The perceived impact of the National Health Service on personalised nutrition service delivery among the UK public

Personalised nutrition (PN) has the potential to reduce disease risk and optimise health and performance. Although previous research has shown good acceptance of the concept of PN in the UK, preferences regarding the delivery of a PN service (e.g. online v. face-to-face) are not fully understood. It is anticipated that the presence of a free at point of delivery healthcare system, the National Health Service (NHS), in the UK may have an impact on end-user preferences for deliverances. To determine this, supplementary analysis of qualitative data obtained from focus group discussions on PN service delivery, collected as part of the Food4Me project in the UK and Ireland, was undertaken. Irish data provided comparative analysis of a healthcare system that is not provided free of charge at the point of delivery to the entire population. Analyses were conducted using the 'framework approach' described by Rabiee (Focus-group interview and data analysis. Proc Nutr Soc 63, 655-660). There was a preference for services to be led by the government and delivered face-to-face, which was perceived to increase trust and transparency, and add value. Both countries associated paying for nutritional advice with increased commitment and motivation to follow guidelines. Contrary to Ireland, however, and despite the perceived benefit of paying, UK discussants still expected PN services to be delivered free of charge by the NHS. Consideration of this unique challenge of free healthcare that is embedded in the NHS culture will be crucial when introducing PN to the UK.

Tolerance of ruminant animals to high dose in-feed administration of a selenium-enriched yeast

The objective of the study was to determine if there were adverse effects on animal health and performance when a range of ruminant animals species were fed at least 10 times the maximum permitted European Union (EU) selenium (Se) dietary inclusion rate (0.568 mg Se/kg DM) in the form of selenium enriched yeast (SY) derived from a specific strain of Saccharomyces cerevisiae CNCM I-3060. In a series of studies, dairy cows, beef cattle, calves and lambs were offered either a control diet which contained no Se supplement or a treatment diet which contained the same basal feed ingredients plus a SY supplement which increased total dietary Se from 0.15 to 6.25, 0.20 to 6.74, 0.15 to 5.86 and 0.14 to 6.63 mg Se/kg DM, respectively. The inclusion of the SY supplement (P < 0.001) increased whole blood Se concentrations, reaching maximum mean values of 716, 1,505, 1,377, and 724 ng Se/mL for dairy cattle, beef cattle, calves and lambs, respectively. Selenomethionine accounted for 10% of total whole blood Se in control animals whereas the proportion in SY animals ranged between 40 and 75%. Glutathione peroxidase (EC 1.11.1.9) activity was higher (P < 0.05) in SY animals when compared with controls. A range of other biochemical and hematological parameters were assessed, but few differences of biological significance were established between treatments groups. There were no differences between treatment groups within each species with regard to animal physical performance or overall animal health. It was concluded that there were no adverse effects on animal health, performance and voluntary feed intake to the administration of at least ten times the EU maximum, or approximately twenty times the US FDA permitted concentration of dietary Se in the form of SY derived from a specific strain of Saccharomyces cerevisiae CNCM I-3060.

Particulate matter mass concentration (PM10) under different ventilation methods in classrooms

Recently, studies have shown that the classroom environment is very important for students' health and performance. Thus, the evaluation of indoor air quality (IAQ) in a classroom is necessary to ensure students' well-being. In this paper the emphasis is on airborne concentration of particulate matter (PM) in adult education rooms. The mass concentration of PM10 particulates was measured in two classrooms under different ventilation methods in the University of Reading, UK, during the winter period of 2008. In another study the measurement of the concentration of particles was accompanied with measurements of CO2 concentration in these classrooms but this study is the subject of another publication. The ambient PM10, temperature, relative humidity, wind speed and direction, and rainfall events were monitored as well. In general, this study showed that outdoor particle concentrations and outdoor meteorological parameters were identified as significant factors influencing indoor particle concentration levels. Ventilation methods showed significant effects on air change rate and on indoor/outdoor (I/O) concentration ratios. Higher levels of indoor particulates were seen during occupancy periods. I/O ratios were significantly higher when classrooms were occupied than when they were unoccupied, indicating the effect of both people presence and outdoor particle concentration levels. The concentrations of PM10 indoors and outdoors did not meet the requirements of WHO standards for PM10 annual average.

