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Introduction: This study aimed to examine the effect of breakages and re-introduction into cold chain on the rocuronium bromide compound. Rocuronium bromide is frequently used in routine theatre lists and plays a vital role in modified rapid sequence induction and intubation for emergency patients who have contraindications to the primarily used muscle relaxant, succinylcholine. With the current practice of removing the drug from, and then reintroducing it into the cold chain, unpredictable clinical effects, including delayed onset of action and shortened duration of action have been observed. This may pose significant risks to the patient. Methods: Rocuronium bromide was subjected to different clinically applicable storage and temperature scenarios, after which the compound was analysed for integrity and quantities of the active compound, including detection of possible degradation products, by mass spectrometry, and compared to cold chain control samples. Results: There were no significant differences between any of the temperature exposure groups (18 °C or 24 °C) or between single or double exposures at these temperatures. No statistically significant difference could be demonstrated between the two control groups (cold chain preserved and room temperature controlled) with testing done at weeks one and six. However, week twelve analysis revealed a statistically significant result which translates to a 26 μg/ml difference, which clinically would have no effect. Substantial results were obtained with a secondary exposure to air; which lead to a 20% decrease in rocuronium concentration (p = 0.02). Conclusion: Practice should be adapted by keeping careful documentation as to when cold-chain was broken, and when the recommended 12 week period will lapse. Vial sharing as a standard is not recommended. If small quantities are repeatedly withdrawn from the vial during a prolonged case, the unused contents should be discarded after eight hours.

Confined to a single island where its small population fluctuates in response to rainfall, the Raso lark is likely to remain Critically Endangered unless a second population becomes established This paper reports translocations of larks, 37 in 2018 and 33 in 2019, to the nearby island of Santa Luzia where the species existed until about 500 years ago Both islands lie within the Reserva Natural Integral de Santa Luzia While the hard release protocol proceeded without mishap, problems with radio-tagging the released birds were encountered However early indications are encouraging;the released birds have bred, and their annual survival is not substantially worse than that of larks on the source island, Raso Unexpectedly, the study documented several natural, unassisted movements of larks from Raso to Santa Luzia (and, less unexpectedly, of translocated birds returning to Raso) The ultimate outcome of the project remains uncertain since eradication of Santa Luzia’s introduced cats, possible predators of the larks, was interrupted when the island was evacuated because of the Covid-19 pandemic © Paul Donald

Background The UK does not currently have guidelines on gestational weight gain owing to gaps in the evidence base. Reintroducing routine weighing of women throughout pregnancy would begin to provide the evidence needed to fill this gap. The aim of this research was to re-introduce measurement of weight at each routine antenatal appointment in a small scale study, in order to determine the feasibility and acceptability of implementing the practice on a larger scale. Methods A feasibility study, incorporating quantitative and qualitative components, was conducted in one antenatal hospital clinic and with one community midwifery team. Thirty-eight pregnant women were recruited at their 20 week anomaly scan appointment and weighed at their appointments throughout the rest of their pregnancy; five participated in a telephone interview at approximately 37 weeks gestation. Data were collected on: numbers consenting to be weighed, reasons for declining to be weighed and number of weight measurements recorded. Qualitative interviews were used to explore acceptability of the practice to pregnant women. Results Overall, 79.2% (38 out of 48) of those approached consented to being weighed throughout pregnancy; of the 10 who declined, three cited not wanting to be weighed. In the interviews, women discussed routine weighing as a positive experience, described several benefits of weighing and indicated they would like more information about weight during pregnancy. No major barriers to the integration of a weight measurement into routine antenatal appointments were encountered. Completion of the weight record sheets that were inserted into women’s handheld notes varied between staff: of the 26 sheets recovered from handheld notes, only 3 (11.5%) had no weights recorded, 17 (65.4%) had between one and three weights recorded and six (23.1%) had more than 4 weights recorded. Conclusions In this feasibility study, routine weighing was acceptable to pregnant women. No barriers that would inhibit re-introduction of weighing women throughout pregnancy into standard antenatal care were encountered. Implementation of routine weighing during pregnancy on a larger scale should be considered as it may have benefits for women in the short and long-term, particularly with regard to informing appropriate gestational weight gain guidelines in the UK.

