Let's talk about health: shoppers' discourse regarding health while food shopping

Objective: The present study aimed to examine the role of health in consumers’ food purchasing decisions through investigating the nature of people’s discourse regarding health while conducting their food shopping.

Design: The study employed the think-aloud technique as part of an accompanied shop. All mentions of health and terms relating to health were identified from the data set. Inductive thematic analysis was conducted to examine how health was talked about in relation to people’s food choice decisions.

Setting: Supermarkets in Dublin, Republic of Ireland and Belfast, Northern Ireland.

Subjects Participants: (n 50) were aged over 18 years and represented the main household shopper.

Results: Responsibility for others and the perceived need to illicit strict control to avoid ‘unhealthy’ food selections played a dominant role in how health was talked about during the accompanied shop. Consequently healthy shopping was viewed as difficult and effort was required to make the healthy choice, with shoppers relating to product-based inferences to support their decisions.

Conclusions: This qualitative exploration has provided evidence of a number of factors influencing the consideration of health during consumers’ food shopping. These results highlight opportunities for stakeholders such as public health bodies and the food industry to explore further ways to help enable consumers make healthy food choices.

Transition from Children’s to Adult Services forYoung People with Life-limiting Conditions: Findings from a Questionnaire Survey in Northern Ireland

Research aims: 
To describe service provision for the transition from children’s to adult services for young people with life-limiting conditions in Northern Ireland, and to identify organisational factors that promote or inhibit effective transition. 
Study population: 
Health, social, educational and charitable organisations providing transition services to young people with life-limiting conditions in Northern Ireland. 
Study design and methods: 
A questionnaire has been developed by the research team drawing on examples from the literature and the advice of an expert advisory group. The questionnaire was piloted with clinicians,academics and researchers in June 2013. The questionnaire focuses on components of practice which may promote continuity in the transition from child to adult care for young people with a life-limiting condition. The survey will be distributed throughout Northern Ireland to an estimated 75 organisations, following the Dillman total design survey method. Numerical data will be analysed using PASW Statistical software to generate descriptive statistics along with a thematic analysis of data generated by open-ended questions. 
Results and interpretations: 
The survey will provide a description of services, transition policies, approaches to managing transition, categories of service users, the ages at which transition starts and completes, experiences with minority ethnic groups, the input of service users to the process, organisational factors promoting or hindering effective transition, links between services, and service providers’ recommendations for improvements in services.The outcomes will be an overview of the transition services currently provided in Northern Ireland identifying models of good practice and the key factors influencing the quality, safety and continuity of care. Survey results are due early in 2014.

Holocene “turn-on” and evolution of the Southern Great Barrier Reef: Revisiting reef cores from the Capricorn Bunker Group

Extensive drilling of the Great Barrier Reef (GBR) in the 70s and 80s illuminated the main factors controlling reef growth during the Holocene. However, questions remain about: (1) the precise nature and timing of reef "turnon" or initiation, (2) whether consistent spatio-temporal patterns occur in the bio-sedimentologic response of the reef to Holocene sea-level rise then stability, and (3) how these factors are expressed in the context of the different evolutionary states (juvenile-mature-senile reefs). Combining 21 new C14-AMS and 146 existing recalibrated radiocarbon and U/Th ages, we investigated the detailed spatial and temporal variations in sedimentary facies and coralgal assemblages in fifteen cores across four reefs (Wreck, Fairfax, One Tree and Fitzroy) from the Southern GBR. Our newly defined facies and assemblages record distinct chronostratigraphic patterns in the cores, displaying both lateral zonation across the different reefs and shallowing upwards sequences, characterised by a transition from deep (Porites/faviids) to shallow (Acropora/Isopora) coral types. The revised reef accretion curves show a significant lag period, ranging from 0.7-2 ka, between flooding of the antecedent Pleistocene substrate and Holocene reef turn-on. This lag period and dominance of more environmentally tolerant early colonizers (e.g., domal Porites and faviids), suggests initial conditions that were unfavourable for coral growth. We contend that higher input of fine siliciclastic material from regional terrigenous sources, exposure to hydrodynamic forces and colonisation in deeper waters are the main factors influencing initially reduced growth and development. All four reefs record a time lag and we argue that the size and shape of the antecedent platform is most important in determining the duration between flooding and recolonisation of the Holocene reef. Finally, our study of Capricorn Bunker Group Holocene reefs suggests that the size and shape of the antecedent substrate has a greater impact on reef evolution and final evolutionary state (mature vs. senile), than substrate depth alone. 

