Insights on the Intersection of Health Equity and School Nutrition Policy Implementation: An Exploratory Qualitative Secondary Analysis

Background. Recent federal policies aimed to ensure that all children have equitable access to healthy school nutrition environments. However, historically, disparities have persisted in the quality of school nutrition environments across geographic and socioeconomic groups. There is limited literature addressing if and how recent efforts to reform the school nutrition environment have influenced such disparities. The main objective of this study was to explore stakeholders’ insights on how school nutrition reform intersected with issues of inequity. Method. Qualitative secondary analysis (QSA) offers a unique method to examine existing data with a related but distinct inquiry. This QSA analyzed three primary studies, including stakeholder interviews and focus group data with school professionals and students (total 60 transcripts). Two trained analysts iteratively coded all transcripts in Atlas.ti Version 7 and followed principles of constant comparative analysis. Measures to enhance “trustworthiness” were built into the primary studies and the QSA. Results. Broadly, stakeholders’ complex insights about the school food environments’ ability to compensate for healthy dietary options and “whole child” education that were perceived to be lacking in home environments. Despite the majority of respondents’ positive perceptions of reforms, they also noted the challenges of addressing disparities due to family home environments and complex socioeconomic conditions. Overall, respondents reported that school food reform and nutrition education had the potential for long-term impacts on students’ health, including the potential to improve disparities through enhanced academic achievement for disadvantaged populations. Discussion and Conclusion. QSA allowed for inquiry into frontline stakeholders’ understandings of how school nutrition reform may affect health inequities. Qualitative methods allowed for the examination of complex motivations and perspectives involved in policy implementation. Understanding frontline stakeholders’ perspectives is key to advance school nutrition reform in a sustainable manner, especially in light of the federal local school wellness policy final rule. © 2017, © 2017 Society for Public Health Education

The doctors in training committee: a mechanism for change?

Medical engagement is increasingly important in ensuring that organizations deliver safe and effective patient care. The recent wave of encouragement for junior doctors to become 'change agents' is fundamental to embedding this culture. However, the mechanisms by which junior doctors engage in complex health-care systems are not well developed. The authors describe the process of setting up a doctors in training committee and its role in a large NHS trust as a way of improving junior doctor engagement

Corrosion Inhibition, Inhibitor Environments, and the Role of Machine Learning

Machine learning (ML) is providing a new design paradigm for many areas of technology, including corrosion inhibition. However, ML models require relatively large and diverse training sets to be most effective. This paper provides an overview of developments in corrosion inhibitor research, focussing on how corrosion performance data can be incorporated into machine learning and how large sets of inhibitor performance data that are suitable for training robust ML models can be developed through various corrosion inhibition testing approaches, especially high-throughput performance testing. It examines different types of environments where corrosion by-products and electrolytes operate, with a view to understanding how conventional inhibitor testing methods may be better designed, chosen, and applied to obtain the most useful performance data for inhibitors. The authors explore the role of modern characterisation techniques in defining corrosion chemistry in occluded structures (e.g., lap joints) and examine how corrosion inhibition databases generated by these techniques can be exemplified by recent developments. Finally, the authors briefly discuss how the effects of specific structures, alloy microstructures, leaching structures, and kinetics in paint films may be incorporated into machine learning strategies. </p

Can receipt of a regular postcard reduce suicide-related behaviour in young help seekers? A randomized controlled trial

Aim: Suicide attempt, ideation and deliberate self-harm are common among adolescents. Limited evidence exists regarding interventions that can reduce risk; however, research indicates that maintaining contact with at-risk adults following discharge from services via letter or postcard can reduce risk. The aim of the study was to test a postcard intervention among people aged 15-24 who presented to mental health services but were not accepted, yet were at risk of suicide. Methods: A randomized controlled trial of 3years in duration was used. The intervention consisted of 12 postcards sent once a month for 12months following presentation to the service. Key outcomes of interest were reduced rates of suicide attempt, suicidal ideation and deliberate self-harm, assessed at 12 and 18months. Results: Participants reported that they liked receiving the postcard and that they used the strategies recommended. However, no significant effect of the postcard intervention was found on suicide risk, although participants in both groups improved on measures of mental health over the course of the study. Conclusions: There remains a need for further research into youth-friendly interventions for young people at risk of suicide. © 2012 Blackwell Publishing Asia Pty Ltd

Changes in health in the countries of the UK and 150 English Local Authority areas 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016.

