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Schools have been recognised as a potential setting for improving young peoples’ food and beverage choices; however, many schools fail to adhere to healthy food and beverage policy standards. The current study aimed to explore the enablers and barriers to effective implementation of and compliance with school-based food and beverage policies.
Systematic review and meta-synthesis. Eight electronic databases were searched for articles in June 2019. Studies were eligible for inclusion if they reported on implementation and/or compliance of school-based food and/or beverage policies with outcomes relating to enablers and/or barriers. This review had no restrictions on study design, year of publication or language. Seventy-two full-text articles were assessed for eligibility, of which twenty-eight were included in this review.
Studies conducted globally that focused on schools.
School-based healthy food and beverage policies.
Financial (cost of policy-compliant foods, decreased profit and revenue), physical (availability of policy-compliant foods, close geographical proximity to unhealthy food outlets) and social (poor knowledge, understanding, and negative stakeholders’ attitudes towards policy) factors were the most frequently reported barriers for policy implementation. Sufficient funding, effective policy communication and management, and positive stakeholders’ attitudes were the most frequently reported enablers for policy implementation.
There is a need for better communication strategies, financial and social support prior to school-based food policy implementation. Findings of this review contribute to a thorough understanding of factors that underpin best practice recommendations for the implementation of school-based food policy, and inform those responsible for improving public health nutrition.
Following pioneering work in Norway, cirque glaciers have widely been viewed as rigidly rotating bodies. This model is incorrect for basin-filling cirque glaciers, as we have demonstrated at West Washmawapta Glacier, a small glacier in the Canadian Rocky Mountains. Here we report observations at the same glacier that assess whether complex temporal variations of flow also occur. For parts of three summers, we measured daily displacements of the glacier surface. In one year, four short-duration speed-up events were recorded. Three of the events occurred during the intervals of warmest weather, when melt was most rapid; the fourth event occurred immediately following heavy rain. We interpret the speed-up events as manifestations of enhanced water inputs to the glacier bed and associated slip lubrication by increased water volumes and pressures. No further speed-ups occurred in the final month of the melt season, despite warm temperatures and several rainstorms; the dominant subglacial water system likely transformed from one of poorly connected cavities to one with an efficient channel network. The seasonal evolution of hydrology and flow resembles behaviors documented at other, larger temperate glaciers and indicates that analyses of cirque erosion cannot rely on simple assumptions about ice dynamics.
Supergiant X-ray Binaries host a compact object, generally a neutron star, orbiting an evolved O/B star. Mass transfer proceeds through the intense radiatively-driven wind of the stellar donor, a fraction of which is captured by the gravitational field of the neutron star. The subsequent accretion process onto the neutron star is responsible for the abundant X-ray emission from those systems. They also display variations in time of the X-ray flux by a factor of a few 10, along with changes in the hardness ratios believed to be due to varying absorption along the line-of-sight. We used the most recent results on the inhomogeneities (aka clumps) in the non-stationary wind of massive hot stars to evaluate their impact on the time-variable accretion process. We ran three-dimensional simulations of the wind in the vicinity of the accretor to witness the formation of the bow shock and follow the inhomogeneous flow over several spatial orders of magnitude, down to the neutron star magnetosphere. In particular, we show that the impact of the clumps on the time-variability of the intrinsic mass accretion rate is severely damped by the crossing of the shock, compared to the purely ballistic Bondi-Hoyle-Lyttleton estimation. We also account for the variable absorption due to clumps passing by the line-of-sight and estimate the final effective variability of the mass accretion rate for different orbital separations. These results are confronted to recent analysis of Vela X-1 observations with Chandra by Grinberg et al. (2017). It shows that clumps account well for time-variability at low luminosity but can not generate, per se, the high luminosity activity observed.
Understanding the complex behavior of High Mass X-ray binaries (HMXBs) is not possible without detailed information about their donor stars. While crucial, this turns out to be a challenge on multiple fronts. First, multi-wavelength spectroscopy is vital. As such systems can be highly absorbed, this is often already hard to accomplish. Secondly, even if the spectroscopic data is available, the determination of reliable stellar parameters requires sophisticated model atmospheres that accurately describe the outermost layers and the wind of the donor star.
For early-type donors, the stellar wind is radiatively driven and there is a smooth transition between the outermost layers of the star and the wind. The intricate non-LTE conditions in the winds of hot stars complicate the situation even further, as proper model atmospheres need to account for a multitude of physics to accurately provide stellar and wind parameters. The latter are especially crucial for the so-called “wind-fed” HXMBs, where the captured wind of the supergiant donor is the only source for the material accreted by the compact object.
