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To assess current performance and identify opportunities and reforms necessary for positioning a food standards programme to help protect public health against dietary risk factors.
A case study design in which a food standards programme’s public health protection performance was analysed against an adapted Donabedian model for assessing health-care quality. The criteria were the food standards programme’s structure (governance arrangements and membership of its decision-making committees), process (decision-making tools, public engagement and transparency) and food standards outcomes, which provided the information base on which performance quality was inferred.
The Australia and New Zealand food standards programme.
The structure, process and outcomes of the Programme.
The Programme’s structure and processes produce food standards outcomes that perform well in protecting public health from risks associated with nutrient intake excess or inadequacy. The Programme performs less well in protecting public health from the proliferation and marketing of ‘discretionary’ foods that can exacerbate dietary risks. Opportunities to set food standards to help protect public health against dietary risks are identified.
The structures and decision-making processes used in food standards programmes need to be reformed so they are fit for purpose for helping combat dietary risks caused by dietary excess and imbalances. Priorities include reforming the risk analysis framework, including the nutrient profiling scoring criterion, by extending their nutrition science orientation from a nutrient (reductionist) paradigm to be more inclusive of a food/diet (holistic) paradigm.
Investigate short- and long-term effects of Superstorm Sandy on multiple morbidities among the elderly.
We examined emergency department visits; outpatient visits; and hospital admissions for cardiovascular disease (CVD), respiratory disease, and injury among residents residing in 8 affected counties immediately, 4 months, and 12 months following Superstorm Sandy. Control groups were defined as visits/admissions during the identical time window in the 5 years before (2007-2011) and 1 year after (2013-2014) the storm in affected and nonaffected counties in New York. We performed Poisson regression to test whether there was an association of increased visits/admissions for periods following Superstorm Sandy while controlling for covariates.
We found that the risk for CVD, respiratory disease, and injury visits/admissions was more than twice as high immediately, 4 months, and 12 months after the storm than it was in the control periods. Women were at greater risk at all time periods for CVD (risk ratio [RR], 2.04) and respiratory disease (RRs: 1.89 to 1.92). Whites had higher risk for CVD, respiratory disease, and injury than other racial groups during each period.
We observed increases in CVD, respiratory disease, and injury up to a year following Superstorm Sandy. Findings demonstrate the need to incorporate short- and long-term health effects into public health recovery. (Disaster Med Public Health Preparedness. 2019;13:28-32)
Australian mosquito species significantly impact human health through nuisance biting and the transmission of endemic and exotic pathogens. Surveillance programmes designed to provide an early warning of mosquito-borne disease risk require reliable identification of mosquitoes. This study aimed to investigate the viability of Matrix-Assisted Laser Desorption/Ionization–Time-of-Flight Mass Spectrometry (MALDI-TOF MS) as a rapid and inexpensive approach to the identification of Australian mosquitoes and was validated using a three-step taxonomic approach. A total of 300 mosquitoes representing 21 species were collected from south-eastern New South Wales and morphologically identified. The legs from the mosquitoes were removed and subjected to MALDI-TOF MS analysis. Fifty-eight mosquitoes were sequenced at the cytochrome c oxidase subunit I (cox1) gene region and genetic relationships were analysed. We create the first MALDI-TOF MS spectra database of Australian mosquito species including 19 species. We clearly demonstrate the accuracy of MALDI-TOF MS for identification of Australian mosquitoes. It is especially useful for assessing gaps in the effectiveness of DNA barcoding by differentiating closely related taxa. Indeed, cox1 DNA barcoding was not able to differentiate members of the Culex pipiens group, Cx. quinquefasciatus and Cx. pipiens molestus, but these specimens were correctly identified using MALDI-TOF MS.