High variability in the dosing of commonly used antibiotics revealed by a Europe-wide point prevalence study: implications for research and dissemination

BACKGROUND: Antibiotic dosing in neonates varies between countries and centres, suggesting suboptimal exposures for some neonates. We aimed to describe variations and factors influencing the variability in the dosing of frequently used antibiotics in European NICUs to help define strategies for improvement.

METHODS: A sub-analysis of the European Study of Neonatal Exposure to Excipients point prevalence study was undertaken. Demographic data of neonates receiving any antibiotic on the study day within one of three two-week periods from January to June 2012, the dose, dosing interval and route of administration of each prescription were recorded. The British National Formulary for Children (BNFC) and Neofax were used as reference sources. Risk factors for deviations exceeding ±25% of the relevant BNFC dosage recommendation were identified by multivariate logistic regression analysis.

RESULTS: In 89 NICUs from 21 countries, 586 antibiotic prescriptions for 342 infants were reported. The twelve most frequently used antibiotics - gentamicin, penicillin G, ampicillin, vancomycin, amikacin, cefotaxime, ceftazidime, meropenem, amoxicillin, metronidazole, teicoplanin and flucloxacillin - covered 92% of systemic prescriptions. Glycopeptide class, GA <32 weeks, 5(th) minute Apgar score <5 and geographical region were associated with deviation from the BNFC dosage recommendation. While the doses of penicillins exceeded recommendations, antibiotics with safety concerns followed (gentamicin) or were dosed below (vancomycin) recommendations.

CONCLUSIONS: The current lack of compliance with existing dosing recommendations for neonates needs to be overcome through the conduct of well-designed clinical trials with a limited number of antibiotics to define pharmacokinetics/pharmacodynamics, efficacy and safety in this population and by efficient dissemination of the results.

Does ageism still exist in nurse education?

Worldwide demographic changes mean that older people represent a significant group of patients for nurses everywhere. Ageism is increasingly recognised as an issue among healthcare professionals and evidence suggests that problems with quality of care remain. Nursing curricula have to address the needs of an ageing population in a variety of settings, reflect the importance of therapeutic care and explore nursing students’ attitudes, in order to provide them with the appropriate skills to meet the needs of older people. This article debates the main factors influencing gerontological content in nursing curricula and suggests that ageism is still evident in nurse education. A variety of strategies are identified to assist in developing appropriate curriculum content.

Physiological stress in the Eurasian badger (Meles meles): Effects of host, disease and environment

A method for monitoring hypothalamic–pituitary–adrenal (HPA) responses of the Eurasian badger (Meles meles) to stressors was validated by measuring cortisol excretion in serum and faeces. Serum and faecal samples were collected under anaesthesia from live-captured, wild badgers and fresh faeces was collected from latrines at 15 social groups in County Down, Northern Ireland. Variation in levels of cortisol in wild badgers was investigated relative to disease status, season, age, sex, body mass, body condition and reproductive status and environmental factors that might influence stress. Faecal cortisol levels were significantly higher in animals testing culture-positive for Mycobacterium bovis. Prolonged elevation of cortisol can suppress immune function, which may have implications for disease transmission. There was a strong seasonal pattern in both serum cortisol, peaking in spring and faecal cortisol, peaking in summer. Cortisol levels were also higher in adults with poor body condition and low body mass. Faecal samples collected from latrines in grassland groups had significantly higher cortisol than those collected from woodland groups, possibly as a result of greater exposure to sources of environmental stress. This study is the first to investigate factors influencing physiological stress in badgers and indicates that serological and faecal excretion are valid indices of the HPA response to a range of stressors.

IGF-Binding Protein 2 - Oncogene or Tumor Suppressor?

The role of insulin-like growth factor binding protein 2 (IGFBP2) in cancer is unclear. In general, IGFBP2 is considered to be oncogenic and its expression is often observed to be elevated in cancer. However, there are a number of conflicting reports in vitro and in vivo where IGFBP2 acts in a tumor suppressor manner. In this mini-review, we discuss the factors influencing the variation in IGFBP2 expression in cancer and our interpretation of these findings.

