To cite this article: Cummings AJ, Knibb RC, King RM, Lucas JS. The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy 2010; ...65: 933-945. Food allergy affects 6% of children but there is no cure, and strict avoidance of index allergens along with immediate access to rescue medication is the current best management. With specialist care, morbidity from food allergy in children is generally low, and mortality is very rare. However, there is strong evidence that food allergy and food hypersensitivity has an impact on psychological distress and on the quality of life (QoL) of children and adolescents, as well as their families. Until recently, the measurement of QoL in allergic children has proved difficult because of the lack of investigative tools available. New instruments for assessing QoL in food allergic children have recently been developed and validated, which should provide further insights into the problems these children encounter and will enable us to measure the effects of interventions in patients. This review examines the published impact of food allergy on affected children, adolescents and their families. It considers influences such as gender, age, disease severity, co-existing allergies and external influences, and examines how these may impact on allergy-related QoL and psychological distress including anxiety and depression. Implications of the impact are considered alongside avenues for future research.
Purpose
To derive a health state classification system (HSCS) from the cancer-specific quality of life questionnaire, the EORTC QLQ-C30, as the basis for a multi-attribute utility instrument.
Methods
...The conceptual model for the HSCS was based on the established domain structure of the QLQ-C30. Several criteria were considered to select a subset of dimensions and items for the HSCS. Expert opinion and patient input informed a priori selection of key dimensions. Psychometric criteria were assessed via secondary analysis of a pooled dataset comprising HRQOL and clinical data from 2616 patients from eight countries and a range of primary cancer sites, disease stages, and treatments. We used confirmatory factor analysis (CFA) to assess the conceptual model’s robustness and generalisability. We assessed item floor effects (>75 % observations at lowest score), disordered item response thresholds, coverage of the latent variable and differential item function using Rasch analysis. We calculated effect sizes for known group comparisons based on disease stage and responsiveness to change. Seventy-nine cancer patients assessed the relative importance of items within dimensions.
Results
CFA supported the conceptual model and its generalisability across primary cancer sites. After considering all criteria, 12 items were selected representing 10 dimensions: physical functioning (mobility), role functioning, social functioning, emotional functioning, pain, fatigue, sleep, appetite, nausea, bowel problems.
Conclusions
The HSCS created from QLQ-C30 items is known as the EORTC Quality of Life Utility Measure-Core 10 dimensions (QLU-C10D). The next phase of the QLU-C10D’s development involves valuation studies, currently planned or being conducted across the globe.
The INT/WFC Photometric Hα Survey of the Northern Galactic Plane (IPHAS) is a 1800 deg2 imaging survey covering Galactic latitudes |b| < 5° and longitudes ℓ = 30°–215° in the r, i, and Hα filters ...using the Wide Field Camera (WFC) on the 2.5-m Isaac Newton Telescope (INT) in La Palma. We present the first quality-controlled and globally calibrated source catalogue derived from the survey, providing single-epoch photometry for 219 million unique sources across 92 per cent of the footprint. The observations were carried out between 2003 and 2012 at a median seeing of 1.1 arcsec (sampled at 0.33 arcsec pixel−1) and to a mean 5σ depth of 21.2 (r), 20.0 (i), and 20.3 (Hα) in the Vega magnitude system. We explain the data reduction and quality control procedures, describe and test the global re-calibration, and detail the construction of the new catalogue. We show that the new calibration is accurate to 0.03 mag (root mean square) and recommend a series of quality criteria to select accurate data from the catalogue. Finally, we demonstrate the ability of the catalogue's unique (r − Hα, r − i) diagram to (i) characterize stellar populations and extinction regimes towards different Galactic sightlines and (ii) select and quantify Hα emission-line objects. IPHAS is the first survey to offer comprehensive CCD photometry of point sources across the Galactic plane at visible wavelengths, providing the much-needed counterpart to recent infrared surveys.