The triazines are one of the most widely used herbicide classes ever developed and are critical for managing weed populations that have developed herbicide resistance. These herbicides are traditionally valued for their residual weed control in more than 50 crops. Scientific literature suggests that atrazine, and perhaps other s-triazines, may no longer remain persistent in soils due to enhanced microbial degradation. Experiments examined the rate of degradation of atrazine and two other triazine herbicides, simazine and metribuzin, in both atrazine-adapted and non-history Corn Belt soils, with similar soils being used from each state as a comparison of potential triazine degradation. In three soils with no history of atrazine use, the t1/2 of atrazine was at least four times greater than in three soils with a history of atrazine use. Simazine degradation in the same three sets of soils was 2.4 to 15 times more rapid in history soils than non-history soils. Metribuzin in history soils degraded at 0.6, 0.9, and 1.9 times the rate seen in the same three non-history soils. These results indicate enhanced degradation of the symmetrical triazine simazine, but not of the asymmetrical triazine metribuzin.
To determine whether probiotic prophylaxes reduce the odds of Clostridium difficile infection (CDI) in adults and children.
Individual participant data (IPD) meta-analysis of randomized controlled trials (RCTs), adjusting for risk factors.
We searched 6 databases and 11 grey literature sources from inception to April 2016. We identified 32 RCTs (n=8,713); among them, 18 RCTs provided IPD (n=6,851 participants) comparing probiotic prophylaxis to placebo or no treatment (standard care). One reviewer prepared the IPD, and 2 reviewers extracted data, rated study quality, and graded evidence quality.
Probiotics reduced CDI odds in the unadjusted model (n=6,645; odds ratio [OR] 0.37; 95% confidence interval [CI], 0.25–0.55) and the adjusted model (n=5,074; OR, 0.35; 95% CI, 0.23–0.55). Using 2 or more antibiotics increased the odds of CDI (OR, 2.20; 95% CI, 1.11–4.37), whereas age, sex, hospitalization status, and high-risk antibiotic exposure did not. Adjusted subgroup analyses suggested that, compared to no probiotics, multispecies probiotics were more beneficial than single-species probiotics, as was using probiotics in clinical settings where the CDI risk is ≥5%. Of 18 studies, 14 reported adverse events. In 11 of these 14 studies, the adverse events were retained in the adjusted model. Odds for serious adverse events were similar for both groups in the unadjusted analyses (n=4,990; OR, 1.06; 95% CI, 0.89–1.26) and adjusted analyses (n=4,718; OR, 1.06; 95% CI, 0.89–1.28). Missing outcome data for CDI ranged from 0% to 25.8%. Our analyses were robust to a sensitivity analysis for missingness.
Moderate quality (ie, certainty) evidence suggests that probiotic prophylaxis may be a useful and safe CDI prevention strategy, particularly among participants taking 2 or more antibiotics and in hospital settings where the risk of CDI is ≥5%.
A field study was conducted for the 2014 and 2015 growing season in Arkansas, Indiana, Illinois, Missouri, Ohio, and Tennessee to determine the effect of cereal rye and either oats, radish, or annual ryegrass on the control of Amaranthus spp. when integrated with comprehensive herbicide programs in glyphosate-resistant and glufosinate-resistant soybean. Amaranthus species included redroot pigweed, waterhemp, and Palmer amaranth. The two herbicide programs included were: a PRE residual herbicide followed by POST application of foliar and residual herbicide (PRE/POST); or PRE residual herbicide followed by POST application of foliar and residual herbicide, followed by another POST application of residual herbicide (PRE/POST/POST). Control was not affected by type of soybean resistance trait. At the end of the season, herbicides controlled 100 and 96% of the redroot pigweed and Palmer amaranth, respectively, versus 49 and 29% in the absence of herbicides, averaged over sites and other factors. The PRE/POST and PRE/POST/POST herbicide treatments controlled 83 and 90% of waterhemp at the end of the season, respectively, versus 14% without herbicide. Cover crop treatments affected control of waterhemp and Palmer amaranth and soybean yield, only in the absence of herbicides. The rye cover crop consistently reduced Amaranthus spp. density in the absence of herbicides compared to no cover treatment.
