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Maximising synergies and minimising conflicts (i.e. building policy coherence) between trade and nutrition policy is an important objective. One understudied driver of policy coherence is the alignment in the frames, discourses and values of actors involved in the respective sectors. In the present analysis, we aim to understand how such actors interpret (i.e. ‘frame’) nutrition and the implications for building trade–nutrition policy coherence.
We adopted a qualitative single case study design, drawing on key informant interviews with those involved in trade policy.
We focused on the Australian trade policy sub-system, which has historically emphasised achieving market growth and export opportunities for Australian food producers.
Nineteen key informants involved in trade policy spanning the government, civil society, business and academic sectors.
Nutrition had low ‘salience’ in Australian trade policy for several reasons. First, it was not a domestic political priority in Australia nor among its trading partners; few advocacy groups were advocating for nutrition in trade policy. Second, a ‘productivist’ policy paradigm in the food and trade policy sectors strongly emphasised market growth, export opportunities and deregulation over nutrition and other social objectives. Third, few opportunities existed for health advocates to influence trade policy, largely because of limited consultation processes. Fourth, the complexity of nutrition and its inter-linkages with trade presented difficulties for developing a ‘broader discourse’ for engaging the public and political leaders on the topic.
Overcoming these ‘ideational challenges’ is likely to be important to building greater coherence between trade and nutrition policy going forward.
Latent stochastic blockmodels are flexible statistical models that are widely used in social network analysis. In recent years, efforts have been made to extend these models to temporal dynamic networks, whereby the connections between nodes are observed at a number of different times. In this paper, we propose a new Bayesian framework to characterize the construction of connections. We rely on a Markovian property to describe the evolution of nodes' cluster memberships over time. We recast the problem of clustering the nodes of the network into a model-based context, showing that the integrated completed likelihood can be evaluated analytically for a number of likelihood models. Then, we propose a scalable greedy algorithm to maximize this quantity, thereby estimating both the optimal partition and the ideal number of groups in a single inferential framework. Finally, we propose applications of our methodology to both real and artificial datasets.
The current short communication aimed to provide a new conceptualisation of the policy drivers of inequities in healthy eating and to make a call to action to begin populating this framework with evidence of actions that can be taken to reduce the inequities in healthy eating.
The Healthy and Equitable Eating (HE2) Framework derives from a systems-based analytical approach involving expert workshops.
Academics, government officials and non-government organisations in Australia.
The HE2 Framework extends previous conceptualisations of policy responses to healthy eating to include the social determinants of healthy eating and its social distribution, encompassing policy areas including housing, social protection, employment, education, transport, urban planning, plus the food system and environment.
As the burden of non-communicable diseases continues to grow globally, it is important that governments, practitioners and researchers focus attention on the development and implementation of policies beyond the food system and environment that can address the social determinants of inequities in healthy eating.
In general, a functioning liability and insurance framework should ensure an adequate level of third party claimant protection and a reasonable and adequate final allocation of liability costs for the involved parties. This research examines whether the liability and insurance framework resulting from the amendment to German Road Traffic Act meets these two central objectives. The article shows that a reasonable and adequate allocation of liability costs is inhibited because of several barriers that hinder the shift of liability costs from the owner of the vehicle to the manufacturer. In particular, it is highly dependent on the practical application of subrogation claims. The ability and the motivation of motor insurers to conduct subrogation claims could be negatively affected because of a lack of required technical and engineering know-how and because a market-wide conduction of subrogation claims would erode the business model of motor insurance. This article proposes changes to the current framework particularly by removing specific exclusions of product liability and by easing the burden of proof of a product defect.
