Lifestyle Preferences Research Articles

Nephrologists\u2019 experiences with patient participation when long-term dialysis is required

BackgroundFor individuals in need of dialysis, patient participation is important when determining care goals and in decision making regarding dialysis modality. Nephrologists hold a key role in delivering evidence-based healthcare that integrates patient preferences and values throughout the trajectory, and their experiences with patient participation are important for improving health care. The aim of this study was to explore nephrologists’ experiences with patient participation in different phases of the end-stage renal disease trajectory for working-age individuals who require dialysis.MethodsThis explorative study comprised interviews with ten nephrologists from four different dialysis units in Central Norway. We analysed the interviews by applying an interpretive phenomenological approach.ResultsNephrologists had varied experiences with patient participation throughout the different phases of the treatment trajectory. During decision making on the dialysis modality, nephrologists emphasised patients’ choices in two approaches. In the first approach, they expected patients to choose the modality based on the provided information, which could be actively steered. In the second approach, they recognised the patients’ values and lifestyle preferences through shared decision-making. Within hospital haemodialysis, nephrologists considered patients’ self-care activities equivalent to patient participation, seeing self-care as a source of patient empowerment. They identified divergent patient–professional values and organisational structures as barriers to patient participation.ConclusionOur study shows that nephrologists have different approaches to patient participation in different phases of the end-stage renal disease trajectory. Individual understanding as well as organisational structures are important factors to address to increase patient participation in end-stage renal disease care. Shared decision making, in which patient values are balanced against biomedical treatment targets, allows for mutual agreement between patients and healthcare professionals concerning medical plans and minimises the potential for patient–professional tensions.

Integrating User Voice in Hearing Care With Focus on Off-Duty Warfighter.

Noise-Induced Hearing Loss (NIHL) is a growing public health concern in the USA and globally because of the emergence of lifestyle preferences and environmental exposures to sound levels exceeding safe listening limits for extended periods of time. In the military, hearing and communication are important for survival and the Department of Defense's Hearing Center of Excellence highlights the importance of protection from NIHL. Issuance of the World health organization safe audio listening standards along with existing U.S. federal and military standards provides a framework for developing an accessible tool for promoting safe listening. An App is being proposed for an aggregated assessment of a user's daily sound exposure, through personal audio system and ambient sources and providing tools for managing personal sound exposures. The key elements for development of App features were integration of user voice for functionalities, computations based on global standards, including military, for safe listening and alignment with regulatory standards for Apps. Features of the App are "Track" for audio and ambient exposures, "Compute" for real-time and cumulative exposures vs. safe listening standards, "Alert" for unsafe exposures using visual and haptic, "Inform" for personal exposures vs. safe dose, associated NIHL risk and education, "Choice" for alternatives that can be relatable to personal lifestyle, and "Share" for informing others as determined by the user. App safety is ensured by privacy and cybersecurity regulatory standards. The overall goals of the App are to increase NIHL awareness and to empower users to improve personal listening behaviors that can potentially reduce the risk of NIHL.

Adaptive Reorientation Therapy: An Adlerian-Based Model of Psychological Treatment

Compelling and aversive emotions emerge in a person's life as adaptive mechanisms to help the individual overcome the challenges that life presents. When one's lifestyle orientation is characterized by biased convictions and skewed private logic, those compelling, aversive emotions can predominate life and contribute to recurrent and worsening difficulties, many of which are diagnosed as a recognizable clinical condition. Rather than focusing specifically on the expressed symptoms, Adlerian treatment focuses on the lifestyle orientation that necessitates those symptoms. A reorientation to life that is more optimally adaptive is needed. Adaptive reorientation focuses on the individual's desired state and helps the individual to adjust lifestyle orientation in a way that proves more optimally effective.

Lifestyle Risk Factors, Quality of Life, and Intervention Preferences of Barrett's Esophagus Patients: A Prospective Cohort Study.

