRC) ‘Empathy and Trust in Communicating Online’ (EMoTICON) program, with funding from the Arts and Humanities Research Council (AHRC), the Engineering and Physical Sciences Research Council (EPSRC), the Defence Science and Technology Laboratory (Dstl) and the Centre for the Protection of National Infrastructure (CPNI)

Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period

Background: Choosing a suitable sample size in qualitative research is an area of conceptual debate and practical uncertainty. That sample size principles, guidelines and tools have been developed to enable researchers to set, and justify the acceptability of, their sample size is an indication that the issue constitutes an important marker of the quality of qualitative research. Nevertheless, research shows that sample size sufficiency reporting is often poor, if not absent, across a range of disciplinary fields. Methods: A systematic analysis of single-interview-per-participant designs within three health- related journals from the disciplines of psychology, sociology and medicine, over a 15-year period, was conducted to examine whether and how sample sizes were justified and how sample size was characterised and discussed by authors. Data pertinent to sample size were extracted and analysed using qualitative and quantitative analytic techniques. Results: Our findings demonstrate that provision of sample size justifications in qualitative health research is limited; is not contingent on the number of interviews; and relates to the journal of publication. Defence of sample size was most frequently supported across all three journals with reference to the principle of saturation and to pragmatic considerations. Qualitative sample sizes were predominantly – and often without justification – characterised as insufficient (i.e., ‘small’) and discussed in the context of study limitations. Sample size insufficiency was seen to threaten the validity and generalizability of studies’ results, with the latter being frequently conceived in nomothetic terms. Conclusions: We recommend, firstly, that qualitative health researchers be more transparent about evaluations of their sample size sufficiency, situating these within broader and more encompassing assessments of data adequacy. Secondly, we invite researchers critically to consider how saturation parameters found in prior methodological studies and sample size community norms might best inform, and apply to, their own project and encourage that data adequacy is best appraised with reference to features that are intrinsic to the study at hand. Finally, those reviewing papers have a vital role in supporting and encouraging transparent study-specific reporting.Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH) programm

Residual stress measurement round robin on an electron beam welded joint between austenitic stainless steel 316L(N) and ferritic steel P91

This paper is a research output of DMW-Creep project which is part of a national UK programme through the RCUK Energy programme and India's Department of Atomic Energy. The research is focussed on understanding the characteristics of welded joints between austenitic stainless steel and ferritic steel that are widely used in many nuclear power generating plants and petrochemical industries as well as conventional coal and gas-fired power systems. The members of the DMW-Creep project have under- taken parallel round robin activities measuring the residual stresses generated by a dissimilar metal weld (DMW) between AISI 316L(N) austenitic stainless steel and P91 ferritic-martensitic steel. Electron beam (EB) welding was employed to produce a single bead weld on a plate specimen and an additional smoothing pass (known cosmetic pass) was then introduced using a defocused beam. The welding re- sidual stresses have been measured by five experimental methods including (I) neutron diffraction (ND), (II) X-Ray diffraction (XRD), (III) contour method (CM), (IV) incremental deep hole drilling (iDHD) and (V) incremental centre hole drilling (iCHD). The round robin measurements of weld residual stresses are compared in order to characterise surface and sub-surface residual stresses comprehensively

GeoTriples: Transforming geospatial data into RDF graphs using R2RML and RML mappings

A lot of geospatial data has become available at no charge in many countries recently. Geospatial data that is currently made available by government agencies usually do not follow the linked data paradigm. In the few cases where government agencies do follow the linked data paradigm (e.g., Ordnance Survey in the United Kingdom), specialized scripts have been used for transforming geospatial data into RDF. In this paper we present the open source tool GeoTriples which generates and processes extended R2RML and RML mappings that transform geospatial data from many input formats into RDF. GeoTriples allows the transformation of geospatial data stored in raw files (shapefiles, CSV, KML, XML, GML and GeoJSON) and spatially-enabled RDBMS (PostGIS and MonetDB) into RDF graphs using well-known vocabularies like GeoSPARQL and stSPARQL, but without being tightly coupled to a specific vocabulary. GeoTriples has been developed in European projects LEO and Melodies and has been used to transform many geospatial data sources into linked data. We study the performance of GeoTriples experimentally using large publicly available geospatial datasets, and show that GeoTriples is very efficient and scalable especially when its mapping processor is implemented using Apache Hadoop

An Exploration of the Patient Lived Experience of Remission and Relapse of Type 2 Diabetes Following Bariatric Surgery