In a previous study, we found that 2-ketobutyrate (2-KB) was seriously degraded in Escherichia coli. In the present investigation, we tried to clarify the products of that degradation process, and intriguingly reconfirmed that 2-KB is chopped up to form propionyl-CoA, 1-propanol and propionate. This short commentary re-introduces efficient endogenous pathways for production of value-added odd-chain compounds such as propionyl-CoA-derived chemicals.

Purpose: To investigate the relationship between timing of re-introduction of feeds following surgery for Necrotising Enterocolitis (NEC) and important early outcomes.Methods: Secondary analysis of prospectively collected data from paediatric surgical units in UK/Ireland of infants who underwent laparotomy for NEC between 01/03/2013 and 28/02/2014. Multivariable logistic regression analysis was used to compare the relationship of early (≤ 7 days) and later (8-27 days) re-introduction of feeding after surgery on death or need for PN at 28 days, correcting for known cofounders.Results: 41/143 infants (29%) received early and 102/143 infants (71%) had delayed reintroduction of feeding. Infants in the early feeding group had a higher gestational age at birth, higher proportion of growth restriction, lower inotrope requirement, and weremore likely to have undergone primary anastomosis. Following adjustment there was no statistically significant difference detected in the rate of death or need for PN at 28 days, adjusted OR 0.4 (95% CI 0.2-1.1), noting the limited statistical power of this comparison.Conclusions: There is no evidence from this study to support a minimum period of 7 days nil by mouth post laparotomy for infants with NEC. Early feed reintroduction following laparotomy for NEC is safe in appropriate cases.Level of evidence: Level II - Treatment Study Group; Prospective comparative study.Keywords: Bowel rest; Necrotising enterocolitis (NEC); Neonatal; Total parenteral nutrition (TPN); Treatment.

The article presents the results of field studies conducted in the Tysmenytsia district of Ivano-Frankivsk region on sod-podzolic soils with the use of sewage sludge as fertilizer, to determine the productivity of willow energy of the second cycle of plantation use. Studies have shown that sewage sludge before the second cycle of using willow plantation energy, increases the content of organic matter in the soil, increases the productivity of agrophytocenosis, in particular raises the yield of raw and dry biomass.

In April 2018, Hong Kong issued new listing rules to introduce the dual-class share structure, also known as weighted voting rights (WVR), under which a special class of shareholders' voting rights...

Introduction During the COVID-19 pandemic, operations performed in NHS hospitals were restricted. Breast cancer surgery remained vital, however, to reduce theatre capacity pressures and re-admission rates the procedures available were rationalised to keep the risk of complications low. Immediate breast reconstruction was stopped. COVID-19 recovery meant careful reintroduction of complex surgeries, with competing interests from different surgical specialities for theatre capacity within the Trust. The psychological effects of breast cancer are significant. Therefore, it was important to advocate for our patients and ensure the reintroduction of this service. Method To strengthen our case, a retrospective audit of all immediate breast reconstruction outcomes was performed for cases during the 12 months preceding COVID-19. Results 64 patients underwent immediate implant and Acellular Dermal Matrix (ADM) breast reconstruction. Five (7.8%) patients returned to theatre. One (1.5%) returned during their initial in-patient stay due to haematoma. Four patients (6.3%) returned between 3 and 12 weeks following their original surgery date. Infection rates were higher in smokers or those with a BMI >35. Conclusions These results were presented to management and the reconstruction services were re-introduced in our Trust with stringent inclusion criteria. We can therefore offer our patients an improved service that considers both physical and psychological health.

