A systematic evaluation of physical activity and diet policies in Scotland: Results from the 2021 Active Healthy Kids Report Card

Background Policymaking regarding physical activity (PA) and diet plays an important role in childhood health promotion. This study provides a detailed examination of Scottish government and policy for child and adolescent PA and diet and discusses strengths and areas for improvement. Methods Scottish policy documents (n = 18 [PA]; n = 10 [diet])—published in 2011–20—were reviewed for grading using an adapted version of the Health-Enhancing Physical Activity Policy Audit Tool Version 2. Results There is clear evidence of leadership and commitment to improving PA and diet and tackling obesity in children and adolescents. The allocation of funds and resources for policy implementation has increased substantially over the past decade. Progress through early key stages of public policymaking—policy agenda and formation—has improved. However, there is limited information on later key stages, including policy monitoring and evaluation. Conclusions Childhood PA and diet are a clear priority in Scotland, and PA and diet policies clearly support the desire to achieve other goals, including reducing inequalities and increasing active travel in Scotland. Nonetheless, future policies should be further strengthened through clear(er) plans of implementation, and monitoring and evaluation to support their societal impact

Evaluation of physical activity policies in Scotland : results from the 2021 Active Healthy Kids Scotland Report Card

Purpose: The benefits of physical activity (PA) are well-established for children and adolescents, and policy making regarding PA plays an important role in increasing PA. As part of the Active Healthy Kids Global Alliance initiative, the 2021 Active Healthy Kids Scotland Report Card summarised the status of PA and health in Scottish children and adolescents prior to the COVID-19 pandemic—reporting on a range of indicators (Bardid et al., 2022). This study provides a detailed examination of the evidence informing the Government and Policy indicator. Methods: Current Scottish PA policy documents (n=18) published in 2011-2020—not including responses to COVID-19—were reviewed for grading. The grade was determined using an adapted version of the Policy Audit Tool Version 2 (Ward et al., 2021). Key criteria in the scoring rubric include number and breadth of policies, identified funding, identifiable reporting structures, and monitoring and evaluation plan. Results: A C- grade was assigned to the Government and Policy indicator. There is clear evidence of leadership and commitment to increasing levels of PA and providing PA opportunities for children and youth. The allocation of funds and resources for implementation of policy has increased substantially since the publication of previous report cards. Progress through the key stages of public policymaking—policy agenda and formation—has improved. However, some policy documents do not identify accountable organisations, whilst others do not include details regarding reporting structures. Moreover, many policy documents do not provide information on monitoring and evaluation of policies. Conclusions: Scotland has many creditable policies at national level. There appears to be good links between the government and organisations accountable for implementation. Child and adolescent PA is clearly a priority in Scotland; it is not only an outcome, but also a means to achieve other goals (e.g., active travel to take climate action). However, current policies provide limited information on how delivery of proposed actions will be monitored and evaluated in practice. Future policies should therefore include more information on monitoring, evaluation, and reporting of delivery of actions, in order to better understand and support policy implementation and its impact on PA in children and adolescents

A systematic evaluation of physical activity and diet policies in Scotland : results from the 2021 Active Healthy Kids Report Card

Background: Policymaking regarding physical activity (PA) and diet plays an important role in childhood health promotion. This study provides a detailed examination of Scottish government and policy for child and adolescent PA and diet and discusses strengths and areas for improvement. Methods: Scottish policy documents (n = 18 [PA]; n = 10 [diet])—published in 2011–20—were reviewed for grading using an adapted version of the Health-Enhancing Physical Activity Policy Audit Tool Version 2. Results: There is clear evidence of leadership and commitment to improving PA and diet and tackling obesity in children and adolescents. The allocation of funds and resources for policy implementation has increased substantially over the past decade. Progress through early key stages of public policymaking—policy agenda and formation—has improved. However, there is limited information on later key stages, including policy monitoring and evaluation. Conclusions: Childhood PA and diet are a clear priority in Scotland, and PA and diet policies clearly support the desire to achieve other goals, including reducing inequalities and increasing active travel in Scotland. Nonetheless, future policies should be further strengthened through clear(er) plans of implementation, and monitoring and evaluation to support their societal impact

Multihospital Outbreak of Clostridium difficile Ribotype 027 Infection: Epidemiology and Analysis of Control Measures

Objective. To report a large outbreak of Clostridium difficile infection (CDI; ribotype 027) between June 2007 and August 2008, describe infection control measures, and evaluate the impact of restricting the use of fluoroquinolones in controlling the outbreak. Design. Outbreak investigation in 3 acute care hospitals of the Northern Health and Social Care Trust in Northern Ireland. Interventions. Implementation of a series of CDI control measures that targeted high-risk antibiotic agents (ie, restriction of fluoroquinolones), infection control practices, and environmental hygiene. Results. A total of 318 cases of CDI were identified during the outbreak, which was the result of the interaction between C. difficile ribotype 027 being introduced into the affected hospitals for the first time and other predisposing risk factors (ranging from host factors to suboptimal compliance with antibiotic guidelines and infection control policies). The 30-day all-cause mortality rate was 24.5%; however, CDI was the attributable cause of death for only 2.5% of the infected patients. Time series analysis showed that restricting the use of fluoroquinolones was associated with a significant reduction in the incidence of CDI (coefficient, —0.054; lag time, 4 months; P = .003). Conclusion. These findings provide additional evidence to support the value of antimicrobial stewardship as an essential element of multifaceted interventions to control CDI outbreaks. The present CDI outbreak was ended following the implementation of an action plan improving communication, antibiotic stewardship, infection control practices, environmental hygiene, and surveillanc

