Current intakes of EPA and DHA in European populations and the potential of animal-derived foods to increase them

The beneficial effects of long-chain (C chain >= 20) n-3 PUFA are well documented and, overall, increased intake reduces risk of CVD. Recent evidence also points to a role in reducing, age-related decline in cognitive function. The two key fatty acids are EPA (20:5) and DHA (22:6), with current UK recommendation for adults being 450 mg EPA + DHA/d. Whilst some EPA and DHA can be synthesised in vivo from alpha-linolenic acid, recent data indicate this source to be very limited, Suggesting that EPA and DHA should be classified as dietary essentials. In many parts of Europe the daily intake of EPA + DHA by adults and especially young adults (18-24 years) is < 100 mg/d, since many never eat oily fish. Poultry meat contributes small but worthwhile amounts of EPA+DHA. Studies to enrich the EPA+DHA content of animal-derived foods mainly use fish oil in the diet of the animal. Recent work has shown that such enrichment has the potential to provide to the UK adult diet a daily intake of EPA+DHA of about 230 mg, with poultry meat providing the largest amount (74 mg). There are. however. concerns that the Continued and possibly increased use of fish oils in animals diets is not Sustainable and alternative approaches are being examined, including the genetic modification of certain plants to allow them to synthesise EPA and DHA from shorter-chain precursors.

An illustration of the modelling of cost and efficacy data from a clinical trial

Health care providers, purchasers and policy makers need to make informed decisions regarding the provision of cost-effective care. When a new health care intervention is to be compared with the current standard, an economic evaluation alongside an evaluation of health benefits provides useful information for the decision making process. We consider the information on cost-effectiveness which arises from an individual clinical trial comparing the two interventions. Recent methods for conducting a cost-effectiveness analysis for a clinical trial have focused on the net benefit parameter. The net benefit parameter, a function of costs and health benefits, is positive if the new intervention is cost-effective compared with the standard. In this paper we describe frequentist and Bayesian approaches to cost-effectiveness analysis which have been suggested in the literature and apply them to data from a clinical trial comparing laparoscopic surgery with open mesh surgery for the repair of inguinal hernias. We extend the Bayesian model to allow the total cost to be divided into a number of different components. The advantages and disadvantages of the different approaches are discussed. In January 2001, NICE issued guidance on the type of surgery to be used for inguinal hernia repair. We discuss our example in the light of this information. Copyright © 2003 John Wiley & Sons, Ltd.

A review of vertebroplasty for osteoporotic and malignant vertebral compression fractures

Vertebral compression fractures are a common clinical problem and the incidence of them will increase with the ageing population. Traditionally management has been conservative; however, there has been a growing trend towards vertebroplasty as an alternative therapy in patients with persisting severe pain. NICE produced guidance in 2003 recommending the procedure after 4 weeks of conservative management. Recent high-quality studies have been contradictory and there is currently a debate surrounding the role of the procedure with no agreement in the literature. We examine the evidence in both osteoporotic and malignant vertebral compression fractures; we also describe the benefits and side effects, alternative treatment options and the cost of the procedure. Finally, we recommend when vertebroplasty is most appropriately used based on the best available evidence.

Enhancing recovery rates: lessons from year one of IAPT

BACKGROUND: The English Improving Access to Psychological Therapies (IAPT) initiative aims to make evidence-based psychological therapies for depression and anxiety disorder more widely available in the National Health Service (NHS). 32 IAPT services based on a stepped care model were established in the first year of the programme. We report on the reliable recovery rates achieved by patients treated in the services and identify predictors of recovery at patient level, service level, and as a function of compliance with National Institute of Health and Care Excellence (NICE) Treatment Guidelines. METHOD: Data from 19,395 patients who were clinical cases at intake, attended at least two sessions, had at least two outcomes scores and had completed their treatment during the period were analysed. Outcome was assessed with the patient health questionnaire depression scale (PHQ-9) and the anxiety scale (GAD-7). RESULTS: Data completeness was high for a routine cohort study. Over 91% of treated patients had paired (pre-post) outcome scores. Overall, 40.3% of patients were reliably recovered at post-treatment, 63.7% showed reliable improvement and 6.6% showed reliable deterioration. Most patients received treatments that were recommended by NICE. When a treatment not recommended by NICE was provided, recovery rates were reduced. Service characteristics that predicted higher reliable recovery rates were: high average number of therapy sessions; higher step-up rates among individuals who started with low intensity treatment; larger services; and a larger proportion of experienced staff. CONCLUSIONS: Compliance with the IAPT clinical model is associated with enhanced rates of reliable recovery.