Simple Summary Like humans, great apes have extended childhoods during which they depend on maternal pedagogy. To help rescued orphans recover from maternal loss our rehabilitation programme is modelled on the natural infant development of orangutans. Orphaned apes cannot be released back into freedom before they have learned the skills necessary to survive alone. To prevent suffering after release we documented the development of survival skills during the rehabilitation process. Seven orangutan orphans aged 1.5–9 years were observed over 18 months in their forest school, immersed in a natural forest environment with human surrogate mothers and other orphans. Social interactions deviated from wild mother-reared immatures: Infant orphans spent more time playing with peers, rested less, and were far from their human surrogate mothers earlier and often than wild immatures are from their biological mothers. Around weaning age, 4- to 7-year-old orphans took up a typical orangutan life-style: they interacted less with human surrogate mothers and peers, stayed high in the trees and slept in nests in the forest. Their time budgets resembled those of wild adults. We conclude that it is not only ethical but also possible to assess survival competences of rehabilitant orphans before release and choose release candidates accordingly. Abstract Orangutans depend on social learning for the acquisition of survival skills. The development of skills is not usually assessed in rescued orphans’ pre-release. We collected data of seven orphans over an 18-months-period to monitor the progress of ontogenetic changes. The orphans, 1.5–9 years old, were immersed in a natural forest environment with human surrogate mothers and other orphans. Social interactions deviated significantly from those of wild mother-reared immatures. Infants spent more time playing socially with peers, at the expense of resting and solitary play. Infants were also more often and at an earlier age distant from their human surrogate mothers than wild immatures are from their biological mothers. We found important changes towards an orangutan-typical lifestyle in 4- to 7-year-old orphans, corresponding to the weaning age in maternally reared immatures. The older orphans spent less time interacting with human surrogate mothers or peers, started to use the canopy more than lower forest strata and began to sleep in nests in the forest. Their time budgets resembled those of wild adults. In conclusion, juvenile orphans can develop capacities that qualify them as candidates for release back into natural habitat when protected from humanising influences and immersed in a species-typical environment.

Sub-Tenon's block (STB) is a good technique of local anaesthesia for many types of eye surgery. It has a relatively good risk profile, in that sight- and life-threatening complications appear to be extremely rare. STB has gained popularity in the last three decades, with refinements including different types of blunt metal cannula, plastic cannulae and 'incisionless' approaches. Usage of STB varies significantly across the globe. This narrative review documents the historical evolution of STB techniques, anatomical and physiological considerations, its utility and suitability, complications, explores the current practice and possible future applications.摘要: 球筋膜下麻醉技术 (Sub-Tenon’s block, STB) 是许多眼科手术优选的局部麻醉技术。STB风险相对较低, 威胁视力和生命的并发症极为罕见。在过去的三十年里, STB不断发展并广泛应用, 其改进技术包括使用不同类型的钝性金属注射管、塑料注射管以及 “无切口”的方法。STB在全球的应用差异很大。这篇叙述性文献综述回顾了STB技术的历史演变、解剖学和生理学相关理论依据、实用性及适用性、相关并发症, 并探讨了STB当前的应用及未来展望。.

BackgroundSusceptibility to malaria is the predisposition of populations to be infected by malaria parasites. It is influenced by the age-sex composition, parasitaemia, immunity, pregnancy status, type of residency, socio economic status, history migration of the population; broadly biological and generic factors. As imported cases are still being reported and one introduced malaria case was reported in 2018, prevention of re-introduction/re-establishment of malaria is a challenge for Sri Lanka. Addressing susceptibility to malaria is crucial for planning and implementing appropriate interventions to sustain malaria-free status of the country. The aim of this study was to assess susceptibility to malaria during the prevention of re-introduction/re-establishment phase in Sri Lanka. Methods A national survey was conducted among 3,454 households. A multistage cluster sampling technique was used to select the households. Susceptibility was assessed based on a developed conceptual framework adapted from Kienberger and Hagenlocher (2014), and an interviewer-administered questionnaire. Data analysis was done using SPSS version 20 package. ResultsThere was zero prevalence of malaria parasites both in the general population and among fever patients. The proportion of population who had been overseas within the last 3 years in the urban sector (4.5%, n=99) was significantly higher than that of rural (2.8%, n=288) and estate sectors (0.2%, n=2) (χ42=66.103; pthquintile with a slight rise in the 5th quintile (χ82=60.985; PConclusions Zero prevalence of malaria parasites supports the malaria-free status of the country and pooled blood samples may be tested during reactive case surveillance as a cost-effective approach. Urban and upper socioeconomic class population should be targeted for screening and awareness programmes on prevention of re-establishment of malaria.As susceptibility is a dynamic phenomenon, its assessment should be done periodically. Combining it with the resilience and receptivity, social vulnerability and risk of re-introduction/re-establishment of malaria could be assessed.