Axillary treatment for operable primary breast cancer

Axillary surgery is an established part of the management of primary breast cancer. It provides staging information to guide adjuvant therapy and potentially local control of axillary disease. Several alternative approaches to axillary surgery are available, most of which aim to spare a proportion of women the morbidity of complete axillary dissection

Genome-wide meta-analysis identifies five new susceptibility loci for cutaneous malignant melanoma.

Thirteen common susceptibility loci have been reproducibly associated with cutaneous malignant melanoma (CMM). We report the results of an international 2-stage meta-analysis of CMM genome-wide association studies (GWAS). This meta-analysis combines 11 GWAS (5 previously unpublished) and a further three stage 2 data sets, totaling 15,990 CMM cases and 26,409 controls. Five loci not previously associated with CMM risk reached genome-wide significance (P < 5 × 10(-8)), as did 2 previously reported but unreplicated loci and all 13 established loci. Newly associated SNPs fall within putative melanocyte regulatory elements, and bioinformatic and expression quantitative trait locus (eQTL) data highlight candidate genes in the associated regions, including one involved in telomere biology.[Please see the Supplementary Note for acknowledgments.]This is the author accepted manuscript. The final version is available from NPG via http://dx.doi.org/10.1038/ng.337

Novel pleiotropic risk loci for melanoma and nevus density implicate multiple biological pathways.

The total number of acquired melanocytic nevi on the skin is strongly correlated with melanoma risk. Here we report a meta-analysis of 11 nevus GWAS from Australia, Netherlands, UK, and USA comprising 52,506 individuals. We confirm known loci including MTAP, PLA2G6, and IRF4, and detect novel SNPs in KITLG and a region of 9q32. In a bivariate analysis combining the nevus results with a recent melanoma GWAS meta-analysis (12,874 cases, 23,203 controls), SNPs near GPRC5A, CYP1B1, PPARGC1B, HDAC4, FAM208B, DOCK8, and SYNE2 reached global significance, and other loci, including MIR146A and OBFC1, reached a suggestive level. Overall, we conclude that most nevus genes affect melanoma risk (KITLG an exception), while many melanoma risk loci do not alter nevus count. For example, variants in TERC and OBFC1 affect both traits, but other telomere length maintenance genes seem to affect melanoma risk only. Our findings implicate multiple pathways in nevogenesis

Cell-type–specific eQTL of primary melanocytes facilitates identification of melanoma susceptibility genes

Most expression quantitative trait locus (eQTL) studies to date have been performed in heterogeneous tissues as opposed to specific cell types. To better understand the cell-type–specific regulatory landscape of human melanocytes, which give rise to melanoma but account for <5% of typical human skin biopsies, we performed an eQTL analysis in primary melanocyte cultures from 106 newborn males. We identified 597,335 cis-eQTL SNPs prior to linkage disequilibrium (LD) pruning and 4997 eGenes (FDR < 0.05). Melanocyte eQTLs differed considerably from those identified in the 44 GTEx tissue types, including skin. Over a third of melanocyte eGenes, including key genes in melanin synthesis pathways, were unique to melanocytes compared to those of GTEx skin tissues or TCGA melanomas. The melanocyte data set also identified trans-eQTLs, including those connecting a pigmentation-associated functional SNP with four genes, likely through cis-regulation of IRF4. Melanocyte eQTLs are enriched in cis-regulatory signatures found in melanocytes as well as in melanoma-associated variants identified through genome-wide association studies. Melanocyte eQTLs also colocalized with melanoma GWAS variants in five known loci. Finally, a transcriptome-wide association study using melanocyte eQTLs uncovered four novel susceptibility loci, where imputed expression levels of five genes (ZFP90, HEBP1, MSC, CBWD1, and RP11-383H13.1) were associated with melanoma at genome-wide significant P-values. Our data highlight the utility of lineage-specific eQTL resources for annotating GWAS findings, and present a robust database for genomic research of melanoma risk and melanocyte biology

Water, land use change and \u27new forests\u27: what are the challenges for South-Western Victoria?

Land use change has occurred rapidly in southwestern Victoria over the last decade and is expected to continue, albeit at a slower pace. One of these changes has been the development of \u27new forests\u27, that is industrial and farm forestry plantations and environmental plantings. Some of the challenges that these land use changes pose for water and natural resource managers are discussed. Land use change is expected to substantially reduce potential water yield in four of the region\u27s seven drainage basins (A).<br /