Global standard for the composition of infant formula: Recommendations of an ESPGHAN coordinated international expert group

The Codex Alimentarius Commission of the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO) develops food standards, guidelines and related texts for protecting consumer health and ensuring fair trade practices globally. The major part of the world's population lives in more than 160 countries that are members of the Codex Alimentarius. The Codex Standard on Infant Formula was adopted in 1981 based on scientific knowledge available in the 1970s and is currently being revised. As part of this process, the Codex Committee on Nutrition and Foods for Special Dietary Uses asked the ESPGHAN Committee on Nutrition to initiate a consultation process with the international scientific community to provide a proposal on nutrient levels in infant formulae, based on scientific analysis and taking into account existing scientific reports on the subject. ESPGHAN accepted the request and, in collaboration with its sister societies in the Federation of International Societies on Pediatric Gastroenterology, Hepatology and Nutrition, invited highly qualified experts in the area of infant nutrition to form an International Expert Group (IEG) to review the issues raised. The group arrived at recommendations on the compositional requirements for a global infant formula standard which are reported here.

The treatment of recurrent abdominal pain in children : a controlled comparison of cognitive-behavioral family intervention and standard pediatric care

This study describes the results of a controlled clinical trial involving 44 7- to 14-year-old children with recurrent abdominal pain who were randomly allocated to either cognitive-behavioral family intervention (CBFI) or standard pediatric care (SPC). Both treatment conditions resulted in significant improvements on measures of pain intensity and pain behavior. However, the children receiving CBFI had a higher rate of complete elimination of pain, lower levels of relapse at 6- and 12-month follow-up, and lower levels of interference with their activities as a result of pain and parents reported a higher level of satisfaction with the treatment than children receiving SPC. After controlling for pretreatment levels of pain, children's active self-coping and mothers' caregiving strategies were significant independent predictors of pain behavior at posttreatment.

Physics beyond Standard Model: Working group 3 report

This is a summary of the beyond the Standard Model (including model building working group of the WHEPP-X workshop held at Chennai from January 3 to 15, 2008.

Latitudinal and seasonal effects on growth of the Australian eastern king prawn (Melicertus plebejus)

The growth of the Australian eastern king prawn (Melicertus plebejus) is understood in greater detail by quantifying the latitudinal effect. The latitudinal effect is the change in the species' growth rate during migration. Mark-recapture data (N = 1635, latitude 22.21 degrees S-34.00 degrees S) presents northerly movement of the eastern king prawn, with New South Wales prawns showing substantial average movement of 140 km (standard deviation: 176 km) north. A generalized von Bertalanffy growth model framework is used to incorporate the latitudinal effect together with the canonical seasonal effect. Applying this method to eastern king prawn mark-recapture data guarantees consistent estimates for the latitudinal and seasonal effects. For M. plebejus, it was found that growth rate peaks on 25 and 29 January for males and females, respectively; is at a minimum on 27 and 31 July, respectively; and that the shape parameter, k (per year), changes by -0.0236 and -0.0556 every 1 degree of latitude south increase for males and females, respectively.

Community Pharmacies and the Needs of Mobile EU Citizens - A study on Finns living in Spain

Migration within the European Union (EU) has increased since the Union was established. Community pharmacies provide open access to health care services and can be the first, most frequently used or even the only contact with a nation s health care system among mobile community residents. In some of the mass-migration areas in Southern Europe, most of the customers may represent mobile citizens of foreign background. This has not always been taken into consideration in the development of community pharmacy services. Mobile patients have been on the EU's health policy agenda, but they have seldom been mentioned in the context of community pharmacies. In most of the EU member states, governments control the specific legislation concerning community pharmacies and there is no harmonised pharmaceutical policy or consistent minimal standards for community pharmacy services in the EU. The aim of this study was to understand medication use, the role of community pharmacies and the symptom mitigation process of mobile community residents. Finns living in Spain were used as an example to examine how community pharmacies in a EU member state meet the needs of mobile community residents. The data were collected by a survey in 2002 (response rate 53%, n= 533) and by five focus group discussions in 2006 (n=30). A large number (70%) of the respondents had moved to Spain for health reasons and suffered from chronic morbidity. Community pharmacies had an important role in the healthcare of mobile community residents and the respondents were mostly satisfied with these services. However, several medication safety risks related to community pharmacy practices were identified: 1) Availability of prescription medicines without prescription (e.g., antibiotics, sleeping pills, Viagra®, asthma medications, cardiovascular medicines, psoriasis medicines and analgesics); 2) Irrational use of medicines (e.g., 41% of antibiotic users had bought their antibiotics without a prescription, and the most common reasons for antibiotic self-medication were symptomatic common colds and sore throats); 3) Language barriers between patients and pharmacy professionals; 4) Lack of medication counselling; 5) Unqualified pharmacy personnel providing pharmacotherapy. A fifth of the respondents reported experiencing problems during pharmacy visits in Spain, and the lack of a common language was the source of most of these problems. The findings of this study indicate that regulations and their enforcement can play a crucial role in actually assuring the rational and safe use of medicines. These results can be used in the development of pharmaceutical and healthcare policies in the EU. It is important to define consistent minimum standards for community pharmacy services in the EU. Then, the increasing number of mobile community residents could access safe and high quality health care services, including community pharmacy services, in every member state within the EU.