Spatial variation in adult sex ratio across multiple scales in the invasive golden apple snail, Pomacea canaliculata

Adult sex ratio (ASR) has critical effects on behavior and life history and has implications for population demography, including the invasiveness of introduced species. ASR exhibits immense variation in nature, yet the scale dependence of this variation is rarely analyzed. In this study, using the generalized multilevel models, we investigated the variation in ASR across multiple nested spatial scales and analyzed the underlying causes for an invasive species, the golden apple snail Pomacea canaliculata. We partitioned the variance in ASR to describe the variations at different scales and then included the explanatory variables at the individual and group levels to analyze the potential causes driving the variation in ASR. We firstly determined there is a significant female-biased ASR for this species when accounting for the spatial and temporal autocorrelations of sampling. We found that, counter to nearly equal distributed variation at plot, habitat and region levels, ASR showed little variation at the town level. Temperature and precipitation at the region level were significantly positively associated with ASR, whereas the individual weight, the density characteristic, and sampling time were not significant factors influencing ASR. Our study suggests that offspring sex ratio of this species may shape the general pattern of ASR in the population level while the environmental variables at the region level translate the unbiased offspring sex ratio to the female-biased ASR. Future research should consider the implications of climate warming on the female-biased ASR of this invasive species and thus on invasion pattern.

Gendered Candidate Selection and the Representation of Women in Northern Ireland

In an attempt to account for the exceptionally low levels of female representation in Northern Ireland, this paper provides an analysis of the contemporary candidate selection procedures of the region's five main political parties. Drawing on evidence gathered from 29 elite interviews, plus official internal party documents, the study finds that the localised nature of the parties' selection procedures may disadvantage women aspirants. Also important are ‘supply-side’ factors influencing legislative recruitment and female participation rates, namely the strongly embedded social norm of female domestic responsibility, a masculinised political culture and the lack of confidence of potential female candidates.

A Systematic Review of End-of-Life Visual Impairment in Open-Angle Glaucoma: An Epidemiological Autopsy

PURPOSE: Glaucoma patients are still at risk of becoming blind. It is of clinical significance to determine the risk of blindness and its causes to prevent its occurrence. This systematic review estimates the number of treated glaucoma patients with end-of-life visual impairment (VI) and blindness and the factors that are associated with this.

METHODS: A systematic literature search in relevant databases was conducted in August 2014 on end-of-life VI. A total of 2574 articles were identified, of which 5 on end-of-life VI. Several data items were extracted from the reports and presented in tables.

RESULTS: All studies had a retrospective design. A considerable number of glaucoma patients were found to be blind at the end of their life; with up to 24% unilateral and 10% bilateral blindness. The following factors were associated with blindness: (1) baseline severity of visual field loss: advanced stage of glaucoma or substantial visual field loss at the initial visit; (2) factors influencing progression: fluctuation of intraocular pressure (IOP) during treatment, presence of pseudoexfoliation, poor patient compliance, higher IOP; (3) longer time period: longer duration of disease and older age at death because of a longer life expectancy; and (4) coexistence of other ocular pathology.

CONCLUSIONS: Further prevention of blindness in glaucoma patients is needed. To reach this goal, it is important to address the risk factors for blindness identified in this review, especially those that can be modified, such as advanced disease at diagnosis, high and fluctuating IOP, and poor compliance.