OBJECTIVES/SPECIFIC AIMS: The aim of this study was to assess the ultra-dose Na18F dPET protocol feasibility for skeleton imaging in a canine model with reduced radiation dose and preserved quantitative characteristics. We hypothesized that administering an ultra-low Na18F dose would provide suitable image quality while reducing subject’s exposure to radiation. METHODS/STUDY POPULATION: In total, 13 adult male beagles [weight (kg) mean±SD; 14.3±2.2] were scanned. The dogs were administered 3 different Na18F doses: 3 (standard dose/SD), 1 (low dose/LD), and 0.05 (ultra-low dose/ULD) mCi. Imaging started ≃45 minutes post injection for ≃ 33 minute total acquisition time. Covering the whole body, 11 bed positions, acquiring 120 (3 mCi) and 180 (1, 0.05 mCi) seconds per bed position. All imaging was performed on a digital photon counting system (Philips Vereos, pre-commercial release). PET list mode data were reconstructed using Time-of-flight with 4, 2, and 1 mm3 voxel volumes. Point spread function, and Gaussian filtering were applied. Two experienced blinded readers evaluated image sets overall quality, tissue characterization, and quality of background in the whole body skeleton. Three-dimensional (3D) regions of interest (ROI) were traced over the distal femur, first lumbar vertebra, and a portion of the liver, recording standard uptake values (SUVmax and SUVmean). RESULTS/ANTICIPATED RESULTS: All the scans and reconstructions were successfully completed in all subjects. Decreasing Na18F dose from the standard dose (3 mCi) to the ultra-low dose/ULDO (0.05 mCi), demonstrated acceptable image quality and quantification. Ultra-low dose Na18F SUVmean values for the 3D ROIs reported (mean±SD) 2.6±0.7, 2.5±1.1, 9±1.6, and 0.6±0.3 from the right and left distal femur, first lumbar vertebra, and a portion of the liver, respectively. When compared the SD with the LD and ULD, dPET demonstrated acceptable image quality and definition for qualitative overall assessment. This was also found for the overall quantitative ROI assessment of the healthy canine skeletons. DISCUSSION/SIGNIFICANCE OF IMPACT: Ultra-low dose Na18F at a level of 50 μCi for a 14 kg canine appears to be diagnostically feasible and a robust option to reduce (60-fold) radiotracer doses in a translational animal model using a dPET system. Furthermore, it allows us to move preclinical nuclear medicine imaging forward with substantial reduced exposure levels while preserving image quality. Both visual and quantitative results indicate that the standard-dose bone Na18F dPET can be decreased with a satisfactory diagnostic image quality. Ultra-low Na18F dose is indeed important for younger populations, control patients, and nononcological diseases/conditions. Favorable pharmacokinetics of Na18F (such as high bone uptake, minimal binding to serum proteins, rapid single-pass extraction, and fast clearance from the soft tissues) in addition to the technological capabilities of dPET/CT demonstrated feasibility enabling dose reduction strategies. Ultra-low dose has diagnostic reproducibility and lower radiation burden compared with higher fixed dose techniques in current available guidelines [Society of Nuclear Medicine and Molecular Imaging; SNMMI (5–10 mCi)]. Na18F dPET/CT provides higher sensitivity and diagnostic accuracy, which enables high-quality images with lower tracer activity in this translational animal model. Future research will apply the same methodology to other anatomical targets as well as to the use of different tracers. Preclinical nuclear medicine imaging using ultra-low tracer doses, demonstrated the potential to obtain reasonable quality images and diminishing radiation surveillance in accordance with as low as reasonably achievable tracer levels.
The latent position cluster model is a popular model for the statistical analysis of network data. This model assumes that there is an underlying latent space in which the actors follow a finite mixture distribution. Moreover, actors which are close in this latent space are more likely to be tied by an edge. This is an appealing approach since it allows the model to cluster actors which consequently provides the practitioner with useful qualitative information. However, exploring the uncertainty in the number of underlying latent components in the mixture distribution is a complex task. The current state-of-the-art is to use an approximate form of BIC for this purpose, where an approximation of the log-likelihood is used instead of the true log-likelihood which is unavailable. The main contribution of this paper is to show that through the use of conjugate prior distributions, it is possible to analytically integrate out almost all of the model parameters, leaving a posterior distribution which depends on the allocation vector of the mixture model. This enables posterior inference over the number of components in the latent mixture distribution without using trans-dimensional MCMC algorithms such as reversible jump MCMC. Our approach is compared with the state-of-the-art latentnet (Krivitsky & Handcock, 2015) and VBLPCM (Salter-Townshend & Murphy, 2013) packages.
ABSTRACT. The sea was profoundly important in medieval England. Anglo-Saxon seaborne colonisation led to the development of the nation, and the later Norman Conquest drew England into what proved to be a fatal involvement in the politics of France. English maritime technology belonged to the north-European tradition, and sea trade permeated the nation and stimulated urban development. However, until the 15th century the country's trade was mostly dominated by foreign merchants and ships. English kings were able make effective use of the country's shipping in various wars between the 13th and 15th centuries, though by the late 15th century England was in decline as a naval and economic seapower.
RÉSUMÉ. La mer était très importante dans l'Angleterre médiévale. La colonisation maritime des Anglo-Saxons a conduit au développement de la nation, et la conquête normande plus tard a attiré l'Angleterre dans ce qui s'est avéré être une implication mortelle dans la politique de la France. La technologie maritime anglaise appartenait à la tradition nord-européenne et le commerce maritime imprégnait la nation et stimulait le développement urbain. Cependant, jusqu'au XVe siècle le commerce du pays était principalement dominé par des marchands et des navires étrangers. Les rois anglais ont été en mesure d'utiliser efficacement le transport maritime du pays dans les différentes guerres entre le XIIIe et le XVe siècle, bien qu'à la fin du XVe siècle, l'Angleterre fût en déclin comme puissance maritime navale et économique.
