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Culinary nutrition (encompassing culinary medicine) is an emerging field that is gaining traction as potential means to mitigate the global disease burden linked to unhealthy dietary patterns, by fostering practical culinary and nutrition literacy among health professionals. Culinary nutrition programmes have shown promise in improving dietary behaviour, cooking confidence, and nutrition counselling skills among students and professionals(1). There is a recognised need for the development and evaluation of standardised culinary nutrition training for nutrition and dietetics (N&D) professionals and there is limited understanding regarding the preparedness of the next generation of nutritionists and dietitians in delivering effective culinary nutrition programmes(2). This study aimed to investigate the cooking and food practices of students of N&D in UK to assess their capabilities and to inform the requirements of future educational curricula.
Between May and June 2023, an online survey was circulated to all UK universities delivering AfN- or BDA-approved nutrition or dietetics programmes, for subsequent circulation to students. It contained validated questionnaires on cooking and food skills confidence, meal preparation frequency, food engagement, and completion of curriculum-based cooking sessions. King’s College London provided ethical approval. Kruskal-Wallis H tests and hierarchical multiple regression modelling with adjustment of relevant covariates were conducted using SPSS Statistics v29.0.2, with a significance threshold of p<0.05.
There were complete responses from 213 students of N&D from 27 UK universities. Respondents mean age was 28.1± 9.4 years, 194 (91.1%) were female, and 132 (62.1%) were white ethnicity. The cohort comprised 57 undergraduate and 95 postgraduate nutrition and 32 undergraduate and 29 postgraduate dietetic students. Students’ average confidence scores were 84.3± 14.7 (out of 98) for cooking skills and 112.0± 20.7 (out of 133) for food skills, with an average food engagement score of 40.2± 4.7 (out of 50). 95 (44.6%) students reported cooking a main meal daily, and 141 (66.2%) had completed an average of 14.2± 16.4 practical cooking session hours as part of their degree program. Undergraduate dietitians completed the least time of cooking sessions at 3.00h, versus undergraduate nutritionists at 9.00h (p = 0.044) and postgraduate nutritionists at 10.00h (p = 0.025). Hierarchical regression models accounted for 18.8% of the variance in cooking skills confidence and 27.7% in food skills confidence. Notably, meal preparation frequency and food engagement significantly contributed to the explained variance in the respective models (p<0.001), even after adjusting for demographic factors such as gender and ethnicity.
Students of N&D in the UK exhibit higher cooking and food skills confidence compared to the general population(3). Coupled with their inherent knowledge of nutritional science, they are wellpositioned to implement future culinary nutrition interventions that could enhance public dietary behaviour and health outcomes. However, to ensure the future workforce is ready, there is a need for curriculum consensus.
We present deep near-infrared $K_\textrm{s}$-band imaging for 35 of the 53 sources from the high-redshift ($z \gt 2$) radio galaxy candidate sample defined in Broderick et al. (2022, PASA, 39, e061). These images were obtained using the High-Acuity Widefield K-band Imager (HAWK-I) on the Very Large Telescope. Host galaxies are detected for 27 of the sources, with $K_\textrm{s} \approx 21.6$–23.0 mag (2$^{\prime\prime}$ diameter apertures; AB). The remaining eight targets are not detected to a median $3\unicode{x03C3}$ depth of $K_\textrm{s} \approx 23.3$ mag (2$^{\prime\prime}$ diameter apertures). We examine the radio and near-infrared flux densities of the 35 sources, comparing them to the known $z \gt 3$ powerful radio galaxies with 500-MHz radio luminosities $L_{500\,\textrm{MHz}} \gt 10^{27}$ W Hz$^{-1}$. By plotting 150-MHz flux density versus $K_\textrm{s}$-band flux density, we find that, similar to the sources from the literature, these new targets have large radio to near-infrared flux density ratios, but extending the distribution to fainter flux densities. Five of the eight HAWK-I deep non-detections have a median $3\unicode{x03C3}$ lower limit of $K_\textrm{s} \gtrsim 23.8$ mag (1$.