Cross-infection in cystic fibrosis: The knowledge and behaviour of adult patients

AbstractIntroductionThe knowledge and behaviour of adult patients with cystic fibrosis (CF) regarding cross-infection are ill understood.MethodsA questionnaire was designed to investigate this at the West Midlands Adult CF Centre.Results94 patients completed the questionnaire. 54%, 36% and 46% had “no idea” of the lifetime risk of contracting Burkholderia cepacia complex, epidemic strains of Pseudomonas aeruginosa, and MRSA, respectively. 25–33% did not know the consequences of infection with these bacteria. 35% mixed with other people with CF, 6.5% during physiotherapy or nebulizer use. Most respondents did not think quality of life was significantly linked with segregation from other patients with CF.ConclusionsAdults with CF, at least in the West Midlands, have poor knowledge of the risk and consequences of cross-infection. A significant proportion ignored advice not to mix with other patients, although segregation was not thought to impact upon quality of life. This suggests that more education about the risks of cross-infection would be beneficial

Optimizing treatment outcomes in adolescents with eating disorders: The potential role of cognitive behavioral therapy

Objective While family‐based treatment (FBT) is the leading psychological therapy for adolescents with eating disorders, it is not universally effective or suitable. This study considered the effectiveness of cognitive‐behavioral therapy for eating disorders (CBT‐ED) in adolescent cases where FBT was not fully effective or where it was not applicable to the individual case. Method A transdiagnostic case series of 54 adolescents with eating disorders (52% with anorexia nervosa; 31% with atypical anorexia nervosa) were offered CBT‐ED following previous treatment using FBT or following FBT being judged inappropriate. Pre‐post outcomes were assessed using standardized measures of eating attitudes and clinical impairment, and weight change was measured for the patients with anorexia nervosa. Results The rate of attrition was similar to that found in other CBT‐ED studies (38.9% of patients who started CBT‐ED; 59.3% of those offered CBT‐ED). The patients showed positive outcomes on all measures, regardless of whether they had previously been treated with FBT. Effect sizes were moderate to large. Severity and duration of the eating disorder were unrelated to outcomes. Discussion CBT‐ED merits consideration as a second‐line approach for adolescents with eating disorders when FBT has not been effective or could not be applied. There is no evidence that previous failure to benefit from FBT impairs outcome from subsequent CBT‐ED, and severity and duration of the eating disorder did not influence outcome. Treatment matching for adolescents with eating disorders might consider the role of previous treatment outcomes and family availability in determining optimum treatment strategies for individuals

Physical soil quality indicators for monitoring British soils

The condition or quality of soils determines its ability to deliver a range of functions that support ecosystem services, human health and wellbeing. The increasing policy imperative to implement successful soil monitoring programmes has resulted in the demand for reliable soil quality indicators (SQIs) for physical, biological and chemical soil properties. The selection of these indicators needs to ensure that they are sensitive and responsive to pressure and change e.g. they change across space and time in relation to natural perturbations and land management practices. Using a logical sieve approach based on key policy-related soil functions, this research assessed whether physical soil properties can be used to indicate the quality of British soils in terms of its capacity to deliver ecosystem goods and services. The resultant prioritised list of physical SQIs were tested for robustness, spatial and temporal variability and expected rate of change using statistical analysis and modelling. Six SQIs were prioritised; packing density, soil water retention characteristics, aggregate stability, rate of erosion, depth of soil and soil sealing. These all have direct relevance to current and likely future soil and environmental policy and are appropriate for implementation in soil monitoring programs

Evidence of collaborative opportunities to ensure long-term sustainability in African farming

