A review of non-pharmacological and pharmacological management of seasonal and perennial allergic conjunctivitis

Allergic eye disease encompasses a group of hypersensitivity disorders which primarily affect the conjunctiva and its prevalence is increasing. It is estimated to affect 8% of patients attending optometric practice but is poorly managed and rarely involves ophthalmic assessment. Seasonal allergic conjunctivitis (SAC) is the most common form of allergic eye disease (90%), followed by perennial allergic conjunctivitis (PAC; 5%). Both are type 1 IgE mediated hypersensitivity reactions where mast cells play an important role in pathophysiology. The signs and symptoms are similar but SAC occurs periodically whereas PAC occurs year round. Despite being a relatively mild condition, the effects on the quality of life can be profound and therefore they demand attention. Primary management of SAC and PAC involves avoidance strategies depending on the responsible allergen(s) to prevent the hypersensitivity reaction. Cooled tear supplements and cold compresses may help bring relief. Pharmacological agents may become necessary as it is not possible to completely avoid the allergen(s). There are a wide range of anti-allergic medications available, such as mast cell stabilisers, antihistamines and dual-action agents. Severe cases refractory to conventional treatment require anti-inflammatories, immunomodulators or immunotherapy. Additional qualifications are required to gain access to these medications, but entry-level optometrists must offer advice and supportive therapy. Based on current evidence, the efficacy of anti-allergic medications appears equivocal so prescribing should relate to patient preference, dosing and cost. More studies with standardised methodologies are necessary elicit the most effective anti-allergic medications but those with dual-actions are likely to be first line agents.

Is breast best? Perceptions of infant feeding

This study explored the reasons why young women from low income areas are among those least likely to breastfeed. Focus groups were conducted with 15 health professionals and 11 young, first time mothers were interviewed. Health professionals participating believed that white communities endorsed bottle feeding while Pakistani and Bangladeshi communities, although they accepted breastfeeding more readily, were likely to give prelacteal feeds of non-breast milk and to delay weaning. The interviews with mothers revealed a belief that 'breast is best' but factors intervened in a detrimental way resulting in the decision not to breastfeed or in early cessation. Participating mothers expected breastfeeding to be painful and were preoccupied with feeding and weight gain. The desire to have 'fat bonnie babies' demonstrated the mothers' moral attempts to be perceived as 'good mothers' although their actions went against the knowledge that 'breast is best'. Recommendations include educating health professionals about subcultures in their communities and reversing the misconception that breast milk is insufficient for a baby's healthy development. Promoting breastfeeding must include the crucial message that breast milk contains all the nourishment a baby needs.

Sibling eating behaviours and differential child feeding practices reported by parents

The purpose of this study was to investigate the intra-familial relationships between parental reports of feeding practices used with siblings in the same family, and to evaluate whether differences in feeding practices are related to differences in siblings' eating behaviours. Eighty parents of two sibling children completed measures assessing their feeding practices and child eating behaviours. Parents reported using greater restrictive feeding practices with children who were fussier and desired to drink more than their sibling. Parents reported using more pressure to eat with siblings who were slower to eat, were fussier, emotionally under-ate, enjoyed food less, were less responsive to food, and were more responsive to internal satiety cues. Restriction and pressure to eat appear to be part of the non-shared environment which sibling children experience differently. These feeding practices may be used differently for children in the same family in response to child eating behaviours or other specific characteristics.

A review of non-pharmacological and pharmacological management of seasonal and perennial allergic conjunctivitis

Allergic eye disease encompasses a group of hypersensitivity disorders which primarily affect the conjunctiva and its prevalence is increasing. It is estimated to affect 8% of patients attending optometric practice but is poorly managed and rarely involves ophthalmic assessment. Seasonal allergic conjunctivitis (SAC) is the most common form of allergic eye disease (90%), followed by perennial allergic conjunctivitis (PAC; 5%). Both are type 1 IgE mediated hypersensitivity reactions where mast cells play an important role in pathophysiology. The signs and symptoms are similar but SAC occurs periodically whereas PAC occurs year round. Despite being a relatively mild condition, the effects on the quality of life can be profound and therefore they demand attention. Primary management of SAC and PAC involves avoidance strategies depending on the responsible allergen(s) to prevent the hypersensitivity reaction. Cooled tear supplements and cold compresses may help bring relief. Pharmacological agents may become necessary as it is not possible to completely avoid the allergen(s). There are a wide range of anti-allergic medications available, such as mast cell stabilisers, antihistamines and dual-action agents. Severe cases refractory to conventional treatment require anti-inflammatories, immunomodulators or immunotherapy. Additional qualifications are required to gain access to these medications, but entry-level optometrists must offer advice and supportive therapy. Based on current evidence, the efficacy of anti-allergic medications appears equivocal so prescribing should relate to patient preference, dosing and cost. More studies with standardised methodologies are necessary elicit the most effective anti-allergic medications but those with dual-actions are likely to be first line agents. © 2011 British Contact Lens Association.

