University of Winchester

Background/Objectives : Adherence to exercise programs is required to reap their established benefits and to sustain Quality of Life (QoL). This study explored People Living with Dementia’s (PLWD) adherence to a Tai Chi exercise program and its effects on their QoL. The study included assessment of factors affecting adherence to a Tai Chi exercise intervention, causes of nonadherence, and effect of adherence on PLWD’s QoL. Methods : This study was part of a randomized controlled trial where 41 community-dwelling PLWD received a Tai Chi exercise intervention in addition to usual care for 20 weeks. The measures used in this study included PLWD’s QoL, global cognitive function, moderate physical activity, intention and confidence to attend classes, record of PLWD’s and their carers’ health conditions, and percentages of PLWD’s Tai Chi class attendance and home practice during the intervention phase. Multiple linear regression, bivariate correlation, and independent sample t -test analyses were conducted to evaluate associations between these variables. Results : PLWD’s overall percentage of class attendance, M ( SD ) = 69.19 (29.95), demonstrated high adherence. Moreover, QoL of highly adherent PLWD was significantly higher than low adherents. Among all variables, PLWD’s and carers’ health conditions (β = −0.64; p < .001, β = −0.38; p < .001, respectively) were the dominating factors that reduced PLWD’s Tai Chi adherence, while PLWD’s moderate physical activity at baseline (β = 0.27; p = .02) was significant positive predictor. Significance/Implications : PLWD’s and their carers’ health issues must be addressed to enhance PLWD’s exercise adherence and sustain good QoL.

Big team science has the potential to reshape comparative cognition research, but its implementation — especially in making fair comparisons between species, handling multisite variation and reaching researcher consensus — poses daunting challenges. Here, we propose solutions and discuss how big team science can transform the field.

The objective of the study was to show the clinical performance and cost‐effectiveness of a Silicone foam dressing with 3DFit™ Technology compared to current standard of care. This was an open‐labelled, two‐arm, randomised controlled multicentre study conducted from February to December 2023. One hundred and two participants with an exuding, non‐infected and chronic ulcer were randomised in a 1:1 fashion and treated with either a Silicone foam with 3DFit™ Technology or standard of care (a filler combined with a secondary dressing), stratified by venous leg ulcers and diabetic foot ulcers. After a 4‐week study period, wound size and total costs were evaluated. After 4 weeks of treatment, a comparable percentage in wound area reduction was observed in both treatment arms with mean and 95% confidence interval of 54.3% (37.1%; 71.5%) and 43.0% (26.5%; 59.6%) for the investigational and comparator dressing, respectively. This corresponded to a mean difference of 11.3% ([−10.22; 32.86], p = 0.299). Total mean estimated costs were significantly lower for the investigational dressing (£14.3, 95% confidence interval [£9.6; £19.0]) compared to the two‐dressing regime (£21.4 [£16.9; £26.0]), corresponding to a 33% price reduction (p = 0.033) after 4 weeks of treatment. With this RCT, a conforming Silicone foam dressing with 3DFit™ Technology was shown to be clinically comparable and a cost‐effective alternative to using a filler and a secondary dressing at a significantly lower cost in both venous leg ulcers and diabetic foot ulcers up to 2 cm in depth.

Late medievalists have shown that retaining was central to English political society in the fourteenth and fifteenth centuries. They have also debunked the myth that Henry VII sought to end noble retaining and shown that such practices continued into the sixteenth century. Despite this, there has been no focused examination of licenses that Edward VI, Mary I and Elizabeth I granted to select individuals permitting them to retain beyond those categories of servants specified in early acts. These licenses are a unique and underexplored source base that allows questions normally posed by medievalists to be posed for the early modern period. This article examines 138 licenses between 1541 and 1585, identifying the patterns of such grants and their role in understanding the crown's use of noble and gentry retaining in the mid sixteenth century. The reason for each grant differed but all recipients were deemed useful to the crown for various reasons, illustrating the continued collaboration between crown and nobility into the sixteenth century. Throughout, this article emphasises the implications of licenses to retain for understanding the attitude of the English crown to the private power of nobles and gentry over the longue durée .