Mass-balance quantities at specific points on a glacier as defined in [IHD] (1970) relate either to annual maxima or minima in ice mass at that point (the stratigraphic system), or to values at the beginning and end of a hydrologic year (the annual or fixed-date system). Most quantities measured in the field relate to summer surfaces, which correspond to the annual minima at the measurement points. When stratigraphic system point values are integrated over a whole glacier, the result may be meaningless because annual maxima and minima and summer surfaces may form at different times at different places.
The combined system utilizes several kinds of data to derive meaningful area-average results that can be directly related to other hydrologic and meteorologic information. Measurements to summer surfaces at certain specific times, including the beginning and end of a hydrologic year, are added together with proper recognition of the types of material involved: old firn and ice, snow and superimposed ice of the year under study, new firn formed during that year, and late snow deposited toward the end of the year. Other “balance increment” terms relate values at the beginning and end of a hydrologic year to corresponding area-average balance minima. As a result, two types of “net balance” and many other terms are given precise meaning for a glacier as a whole. The scheme is sufficiently versatile to be used on any glacier, although the terms relating to summer surfaces are not defined on a glacier in which ablation or accumulation is continuous throughout a year.
A field study was conducted in 2014 and 2015 in Arkansas, Illinois, Indiana, Ohio, Tennessee, Wisconsin, and Missouri to determine the effects of tillage system and herbicide program on season-long emergence of Amaranthus species in glufosinate-resistant soybean. The tillage systems evaluated were deep tillage (fall moldboard plow followed by (fb) one pass with a field cultivator in the spring), conventional tillage (fall chisel plow fb one pass with a field cultivator in the spring), minimum tillage (one pass of a vertical tillage tool in the spring), and no-tillage (PRE application of paraquat). Each tillage system also received one of two herbicide programs; PRE application of flumioxazin (0.09 kg ai ha–1) fb a POST application of glufosinate (0.59 kg ai ha−1) plus S-metolachlor (1.39 kg ai ha–1), or POST-only applications of glufosinate (0.59 kg ha−1). The deep tillage system resulted in a 62, 67, and 73% reduction in Amaranthus emergence when compared to the conventional, minimum, and no-tillage systems, respectively. The residual herbicide program also resulted in an 87% reduction in Amaranthus species emergence compared to the POST-only program. The deep tillage system, combined with the residual program, resulted in a 97% reduction in Amaranthus species emergence when compared to the minimum tillage system combined with the POST-only program, which had the highest Amaranthus emergence. Soil cores taken prior to planting and herbicide application revealed that only 28% of the Amaranthus seed in the deep tillage system was placed within the top 5-cm of the soil profile compared to 79, 81, and 77% in the conventional, minimum, and no-tillage systems. Overall, the use of deep tillage with a residual herbicide program provided the greatest reduction in Amaranthus species emergence, thus providing a useful tool in managing herbicide-resistant Amaranthus species where appropriate.
The reader might get the impression that the four projects described in this Special Section proceeded in a systematic and predictable way. Of course, those of us engaged in each research project encountered pitfalls and challenges along the way. A main goal of this Special Section is to provide pathways and encouragement for those who may be interested in advancing high-quality research on this topic. In this paper, we describe a set of practical and ethical challenges that we encountered in conducting our longitudinal, process-oriented, and translational research with conflict-affected youth, and we illustrate how problems can be solved with the goal of maintaining the internal and external validity of the research designs. We are hopeful that by describing the challenges of our work, and how we overcame them, which are seldom treated in this or any other literature on research on child development in high-risk contexts, we can offer a realistic and encouraging picture of conducting methodologically sound research in conflict-affected contexts.