Quite apart from its direct physical effects, the sea has always had a powerful impact on the history of island nations. In this paper ‘the sea’ is taken to mean ‘the uses that people have made of the sea’. In this sense, the medieval English nation owed its origin to the sea, and the country's subsequent development was deeply affected by it.
AN HISTORICAL OVERVIEW
One of the key attributes of a ship is mobility, and this attribute made medieval Britain vulnerable to the ships of invaders and colonisers. In the 5th and 6th centuries those incomers were the pagan Angles, Saxons and Jutes, who landed on the eastern and southern shores of the former Roman province of Britannia.
We consider the task of simultaneous clustering of the two node sets involved in a bipartite network. The approach we adopt is based on use of the exact integrated complete likelihood for the latent blockmodel. Using this allows one to infer the number of clusters as well as cluster memberships using a greedy search. This gives a model-based clustering of the node sets. Experiments on simulated bipartite network data show that the greedy search approach is vastly more scalable than competing Markov chain Monte Carlo-based methods. Application to a number of real observed bipartite networks demonstrate the algorithms discussed.
We derive properties of latent variable models for networks, a broad class of models that includes the widely used latent position models. We characterize several features of interest, with particular focus on the degree distribution, clustering coefficient, average path length, and degree correlations. We introduce the Gaussian latent position model, and derive analytic expressions and asymptotic approximations for its network properties. We pay particular attention to one special case, the Gaussian latent position model with random effects, and show that it can represent the heavy-tailed degree distributions, positive asymptotic clustering coefficients, and small-world behaviors that often occur in observed social networks. Finally, we illustrate the ability of the models to capture important features of real networks through several well-known datasets.
The marketing of infant/child milk-based formulas (MF) contributes to suboptimal breast-feeding and adversely affects child and maternal health outcomes globally. However, little is known about recent changes in MF markets. The present study describes contemporary trends and patterns of MF sales at the global, regional and country levels.
Descriptive statistics of trends and patterns in MF sales volume per infant/child for the years 2008–2013 and projections to 2018, using industry-sourced data.
Eighty countries categorized by country income bracket, for developing countries by region, and in countries with the largest infant/child populations.
MF categories included total (for ages 0–36 months), infant (0–6 months), follow-up (7–12 months), toddler (13–36 months) and special (0–6 months).
In 2008–2013 world total MF sales grew by 40·8 % from 5·5 to 7·8 kg per infant/child/year, a figure predicted to increase to 10·8 kg by 2018. Growth was most rapid in East Asia particularly in China, Indonesia, Thailand and Vietnam and was led by the infant and follow-up formula categories. Sales volume per infant/child was positively associated with country income level although with wide variability between countries.
A global infant and young child feeding (IYCF) transition towards diets higher in MF is underway and is expected to continue apace. The observed increase in MF sales raises serious concern for global child and maternal health, particularly in East Asia, and calls into question the efficacy of current regulatory regimes designed to protect and promote optimal IYCF. The observed changes have not been captured by existing IYCF monitoring systems.
Spectral lines of the ΔV=2 rotation vibration bands of CO are well suited for study of photospheric motions and the mass ejection process in cool stars. We have obtained high spectral resolution (1.8 km/sec) and high signal-to-noise (>102) line profiles for a selection of K and M giants. These profiles are being studied for evidence of gas motions in the photosphere and near circumstellar regions.
To develop a policy formulation tool for strategically informing food and nutrition policy activities to promote healthy and sustainable diets (HSD).
A policy formulation tool consisting of two complementary components was developed. First, a conceptual framework of the environment–public health nutrition relationship was constructed to characterise and conceptualise the food system problem. Second, an ‘Orders of Food Systems Change’ schema drawing on systems dynamics thinking was developed to identify, assess and propose policy options to redesign food systems.
Food and nutrition policy activities to promote HSD have been politicised, fragmented and lacking a coherent conceptual and strategic focus to tackle complex food system challenges.
The tool’s conceptual framework component comprises three integrated dimensions: (i) a structure built around the environment and public health nutrition relationship that is mediated via the food system; (ii) internal mechanisms that operate through system dynamics; and (iii) external interactions that frame its nature and a scope within ecological parameters. The accompanying schema is structured around three orders of change distinguished by contrasting ideological perspectives on the type and extent of change needed to ‘solve’ the HSD problem.
The conceptual framework’s systems analysis of the environment–public health nutrition relationship sets out the food system challenges for HSD. The schema helps account for political realities in policy making and is a key link to operationalise the framework’s concepts to actions aimed at redesigning food systems. In combination they provide a policy formulation tool to strategically inform policy activities to redesign food systems and promote HSD.