\!^{\prime\prime}$5 diameter apertures); these five targets, along with a further source from Broderick et al. (2022, PASA, 39, e061) with a deep non-detection ($K_\textrm{s} \gtrsim 23.7$ mag; $3\unicode{x03C3}$; 2$^{\prime\prime}$ diameter aperture) in the Southern H-ATLAS Regions $K_\textrm{s}$-band Survey, are considered candidates to be ultra-high-redshift ($z \gt 5$) radio galaxies. The extreme radio to near-infrared flux density ratios ($\gt 10^5$) for these six sources are comparable to TN J0924$-$2201, GLEAM J0856$+$0223 and TGSS J1530$+$1049, the three known powerful radio galaxies at $z \gt 5$. For a selection of galaxy templates with different stellar masses, we show that $z \gtrsim 4.2$ is a plausible scenario for our ultra-high-redshift candidates if the stellar mass $M_\textrm{*} \gtrsim 10^{10.5}$ M$_\odot$. In general, the 35 targets studied have properties consistent with the previously known class of infrared-faint radio sources. We also discuss the prospects for finding more UHzRG candidates from wide and deep near-infrared surveys.
We examined 3,046,538 acute respiratory infection (ARI) encounters with 6,103 national telehealth physicians from January 2019 to October 2021. The antibiotic prescribing rates were 44% for all ARIs; 46% were antibiotic appropriate; 65% were potentially appropriate; 19% resulted from inappropriate diagnoses; and 10% were related to coronavirus disease 2019 (COVID-19) diagnosis.
We present detailed characterization of laser-driven fusion and neutron production ($\sim {10}^5$/second) using 8 mJ, 40 fs laser pulses on a thin (<1 μm) D${}_2$O liquid sheet employing a measurement suite. At relativistic intensity ($\sim 5\times {10}^{18}$ W/cm${}^2$) and high repetition rate (1 kHz), the system produces deuterium–deuterium (D-D) fusion, allowing for consistent neutron generation. Evidence of D-D fusion neutron production is verified by a measurement suite with three independent detection systems: an EJ-309 organic scintillator with pulse-shape discrimination, a ${}^3\mathrm{He}$ proportional counter and a set of 36 bubble detectors. Time-of-flight analysis of the scintillator data shows the energy of the produced neutrons to be consistent with 2.45 MeV. Particle-in-cell simulations using the WarpX code support significant neutron production from D-D fusion events in the laser–target interaction region. This high-repetition-rate laser-driven neutron source could provide a low-cost, on-demand test bed for radiation hardening and imaging applications.
On a summer afternoon, twenty-two years ago, I joined my mother, a veteran schoolteacher, in a crowd of several thousand people to listen to a campaign speech by a U.S. Presidential candidate. I was 13 years old, about to begin 8th grade and start my tenure as Student Council President at my elementary school. At the time, I didn't have particularly strong political leanings, but I was excited to be part of the political process. After the candidate gave his speech, I left my mom's side to run to the front of the crowd, joining a line of people gathered along a metal barrier, hoping to shake the candidate's hand. I was the first person in the line, and next to me clustered a group of young people, a dozen or so of us, all about the same age. Clearly, none of us were old enough to vote, but how exciting, how affirming, that we had all found our way to the front of the crowd! For a few moments, I felt a valued part of this ritual. Our excitement grew as the candidate descended the stairs from the stage. In front of him, along the length of the metal barricade, stood a line of citizens, all of us eager to meet him. I watched his eyes skim the crowd, beginning with us young people, then darting to my left, toward the adults. My heart sank, as he pivoted to the side and began walking briskly toward the first adult in line, who he greeted with a smile and handshake, before moving on to the other adults. The group of us young people stood utterly ignored. This was a moment I would not soon forget.