Wildlife reintroduction regulations require feasibility assessment to inform planning. The study aims to contribute to the existing knowledge on northern Gonarezhou National Park (GNP), southeastern Zimbabwe, prior to the black rhino re-introduction project. The study objective was to assess browse availability and suitability for black rhino re-introduction in northern GNP. We stratified the study area into two strata, i.e. north and south of Runde River in GNP. A total of 96 sample plots measuring 20 m × 30 m (i.e., 48 plots in each study stratum) were randomly placed across the study strata, between March and April 2011. Woody plant variables recorded are: shrub height, shrub canopy diameters, evidence of browsing on woody plants, number of shrubs and woody species. Principal browse frequency of occurrence and proportional quality of woody species were categorized and analyzed in combination with knowledge on the woody species’ value to black rhino diet. Preferred woody species were determined using browse suitability/electivity index. A total of 3201 woody plants were recorded across the study strata. Woody species diversity and black rhino’s browse suitability/electivity value significantly (p = 0.001) differed across the study strata. However, there were no significant differences in shrub density, shrub canopy volume and density of browsed plants. Common principal forages were recorded and included: knob thorn Acacia (Acacia nigrescens), small-leaved sickle-bush (Dichrostachys cineria) and tamboti (Spirostachys africana). The study suggested that black rhino’s browse suitability, preferred browse woody species, woody species diversity and proportional browse availability, as selected attributes are favorably more pronounced in the northern side of the Runde River in GNP, suggesting it is more suitable as a sanctuary for the black rhino re-introduction programme. It was recommended that black rhinos could be re-introduced in the northern GNP area provided other important factors such as law enforcement are taken into consideration.

Background NICE guidance approves pathways for inflammatory arthritis biologic therapies. Locally, CCG's commission pathways based on their interpretation of NICE guidance. For patients to have equal access to biologics, CCG pathways in different areas must be uniform. We examined whether CCG biologics pathways complied with this standard. Methods Using Freedom of Information requests, direct requests and internet searches, we found 21 approved biologics pathways in England for rheumatoid arthritis, 12 for psoriatic arthritis and 11 for ankylosing spondylitis. This covered 22.8 million people in England for RA (2017 population estimates). CCG Pathways were compared to NICE guidance with respect to restrictions and number of therapies allowed before an Individual Funding Request (IFR) was needed. Results We studied NICE guidance and determined an 'ideal' pathway for patients requiring > 1 biologic. All CCG pathways followed NICE guidance for 1st line biologics but there was significant variation for biologic failures. 18/21 CCG RA pathways indicated the maximum number of drugs that the CCG would commission without the clinician needing IFR. 7/18 allowed 1-3 biologics serially, 10/18 allowed 4-6 and 1/18 was unrestricted. Rituximab is NICE approved in RA in inadequate responders/intolerance to DMARDs/anti-TNF-α. 17/21 RA pathways allowed rituximab 1stline for haematological or treated solid malignancies, 4/21 did not. 6/21 CCG’s allowed rituximab 5 years after solid organ malignancy, 5/21 after 10 years, 10/21 did not specify or allow this usage. NICE guidelines for RA approve 11 biologics. 14/21 RA pathways allowed all 11 biologics, 7/21 pathways excluded sarilumab, tofacitinib or baricitinib or all three. NICE guidelines for PsA recommend the least expensive drug used first of the injected biologics or JAK inhibitors. IFR was required after 3 drugs in 9/12 pathways with 1/12 allowing 4 lines of therapy. For AS, 5/11 allowed 2 lines of therapy, the remainder 3 or 4 lines. Again, many pathways pre-specified which biologics could be used and excluded other NICE approved drugs at specific stages. Conclusion NICE specify the least expensive drug should be used for injected biologics with variation for administration mode/dosage. CCG’ s commission variably restrictive pathways potentially against NICE guidance, both with number and type of therapies before IFR submission is required. Some pathways allowed little scope to use therapies from earlier pathway points without breaching CCG limits. The IFR process for NICE approved therapies can exhibit wide variation in our experience with different outcomes for similar cases, and is time consuming with CCG decision making being opaque, despite NICE approval being legally enforceable. CCG biologic pathways introduce wide regional variation and potential unfairness in their interpretation of NICE guidance. This may disadvantage the worst affected patients who fail several therapies and prevent access to life changing therapy depending on geographical location. Disclosures J. Mistry None. D. Hill None. A. Kaul None.

