Creating good feelings about unhealthy food: children’s televised ‘advertised diet’ on the island of Ireland, in a climate of regulation

Childhood eating habits and associations with advertising persist through life. Obesity is high in Ireland, and is increasing worldwide. Links between food promotion and children’s diets are well-established, and the World Health Organisation has called for reduced marketing of foods high in fat, sugar and salt (HFSS) to children. In Ireland and the UK, statutory regulation restricts HFSS television advertising, but only during children’s programming – yet children view much television at other times. This study is the first to identify young children’s exposure to television food advertising on the island of Ireland (IoI), and its nature, with systematic sampling according to Irish audience panel research. Food advertisements were nutrient profiled and content analyses were conducted of marketing techniques. The IoI ‘advertised diet’ viewed by young children primarily features dairy and fast foods, pizza, sweets and chocolate, normalising this consumption and associating it with taste/aroma, fun, magic/ imagination, physical activity, humour and exaggerated pleasure. HFSS ads primarily featured taste/aroma, humour and novelty. Despite complying with statutory regulations, more than half of IoI food advertisements featured HFSS items; young children see over 1000 HFSS ads annually in the Republic of Ireland, nearly 700 in Northern Ireland. Policy implications for remedying children’s HFSS ad exposure include (i) applying food advertising restrictions to times when higher proportions of young children watch television – not just child-directed programming – as well as to digital media, (ii) employing a stricter nutrient profiling method and (iii) normalising children’s ‘advertised diet’ by exploring ways to advertise healthy foods

The circulating proteinase inhibitor α-1 antitrypsin regulates neutrophil degranulation and autoimmunity.

Pathological inflammation and autoimmune disease frequently involve elevated neutrophil activity in the absence of infectious agents. Tumor necrosis factor-α (TNF-α) contributes to many of the problems associated with autoimmune diseases. We investigated the ability of serum α-1 antitrypsin (AAT) to control TNF-α biosynthesis and signaling in neutrophils and assessed whether AAT deficiency (AATD) is a TNF-α-related disease. In vitro studies demonstrate that serum AAT coordinates TNF-α intracellular signaling and neutrophil degranulation of tertiary and secondary granules via modulation of ligand-receptor interactions. AATD patients homozygous for the Z allele were characterized by increased activation of the TNF-α system, as demonstrated by increased membrane TNF-α levels and increased plasma concentrations of TNF receptor 1 and neutrophil-released secondary and tertiary granule proteins. The incidence of autoantibodies directed against degranulated lactoferrin and surface protein accessible to these antibodies was increased in ZZ-AATD, leading to an enhanced rate of neutrophil reactive oxygen species production. Treatment of ZZ-AATD individuals with AAT augmentation therapy resulted in decreased membrane TNF-α expression and plasma levels of granule antigenic proteins and immunoglobulin G class autoantibodies. These results provide a mechanism by which AAT augmentation therapy affects TNF-α signaling in the circulating neutrophil, indicating promising potential of this therapy for other TNF-α-related diseases

CO in Protostars (COPS): HerschelHerschel-SPIRE Spectroscopy of Embedded Protostars