Background and AimsLifestyle counseling to achieve a healthy weight, quit smoking, and reduce alcohol is a cornerstone in the management of Barrett’s Esophagus (BE). However, little is known about whether patients make these recommended lifestyle changes or the impact of non-adherence on their quality of life (QOL). This study characterized the lifestyle risk factors, QOL, and intervention preferences of BE patients as a first step toward developing lifestyle change interventions for this population.MethodsPatients with a confirmed BE diagnosis (N = 106) completed surveys at a surveillance endoscopy visit (baseline) and at 3- and 6-month follow-ups. Patients reported on lifestyle risk factors, adherence determinants (e.g., perceived benefits/barriers, risk, intentions), QOL, and intervention preferences.ResultsMost patients (56%) had uncontrolled reflux, were overweight/obese (65.1%), and had low dietary fiber intake (91%). Many (45%) reported poor QOL. Patients’ perceived risk of developing esophageal cancer was high, but their behavior change intentions were low. Despite receiving lifestyle counseling from physicians, there were no significant changes in patients’ QOL or lifestyle risk factors over time. Nonetheless, patients indicated strong interest in internet (62.6%) and multimedia programs (57.9%) addressing acid reflux and weight control.ConclusionBE patients reported uncontrolled reflux, poor QOL, and multiple lifestyle risk factors that did not change over time. Despite low levels of intention for making lifestyle changes, patients were interested receiving more information about controlling acid reflux, suggesting a potential teachable moment and opportunity for web-based and multimedia multiple behavior interventions that seek to control acid reflux symptoms through weight loss and a high fiber diet.

Men, women and STEM: Why the differences and what should be done?

It is a well-known and widely lamented fact that men outnumber women in a number of fields in STEM (science, technology, engineering and maths). The most commonly discussed explanations for the gender gaps are discrimination and socialization, and the most common policy prescriptions target those ostensible causes. However, a great deal of evidence in the behavioural sciences suggests that discrimination and socialization are only part of the story. The purpose of this paper is to highlight other aspects of the story: aspects that are commonly overlooked or downplayed. More precisely, the paper has two main aims. The first is to examine the evidence that factors other than workplace discrimination contribute to the gender gaps in STEM. These include relatively large average sex differences in career and lifestyle preferences, and relatively small average differences in cognitive aptitudes – some favouring males, others favouring females – which are associated with progressively larger differences the further above the average one looks. The second aim is to examine the evidence suggesting that these sex differences are not purely a product of social factors but also have a substantial biological (i.e. inherited) component. A more complete picture of the causes of the unequal sex ratios in STEM may productively inform policy discussions.

Improving patient informed consent for haemophilia gene therapy: the case for change.

Improving the informed consent process for people living with haemophilia considering gene therapy. Gene therapy is the process of replacing faulty genes with healthy ones. In haemophilia, gene therapy involves introducing a working copy of the gene for the clotting factor that patients are missing. Following treatment, patients should begin producing their own clotting factor normally. However, people living with haemophilia (PwH) need to be fully informed regarding the potential benefits and risks of gene therapy and what this means for them, whether as part of a research study or routine medical care.Patients must be respected and supported to make decisions about their own health and wellbeing, recognising their legal and moral right to set personal goals and make treatment choices. For this to happen in practice, patients should be aware of their individual health needs, understand the effects of treatment and consider lifestyle preferences in relation to their decisions. This article attempts to describe how informed consent is obtained in haemophilia gene therapy clinical trials, what affects a patient's ability to make decisions and the availability of information and support to respect and protect the interests of PwH.Regulators responsible for approving medical products have published guidance on informed consent for physicians and pharmaceutical manufacturers in haemophilia, including for gene therapy. Recommendations have been made about the best ways for PwH to discuss gene therapy with their physicians. Yet, poor communication of complex topics, such as gene therapy, can be problematic, especially if patients lack the skills and confidence to understand and discuss the science, or for physicians with limited time in clinic.We propose strategies to improve the consent process, so patients can feel more able to make informed decisions about new treatments. Further research is needed to find new, creative approaches for educating patients and ensuring that the informed consent process for gene therapy in haemophilia is ethical.

