A Comparison of Behavior of Transitional-State Foods Under Varying Oral Conditions.

Transitional foods are under-utilized in the adult population as they may provide an opportunity to optimize eating pleasure and nutrition for individuals on a modified texture diet. Yet, little is known about the behavioral properties of transitional foods and no research to date has explored the dissolution of known transitional foods in adults. This study aimed to understand the extent of dissolution of five transitional snacks items in relationship to time, tongue pressure, and amount of saliva. Thirty individuals ages 50 to 88 participated in this study (10 with diagnosed xerostomia). The foods tested included shrimp chips, Baby Mum Mums, the EAT bar, and the Savorease cracker with and without dip. Each test food was placed in the mouth for 5 s or 12 s with or without tongue pressure and then expectorated. Benchtop preparation via the International Dysphagia Diet Standardisation Initiative (IDDSI) protocol was also completed. An IDDSI fork pressure test was then performed on all samples. Significant differences between snacks were found in degree of dissolution, with Savorease crackers dissolving more consistently than all others and Baby Mum Mums dissolving least frequently than all others. Tongue pressure positively influenced the dissolution of some foods, particularly those with decreased rates of dissolution. Differences also existed between testing conditions. Overall, there was a wide variability in degree and speed of dissolution across different transitional foods and testing methods. These findings support the need for individual testing to explore post-oral processing consistency when determining the clinical utility of transitional foods.

Evolution of a multifunctional trait: shared effects of foraging ecology and thermoregulation on beak morphology, with consequences for song evolution.

While morphological traits are often associated with multiple functions, it remains unclear how evolution balances the selective effects of different functions. Birds' beaks function not only in foraging but also in thermoregulating and singing, among other behaviours. Studies of beak evolution abound, however, most focus on a single function. Hence, we quantified relative contributions of different functions over an evolutionary timescale. We measured beak shape using geometric morphometrics and compared this trait with foraging behaviour, climatic variables and song characteristics in a phylogenetic comparative study of an Australasian radiation of songbirds (Meliphagidae). We found that both climate and foraging behaviour were significantly correlated with the beak shape and size. However, foraging ecology had a greater effect on shape, and climate had a nearly equal effect on size. We also found that evolutionary changes in beak morphology had significant consequences for vocal performance: species with elongate-shaped beaks sang at higher frequencies, while species with large beaks sang at a slower pace. The evolution of the avian beak exemplifies how morphological traits can be an evolutionary compromise among functions, and suggests that specialization along any functional axis may increase ecological divergence or reproductive isolation along others.

Headache in a patient with influenza.

Complications from influenza have been documented in the literature, but this patient case represents a rare and potentially deadly result in an otherwise healthy adult. Providers in the emergency department should be vigilant when assessing patients with influenza symptoms and monitoring those that don't always present with common symptoms and complaints. This patient's cerebral edema and tonsillar herniation was life-threatening and was caused from the influenza B virus.

Swine flu panic shows how little we really care.

I have to confess that when the first reports of swine flu started circulating, I did have a strong sense of déjà vu - after all, we've been here before. Back in 2003, the world was under threat from another potentially lethal virus that began in an economically deprived part of the world among animal stocks and briefly (according to some anyway) threatened to turn into a global pandemic--Avian flu.

Combating a rising incidence of Legionnaire's disease.

A statement released last week by the Health Protection Agency highlighted a recent increase in the incidence of Legionnaire's disease in England and Wales. Although an upsurge in cases is common at this time of year due to people returning from holidays abroad, only a small proportion of the recent cases can be attributed to foreign travel. Nurses need to be aware of the symptoms and what health measures they can take.

Management of suspected bacterial urinary tract infection.

New guidelines on the management of suspected bacterial urinary tract infection in adults have just been released by the Scottish Intercollegiate Guidelines Network (SIGN). The guidance states that the presence of bacteriuria should lead to antibiotic treatment only when there is definitive evidence that eradicating the bacterial infection will result in a tangible health gain at a reasonable level of risk (SIGN, 2006).

An overview of the new NICE guidelines on bipolar disorder.

Bipolar disorder can be a debilitating long-term condition characterised by extreme mood swings, ranging from elation to severe depression and sometimes coexisting mixtures of the two. This article looks at new guidance from NICE (2006) that provides recommendations for nurses on the assessment, treatment and long-term management of bipolar disorder.

Implications of the latest NICE Parkinson's disease guidance.

This month sees the release of new NICE best practice guidance for healthcare professionals caring for people with Parkinson's disease. The variety and severity of symptoms that affect people with Parkinson's result in significant disability and present a unique set of challenges for nurses.

New initiatives to address the healthcare needs of men.

The recent Men's Health Week has brought the issue of men's health back to the forefront of the health provision agenda, but historically men's health has compared badly to that of women. This article examines what nurses can do to improve men's health.

NICE guidelines to improve TB management and prevention.

In the UK although the majority of the population is at very low risk of TB due to vaccination, the number of cases reported is increasing. In response NICE has released fresh guidance on prevention and treatment. Nurses can play a crucial role in adherence due to the extent of their patient contact.