Ireland is the largest beef trader and a major dairy exporter within the European Union. Horse racing holds significant cultural value, while greyhound racing is economically important at the regional level. As public concern about farm animal welfare rises and biodiversity loss intensifies, this research examines the political salience of animal protection in Ireland across the 2011, 2016, and 2020 general elections. Political salience measures the degree of public concern about political issues, with party manifestos serving as indicators of this concern. Using both quantitative and qualitative methods, this study analysed 364 statements on animal protection from Fianna Fáil, Fine Gael, the Green Party, the Labour Party, and Sinn Féin. The results show a significant increase in the frequency and positivity of animal protection statements over the course of the election period, with a shift in the attitudes of Fianna Fáil and Fine Gael. The Green Party has consistently promoted progressive animal protection policies. Key issues such as farmed animal welfare, wildlife and biodiversity, and horse and greyhound racing have gained prominence in party manifestos, also reflecting economic influences. Despite this growing focus, critical issues such as the puppy trade and certain aspects of farmed animal welfare remain underrepresented. This research provides the first comprehensive academic analysis of animal protection policy in political party manifestos in the Republic of Ireland.

Background To assess fatigue in cancer patients, several patient-reported outcome measures (PROMs) are available that differ in content. To support the selection of suitable measures for specific applications and to evaluate possibilities of quantitative linking, the present study provides a content comparison of common fatigue measures, scales, and item banks. We included the EORTC CAT Core, EORTC QLQ-FA12, EORTC QLQ-C30, FACIT-F, PROMIS Fatigue (Cancer item bank v1.0), Brief Fatigue Inventory (BFI), Multidimensional Fatigue Inventory (MFI-20), Piper Fatigue Scale (PFS-12), and PRO-CTCAE. Methods All items of the included measures were linked to the International Classification of Functioning, Disability and Health (ICF). Additionally, they were categorized as assessing general, physical, emotional, or cognitive fatigue. Descriptive statistics were used to display the contents covered in each measure and to allow for a qualitative comparison. Results The measures consist of 160 items in total and covered primarily contents of the ICF components ‘Body functions’, ‘Activities and participation’, and ‘Environmental Factors’. Most ICF codings refer to ‘b1300 Energy level’ (9–67% of the codings per instrument; 47% of all coded content). Within the broad categorization of types of fatigue, most items were classified as general fatigue (33–100% of the codings per instrument; 49% of the overall item pool). While the EORTC CAT Core focuses exclusively on physical and general fatigue, FACIT and BFI additionally assess emotional fatigue. The EORTC QLQ-FA12, PROMIS, MFI-20, and PFS-12 cover all fatigue components, including cognitive fatigue. Discussion The review provides an in-depth content comparison of PROMs assessing cancer-related fatigue. This can inform the selection of suitable measures in different clinical contexts. Furthermore, it will inform quantitative analyses to facilitate comparison of scores obtained with different PROMs.

Classical and operant conditioning for cooperative husbandry and health care in zoos has largely been mammal-focused while other taxa are typically physically handled or anaesthetised, with birds primarily being trained for shows and demonstrations. The concept of ‘bird training’ is likely to elicit images of parrot fly-bys, falcons chasing a lure or corvids taking money from guests to put into a donation box. The training of captive birds for cooperative husbandry and veterinary care is, however, growing within the zoo industry and has expanded to involve a huge variety of species and goals. This case study provides an example of how classical and operant conditioning were utilised to improve the welfare of a highly fearful green peafowl Pavo muticus. Training enabled zookeepers to overcome management difficulties that resulted from enclosure design and a negative animal-zookeeper relationship, leading to reduced stress, better health care and ultimately improved animal welfare. This case study also highlights the importance of frequently reviewing training plans, the training environment, and the behaviour of the animal being trained to enhance training success.

It remains common practice for zoos to chop animal diets into small pieces, even though there is limited evidence to support this practice. It is important that the purported benefits of chopping food are investigated, to determine whether there are any benefits for animal welfare. This study investigates the impact of food presentation on the behaviour of the binturong (Arctictis binturong), a large Asian viverrid, at Beale Wildlife Park in the United Kingdom. For this study, food was provided in three sizes: very finely chopped, chopped, and in whole pieces, and the behaviour and food preference of binturongs was investigated alongside the time taken for keepers to prepare diets. There were relatively few behavioural differences when binturongs were provided with the three food sizes. Only a few behaviours, namely feeding, food manipulation and locomotion with food were significantly more frequent when food was whole, whilst vocalisations were significantly less frequent in this condition. When food items are large, the binturongs appeared to take a large item and move elsewhere to eat, thus moving away from one another, which therefore reduces opportunities for aggression or stealing. This suggests that large food items may have benefits in terms of reduced food monopolisation, especially for binturongs housed in pairs or groups. Keepers saved almost five minutes when preparing whole food diets as opposed to the very chopped size. Given the potential benefits, plus the keeper time saved, whole diets are a viable option for feeding binturongs.