Farmers face the challenge of increasing production to feed a growing population and support livelihoods, whilst also improving the sustainability and resilience of cropping systems. Understanding the key factors that influence farming management practices is crucial for determining farmers’ adaptive capacity and willingness to engage in cooperative strategies. To that end, we investigated management practices that farmers adopt and the factors underlying farmers’ decision-making. We also aimed to identify the constraints that impede the adoption of strategies perceived to increase farming resilience and to explore how the acceleration of technology adoption through cooperation could ensure the long-term sustainability of farming. Surveys were distributed to farming stakeholders and professionals who worked across the contrasting environments of Morocco. We used descriptive statistics and analysis by log-linear modelling to predict the importance of factors influencing farmers’ decision- making. The results show that influencing factors tended to cluster around environmental pressures, crop characteristics and water availability with social drivers playing a lesser role. Subsidies were also found to be an important factor in decision-making. Farming stakeholders generally believed that collaborative networks are likely to facilitate the adoption of sustainable agricultural practices. We conclude that farmers need both eco- nomic incentives and technical support to enhance their adaptive capacity as this can lessen the socioeconomic vulnerability inherent in arid and semi-arid regions

Bias correction of high-resolution regional climate model precipitation output gives the best estimates of precipitation in Himalayan catchments

The need to provide accurate estimates of precipitation over catchments in the Hindu Kush, Karakoram, and Himalaya mountain ranges for hydrological and water resource systems assessments is widely recognised, as is identifying precipitation extremes for assessing hydro‐meteorological hazards. Here, we investigate the ability of bias‐corrected Weather Research and Forecasting model output at 5 km grid spacing to reproduce the spatiotemporal variability of precipitation for the Beas and Sutlej river basins in the Himalaya, measured by 44 stations spread over the period 1980 to 2012. For the Sutlej basin, we find that the raw (uncorrected) model output generally underestimated annual, monthly, and (particularly low‐intensity) daily precipitation amounts. For the Beas basin, the model performance was better, although biases still existed. It is speculated that the cause of the dry bias over the Sutlej basin is a failure of the model to represent an early‐morning maximum in precipitation during the monsoon period, which is related to excessive precipitation falling upwind. However, applying a non‐linear bias‐correction method to the model output resulted in much better results, which were superior to precipitation estimates from reanalysis and two gridded datasets. These findings highlight the difficulty in using current gridded datasets as input for hydrological modelling in Himalayan catchments, suggesting that bias‐corrected high‐resolution regional climate model output is in fact necessary. Moreover, precipitation extremes over the Beas and Sutlej basins were considerably under‐represented in the gridded datasets, suggesting that bias‐corrected regional climate model output is also necessary for hydro‐meteorological risk assessments in Himalayan catchments

Assessing n-alkane and neutral lipid biomarkers as tracers for land-use specific sediment sources

Sediment fingerprinting (SF) methods using taxonomic-specific biomarkers such as n-alkanes have been successfully used to distinguish sediment sources originating from different land uses at a catchment scale. In this study, we hypothesise that using a combination of soil biomarkers of plant, fungal and bacterial origin may allow greater discrimination between land uses in SF studies. Furthermore, we assess if the inclusion of short chain (shorter than C22) neutral lipid fatty acids (SC-NLFA) improves land use discrimination, considering the Loch Davan catchment (34 km2) in Scotland as a case study. Fatty acids are commonly used to measure abundance and diversity of soil microbial and fungal communities. The spatial distribution of these soil communities has been shown to depend mainly on soil properties and, therefore, soil types and land management practices. The n-alkane and SC-NLFA concentrations and their compound specific stable isotope signatures (CSSI) in four land cover classes (crop land, pasture, forest, and moorland) were determined and their contribution to six virtual sediment mixture samples was modelled. Using a Bayesian un-mixing model, the performance of the combined n-alkane and SC-NLFA biomarkers in distinguishing sediment sources was assessed. The collection of new empirical data and novel combinations of biomarkers in this study found that land use can be distinguished more accurately in organic sediment fingerprinting when combining n-alkanes and SC-NLFA or using SC-NLFA and their CSSI alone. These results suggest that fingerprinting methods using the output of unmixing models could be improved by the use of multiple tracer sets if there is a commensurate way to determine which tracer set provides the “best” capacity for land use source discrimination. This new contribution to the organic sediment fingerprinting field highlights that different combinations of biomarkers may be required to optimise discrimination between soils from certain land use sources (e.g., arable-pasture). The use of virtual mixtures, as presented in this study, provides a method to determine if addition or removal of tracers can improve relative error in source discrimination. Combining biomarkers from different soil communities could have a significant impact on the identification of recent sources of sediment within catchments and therefore on the development of effective management strategies.Natural Environment Research Council (NERC): Biotechnology and Biological Sciences Research Council: NE/M009106/