Improving children's learning and development in conflict-affected countries is critically important for breaking the intergenerational transmission of violence and poverty. Yet there is currently a stunning lack of rigorous evidence as to whether and how programs to improve learning and development in conflict-affected countries actually work to bolster children's academic learning and socioemotional development. This study tests a theory of change derived from the fields of developmental psychopathology and social ecology about how a school-based universal socioemotional learning program, the International Rescue Committee's Learning to Read in a Healing Classroom (LRHC), impacts children's learning and development. The study was implemented in three conflict-affected provinces of the Democratic Republic of the Congo and employed a cluster-randomized waitlist control design to estimate impact. Using multilevel structural equation modeling techniques, we found support for the central pathways in the LRHC theory of change. Specifically, we found that LRHC differentially impacted dimensions of the quality of the school and classroom environment at the end of the first year of the intervention, and that in turn these dimensions of quality were differentially associated with child academic and socioemotional outcomes. Future implications and directions are discussed.
Archaeologists commonly use the onset of the construction of large burial monuments as a material indicator of a fundamental shift in authority in prehistoric human societies during the Holocene. High-quality direct evidence of this transition is rare. We report new interdisciplinary research at the archaeological site of Nan Madol that allows us to specify where and when people began to construct monumental architecture in the remote islands of the Pacific. Nan Madol is an ancient administrative and mortuary center and the former capital of the island of Pohnpei. It was constructed over 83 ha of lagoon with artificial islets and other architecture built using columnar basalt and coral. We employed geochemical sourcing of basalt used as architectural stone and high-precision uranium-thorium series dates (230Th/U) on coral from the tomb of the first chief of the entire island to identify the beginning of monument building at Nan Madol in AD 1180-1200. Over the next several centuries (AD 1300-1600) monument building began on other islands across Oceania. Future research should be aimed at resolving the causes of these social transformations through higher quality data on monument building.
To determine and compare the level of implementation of policies for healthy food environments in Thailand with reference to international best practice by state and non-state actors.
Data on the current level of implementation of food environment policies were assessed independently using the adapted Healthy Food Environment Policy Index (Food-EPI) by two groups of actors. Concrete actions were proposed for Thai Government. A joint meeting between both groups was subsequently held to reach consensus on priority actions.
Thirty state actors and twenty-seven non-state actors.
Level of policy implementation varied across different domains and actor groups. State actors rated implementation levels higher than non-state actors. Both state and non-state actors rated level of implementation of monitoring of BMI highest. Level of implementation of policies promoting in-store availability of healthy foods and policies increasing tax on unhealthy foods were rated lowest by state and non-state actors, respectively. Both groups reached consensus on eleven priority actions for implementation, focusing on food provision in public-sector settings, food composition, food promotion, leadership, monitoring and intelligence, and food trade.
Although the implementation gaps identified and priority actions proposed varied between state and non-state actors, both groups achieved consensus on a comprehensive food policy package to be implemented by the Thai Government to improve the healthiness of food environments. This consensus is a platform for continued policy dialogue towards cross-sectoral policy coherence and effective actions to address the growing burden of non-communicable diseases and obesity in Thailand.
Pigweeds are among the most abundant and troublesome weed species across Midwest and mid-South soybean production systems because of their prolific growth characteristics and ability to rapidly evolve resistance to several herbicide sites of action. This has renewed interest in diversifying weed management strategies by implementing integrated weed management (IWM) programs to efficiently manage weeds, increase soybean light interception, and increase grain yield. Field studies were conducted across 16 site-years to determine the effectiveness of soybean row width, seeding rate, and herbicide strategy as components of IWM in glufosinate-resistant soybean. Sites were grouped according to optimum adaptation zones for soybean maturity groups (MGs). Across all MG regions, pigweed density and height at the POST herbicide timing, and end-of-season pigweed density, height, and fecundity were reduced in IWM programs using a PRE followed by (fb) POST herbicide strategy. Furthermore, a PRE fb POST herbicide strategy treatment increased soybean cumulative intercepted photosynthetically active radiation (CIPAR) and subsequently, soybean grain yield across all MG regions. Soybean row width and seeding rate manipulation effects were highly variable. Narrow row width (≤ 38 cm) and a high seeding rate (470,000 seeds ha−1) reduced end-of-season height and fecundity variably across MG regions compared with wide row width (≥ 76 cm) and moderate to low (322,000 to 173,000 seeds ha−1) seeding rates. However, narrow row widths and high seeding rates did not reduce pigweed density at the POST herbicide application timing or at soybean harvest. Across all MG regions, soybean CIPAR increased as soybean row width decreased and seeding rate increased; however, row width and seeding rate had variable effects on soybean yield. Furthermore, soybean CIPAR was not associated with end-of-season pigweed growth and fecundity. A PRE fb POST herbicide strategy was a necessary component for an IWM program as it simultaneously managed pigweeds, increased soybean CIPAR, and increased grain yield.