Cow's milk allergy (CMA) remains one of the most common and complex paediatric food allergies. In the last decade, our understanding has advanced in terms of immunoglobulin E (IgE)‐mediated CMA and focus is now also paid to non‐IgE‐mediated CMA, particularly in some Western countries where incidence rates are high. We have had significant progress in the last 10 years in relation to our understanding of existing supportive tests for IgE‐mediated CMA, with the advancement of newer tests, such as the basophil activation test (BAT), which have shown great promise. However, little advancement has been made in terms of tests for non‐IgE‐mediated CMA, and controversy still exists around symptoms. Our understanding of the natural history of CMA has also advanced with more awareness of different phenotypes. While the mainstay of management remains cow's milk elimination, the importance of supporting breastfeeding and avoidance of unwarranted cow's milk elimination diets in breastfeeding mothers has been highlighted. For non‐breastfed children, there has been some advancement in the formulas offered for the management of CMA, including the recognition of hydrolysed rice‐based formulas and increased demand for nutritionally complete plant‐based options, some of which are currently being assessed. The addition of pro, pre and synbiotics is considered safe to use, although research and guidance on routine use remain absent. Knowledge of tolerance induction from studies on the early introduction of peanuts has also highlighted the importance of a more active approach to managing CMA with the use of milk ladders, primarily in non‐IgE‐mediated CMA and baked milk (BM) introduction in IgE‐mediated CMA. In addition, modulation of the microbiome and diet diversity during complementary feeding has been a major advancement in the last 10 years. While data on poor growth and feeding difficulties in children with CMA has not changed much, increased rates of obesity are now also reported. Finally, novel approaches, including oral immunotherapy, the use of milk ladders and earlier consideration of BM, have advanced somewhat in the last decade, although the risks and benefits of these novel approaches require further research. While CMA remains a complicated allergy to diagnose and manage, the evolution of science has advanced our knowledge and brought some novel innovations, which combined have enhanced our practice.

The book of Kings portrays the period from Solomon’s death to the death of Ahab as signally consequential for Israel’s history as a people. The period began with the permanent partition of the nation. From the Kings perspective, however, the impact of Jeroboam I’s cultic innovations was even more catastrophic. The book’s preoccupation is to demonstrate a causal relationship between infidelity to YHWH and deleterious change manifested in societal and political instability and misfortune. This study applies two current trajectories of biblical interpretation, namely, ‘form follows function/content’ analysis and close reading of the text’s orthographic features to probe what 1 Kings 11–22 is saying about this dynamic and how it says it. The study concludes that, whether the medium be orthographic manipulation, graphic polysemous constructions, or onomastic paronomasia, form and content are closely coordinated in this text. This symbiosis between paronyms and content subtly reinforces the composition’s unity.

Background:: The term “faltering growth” (FG) is widely used to refer to a slower rate of weight gain in childhood than expected for age and gender. The prevalence varies depending on the definition and the studied population. Early recognition is important when considering the short- and long-term consequences, which include reduced cognitive development and increased risk of morbidity and mortality. Summary:: The causes of FG are traditionally classified into being either illness- or non-illness-related. However, such a rigid classification does not acknowledge the fact that poor growth may be multifactorial. While many definitions for FG exist, a recent consensus document suggested that a drop of weight-for-height of 1 z-score warrants the consideration for FG. The nutritional assessment supports the calculation of energy and protein requirements, which should be tailored to the underlying cause.

Background The use of blood specific IgE or skin prick tests (SPT) to guide dietary exclusions for disease control in children with atopic dermatitis (AD) is controversial. We undertook a consensus exercise on how to interpret SPT results and dietary history for cow's milk, hen's egg, wheat, and soy in children < 2 years old with AD. Methods Fourteen clinicians from general practice, pediatrics, pediatric dermatology, pediatric allergy, and pediatric dietetics from UK and Ireland took part in an online modified Delphi study. Over three rounds, participants gave their anonymous opinions and received individualized and group feedback, based on the premise that all children had SPTs. The findings were discussed in an online workshop. Results Of 18 symptoms, 12 were identified as relevant to immediate and 7 to delayed allergy. Regarding SPTs, there was consensus over which allergens to use for wheat and soy but not cow's milk or hen's egg; for all study foods, wheal size was determined as 0–1 mm negative, ≥ 5 mm sensitized, but between 2 and 4 mm, categorization varied by food. During the final workshop, consensus was reached on dietary advice for nine combinations of SPT results and dietary history. Conclusion We attained consensus on how SPTs and dietary history for four common food allergens should be interpreted in young children under 2 years of age with AD. These pragmatic recommendations may support clinician education, consistency of decision‐making, and future research.