Non-manipulable domains for the Borda count

We characterize the preference domains on which the Borda count satises Arrow's "independence of irrelevant alternatives" condition. Under a weak richness condition, these domains are obtained by xing one preference ordering and including all its cyclic permutations ("Condorcet cycles"). We then ask on which domains the Borda count is non-manipulable. It turns out that it is non-manipulable on a broader class of domains when combined with appropriately chosen tie-breaking rules. On the other hand, we also prove that the rich domains on which the Borda count is non-manipulable for all possible tie-breaking rules are again the cyclic permutation domains.

Preferência e competição alimentar em um grupo de Sapajus flavius em fragmento de Mata Atlântica em Caaporã – Paraíba – Brasil

Feeding is the primary selective pressure in all forms of animals. Nutritional ecological models predict consequences of preferred and non-preferred food consumption on behavioural, physiological and morphological adaptations. At same time, socioecological models infer socio-organizarion patterns based on feeding competition faced by animals. A list of preferred foods, and inferences regarding the intensity of feeding competition and its behavioural consequences are information of much importance for management of populations in fragments. In this work we observed the feeding behavior and spatial positioning of a group of more than 100 blond capuchin monkeys (Sapajus flavius) that inhabit a fragment of Atlantic forest, surrounded by sugarcane plantation. We compared the consumption of different food items with their monthly availability in the area to define the preferred and fallback food items. We recorded the vocalizations of aggression and the inter-individual distance (area of Minimum Convex Polygon/n individuals) to infer the type of food competition experienced by animals. In the year studied the fruit feeding time correlated with top consumed fruit productivity, indicating preference for fruits. Our data indicate that the species Elaeis sp., Cecropia palmata, Inga spp. and Simarouba amara are the preferred food items in the diet. Available all year round and uniformly distributed, sugarcane was a regular item in the diet and its was characterized as a staple fallback food for this group. Although fruits are preferential food items, direct competition rate did not correlate to fruit productivity in the area, maintaining the high rates throughout the year (2.45 events/ hour). The inter-individual distance index positively correlated with rain fall indicating scramble food competition. The number of neighbours of females carrying infants was smaller when fruit productivity is low, indicating that females carrying infants are suffering increased indirect competition. Our data indicates that blond capuchins in this fragment make use of sugar cane as a staple fallback food, which evidence the importance of sugar cane landscape for the survival of this critically endangered capuchin species in fragmented habitats in Northeast Brazil. A preliminary list of preferred and important foods is offered, and can assist in the choice of trees for reforestation, better fragments to be preserved and areas of release and translocation of animals. We did not observe an increase of contest competition while using preferred foods, but when using staple FBF. This may be due the altered environment, which results in high competition food throughout the year. Both the food preference as the social and behavioral consequences of high food competition experienced by animals in this fragment must be accompanied over the years to ensure the survival of this population.

Preferência e competição alimentar em um grupo de Sapajus flavius em fragmento de Mata Atlântica em Caaporã – Paraíba – Brasil

Feeding is the primary selective pressure in all forms of animals. Nutritional ecological models predict consequences of preferred and non-preferred food consumption on behavioural, physiological and morphological adaptations. At same time, socioecological models infer socio-organizarion patterns based on feeding competition faced by animals. A list of preferred foods, and inferences regarding the intensity of feeding competition and its behavioural consequences are information of much importance for management of populations in fragments. In this work we observed the feeding behavior and spatial positioning of a group of more than 100 blond capuchin monkeys (Sapajus flavius) that inhabit a fragment of Atlantic forest, surrounded by sugarcane plantation. We compared the consumption of different food items with their monthly availability in the area to define the preferred and fallback food items. We recorded the vocalizations of aggression and the inter-individual distance (area of Minimum Convex Polygon/n individuals) to infer the type of food competition experienced by animals. In the year studied the fruit feeding time correlated with top consumed fruit productivity, indicating preference for fruits. Our data indicate that the species Elaeis sp., Cecropia palmata, Inga spp. and Simarouba amara are the preferred food items in the diet. Available all year round and uniformly distributed, sugarcane was a regular item in the diet and its was characterized as a staple fallback food for this group. Although fruits are preferential food items, direct competition rate did not correlate to fruit productivity in the area, maintaining the high rates throughout the year (2.45 events/ hour). The inter-individual distance index positively correlated with rain fall indicating scramble food competition. The number of neighbours of females carrying infants was smaller when fruit productivity is low, indicating that females carrying infants are suffering increased indirect competition. Our data indicates that blond capuchins in this fragment make use of sugar cane as a staple fallback food, which evidence the importance of sugar cane landscape for the survival of this critically endangered capuchin species in fragmented habitats in Northeast Brazil. A preliminary list of preferred and important foods is offered, and can assist in the choice of trees for reforestation, better fragments to be preserved and areas of release and translocation of animals. We did not observe an increase of contest competition while using preferred foods, but when using staple FBF. This may be due the altered environment, which results in high competition food throughout the year. Both the food preference as the social and behavioral consequences of high food competition experienced by animals in this fragment must be accompanied over the years to ensure the survival of this population.

