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Infections from prolonged use of axillary intra-aortic balloon pumps (IABPs) have not been well studied. Bloodstream infection (BSI) occurred in 13% of our patients; however, no difference in outcome was noted between those with BSI and those without. Further studies regarding protocol developments that minimize BSI risk are needed.
This study aimed to evaluate the perceived quality of life, unmet needs and psychological distress in patients with head and neck cancer in a rural setting in New Zealand.
Method
Patients presenting with head and neck cancer in Northland, New Zealand, were asked to complete questionnaires on quality of life, unmet needs, and anxiety or depression together with a free-text option.
Results
About one quarter of respondents (27 per cent) scored high in the anxiety and depression scale, with corresponding diminished quality of life scores and increased needs. Over half of respondents (54 per cent) found it challenging to travel for treatment. Financial difficulties were encountered more frequently with indigenous patients. Rurality alone does not lead to significant differences in quality of life or needs.
Conclusion
After treatment for head and neck cancer, it is important to monitor and manage patients’ psychological distress and ease of access to health services to improve quality of life.
Eggs contain important compounds related to enhanced cognition, but it is not clear if egg consumption, as a whole, has a direct impact on memory decline in older adults. This study aimed to determine whether egg intake levels predict the rate of memory decline in healthy older adults after sociodemographic and dietary controls. We conducted a secondary analysis of data from 470 participants, age 50 and over, from the Biospsychosocial Religion and Health Study. Participants completed a food frequency questionnaire, which was used to calculate egg intake and divide participants into Low (<23 g/week, about half an egg), Intermediate (24–63 g/week, half to 1½ eggs) and High (≥63 g/week, about two or more eggs) tertiles. Participants were administered the California Verbal Learning Test – 2nd Edition (CVLT-II) Short Form in 2006–2007, and 294 of them were again tested in 2010–2011. Using linear mixed model analysis, no significant cross-sectional differences were observed in CVLT-II performance between egg intake levels after controlling for age, sex, race, education, body mass index, cardiovascular risk, depression and intake of meat, fish, dairy and fruits/vegetables. Longitudinally, the Intermediate egg group exhibited significantly slower rates of decline on the CVLT-II compared to the Low egg group. The High egg group also exhibited slower rates of decline, but not statistically significant. Thus, limited consumption of eggs (about 1 egg/week) was associated with slower memory decline in late life compared to consuming little to no eggs, but a dose-response effect was not clearly evident. This study may help explain discrepancies in previous research that did not control for other dietary intakes and risk factors.
Using data from a nationally generalisable birth cohort, we aimed to: (i) describe the cohort’s adherence to national evidence-based dietary guidelines using an Infant Feeding Index (IFI) and (ii) assess the IFI’s convergent construct validity, by exploring associations with antenatal maternal socio-demographic and health behaviours and with child overweight/obesity and central adiposity at age 54 months. Data were from the Growing Up in New Zealand cohort (n 6343). The IFI scores ranged from zero to twelve points, with twelve representing full adherence to the guidelines. Overweight/obesity was defined by BMI-for-age (based on the WHO Growth Standards). Central adiposity was defined as waist-to-height ratio > 90th percentile. Associations were tested using multiple linear regression and Poisson regression with robust variance (risk ratios, 95 % CI). Mean IFI score was 8·2 (sd 2·1). Maternal characteristics explained 29·1 % of variation in the IFI score. Maternal age, education and smoking had the strongest independent relationships with IFI scores. Compared with children in the highest IFI tertile, girls in the lowest and middle tertiles were more likely to be overweight/obese (1·46, 1·03, 2·06 and 1·56, 1·09, 2·23, respectively) and boys in the lowest tertile were more likely to have central adiposity (1·53, 1·02, 2·30) at age 54 months. Most infants fell short of meeting national Infant Feeding Guidelines. The associations between IFI score and maternal characteristics, and children’s overweight/obesity/central adiposity, were in the expected directions and confirm the IFI’s convergent construct validity.
The objective of this study was to derive a factor structure of the measures of the National Institutes of Health (NIH) Toolbox Cognition Battery (CB) that is representative of cognitive abilities in a large ethnically diverse cohort of 8-year-old children in Aotearoa New Zealand.
Methods:
Our sample comprised of 4298 8-year-old children from the Growing Up in New Zealand study. We conducted exploratory and confirmatory factor analysis for the NIH Toolbox CB measures to discover the best-fitting factor structure in our sample. Measurement invariance of the identified model was tested across child’s gender, socio-economic status (SES), and ethnicity.
