Factors influencing eating a varied diet in old age

OBJECTIVE:
To investigate the influences of resources and food-related goals on the variety of food choice among older people.
DESIGN:
A questionnaire-based survey in eight European countries: Poland, Portugal, United Kingdom, Germany, Sweden, Denmark, Italy and Spain.
SUBJECTS:
Participants (n 3200) were above 65 years of age and living in their own homes. The samples were quota samples, eight groups of fifty in each country, based on gender, age and living circumstances, reflecting the diversity of each of the national populations based on education, income and urbanization of living environment.
RESULTS:
Hierarchical multiple regression analysis showed that income, health status, access to a car and living arrangement affected the level of dietary variety. The perceived level of different food-related resources impacted the consumption of a varied diet over and above actual resource levels. Food-related goals contributed to variety of food intake that was not accounted for by the amount of material resources possessed or the social and other resources perceived to be possessed.
CONCLUSIONS:
Older people's variety of food intake depended on material resources (e.g. monthly income, access to a car, living arrangement, physical and mental health). However, in addition to these variables, the way older people perceived other resources, such as their level of appetite, their food knowledge, their perception of the distance to the shops, access to high-quality products, having better kitchen facilities, access to good service providers and support from friends and neighbours, all contributed to how varied a diet they ate.

Changes in solar activity and Holocene climatic shifts derived from C-14 wiggle-match dated peat deposits

Closely spaced sequences of accelerator mass spectrometer (AMS) C-14 dates of peat deposits display century-scale wiggles which can be fitted to the radiocarbon calibration curve. By wiggle-matching such sequences, high-precision calendar age chronologies can be generated which show that changes in mire surface wetness during the Bronze Age/Iron Age transition (c. 850 cal. BC) and the 'Little Ice Age' (Wolf, Sporer, Maunder and Dalton Minima) occurred during periods of suddenly increasing atmospheric concentration of C-14. Replicate evidence from peat-based proxy climate indicators in northwest Europe suggest these changes in climate may have been driven by temporary declines of solar activity. Carbon-accumulation rates of two raised peat bogs in the UK and Denmark record low values during the 'Little Ice Age' which reflects reduced primary productivity of the peat-forming vegetation during these periods of climatic deterioration.

Tight constraints on the existence of additional planets around HD 189733†

We report a transit timing study of the transiting exoplanetary system HD 189733. In total, we observed 10 transits in 2006 and 2008 with the 2.6-m Nordic Optical Telescope, and two transits in 2007 with the 4.2-m William Herschel Telescope. We used Markov Chain Monte Carlo simulations to derive the system parameters and their uncertainties, and our results are in a good agreement with previously published values. We performed two independent analyses of transit timing residuals to place upper mass limits on putative perturbing planets. The results show no evidence for the presence of planets down to 1 Earth mass near the 1:2 and 2:1 resonance orbits, and planets down to 2.2 Earth masses near the 3:5 and 5:3 resonance orbits with HD 189733b. These are the strongest limits to date on the presence of other planets in this system. Based on observations made with the Nordic Optical Telescope, operated on the island of La Palma jointly by Denmark, Finland, Iceland, Norway and Sweden, in the Spanish Observatorio del Roque de los Muchachos of the Instituto de Astrofísica de Canarias. Based on observations made with the William Herschel Telescope operated on the island of La Palma by the Isaac Newton Group in the Spanish Observatorio del Roque de los Muchachos of the Instituto de Astrofísica de Canarias. ‡

Participation of 8-12 year old children with cerebral palsy: a cross-sectional European Survey

Objectives
To evaluate how involvement in life situations (participation) in children with cerebral palsy varies with type and severity of impairment and to investigate geographical variation in participation.

Design
Cross sectional study. Trained interviewers visited parents of children with cerebral palsy; multilevel multivariable regression related participation to impairments, pain, and sociodemographic characteristics.

Setting
Eight European regions with population registers of children with cerebral palsy; one further region recruited children from multiple sources.