Composition-controlled metal-insulator transitions and minimum metallic conductivity in the oxide systems LaNi1-xMxO3 (M = Cr, Mn, Fe, or Co)

The composition-controlled metal-insulator transition in the perovskite systems LaNi1-xMxO3 (M = Cr, Mn, Fe, and Co) has been investigated by transport measurements over the temperature range 12-300 K. These systems, which have critical electron densities (nc) in the range (1-2) -1020 electrons cm-3, exhibit sharp metal-insulator transitions at the base temperature. The corresponding minimum metallic conductivity (Ï-min), separating the localized and itinerant electronic regimes, is of the order of 102 ohm-1 cm-1. Particular attention is paid to the idea of Ï-min scaling with nc, and our present results are compared with earlier studies of the metal-insulator transition in low (e.g., Ge:Sb) and high (e.g., metal-ammonia, supercritical Hg) electron-density systems. A link is established between the transport and magnetic properties of the title systems at the metal-insulator transition.

Standard errors and covariance matrices for smoothed rank estimators

A 'pseudo-Bayesian' interpretation of standard errors yields a natural induced smoothing of statistical estimating functions. When applied to rank estimation, the lack of smoothness which prevents standard error estimation is remedied. Efficiency and robustness are preserved, while the smoothed estimation has excellent computational properties. In particular, convergence of the iterative equation for standard error is fast, and standard error calculation becomes asymptotically a one-step procedure. This property also extends to covariance matrix calculation for rank estimates in multi-parameter problems. Examples, and some simple explanations, are given.

The standard you walk past is the standard you accept

In his 2013 three-minute speech on unacceptable behaviour in the workplace, Lieutenant General David Morrison makes the above insightful statement. While the context of the speech is the defence force, the meaning of the powerful message holds true for perioperative nursing. Perioperative nurses are part of a profession. Professions Australia, a national organisation of professional associations which aims to advance and promote professionalism for the benefit of the community, provides us with a definition of a profession2 and perioperative nurses meet this definition. Perioperative nurses possess special knowledge and skills grounded in a widely recognised body of discipline knowledge derived from research, education and high-level training. We control and regulate our own boundaries of work. We adhere to ethical and professional standards and values. Specialty professional practice standards define perioperative nurses as a community of professionals — assisting perioperative nurses when advocating for consistency in quality patient care3. It is an imperative for every professional perioperative nurse to model practice underpinned by the ACORN Standards throughout their workplace. Hence, Lieutenant General Morrison’s profound statement is a mantra each perioperative nurse could readily adopt and model in their practice environment...

Seasonal effects of foliar application of phosphonate on phosphonate translocation, in vitro pollen viability and pollen germination in `Hass' avocado (Persea americana Mill.)