Measurement and prediction of the effect of students activities on airborne particulate concentration in a classroom.

Epidemiological studies have shown links between human exposure to indoor airborne particles and adverse health affects. Several recent studies have also reported that the classroom environment has an impact on students’ health and performance. In this study particle concentration in a university classroom is assessed experimentally for different occupancy periods. The mass concentrations of different particle size ranges (0.3 – 20 µm), and the three particulate matter fractions (PM10, PM2.5, and PM1) were measured simultaneously in a classroom with different occupancy periods including occupied and unoccupied periods in the University of Reading, UK, during the winter period of 2010. The results showed that students’ presence is a significant factor affecting particles concentration for the fractions above PM1 in the measured range of 0.3 to 20 µm. The resuspension of the three PM fractions was also determined in the study.

The effects of a short-term increase in supplementation on the reproduction performance in lactating crossbred dairy cows

The hypothesis that dairy cows partially suckling their calves would ovulate following removal of calves when restored to positive energy balance by a short-term increase in supplementation was investigated in 65 crossbred cows. Five treatments (T1, T2, T3, T4, and T5) that differed in the amount of total concentrate fed from calving to week 24 were involved. Calves were allowed to suck residual milk to 12 weeks of age. Energy balance was estimated by measuring intake, milk yield and organic matter digestibility. The occurrence of ovulation was determined by the analysis of milk progesterone (P4) concentration. Four groups that were receiving additional supplementation were restored to positive energy balance, while the control group (T I) remained in negative energy balance. The percentage of cows ovulating was 36%, 58%, 92%, 90% and 60% for T1, T2, T3, T4 and T5, respectively (P = 0.026). Comparison of the timing of ovulation for combined results from T1+T2 and T3+T4+T5 estimated mean time to fail to ovulate as 110 +/- 9.0 and 87 +/- 7.6 days, respectively (p = 0.023). The percentage of the cows showing oestrus was 9%, 8%, 33%, 40% and 40% for T1, T2, T3, T4 and T5, respectively (P = 0.197). Short-term increases in supplementation are unlikely to be an attractive means of reducing calving intervals.

A cross-sectional study of reproductive performance of smallholder dairy cows in coastal Tanzania

A retrospective cross-sectional study was conducted on 200 randomly selected smallholder farms from a mixed dairy farming system in Tanga, Tanzania, between January and April 1999. We estimated the frequency and determinants of long calving interval (LCI), retention of fetal membrane (RFM), dystocia, and abortion in smallholder crossbred cattle and explored birth trends. The mean calving interval was 500 days and birth rate was 65 per 100 cow-years. Dystocia was reported to affect 58% of calvings, and 17.2% of animals suffered RFM. Using mixed effect models, the variables associated with LCI, RFM and dystocia were breed, level of exotic blood and condition score. Zebu breeding was associated with LCI (odds ratio (OR) = 2.3, p = 0.041) and Friesian breeding with lower odds for RF (OR = 0.26, p = 0.020). Animals with higher levels of exotic blood had lower odds for evidence of dystocia (OR = 0.45, p = 0.021). Evidence of dystocia was significantly associated with poor condition score (beta = -1.10, p = 0.001). Our observations suggest that LCIs are common in smallholder dairy farms in this region and a likely source of economic loss. Dystocia, RFM, poor condition score and mineral deficiency were common problems and were possibly linked to LCI.