Results:
A three-dimensional factor structure was identified, with one factor of Crystallised Cognition (Reading and Vocabulary), and two distinguished factors of fluid cognition: Fluid Cognition I (Attention/Inhibitory Control, Processing Speed, and Cognitive Flexibility) and Fluid Cognition II (Working Memory, Episodic Memory). The results demonstrate excellent model fit, but reliability of the factors was low. Measurement invariance was confirmed for child’s gender. We found configural, but neither metric nor scalar, invariance across SES and the four major ethnic groups: European, Māori, Pacific Peoples, and Asian.
Conclusion:
Our findings show that, at the age of 8 years, fluid abilities are more strongly associated with one another than with crystallised abilities and that fluid abilities need to be further differentiated. This dimensional structure allows for comparisons across child’s gender, but evaluations across SES and ethnicity within the Aotearoa New Zealand context must be conducted with caution. We recommend using raw scores of the individual NIH Toolbox CB measures in future research.
To simulate effects of different scenarios of folic acid fortification of food on dietary folate equivalents (DFE) intake in an ethnically diverse sample of pregnant women.
Design
A forty-four-item FFQ was used to evaluate dietary intake of the population. DFE intakes were estimated for different scenarios of food fortification with folic acid: (i) voluntary fortification; (ii) increased voluntary fortification; (iii) simulated bread mandatory fortification; and (iv) simulated grains-and-rice mandatory fortification.
Setting
Ethnically and socio-economically diverse cohort of pregnant women in New Zealand.
Participants
Pregnant women (n 5664) whose children were born in 2009–2010.
Results
Participants identified their ethnicity as European (56·0 %), Asian (14·2 %), Māori (13·2 %), Pacific (12·8 %) or Others (3·8 %). Bread, breakfast cereals and yeast spread were main food sources of DFE in the two voluntary fortification scenarios. However, for Asian women, green leafy vegetables, bread and breakfast cereals were main contributors of DFE in these scenarios. In descending order, proportions of different ethnic groups in the lowest tertile of DFE intake for the four fortification scenarios were: Asian (39–60 %), Others (41–44 %), European (31–37 %), Pacific (23–26 %) and Māori (23–27 %). In comparisons within each ethnic group across scenarios of food fortification with folic acid, differences were observed only with DFE intake higher in the simulated grains-and-rice mandatory fortification v. other scenarios.
Conclusions
If grain and rice fortification with folic acid was mandatory in New Zealand, DFE intakes would be more evenly distributed among pregnant women of different ethnicities, potentially reducing ethnic group differences in risk of lower folate intakes.
Significant ethnic and socio-economic disparities exist in infectious diseases (IDs) rates in New Zealand, so accurate measures of these characteristics are required. This study compared methods of ascribing ethnicity and socio-economic status. Children in the Growing Up in New Zealand longitudinal cohort were ascribed to self-prioritised, total response and single-combined ethnic groups. Socio-economic status was measured using household income, and both census-derived and survey-derived deprivation indices. Rates of ID hospitalisation were compared using linked administrative data. Self-prioritised ethnicity was simplest to use. Total response accounted for mixed ethnicity and allowed overlap between groups. Single-combined ethnicity required aggregation of small groups to maintain power but offered greater detail. Regardless of the method used, Māori and Pacific children, and children in the most socio-economically deprived households had a greater risk of ID hospitalisation. Risk differences between self-prioritised and total response methods were not significant for Māori and Pacific children but single-combined ethnicity revealed a diversity of risk within these groups. Household income was affected by non-random missing data. The census-derived deprivation index offered a high level of completeness with some risk of multicollinearity and concerns regarding the ecological fallacy. The survey-derived index required extra questions but was acceptable to participants and provided individualised data. Based on these results, the use of single-combined ethnicity and an individualised survey-derived index of deprivation are recommended where sample size and data structure allow it.
This computational aerodynamics textbook is written at the undergraduate level, based on years of teaching focused on developing the engineering skills required to become an intelligent user of aerodynamic codes. This is done by taking advantage of CA codes that are now available and doing projects to learn the basic numerical and aerodynamic concepts required. This book includes a number of unique features to make studying computational aerodynamics more enjoyable. These include:The computer programs used in the book's projects are all open source and accessible to students and practicing engineers alike on the book's website, www.cambridge.org/aerodynamics. The site includes access to images, movies, programs, and moreThe computational aerodynamics concepts are given relevance by CA Concept Boxes integrated into the chapters to provide realistic asides to the conceptsReaders can see fluids in motion with the Flow Visualization Boxes carefully integrated into the text.
To evaluate the sociodemographic and lifestyle factors associated with insufficient and excessive use of folic acid supplements (FAS) among pregnant women.
Design
A pregnancy cohort to which multinomial logistic regression models were applied to identify factors associated with duration and dose of FAS use.
Setting
The Growing Up in New Zealand child study, which enrolled pregnant women whose children were born in 2009–2010.
Subjects
Pregnant women (n 6822) enrolled into a nationally generalizable cohort.