The purpose of this study was to explore how the socio-cultural context impacts athletes living with persistent post-concussion syndrome (PPCS). Following interviews with 19 retired athletes with PPCS, a reflexive, thematic analysis was used to identify two main themes (Feeling Abandoned by Society, Support Encouraging Resilience), with each main theme having three sub-themes. Specifically, when feeling abandoned by society, the athlete with PPCS feels hopeless as socio- cultural stakeholders lack awareness, which can result in limited support and isolation. In contrast, when they feel supported, this leads to building resilience, with athletes with PPCS engaging in self- improvement and overcoming challenges. Awareness and advocacy further empower the athlete with PPCS and can result in more effective social, medical, and professional support. Therefore, our findings suggest that more support, including an early diagnosis, should be extended to athletes with PPCS, which could enable them to integrate their new identity into society more effectively. Moreover, our findings provide a call to action to promote awareness of PPCS and increased support like that currently extended to more visible conditions.

Background Plant‐based diets (PBDs) have gained popularity in recent years due to their co‐benefits for human and planetary health. Although clinical guidelines now recommend well‐balanced PBDs, it remains unclear how dietitians in the United Kingdom (UK) and Republic of Ireland (ROI) view such diets and their implementation in practice. This study aimed to evaluate the perspectives of registered dietitians (RDs) on the role of a whole food plant‐based diet (WFPBD) in clinical practice. Methods A cross‐sectional online survey was conducted amongst RDs in the UK and ROI between September and November 2023. Results A total of 335 RDs participated in the survey. Most RDs (76%) agree that a well‐planned WFPBD is suitable for all stages of life, with some (48%) expressing concerns over the risk of malnutrition and micronutrient deficiencies. Three‐quarters of RDs (75%) incorrectly thought that plant protein is incomplete, necessitating protein combining. A WFPBD was on average ranked fourth out of 14 dietary strategies for managing some of the leading non‐communicable diseases. Excluding dairy and eggs was the primary reason preventing RDs from personally adopting a WFPBD, whereas meal preparation and cost were the main barriers for their clients. The majority of RDs (79%) feel they did not receive sufficient education on WFPBDs, with 58% agreeing there are insufficient evidence‐based resources available in their field. Only 33% feel supported when advocating for a WFPBD in their workplace. Conclusions Although many RDs view WFPBDs as viable and clinically relevant, significant barriers to their implementation exist, underscoring the need for enhanced education and support.

Background/Aims Following stroke, people can present with spatial perceptual deficits, which are associated with vertical perception deficits and are known to negatively influence the outcome of rehabilitation. It is not known how vertical perception deficits influence rehabilitation therapists’ assessment and treatment choices. A survey of mainly UK-based physiotherapists and occupational therapists was undertaken to explore views and current practice in relation to vertical perception following stroke. Specifically, the survey investigated rehabilitation therapists’ views on terminology, assessment and treatment, impact on functional outcome and clinical decision making. Methods An online survey was completed by a convenience sample of 70 rehabilitation therapists (52 physiotherapists and 18 occupational therapists). Results Vertical perception deficits were commonly encountered by respondents and were diagnosed mainly through observation. Respondents were confident in their ability to assess and treat vertical perception deficits. Vertical perception deficits were understood to be associated with pushing behaviour, neglect, weight-bearing asymmetry and decreased balance. Respondents understood it was related to severe, right-sided strokes with sensory and proprioceptive loss, but were inconsistent in their awareness of the specific brain regions involved in vertical perception deficits, specifically in posterior circulation strokes. Respondents reported that stroke survivors with vertical perception deficits require longer periods of rehabilitation, and overall have a worse functional outcome than those without. A variety of treatment options were used to address vertical perception deficits. Conclusions Further research should investigate the treatment and assessment used by rehabilitation therapists in relation to vertical perception deficits following stroke. Implications for practice Vertical perception deficits are commonly encountered in stroke rehabilitation. Rehabilitation therapists identify this mainly through observation. There are currently no methods to quantify vertical perception deficits in the clinical environment. Individuals living with vertical perception deficit may require longer periods of rehabilitation. At present, there are no evidence-based interventions to address vertical perception deficits in people who have had a stroke.