Dietetic-Led Nutrition Interventions in Patients with COVID-19 during Intensive Care and Ward-Based Rehabilitation: A Single-Center Observational Study.

BACKGROUND: In this study, a report of dietitian-led nutrition interventions for patients with COVID-19 during ICU and ward-based rehabilitation is provided. As knowledge of COVID-19 and its medical treatments evolved through the course of the pandemic, dietetic-led interventions were compared between surge 1 (S1) and surge 2 (S2). METHODS: A prospective observational study was conducted of patients admitted to the ICU service in a large academic hospital (London, UK). Clinical and nutrition data were collected during the first surge (March-June 2020; n = 200) and the second surge (November 2020-March 2021; n = 253) of COVID-19. RESULTS: A total of 453 patients were recruited. All required individualized dietetic-led interventions during ICU admission as the ICU nutrition protocol did not meet nutritional needs. Feed adjustments for deranged renal function (p = 0.001) and propofol calories (p = 0.001) were more common in S1, whereas adjustment for gastrointestinal dysfunction was more common in S2 (p = 0.001). One-third of all patients were malnourished on ICU admission, and all lost weight in ICU, with a mean (SD) total percentage loss of 8.8% (6.9%). Further weight loss was prevented over the remaining hospital stay with continued dietetic-led interventions. CONCLUSIONS: COVID-19 patients have complex nutritional needs due to malnutrition on admission and ongoing weight loss. Disease complexity and evolving nature of medical management required multifaceted dietetic-led nutritional strategies, which differed between surges.

Elementary student and teacher perceptions of a mindfulness and yoga-based program in school: A qualitative evaluation.

RESEARCH QUESTION: What are the qualitative insights and perspectives about the implementation of a mindfulness and yoga-based program from elementary youth and teachers? CONTEXT: A mindfulness and yoga-based curriculum was implemented in 15 schools. The curriculum was taught to students during a physical education or dance class by instructors who were within each school and received training on the curriculum. SAMPLE SELECTION: Volunteer focus group elementary students who participated for one year and teachers who did not implement the program were qualitatively interviewed, by three trained University researchers. DATA COLLECTION: Nine focus groups were completed within three different elementary schools. Six focus groups were completed with 3rd and 5th grade students. Three focus groups were conducted with teachers within each school which received the program, excluding instructors. ANALYSIS: Focus group data were coded and a thematic analysis was completed among the 40 students and 23 teachers. INTERPRETATION AND MAIN RESULTS: Teachers had varying degrees of involvement with the program and communication emerged as a critical theme for buy-in as communication represents the underpinnings of creating and retaining stakeholders. Most students talked about perceived improvements in focus, emotional regulation, flexibility, breathing, and school work. A common theme to describe benefits of the program emerged with the idea of "increased focus". Conceptually, it may be that increasing mindfulness increases "focus" thus increasing positive outcomes. More research is needed to understand if "focus" may serve as a mediating variable on emotional regulation, cognitive improvements, and other health outcomes.

The Role of Violent Thinking in Violent Behavior: It's More About Thinking Than Drinking.

This article aims to explore and report on violent thinking and alcohol misuse; how these factors may predict self-reported violence. The role of violent thinking in violent behavior is both well established in theoretical models, yet there are few measures that explain this role. One measure that has been identified is the Maudsley Violence Questionnaire (MVQ). This is the first study to explore the use of the MVQ with a general (nonoffender) adult sample, having already been shown to be valid with young people (under 18 years old), adult male offenders, and mentally disordered offenders. This study involved 808 adult participants-569 female and 239 male participants. As figures demonstrate that around half of all violent crime in the United Kingdom is alcohol related, we also explored the role of alcohol misuse. Regression was used to explore how these factors predicted violence. The results demonstrate the important role of violent thinking in violent behavior. The MVQ factor of "Machismo" was the primary factor in regression models for both male and female self-reported violence. The role of alcohol in the regression models differed slightly between the male and female participants, with alcohol misuse involved in male violence. The study supports theoretical models including the role of violent thinking and encourages those hoping to address violence, to consider "Machismo" as a treatment target. The study also provides further validation of the MVQ as a helpful tool for clinicians or researchers who may be interested in "measuring" violent thinking.

A multi-dimensional experiment for characterization of pore structure heterogeneity using NMR.

In a liquid saturated porous sample the spatial inhomogeneous internal magnetic field in general depends on the strength of the static magnetic field, the differences in magnetic susceptibilities, but also on the geometry of the porous network. To thoroughly investigate how the internal field can be used to determine various properties of the porous structure, we present a novel multi-dimensional NMR experiment that enables us to measure several dynamic correlations in one experiment, and where all of the correlations involve the internal magnetic field and its dependence on the geometry of the porous network. (Correlations: internal gradient - pore size, internal gradient - magnetic susceptibility difference, internal gradient - longitudinal relaxation, longitudinal relaxation - magnetic susceptibility difference.) It is always a spatial average of the internal magnetic field, or one of the related properties, that is measured, which is important to take into consideration when analyzing the obtained results. We demonstrate how these correlations can be an indicator for pore structure heterogeneity, and focus in particular on how the effect from spatial averaging can be evaluated and taken into account in the different cases.