Participants
1174 children aged 8-12 with cerebral palsy randomly selected from the population registers, 743 (63%) joined in the study; the further region recruited 75 children.

Main outcome measure
Children’s participation assessed by the Life-H questionnaire covering 10 main areas of daily life. Scoring ignored adaptations or assistance required for participation.

Results
Children with pain and those with more severely impaired walking, fine motor skills, communication, and intellectual abilities had lower participation across most domains. Type of cerebral palsy and problems with feeding and vision were associated with lower participation for specific domains, but the sociodemographic factors examined were not. Impairment and pain accounted for up to a sixth of the variation in participation. Participation on all domains varied substantially between regions: children in east Denmark had consistently higher participation than children in other regions. For most participation domains, about a third of the unexplained variation could be ascribed to variation between regions and about two thirds to variation between individuals.

Conclusions
Participation in children with cerebral palsy should be assessed in clinical practice to guide intervention and assess its effect. Pain should be carefully assessed. Some European countries facilitate participation better than others, implying some countries could make better provision. Legislation and regulation should be directed to ensuring this happens.

International perspectives on the influence of structure and process of weaning from mechanical ventilation.

Background 
Recently, clinical and research attention has been focused on refining weaning processes to improve outcomes for critically ill patients who require mechanical ventilation. One such process, use of a weaning protocol, has yielded conflicting results, arguably because of the influence of existing context and processes.

Objective 
To compare international data to assess differences in context and processes in intensive care units that could influence weaning.  

Methods 
Review of existing national data on provision of care for critically ill patients, including structure, staffing, skill mix, education, roles, and responsibilities for weaning in intensive care units of selected countries.

Results 
Australia, New Zealand, Denmark, Norway, Sweden, and the United Kingdom showed similarities in critical care provision, structure, skill mix, and staffing ratios in intensive care units. Weaning in these countries is generally a collaborative process between nurses and physicians. Notable differences in intensive care units in the United States were the frequent use of an open structure and inclusion of respiratory therapists on the intensive care unit’s health care team. Nurses may be excluded from direct management of ventilator weaning in some institutions, as this role is primarily assumed by respiratory therapists guided by medical directives. Availability of critical care beds was highest in the United States and lowest in the United Kingdom.

Conclusion 
Context and processes of care that could influence ventilator weaning outcomes varied considerably across countries. Further quantification of these contextual influences should be considered when translating research findings into local clinical practice and when designing randomized, controlled trials.

Peer Rating for Feedback in Group Projects

The National Student Survey (NSS) in the UK has since 2005 questioned final year
undergraduate students on a broad range of issues relating to their university experience.
Across disciplines and universities students have expressed least satisfaction in the areas of
assessment and feedback. In response to these results many educational practitioners have
reviewed and revised their procedures and the UK Higher Education Academy (HEA) has
produced guidelines of best practice to assist academics in improving these specific areas.
The Product Design and Development (PDD) degree at Queen’s University Belfast is
structured with an integrated curriculum with group Design Build Test (DBT) projects as the
core of each year of the undergraduate programme. Based on the CDIO syllabus and
standards the overall learning outcomes for the programme are defined and developed in a
staged manner, guided by Bloom’s taxonomy of learning domains.
Feedback in group DBT projects, especially in relation to the development of personal and
professional skills, represents a different challenge to that of individual assignment feedback.
A review of best practice was carried out to establish techniques which could be applied to
the particular context of the PDD degree without modification and also to identify areas
where a different approach would need to be applied.
A revised procedure was then developed which utilised the structure of the PDD degree to
provide a mechanism for enhanced feedback in group project work, while at the same time
increasing student development of self and peer evaluation skills. Key to this improvement
was the separation of peer ratings from assessment in the perception of the students and the
introduction of more frequent face to face feedback interviews.
This paper details the new procedures developed and additional issues which have been
raised and addressed, with reference to the published literature, during 3 years of operation.