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The Systems Ecology Paradigm (SEP) incorporates humans as integral parts of ecosystems and emphasizes issues that have significant societal relevance such as grazing land, forestland, and agricultural ecosystem management, biodiversity and global change impacts. Accomplishing this societally relevant research requires cutting-edge basic and applied research. This book focuses on environmental and natural resource challenges confronting local to global societies for which the SEP methodology must be utilized for resolution. Key elements of SEP are a holistic perspective of ecological/social systems, systems thinking, and the ecosystem approach applied to real world, complex environmental and natural resource problems. The SEP and ecosystem approaches force scientific emphasis to be placed on collaborations with social scientists and behavioral, learning, and marketing professionals. The SEP has given environmental scientists, decision makers, citizen stakeholders, and land and water managers a powerful set of tools to analyse, integrate knowledge, and propose adoption of solutions to important local to global problems.
We examined demographic, clinical, and psychological characteristics of a large cohort (n = 368) of adults with dissociative seizures (DS) recruited to the CODES randomised controlled trial (RCT) and explored differences associated with age at onset of DS, gender, and DS semiology.
Prior to randomisation within the CODES RCT, we collected demographic and clinical data on 368 participants. We assessed psychiatric comorbidity using the Mini-International Neuropsychiatric Interview (M.I.N.I.) and a screening measure of personality disorder and measured anxiety, depression, psychological distress, somatic symptom burden, emotional expression, functional impact of DS, avoidance behaviour, and quality of life. We undertook comparisons based on reported age at DS onset (<40 v. ⩾40), gender (male v. female), and DS semiology (predominantly hyperkinetic v. hypokinetic).
Our cohort was predominantly female (72%) and characterised by high levels of socio-economic deprivation. Two-thirds had predominantly hyperkinetic DS. Of the total, 69% had ⩾1 comorbid M.I.N.I. diagnosis (median number = 2), with agoraphobia being the most common concurrent diagnosis. Clinical levels of distress were reported by 86% and characteristics associated with maladaptive personality traits by 60%. Moderate-to-severe functional impairment, high levels of somatic symptoms, and impaired quality of life were also reported. Women had a younger age at DS onset than men.
Our study highlights the burden of psychopathology and socio-economic deprivation in a large, heterogeneous cohort of patients with DS. The lack of clear differences based on gender, DS semiology and age at onset suggests these factors do not add substantially to the heterogeneity of the cohort.
The integration of first-, second-, and third-personal information within joint intentional collaboration provides the foundation for broad-based second-personal morality. We offer two additions to this framework: a description of the developmental process through which second-personal competence emerges from early triadic interactions, and empirical evidence that collaboration with a concrete goal may provide an essential focal point for this integrative process.
Current dietary recommendations encourage increased fibre and reduced sugar consumption. In the UK, specific targets and benchmarks have been established for the sugar content of some foods but not for fibre. National Food Consumption Surveys provide comprehensive information of all foods consumed by representative population samples. The Irish national food surveys as completed by the Irish Universities Nutrition Alliance (IUNA) capture dietary data at brand level with all details as gathered on pack entered into a discrete but inter-linked database, the Irish National Food Ingredient Database (INFID). The aim of this study was to profile the carbohydrate quality of a convenience sub-sample of packaged foods as eaten by Irish children during the National Children's Food Survey II (2017/2018) as entered into INFID.
Materials and Methods:
All on-pack details from 385 available foods in the categories ‘white breads and rolls’; ‘brown breads and rolls’; ‘other breads and scones’; ‘ready to eat breakfast cereals (RTEBC)’; ‘biscuits’; and ‘cakes, buns and pastries’ were entered in to INFID and quality control completed. The carbohydrate profile of the products was assessed with respect to fibre labelling criteria and UK sugar guidelines and targets. SPSS Version 25 was used for all analyses.
