The Five Main Themes of the Old Testament

Definition and history of the Old Testament themes of covenant, kingship, grace, sacrifice, and prophetism

Diabetic Ketoacidosis: Pathophysiology and Treatment

The pathophysiology of DKA in patients with T1D is addressed, followed by a discussion of proper emergency treatment for this life-threatening condition

Diabetes Self-Management Education for Adolescent Patients: The Importance of a Developmentally Sensitive Approach

The attention of healthcare providers to the developmental level of adolescent patients with type one diabetes (T1D) maximizes effective patient education and glycemic control. Due to the dynamic changes that occur in the mind and body during adolescence, self-care for adolescent T1D patients is overwhelming as it envelopes activities of everyday life. The disease process and the unique aspects of adolescence in relation to T1D are important for caregivers to consider. Developmentally appropriate teaching during the initial onset of the disease must inform the patient and the patient’s family of the basics of the disease process and the daily care necessary for survival. Continuous and gradually increasing education is accomplished through regular appointments with the healthcare provider as well as through the gradual handing over of self-care responsibility from the parent to the adolescent. The physical and social needs of the adolescent should be incorporated into the education for the best results in compliance and adherence to the diabetes regimen. Motivational interviewing (MI) is an effective intervention for patients who are entering puberty and who experience increased ambivalence toward diabetes self-management

Unifying the Field: Mapping the Relationship Between Work Law Regimes in Ontario, Then and Now

Since the mid-20th century in Canada, labour and employment law have been treated as two separate but related fields. In 1981 Brian Langille argued in “Labour Law is a Subset of Employment Law” for the unification of the fields, so that all forms of waged work were understood as matters of public policy, rather than leaving some types of work to private law regulation. Taking up Langille’s argument, this paper argues that employment contracts, individual and collective, are structured through the overlap, interaction and gaps between work law regimes. The creation of a unified field moves from studying the regimes in isolation to studying the relationship between them, particularly the common law, labour law and minimum standards legislation. Adopting such a focus leads us backward to retell the historical story of the relationship between the regimes in the mid-20th century. It also points us forward towards new questions about how the regimes interact to structure employment contracts, and how their gaps and interactions are acting to build and sustain inequalities in the context of changing forms of work. Depuis le milieu du XXe siècle au Canada, le droit du travail et le droit de l’emploi sont traités comme deux domaines distincts mais liés. En 1981, Brian Langille a plaidé dans « Labour Law is a Subset of Employment Law » pour l’unification des deux domaines, afin que toutes les formes de travail salarié soient comprises comme des questions d’intérêt public, plutôt que de laisser certains types de travail à la réglementation du droit privé. Reprenant l’argument de Langille, nous soutenons dans le présent article que les contrats de travail, individuels et collectifs, sont structurés par le chevauchement, l’interaction et les lacunes entre les régimes de droit du travail. La création d’un domaine unifié permet de passer de l’étude isolée des régimes à l’étude des relations entre eux, en particulier la common law, le droit du travail et la législation sur les normes minimales. L’adoption d’une telle approche nous amène à revenir en arrière pour raconter l’histoire des relations entre les régimes au milieu du XXe siècle. Cela nous amène également à nous poser de nouvelles questions sur la manière dont les régimes interagissent pour structurer les contrats de travail, et sur la manière dont leurs lacunes et leurs interactions contribuent à créer et à maintenir des inégalités dans le contexte de l’évolution des formes de travail

The State Giveth and Taketh Away: Public Sector Labour Law, the Legitimacy of the Legislative Override Power and Constitutional Freedom of Association in Canada

This article investigates the role of courts and legislatures in the design and enforcement of labour laws in the context of public sector employment. It does so by focusing on government employers’ legislative ability to temporarily override public sector labour rights, or to displace outcomes achieved under their processes. This issue is analysed through a case study of Canada, a country which offers constitutional protections for freedom of association, but which is also constructing a highly deferential approach to the constitutional review of override statutes. As a result of this deference, governments have been afforded significant leeway in the use and design of override legislation, which serves to undermine the legitimacy of the underlying public sector labour law regime. The result is to shake the confidence of public sector employees in the promise of workplace power redistribution and workplace voice and to undermine the legitimacy of public sector labour law. Because override legislation can so fundamentally undermine public sector labour rights, the courts should avoid excessive deference and instead undertake an active constitutional review of their use, where constitutional protections are available

High current lightning test of space shuttle external tank lightning protection system

During lift-off, the shuttle launch vehicle (external tank, solid rocket booster and orbiter) may be subjected to a lightning strike. Tests of a proposed lightning protection method for the external tank and development materials which were subjected to simulated lightning strikes are described. Results show that certain of the high resistant paint strips performed remarkably well in diverting the 50 kA lightning strikes

Dietary patterns in the older New Zealand adult and their associations with cognitive function and metabolic syndrome : the Researching Eating, Activity, and Cognitive Health (REACH) study : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Nutritional Science at Massey University, Albany, New Zealand