In this review I will briefly address the different approaches for treating stellar winds in the analysis of HMXBs. The fundamentals of stellar atmosphere modeling will be discussed, also addressing the limitations of modern models. Examples from recent analysis results for particular HMXBs will be outlined. Furthermore, the path for the next generation of stellar atmosphere models will be outlined, where models can be used not only for measurement purposes, but also to make predictions and provide a laboratory for theoretical conclusions. Stellar atmospheres are a key tool in understanding HMXBs, e.g. by providing insights about the accretion of stellar winds onto the compact object, or by placing the studied systems in the correct evolutionary context in order to identify potential gravitational wave (GW) progenitors.
We present deep low radio frequency (230-470 MHz) observations from the Karl G. Jansky Very Large Array of the Perseus cluster, probing the non-thermal emission from the old particle population of the AGN outflows. Our observations of this nearby relaxed cool core cluster have revealed a multitude of new structures associated with the mini-halo, extending to hundreds of kpc in size. Its irregular morphology seems to have been influenced both by the AGN activity and by the sloshing motion of the cluster’ gas. In addition, it has a filamentary structure similar to that seen in radio relics found in merging clusters. These results illustrate the high-quality images that can be obtained with the new JVLA at low radio-frequencies.
Although financing represents a critical component of health system strengthening and also a defining concern of efforts to move towards universal health coverage, many countries lack the tools and capacity to plan effectively for service scale-up. As part of a multi-country collaborative study (the Emerald project), we set out to develop, test and apply a fully integrated health systems resource planning and health impact tool for mental, neurological and substance use (MNS) disorders.
A new module of the existing UN strategic planning OneHealth Tool was developed, which identifies health system resources required to scale-up a range of specified interventions for MNS disorders and also projects expected health gains at the population level. We conducted local capacity-building in its use, as well as stakeholder consultations, then tested and calibrated all model parameters, and applied the tool to three priority mental and neurological disorders (psychosis, depression and epilepsy) in six low- and middle-income countries.
Resource needs for scaling-up mental health services to reach desired coverage goals are substantial compared with the current allocation of resources in the six represented countries but are not large in absolute terms. In four of the Emerald study countries (Ethiopia, India, Nepal and Uganda), the cost of delivering key interventions for psychosis, depression and epilepsy at existing treatment coverage is estimated at US$ 0.06–0.33 per capita of total population per year (in Nigeria and South Africa it is US$ 1.36–1.92). By comparison, the projected cost per capita at target levels of coverage approaches US$ 5 per capita in Nigeria and South Africa, and ranges from US$ 0.14–1.27 in the other four countries. Implementation of such a package of care at target levels of coverage is expected to yield between 291 and 947 healthy life years per one million populations, which represents a substantial health gain for the currently neglected and underserved sub-populations suffering from psychosis, depression and epilepsy.
This newly developed and validated module of OneHealth tool can be used, especially within the context of integrated health planning at the national level, to generate contextualised estimates of the resource needs, costs and health impacts of scaled-up mental health service delivery.
For efficient and effective medical responses to mass casualty events, detailed advanced planning is required. For federal responders, this is an ongoing responsibility. The US Department of Health and Human Services (DHHS) prepares playbooks with formal, written plans that are reviewed, updated, and exercised regularly. Recognizing that state and local responders with fewer resources may be helped in creating their own event-specific response plans, subject matter experts from the range of sectors comprising the Scarce Resources for a Nuclear Detonation Project, provided for this first time a state and local planner's playbook template for responding to a nuclear detonation. The playbook elements are adapted from DHHS playbooks with appropriate modification for state and local planners. Individualization by venue is expected, reflecting specific assets, populations, geography, preferences, and expertise. This playbook template is designed to be a practical tool with sufficient background information and options for step-by-step individualized planning and response.
(Disaster Med Public Health Preparedness. 2011;5:S89-S97)
The rate of manifestation of depressive episodes can vary appreciably. The complete development of a depressive episode may be very rapid, taking less than one hour or be very slow, taking up to one month. Altough this clinical observation suggests different neurobiological pathomechanisms, the onset speed of depressive episodes in different affective disorders has not been investigated systematically up to now. The objective of this study was to establish the onset speed of depressive episodes in patients with a history of at least one depressive episode and to compare the onset speed in unipolar with that in bipolar affective disorders.