Reproducibility of a short semi-quantitative food group questionnaire and its performance in estimating nutrient intake compared with a 7-day diet diary in the Million Women Study

Objectives: To assess the short- and long-term reproducibility of a short food group questionnaire, and to compare its performance for estimating nutrient intakes in comparison with a 7-day diet diary. Design: Participants for the reproducibility study completed the food group questionnaire at two time points, up to 2 years apart. Participants for the performance study completed both the food group questionnaire and a 7-day diet diary a few months apart. Reproducibility was assessed by kappa statistics and percentage change between the two questionnaires; performance was assessed by kappa statistics, rank correlations and percentages of participants classified into the same and opposite thirds of intake. Setting: A random sample of participants in the Million Women Study, a population-based prospective study in the UK. Subjects: In total, 12 221 women aged 50-64 years. Results: in the reproducibility study, 75% of the food group items showed at least moderate agreement for all four time-point comparisons. Items showing fair agreement or worse tended to be those where few respondents reported eating them more than once a week, those consumed in small amounts and those relating to types of fat consumed. Compared with the diet diary, the food group questionnaire showed consistently reasonable performance for the nutrients carbohydrate, saturated fat, cholesterol, total sugars, alcohol, fibre, calcium, riboflavin, folate and vitamin C. Conclusions: The short food group questionnaire used in this study has been shown to be reproducible over time and to perform reasonably well for the assessment of a number of dietary nutrients.

Ventilation rates in schools and pupil’s performance using computerized assessment tests

Research shows that poor indoor air quality (IAQ) in school buildings can cause a reduction in the students’ performance assessed by short-term computer-based tests; whereas good air quality in classrooms can enhance children's concentration and also teachers’ productivity. Investigation of air quality in classrooms helps us to characterise pollutant levels and implement corrective measures. Outdoor pollution, ventilation equipment, furnishings, and human activities affect IAQ. In school classrooms, the occupancy density is high (1.8–2.4 m2/person) compared to offices (10 m2/person). Ventilation systems expend energy and there is a trend to save energy by reducing ventilation rates. We need to establish the minimum acceptable level of fresh air required for the health of the occupants. This paper describes a project, which will aim to investigate the effect of IAQ and ventilation rates on pupils’ performance and health using psychological tests. The aim is to recommend suitable ventilation rates for classrooms and examine the suitability of the air quality guidelines for classrooms. The air quality, ventilation rates and pupils’ performance in classrooms will be evaluated in parallel measurements. In addition, Visual Analogue Scales will be used to assess subjective perception of the classroom environment and SBS symptoms. Pupil performance will be measured with Computerised Assessment Tests (CAT), and Pen and Paper Performance Tasks while physical parameters of the classroom environment will be recorded using an advanced data logging system. A total number of 20 primary schools in the Reading area are expected to participate in the present investigation, and the pupils participating in this study will be within the age group of 9–11 years. On completion of the project, based on the overall data recommendations for suitable ventilation rates for schools will be formulated.

Work performance, productivity and indoor air

Temperature, relative humidity, and air quality all affect the sensory system via thermo receptors in the skin and the olfactory system. Air quality is mainly defined by the contaminants in the air. However, the most persistent memory of any space is often its odor. Strong, emotional, and past experiences are awakened by the olfactory sense. Odors can also influence cognitive processes that affect creative task performance, as well as personal memories and moods. Besides nitrogen and oxygen, the air contains particles and many chemicals that affect the efficiency of the oxygenation process in the blood, and ultimately the air breathed affects thinking and concentration. It is important to show clients the value of spending more capital on high-quality buildings that promote good ventilation. The process of achieving indoor-air quality is a continual one throughout the design, construction, commissioning, and facilities management processes. This paper reviews the evidence.