Perfect weddings abroad

Approximately 16% of UK couples are currently married abroad. However, academic or practitioner focused research that explores the complex nature of a couple’s buying preferences or the development of innovative marketing strategies by businesses operating within the weddings abroad niche sector, is almost non-existent. This exploratory paper examines the role and relevance of marketing within the weddings abroad sector. The complex nature of customer needs in this high emotional and involvement experience, are identified and explored. A case study of Perfect Weddings Abroad Ltd highlights distinctive features and characteristics. Social networking and the use of home-workers, with a focus on reassurance and handholding are important tools used to develop relationships with customers. These tools and techniques help increase the tangibility of a weddings abroad package. Clusters of complementary services that are synergistic and provide sources of competitive advantage are identified and an agenda for future research is developed

Deriving wheat crop productivity indicators using Sentinel-1 time series

High-frequency Earth observation (EO) data have been shown to be effective in identifying crops and monitoring their development. The purpose of this paper is to derive quantitative indicators of crop productivity using synthetic aperture radar (SAR). This study shows that the field-specific SAR time series can be used to characterise growth and maturation periods and to estimate the performance of cereals. Winter wheat fields on the Rothamsted Research farm in Harpenden (UK) were selected for the analysis during three cropping seasons (2017 to 2019). Average SAR backscatter from Sentinel-1 satellites was extracted for each field and temporal analysis was applied to the backscatter cross-polarisation ratio (VH/VV). The calculation of the different curve parameters during the growing period involves (i) fitting of two logistic curves to the dynamics of the SAR time series, which describe timing and intensity of growth and maturation, respectively; (ii) plotting the associated first and second derivative in order to assist the determination of key stages in the crop development; and (iii) exploring the correlation matrix for the derived indicators and their predictive power for yield. The results show that the day of the year of the maximum VH/VV value was negatively correlated with yield (r = −0.56), and the duration of “full” vegetation was positively correlated with yield (r = 0.61). Significant seasonal variation in the timing of peak vegetation (p = 0.042), the midpoint of growth (p = 0.037), the duration of the growing season (p = 0.039) and yield (p = 0.016) were observed and were consistent with observations of crop phenology. Further research is required to obtain a more detailed picture of the uncertainty of the presented novel methodology, as well as its validity across a wider range of agroecosystem

Using digital technologies to facilitate social inclusion during the COVID-19 pandemic: Experiences of co-resident and non-co-resident family carers of people with dementia from DETERMIND-C19

Background The COVID-19 pandemic triggered rapid and unprecedented changes in the use of digital technologies to support people's social inclusion. We examined whether and how co-resident and non-co-resident family carers of people with dementia engaged with digital technologies during this period. Methods Throughout November 2020-February 2021, we interviewed 42 family carers of people with dementia from our DETERMIND-C19 cohort. Preliminary analysis was conducted through Framework analysis, followed by an inductive thematic analysis. Findings Digital technologies served as a Facilitator for social inclusion by enabling carers to counter the effects of the differing restrictions imposed on them so they could remain socially connected and form a sense of solidarity, access resources and information, engage in social and cultural activities and provide support and independence in their caring role. However, these experiences were not universal as carers discussed some Challenges for tech inclusion, which included preferences for face-to-face contact, lack of technological literacy and issues associated with the accessibility of the technology. Conclusion Many of the carers engaged with Information and Communication Technologies, and to a lesser extent Assistive Technologies, during the pandemic. Whilst carers experienced different challenges due to where they lived, broadly the use of these devices helped them realise important facets of social inclusion as well as facilitated the support they provided to the person with dementia. However, to reduce the ‘digital divide’ and support the social inclusion of all dementia carers, our findings suggest it is essential that services are attuned to their preferences, needs and technological abilities