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To describe snacking characteristics and patterns in children and examine associations with diet quality and BMI.
Children’s weight and height were measured. Participants/adult proxies completed multiple 24 h dietary recalls. Snack occasions were self-identified. Snack patterns were derived for each sample using exploratory factor analysis. Associations of snacking characteristics and patterns with Healthy Eating Index-2010 (HEI-2010) score and BMI were examined using multivariable linear regression models.
Childhood Obesity Prevention and Treatment Research (COPTR) Consortium, USA: NET-Works, GROW, GOALS and IMPACT studies.
Two snack patterns were derived for three studies: a meal-like pattern and a beverage pattern. The IMPACT study had a similar meal-like pattern and a dairy/grains pattern. A positive association was observed between meal-like pattern adherence and HEI-2010 score (P for trend < 0⋅01) and snack occasion frequency and HEI-2010 score (β coefficient (95 % CI): NET-Works, 0⋅14 (0⋅04, 0⋅23); GROW, 0⋅12 (0⋅02, 0⋅21)) among younger children. A preference for snacking while using a screen was inversely associated with HEI-2010 score in all studies except IMPACT (β coefficient (95 % CI): NET-Works, −3⋅15 (−5⋅37, −0⋅92); GROW, −2⋅44 (−4⋅27, −0⋅61); GOALS, −5⋅80 (−8⋅74, −2⋅86)). Associations with BMI were almost all null.
Meal-like and beverage patterns described most children’s snack intake, although patterns for non-Hispanic Blacks or adolescents may differ. Diets of 2–5-year-olds may benefit from frequent meal-like pattern snack consumption and diets of all children may benefit from decreasing screen use during eating occasions.
Introduction: Emergency department (ED) staff carry a high risk for the burnout syndrome of increased emotional exhaustion, depersonalization and decreased personal accomplishment. Previous research has shown that task-oriented coping skills were associated with reduced levels of burnout compared to emotion-oriented coping. ED staff at one hospital participated in an intervention to teach task-oriented coping skills. We hypothesized that the intervention would alter staff coping behaviors and ultimately reduce burnout. Methods: ED physicians, nurses and support staff at two regional hospitals were surveyed using the Maslach Burnout Inventory (MBI) and the Coping Inventory for Stressful Situations (CISS). Surveys were performed before and after the implementation of communication and conflict resolution skills training at the intervention facility (I) consisting of a one-day course and a small group refresher 6 to 15 months later. Descriptive statistics and multivariate analysis assessed differences in staff burnout and coping styles compared to the control facility (C) and over time. Results: 85/143 (I) and 42/110 (C) ED staff responded to the initial survey. Post intervention 46 (I) and 23(C) responded. During the two year study period there was no statistically significant difference in CISS or MBI scores between hospitals (CISS: (Pillai's trace = .02, F(3,63) = .47, p = .71, partial η2 = .02); MBI: (Pillai's trace = .01, F(3,63) = .11, p = .95, partial η2 = .01)) or between pre- and post-intervention groups (CISS: (Pillai's trace = .01, F(3,63) = .22, p = .88, partial η2 = .01); MBI: (Pillai's trace = .09, F(3,63) = 2.15, p = .10, partial η2 = .01)). Conclusion: We were not able to measure improvement in staff coping or burnout in ED staff receiving communication skills intervention over a two year period. Burnout is a multifactorial problem and environmental rather than individual factors may be more important to address. Alternatively, to demonstrate a measurable effect on burnout may require more robust or inclusive interventions.