Modelling the Minho river plume intrusion into the rias baixas

The Minho River, situated 30 km south of the Rias Baixas is the most important freshwater source flowing into the Western Galician Coast (NW of the Iberian Peninsula). This discharge is important to determine the hydrological patterns adjacent to its mouth, particularly close to the Galician coastal region. The buoyancy generated by the Minho plume can flood the Rias Baixas for long periods, reversing the normal estuarine density gradients. Thus, it becomes important to analyse its dynamics as well as the thermohaline patterns of the areas affected by the freshwater spreading. Thus, the main aim of this work was to study the propagation of the Minho estuarine plume to the Rias Baixas, establishing the conditions in which this plume affects the circulation and hydrographic features of these coastal systems, through the development and application of the numerical model MOHID. For this purpose, the hydrographic features of the Rias Baixas mouths were studied. It was observed that at the northern mouths, due to their shallowness, the heat fluxes between the atmosphere and ocean are the major forcing, influencing the water temperature, while at the southern mouths the influence of the upwelling events and the Minho River discharge were more frequent. The salinity increases from south to north, revealing that the observed low values may be caused by the Minho River freshwater discharge. An assessment of wind data along the Galician coast was carried out, in order to evaluate the applicability of the study to the dispersal of the Minho estuarine plume. Firstly, a comparative analysis between winds obtained from land meteorological stations and offshore QuikSCAT satellite were performed. This comparison revealed that satellite data constitute a good approach to study wind induced coastal phenomena. However, since the numerical model MOHID requires wind data with high spatial and temporal resolution close to the coast, results of the forecasted model WRF were added to the previous study. The analyses revealed that the WRF model data is a consistent tool to obtain representative wind data near the coast, showing good results when comparing with in situ wind observations from oceanographic buoys. To study the influence of the Minho buoyant discharge influence on the Rias Baixas, a set of three one-way nested models was developed and implemented, using the numerical model MOHID. The first model domain is a barotropic model and includes the whole Iberian Peninsula coast. The second and third domains are baroclinic models, where the second domain is a coarse representation of the Rias Baixas and adjacent coastal area, while the third includes the same area with a higher resolution. A bi-dimensional model was also implemented in the Minho estuary, in order to quantify the flow (and its properties) that the estuary injects into the ocean. The chosen period for the Minho estuarine plume propagation validation was the spring of 1998, since a high Minho River discharge was reported, as well as favourable wind patterns to advect the estuarine plume towards the Rias Baixas, and there was field data available to compare with the model predictions. The obtained results show that the adopted nesting methodology was successful implemented. Model predictions reproduce accurately the hydrodynamics and thermohaline patterns on the Minho estuary and Rias Baixas. The importance of the Minho river discharge and the wind forcing in the event of May 1998 was also studied. The model results showed that a continuous moderate Minho River discharge combined with southerly winds is enough to reverse the Rias Baixas circulation pattern, reducing the importance of the occurrence of specific events of high runoff values. The conditions in which the estuarine plume Minho affects circulation and hydrography of the Rias Baixas were evaluated. The numerical results revealed that the Minho estuarine plume responds rapidly to wind variations and is also influenced by the bathymetry and morphology of the coastline. Without wind forcing, the plume expands offshore, creating a bulge in front of the river mouth. When the wind blows southwards, the main feature is the offshore extension of the plume. Otherwise, northward wind spreads the river plume towards the Rias Baixas. The plume is confined close to the coast, reaching the Rias Baixas after 1.5 days. However, for Minho River discharges higher than 800 m3 s-1, the Minho estuarine plume reverses the circulation patterns in the Rias Baixas. It was also observed that the wind stress and Minho River discharge are the most important factors influencing the size and shape of the Minho estuarine plume. Under the same conditions, the water exchange between Rias Baixas was analysed following the trajectories particles released close to the Minho River mouth. Over 5 days, under Minho River discharges higher than 2100 m3 s-1 combined with southerly winds of 6 m s-1, an intense water exchange between Rias was observed. However, only 20% of the particles found in Ria de Pontevedra come directly from the Minho River. In summary, the model application developed in this study contributed to the characterization and understanding of the influence of the Minho River on the Rias Baixas circulation and hydrography, highlighting that this methodology can be replicated to other coastal systems.

Fatores de atratividade para investimento direto estrangeiro no setor do turismo português