The snacking pattern, diet, lifestyle and menu preferences of elementary school students in Gyeonggi area, considering the most frequently eaten snacks

The snacking pattern, diet, lifestyle and menu preferences of elementary school students in Gyeonggi area, considering the most frequently eaten snacks

Urban regulation and diverse housing supply: An Investigative Panel

This research examined the barriers and challenges within the housing system for delivering housing supply that is more diverse in terms of size and built form; tenure; development model; and affordability level.

Modeling the Evolution of Ride-Hailing Adoption and Usage: A Case Study of the Puget Sound Region

Ride-hailing services have grown in cities around the world. There are, however, few studies and even fewer publicly available data sources that provide a basis to understand and quantify changes in ride-hailing usage over time. Ride-hailing use may change over time because of socio-demographic shifts, economic and technological changes, and service attribute enhancements, as well as changes in unobserved attributes such as attitudes and perceptions, lifestyle preferences, technology savviness, and social influences. It is important to quantify the effects of these different forces on ride-hailing frequency so that robust forecasts of ride-hailing use can be developed. This paper uses repeated cross-sectional data collected in 2015 and 2017 in the Puget Sound region to analyze the differential effects of socio-demographic variables on the evolution of ride-hailing adoption and usage. By doing so, the study is able to isolate and quantify the pure effect of the passage of time on adoption of ride-hailing services. A joint binary probit-ordered probit model is estimated on the pooled dataset to explicitly account for sample-selection differences between the 2015 and 2017 surveys that may affect estimates of ride-hailing adoption in the two years. Model estimation results are used to compute average treatment effects of different variables on ride-hailing usage over time. It is found that the effects of most demographic variables on individuals’ propensity to use ride-hailing are softening over time, leading to reduced differences in ride-hailing use among market segments. This suggests that there is a “democratization” of ride-hailing services over time.

Semi-modified okara whey diet increased insulin secretion in diabetic rats fed a basal or high fat diet.

Lifestyle and diet preferences are primarily responsible for developing type 2 diabetes. In this study, okara was manufactured into okara whey crackers (OWC) to investigate its dietary role in controlling diabetes in streptozotocin-diabetic rats with and without a high-fat diet. Forty-eight rats were divided into eight groups. G1-G4 were nondiabetic and fed a basal diet, a basal diet with 30% crackers, high fat diet, and a high-fat diet with 30% crackers, respectively. G5-G8 were diabetic groups that received similar diets as previous groups. Blood glucose, liver function, lipid pattern, pancreas and liver histopathology, and insulin immunohistochemistry were performed. OWC improved measured parameters and histopathology of the liver and pancreas in diabetic rats. The area % of positive insulin cells was increased in G6 (5.20%) and G8 rats (2.83%) fed OWC compared to diabetic rats (1.17%). In conclusion, the use of 30% OWC in a semi-modified diet has controlled the hyperglycemia and hyperlipidemia associated with diabetes.

Unraveling Causes and Consequences of International Retirement Migration to Coastal and Rural Areas in Mediterranean Europe

In a context of aging, low fertility, and progressive slowdown of both internal population mobility and international migration at working age, residential mobility at older ages was regarded as an emerging phenomenon in Mediterranean Europe, a region with increasingly attractive retirement places. The present work discusses the socioeconomic processes (and the environmental impacts) associated with an increasing flow of retirees, which decide to settle from ‘Northern’ countries to Southern Europe, concentrating in coastal districts and in rural countryside. Understanding lifestyle preferences and territorial patterns of residential mobility at older ages allows a refined analysis of short- and medium-term impacts of International Retirement Migration (IRM) on population dynamics in economically growing and declining regions. A refined analysis reveals that destinations of IRM are progressively enlarging from strictly coastal places to a broader set of locations in the rural countryside. Mobility choices among retirees may jeopardize the role of spatial planning, which is increasingly asked to provide specific services for an international, elder population, e.g., stimulating re-use of abandoned rural buildings. Taken as an effective option for rural development, an improved planning and management of local districts attracting and hosting intense flows of residential mobility at older ages is urgent in the present socioeconomic context. A convenient set of policies and a refined taxation system may contribute to reconcile demographic shrinkage with local competitiveness and social cohesion.