However personally disappointing to the young Kathleen Sellers, the cordial political tenor of that rally two decades ago bears little resemblance to the polarised and even violent energy present in American politics today. We live in a ‘populist moment’ (Mouffe, 2018, p 1), a time of frequent uprisings and movements of the people, the demos, making demands of political leaders. Edda Sant (2021, p 75) has suggested that populist political action is ‘an alert to a crisis, and an anticipation of times of change’.
Wisdom researchers acknowledge the complex nature of this ancient construct, although they are yet to agree on its core components. A key question in the literature is whether Openness and Humour are aspects of wisdom or whether Openness is an antecedent of wisdom with Humour as a consequence.
Methods:
Using structural equation modelling, we evaluated data from 457 online respondents aged 16–87 years (Mage = 35.19, SD = 17.45). We analyzed a model with Openness as a precursor to Wisdom (conceptualised as a latent mediator variable using parcels of the SAWS Experience, Reminiscence/Reflection, and Emotional Regulation items), with Humor as outcome. We compared this model with a model using Wisdom as a latent mediator variable using parcels of the Three-Dimensional Wisdom Scale-12 (3D-WS-12).
Results:
A model using Self-Assessed Wisdom Scale (SAWS)-9 latent mediator variable with Openness as precursor to wisdom and Humour as a consequence was good fit for the data and displayed full mediation. Similarly, a model using the 3D-WS-12 as latent mediator variable to measure wisdom and with Openness as a precursor to wisdom and Humour as a consequence also fits the data with full mediation.
Discussion:
These findings provide empirical support for theoretical suggestions in the literature that Openness is a precursor to wisdom and that Humour is a consequence of wisdom using two of the most common self-report measures of wisdom. An improved understanding of the nature of wisdom and especially of its potential precursors can also be of use in future efforts to facilitate the development of wisdom.
Ensuring equitable access to health care is a widely agreed-upon goal in medicine, yet access to care is a multidimensional concept that is difficult to measure. Although frameworks exist to evaluate access to care generally, the concept of “access to genomic medicine” is largely unexplored and a clear framework for studying and addressing major dimensions is lacking.
Methods:
Comprised of seven clinical genomic research projects, the Clinical Sequencing Evidence-Generating Research consortium (CSER) presented opportunities to examine access to genomic medicine across diverse contexts. CSER emphasized engaging historically underrepresented and/or underserved populations. We used descriptive analysis of CSER participant survey data and qualitative case studies to explore anticipated and encountered access barriers and interventions to address them.
Results:
CSER’s enrolled population was largely lower income and racially and ethnically diverse, with many Spanish-preferring individuals. In surveys, less than a fifth (18.7%) of participants reported experiencing barriers to care. However, CSER project case studies revealed a more nuanced picture that highlighted the blurred boundary between access to genomic research and clinical care. Drawing on insights from CSER, we build on an existing framework to characterize the concept and dimensions of access to genomic medicine along with associated measures and improvement strategies.
Conclusions:
Our findings support adopting a broad conceptualization of access to care encompassing multiple dimensions, using mixed methods to study access issues, and investing in innovative improvement strategies. This conceptualization may inform clinical translation of other cutting-edge technologies and contribute to the promotion of equitable, effective, and efficient access to genomic medicine.
The first demonstration of laser action in ruby was made in 1960 by T. H. Maiman of Hughes Research Laboratories, USA. Many laboratories worldwide began the search for lasers using different materials, operating at different wavelengths. In the UK, academia, industry and the central laboratories took up the challenge from the earliest days to develop these systems for a broad range of applications. This historical review looks at the contribution the UK has made to the advancement of the technology, the development of systems and components and their exploitation over the last 60 years.
Transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is possible among symptom-free individuals. Patients are avoiding medically necessary healthcare visits for fear of becoming infected in the healthcare setting. We screened 489 symptom-free healthcare workers for SARS-CoV-2 and found no positive results, strongly suggesting that the prevalence of SARS-CoV-2 was <1%.