Increased use of dicamba and/or glyphosate in dicamba/glyphosate-tolerant soybean might affect many sensitive crops, including potato. The objective of this study was to determine the growth and yield of ‘Russet Burbank’ potato grown from seed tubers (generation 2) from mother plants (generation 1) treated with dicamba (4, 20, and 99 g ae ha−1), glyphosate (8, 40, and 197 g ae ha−1), or a combination of dicamba and glyphosate during tuber initiation. Generation 2 tubers were planted near Oakes and Inkster, ND, in 2016 and 2017, at the same research farm where the generation 1 tubers were grown the previous year. Treatment with 99 g ha−1 dicamba, 197 g ha−1 glyphosate, or 99 g ha−1 dicamba + 197 g ha−1 glyphosate caused emergence of generation 2 plants to be reduced by up to 84%, 86%, and 87%, respectively, at 5 wk after planting. Total tuber yield of generation 2 was reduced up to 67%, 55%, and 68% when 99 g ha−1 dicamba, 197 g ha−1 glyphosate, or 99 g ha−1 dicamba + 197 g ha−1 glyphosate was applied to generation 1 plants, respectively. At each site year, 197 g ha−1 glyphosate reduced total yield and marketable yield, while 99 g ha−1 dicamba reduced total yield and marketable yield in some site-years. This study confirms that exposure to glyphosate and dicamba of potato grown for potato seed tubers can negatively affect the growth and yield potential of the subsequently grown daughter generation.
This paper discusses the sustainability of livestock systems, emphasising bidirectional relations with animal health. We review conventional and contrarian thinking on sustainability and argue that in the most common approaches to understanding sustainability, health aspects have been under-examined. Literature review reveals deep concerns over the sustainability of livestock systems; we recognise that interventions are required to shift to more sustainable trajectories, and explore approaches to prioritising in different systems, focusing on interventions that lead to better health. A previously proposed three-tiered categorisation of ‘hot spots’, ‘cold spots’ and ‘worried well’ animal health trajectories provides a mental model that, by taking into consideration the different animal health status, animal health risks, service response needs and key drivers in each system, can help identify and implement interventions. Combining sustainability concepts with animal health trajectories allows for a richer analysis, and we apply this to three case studies drawn from North Africa and the Middle East; Bangladesh; and the Eastern Cape of South Africa. We conclude that the quest for sustainability of livestock production systems from the perspective of human and animal health is elusive and difficult to reconcile with the massive anticipated growth in demand for livestock products, mainly in low- and middle-income countries, as well as the aspirations of poor livestock keepers for better lives. Nevertheless, improving the health of livestock can contribute to health sustainability both through reducing negative health impacts of livestock and increasing efficiency of production. However, the choice of the most appropriate options must be under-pinned by an understanding of agro-ecology, economy and values. We argue that a new pillar of One Health should be added to the three traditional sustainability pillars of economics, society and environment when addressing livestock systems.
This concise guide offers an ideal overview of both the practical and theoretical aspects of foot and ankle surgery for trainees and junior consultants. Easy to read chapters cover all areas of surgery, from examination, imaging, and the biomechanics of the foot and ankle, to specific conditions including amputations and prostheses, deformities, arthritis, cavus and flat foot, sports injuries, Achilles tendon, benign and malignant tumors and heel pain. Fractures and dislocations of the ankle, hind-, mid- and forefoot are also covered, as are the foot in diabetes and pediatrics. Written by a team of international experts, the text is an accessible way to prepare for postgraduate examinations and manage patients successfully.
An effective method for enhancing milk production efficiency in dairy cows is to increase milk yield and significant progress has been achieved through intense selection, assisted by the application of new reproductive techniques. However this increased milk yield has been accompanied by a slow but steady decline in dairy cow fertility. The two main reasons for this reducing level of fertility appear to be selection for increased milk yield and large herd sizes, although the affect of the introduction of Holstein genes needs to be investigated. In addition, other negative consequences such as an increase in the incidence of metabolic diseases and lameness have been observed. This has given rise to public concern that the high-yielding dairy cow may be under a state of metabolic stress during peak lactation and therefore the welfare and performance of other body functions are compromised.
The reason for this decline in fertility is not well understood, although a nutritional influence on the initiation of oestrous cycles, follicular growth, oocyte quality and early embryonic development has been implicated. In early lactation dietary intake is unable to meet the demands of milk production and most cows enter a period of negative energy balance. Negative energy balance has a broadly similar effect to undernutrition leading to a mobilization of body reserves. Furthermore diets high in rumen degradable protein lead to an excess of rumen ammonia, which before it is converted to urea by the liver and excreted in the urine, may cause an alteration in the reproductive tract environment reducing embryo survival. Such major changes in the metabolic and endocrine systems can therefore influence fertility at a number of key points.