BACKGROUND: Bariatric surgery is the most effective treatment for patients with obesity and type 2 diabetes (T2DM), inducing profound metabolic changes associated with improvements in glycaemic control. In spite of the recognition of the physiological changes associated with bariatric surgery, what remains underappreciated is the patient experience of surgery to treat T2DM. OBJECTIVES: This study explored the patient experience with regard to motivations, expectations and outcomes, including remission and relapse of diabetes. METHODS: An in-depth qualitative approach was adopted, encompassing semi-structured interviews with patients (n=17) living with obesity and T2DM both pre- and postsurgery. Interpretive thematic analysis identified emergent themes using a grounded approach. RESULTS: Analysis revealed a number of themes throughout the interviews which included motivations and perceived benefits of surgery, obesity stigma and its impact on self-worth as well as perceptions of remission or relapse and the implications for sense of control. CONCLUSIONS: The motivation for undergoing bariatric surgery was driven by health concerns, namely T2DM and the desire to reduce the risk of developing diabetes-related complications. Patients highlighted social and self-stigmatisation associated with obesity and T2DM, leading to feelings of shame and an inability to seek support from family or healthcare professionals. Stigmatisation created a sense of failure and feeling of guilt for having T2DM. As a result, patients felt responsible for maintaining disease remission postoperatively and regarded the need for medication as a sign of treatment failure

Temporal trends and forecasting of COVID-19 hospitalisations and deaths in Scotland using a national real-time patient-level data platform: a statistical modelling study

This study is part of the EAVE II project. EAVE II is funded by the MRC (MR/R008345/1) with the support of BREATHE—The Health Data Research Hub for Respiratory Health (MC_PC_19004), which is funded through the UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK. Additional support has been provided through Public Health Scotland and Scottish Government Director General Health and Social Care. The original EAVE project was funded by the NIHR Health Technology Assessment programme (11/46/23).Background   As the COVID-19 pandemic continues, national-level surveillance platforms with real-time individual person-level data are required to monitor and predict the epidemiological and clinical profile of COVID-19 and inform public health policy. We aimed to create a national dataset of patient-level data in Scotland to identify temporal trends and COVID-19 risk factors, and to develop a novel statistical prediction model to forecast COVID-19-related deaths and hospitalisations during the second wave.  Methods   We established a surveillance platform to monitor COVID-19 temporal trends using person-level primary care data (including age, sex, socioeconomic status, urban or rural residence, care home residence, and clinical risk factors) linked to data on SARS-CoV-2 RT-PCR tests, hospitalisations, and deaths for all individuals resident in Scotland who were registered with a general practice on Feb 23, 2020. A Cox proportional hazards model was used to estimate the association between clinical risk groups and time to hospitalisation and death. A survival prediction model derived from data from March 1 to June 23, 2020, was created to forecast hospital admissions and deaths from October to December, 2020. We fitted a generalised additive spline model to daily SARS-CoV-2 cases over the previous 10 weeks and used this to create a 28-day forecast of the number of daily cases. The age and risk group pattern of cases in the previous 3 weeks was then used to select a stratified sample of individuals from our cohort who had not previously tested positive, with future cases in each group sampled from a multinomial distribution. We then used their patient characteristics (including age, sex, comorbidities, and socioeconomic status) to predict their probability of hospitalisation or death.  Findings   Our cohort included 5 384 819 people, representing 98·6% of the entire estimated population residing in Scotland during 2020. Hospitalisation and death among those testing positive for SARS-CoV-2 between March 1 and June 23, 2020, were associated with several patient characteristics, including male sex (hospitalisation hazard ratio [HR] 1·47, 95% CI 1·38–1·57; death HR 1·62, 1·49–1·76) and various comorbidities, with the highest hospitalisation HR found for transplantation (4·53, 1·87–10·98) and the highest death HR for myoneural disease (2·33, 1·46–3·71). For those testing positive, there were decreasing temporal trends in hospitalisation and death rates. The proportion of positive tests among older age groups (>40 years) and those with at-risk comorbidities increased during October, 2020. On Nov 10, 2020, the projected number of hospitalisations for Dec 8, 2020 (28 days later) was 90 per day (95% prediction interval 55–125) and the projected number of deaths was 21 per day (12–29). Interpretation The estimated incidence of SARS-CoV-2 infection based on positive tests recorded in this unique data resource has provided forecasts of hospitalisation and death rates for the whole of Scotland. These findings were used by the Scottish Government to inform their response to reduce COVID-19-related morbidity and mortality.Publisher PDFPeer reviewe