Muitas são as teorias que sugerem uma explicação para a realização do comércio internacional, tentando justificar porque é que determinados países são mais atrativos para Investimento Direto Estrangeiro (IDE) do que outros. A revisão de literatura realizada no âmbito desta investigação permitiu perceber que, embora sejam muitas as teorias existentes, os autores são unânimes ao afirmar que a internacionalização das empresas, através de IDE, é influenciada por fatores de atração relacionados com as características específicas dos países de acolhimento (meio envolvente contextual e transacional) e por fatores impulsionadores relacionados com características específicas das empresas e do país de origem das mesmas. Apesar do número existente de estudos sobre IDE ser vasto, são poucos aqueles que analisam este tipo de investimento no setor do Turismo e inexistentes os que analisam o IDE no setor do Turismo português. A presente investigação pretende colmatar essa lacuna e tem como objetivo identificar os principais fatores de atratividade para IDE no setor do Turismo português. Para o efeito, foi construído um modelo teórico onde foram considerados como fatores de atração seis fatores relacionados com o meio envolvente de Portugal e cinco fatores relacionados com o setor do Turismo. Como fatores impulsionadores consideraram-se aspetos relativos ao país de origem das empresas estrangeiras e às características endógenas das mesmas. A metodologia utilizada para validar o modelo e respetivas hipóteses assentou, numa primeira fase, na elaboração de entrevistas exploratórias semiestruturadas à Agência para o Investimento e Comércio Externo de Portugal e ao Turismo de Portugal. Numa segunda fase, foram aplicados inquéritos por questionário aos investidores estrangeiros a explorar empreendimentos turísticos e unidades de alojamento local em Portugal continental. Foram considerados válidos para análise 53 questionários, representando 63,9% do universo de investidores estrangeiros em Portugal (subsetor do Alojamento), responsáveis pela exploração de 20.999 camas. Os resultados obtidos no âmbito deste estudo permitem concluir que a localização geográfica de Portugal, a imagem/marca do setor do Turismo português e a oferta turística portuguesa são considerados os fatores de atração mais importantes para IDE. As afinidades culturais e históricas foram consideradas fatores de atração pelos investidores de pequena dimensão, enquanto a procura turística foi considerada atrativa pelos investidores de média/grande dimensão. Este estudo identificou claramente que os maiores entraves ao IDE são a burocracia, a carga fiscal e a atual situação económica do país. Conclui-se, ainda, que os países que mais investem no setor do Turismo português são também os principais emissores de turistas para Portugal e que investidores provenientes de diferentes mercados de origem procuram diferentes regiões em Portugal para investir. Por fim, apresentam-se as principais contribuições da investigação do ponto de vista teórico e prático, indicam-se algumas limitações e sugerem-se recomendações para investigações futuras.

Sustainability study of the application of geosynthetic clay liners in hostile and aggressive environments

This paper discusses the sustainable performance of geosynthetic clay liners (GCLs) which are popularly specified as “leachate retaining” or as “water proofing” membranes in the geo-environmental construction industry. Geosynthetic clay liners (GCLs) are composite matting comprising of bentonite clay with two covering geosynthetics. These are innovative labour saving construction material, developed over the last three decades. The paper outlines the variety of Geosynthetic Clay Liners (GCLs) can be classified essentially into two distinctly different forms viz; (a) air dry (< 8% m/c) with granular or powdered bentonite or (b) bentonite cake factory prehydrated to a moisture content (~40% m/c) beyond its shrinkage limit and vacuum extruded as a clay cake to enhance its sustainable performance. The dominant mineral in bentonite clay is the three-layered (2:1) clay mineral montmorillonite. High quality bentonites need to be used in the GCL manufacture. Sodium montmorillonite has the desired characteristic of high swelling capacity, high cation exchange capacity and the consequently very low hydraulic conductivity, providing the basis for the hydraulic sealing medium in GCLs. These encapsulate the active montmorillonite clay minerals which depend on the water and chemical balance between the sealing element and the surrounding geo environment. Quantitative mineralogical analyses and an assessment of the adsorbed cation regime, diffusion coefficients and clay leachate compatibility must necessarily be an integral part of the site appraisal to ensure acceptable long term sustainability and performance. Factors influencing the desired performance of bentonite in the GCLs placed in difficult construction and hostile chemical environments are discussed in this paper. Accordingly, the performance specifications for GCLs are identified and the appropriateness of enhancing the cation exchange capacity with polymer treatment and the need for factory prehydration of the untreated sodium bentonite is emphasised. The advantage of factory prehydrating the polymer treated bentonite to fluid content beyond its shrinkage limit and subsequently factory processing it to develop laminated clay is to develop a GCL that has enviable sealing characteristics with a greater resistance to geochemical attack and cracking. Since clay liners are buried in the ground as base liners, capping layer or as structural water proofing membrane, they can easily avoid strict quality and performance monitoring being “out of sight, out of mind!”. It is very necessary that barrier design for leachate containment must necessarily be in accordance with legislative requirement Assessment of long term hydraulic conductivities and clay-leachate compatibility assessment is deemed necessary. The derogatory factors affecting the sustainable performance of the bentonite in GCLs placed in difficult construction and hostile chemical environments are discussed. Sustainability concepts incorporated in waste management practice must aim to achieve 100% recycling and fully implement the handling of solid waste in developing countries with relatively lower labour costs.

Primary production in systems subject to natural and anthropogenic eutrophication

Tese dout., Química, Universidade do Algarve, 2005

Lancefield group C and G streptococci in human infection : molecular typing, virulence and antimicrobial susceptibility

Tese de doutoramento, Ciências e Tecnologias da Saúde (Microbiologia), Universidade de Lisboa, Faculdade de Medicina, 2014