Wireless Sensor Networks: MAC protocols and real time applications

Wireless Senor Networks(WSNs) detect events using one or more sensors, then collect data from detected events using these sensors. This data is aggregated and forwarded to a base station(sink) through wireless communication to provide the required operations. Different kinds of MAC and routing protocols need to be designed for WSN in order to guarantee data delivery from the source nodes to the sink. Some of the proposed MAC protocols for WSN with their techniques, advantages and disadvantages in the terms of their suitability for real time applications are discussed in this paper. We have concluded that most of these protocols can not be applied to real time applications without improvement

Since we have been a dialogue: Blanchot's 'Entretiens'

At the turn of the 1960s, Maurice Blanchot began publishing texts that he named entretiens, this change in his writing responding to what deconstruction sees as the closure of logocentric or continuous discourse. Paradoxically, this closure does not prevent such discourse, in which philosophical enquiry and technological change are intertwined, from dominating the modern world. By changing his writing, and by reiterating the dialogical form so central to metaphysical tradition since Plato, Blanchot gives voice to the tensions between continuity and its ‘outside’, between philosophy and literature. This is one sense in which his entretiens do not engage in a representation of difference, but instead open themselves to the inflections of what Jean-Luc Nancy calls le partage des voix.

Children’s and adults’ processing of syntactically ambiguous sentences during reading

While there has been a fair amount of research investigating children’s syntactic processing during spoken language comprehension, and a wealth of research examining adults’ syntactic processing during reading, as yet very little research has focused on syntactic processing during text reading in children. In two experiments, children and adults read sentences containing a temporary syntactic ambiguity while their eye movements were monitored. In Experiment 1, participants read sentences such as, ‘The boy poked the elephant with the long stick/trunk from outside the cage’ in which the attachment of a prepositional phrase was manipulated. In Experiment 2, participants read sentences such as, ‘I think I’ll wear the new skirt I bought tomorrow/yesterday. It’s really nice’ in which the attachment of an adverbial phrase was manipulated. Results showed that adults and children exhibited similar processing preferences, but that children were delayed relative to adults in their detection of initial syntactic misanalysis. It is concluded that children and adults have the same sentence-parsing mechanism in place, but that it operates with a slightly different time course. In addition, the data support the hypothesis that the visual processing system develops at a different rate than the linguistic processing system in children.

Chemically tagging the Hyades stream: does it partly originate from the Hyades cluster?

The Hyades stream has long been thought to be a dispersed vestige of the Hyades cluster. However, recent analyses of the parallax distribution, of the mass function, and of the action-space distribution of stream stars have shown it to be rather composed of orbits trapped at a resonance of a density disturbance. This resonant scenario should leave a clearly different signature in the element abundances of stream stars than the dispersed cluster scenario, since the Hyades cluster is chemically homogeneous. Here, we study the metallicity as well as the element abundances of Li, Na, Mg, Fe, Zr, Ba, La, Ce, Nd and Eu for a random sample of stars belonging to the Hyades stream, and compare them with those of stars from the Hyades cluster. From this analysis: (i) we independently confirm that the Hyades stream cannot be solely composed of stars originating in the Hyades cluster; (ii) we show that some stars (namely 2/21) from the Hyades stream nevertheless have abundances compatible with an origin in the cluster; (iii) we emphasize that the use of Li as a chemical tag of the cluster origin of main-sequence stars is very efficient in the range 5500 K <= T(eff) <= 6200 K, since the Li sequence in the Hyades cluster is very tight, while at the same time spanning a large abundance range; (iv) we show that, while this evaporated population has a metallicity excess of similar to 0.2 dex with respect to the local thin-disc population, identical to that of the Hyades cluster, the remainder of the Hyades stream population has still a metallicity excess of similar to 0.06-0.15 dex, consistent with an origin in the inner Galaxy and (v) we show that the Hyades stream can be interpreted as an inner 4:1 resonance of the spiral pattern: this then also reproduces an orbital family compatible with the Sirius stream, and places the origin of the Hyades stream up to 1 kpc inwards from the solar radius, which might explain the observed metallicity excess of the stream population.

A unified view on lifetime distributions arising from selection mechanisms

In this paper, we formulate a flexible density function from the selection mechanism viewpoint (see, for example, Bayarri and DeGroot (1992) and Arellano-Valle et al. (2006)) which possesses nice biological and physical interpretations. The new density function contains as special cases many models that have been proposed recently in the literature. In constructing this model, we assume that the number of competing causes of the event of interest has a general discrete distribution characterized by its probability generating function. This function has an important role in the selection procedure as well as in computing the conditional personal cure rate. Finally, we illustrate how various models can be deduced as special cases of the proposed model. (C) 2011 Elsevier B.V. All rights reserved.