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Food insecurity – when individuals or households have difficulty accessing sufficient, safe, culturally appropriate and nutritious food due to lack of money or other resources – is a global public health concern. Levels of food insecurity have increased across the UK in recent years, due in part to a decade of austerity, widespread loss of income during the COVID-19 pandemic and the more recent cost-of-living crisis, leading to rising use of food banks. The stress of living with uncertain access to food and going periods without food is damaging to physical and mental health. Food insecurity is linked to both obesity and malnutrition, as often the most readily available foods are processed, high in fats, sugars and salt, but low in essential nutrients for health. While recognising that many of the drivers of food insecurity, and health inequalities more broadly (i.e. the social determinants of health) lie outside the health service, it is increasingly acknowledged that the National Health Service – and primary care in particular – has a key role to play in mitigating health inequalities. This review considers the potential role of healthcare in mitigating food insecurity, with a focus on primary care settings. Recent initiatives in Scotland, such as community links workers and general practitioner practice-attached financial advice workers, have shown promise as part of a more community-oriented approach to primary care, which can mitigate the effects of food insecurity. However, a more ‘upstream’ response is required, including ‘cash first’ interventions as part of broader national strategies to end the need for food banks.
As the third edition of the Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals is released with the latest recommendations for the prevention and management of healthcare-associated infections (HAIs), a new approach to reporting HAIs is just beginning to unfold. This next generation of HAI reporting will be fully electronic and based largely on existing data in electronic health record (EHR) systems and other electronic data sources. It will be a significant change in how hospitals report HAIs and how the Centers for Disease Control and Prevention (CDC) and other agencies receive this information. This paper outlines what that future electronic reporting system will look like and how it will impact HAI reporting.
We study the effect of a confined turbulent counter-current gas flow on the waviness of a weakly inclined falling liquid film. Our study is centred on experiments in a channel of 13 mm height, using water and air, where we have successively increased the counter-current gas flow rate until flooding. Computations with a new low-dimensional model and linear stability calculations are used to elucidate the linear and nonlinear wave dynamics. We find that the gas pressure gradient plays an important role in countering the stabilizing effect of the tangential gas shear stress at the liquid–gas interface. At very low inclination angles, the latter effect dominates and can suppress the long-wave Kapitza instability unconditionally. By contrast, for non-negligible inclination, the gas effect is linearly destabilizing, amplifies the height of nonlinear Kapitza waves, and exacerbates coalescence-induced formation of large-amplitude tsunami waves. Kapitza waves do not undergo any catastrophic transformation when the counter-current gas flow rate is increased beyond the absolute instability (AI) limit. On the contrary, we find that AI is an effective linear wave selection mechanism in a noise-driven wave evolution scenario, leading to highly regular downward-travelling nonlinear wave trains, which preclude coalescence events. In our experiments, where Kapitza waves develop in a protected region before coming into contact with the gas, flooding is eventually caused far beyond the AI limit by upward-travelling short-wave ripples. Based on our linear stability calculations for arbitrary wavenumbers, we have uncovered a new short-wave interfacial instability mode with negative linear wave speed, causing these ripples.
Family background characteristics and educational resources are crucial in shaping individuals’ income and therefore a potential source of income inequality and inequality of opportunity. This article analyses inequalities in the Spanish diverse regions using data from the European Survey of Income and Living Conditions (EU-SILC). Along this article we analyse the relevance of family background characteristics in shaping individuals’ opportunities as well as the role education plays in income inequality. Our findings show that family background characteristics are of great importance in shaping individuals’ performance and opportunities of achieving a certain level of income, well-being and education; also, educational variables at regional level, such as the education expenditure per student, are highly correlated to the levels of inequality. In view of the results, it would be advisable to implement public policies targeting vulnerable groups to ensure equal opportunities and invest in education given its potential as equalizer of income inequality.
Emotional disorders in children are often associated with low self-concept and problems with peers, and in many cases externalizing symptoms. Super Skills for Life (SSL) is a transdiagnostic treatment for emotional problems in children that has also shown benefits in other comorbid symptoms. This study aimed to examine, for the first time, the effect of SSL on a clinical sample of Spanish children aged 8–12 years with a major emotional disorder and comorbid externalizing symptoms and low self-concept. A quasi-experimental design with two groups, pretest and posttest, was carried out. Thirty-eight children received the SSL intervention, and 36 children were assigned to a wait-list control (WLC) group. Children in SSL showed statistically fewer posttest emotional symptoms (p < .001), peer problems (p = .002), and overall internalizing and externalizing difficulties (p = .005) compared to children in WLC, in addition to higher posttest self-concept (p = .002). There were no differences in the postinterventional changes between boys and girls in internalizing and externalizing symptoms. However, significant differences were found in some facets of self-concept. The results of this study suggest that the SSL protocol may be useful in Spanish clinical contexts. Still, more research is needed to overcome some of the inherent limitations.