Exploration of Lifestyle Choices, Reproductive Health Knowledge, and Polycystic Ovary Syndrome (PCOS) Awareness Among Female Emirati University Students.

ObjectiveHealthy lifestyle and adequate reproductive health knowledge are prerequisites for maintenance of physical and mental well-being of women across the world. With increasing prevalence of metabolic disorders such as polycystic ovary syndrome (PCOS), it is important that sufficient awareness of these issues is generated, especially in conservative communities in Arab regions. The main objective of this study is to assess reproductive health (RH) knowledge and awareness of PCOS among female Emirati students and also to explore their lifestyle choices.Materials and MethodsA total of 493 Emirati students were recruited based on convenience sampling and completed a survey containing questions related to demography, lifestyle preferences, RH knowledge, and PCOS awareness.ResultsOf the students, 13% self-reported being diagnosed with PCOS, with 3.5% also taking medication for the same, 6% reported having high androgen levels, 30.7% reported polymenorrhea, and 3.5% reported oligomenorrhea for frequency of menstrual cycle. Also, 12.4% students experienced abnormal bleeding (heavy/none) during menstruation and 24% reported excessive body hair. It was found that 4.3% of students were taking medication for hyperglycemia and 75% of students reported a family history of diabetes. Students displayed low reproductive health knowledge and poor awareness of PCOS. Lifestyle preferences indicated low physical activity and high indulgence in fast food.ConclusionLifestyle choices adopted by Emirati University students may predispose them to disorders such as PCOS. Early detection and management of PCOS coupled with a dynamic awareness campaign for RH can help in improving fertility rates of Emirati women. The study identifies major gaps in knowledge and awareness of RH and PCOS in Emirati women that need to be addressed by creating a culturally congruent heathcare policy with emphasis on education and health promotion. Mandatory PA programs and increasing availability of healthy eating options in campus should be considered by all universities, particularly in Arab regions, for improving lifestyle and preventing metabolic disorders in young students.

Made in Swedish: diasporisation and lifestyle orientation among Swedish migrant networks in Southern Spain

ABSTRACT The article demonstrates how large social associations are operating at the locus of a community-making related to the networks of Swedish migrants in Southern Spain. The associations are selectively targeting relatively wealthy older (ethnic) Swedish individuals, offering them a home-like social arena with access to a club equipped with well-known facilities and activities from the Swedish tradition. In addition, these associations offers valuable information and services that ensure their members a comfortable lifestyle in Spain but also facilitates a life with close connection to the Swedish society. In this social space, the Swedish migrants meet, socialise and to some extent, consume, rather than making efforts to participate and becoming integrated in Spanish society. It is also obvious how this environment becomes a hub for maintaining links and societal life with the Swedish society. The article argues that the practices used by the social associations in their mobilisation, are becoming part of a ‘diasporisation’ of Swedes in Southern Spain. It is also argued that these practices are both reflecting assumed needs and requests from the individuals in the migrant networks as well as orientating them into a lifestyle that promotes comfort and transnational links with their country of origin.

A Global Survey of Carbohydrate Esterase Families 1 and 10 in Oomycetes.