We present full spectral scans from 200-670$\mu$m of 26 Class 0+I protostellar sources, obtained with $Herschel$-SPIRE, as part of the "COPS-SPIRE" Open Time program, complementary to the DIGIT and WISH Key programs. Based on our nearly continuous, line-free spectra from 200-670 $\mu$m, the calculated bolometric luminosities ($L_{\rm bol}$) increase by 50% on average, and the bolometric temperatures ($T_{\rm bol}$) decrease by 10% on average, in comparison with the measurements without Herschel. Fifteen protostars have the same Class using $T_{\rm bol}$ and $L_{\rm bol}$/$L_{\rm submm}$. We identify rotational transitions of CO lines from J=4-3 to J=13-12, along with emission lines of $^{13}$CO, HCO$^+$, H$_{2}$O, and [CI]. The ratios of $^{12}$CO to $^{13}$CO indicate that $^{12}$CO emission remains optically thick for $J_{\rm up}$ < 13. We fit up to four components of temperature from the rotational diagram with flexible break points to separate the components. The distribution of rotational temperatures shows a primary population around 100 K with a secondary population at $\sim$350 K. We quantify the correlations of each line pair found in our dataset, and find the strength of correlation of CO lines decreases as the difference between $J$-level between two CO lines increases. The multiple origins of CO emission previously revealed by velocity-resolved profiles are consistent with this smooth distribution if each physical component contributes to a wide range of CO lines with significant overlap in the CO ladder. We investigate the spatial extent of CO emission and find that the morphology is more centrally peaked and less bipolar at high-$J$ lines. We find the CO emission observed with SPIRE related to outflows, which consists two components, the entrained gas and shocked gas, as revealed by our rotational diagram analysis as well as the studies with velocity-resolved CO emission.Comment: 50 pages, 18 figures, accepted to ApJS. Revised for Table 6 and Figure

Diagnostic routes and time intervals for ovarian cancer in nine international jurisdictions; findings from the International Cancer Benchmarking Partnership (ICBP)

BACKGROUND: International Cancer Benchmarking Partnership Module 4 reports the first international comparison of ovarian cancer (OC) diagnosis routes and intervals (symptom onset to treatment start), which may inform previously reported variations in survival and stage. METHODS: Data were collated from 1110 newly diagnosed OC patients aged >40 surveyed between 2013 and 2015 across five countries (51-272 per jurisdiction), their primary-care physicians (PCPs) and cancer treatment specialists, supplement by treatment records or clinical databases. Diagnosis routes and time interval differences using quantile regression with reference to Denmark (largest survey response) were calculated. RESULTS: There were no significant jurisdictional differences in the proportion diagnosed with symptoms on the Goff Symptom Index (53%; P = 0.179) or National Institute for Health and Care Excellence NG12 guidelines (62%; P = 0.946). Though the main diagnosis route consistently involved primary-care presentation (63-86%; P = 0.068), onward urgent referral rates varied significantly (29-79%; P < 0.001). In most jurisdictions, diagnostic intervals were generally shorter and other intervals, in particular, treatment longer compared to Denmark. CONCLUSION: This study highlights key intervals in the diagnostic pathway where improvements could be made. It provides the opportunity to consider the systems and approaches across different jurisdictions that might allow for more timely ovarian cancer diagnosis and treatment

Time intervals and routes to diagnosis for lung cancer in 10 jurisdictions: cross-sectional study findings from the International Cancer Benchmarking Partnership (ICBP)

OBJECTIVE: Differences in time intervals to diagnosis and treatment between jurisdictions may contribute to previously reported differences in stage at diagnosis and survival. The International Cancer Benchmarking Partnership Module 4 reports the first international comparison of routes to diagnosis and time intervals from symptom onset until treatment start for patients with lung cancer. DESIGN: Newly diagnosed patients with lung cancer, their primary care physicians (PCPs) and cancer treatment specialists (CTSs) were surveyed in Victoria (Australia), Manitoba and Ontario (Canada), Northern Ireland, England, Scotland and Wales (UK), Denmark, Norway and Sweden. Using Wales as the reference jurisdiction, the 50th, 75th and 90th percentiles for intervals were compared using quantile regression adjusted for age, gender and comorbidity. PARTICIPANTS: Consecutive newly diagnosed patients with lung cancer, aged ≥40 years, diagnosed between October 2012 and March 2015 were identified through cancer registries. Of 10 203 eligible symptomatic patients contacted, 2631 (27.5%) responded and 2143 (21.0%) were included in the analysis. Data were also available from 1211 (56.6%) of their PCPs and 643 (37.0%) of their CTS. PRIMARY AND SECONDARY OUTCOME MEASURES: Interval lengths (days; primary), routes to diagnosis and symptoms (secondary). RESULTS: With the exception of Denmark (-49 days), in all other jurisdictions, the median adjusted total interval from symptom onset to treatment, for respondents diagnosed in 2012-2015, was similar to that of Wales (116 days). Denmark had shorter median adjusted primary care interval (-11 days) than Wales (20 days); Sweden had shorter (-20) and Manitoba longer (+40) median adjusted diagnostic intervals compared with Wales (45 days). Denmark (-13), Manitoba (-11), England (-9) and Northern Ireland (-4) had shorter median adjusted treatment intervals than Wales (43 days). The differences were greater for the 10% of patients who waited the longest. Based on overall trends, jurisdictions could be grouped into those with trends of reduced, longer and similar intervals to Wales. The proportion of patients diagnosed following presentation to the PCP ranged from 35% to 75%. CONCLUSION: There are differences between jurisdictions in interval to treatment, which are magnified in patients with lung cancer who wait the longest. The data could help jurisdictions develop more focused lung cancer policy and targeted clinical initiatives. Future analysis will explore if these differences in intervals impact on stage or survival