Although 56% (n210) of all products entered were eligible to make a ‘source of’ or ‘high’ fibre claim, only 20% (n78) made such a claim. Of this, 46% stated ‘high fibre’ and 32% ‘source’, predominately in the ‘brown breads and rolls’ and ‘RTEBC’ groups. When compared to UK Department of Health guidance for ‘low’, ‘medium’ and ‘high’ sugar, 65% of all products examined (n250) were either ‘low’ or ‘medium’ sugar. Comparison of median sugar contents with Public Health England sugar reformulation targets revealed different responses in each category, with all categories other than foods deemed as “morning goods” yet to meet the 2020 target of 20% reduction in sugar content.
This small pilot study of a convenience sample of foods suggests that for the limited number of foods examined, for some there remains challenges to reduce sugar and increase fibre contents. Strategies such as reformulation, change in portion size, flexibility in labelling and/or a shift in sales portfolios could be considered but only alongside technological and safety considerations. Further research to broaden this analysis and to link nutrient levels as listed on pack with actual consumption patterns could help ensure all recent initiatives including reformulation are recognised.
Being physically active is associated with fundamental health benefits and assists with the maintenance of normal weight in children. The current World Health Organizations’ recommendation is for children to accumulate 60 minutes of physical activity (PA) per day to obtain such benefits. Conversely, time spent in sedentary behaviours including watching screens (ST) are positively associated with the risk of overweight and obesity in young people. The aim of this research was to estimate PA levels and ST usage of Irish children and to examine the relationship with body fat.
This analysis was based on data collected from a nationally representative sample of Irish children aged 5–12-years (n = 591, 50% female) from The National Children's Food Consumption Survey II (www.iuna.net). The Child/Youth Physical Activity Questionnaires (C-PAQ/Y-PAQ) were used to measure PA and ST in 5–8 and 9–12-year-olds respectively. Both questionnaires were self-administered, recall instruments that assessed the frequency/duration of activities participated in over the previous 7-day period. The MET minutes (metabolic cost of the activity multiplied by the duration in minutes) of the PA's were calculated per child. Percentage body fat (%BF) was measured by a Tanita BC420MA device and participants were classified into categories based on their %BF, age and gender. Independent t-tests and ANOVA (post-hoc DunnettT-3) were used to assess differences between gender and %BF category.
Overall, children spent 93 mins/d being physically active with 69% meeting the > 1hr recommendation. There was a significant difference in the time spent undertaking PA between boys (99 mins/d) and girls (88 mins/d) p = 0.020. Children spent 107 mins/d watching screens with 68% meeting the < 2hr guidance. Girls spent significantly less time watching screens (89 mins/d) than boys (124 mins/d) p ≤ 0.001. Children who had a normal %BF accumulated more PA MET mins/day compared to those who were classified as obese, which was significant in the total population (p = 0.007), for boys (p ≤ 0.001), but not girls (p = 0.929).
This preliminary analysis indicates that a high proportion of Irish children are meeting the PA and ST recommendations, with boys being more physically active and spending more time watching screens compared to girls. However, results should be interpreted with caution as PA and ST usage were self-reported by participants. The association between PA MET minutes and %BF suggest that advice to encourage PA participation to combat excess adiposity in Irish children is justified. Future work should examine the role of other potential determinants of obesity in this cohort.
The Food Safety Authority of Ireland (FSAI) have set target maximum daily salt intakes for children (4–6y: 3 g, 7–10y: 5 g, 11–14y: 6g) while the European Food Safety Authority (EFSA) have set Adequate Intakes (AI) for potassium of 1100mg/d, 1800mg/d and 2700mg/d for children of the same respective age groups. An individual's sodium to potassium (Na:K) intake ratio is an important predictor of hypertension and the World Health Organization (WHO) recommend a Na:K intake ratio of ≤ 1.0mmol/mmol for both adults and children. Although the morbidities associated with hypertension may not be seen until adulthood, blood pressure in childhood has a significant association with blood pressure in adulthood. Therefore, estimation of Na:K intake ratios (best measured by urinary excretion) in children may predict their susceptibility to hypertension related diseases in later life. The aim of this study was to estimate sodium and potassium intake and mean molar Na:K intake ratio of Irish children and to assess compliance with dietary guidance.