The Mediterranean ribbed limpet Patella ferruginea Gmelin, 1791 is the most endangered marine invertebrate listed in the EU Habitats Directive. A diversity of anthropic pressures have reduced its present-day distribution to a fraction of its former size. Perhaps surprisingly, this highly protected species has successfully established along man-made harbour breakwaters, resulting in serious complications when these structures have required modification or repair, often leading to costly impasses due to the legal status of the species. Attempts to move the limpets to other locations have resulted in unacceptably high mortality rates. This article describes the result of a field experiment where 97 P. ferruginea individuals were transported to a new site, using a technique which involved carefully moving the limpets whilst inactive (during low tide), still attached to their home scars on breakwater boulders. The results of this experiment were significantly positive, with 87% of all translocated limpets still alive 10 mo after the move, a mortality rate which compared favourably with that obtained for the existing control population at the receptor site. We propose that this method could be a practical solution to address the conflicts generated by this endangered species’ preference for harbour constructs. We further propose that this method can be used as a management tool to enhance the species’ survival prospects, by creating ‘stepping stones’ of pockets of reproducing individuals that can connect currently fragmented populations to effect a population recovery of this threatened organism.

This paper examines the performance of opposition parties and the prospects of multiparty politics in Tanzania. At independence in 1961 and during Colonial Rule, Tanganyika now Tanzania Mainland was enjoying a multiparty democracy but moved to one party state during 1970s. The Chama Cha Mapinduzi (CCM) has won all elections since re-introduction of multiparty politics in 1992. The debate now is on the performance of Tanzania's opposition parties. Some scholars argue that many Tanzanians especially smallholders and rural inhabitants have strong loyalty to the ruling party CCM despite the economic difficulties they face. They further argue that, this strong loyalty to CCM is largely a result of lack of a strong alternative among the political parties, and nostalgia for the party which brought them independence and which has maintained relative peace. They also maintain that, it will simply take time for such nostalgia to fade and for a pro-rural challenge to the CCM to emerge; otherwise, age appears to have no significant effect on CCM support both Tanzanians old and young are loyal to the CCM. However, others claim that even if CCM is enjoying the power of the incumbency past elections results show that the margin of votes across constituencies for the CCM is in steady decline, thus challenging its dominance’. This paper is set to contribute to this live debate but taking the readers to a slightly different view point. In this paper, it is argued that, in spite of the claims made on the nature and quality of electoral institutions, and electoral system, opposition parties in the country have remained both numerically institutionally weak and fragmented. It is further argued that failure of the Tanzanian opposition parties is largely a product of internal weaknesses. Key words: Tanzanian opposition, elections, Chama Cha Mapinduzi (CCM), political parties, politics.

The editorial staff of the Journal of Gerontological Social Work is pleased to announce the re-introduction of the Book, Media, and Resource Review section of the journal. This section will provide...

Modern agriculture depends on the production of very few crop species, which provide lower nutritive value for consumers. The present work summarizes the results of a three-year experiment on hulled wheat varieties as potential candidates for food system diversification. The organic field cultivation tests with 10 emmer and five einkorn landraces and varieties were conducted on ~10m2 plots on sandy soil, and from 2017, under on-farm conditions in eastern Hungary. Most accessions adapted well to the marginal conditions, with some landraces even yielding higher than registered varieties&mdash, over 3 t per ha on average over three years. Compared to emmer, einkorn had higher maximum grain yields, but its yield performance varied more than that of emmer. Grain protein and the total phenolic content were high in both species. Compared to emmer, einkorn seeds exhibited a 3.8 times higher content of bound flavonoids and had 3.4 times higher antioxidant activity. Four einkorn accessions were resistant to leaf spot, as well as yellow and leaf rusts. Fusarium infected both species similarly. Our findings indicate that not only registered varieties of ancient wheat species but also their landraces can provide sustainable alternatives both for organic farmers and also for the diversification of agriculture.

Background:\ud \ud Faecal calprotectin decreases during exclusive enteral nutrition in children with active Crohn's disease. It is unknown how faecal calprotectin changes during food re‐introduction and the influence of maintenance enteral nutrition.\ud Aims:\ud \ud To study changes to faecal calprotectin during exclusive enteral nutrition and at food reintroduction, and explore associations with maintenance enteral nutrition.\ud Methods:\ud \ud Children with Crohn's disease were followed during exclusive enteral nutrition and during food‐reintroduction. Faecal calprotectin was measured before, at 33 and 54 days of exclusive enteral nutrition, and at 17, 52 and 72 days after food‐reintroduction. Maintenance enteral nutrition use was recorded with estimated weight food diaries. Data are presented with medians and Q1:Q3.\ud Results:\ud \ud Sixty‐six patients started exclusive enteral nutrition and 41 (62%) achieved clinical remission (weighted paediatric Crohn's disease activity index

Published in 1975, The Machiavellian Moment stands a little short of a midpoint in a sequence of works I have written over the last 60 years. I shall attempt to situate it in this sequence and thei...