Carbohydrate-active enzymes (CAZymes) are a cornerstone in the phytopathogenicity of filamentous microbes. CAZymes are required for every step of a successful infection cycle—from penetration, to nutrient acquisition (during colonization), to exit and dispersal. Yet, CAZymes are not a unique feature of filamentous pathogens. They are found across eukaryotic genomes and including, for example, saprotrophic relatives of major pathogens. Comparative genomics and functional analyses revealed that CAZyme content is shaped by a multitude of factors, including utilized substrate, lifestyle, and host preference. Yet, family size alone says little about usage. Indeed, in a previous study, we found that genes putatively coding for the CAZyme families of carbohydrate esterase (CE)1 and CE10, while not specifically enriched in number, were suggested to have lifestyle-specific gene expression patterns. Here, we used comparative genomics and a clustering approach to understand how the repertoire of the CE1- and CE10-encoding gene families is shaped across oomycete evolution. These data are combined with comparative transcriptomic analyses across homologous clusters within the gene families. We find that CE1 and CE10 have been reduced in number in biotrophic oomycetes independent of the phylogenetic relationship of the biotrophs to each other. The reduction in CE1 is different from that observed for CE10: While in CE10 specific clusters of homologous sequences show convergent reduction, CE1 reduction is caused by species-specific losses. Comparative transcriptomics revealed that some clusters of CE1 or CE10 sequences have a higher expression than others, independent of the species composition within them. Further, we find that CE1- and CE10-encoding genes are mainly induced in plant pathogens and that some homologous genes show lifestyle-specific gene expression levels during infection, with hemibiotrophs showing the highest expression levels.

Fruit quality of ‘Salustiana’ seedless oranges during cold storage: effect of carnauba-based wax and rootstocks

Consumer preference for a healthier lifestyle has promoted the consumption of fresh citrus. To ensure its supply throughout the year, the use of different rootstocks for citrus cultivation associated with adequate postharvest techniques of fruit can be practical. This study aimed to evaluate methods to extend shelf life and to reduce postharvest losses of fruit from ‘Salustiana’ orange trees [Citrus sinensis (L.) Osbeck] grafted on five rootstocks: ‘Rangpur’ lime, ‘Cleopatra’ mandarin, ‘Sunki’ mandarin, ‘Swingle’ citrumelo, and ‘C-13’ citrange. Mature fruit were harvested from each scion:rootstock combination and divided into two experiments: coated with carnauba wax and non-coating. Then, fruit were stored in a cold chamber at 4 ± 1 °C and 90% RH for 0, 20, 40 and 60 days. At harvest, fruit were characterized according to their physical parameters and had their weight loss, color, chemical, and sensory attributes monitored at each period of cold storage. Wax coating treatment associated with cold storage were efficient to prevent weight loss in ‘Salustiana’ orange up to 40 days. Color attributes decreased during storage, for both non-coating and wax coating fruit causing reduction of lightness. Wax coating treatment ensured better sugar:acidity balance in ‘Salustiana’ orange fruit, preserving their chemical-quality up to 60 days. Fruit from ‘C-13’ citrange and ‘Cleopatra’ mandarin treatments were more tasteful according to the sensory profile while ‘Swingle’ citrumelo exhibited better overall appearance. Wax coating treatment and cold storage can prolong ‘Salustiana’ orange shelf life up to 40 days, by reducing weight loss and preserving their chemical and sensorial profile.

Who shines most among the brightest?: A 25-year longitudinal study of elite STEM graduate students.

In 1992, the Study of Mathematically Precocious Youth (SMPY) surveyed 714 first- and second-year graduate students (48.5% female) attending U.S. universities ranked in the top-15 by science, technology, engineering, and mathematics (STEM) field. This study investigated whether individual differences assessed early in their graduate school career were associated with becoming a STEM leader 25 years later (e.g., STEM full professors at research-intensive universities, STEM CEOs, and STEM leaders in government) versus not becoming a STEM leader. We also studied whether there were any important gender differences in relation to STEM leadership. For both men and women, small to medium effect size differences in interests, values, and personality distinguished STEM leaders from nonleaders. Lifestyle and work preferences also distinguished STEM leaders who were more exclusively career-focused and preferred to work-and did work-more hours than nonleaders. Also, there were small to large gender differences in abilities, interests, and lifestyle preferences. Men had more intense interests in STEM and were more career-focused. Women had more diverse educational and occupational interests, and they were more interested in activities outside of work. Early in graduate school, therefore, there are signs that predict who will become a STEM leader-even among elite STEM graduate students. Given the many ways in which STEM leadership can be achieved, the gender differences uncovered within this high-potential sample suggest that men and women are likely to assign different priorities to these opportunities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Lifestyle behaviors and intervention preferences of early-stage lung cancer survivors and their family caregivers.