Characterising oil and water in porous media using decay due to diffusion in the internal field.

In the method Decay due to Diffusion in the Internal Field (DDIF), the diffusion behaviour of water molecules in the internal magnetic field makes it possible to determine a distribution of pore sizes in a sample. The DDIF experiment can also be extended to a DDIF-Carr-Purcell-Meiboom-Gill (DDIF-CPMG) experiment to measure correlations between the pore size and the transverse relaxation time, T2. In this study we have for the first time applied the DDIF experiment and the DDIF-CPMG experiment to porous materials saturated with both water and oil. Because of the large difference in diffusion rates between water and oil molecules, the DDIF experiment will act as a filter for the signal from oil, and we are left with the DDIF-signal from water only. This has been verified in model systems consisting of glass beads immersed in separate layers of water and oil, and in a sandstone sample saturated with water and oil. The results show that the DDIF and DDIF-CPMG experiments enable the determination of the confining geometry of the water phase, and how this geometry is correlated to T2. Data obtained in the sandstone sample saturated with water and oil also show that with the exception of the smallest pores there is no clear correlation between pore size and the relaxation time of water.

Understanding conduct disorder: The ways in which mothers attempt to make sense of their children's behaviour.

'Disruptive behaviour disorders' are the most common reason for referral to Child and Adolescent Mental Health Services (CAMHS). Current treatment guidelines focus on parent-training programmes. Difficulties are often reported when engaging families, with parental attributions and attitudes towards help-seeking proposed as influential factors. Previous research has tended to privilege pre-existing frameworks; this study utilised qualitative methods to add to the current understanding of the ways in which parents make sense of their children's behaviour. Semi-structured interviews were carried out with six mothers, recruited through CAMHS. Interpretative Phenomenological Analysis (IPA) revealed four master themes: 'Understanding the Emotional Child', 'The Emotional Parent', 'Getting Help' and 'The Journey'. Participants used a variety of explanations in order to make sense of their children's behaviour, including the impact of loss and trauma. Help-seeking was associated with feelings of shame, and services were often viewed as inconsistent and stigmatising. In contrast, positive experiences were those which were characterised as being non-judgemental, normalising and took into account the wider family context, including mothers' own emotional needs. These findings were discussed in relation to existing research and implications for clinical practice.

Long-range surface-induced water structures and the effect of 1-butanol studied by 1H nuclear magnetic resonance.

Thin films of water between glass plates were investigated in this study with regard to water structure and dynamics in the temperature range of 278-313 K. We further investigated how addition of 1-butanol (0.05 and 0.5 M) affects the range and properties of the surface-induced water structures. From the observation of two (1)H nuclear magnetic resonance (NMR) water resonances and two relaxation components, it was found that the interfacial water exists in a two-state mixture in dynamic equilibrium, with the respective structures interpreted as being high-density water (HDW) and low-density water (LDW). In the absence of 1-butanol, the LDW state is more pronounced, with a further shift in equilibrium toward the LDW state with an increase in temperature. However, in water film samples containing 1-butanol, the HDW state dominates at low temperatures while the LDW state becomes more visible at higher temperatures. Furthermore, the addition of 1-butanol significantly increased the extent of the surface-induced water structures. NMR relaxation shows that the dynamics of water in the HDW state is significantly affected by the presence of 1-butanol and further indicates that the distribution of values for the enthalpy of activation associated with translational motion of water molecules in the HDW state is narrower in the 0.05 M 1-butanol sample than in the 0.5 M 1-butanol sample.

1H NMR relaxation of water: a probe for surfactant adsorption on kaolin.

In this study, (1)H NMR is used to investigate properties of sodium dodecyl sulfate (SDS), tetradecyl trimethyl ammonium bromide (TTAB), and dodecyl trimethyl ammonium bromide (DTAB) adsorbed on kaolin by NMR T(1) and T(2) measurements of the water proton resonance. The results show that adsorbed surfactants form a barrier between sample water and the paramagnetic species present on the clay surface, thus significantly increasing the proton T(1) values of water. This effect is attributed to the amount of adsorbed surfactants and the arrangement of the surfactant aggregates. The total surface area covered by the cationic (DTAB and TTAB) and anionic (SDS) surfactants could be estimated from the water T(1) data and found to correspond to the fractions of negatively and positively charged surface area, respectively. For selected samples, the amount of paramagnetic species on the clay surface was reduced by treatment with hydrofluoric (HF) acid. For these samples, T(1) and T(2) measurements were taken in the temperature range 278-338 K, revealing detailed information on molecular mobility and nuclear exchange for the sample water that is related to surfactant behavior both on the surface and in the aqueous phase.