Globally, plants are becoming extinct at an unprecedented rate. Seed banking is considered as the most cost-effective technique to preserve many conservation concern species. From a practical standpoint, however, banking seeds is essentially just the first step in tackling plant loss, as the real-life challenge lies in how well these seeds when re-introduced become whole plants and maintain species count. In the current model, merely very few seed banks extend their efforts in re-introduction problems. Compelling evidence suggests that many re-introduction efforts are less than successful. Such axiom convicts seed banks must also participate in the ‘post-storage’ process and engage working with other ecologists, physiologists and re-introduction practitioners to devise a robust re-introduction practice and exchange information about the seed lot including collection site, maternal environment etc. Bridging these gaps would facilitate enhanced restoration practice and pave way for efficient reconstruction of the ecosystem.

Prolonging survival, achieving symptoms palliation and preserving quality of life are the primary therapeutic goals of treatments administered after disease progression in mCRC. Even if the impact of these therapies on the prognosis of affected patients is less relevant than the impact of the upfront treatment, tailoring the optimal second-line therapy is increasingly important. Several therapeutic options are available, and different factors including not only patient- and disease-related characteristics, but also the first-line treatment received (i.e., type, timing of disease progression, observed outcome and reported toxicities) may drive this choice. Herein, we describe the current state of the art in the landscape of treatments after progression in mCRC. Based on a critical review of the literature, we built a patient-oriented therapeutic algorithm, aiming to guide clinicians in their daily decision-making.

A practical way to reduce energy consumption is to use traditional construction methods and materials. Persian architecture has a long history of constructing energy-efficient and comfortable buildings for the human and has created sustainable cities. Hygrothermal analysis of a building in Yazd, a city in the hot-dry region of Iran, was performed, and the possibility of use of adobe in modern construction for energy-efficient buildings was examined. The aim was to determine the indoor temperature and relative humidity and study its effect using or not using cooling and heating systems. For the simulation, the WUFI + code was used, where internal temperature and relative humidity were determined. Results showed that the use of traditional materials had a considerable effect on reducing internal temperature and humidity fluctuations.

Alectinib is a member of the family of anaplastic lymphoma kinase inhibitors. This agent is effective in the treatment of advanced anaplastic lymphoma kinase-positive non-small cell lung cancer and has excellent blood–brain barrier penetrability. It is generally well tolerated; however, significant toxicities such as interstitial lung disease have been reported. We present herein an instance of interstitial lung disease four weeks into alectinib treatment. Alectinib was held, and the patient showed clinical and radiographic improvement of her interstitial lung disease. Alectinib was then resumed at half dosage without further complications. Prompt recognition of adverse reactions to this targeted agent is paramount. Cessation of therapy may be needed on a case-to-case basis. However, as our case highlights, safe re-introduction of alectinib can be accomplished in some cases.

There is a public concern of rabies re-introduction to the UK, given the recent changes in pet trade with parts of Eastern Europe and an increase in the movement of puppies. A previously developed quantitative risk assessment (QRA) for rabies introduction into the UK was modified in order to assess the risk from only Eastern European Union member states. The model estimates the annual probability of rabies entering the UK and also the expected number of years between rabies introductions. The change in risk between the original model and the updated model is then assessed. While the risk has increased compared to the previous assessment, the risk still remains low, with a case expected every 317 years (5th and 95th percentile, 193 and 486 years, respectively) and an annual risk of 3.41 × 10−3 (5th and 95th percentile, 2.05 × 10−3 and 5.17 × 10−3, respectively).

Background After a passed oral food challenge (OFC), regular and normal food consumption is attended. The main objective of this study is to assess the safety of tested food dietary re-introduction after a passed OFC. Patients and methods In 2014, a telephone survey was submitted to patients who passed OFC and those who failed it only presenting with contact urticaria (we consider these OFC as passed), between 2009 and 2013. Questionnaire items included demographic data, food allergy details, food consumption after the OFC was performed, recurring symptoms and life style changes. Results 249 OFC questionnaires were collected from 199 children, 228 OFC were passed, 21 were failed exclusively due to contact urticaria. The most tested food was cows’ milk. In 71% of cases target food was re-introduced in patients diet in normal amounts. We found children >2 years introduced less frequently tested food than infants. In 2% of cases adverse reactions to offending food were reported, but severe reactions never occurred. Discussion The majority of children of this study ate target food regularly and their family's quality of life improved. In our study, adverse reactions frequency in patients who passed OFC was very low and never serious. We highlight the importance of re-assessing proper food consumption in every patient who passed OFC.