The Fontan procedure is considered one of the most remarkable achievements in paediatric cardiology and cardiac surgery. Its final anatomical objective is a venous return through the superior and inferior vena cava. The complications inherent to this procedure and subsequent failure are its limitations.
Objective:
To describe the clinical and haemodynamic characteristics of patients with Fontan failure and define the risk factors associated with it, with its short- and long-term outcomes during a 21-year observation period.
Methods:
This is a retrospective follow-up study in which 15 patients diagnosed with Fontan failure in the single-ventricle programme of a high-complexity hospital in Medellín, Colombia, between 2001 and 2022 were included.
Results:
One hundred and eight patients were identified in whom the Fontan procedure was performed, and 17 met the failure criteria. 82.4% were men, with a median age of 4.3 years. Ebstein’s anomaly was the most common diagnosis, 29.4%. All patients underwent Fontan with an extracardiac tube following the procedure. According to the type of failure, 58.8% of patients presented protein-losing enteropathy and 17.6% plastic bronchitis. During follow-up, 5.9% of patients died.
Conclusion:
Fontan surgery in our centre is an option for patients with univentricular physiology. The correct selection of the patient is essential to mitigate failure risks.
Rehabilitation robots help the treatment of diseases by performing cyclic exercises for a long period of time. These exercises must perform movements of the patient’s limbs; thus, the robots are required to be flexible and safe. Among rehabilitation robots, cable robots are widely used due to their unique properties, such as being lightweight and the possibility of being equipped with magnetic hooks to improve both safety and ease of use. However, the elasticity and flexibility of cables result in vibrations of the payload and hooks. In this paper, the forced vibrations due to rehabilitation exercises are studied. Since the previous studies of the authors showed a weak coupling between longitudinal and transverse vibrations, a two-cable planar model for the study of transverse vibrations is developed. The model makes it possible to study the forced transverse vibrations due to both cable motion and robot motion. Stiffness and damping of the patient’s arm are considered. Results show that the cable system exhibits a simple linear behavior when excited by robot motion and a non-linear behavior when excited by cable motion.
The aim was to evaluate the effect of different energy diets available in adulthood on the longevity, dispersal capacity and sexual performance of Aedes aegypti produced under a mass-rearing system. To evaluate the effects of diets in relation to the survival of the adult male insects of Ae. aegypti, six treatments were used: sucrose at a concentration of 10%, as a positive control (sack10); starvation, as a negative control (starvation); sucrose at a concentration of 20% associated with 1 g/l of ascorbic acid (sac20vitC); wild honey in a concentration of 10% (honey10); demerara sugar in a 10% concentration (demerara10); and sucrose at a concentration of 20% associated with 1 g/l of ascorbic acid and 0.5 g/l of amino acid proline (sac20vitCPr). Each treatment had 16 cages containing 50 adult males. For the tests of flight ability and propensity to copulation, five treatments were used (saca10; sac20vitC; mel10; demerara10; and sac20vitCPr), with males each for flight ability and females copulated by a single male for copulation propensity. The diet composed of sucrose at a concentration of 20% associated with ascorbic acid, as an antioxidant, improved the survival, flight ability and propensity to copulate in Ae. aegypti males under mass-rearing conditions, and may be useful to enhance the performance of sterile males, thus improving the success of sterile insect technique programmes.
In recent decades, the labour share has experienced a downward trend in Portugal at the same time as a weaker and anaemic growth pattern. This seems to suggest that the fall in the labour share represents an important constraint on Portuguese economic growth, which is contrary to the orthodox claims around wage restraint policies – namely, that such policies are a necessary condition of improved macroeconomic performance, owing to their positive effects on private investment through higher profits and on net exports through reduced unit labour costs and a corresponding rise in competitiveness. This study assesses the relationship between labour share growth and economic growth by performing a time series econometric analysis focused on Portugal from 1971 to 2021. Findings show that labour share growth has positively impacted on economic growth in Portugal, which is in line with heterodox claims and particularly with post-Keynesian economics on the beneficial effects on private consumption played by the growth of wages. Findings also confirm that the Portuguese economy has followed a wage-led growth regime instead of a profit-led growth regime; that is, a rise in wages increases aggregate demand and, therefore, boosts economic growth because its beneficial effect on private consumption more than compensates for a prejudicial effect on private investment and on net exports. The study points out the urgent need to adopt public policies to support the growth of wages to avoid more decades of dismal growth and a new ‘secular stagnation’ in Portugal.