Body composition changes in acute stroke by type of feeding regimen

Funded by University of East Anglia Birzeit University

Seawater carbonate chemistry and brown dottyback (Pseudochromis fuscus) movement and feeding behaviour during experiments, 2011

Changes in olfactory-mediated behaviour caused by elevated CO2 levels in the ocean could affect recruitment to reef fish populations because larval fish become more vulnerable to predation. However, it is currently unclear how elevated CO2 will impact the other key part of the predator-prey interaction - the predators. We investigated the effects of elevated CO2 and reduced pH on olfactory preferences, activity levels and feeding behaviour of a common coral reef meso-predator, the brown dottyback (Pseudochromis fuscus). Predators were exposed to either current-day CO2 levels or one of two elevated CO2 levels (~600 µatm or ~950 µatm) that may occur by 2100 according to climate change predictions. Exposure to elevated CO2 and reduced pH caused a shift from preference to avoidance of the smell of injured prey, with CO2treated predators spending approximately 20% less time in a water stream containing prey odour compared with controls. Furthermore, activity levels of fish was higher in the high CO2 treatment and feeding activity was lower for fish in the mid CO2treatment; indicating that future conditions may potentially reduce the ability of the fish to respond rapidly to fluctuations in food availability. Elevated activity levels of predators in the high CO2 treatment, however, may compensate for reduced olfactory ability, as greater movement facilitated visual detection of food. Our findings show that, at least for the species tested to date, both parties in the predator-prey relationship may be affected by ocean acidification. Although impairment of olfactory-mediated behaviour of predators might reduce the risk of predation for larval fishes, the magnitude of the observed effects of elevated CO2 acidification appear to be more dramatic for prey compared to predators. Thus, it is unlikely that the altered behaviour of predators is sufficient to fully compensate for the effects of ocean acidification on prey mortality.

Alcoholic Beverage Preference and Dietary Habits in Elderly across Europe: Analyses within the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES) Project

INTRODUCTION: The differential associations of beer, wine, and spirit consumption on cardiovascular risk found in observational studies may be confounded by diet. We described and compared dietary intake and diet quality according to alcoholic beverage preference in European elderly.

METHODS: From the Consortium on Health and Ageing: Network of Cohorts in Europe and the United States (CHANCES), seven European cohorts were included, i.e. four sub-cohorts from EPIC-Elderly, the SENECA Study, the Zutphen Elderly Study, and the Rotterdam Study. Harmonized data of 29,423 elderly participants from 14 European countries were analyzed. Baseline data on consumption of beer, wine, and spirits, and dietary intake were collected with questionnaires. Diet quality was assessed using the Healthy Diet Indicator (HDI). Intakes and scores across categories of alcoholic beverage preference (beer, wine, spirit, no preference, non-consumers) were adjusted for age, sex, socio-economic status, self-reported prevalent diseases, and lifestyle factors. Cohort-specific mean intakes and scores were calculated as well as weighted means combining all cohorts.

RESULTS: In 5 of 7 cohorts, persons with a wine preference formed the largest group. After multivariate adjustment, persons with a wine preference tended to have a higher HDI score and intake of healthy foods in most cohorts, but differences were small. The weighted estimates of all cohorts combined revealed that non-consumers had the highest fruit and vegetable intake, followed by wine consumers. Non-consumers and persons with no specific preference had a higher HDI score, spirit consumers the lowest. However, overall diet quality as measured by HDI did not differ greatly across alcoholic beverage preference categories.