Morning spot urine samples were collected for 572 children aged 5–12 years (95% of total sample) as part of the nationally representative Irish National Children's Food Survey II (2017–2018) (NCFSII; www.iuna.net). Samples were transported, processed and stored using best practice procedures. Urinary excretion of sodium and potassium were measured using a Randox RX Daytona and were corrected for gender and age-specific 24-hour urine volume estimations based on 24-hour urine volume estimates from Australian children. SPSS Version 25 was used for all analyses.
Mean 24-hour urinary sodium excretion was 2018mg/d, equivalent to an average salt excretion of 5.0g/d exceeding the FSAI maximum target intake for all age groups except 11–12 year olds. Mean 24-hour urinary potassium excretion was 1411mg/d with mean intakes below the AI from EFSA for all age groups with the exception of 5–6 year olds. The mean molar Na:K ratio of Irish children was 2.8 for boys and 3.4 for girls. Only 5% of Irish children met the WHO recommendation for a Na:K ratio of ≤ 1.0mmol/mmol.
High intakes of sodium and low intakes of potassium reported in this study result in a low compliance with the WHO recommendation of a Na:K ratio ≤ 1.0mmol/mmol. This may lead to a higher risk of hypertension and related morbidities in later life. Based on these findings, dietary interventions to combat hypertension related diseases (such as lowering sodium and increasing potassium intakes) should be implemented from childhood.
Under Regulation (EC) No 1924/2006 the usage of nutrition and health claims are permitted, however foods that are high in fat, sugars and salt are advised not to use such claims as foods promoted with these claims may influence consumer food choice. The use of nutrient profiles has been proposed as a means of avoiding the potential of such claims masking the overall nutritional status of a product. Ready to eat breakfast cereals (RTEBC) often display nutrition claims whilst also contributing significantly to total sugar and energy intake. The aim of this study was to profile a variety of RTEBC and compare nutrient composition and claim information between nutrient profile categories.
The Irish National Food Ingredient database (INFID) is a record of brand specific information from food labels collected during the Irish national food surveys. A convenience sub-sample of RTEBC as eaten by Irish children during the National Children's Food Survey 2 (2017/2018) were selected (n = 102). Nutrient profile (NP) scores were calculated using the UK Nutrient Profiling Model (FSA). NP scores were calculated based on a set of negative macronutrient indicators (energy, saturated fat, total sugars and sodium) minus positive indicators (protein, fibre, “fruit, vegetables and nuts”) present per 100 g. Foods scoring four points or more were classified as “less healthy”.
More than half of RTEBC were classed “less healthy” (53%) with a median NP score of 8.0 with “healthy” RTEBC scoring significantly lower at -0.0 (p < 0.001). “Healthy” RTEBC had a median sugar content of 13.4g/100 g compared to 24g/100 g in the “less healthy” (p < 0.001). “Healthy” RTEBC had a higher fibre content of 8.8g/100 g compared to 5.72g/100 g in the “less healthy” (p = 0.001), with 35% of healthy and 28% of less healthy RTEBC making a substantiated “high in fibre” claim. Micronutrient contents of all RTEBC were similar, with only iron significantly higher in “healthy” (13.3mg/100g) compared to “less healthy” (9.5mg/100g) (p = 0.02). The prevalence of substantiated micronutrient related claims was the same between “healthy” and “less healthy” RTEBC.
“Healthy” and “less healthy” RTEBC display similar micronutrient profiles, with most of the nutrition claims on both pertaining to the micronutrient and fibre content, potentially overshadowing the macronutrient contribution of the cereals. This analysis shows the ability of nutrient profiling to distinguish products by macronutrient profiles however it identifies the complexity of application with respect to micronutrient content. Further research is required to investigate the contribution of the profiled RTEBC to total nutrient intakes.
