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To describe the feasibility, acceptability, and results of Strong Families Start at Home, a 6-month pilot trial of a home-based food parenting/nutrition intervention.
Pilot randomized controlled trial
Parents and their 2–5-year-old child were randomized into intervention (responsive food parenting practices/ nutrition) or control (reading readiness) groups.
Participants received 6 visits with a community health worker trained in motivational interviewing (3 home visits; 3 phone calls); an in-home cooking or reading activity; personalized feedback on a recorded family meal or reading activity; text messages; and tailored printed materials.
Parents (n=63) were mostly mothers (90%), Hispanic/Latinx (87%), born outside the United States (62%), with household incomes <$25k (54%). Despite delivery during COVID-19, 63% of dyads were retained at 6 months. The intervention was delivered with high fidelity.
All parents in the intervention group (n=24) expressed high levels of satisfaction with the intervention, which produced positive treatment effects for whole and total fruit component HEI-2015 scores (PE=2.14, 95%CI 0.17-1.48; PE= 1.71,95%CI 0.16-1.47, respectively) and negative treatment effects for sodium (PE=-2.09,95%CI -1.35-0.04). Positive treatment effects also resulted for the following food parenting practices: regular timing of meals and snacks (PE=1.08, 95%CI 0.61-2.00), reducing distractions during mealtimes (PE=-0.79,95%CI -1.52- -0.19), using food as a reward (PE=-0.54, 95% CI -1.35- -0.04) and providing a supportive meal environment (PE=0.73, 95% CI 0.18-1.51).
Given the continued disparities in diet quality among low-income, and diverse families, continued efforts to improve child diet quality in fully powered intervention trials are needed.
Psychiatrists depend on their patients for clinical information and are obligated to regard them as trustworthy, except in special circumstances. Nevertheless, some critics of psychiatry have argued that psychiatrists frequently perpetrate epistemic injustice against patients. Epistemic injustice is a moral wrong that involves unfairly discriminating against a person with respect to their ability to know things because of personal characteristics like gender or psychiatric diagnosis.
We review the concept of epistemic injustice and several claims that psychiatric practice is epistemically unjust.
While acknowledging the risk of epistemic injustice in psychiatry and other medical fields, we argue that most concerns that psychiatric practice is epistemically unjust are unfounded.
The concept of epistemic injustice does not add significantly to existing standards of good clinical practice, and that it could produce changes in practice that would be deleterious. Psychiatrists should resist calls for changes to clinical practice based on this type of criticism.
We summarize what we assess as the past year's most important findings within climate change research: limits to adaptation, vulnerability hotspots, new threats coming from the climate–health nexus, climate (im)mobility and security, sustainable practices for land use and finance, losses and damages, inclusive societal climate decisions and ways to overcome structural barriers to accelerate mitigation and limit global warming to below 2°C.
We synthesize 10 topics within climate research where there have been significant advances or emerging scientific consensus since January 2021. The selection of these insights was based on input from an international open call with broad disciplinary scope. Findings concern: (1) new aspects of soft and hard limits to adaptation; (2) the emergence of regional vulnerability hotspots from climate impacts and human vulnerability; (3) new threats on the climate–health horizon – some involving plants and animals; (4) climate (im)mobility and the need for anticipatory action; (5) security and climate; (6) sustainable land management as a prerequisite to land-based solutions; (7) sustainable finance practices in the private sector and the need for political guidance; (8) the urgent planetary imperative for addressing losses and damages; (9) inclusive societal choices for climate-resilient development and (10) how to overcome barriers to accelerate mitigation and limit global warming to below 2°C.
Social media summary
Science has evidence on barriers to mitigation and how to overcome them to avoid limits to adaptation across multiple fields.
In current English, the term ‘narrative’ covers a lot of conceptual ground – from an overarching position on some big issue, to all kinds of storytelling, to a general attention to language or metaphor. This chapter argues for narrowing our conception of ‘narrative’ to add value to scholarship in the history and philosophy of science (HPS). This narrower Narrative Science Approach treats narrative as a distinct and complex discursive form, subject to careful technical theorizing in its own right. By using analytical categories from narrative theory, we can identify in rigorous detail how scientific narratives are put together, what might distinguish them from other narrative forms, and the questions they raise for HPS and narrative enquiry. Similarly, when scientists use narrative ways of reasoning, tools from cognitive narratology enable us to reconstruct their imaginative activity. As a reciprocal movement, our Narrative Science Approach promises to enrich narrative studies.