Routes to sustainability in public food procurement: An investigation of different models in primary school catering

Increasingly, policymakers are setting ambitious goals for sustainability in public procurement, integrated across different pillars. Such ambitions are apparent in public catering services, where procurement models have been shifting towards greater localisation of supply chains and purchasing of more organically grown food. To date however, few studies have examined empirically what the impacts of different procurement models are across these multiple pillars of sustainability. This research aimed to fill the gap, by measuring and comparing the environmental, economic and nutritional outcomes of different models of school meals procurement. Case studies were undertaken of ten primary school meals services in five European countries, capturing different procurement model types. Results showed carbon emissions ranged from 0.95 kgs CO2e per meal in the lowest case to 2.41 kgs CO2e in the highest case, with adoption of low carbon food waste disposal methods and reduction of the amount of ruminant meat in the menus being the most important actions for lowering emissions. In terms of economic impact, local economic multiplier ratios ranged from 1.59 to 2.46, and although the level of local food sourcing contributed to these ratios, the effect was eclipsed, in some cases, by investment in local catering staff. Meanwhile, implementation of a robust standards regime and improving canteen environment and supervision were the most important actions for nutritional quality and intake. The paper discusses the implications of the findings for integrated, sustainable models of food procurement

MeCP2 deficiency results in robust Rett-like behavioural and motor deficits in male and female rats

Since the identification of MECP2 as the causative gene in the majority of Rett Syndrome (RTT) cases, transgenic mouse models have played a critical role in our understanding of this disease. The use of additional mammalian RTT models offers the promise of further elucidating critical early mechanisms of disease as well as providing new avenues for translational studies. We have identified significant abnormalities in growth as well as motor and behavioural function in a novel zincfinger nuclease model of RTT utilizing both male and female rats throughout development. Male rats lacking MeCP2 (Mecp2ZFN/y) were noticeably symptomatic as early as postnatal day 21, with most dying by postnatal day 55, while females lacking one copy of Mecp2 (Mecp2ZFN/þ) displayed a more protracted disease course. Brain weights of Mecp2ZFN/y and Mecp2ZFN/þ rats were significantly reduced by postnatal day 14 and 21, respectively. Early motor and breathing abnormalities were apparent in Mecp2ZFN/y rats, whereas Mecp2ZFN/þ rats displayed functional irregularities later in development. The large size of this species will provide profound advantages in the identification of early disease mechanisms and the development of appropriately timed therapeutics. The current study establishes a foundational basis for the continued utilization of this rat model in future RTT research

Decay constants and mixing parameters in a relativistic model for q\barQ system

We extend our recent work, in which the Dirac equation with a ``(asymptotically free) Coulomb + (Lorentz scalar $\gamma_0\sigma r$) linear '' potential is used to obtain the light quark wavefunction for $q\bar Q$ mesons in the limit $m_Q\to \infty$, to estimate the decay constant $f_P$ and the mixing parameter $B$ of the pseudoscalar mesons. We compare our results for the evolution of $f_P$ and $B$ with the meson mass $M_P$ to the non-relativistic formulas for these quantities and show that there is a significant correction in the subasymptotic region. For $\sigma =0.14{{\rm ~GeV}}^{-2}$ and \lms =0.240{\rm ~GeV} we obtain: $f_D =0.371\; ,\; f_{D_s}=0.442\; ,\; f_B=0.301\; ,\; f_{B_s}=0.368 {\rm ~GeV}$ and $B_D=0.88\; ,\; B_{D_s}=0.89\; ,\; B_B=0.95\; ,\; B_{B_s}=0.96\; ,\;$ and $B_K=0.60$.Comment: 13 pages, Latex, 3 figures (included

Status Update and Interim Results from the Asymptomatic Carotid Surgery Trial-2 (ACST-2)

Objectives: ACST-2 is currently the largest trial ever conducted to compare carotid artery stenting (CAS) with carotid endarterectomy (CEA) in patients with severe asymptomatic carotid stenosis requiring revascularization. Methods: Patients are entered into ACST-2 when revascularization is felt to be clearly indicated, when CEA and CAS are both possible, but where there is substantial uncertainty as to which is most appropriate. Trial surgeons and interventionalists are expected to use their usual techniques and CE-approved devices. We report baseline characteristics and blinded combined interim results for 30-day mortality and major morbidity for 986 patients in the ongoing trial up to September 2012. Results: A total of 986 patients (687 men, 299 women), mean age 68.7 years (SD ± 8.1) were randomized equally to CEA or CAS. Most (96%) had ipsilateral stenosis of 70-99% (median 80%) with contralateral stenoses of 50-99% in 30% and contralateral occlusion in 8%. Patients were on appropriate medical treatment. For 691 patients undergoing intervention with at least 1-month follow-up and Rankin scoring at 6 months for any stroke, the overall serious cardiovascular event rate of periprocedural (within 30 days) disabling stroke, fatal myocardial infarction, and death at 30 days was 1.0%. Conclusions: Early ACST-2 results suggest contemporary carotid intervention for asymptomatic stenosis has a low risk of serious morbidity and mortality, on par with other recent trials. The trial continues to recruit, to monitor periprocedural events and all types of stroke, aiming to randomize up to 5,000 patients to determine any differential outcomes between interventions. Clinical trial: ISRCTN21144362. © 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved

Second asymptomatic carotid surgery trial (ACST-2): a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86–1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91–1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable. Funding: UK Medical Research Council and Health Technology Assessment Programme

New Middle-Class Labor Migrants

Migration researchers have tended to focus on social extremes: either highly skilled elites, on the one hand, or low-wage workers on the other. Less attention has been directed toward “ordinary” middle-class professional movers, and there have been no reviews of this literature to date. The chapter addresses this gap and identifies five important themes to guide future class-orientated migration research. First, the complex relationship between migration, social mobility, place, and middle-class membership is examined. Second, age is shown to be an important consideration in middle-class migration decision-making. Third, the cultural versus economic basis of the mobile middle-class is explored, and the role of lifestyle factors in shaping migration is critically examined. Fourth, middle-class migration decisions are connected to gendered household strategies, with the preponderance of dual-career couples now taking migration decision-making well beyond the individual career path. Finally, the social and communal emplacement of middle-class migrants is considered as an important but neglected dimension of research. Overall, it is clear that the class-based analysis of migration is an important yet neglected field of study, and this is especially true for middle-class movers