Phosphonate fungicides are used widely in the control of diseases caused by Phytophthora cinnamomi Rands. For the most part phosphonate is seen as a safe to use on crops with phytotoxicity rare. However, recent research has shown that phosphonate has detrimental effects on the floral biology of some indigenous Australian plants. Since phosphonate fungicides are regularly used for the control of Phytophthora root rot in avocados, research was carried out to study the translocation of phosphonate fungicide in 'Hass' trees and any effects on their floral biology. Field-grown trees were sprayed with 0, 0.06 or 0.12 M mono-dipotassium phosphonate (pH 7.2) at summer flush maturity, floral bud break or anthesis. Following treatment, phosphonic acid concentrations were determined in leaves, roots, inflorescence rachi and flowers and in vitro pollen germination and pollen tube growth studied. Phosphonic acid concentration in the roots and floral parts was related to their sink strength at the respective times of application with concentration in roots highest (36.9.mg g±1) after treatment at summer flush maturity and in flowers (234.7 mg g±1) after treatment during early anthesis. Phosphonate at >0.03 M was found to be significantly phytotoxic to in vitro pollen germination and pollen tube growth. However, this rate gave a concentration far in excess of that measured in plant tissues following standard commercial applications of mono-dipotassium phosphonate fungicide. There was a small effect on pollen germination and pollen tube growth when 0.06 and 0.12 M mono-dipotassium phosphonate was applied during early anthesis. However, under favourable pollination and fruit set conditions it is not expected to have commercial impact on tree yield. However, there may be detrimental commercial implications from phosphonate sprays at early anthesis if unfavourable climatic conditions for pollination and fruit set subsequently occur. A commercial implication from this study is that phosphonic acid root concentrations can be elevated and maintained with strategic foliar applications of phosphonate fungicide timed to coincide with peaks in root sink strength. These occur at the end of the spring and summer flushes when shoot growth is relatively quiescent. Additional foliar applications may be advantageous in under high disease-pressure situations but where possible should be timed to minimize overlap with other significant growth events in the tree such as rapid inflorescence, and fruit development and major vegetative flushing.

Teollisuuden ja yhteiskunnan palveluksessa : Arkkitehti Bertel Liljequist (1885 - 1954) tuotantolaitosten suunnittelijana maailmansotien välisenä aikana

My thesis concerns the plans drawn up by architect Bertel Liljequist (1885 1954) for an industrial corporation and a city in Finland during the interwar years. These were two quite different clients: the Kymi Company operating in Kuusankoski and the City of Helsinki. My study includes the micro-examination of the wider social issues involved. That the industrial community and factories in Kuusankoski be constructed correctly in a way supporting corporate strategy was of primary importance for the company s operations. Through the planning process for Helsinki s abattoirs, I show how a city dealt with the twin problems of hygiene and increasing demand for food resulting from a growth in population. I clarify how society and its economic, political and class structures affected the practice of architecture and its expression in the built environment. I analyse how the different backgrounds and starting points of the clients affected the construction projects under study and architect Bertel Liljequist s work. In studying Liljequist as an industrial designer, I have considered it vital to ascertain the client s intentions and objectives within the framework of the prevailing social situation. I examine the meanings the client wished the architecture to express and also to communicate to those working in the factory and the area as well as to the workers living on company land. The social outlook of the owners and management of Kymi Company implicitly affected the appearance of the factory. A brick fairface for the factories was a safe and natural material at the beginning of the 1920s when taking into consideration the events of the 1918 Civil War. To have built a White factory in the style of a defence building would have been provocative. Outside the factory gates, however, the company supported White architecture. The company used the factory buildings to manifest its power and the dwellings to bind the workers and make them loyal to the company. Architecture was thus one way in which the company manifested its position as the higher and undisputed authority. The role of the City of Helsinki within the planning process was for its officials to provide expert opinions but also to arrange study trips for the architect and the abattoir s general manager. The city also decided on the standard of the design. The city s responsibility for the health of its inhabitants and the requirements of modern meat production can be seen in the minimal architecture and clear functionality of the plant. The architecture left no doubt about the trustworthiness of the modern city. Translation: Michael Wynne-Ellis

Multidisciplinary review of teaching and assessing competency attainment by non-medical prescribers

Background Prescribing is a complex task, requiring specific knowledge and skills, and the execution of effective, context-specific clinical reasoning. Systematic reviews indicate medical prescribing errors have a median rate of 7% [IQR 2%-14%] of medication orders [1-3]. For podiatrists pursuing prescribing rights, a clear need exists to ensure practitioners develop a well-defined set of prescribing skills, which will contribute to competent, safe and appropriate practice. Aim To investigate the methods employed to teach and assess the principles of effective prescribing in the undergraduate podiatry program and compare and contrast these findings with four other non-medical professions who undertake prescribing after training at Queensland University of Technology. Method The NPS National Prescribing Competency Standards were employed as the prescribing standard. A curriculum mapping exercise was undertaken to determine whether the prescribing principles articulated in the competency standards were addressed by each profession. Results A range of methods are currently utilised to teach prescribing across disciplines. Application of prescribing competencies to the context of each profession appears to influence the teaching methods used. Most competencies were taught using a multimodal format, including interactive lectures, self-directed learning, tutorial sessions and clinical placement. In particular clinical training was identified as the most consistent form of educating safe prescribers across all five disciplines. Assessment of prescribing competency utilised multiple techniques including written and oral examinations and research tasks, case studies, objective structured clinical examination exercises and the assessment of clinical practice. Effective and reliable assessment of prescribing undertaken by students in diverse settings remains challenging e.g. that occurring in the clinical practice environment. Conclusion Recommendations were made to refine curricula and to promote efficient cross-discipline teaching by staff from the disciplines of podiatry, pharmacy, nurse practitioner, optometry and paramedic science. Students now experience a sophisticated level of multidisciplinary learning in the clinical setting which integrates the expertise and skills of experience prescribers combined with innovative information technology platforms (CCTV and live patient assessments). Further work is required to establish a practical, effective approach to the assessment of prescribing competence especially between the university and clinical settings.