TRPA1 is a chemosensory ion channel that functions as a sentinel for structurally diverse electrophilic irritants. Channel activation occurs through an unusual mechanism involving covalent ...modification of cysteine residues clustered within an amino-terminal cytoplasmic domain. Here, we describe a peptidergic scorpion toxin (WaTx) that activates TRPA1 by penetrating the plasma membrane to access the same intracellular site modified by reactive electrophiles. WaTx stabilizes TRPA1 in a biophysically distinct active state characterized by prolonged channel openings and low Ca2+ permeability. Consequently, WaTx elicits acute pain and pain hypersensitivity but fails to trigger efferent release of neuropeptides and neurogenic inflammation typically produced by noxious electrophiles. These findings provide a striking example of convergent evolution whereby chemically disparate animal- and plant-derived irritants target the same key allosteric regulatory site to differentially modulate channel activity. WaTx is a unique pharmacological probe for dissecting TRPA1 function and its contribution to acute and persistent pain.
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•WaTx is a cell-penetrating scorpion toxin targeting the TRPA1 ion channel•WaTx and electrophiles converge on a shared intracellular ligand-binding domain•WaTx binding stabilizes the TRPA1 open state and diminishes Ca2+-permeability•WaTx thus produces pain and pain hypersensitivity, but not neurogenic inflammation
A selective cell-penetrating scorpion toxin targets the irritant receptor, TRPA1, via a distinct biochemical mechanism from that used by irritants, allowing definition of a new mechanism of channel activation and interrogation of pathways of pain sensitization.
Purpose
To ensure clarity in communication in the field of quality of life research, and meaningful use of ‘quality of life’ as a research outcome, requires two things: awareness that there is a ...range of conceptualisations and definitions of ‘quality of life’, and for any particular study, consistency between the way the term is defined and operationalised in that setting. We aimed to identify how frequently research articles described (HR)QOL as a construct of interest, how frequently they referred to “patient-reported outcome (measures)”, which patient-reported outcome measures were used, and how (HR)QOL was defined.
Methods
We reviewed all
Quality of Life Research
articles published in 2017 and recorded whether they described
health-related quality of life
or
quality of life
as constructs of interest, and/or mentioned the term(s)
patient-reported outcome
(
measures
). We recorded definitions of (HR)QOL stated and questionnaires used. We classified articles according to constructs assessed and instruments used, and examined whether articles citing the same definition used the same questionnaires.
Results
We reviewed 300 articles; 65% stated that (HR)QOL was a construct of interest, 27% mentioned patient-reported outcome (measures), and 20% mentioned neither. Fifty-one articles provided definitions of (HR)QOL, citing 66 sources, with 11 definitions cited more than once. PROMIS, SF, EQ-5D, and EORTC instruments were the most commonly used. The only definition and questionnaire consistently used together were the WHO definitions/instruments.
Conclusion
These results demonstrate considerable heterogeneity in the definition and operationalisation of (HR)QOL, between and within studies. This limits meaningful interpretation of (HR)QOL scores and complicates literature searches. Investigators should define constructs and select instruments aligned with their definitions.
We present laboratory and numerical models investigating the behavioural regimes of rapidly rotating convection in high-latitude planetary core-style settings. Our combined laboratory-numerical ...approach, utilizing simplified geometries, can access more extreme parameters (e.g. Rayleigh numbers Ra ≲ 1013; Nusselt numbers Nu ≲ 103; Ekman numbers E ≳ 3 × 10− 8) than current global-scale dynamo simulations. Using flow visualizations and heat transfer measurements, we study the axialized flows that exist near the onset of rotating convection, as well as the 3-D flows that develop with stronger forcing. With water as the working fluid (Prandtl number Pr ≃ 7), we find a steep scaling trend for rapidly rotating convective heat transfer, Nu ∼ (Ra/Ra
C
)3.6, that is associated with the existence of coherent, axialized columns. This rapidly rotating trend is steeper than the trends found at moderate values of the Ekman number, and continues a trend of ever-steepening scalings as the rotation rate of the system is increased. In contrast, in more strongly forced or lower rotation rate cases, the heat transfer scaling consistently follows a shallower slope equivalent to that of non-rotating convection systems. The steep heat transfer scaling in the columnar convection regime, corroborated by our laboratory flow visualizations, imply that coherent, axial columns have a relatively narrow range of stability. Thus, we hypothesize that coherent convection columns are not stable in planetary core settings, where the Ekman number is estimated to be ∼10−15. As a consequence, convective motions in the core may not be related to the columnar motions found in present-day global-scale models. Instead, we hypothesize that turbulent rotating convection cascades energy upwards from 3-D motions to large-scale quasi-2-D flow structures that are capable of efficiently generating planetary-scale magnetic fields. We argue that the turbulent regimes of rapidly rotating convection are essential aspects of core dynamics and will be necessary components of robust, next-generation and multiscale dynamo models.