Use of online cultural content for mental health and well-being during COVID-19 restrictions : cross-sectional survey

AIMS AND METHOD: To gain a deeper understanding of the use of online culture and its potential benefits to mental health and well-being, sociodemographic characteristics and self-reported data on usage, perceived mental health benefits and health status were collected in an online cross-sectional survey during COVID-19 restrictions in the UK in June-July 2020. RESULTS: In total, 1056 people completed the survey. A high proportion of participants reported finding online culture helpful for mental health; all but one of the benefits were associated with regular use and some with age. Reported benefits were wide-ranging and interconnected. Those aged under 25 years were less likely to be regular users of online culture or to have increased their use during lockdown. CLINICAL IMPLICATIONS: There may be benefits in targeting cultural resources for mental health to vulnerable groups such as young adults

Nurse-led group consultation intervention reduces depressive symptoms in men with localised prostate cancer: a cluster randomised controlled trial

BACKGROUND: Radiotherapy for localised prostate cancer has many known and distressing side effects. The efficacy of group interventions for reducing psychological morbidity is lacking. This study investigated the relative benefits of a group nurse-led intervention on psychological morbidity, unmet needs, treatment-related concerns and prostate cancer-specific quality of life in men receiving curative intent radiotherapy for prostate cancer. METHODS: This phase III, two-arm cluster randomised controlled trial included 331 men (consent rate: 72&nbsp;%; attrition: 5&nbsp;%) randomised to the intervention (n&thinsp;=&thinsp;166) or usual care (n&thinsp;=&thinsp;165). The intervention comprised four group and one individual consultation all delivered by specialist uro-oncology nurses. Primary outcomes were anxious and depressive symptoms as assessed by the Hospital Anxiety and Depression Scale. Unmet needs were assessed with the Supportive Care Needs Survey-SF34 Revised, treatment-related concerns with the Cancer Treatment Scale and quality of life with the Expanded Prostate Cancer Index -26. Assessments occurred before, at the end of and 6 months post-radiotherapy. Primary outcome analysis was by intention-to-treat and performed by fitting a linear mixed model to each outcome separately using all observed data. RESULTS: Mixed models analysis indicated that group consultations had a significant beneficial effect on one of two primary endpoints, depressive symptoms (p = 0.009), and one of twelve secondary endpoints, procedural concerns related to cancer treatment (p = 0.049). Group consultations did not have a significant beneficial effect on generalised anxiety, unmet needs and prostate cancer-specific quality of life. CONCLUSIONS: Compared with individual consultations offered as part of usual care, the intervention provides a means of delivering patient education and is associated with modest reductions in depressive symptoms and procedural concerns. Future work should seek to confirm the clinical feasibility and cost-effectiveness of group interventions