Flavonoids and brain health: multiple effects underpinned by common mechanisms

The neuroprotective actions of dietary flavonoids involve a number of effects within the brain, including a potential to protect neurons against injury induced by neurotoxins, an ability to suppress neuroinflammation, and the potential to promote memory, learning and cognitive function. This multiplicity of effects appears to be underpinned by two processes. Firstly, they interact with important neuronal signalling cascades leading to an inhibition of apoptosis triggered by neurotoxic species and to a promotion of neuronal survival and differentiation. These interactions include selective actions on a number of protein kinase and lipid kinase signalling cascades, most notably the PI3K/Akt and MAP kinase pathways which regulate pro-survival transcription factors and gene expression. Secondly, they induce peripheral and cerebral vascular blood flow in a manner which may lead to the induction of angiogenesis, and new nerve cell growth in the hippocampus. Therefore, the consumption of flavonoid-rich foods, such as berries and cocoa, throughout life holds a potential to limit the neurodegeneration associated with a variety of neurological disorders and to prevent or reverse normal or abnormal deteriorations in cognitive performance.

Health and safety on construction sites in Ghana

The state of health and safety on construction sites in Ghana was investigated using first hand observation of fourteen (14) construction project sites in 2009 and 2010. At each site, the construction project, workers and the physical environment of the site were inspected and evaluated against health and safety indicators taken from the literature. The results reveal a poor state of health and safety on Ghanaian construction sites. The primary reasons are a lack of strong institutional framework for governing construction activities and poor enforcement of health and safety policies and procedures. Also, Ghanaian society does not place a high premium on health and safety of construction workers on site. Interviews with workers indicated that injuries and accidents are common on sites. However, compensation for injury is often at the discretion of the contractor although collective bargaining agreements between Labour unions and employers prescribe obligations for the contractor in the event of injury to a worker.

Mirror lightpipes: daylighting performance in real buildings

Mirror lightpipes are useful for providing healthy and energy-efficient daylight into buildings where windows and skylights are unsuitable, insufficient or generate too much heat gain. The lightpipes have been installed in dozens of buildings in the UK. Field monitoring has been carried out to assess their performance in four different buildings: the headquaters of a major insurance company, a health clinic, a residential building and a college dining hall In those cases where lighipipes with moderate aspect ratios were installed, good illuminance of up to 450 lux has been obtained with internal/external illuminance ratios around 1%. When long and narrow lightpipes with many bends are used, however, the ratio reduced to around 0.1%. These results showed that lightpipes can be effective daylighting devices provided that excessive aspect ratios and numbers of bends are avoided. Lightpipes with larger diameters should be used whenever possible. The lightpipes often improved signiScantly the visual quality af the interior environment, and high user satisfaction was found even in buildings where a relatively low level of daylight was admitted through the lightpipes

Provider diversity in the English NHS: a study of recent developments in four local health economies

Objectives: The overall objective of the research was to assess the impact of provider diversity on quality and innovation in the English NHS. The aims were to map the extent of diverse provider activity, identify the differences in performance between Third Sector Organisations (TSOs), for-profit private enterprises, and incumbent organisations within the NHS, and the factors that affect the entry and growth of new private and TSOs. Methods: Case studies of four Local Health Economies (LHEs). Data included: semi-structured interviews with 48 managerial and clinical staff from NHS organizations and providers from the private and Third Sector; some documentary evidence; a focus group with service users; and routine data from the Care Quality Commission and Companies House. Data collection was mainly between November 2008 and November 2009. Results: Involvement of diverse providers in the NHS is limited. Commissioners’ local strategies influence degrees of diversity. Barriers to the entry for TSOs include lack of economies of scale in the bidding process. Private providers have greater concern to improve patient pathways and patient experience, whereas TSOs deliver quality improvements by using a more holistic approach and a greater degree of community involvement. Entry of new providers drives NHS Trusts to respond by making improvements. Information sharing diminishes as competition intensifies. Conclusions: There is scope to increase the participation of diverse providers in the NHS, but care must be taken not to damage public accountability, overall productivity, equity and NHS providers (especially acute hospitals, which are likely to remain in the NHS) in the process.