Possible reproductive sites where inadequate nutrition may have detrimental effects include: (i) the hypothalamic/pituitary gland where gonadotropin release may be impaired; (ii) a direct effect on the ovaries, where both follicular growth patterns and corpus luteum function may be directly influenced; (iii) the quality of the oocyte prior to ovulation may be reduced and coupled with an inadequate uterine environment will result in reduced embryo survival and (iv) there may be effects on subsequent embryo development. The initiation of normal oestrous cycles post partum is usually delayed in dairy cows with a higher genetic merit for milk production, confirming that intense selection towards high milk yield can compromise reproductive function. In addition, the effects of increased milk yield may include changes in circulating GH and insulin concentrations, which in turn alter both insulin-like growth factor (IGF) and IGF binding protein production. Nutrition has recently been shown to have a direct effect at the level of both the ovaries and the uterus to alter the expression of these growth factors.
In conclusion, further knowledge is required to determine how the metabolic changes associated with high milk output reduce fertility. Identification and understanding of the mechanisms involved and the key sites of action responsible for compromised reproductive function, will enable the identification of possible indices for future multiple-trait selection programmes.
The Foot and Mouth Disease (FMD) epidemic of 2001 clearly illustrated the fragility of the UK's farm animal genetic resources. In particular, millions of sheep were killed by the disease and by the ‘stamping out’ policy chosen for disease control. Loss of genetic resources was not evenly spread throughout the UK, nor throughout the many different sheep breeds that are native to the UK and for which the UK has a formal responsibility for protection to the United Nations. In fact, the FMD epidemic demonstrated for the first time that sheep breeds comprising large numbers of individuals which are commercially farmed, can nevertheless be at considerable risk of extinction. The breeds most affected were those restricted to geographical regions of the UK into which the FMD spread. These regionally important breeds are adapted to their particular regional environments, represent an important living heritage for the UK and are a key component in sustaining the rural economies of sheep farming communities.
The events of 2001 provided clear proof that there are two components of the UK's farm animal genetic resources demanding protection. One component is already recognised as a priority and is composed of the numerically rare breeds of all domesticated species: these are already under the protection of the Rare Breeds Survival Trust (RBST). The second component has not previously been recognised as a priority for protection. The FMD crisis proved that sheep breeds could exist as large numbers of individuals, but nevertheless face extinction due to their regional location. Urgent attention must be focussed on our Heritage Breeds of sheep. The UK has one of the greatest number of native sheep breeds of any country in the world. The Heritage Breeds provide potentially valuable genetic resources for environmental, low-input farming systems.
Heritage GeneBank was founded during the FMD epidemic specifically to protect sheep breeds at threat of extinction from the disease. A group of academic research scientists established a genetic salvage programme: collecting semen and embryos for protection in a gene bank. Germplasm from seven breeds is in long-term storage. Following the crisis, the scientists involved in the gene bank made a commitment to continue their conservation work in recognition that the Heritage Breeds of sheep in the UK continue to require protection.
This paper describes: (1) the work of Heritage GeneBank (HGB); (2) the threefold mission of The Sheep Trust, the new national charity that evolved from HGB (http://www.thesheeptrust.org); and (3) the ongoing urgent need for conservation of the UK's Heritage Breeds of sheep threatened by genetic erosion.
We present first results from a coordinated multiwavelength study of the neutron star low-mass X-ray binary EXO 0748 676. Fast UV, X-ray, and optical data were obtained including both spectral and timing information. We discuss how this study allows us to probe the temperature distribution within the binary and hence the geometry and efficiency of X-ray irradiation.
Many novel therapeutic options for depression exist that are either not mentioned in clinical guidelines or recommended only for use in highly specialist services. The challenge faced by clinicians is when it might be appropriate to consider such ‘non-standard’ interventions. This analysis proposes a framework to aid this decision.
Declaration of interest
In the past 3 years R.H.M.W. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending advisory boards) from various pharmaceutical companies including Astra Zeneca, Cyberonics, Eli Lilly, Janssen, LivaNova, Lundbeck, MyTomorrows, Otsuka, Pfizer, Roche, Servier, SPIMACO and Sunovion. D.M.B.C. has received fees from LivaNova for attending an advisory board. In the past 3 years A.J.C. has received fees for lecturing from Astra Zeneca and Lundbeck; fees for consulting from LivaNova, Janssen and Allergan; and research grant support from Lundbeck.