Lung cancer (LC) is a highly prevalent disease with more survivors diagnosed and treated at earlier stages. There is a need to understand psychological and lifestyle behavior needs to design interventions for this population. Furthermore, understanding the needs and role of family caregivers, especially given the risks associated with second-hand smoke, is needed. Thirty-one early-stage (stages I or IIA) LC survivors of (52% men) and 22 (50% women) caregivers (N = 53 total) completed surveys after surgery (baseline) and at 3- and 6-month follow-ups. Participants reported on psychological functioning, smoking, and physical activity (PA) as well as intervention preferences. Survivors reported low levels of psychological distress and 3% were current smokers during the study. Approximately 79% were sedentary and not meeting national PA guidelines. Caregivers also reported minimal psychological distress and were sedentary (62% not meeting guidelines), but a larger proportion continued to smoke following the survivor's cancer diagnosis (14%). Both survivors and caregivers expressed interest in home-based PA interventions but differed regarding preferred format for delivery. Most (64%) caregivers preferred a dyadic format, where survivors and caregivers participate in the intervention together. However, most survivors preferred an individual or group format (57%) for intervention delivery. Both LC survivors and family caregivers could benefit from PA interventions, and flexible, dyadic interventions could additionally support smoking cessation for family caregivers.

Inter-generational Effects of Technology: Why Millennial Physicians May Be Less at Risk for Burnout Than Baby Boomers.

Purpose of ReviewYounger generations of physicians are using technology more fluently than previous generations. This has significant implications for healthcare as these digital natives become a majority of the population’s patients, clinicians, and healthcare leaders.Recent FindingsHistorically, healthcare has been slow to adopt new technology. Many physicians have attributed burnout symptoms to technology-related causes like the EMR. This is partly due to policies and practices led by those who were less familiar and comfortable with using new technologies.SummaryYounger physicians will drive technological advancement and integration faster than previous generations, allowing technology to adapt more quickly to serve the needs of clinicians and patients. These changes will improve efficiency, allow more flexible working arrangements, and increase convenience for patients and physicians. The next generation of physicians will use technology to support their work and lifestyle preferences, making them more resilient to burnout than previous generations.

Lifestyle preferences drive the structure and diversity of bacterial and archaeal communities in a small riverine reservoir

Spatial heterogeneity along river networks is interrupted by dams, affecting the transport, processing, and storage of organic matter, as well as the distribution of biota. We here investigated the structure of planktonic (free-living, FL), particle-attached (PA) and sediment-associated (SD) bacterial and archaeal communities within a small reservoir. We combined targeted-amplicon sequencing of bacterial and archaeal 16S rRNA genes in the DNA and RNA community fractions from FL, PA and SD, followed by imputed functional metagenomics, in order to unveil differences in their potential metabolic capabilities within the reservoir (tail, mid, and dam sections) and lifestyles (FL, PA, SD). Both bacterial and archaeal communities were structured according to their life-style preferences rather than to their location in the reservoir. Bacterial communities were richer and more diverse when attached to particles or inhabiting the sediment, while Archaea showed an opposing trend. Differences between PA and FL bacterial communities were consistent at functional level, the PA community showing higher potential capacity to degrade complex carbohydrates, aromatic compounds, and proteinaceous materials. Our results stressed that particle-attached prokaryotes were phylogenetically and metabolically distinct from their free-living counterparts, and that performed as hotspots for organic matter processing within the small reservoir.