BACKGROUND: Previous studies have reported national and regional Global Burden of Disease (GBD) estimates for the UK. Because of substantial variation in health within the UK, action to improve it requires comparable estimates of disease burden and risks at country and local levels. The slowdown in the rate of improvement in life expectancy requires further investigation. We use GBD 2016 data on mortality, causes of death, and disability to analyse the burden of disease in the countries of the UK and within local authorities in England by deprivation quintile. METHODS: We extracted data from the GBD 2016 to estimate years of life lost (YLLs), years lived with disability (YLDs), disability-adjusted life-years (DALYs), and attributable risks from 1990 to 2016 for England, Scotland, Wales, Northern Ireland, the UK, and 150 English Upper-Tier Local Authorities. We estimated the burden of disease by cause of death, condition, year, and sex. We analysed the association between burden of disease and socioeconomic deprivation using the Index of Multiple Deprivation. We present results for all 264 GBD causes of death combined and the leading 20 specific causes, and all 84 GBD risks or risk clusters combined and 17 specific risks or risk clusters. FINDINGS: The leading causes of age-adjusted YLLs in all UK countries in 2016 were ischaemic heart disease, lung cancers, cerebrovascular disease, and chronic obstructive pulmonary disease. Age-standardised rates of YLLs for all causes varied by two times between local areas in England according to levels of socioeconomic deprivation (from 14 274 per 100 000 population [95% uncertainty interval 12 791-15 875] in Blackpool to 6888 [6145-7739] in Wokingham). Some Upper-Tier Local Authorities, particularly those in London, did better than expected for their level of deprivation. Allowing for differences in age structure, more deprived Upper-Tier Local Authorities had higher attributable YLLs for most major risk factors in the GBD. The population attributable fractions for all-cause YLLs for individual major risk factors varied across Upper-Tier Local Authorities. Life expectancy and YLLs have improved more slowly since 2010 in all UK countries compared with 1990-2010. In nine of 150 Upper-Tier Local Authorities, YLLs increased after 2010. For attributable YLLs, the rate of improvement slowed most substantially for cardiovascular disease and breast, colorectal, and lung cancers, and showed little change for Alzheimer's disease and other dementias. Morbidity makes an increasing contribution to overall burden in the UK compared with mortality. The age-standardised UK DALY rate for low back and neck pain (1795 [1258-2356]) was higher than for ischaemic heart disease (1200 [1155-1246]) or lung cancer (660 [642-679]). The leading causes of ill health (measured through YLDs) in the UK in 2016 were low back and neck pain, skin and subcutaneous diseases, migraine, depressive disorders, and sense organ disease. Age-standardised YLD rates varied much less than equivalent YLL rates across the UK, which reflects the relative scarcity of local data on causes of ill health. INTERPRETATION: These estimates at local, regional, and national level will allow policy makers to match resources and priorities to levels of burden and risk factors. Improvement in YLLs and life expectancy slowed notably after 2010, particularly in cardiovascular disease and cancer, and targeted actions are needed if the rate of improvement is to recover. A targeted policy response is also required to address the increasing proportion of burden due to morbidity, such as musculoskeletal problems and depression. Improving the quality and completeness of available data on these causes is an essential component of this response. FUNDING: Bill & Melinda Gates Foundation and Public Health England

SCOPE: SCUBA-2 Continuum Observations of Pre-protostellar Evolution - survey description and compact source catalogue

We present the first release of the data and compact-source catalogue for the JCMT Large Program SCUBA-2 Continuum Observations of Pre-protostellar Evolution (SCOPE). SCOPE consists of 850 μm continuum observations of 1235 Planck Galactic Cold Clumps (PGCCs) made with the Submillimetre Common-User Bolometer Array 2 on the James Clerk Maxwell Telescope. These data are at an angular resolution of 14.4 arcsec, significantly improving upon the 353 GHz resolution of Planck at 5 arcmin, and allowing for a catalogue of 3528 compact sources in 558 PGCCs. We find that the detected PGCCs have significant sub-structure, with 61 per cent of detected PGCCs having three or more compact sources, with filamentary structure also prevalent within the sample. A detection rate of 45 per cent is found across the survey, which is 95 per cent complete to Planck column densities of N(H2) > 5 × 10^21 cm^−2. By positionally associating the SCOPE compact sources with young stellar objects, the star formation efficiency, as measured by the ratio of luminosity to mass, in nearby clouds is found to be similar to that in the more distant Galactic Plane, with the column density distributions also indistinguishable from each other