A group of 96 inpatients was investigated consecutively using the structured patient interview “Onset of Depression Inventory” (ODI). In 76 patients, there was a unipolar depressive disorder and 20 patients suffered from a bipolar depressive disorder.
The onset speed of the current depressive episode in patients with effective disorders correlated significantly with the onset speed of the previous depressive episodes (p < 0.001). Furthermore, there was a significant difference in the onset of the depressive episodes between unipolar and bipolar affective disorders (p < 0.001). In 55% of patients with a bipolar disorder, the depressive episode was manifested within one week whereas this was the case in only 22,37% of the patients with a unipolar affective disorder.
The rate of manifestation of depressive episodes differs between unipolar and bipolar disorders. The clinical observation reported here can support the diagnostic appraisal of depressive episodes.
The molecular epidemiology of rotavirus infections in Glasgow and the west of Scotland during 1981/82 and 1982/83 was investigated by electron microscopy, ELISA testing and RNA migration pattern analysis. In 1981/82, rotaviruses of both the ‘long’ and the ‘short’ electropherotype (in different variants) co-circulated from the onset throughout the winter peak of the outbreak. Approximately 80 % of the children were infected during the first year of life. No differences in incidence were found between sexes. In 1982/83 the isolated rotaviruses were almost exclusively of the ‘long’ electropherotype (in different variants) and 36% of the children were infected beyond the first year of life. Rotaviruses of the ‘long’ electropherotype serologically were of subgroup II and serotype 1 and those of the ‘short’ electropherotype of subgroup I and serotype 2.
Sauropod dinosaurs were typically one magnitude larger than any other living or extinct terrestrial animal. This sheer size of the sauropod leads to scale effects in their biology and physiology that still are inadequately understood. The only remnants of the sauropods are their fossilized bones. These fossilized bones have sustained burial for some hundred million years and thus may have experienced significant diagenetic changes. These diagenetic changes often do not affect bone preservation on the histological level, but may lead to significant alterations of the bone microstructure. Here the influence of diagenesis on the microstructure of fossilized sauropod bones using femur cross section of Brachiosaurus brancai that was excavated in the Tendaguru beds in Tanzania is investigated. The element distribution in this dinosaur bone is studied by a combination of micro-X-ray-fluorescence (μ-XRF) using synchrotron radiation and energy dispersive X-ray analyses (EDX) in the scanning electron microscope. These techniques reveal quantitative values of the element concentration at a macroscopic level combined with qualitative information at high spatial resolution of the distribution of Ca, Co, Cr, V, Pb, U, Sr, Y, and As in the fossil bones. This allows a differentiation between the remnants of the original bone apatite and pore filling minerals and also a visualization of damage, e.g., cracks introduced by diagenetic processes.
Anti-pneumococcal polysaccharide antibody (anti-PPS) levels were measured in 153 serum samples collected from children aged between 2 and 47 months living in the highlands of Papua New Guinea (PNG). Fifty-seven of the samples were collected during acute episodes of lower respiratory tract infection (ALRI). Total IgA and IgG increased steadily with age; however, no association was found between the levels of these antibodies and the health status of the child. Total IgM levels showed little relationship to the age of the child but under 12 months of age levels were somewhat higher on average in children with pneumonia. For most of eight pneumococcal serotypes tested, specific IgG levels were found to decline rapidly in the first 6–8 months, reaching a minimum at approximately 12 months of age. Serotype 3 was exceptional in having very low titres in the youngest children. A separate analysis of 24 cord sera suggested that antibodies to this serotype do not usually cross the placenta in PNG. Children with pneumonia tended to have lower levels of specific IgG than healthy controls of the same age. Specific anti-PPS IgA levels were found to increase steadily with age, but were not associated with health status.
Eighty-seven cases of subacute sclerosing panencephalitis (SSPE) were diagnosed from September 1988 to April 1991 in Papua New Guinea (PNG), by demonstration of high-titre measles-specific antibodies in cerebrospinal fluid (CSF). For 1990 the annual incidence of SSPE, for the study provinces, was calculated to be 56 cases per million under 20 years of age and it is expected that this figure will be higher in 1991. The mean age of presentation was 4.9 years, with a male to female ratio of 1.8:1. An elevation in the ratio of immunoglobulin G as a percentage of total protein in CSF and an increase in the CSF:serum immunoglobulin G ratio was shown in SSPE patients. The dramatic appearance and high frequency of the disease in PNG might relate to the early age of measles infection encountered in children in this country.