Thomas, Lucy and Alatau: The Atkinsons' Adventures in Siberia and the Kazakh Steppe by Stewart John Massey (review)

REVIEWS 581 It is however somewhat old-fashioned in its approach, focusing above all on Kings and Battles, Dynastic Relations, and Enlightenment and Reforms. Interpretations are also on occasion old-fashioned: thus while Frederick II’s partial but definitely incomplete relaxation of serfdom leads on to a hesitantly positive judgment of him as a monarch of his time (p. 216), Catherine II’s failure to abolish serfdom looms as a major blot on her escutcheon which meant that Russia could not ‘transform itself into a modern society’ (p. 240) — recent re-evaluations of Russian serfdom are not considered. Some items that one might expect are omitted. Christian Wolff is mentioned briefly, but the fact of the dominance of his system in Russian philosophy throughout the eighteenth century, until replaced by another German luminary, Kant, does not appear. The wide-ranging influence in Russia of cameralism, largely a German phenomenon, which equally affected Russia, Prussia and Austria, is ignored. One result of cameralist policy was the formation of a whole new social group in Russia, the Volga Germans (unmentioned, except fleetingly in connection with the 1812 formation of the Russian-German Legion, p. 367). Friedrich II’s opposition to the death penalty for infanticide or abortion is explained (p. 206) in terms of Enlightened Reform, disregarding its place in the cameralist population policies which were a major driver of his domestic regime. The volume ends with detailed military accounts of Napoleon’s invasion of Russia and his downfall 1812–13, including the place of Germans and German forces in the Napoleonic and the Russian ranks. This volume is a cross between detailed history and coffee-table presentation; but it brings together in concise form a great deal of foundational information about Russian-German interactions, parallels and comparisons between 1700 and 1813. Cambridge Roger Bartlett Stewart, John Massey. Thomas, Lucy and Alatau: The Atkinsons’ Adventures in Siberia and the Kazakh Steppe. Unicorn, London, 2018. 344 pp. Illustrations. Appendices. Catalogue raisonné. Notes. Bibliography. Glossary. Index. £25.00. This is the latest book about the fascinating travels of an English family, in 1847–53, across the Urals, Siberia and what is now Eastern Kazakhstan (the previous title on the same topic, South to the Great Steppe by Nick Fielding, came out in 2015 and was reviewed in SEER, vol. 94, no. 4, pp. 748–50). Writing of the industrial towns along his route, the father of the family opined that ‘civilization of a very high character had reached these regions’ (p. 77), while the mother expressed her preference for the nomadic lifestyle of local ethnic SEER, 98, 3, JULY 2020 582 minorities: ‘I could almost wish I were a Kazakh, wandering forth like them, under a serene sky, in search of mountain pastures’ (p. 232). Thomas Witlam Atkinson (1799–1861), an architect who fell into debt, sought to revive his fortunes by travelling to Russia’s little-known regions to make their pictorial record for a subsequent sale. Permission to do so was granted by Emperor Nicholas I. While in Russia, Thomas married the governess Lucy Sherrard Finley (1819–93), who joined him on his journeys. Their son Alatau Tamchiboulac (1848–1906), named after his parents’ favourite geographical locations, was (Thomas claimed) ‘the first and perhaps the only Englishman that [would] ever be born in [the Cossack fort of] Kopal [now Qapal]’ (p. 131). Despite his very young age, Alatau, too, became Thomas and Lucy’s travelling companion along a substantial segment of a total of nearly 50,000 arduous miles. All in all, while in Russia, Thomas produced well over 500 watercolour sketches, chiefly, it seems, of landscapes and indigenes (the whereabouts of most sketches are now unknown). His mission thus accomplished, Thomas and family returned to Britain in 1857. That year also saw the publication of his travel account, Oriental and Western Siberia. The book went into several editions in the UK and the USA and was even translated into Spanish. Thomas became a kind of celebrity and was elected a Fellow at both the Royal Geographical and the Geological Societies in London. However, of his sixtythree pictures auctioned at Christie’s in 1858 only less than a half were sold, possibly...