Although wisdom is a desirable life span developmental goal, researchers have often lacked brief and reliable construct measures. We examined whether an abbreviated set of items could be empirically derived from the popular 40-item five-factor Self-Assessed Wisdom Scale (SAWS).
Design:
Survey data from 709 respondents were randomly split into two and analyzed using confirmatory factor analysis (CFA).
Setting:
The survey was conducted online in Australia.
Participants:
The total sample consisted of 709 participants (Mage = 35.67 years; age range = 15–92 years) of whom 22% were male, and 78% female.
Measurement:
The study analyzed the 40-item SAWS.
Results:
Sample 1 showed the traditional five-factor structure for the 40-item SAWS did not fit the data. Exploratory factor analysis (EFA) on Sample 2 offered an alternative model based on a 15-item, five-factor solution with the latent variables Reminiscence/Reflection, Humor, Emotional Regulation, Experience, and Openness. This model, which replicates the factor structure of the original 40-item SAWS with a short form of 15 items, was then confirmed on Sample 1 using a CFA that produced acceptable fit and measurement invariance across age groups.
Conclusions:
We suggest the abbreviated SAWS-15 can be useful as a measure of individual differences in wisdom, and we highlight areas for future research.
Medically refractory epilepsies account for 20–30% of the patients evaluated in an epilepsy centre. With more than 50% of paediatric epilepsies persisting into adulthood, it is very important for the epileptologist to have an updated understanding of the current advances in the field of medically refractory paediatric epileptic syndromes.
Refractory epilepsies are common in children. Medical intractability becomes quickly apparent after seizure onset in children with developmental epileptic encephalopathies [1].
Implementation of genome-scale sequencing in clinical care has significant challenges: the technology is highly dimensional with many kinds of potential results, results interpretation and delivery require expertise and coordination across multiple medical specialties, clinical utility may be uncertain, and there may be broader familial or societal implications beyond the individual participant. Transdisciplinary consortia and collaborative team science are well poised to address these challenges. However, understanding the complex web of organizational, institutional, physical, environmental, technologic, and other political and societal factors that influence the effectiveness of consortia is understudied. We describe our experience working in the Clinical Sequencing Evidence-Generating Research (CSER) consortium, a multi-institutional translational genomics consortium.
Methods:
A key aspect of the CSER consortium was the juxtaposition of site-specific measures with the need to identify consensus measures related to clinical utility and to create a core set of harmonized measures. During this harmonization process, we sought to minimize participant burden, accommodate project-specific choices, and use validated measures that allow data sharing.
Results:
Identifying platforms to ensure swift communication between teams and management of materials and data were essential to our harmonization efforts. Funding agencies can help consortia by clarifying key study design elements across projects during the proposal preparation phase and by providing a framework for data sharing data across participating projects.
Conclusions:
In summary, time and resources must be devoted to developing and implementing collaborative practices as preparatory work at the beginning of project timelines to improve the effectiveness of research consortia.
For high switching speed HV Schottky diodes, with very high work function metal and extremely lightly doped epi, the built-in potential may be too high for thermionic emission to occur, when the applied external voltage is quite low (near VF = 0.07V). If the epi is lightly doped p type, the built-in potential (VBuilt-in: potential difference between the metal and silicon Fermi levels) is 1.0V (measured with CV). If the external bias is 0.1V, near the measured VF, it is not enough to overcome the built-in potential for thermionic emission as illustrated. It is likely that in addition to thermionic emission, tunnelling and diffusion currents also contribute to the total HV Schottky diode forward current. TCAD simulation of HV Schottky diodes with N+ guard bands suggests the potential barrier and electric fields at the Schottky junction are relatively high for thermionic emission to occur, when external bias V ≈ VF. In this paper we report HV Schottky diodes fabricated with various metals, metal alloys and epitaxial films. Metal work functions and epi doping profiles are extracted with high frequency Capacitance-Voltage (CV) technique. 150V of breakdown voltage and very low forward voltage (VF = 0.07V) are demonstrated. The measured data indicate very high work function metal or metal alloy is needed to achieve high switching speed and low forward voltage.