The present article tracks the development of the Australian National Food Plan as a ‘whole of government’ food policy that aimed to integrate elements of nutrition and sustainability alongside economic objectives.
The article uses policy analysis to explore the processes of consultation and stakeholder involvement in the development of the National Food Plan, focusing on actors from the sectors of industry, civil society and government. Existing documentation and submissions to the Plan were used as data sources. Models of health policy analysis and policy streams were employed to analyse policy development processes.
Australian food policy stakeholders.
The development of the Plan was influenced by powerful industry groups and stakeholder engagement by the lead ministry favoured the involvement of actors representing the food and agriculture industries. Public health nutrition and civil society relied on traditional methods of policy influence, and the public health nutrition movement failed to develop a unified cross-sector alliance, while the private sector engaged in different ways and presented a united front. The National Food Plan failed to deliver an integrated food policy for Australia. Nutrition and sustainability were effectively sidelined due to the focus on global food production and positioning Australia as a food ‘superpower’ that could take advantage of the anticipated ‘dining boom’ as incomes rose in the Asia-Pacific region.
New forms of industry influence are emerging in the food policy arena and public health nutrition will need to adopt new approaches to influencing public policy.
To determine key points of intervention in urban food systems to improve the climate resilience, equity and healthfulness of the whole system.
The paper brings together evidence from a 3-year, Australia-based mixed-methods research project focused on climate change adaptation, cities, food systems and health. In an integrated analysis of the three research domains – encompassing the production, distribution and consumption sectors of the food chain – the paper examines the efficacy of various food subsystems (industrial, alternative commercial and civic) in achieving climate resilience and good nutrition.
Greater Western Sydney, Australia.
Primary producers, retailers and consumers in Western Sydney.
This overarching analysis of the tripartite study found that: (i) industrial food production systems can be more environmentally sustainable than alternative systems, indicating the importance of multiple food subsystems for food security; (ii) a variety of food distributors stocking healthy and sustainable items is required to ensure that these items are accessible, affordable and available to all; and (iii) it is not enough that healthy and sustainable foods are produced or sold, consumers must also want to consume them. In summary, a resilient urban food system requires that healthy and sustainable food items are produced, that consumers can attain them and that they actually wish to purchase them.
This capstone paper found that the interconnected nature of the different sectors in the food system means that to improve environmental sustainability, equity and population health outcomes, action should focus on the system as a whole and not just on any one sector.
This paper presents a series of three patients who were identified as having partial thickness involvement of the laryngotracheal complex secondary to invasive, well-differentiated thyroid cancer. These patients were managed with full thickness window resection and reconstruction using a composite nasal septal graft.
A review of the Princess Alexandra Hospital database (comprising prospectively collated data) was undertaken to identify patients who had undergone full thickness tracheal resection and reconstruction using a composite nasal septal graft; demographic, operative technique and survival outcome data were collated.
Three patients had a composite nasal septal graft performed for reconstruction of full thickness laryngotracheal defects following the excision of well-differentiated thyroid cancer. There were no cases of local recurrence after a minimum of 18 months' follow up.
This paper describes our surgical technique for reconstruction of these defects using a composite nasal septal graft. It also presents data on our three cases to date, in which the technique has been used safely. A discussion of the surgical management of locally invasive, well-differentiated thyroid cancer is provided.
A lower molar of Castor fiber from the sandpit of Langenboom (the Netherlands) represents, so far, the oldest occurrence of a beaver in the North Sea Basin. Its presence in the marine sand deposit of the Langenboom Formation indicates that Castor fiber inhabited areas in or near the river systems of Rhine and Meuse in the Early Pliocene.
To articulate a healthy and sustainable (H&S) diet; outline key health and environmental sustainability principles that can be applied in the selection of foods for inclusion in such a diet; and describe a methodology with which to assess the availability and affordability of a H&S food basket.
We synthesized publically available evidence on the environmental impact of different foods from academic, government, industry and non-government sources and constructed a hypothetical H&S equivalent of the typical Australian diet. Based on this, we constructed a weekly H&S food basket for a household of two adults and two children.
The H&S diet is based on three overarching principles: (i) any food that is consumed above a person's energy requirement represents an avoidable environmental burden in the form of greenhouse gas emissions, use of natural resources and pressure on biodiversity; (ii) reducing the consumption of discretionary food choices, which are energy-dense and highly processed and packaged, reduces both the risk of dietary imbalances and the use of environmental resources; and (iii) a diet comprising less animal- and more plant-derived foods delivers both health and ecological benefits.
We have focused on the articulation of a H&S diet not to facilitate ‘policy drift’ to focus on individual dietary choice, but rather to provide evidence to extend dietary guideline recommendations so as to integrate environmental considerations within the scope of food and health policy advice in Australia and elsewhere.