Pompe disease is a lysosomal storage disorder caused by a deficiency of the enzyme acid alpha-glucosidase. Patients have skeletal muscle and respiratory weakness with or without cardiomyopathy. The objective of our review was to systematically evaluate the quality of evidence from the literature to formulate evidence-based guidelines for the diagnosis and management of patients with Pompe disease. The literature review was conducted using published literature, clinical trials, cohort studies and systematic reviews. Cardinal treatment decisions produced seven management guidelines and were assigned a GRADE classification based on the quality of evidence in the published literature. In addition, six recommendations were made based on best clinical practices but with insufficient data to form a guideline. Studying outcomes in rare diseases is challenging due to the small number of patients, but this is in particular the reason why we believe that informed treatment decisions need to consider the quality of the evidence.
This paper presents the results of an excavation at North Fen, Sutton Gault, Cambridgeshire, which revealed evidence of Early Neolithic occupation comprising some 48 pits together with two in situ artefact scatters preserved within buried soil horizons. Largely as a result of the spatial separation between scatters and pit sites/clusters, it has been possible to identify a series of ‘sites’, which appear to represent temporally discrete episodes of activity ranging from task-specific ‘visits’ to relatively long-lived occupation. Through analysis of pottery and flint assemblages an attempt is made to characterise each individual site in terms of the types of activities undertaken there and to consider their scale and duration. Set within a landscape that has seen extensive archaeological investigation over the past 30 years the excavation also provides an excellent opportunity to explore how these sites relate to activity in the wider locale and to what extent it is possible to characterise Early Neolithic occupation at a landscape scale.
Palmer amaranth and waterhemp have become increasingly troublesome weeds throughout the United States. Both species are highly adaptable and emerge continuously throughout the summer months, presenting the need for a residual PRE application in soybean. To improve season-long control of Amaranthus spp., 19 PRE treatments were evaluated on glyphosate-resistant Palmer amaranth in 2013 and 2014 at locations in Arkansas, Indiana, Nebraska, Illinois, and Tennessee; and on glyphosate-resistant waterhemp at locations in Illinois, Missouri, and Nebraska. The two Amaranthus species were analyzed separately; data for each species were pooled across site-years, and site-year was included as a random variable in the analyses. The dissipation of weed control throughout the course of the experiments was compared among treatments with the use of regression analysis where percent weed control was described as a function of time (the number of weeks after treatment [WAT]). At the mean (i.e., average) WAT (4.3 and 3.2 WAT for Palmer amaranth and waterhemp, respectively) isoxaflutole + S-metolachlor + metribuzin had the highest predicted control of Palmer amaranth (98%) and waterhemp (99%). Isoxaflutole + S-metolachlor + metribuzin, S-metolachlor + mesotrione, and flumioxazin + pyroxasulfone had a predicted control ≥ 97% and similar model parameter estimates, indicating control declined at similar rates for these treatments. Dicamba and 2,4-D provided some, short-lived residual control of Amaranthus spp. When dicamba was added to metribuzin or S-metolachlor, control increased compared to dicamba alone. Flumioxazin + pyroxasulfone, a currently labeled PRE, performed similarly to treatments containing isoxaflutole or mesotrione. Additional sites of action will provide soybean growers more opportunities to control these weeds and reduce the potential for herbicide resistance.