Results
Ninety-two per cent of pregnant women were not taking FAS according to the national recommendation (4 weeks before until 12 weeks after conception), with 69 % taking insufficient FAS and 57 % extending FAS use past 13 weeks’ gestation. The factors associated with extended use differed from those associated with insufficient use. Consistent with published literature, the relative risks of insufficient use were increased for younger women, those with less education, of non-European ethnicities, unemployed, who smoked cigarettes, whose pregnancy was unplanned or who had older children, or were living in more deprived households. In contrast, the relative risks of extended use were increased for women of higher socio-economic status or for whom this was their first pregnancy and decreased for women of Pacific v. European ethnicity.
Conclusions
In New Zealand, current use of FAS during pregnancy potentially exposes pregnant women and their unborn children to too little or too much folic acid. Further policy development is necessary to reduce current socio-economic inequities in the use of FAS.
Pre-school nutrition-related behaviours influence diet and development of lifelong eating habits. We examined the prevalence and congruence of recommended nutrition-related behaviours (RNB) in home and early childhood education (ECE) services, exploring differences by child and ECE characteristics.
Design
Telephone interviews with mothers. Online survey of ECE managers/head teachers.
Setting
New Zealand.
Subjects
Children (n 1181) aged 45 months in the Growing Up in New Zealand longitudinal study.
Results
A mean 5·3 of 8 RNB were followed at home, with statistical differences by gender and ethnic group, but not socio-economic position. ECE services followed a mean 4·8 of 8 RNB, with differences by type of service and health-promotion programme participation. No congruence between adherence at home and in ECE services was found; half of children with high adherence at home attended a service with low adherence. A greater proportion of children in deprived communities attended a service with high adherence, compared with children living in the least deprived communities (20 and 12 %, respectively).
Conclusions
Children, across all socio-economic positions, may not experience RNB at home. ECE settings provide an opportunity to improve or support behaviours learned at home. Targeting of health-promotion programmes in high-deprivation areas has resulted in higher adherence to RNB at these ECE services. The lack of congruence between home and ECE behaviours suggests health-promotion messages may not be effectively communicated to parents/family. Greater support is required across the ECE sector to adhere to RNB and promote wider change that can reach into homes.
Congenital genitourinary tract anomalies are some of the most commonly identified prenatal abnormalities, being identified in between 1 in 250 and 1 in 1000 pregnancies. They consist of a wide spectrum of heterogeneous malformations. Obstructive uropathies account for the majority of these abnormalities. the second-trimester detailed scan (often at 18+0–21+6 weeks) is the examination in which the majority of genitourinary abnormalities are diagnosed. However, with the widespread use of first-trimester ultrasound screening, severe renal anomalies and “megacystis” are being noted between 11+0 and 13+6 weeks. Additionally, third-trimester ultrasound may reveal late-onset uropathies, often associated with changes in liquor volume.
Recent archaeological investigations at Tipan Chen Uitz, Belize, yielded two remarkable Classic Maya ballplayer panels. Iconographic and glyphic analysis of these panels within a regional context provides new insights into large-scale socio-political relationships, demonstrating that the ballgame was an important means and mechanism for macro-political affiliation in the Maya Lowlands. The panels suggest that Tipan was part of a wider system of vassalage that tied it to other Maya centres, including Naranjo, a regional capital under the dominion of Calakmul where the Snake-Head dynasty held sway. The data presented here underpin a more general discussion of archaeological approaches to ancient interaction spheres.
Although quality of life (QoL) is receiving increasing attention in bipolar disorder (BD) research and practice, little is known about its naturalistic trajectory. The dual aims of this study were to prospectively investigate: (a) the trajectory of QoL under guideline-driven treatment and (b) the dynamic relationship between mood symptoms and QoL.
Methods
In total, 362 patients with BD receiving guideline-driven treatment were prospectively followed at 3-month intervals for up to 5 years. Mental (Mental Component Score – MCS) and physical (Physical Component Score – PCS) QoL were measured using the self-report SF-36. Clinician-rated symptom data were recorded for mania and depression. Multilevel modelling was used to analyse MCS and PCS over time, QoL trajectories predicted by time-lagged symptoms, and symptom trajectories predicted by time-lagged QoL.
Results
MCS exhibited a positive trajectory, while PCS worsened over time. Investigation of temporal relationships between QoL and symptoms suggested bidirectional effects: earlier depressive symptoms were negatively associated with mental QoL, and earlier manic symptoms were negatively associated with physical QoL. Importantly, earlier MCS and PCS were both negatively associated with downstream symptoms of mania and depression.