Background: The global population is ageing. Ageing and poor diet are common risk factors for cognitive decline and metabolic syndrome which reduce functionality in later years. A dietary pattern approach considers the full complexity of the diet. Dietary patterns in an older New Zealand context have not been identified nor their associations with cognitive function or metabolic syndrome. Aims and objectives: This thesis, referred to as the REACH (Researching, Eating, Activity, and Cognitive Health) study, explored associations between dietary patterns and cognitive function and metabolic syndrome in older New Zealand adults. To achieve the aim a food frequency questionnaire (FFQ) was assessed for reproducibility, relative validity, and its suitability to derive robust dietary patterns. Further, associations between these dietary patterns and their nutrient and energy intake; the socio-demographic and lifestyle factors of the participants; and cognitive function and metabolic syndrome outcomes were examined. Method: Community-dwelling adults from Auckland, New Zealand were recruited (aged 65-74 years, 36% male, n 371). Dietary patterns were derived from a 109-item FFQ using 57 food groups and principal component analysis. Nutrient, energy, and alcohol intake were calculated using FOODfiles, the New Zealand Food composition database. The REACH FFQ and its derived dietary patterns were assessed for reproducibility and relative validity in a sub-set of the REACH participants (n 294). Reproducibility was assessed using an identical FFQ (FFQ2) administered one month after the initial REACH FFQ. A 4-day food record (4-DFR), collected between FFQ administrations, assessed relative validity. Cognitive function, covering six domains (global cognition, attention and vigilance, executive function, episodic memory, working memory and spatial memory), was assessed using COMPASS (Computerised Mental Performance Assessment System). Self-administered questionnaires collected health (medication and supplement intake), demographic and lifestyle [including sex, education levels, living status (alone or with someone), smoking status, physical activity levels, address (for Index of Multiple Deprivation)], and physical activity (International Physical Activity Questionnaire) data. A fasted blood sample was collected for measuring genetic [Apolipoprotein E -ε4 (APOE -ε4)] and biochemical markers (triglycerides, high- and low-density lipoprotein cholesterol). Blood pressure and anthropometric measures [weight, height, waist circumference, and body fat % (using dual X-ray absorptiometry)] were collected. Metabolic syndrome was defined by the National Cholesterol Education Program Adult Treatment Panel III. Abstract ii Statistical analyses performed: Reproducibility and relative validity of the REACH FFQ (food group intakes) and its derived dietary patterns (scores) were assessed using Spearman correlation coefficients (acceptable correlation rho=0.20-0.49), weighted kappa statistic (κw) (acceptable statistic κw=0.20-0.60), and Bland-Altman analysis including mean difference, limits of agreement, plots, and slope of bias. The similarity between dietary pattern loadings were assessed using Tucker’s congruence coefficient. Linear or logistic regression were used to examine associations between dietary patterns and their nutrients; socio-demographic and lifestyle factors; and health outcomes. Confounding adjustments included age, sex, education, index of multiple deprivation, energy intake, APOE -ε4, and physical activity. Results: In the validation study, the FFQ food groups showed good reproducibility (mean correlation coefficient = 0.69, mean κw = 0.62) and acceptable relative validity (mean correlation coefficient = 0.45, mean κw = 0.38) though Bland Altman plots showed bias and mean differences significantly different to zero in some food groups. Three similar dietary patterns were identified from each dietary assessment tool: ‘Mediterranean style’, ‘Western’, and ‘prudent’. Congruence coefficients between factor loadings ranged from 0.54 to 0.80. Correlations of dietary pattern scores ranged from 0.47 to 0.59 (reproducibility) and 0.33 to 0.43 (validity) (all P<0.001); weighted kappa scores from 0.40 to 0.48 (reproducibility) and 0.27 to 0.37 (validity); limits of agreement from ± 1.79 to ± 2.09 (reproducibility) and ± 2.09 to ± 2.27 (validity); a slope of bias was seen in the ‘prudent’ pattern for reproducibility and validity (P<0.001). From the full REACH dietary data set, three valid dietary patterns were derived explaining 18% of the variation in the diet. The ‘Mediterranean style’ pattern (salad vegetables; leafy cruciferous vegetables; other vegetables; avocados and olives; alliums; nuts and seeds; white fish and shellfish; oily fish; berries; water; salad dressings; cruciferous vegetables; eggs; cheese; tomatoes; and all other fruit) was associated with higher levels of beta-carotene equivalents, vitamin E, and folate intake (all P<0.001, all R2 ≥ 0.26), along with being female, having a higher physical activity level, and higher education (P<0.001, R2 = 0.07). The ‘Western’ pattern (processed meat; sauces and condiments; cakes, biscuits and puddings; meat pies and chips; processed fish; confectionery; vegetable oils; beer; chocolate; salad dressings; cheese; and sweetened cereal) was associated with higher daily energy intake (P<0.001, R2 = 0.43), along with being male, having a higher alcohol intake, living with others, and a secondary education (males only) (P<0.001, R2 = 0.16). The ‘prudent’ pattern (dried legumes; soy-based foods; fresh and frozen legumes; whole grains; carrots; and Abstract iii spices) was associated with a higher fibre and carbohydrate intake (both P<0.001, both R2 ≥ 0.25), along with higher physical activity and lower alcohol intake (P<0.001, R2 = 0.15). Neither the ‘Mediterranean style’ nor ‘prudent’ patterns were associated with either cognitive function or metabolic syndrome. The ‘Western’ pattern was not associated with cognitive function, but was positively associated with metabolic syndrome [odds ratio = 1 .67 (95% CI 1.08, 2.63)] (P=0.02). Being younger (P<0.05), female (P<0.001), having a higher education (P<0.01) or no APOE -ε4 allele (P<0.05) were associated with better cognitive function. Higher deprivation (P<0.001) was associated with metabolic syndrome. Conclusion: A novel and robust study with valid tools did not find any associations between dietary patterns and cognitive function in older adults living in New Zealand. Age, sex, education, and the APOE -ε4 allele were more predictive of cognitive function than the dietary patterns. A ‘Western’ dietary pattern and higher deprivation were predictive of metabolic syndrome. To reduce the odds of metabolic syndrome, actions should aim to improve deprivation, and shift people’s dietary intake away from the ‘Western’ dietary pattern