In the past 3 years A.C. has received fees for lecturing from pharmaceutical companies namely Lundbeck and Sunovion. In the past 3 years A.L.M. has received support for attending seminars and fees for consultancy work (including advisory board) from Medtronic Inc and LivaNova. R.M. holds joint research grants with a number of digital companies that investigate devices for depression including Alpha-stim, Big White Wall, P1vital, Intel, Johnson and Johnson and Lundbeck through his mindTech and CLAHRC EM roles. M.S. is an associate at Blueriver Consulting providing intelligence to NHS organisations, pharmaceutical and devices companies. He has received honoraria for presentations and advisory boards with Lundbeck, Eli Lilly, URGO, AstraZeneca, Phillips and Sanofi and holds shares in Johnson and Johnson. In the past 3 years P.R.A.S. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending an advisory board) from life sciences companies including Corcept Therapeutics, Indivior and LivaNova. In the past 3 years P.S.T. has received consultancy fees as an advisory board member from the following companies: Galen Limited, Sunovion Pharmaceuticals Europe Ltd, myTomorrows and LivaNova. A.H.Y. has undertaken paid lectures and advisory boards for all major pharmaceutical companies with drugs used in affective and related disorders and LivaNova. He has received funding for investigator initiated studies from AstraZeneca, Eli Lilly, Lundbeck and Wyeth.
Objectives: This study investigated the relationship between close proximity to detonated blast munitions and cognitive functioning in OEF/OIF/OND Veterans. Methods: A total of 333 participants completed a comprehensive evaluation that included assessment of neuropsychological functions, psychiatric diagnoses and history of military and non-military brain injury. Participants were assigned to a Close-Range Blast Exposure (CBE) or Non-Close-Range Blast Exposure (nonCBE) group based on whether they had reported being exposed to at least one blast within 10 meters. Results: Groups were compared on principal component scores representing the domains of memory, verbal fluency, and complex attention (empirically derived from a battery of standardized cognitive tests), after adjusting for age, education, PTSD diagnosis, sleep quality, substance abuse disorder, and pain. The CBE group showed poorer performance on the memory component. Rates of clinical impairment were significantly higher in the CBE group on select CVLT-II indices. Exploratory analyses examined the effects of concussion and multiple blasts on test performance and revealed that number of lifetime concussions did not contribute to memory performance. However, accumulating blast exposures at distances greater than 10 meters did contribute to poorer performance. Conclusions: Close proximity to detonated blast munitions may impact memory, and Veterans exposed to close-range blast are more likely to demonstrate clinically meaningful deficits. These findings were observed after statistically adjusting for comorbid factors. Results suggest that proximity to blast should be considered when assessing for memory deficits in returning Veterans. Comorbid psychiatric factors may not entirely account for cognitive difficulties. (JINS, 2018, 24, 466–475)
Extrapolate (EX-ante Tool for RAnking POLicy AlTErnatives) is a decision support tool to assess the impact of policy measures on different target groups. It is designed to serve as a “filter” that, given the broad characteristics of the population, allows the user to sift through different policy measures to assess ex ante the broad potential impacts of these before deciding to look at particular policy options in more detail. Extrapolate models, in a very simple way, the impact of changes on constraints facing potential beneficiary groups, and how these may affect outcomes and their livelihood status. Extrapolate now makes use of mapping facilities from another decision-support tool, PRIMAS (Poverty Reduction Intervention Mapping in Agricultural Systems), that allows the user to match characteristics of particular technological options and constraints with the spatial characteristics of particular target groups in the landscape.
Considerable effort has recently been directed to better defining protein requirements of dry dairy cows. Early efforts (Moorby et al., 1996) suggested substantial increases in milk and milk protein yield of multiparous cows to a small amount of a high undegradable dietary protein (UDP) supplement in the late dry period. Recent studies have not consistently supported these findings. The objective of this experiment was to define the impact of supplementation of a high UDP supplement in the late dry period of multiparous dairy cows on production of milk and its components.