The Australian prime lamb industry is seeking to improve lean meat yield (LMY) as a means to increasing efficiency and profitability across the whole value chain. The LMY of prime lambs is affected by genetics and on-farm nutrition from birth to slaughter and is the total muscle weight relative to the total carcass weight. Under the production conditions of south eastern Australia, many ewe flocks experience a moderate reduction in nutrition in mid to late pregnancy due to a decrease in pasture availability and quality. Correcting nutritional deficits throughout gestation requires the feeding of supplements. This enables the pregnant ewe to meet condition score (CS) targets at lambing. However, limited resources on farm often mean it is difficult to effectively manage nutritional supplementation of the pregnant ewe flock. The impact of reduced ewe nutrition in mid to late pregnancy on the body composition of finishing lambs and subsequent carcass composition remains unknown. This study investigated the effect of moderately reducing ewe nutrition in mid to late gestation on the body composition of finishing lambs and carcass composition at slaughter on a commercial scale. Multiple born lambs to CS2.5 target ewes were lighter at birth and weaning, had lower feedlot entry and exit weights with lower pre-slaughter and carcass weights compared with CS3.0 and CS3.5 target ewes. These lambs also had significantly lower eye muscle and fat depth when measured by ultrasound prior to slaughter and carcass subcutaneous fat depth measured 110 mm from the spine along the 12th rib (GR 12th) and at the C-site (C-fat). Although carcasses were ~5% lighter, results showed that male progeny born to ewes with reduced nutrition from day 50 gestation to a target CS2.5 at lambing had a higher percentage of lean tissue mass as measured by dual energy X-ray absorptiometry and a lower percentage of fat during finishing and at slaughter, with the multiple born progeny from CS3.0 and CS3.5 target ewes being similar. These data suggest lambs produced from multiple bearing ewes that have had a moderate reduction in nutrition during pregnancy are less mature. This effect was also independent of lamb finishing system. The 5% reduction in carcass weight observed in this study would have commercially relevant consequences for prime lamb producers, despite a small gain in LMY.
The spread of the Zika virus (ZIKV) in the Americas led to large outbreaks across the region and most of the Southern hemisphere. Of greatest concern were complications following acute infection during pregnancy. At the beginning of the outbreak, the risk to unborn babies and their clinical presentation was unclear. This report describes the methods and results of the UK surveillance response to assess the risk of ZIKV to children born to returning travellers. Established surveillance systems operating within the UK – the paediatric and obstetric surveillance units for rare diseases, and national laboratory monitoring – enabled rapid assessment of this emerging public health threat. A combined total of 11 women experiencing adverse pregnancy outcomes after possible ZIKV exposure were reported by the three surveillance systems; five miscarriages, two intrauterine deaths and four children with clinical presentations potentially associated with ZIKV infection. Sixteen women were diagnosed with ZIKV during pregnancy in the UK. Amongst the offspring of these women, there was unequivocal laboratory evidence of infection in only one child. In the UK, the number and risk of congenital ZIKV infection for travellers returning from ZIKV-affected countries is very small.
There are a variety of causes of acute heart failure in children including myocarditis, genetic/metabolic conditions, and congenital heart defects. In cases with a structurally normal heart and a negative personal and family history, myocarditis is often presumed to be the cause, but we hypothesise that genetic disorders contribute to a significant portion of these cases. We reviewed our cases of children who presented with acute heart failure and underwent genetic testing from 2008 to 2017. Eighty-seven percent of these individuals were found to have either a genetic syndrome or pathogenic or likely pathogenic variant in a cardiac-related gene. None of these individuals had a personal or family history of cardiomyopathy that was suggestive of a genetic aetiology prior to presentation. All of these individuals either passed away or were listed for cardiac transplantation indicating genetic testing may provide important information regarding prognosis in addition to providing information critical to assessment of family members.