The rocky shores of the north-east Atlantic have been long studied. Our focus is from Gibraltar to Norway plus the Azores and Iceland. Phylogeographic processes shape biogeographic patterns of biodiversity. Long-term and broadscale studies have shown the responses of biota to past climate fluctuations and more recent anthropogenic climate change. Inter- and intra-specific species interactions along sharp local environmental gradients shape distributions and community structure and hence ecosystem functioning. Shifts in domination by fucoids in shelter to barnacles/mussels in exposure are mediated by grazing by patellid limpets. Further south fucoids become increasingly rare, with species disappearing or restricted to estuarine refuges, caused by greater desiccation and grazing pressure. Mesoscale processes influence bottom-up nutrient forcing and larval supply, hence affecting species abundance and distribution, and can be proximate factors setting range edges (e.g., the English Channel, the Iberian Peninsula). Impacts of invasive non-native species are reviewed. Knowledge gaps such as the work on rockpools and host–parasite dynamics are also outlined.
This study evaluated the efficacy of a family-centered preventive intervention, the Family Check-Up (FCU), delivered as an online, eHealth model to middle school families. To increase accessibility of family-centered prevention in schools, we adapted the evidence-based FCU to an online format, with the goal of providing a model of service delivery that is feasible, given limited staffing and resources in many schools. Building on prior research, we randomly assigned participants to waitlist control (n = 105), FCU Online as a web-based intervention (n = 109), and FCU Online with coaching support (n = 108). We tested the effects of the intervention on multiple outcomes, including parental self-efficacy, child self-regulation, and child behavior, in this registered clinical trial (NCT03060291). Families engaged in the intervention at a high rate (72% completed the FCU assessment) and completed 3-month posttest assessments with good retention (94% retained). Random assignment to the FCU Online with coaching support was associated with reduced emotional problems for children (p = .003, d = −0.32) and improved parental confidence and self-efficacy (p = .018, d = 0.25) when compared with waitlist controls. Risk moderated effects: at-risk youth showed stronger effects than did those with minimal risk. The results have implications for online delivery of family-centered interventions in schools.
We read with interest the recent editorial, “The Hennepin Ketamine Study,” by Dr. Samuel Stratton commenting on the research ethics, methodology, and the current public controversy surrounding this study.1 As researchers and investigators of this study, we strongly agree that prospective clinical research in the prehospital environment is necessary to advance the science of Emergency Medical Services (EMS) and emergency medicine. We also agree that accomplishing this is challenging as the prehospital environment often encounters patient populations who cannot provide meaningful informed consent due to their emergent conditions. To ensure that fellow emergency medicine researchers understand the facts of our work so they may plan future studies, and to address some of the questions and concerns in Dr. Stratton’s editorial, the lay press, and in social media,2 we would like to call attention to some inaccuracies in Dr. Stratton’s editorial, and to the lay media stories on which it appears to be based.
Ho JD, Cole JB, Klein LR, Olives TD, Driver BE, Moore JC, Nystrom PC, Arens AM, Simpson NS, Hick JL, Chavez RA, Lynch WL, Miner JR. The Hennepin Ketamine Study investigators’ reply. Prehosp Disaster Med. 2019;34(2):111–113
The genetic and environmental contributions of negative valence systems (NVS) to internalizing pathways study (also referred to as the Adolescent and Young Adult Twin Study) was designed to examine varying constructs of the NVS as they relate to the development of internalizing disorders from a genetically informed perspective. The goal of this study was to evaluate genetic and environmental contributions to potential psychiatric endophenotypes that contribute to internalizing psychopathology by studying adolescent and young adult twins longitudinally over a 2-year period. This report details the sample characteristics, study design, and methodology of this study. The first wave of data collection (i.e., time 1) is complete; the 2-year follow-up (i.e., time 2) is currently underway. A total of 430 twin pairs (N = 860 individual twins; 166 monozygotic pairs; 57.2% female) and 422 parents or legal guardians participated at time 1. Twin participants completed self-report surveys and participated in experimental paradigms to assess processes within the NVS. Additionally, parents completed surveys to report on themselves and their twin children. Findings from this study will help clarify the genetic and environmental influences of the NVS and their association with internalizing risk. The goal of this line of research is to develop methods for early internalizing disorder risk detection.