The vaccination-challenge trial: the gold standard test to evaluate the protective efficacy of infectious coryza vaccines

Infectious coryza is an upper respiratory tract disease of chickens with the major impact occurring in multi-age flocks. We investigated the relationship between the level of antibodies, as detected by a haemagglutination-inhibition (HI) assay, in infectious coryza-vaccinated chickens and the protection against challenge in those chickens. In one experiment, chickens given a single dose of either of two infectious coryza vaccines lacked a detectable HI response to vaccination but showed significant levels of protection 11 weeks after vaccination. In contrast, in chickens given two doses of an infectious coryza vaccine and challenged 3 weeks after the second vaccine dose, there was a strong serological response with 36/40 birds having a HI titre of 1/20 or greater. In this trial there was an apparent relationship between titre and subsequent protection, with none of the 32 chickens with a titre of 1/40 or 1/80 showing any clinical signs and only one of the same group yielding the challenge organism on culture. In contrast, three of the four vaccinated chickens with a HI titre less than 1/5 developed the typical clinical signs of coryza and yielded the challenge organism on culture. Overall, our results suggest that HI titres cannot be regarded as a definitive predictor of vaccine efficacy. We suggest that the vaccination-challenge trial is the gold standard for the evaluation of the immune response to infectious coryza vaccines.

Liquefaction Hazard Mapping of Bangalore, South India

his paper presents identification and mapping of vulnerable and safe zones for liquefaction hazard. About 850 bore logs data collected from geotechnical investigation reports have been used to estimate the liquefaction factor of safety for Bangalore Mahanagara palike (BMP) area of about 220 km(2). Liquefaction factor of safety is arrived based on surface level peak ground acceleration presented by Anbazhagan and Sitharam(5) and liquefaction resistance, using corrected standard penetration test (SPT) N values. The estimated factor of safety against liquefaction is used to estimate liquefaction potential index and liquefaction severity index. These values are mapped using Geographical information system (GIS) to identify the vulnerable and safe zones in Bangalore. This study shows that more than 95% of the BMP area is safe against liquefaction potential. However the western part of the BMP is not safe against liquefaction, as it may be subjected to liquefaction with probability of 35 to 65%. Three approaches used in this study show that 1) mapping least factor of safety irrespective of depth may be used to find liquefiable area for worst case. 2) mapping liquefaction potential index can be used to assess the liquefaction severity of the area by considering layer thickness and factor of safety and 3) mapping of liquefaction severity index can be used to access the probability of liquefaction of area.

Harmonising GAP programs for fresh produce in ASEAN region

Many forces are driving the global demand for assurance that fruit and vegetables are safe to eat and of the right quality, and are produced and handled in a manner that does not cause harm to the environment and the health, safety and welfare of workers. The impact of these driving forces is that retailer requirements for suppliers to comply with Good Agricultural Practice (GAP) is increasing and governments are strengthening legal requirements for food safety, environmental protection, and worker health, safety and welfare. The implementation of GAP programs currently within the ASEAN (Association of South East Asian Nations) region varies, with some countries having government certified systems and others beginning the journey with awareness programs for farmers. Under a project funded by the ASEAN Australia Development Cooperation Program, a standard for ASEAN GAP has been developed to harmonise GAP Programs in the region. The goal is to facilitate trade between ASEAN countries and to global markets, improve viability for farmers, and help sustain a safe food supply and the environment. ASEAN GAP is an umbrella standard that individual member countries will benchmark their national programs against to gain equivalence. The scope of ASEAN GAP covers the production, harvesting and postharvest handling of fresh fruit and vegetables on farm and postharvest handling in locations where produce is packed for sale. ASEAN GAP consists of four modules covering food safety, environmental management, worker health, safety and welfare, and produce quality. Each module can be used alone or in combination with other modules. This enables progressive implementation of ASEAN GAP, module by module based on individual country priorities.