When Journal of Systemic Therapies Editor Jim Duvall asked for input about pivotally important—even essential—publications in the emergence of systemic brief therapies, the research and publications of the Palo Alto Group immediately came to mind. There are many noteworthy contributors to systemic thinking and practice, yet the pervasive influence of this small group of researchers stands almost unparalleled. First in Gregory Bateson’s research team (1952–1961), continuing at the Mental Research Institute (MRI) and later in the MRI Brief Therapy Center (1958– present) the contributions of Gregory Bateson, Don D. Jackson, John Weakland, Jay Haley, William Fry, and later Virginia Satir, Richard Fisch, Paul Watzlawick, and colleagues revolutionized systemic understanding of human behavior and methods for promoting change efficiently and effectively. Systemic epistemology and models of therapy as currently known and practiced stand solidly on the foundation built by what has come to be known as the Palo Alto Group. Imagine being a therapist in 1961, well trained in the individually oriented approaches so prevalent at that time, when Jackson and Weakland’s “Conjoint Family Therapy: Some Considerations on Theory, Technique, and Results” appeared in the journal Psychiatry. Freudian concepts and practices pervaded the behavioral sciences. Most therapeutic theory, clinical practice, and literature focused on identifying and either accepting as incurable or attempting to treat pathology located inside the individual. While the Interpersonal Theory of Harry Stack Sullivan, M.D. (1947), and colleagues such as Frieda Fromm-Reichmann, M.D. (1950), had gained wider acceptance, the focus of theory and clinical practice remained almost exclusively on individual pathology and biology, and was past causal in orientation. One wonders what it was like to read the research papers from the Palo Alto Group. The appearance of “Toward a Theory of Schizophrenia” (Bateson, Jackson, Haley, & Weakland, 1956), “The Question of Family Homeostasis” (Jackson

Dry seeds of many orchid species, when stored at low temperatures, are capable of maintaining high levels of viability for many years, supporting orchid seed banking as a valuable part of emerging integrated conservation strategies. The Orchid Seed Science and Sustainable Use (OSSSU) network has already stored over 300+ species across 26 countries around the world. Its future ambition to store seeds representing a minimum of one thousand species in the next five years, and to expand the network to include more institutes and countries, provides an example of what can be achieved by a small dedicated group, willing to share their technical expertise and to develop a deeper understanding of the underlying science. Recent work indicates that it may also be possible to store orchid pollen of some species for a minimum of six years under similar conditions to those used for orchid seeds, thereby facilitating pollen exchange between collections. OSSSU partners in a number of countries have already demonstrated that raising plants from stored seeds can be used successfully in reintroduction projects.

After stocking with larvae from the Gironde-Garonne-Dordogne population, in 2013, three young-of-the-year Allis shad Alosa alosa, probably originating from natural reproduction, were documented for the first time in a period of nearly 100 years in the River Rhine. In 2014, a further increase was observed when 57 juveniles and eight adults were caught; seven of these eight adults were derived from stocking, indicating the success of stocking measures within the framework of the EU-LIFE project.

The role of dominant discourse in constructing a deficit view of adult numeracy is examined, using reports from recent international surveys of adult skills as illustrative examples. Social practice theory is introduced as an alternative perspective for examining the ways adults actually use numeracy in their daily lives and work. This perspective suggests the test items used by large-scale surveys such as PIACC are only proxies for real-life numeracy skills, and that performance in such tests may misrepresent the numeracy skills of adults. Instead, social practice theory suggests that adults may have informal, situated numeracy practices that serve them adequately in their daily lives. However, it also draws attention to the difficulty of transferring mathematics from the classroom to everyday numeracy situations, while it recognizes that adult numeracy learners may be motivated by other goals than functional numeracy, such as personal fulfillment or a gateway qualification. Alternative approaches to classroom teaching for adult students are suggested which acknowledge and draw on adults’ rich and varied experiences; the challenges and tensions of such approaches are explored.