Essential elements of optimal dietary and exercise referral practices for cancer survivors: expert consensus for medical and nursing health professionals.

PURPOSE: To develop and establish expert consensus on essential elements of optimal dietary and exercise referral practices for cancer survivors. METHODS: A four-round modified, Delphi method (face-to-face and electronic). In round 1, initial statements were drafted based on Cancer Australia's Principles of Cancer Survivorship and input from key stakeholders through a cancer preconference workshop. In round 2, the initial statements were distributed to a panel (round 1 participants) to establish consensus by rating the importance of each statement using a five-point Likert scale. Statements that required significant changes in wording were redistributed to panel members in round 3 for voting. Round 4 was for consumers, requiring them to rate their level of agreement of final statements. RESULTS: In total, 82 stakeholders participated in round 1. Response rates for survey rounds 2 and 3 were 59% (n = 54) and 39% (n = 36). Panel members included nurses (22%), dietitians (19%), exercise professionals (16%), medical practitioners (8%), and consumers (4%). The mean "importance" rating for all essential elements was 4.28 or higher (i.e., fairly important, or very important). Round 4's consumer-only engagement received responses from 58 consumers. Overall, 24 elements reached consensus following some revised wording, including the development of three new statements based on panel feedback. CONCLUSION: Our developed essential elements of optimal dietary and exercise referral practices can help provide guidance to medical and nursing health professionals relevant to dietary and exercise referral practices. Future research should conduct an implementation intervention and evaluation of these essential elements to optimise dietary and exercise care in cancer survivors.

Blast Suppression Foam, Aqueous Gel Blocks, and their Effect on Subsequent Analysis of Forensic Evidence.

In addition to having blast mitigation properties, aqueous foam concentrate AFC-380 blast suppression foam is designed to capture aerosolized chemical, biological, and radioactive particles during render-safe procedures of explosive devices. Exposure to aqueous environments and surfactants may negatively affect forensic evidence found at the scene, but the effects of AFC-380 foam and aqueous gel on the preservation and subsequent analysis of forensic evidence have not previously been investigated. Sebaceous finger and palm prints and DNA samples on paper, cardboard, tape, and various metal and plastic items, along with hairs, carpet and yarn fibers, and inks and documents, were exposed to AFC-380 foam. Similar mock evidence was also exposed to a superabsorbent gel of the type found in aqueous gel blocks used for shrapnel containment. Exposure to foam or aqueous gel was associated with a dilution effect for recovered DNA samples, but quality of the samples was not substantially affected. In contrast, exposure to AFC-380 foam or gel was detrimental to development of latent finger and palm prints on any substrate. Neither the hair nor the fiber samples were affected by exposure to either the foam or gel. Indented writing on the document samples was detrimentally affected by foam or gel exposure, but not inks and toners. The results from this study indicate that most types of forensic evidence recovered after being exposed to aqueous gel or blast suppression foam can be reliably analyzed, but latent finger and palm prints may be adversely affected.

Determining an optimal sequence for chemical development of latent prints on cartridge casings and shotgun shells.

In developing latent prints on cartridge casings and shotgun shells, multiple chemical processes should be used in order to obtain the best results. In Phase I, this study established an optimal chemical sequence for both Brass and Nickel cartridge casings based on six sequences involving four chemicals: Cyanoacrylate, Black Powder, Rhodamine 6G and Acidified Hydrogen Peroxide. Phase II was a validation study of Phase I involving a random sample of both Brass and Nickel cartridge casings, which were processed according to the determined optimal sequences. In addition, ribbed shotgun shells were processed under Phase I results and determined to be dependent upon the utilization of a CrimeScope at 515 nm. Consideration should be given to the type of cartridge case being examined. Although limitations exist, some chemical sequences undeniably work better than others. All photographs were manipulated with Adobe Photoshop. All results were verified by a senior latent print examiner.

Assessment of bioelectrical impedance analysis for the prediction of total body water in cystic fibrosis.

The aim of this study was to compare the measurement of total body water (TBW) by deuterium (2H2O) dilution and bioelectrical impedance analysis (BIA) in patients with cystic fibrosis (CF) and healthy controls. Thirty-six clinically stable patients with CF (age 25.4+/-5.6 yrs) and 42 healthy controls (age 25.4+/-4.8) were recruited into this study. TBW was measured by 2H2O dilution and predicted by BIA in patients and controls. The TBW predicted from BIA was significantly different from TBW as measured using 2H2O in patients (P<0.05) but not in controls. Mean (+/-SD) values for predicted and measured TBW differed by 5.6 (+/-9.1) L in patients and 0.4 (+/-3.6)L in controls. This bias was consistent for all controls but not for patients. In CF, BIA over predicted TBW determined by 2H2O dilution to an increasing extent at larger TBW volumes. There was a strong correlation between height2/impedance and TBW in patients with CF (r=0.90; y=0.67x+2.50) and in controls (r=0.81; y=0.57x+9.60). The slope of the regression lines was similar for both groups, however the y intercepts were significantly different (P<0.05). BIA overestimates TBW in patients with CF, possibly due to invalid factory installed regression equations within BIA instrumentation. Future studies employing BIA as a measure of TBW or FFM in CF should use alternative predictive equations to those that have been developed for healthy individuals. A large scale study to develop specific regression equations for use in CF is warranted.