DISCUSSION: This study using harmonized data from ~30,000 elderly from 14 European countries showed that, after multivariate adjustment, dietary habits and diet quality did not differ greatly according to alcoholic beverage preference.

Effects of mass and body composition on fasting fuel utilisation in grey seal pups (Halichoerus grypus Fabricius): an experimental study using supplementary feeding

This study used supplementary feeding to test the hypothesis that fuel partitioning during the postweaning fast in grey seal pups is affected by size and composition of energy reserves at weaning, and by extra provisioning. Mass and body composition changes were measured during suckling and fasting to investigate the effect of natural differences in energy reserves at weaning on subsequent allocation of fat and protein to energy use. We fed seven pups for 5 days after weaning, to investigate the effect of increased fuel availability, and particularly protein, on fuel utilisation. After correcting for protein used during the moult, the proportional contribution of fat was 86–99% of total energy use. Pups with greater energy reserves, i.e. those that were heavier and fatter at weaning, had higher rates of fat and energy use. There was no significant relationship between adiposity at weaning and proportional contribution of fat to energy use, perhaps due to a limited sample size or range of body masses and adiposity. Supplemented individuals used energy, specifically fat, much faster and utilised proportionally less of their endogenous protein by departure than non-supplemented individuals. Fat metabolism contributed a similar percentage to daily energy use in both groups. These findings show that pups spare protein, even when energy use is dramatically increased. Pups that receive greater maternal provisioning and lay down more protein may have increased survival chances at sea. This study highlights the importance of protein reserves in first year survival of grey seal pups.

THE PRICE SENSITIVITY OF DEMAND FOR HIGHER EDUCATION AMONG NON-TRADITIONAL STUDENTS

This dissertation examines the price sensitivity of demand for higher education among non-traditional students in the United States. Chapter 1 discusses the issues related to the demand for higher education. It presents the recent trends and reviews the literature addressing these issues. A major conclusion that emerges from this chapter is that the price sensitivity of demand for higher education appears to depend on the source of the variation in price and the characteristics of the students who face the price change. The baseline estimate for the price sensitivity of demand is that a $1,000 (in year 2000 dollars) decrease in tuition costs should result in a 4 percentage-point increase in enrollment for the traditional 18- to 24-year-old student. Chapter 2 examines the price sensitivity of demand for higher education for military spouses resulting from variation in tuition due to military-mandated moves across states. The data suggest that a $1,000 (in year 2000 dollars) decrease in the cost of 2-year schools is associated with a 1--1.5 percentage-point increase in the probability of attending college. This estimate is less than half the previous estimates due to in-state tuition price differences faced by the civilian 18- to 24-year-old population on a percentage-point basis. However, this represents a 7--10 percent increase for this population, and the magnitude of this metric is in line with previous estimates. This suggests tuition assistance can be an effective means of increasing enrollment for military spouses, but other barriers to education for this population may also need to be addressed. Chapter 3 examines the impact of a change in the tax treatment of savings set aside for higher education by those who decide to suspend their education and enter the workforce. The taxation of these funds appears to have increased the rate at which these funds are included in an employee's initial contract and the quantity of funds allocated. These results are counterintuitive if the tax preference was the primary reason for the savings plan. However, these results suggest the rationale for the savings plan was to offer targeted additional compensation to recruits with greater negotiating power. Taxation of funds previously set aside did not appear to have a statistically significant impact on their utilization. Point estimates of the price sensitivity of demand from changes in the out-of-pocket costs for higher education induced by the taxation of these funds were small and often not statistically significant. The results from this dissertation show responses to changes in the net cost of college that differ by the source of price variation and the population experiencing them. This is consistent with the previous literature. This dissertation contributes to the literature by providing estimates for the price sensitivity of demand for higher education to previously understudied non-traditional students.

Supra-treatment threshold neonatal jaundice: Incidence in HIV-exposed compared to non-exposed neonates at Queen Elizabeth Central Hospital in Blantyre, Malawi