Conclusions
The present investigation illustrates real-world outcomes for QoL under guideline-driven BD treatment: improvements in mental QoL and decrements in physical QoL were observed. The data permitted investigation of dynamic interactions between QoL and symptoms, generating novel evidence for bidirectional effects and encouraging further research into this important interplay. Investigation of relevant time-varying covariates (e.g. medications) was beyond scope. Future research should investigate possible determinants of QoL and the interplay between symptoms and wellbeing/satisfaction-centric measures of QoL.
Herbicides 4-amino-3,5,6-trichloropicolinic acid (picloram) and 5-bromo-3-sec-butyl-6-methyluracil (bromacil) effectively controlled live oak (Quercus virginiana Mill.) when applied in the spring and fall in south Texas. A mixture of picloram plus (2,4,5-trichlorophenoxy)acetic acid (2,4,5-T) also was effective. Higher rates of bromacil were required than for picloram or picloram plus 2,4,5-T for effective control. Bromacil was more injurious to herbaceous vegetation. The phenoxy herbicides (2,4-dichlorophenoxy)acetic acid (2,4-D) and 2,4,5-T were ineffective.
Field studies were conducted in Michigan, Minnesota, and Wisconsin to explore interactions among DPX-V9360 herbicide applied postemergence, terbufos insecticide applied as an in-furrow treatment, and the environment. Field corn (‘Pioneer 3751’) and sweet corn (‘Jubilee’) were planted with and without an in-furrow application of terbufos. DPX-V9360 was applied postemergence when the corn was in the 4- to 6-leaf stage at 0, 35, 70, 140, and 280 g ai ha-1 with nonionic surfactant and 28% N fertilizer solution. Crop response to DPX-V9360 was similar at all three locations, varying only in magnitude of injury. Crop injury was greater with Jubilee sweet corn than with Pioneer 3751 field corn. Injury to both hybrids increased as DPX-V9360 application rate increased. Application of terbufos increased injury from DPX-V9360 to both hybrids. Significant yield reduction did not occur with either hybrid when DPX-V9360 was applied at rates of 140 g ha-1 or less and no terbufos was applied.
Early spring spray applications of the potassium salt of 4-amino-3,5,6-trichloropicolinic acid (picloram) and certain formulations of 1:1 mixtures of picloram plus (2,4,5-trichlorophenoxy)acetic acid (2,4,5-T) controlled yaupon (Ilex vomitoria Ait.). Ester formulations of picloram or picloram plus 2,4,5-T were ineffective. Combinations of surfactant and oil: water carriers usually did not improve herbicide performance over water carriers. Granular picloram was superior to sprays when applied as soil treatments at equal rates and controlled yaupon at most dates of application. Post oak (Quercus stellata Wangenh.) and blackjack oak (Quercus marilandica Muenchh.) were controlled more effectively by picloram or picloram plus 2,4,5-T sprays on the foliage than by granular picloram as a soil treatment. Picloram granules usually killed winged elm (Ulmus alata Michx.) regardless of date of application.
Field experiments were conducted in Michigan, Minnesota, and Wisconsin in 1990 to explore interactions between nicosulfuron applied POST and terbufos insecticide at 0.06 or 0.11 g ai/m of row applied in-furrow on ‘Pioneer 3751’ field corn and ‘Jubilee’ sweet corn. Nicosulfuron at 0, 70, and 140 g ai/ha plus nonionic surfactant and 28% nitrogen fertilizer was applied to both corn types. Field corn response to nicosulfuron and terbufos was similar at all locations, whereas sweet corn injury varied with location. Nicosulfuron injured field corn more when applied at the four-leaf than the three-leaf stage. Injury to both corn types increased as nicosulfuron rate increased or when applied following terbufos. Nicosulfuron at 140 g/ha without terbufos did not reduce yield of either corn type; however, corn previously treated in-furrow with terbufos reduced yield.
We compared foliage sprays of (2,4-dichlorophenoxy)acetic acid (2,4-D) and 4-amino-3,5,6-trichloropicolinic acid (picloram) for control of Macartney rose (Rosa bracteata Wendl.) applied with ground equipment and airplane. Picloram at 0.5 lb/A was more effective than 2,4-D at 2 lb/A at all dates of application on mowed roses; however, time of application was important. Picloram was most effective in late April and early May, but 2,4-D was most effective in late May and early June. Combinations of picloram and 2,4-D were effective from late April to late June. If mowing is followed by foliage treatment of 2,4-D, the interval between mowing and spraying should be at least 1 year if mowing is done in the spring. The interval between mowing and spraying was not critical when picloram was applied not later than early May. Mowing in the summer reduced the effectiveness of subsequent 2,4-D and picloram treatments applied the following year. Aerial applications of 2,4-D and picloram on undisturbed Macartney rose plants in the fall were not as effective as spring applications; however, two successive fall applications of picloram at 1 lb/A resulted in control equivalent to that obtained with a single 2 lb/A application in spring.