Globular clusters trace the formation history of the spheroidal components of our Galaxy and other galaxies, which represent the bulk of star formation over the history of the Universe. The clusters ...exhibit a range of metallicities (abundances of elements heavier than helium), with metal-poor clusters dominating the stellar halo of the Galaxy, and higher-metallicity clusters found within the inner Galaxy, associated with the stellar bulge, or the thick disk. Age differences between these clusters can indicate the sequence in which the components of the Galaxy formed, and in particular which clusters were formed outside the Galaxy and were later engulfed along with their original host galaxies, and which were formed within it. Here we report an absolute age of 9.9 ± 0.7 billion years (at 95 per cent confidence) for the metal-rich globular cluster 47 Tucanae, determined by modelling the properties of the cluster's white-dwarf cooling sequence. This is about two billion years younger than has been inferred for the metal-poor cluster NGC 6397 from the same models, and provides quantitative evidence that metal-rich clusters like 47 Tucanae formed later than metal-poor halo clusters like NGC 6397.
Analysis of delta 18O in igneous zircons of known age traces the evolution of intracrustal recycling and crust-mantle interaction through time. This record is especially sensitive because oxygen ...isotope ratios of igneous rocks are strongly affected by incorporation of supracrustal materials into melts, which commonly have delta 18O values higher than in primitive mantle magmas. This study summarizes data for delta 18O in zircons that have been analyzed from 1,200 dated rocks ranging over 96% of the age of Earth. Uniformly primitive to mildly evolved magmatic delta 18O values are found from the first half of Earth history, but much more varied values are seen for younger magmas. The similarity of values throughout the Archean, and comparison to the composition of the "modern" mantle indicate that delta 18O of primitive mantle melts have remained constant (+-0.2 0/00) for the past 4.4 billion years. The range and variability of delta 18O in all Archean zircon samples is subdued (delta 18O(Zrc)=5-7.5 0/00) ranging from values in high temperature equilibrium with the mantle (5.3+- 0.3 0/00) to slightly higher, more evolved compositions (6.5-7.5 0/00) including samples from: the Jack Hills (4.4-3.3 Ga), the Beartooth Mountains (4.0-2.9 Ga), Barberton (3.5-2.7 Ga), the Superior and Slave Provinces (3.0 to 2.7 Ga), and the Lewisian (2.7 Ga). No zircons from the Archean have been analyzed with magmatic delta 18O above 7.5 0/00. The mildly evolved, higher Archean values (6.5-7.5 0/00) are interpreted to result from exchange of protoliths with surface waters at low temperature followed by melting or contamination to create mildly elevated magmas that host the zircons. During the Proterozoic, the range of delta 18O(Zrc) and the highest values gradually increased in a secular change that documents maturation of the crust. After delta 1.5 Ga, high delta 18O zircons (8 to >10 0/00) became common in many Proterozoic and Phanerozoic terranes reflecting delta 18O(whole rock) values from 9 to over 12 0/00. The appearance of high delta 18O magmas on Earth reflects nonuniformitarian changes in the composition of sediments, and rate and style of recycling of surface-derived material into magmas within the crust. PUBLICATION ABSTRACT
We present a new 400-ks Chandra X-ray observation of the merging galaxy cluster Abell 2146. This deep observation reveals detailed structure associated with the major merger event including the Mach ...number M= 2.3 ± 0.2 bow shock ahead of the dense, ram pressure stripped subcluster core and the first known example of an upstream shock in the intracluster medium (ICM) (M= 1.6 ± 0.1). By measuring the electron temperature profile behind each shock front, we determine the time-scale for the electron population to thermally equilibrate with the shock-heated ions. We find that the temperature profile behind the bow shock is consistent with the time-scale for Coulomb collisional equilibration and the post-shock temperature is lower than expected for instant shock heating of the electrons. Although like the Bullet cluster the electron temperatures behind the upstream shock front are hotter than expected, favouring the instant heating model, the uncertainty on the temperature values is greater here and there is significant substructure complicating the interpretation. We also measured the width of each shock front and the contact discontinuity on the leading edge of the subcluster core to investigate the suppression of transport processes in the ICM. The upstream shock is ∼440 kpc in length but appears remarkably narrow over this distance with a best-fitting width of only 6+5