Introduction Jaundice is the yellowish pigmentation of the skin, sclera, and mucous membranes resulting from bilirubin deposition. Children born to mothers with HIV are more likely to be born premature, with low birth weight, and to become septic—all risk factors for neonatal jaundice. Further, there has been a change in the prevention of mother-to-child transmission (PMTCT) of HIV guidelines from single-dose nevirapine to a six-week course, all of which theoretically put HIV-exposed newborns at greater risk of developing neonatal jaundice. Aim We carried out a study to determine the incidence of severe and clinical neonatal jaundice in HIV-exposed neonates admitted to the Chatinkha Nursery (CN) neonatal unit at Queen Elizabeth Central Hospital (QECH) in Blantyre. Methods Over a period of four weeks, the incidence among non-exposed neonates was also determined for comparison between the two groups of infants. Clinical jaundice was defined as transcutaneous bilirubin levels greater than 5 mg/dL and severe jaundice as bilirubin levels above the age-specific treatment threshold according the QECH guidelines. Case notes of babies admitted were retrieved and information on birth date, gestational age, birth weight, HIV status of mother, type of feeding, mode of delivery, VDRL status of mother, serum bilirubin, duration of stay in CN, and outcome were extracted. Results Of the 149 neonates who were recruited, 17 (11.4%) were HIV-exposed. One (5.88%) of the 17 HIV-exposed and 19 (14.4%) of 132 HIVnon- exposed infants developed severe jaundice requiring therapeutic intervention (p = 0.378). Eight (47%) of the HIV-exposed and 107 (81%) of the non-exposed neonates had clinical jaundice of bilirubin levels greater than 5 mg/dL (p < 0.001). Conclusions The study showed a significant difference in the incidence of clinical jaundice between the HIV-exposed and HIV-non-exposed neonates. Contrary to our hypothesis, however, the incidence was greater in HIVnon- exposed than in HIV-exposed infants.

Don’t expect me to vote for you just because I like you, even if you do make me feel warm inside: a comparison of the validity of non-ipsative measures of party support

The inclusion of non-ipsative measures of party preference (in essence ratings for each of the parties of a political system) has become established practice in mass surveys conducted for election studies. They exist in different forms, known as thermometer ratings or feeling scores, likes and dislikes scores, or support propensities. Usually only one of these is included in a single survey, which makes it difficult to assess the relative merits of each. The questionnaire of the Irish National Election Study 2002 (INES2002) contained three different batteries of non-ipsative party preferences. This paper investigates some of the properties of these different indicators. We focus in particular on two phenomena. First, the relationship between non-ipsative preferences and the choices actually made on the ballot. In Ireland this relationship is more revealing than in most other countries owing to the electoral system (STV) which allows voters to cast multiple ordered votes for candidates from different parties. Second, we investigate the latent structure of each of the batteries of party preferences and the relationships between them. We conclude that the three instruments are not interchangeable, that they measure different orientations, and that one –the propensity to vote for a party– is by far preferable if the purpose of the study is the explanation of voters’ actual choice behaviour. This finding has important ramifications for the design of election study questionnaires.

Effect of intermittent feeding on growth in early juveniles of the crayfish Cherax quadricarinatus

Three experiments were conducted with juveniles of the crayfish Cherax quadricarinatus to investigate the effect of intermittent feeding regimes on growth and the ability to tolerate the shortage of food. In experiment 1, stage III juveniles were assigned to one of seven intermittent feeding groups (from FS1: 1 day fed/1 day non-fed to FS7: 7 days fed/7 days non-fed) and two control groups, continuously fed (CF) and continuously starved (CS) animals; this experiment comprised a short-term intermittent feeding period until the first molt, followed by a continuous feeding period. In the experiment 2, stage III juveniles were assigned to one of three intermittent feeding groups (FS2 to FS4) and one control group (CF); it consisted of a prolonged intermittent feeding period, until the end of the experiment In the experiment 3, stage VI and VII juveniles were assigned to one of three intermittent feeding groups (FS2 to FS4) and one control (CF); it also consisted of a prolonged intermittent feeding period. The red claw crayfish juveniles were able to tolerate periods of intermittent feeding and underwent compensatory growth after continuous feed was re-established. The ability of crayfish to tolerate intermittent feeding was influenced by developmental stage and duration of the intermittent feeding period. Stage III juveniles survived, but decreased growth, when subjected to prolonged intermittent feeding. However, they showed full compensatory growth when the intermittent feeding period was short and followed by continuous feeding. on the other hand, stage VI-VII tolerated 60 days of prolonged intermittent feeding without any change in growth and survival. The hepatosomatic index (based on wet weight) values of the treatments and the control were similar, suggesting that intermittent feeding may not be considered a nutritional stress condition. The relative pleon weight (based on wet weight) values of the treatments and control were similar suggesting low use of nutrients from the muscle to increase the chance for survival. The juveniles of C quadricarinatus can tolerate relatively long periods of low food availability and this is an important adaptation for their survival in changing/unpredictable environments and an attribute favorable for the production of the species. (C) 2011 Elsevier B.V. All rights reserved.