−3 kpc compared with the mean free path of 23 ± 5 kpc. The leading edge of the subcluster core is also narrow with an upper limit on the width of only 2 kpc separating the cool, multiphase gas at 0.5-2 keV from the shock-heated surrounding ICM at ∼6 keV. The strong suppression of diffusion and conduction across this edge suggests a magnetic draping layer may have formed around the subcluster core. The deep Chandra observation has also revealed a cool, dense plume of material extending ∼170 kpc perpendicular to the merger axis, which is likely to be the disrupted remnant of the primary cluster core. This asymmetry in the cluster morphology indicates the merger has a non-zero impact parameter. We suggest that this also explains why the south-western edge of the subcluster core is narrow and stable over ∼150 kpc in length, but the north-eastern edge is broad and being stripped of material.
The Antarctic Ice Sheet (AIS) is out of equilibrium with the current anthropogenic‐enhanced climate forcing. Paleoenvironmental records and ice sheet models reveal that the AIS has been tightly ...coupled to the climate system during the past and indicate the potential for accelerated and sustained Antarctic ice mass loss into the future. Modern observations by contrast suggest that the AIS has only just started to respond to climate change in recent decades. The maximum projected sea level contribution from Antarctica to 2100 has increased significantly since the Intergovernmental Panel on Climate Change (IPCC) 5th Assessment Report, although estimates continue to evolve with new observational and theoretical advances. This review brings together recent literature highlighting the progress made on the known processes and feedbacks that influence the stability of the AIS. Reducing the uncertainty in the magnitude and timing of the future sea level response to AIS change requires a multidisciplinary approach that integrates knowledge of the interactions between the ice sheet, solid Earth, atmosphere, and ocean systems and across time scales of days to millennia. We start by reviewing the processes affecting AIS mass change, from atmospheric and oceanic processes acting on short time scales (days to decades), through to ice processes acting on intermediate time scales (decades to centuries) and the response to solid Earth interactions over longer time scales (decades to millennia). We then review the evidence of AIS changes from the Pliocene to the present and consider the projections of global sea level rise and their consequences. We highlight priority research areas required to improve our understanding of the processes and feedbacks governing AIS change.
Plain Language Summary
The Antarctic Ice Sheet (AIS) is an important component of the global climate system. Human activities have caused the atmosphere and especially the oceans to warm. However, the full effect of human caused climate change on the AIS has not currently been realized because the ice sheet responds on a range of time scales and to many different Earth processes. Modern observations show that West Antarctica has been melting at an accelerating rate since the 2000s, while the data for East Antarctica are less clear. Environmental records preserve the history of the climate and AIS, which extend beyond the instrumental record and reveal how the AIS responded to past climate warming. Estimates of how much the AIS will contribute to sea level rise by the Year 2100 have changed as a result of new information on how the AIS evolved in the past and research into the interactions between the ice sheet, solid Earth atmosphere, and ocean systems. This review brings together our knowledge of the major processes and feedbacks affecting the AIS and the evidence for how the ice sheet changed since the Pliocene. We consider the future estimates and consequences of global sea level rise from melting of the AIS and highlight priority research areas.
Key Points
The AIS is a highly dynamic component of the Earth system, evolving on a broad range of temporal and spatial scales
Paleoenvironmental evidence highlights the centennial to millennial response time scales of the AIS to atmospheric‐ocean forcing
Coupling feedbacks in Earth system components are required to reduce the uncertainty in AIS's contribution to past and future sea level rise
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