The challenge of embedding an ecosystems approach:patterns of knowledge utilisation in public policy appraisal

The ‘ecosystem services approach’ (ESA) to policy making has refocused attention on how knowledge is embedded in policy. Appraisal has long been identified as an important venue for embedding, but suffers from well-known difficulties. This paper examines the extent to which an ESA appears in UK policy appraisal documents, and how far implementing an ESA via appraisal may encounter the same difficulties. A clear understanding of this is vital for interrogating claims that improving knowledge necessarily leads to more sustainable ecosystem management. The paper reports on the content of seventy-five national-level policy appraisals undertaken in the United Kingdom between 2008 and 2012. Only some elements of an ESA appear, with even the environment ministry failing to systematically pick up the concept, which is indeed subject to many of the familiar barriers to embedding environmental knowledge in appraisals. Policy initiatives attempting to institutionalise ecosystem values need to be conversant with these barriers

Unexpected Consequences: Women’s experiences of a self-hypnosis intervention to help with pain relief during labour.

Background Self-hypnosis is becoming increasingly popular as a means of labour pain management. Previous studies have produced mixed results. There are very few data on women’s views and experiences of using hypnosis in this context. As part of a randomized controlled trial of self-hypnosis for intra-partum pain relief (the SHIP Trial) we conducted qualitative interviews with women randomized to the intervention arm to explore their views and experiences of using self-hypnosis during labour and birth. Methods Participants were randomly selected from the intervention arm of the study, which consisted of two antenatal self-hypnosis training sessions and a supporting CD that women were encouraged to listen to daily from 32 weeks gestation until the birth of their baby. Those who consented were interviewed in their own homes 8-12 weeks after birth. Following transcription, the interviews were analysed iteratively and emerging concepts were discussed amongst the authors to generate organizing themes. These were then used to develop a principal organizing metaphor or global theme, in a process known as thematic networks analysis. Results Of the 343 women in the intervention group, 48 were invited to interview, and 16 were interviewed over a 12 month period from February 2012 to January 2013. Coding of the data and subsequent analysis revealed a global theme of ‘unexpected consequences’, supported by 5 organising themes, ‘calmness in a climate of fear’, ‘from sceptic to believer’, ‘finding my space’, ‘delays and disappointments’ and ‘personal preferences’. Most respondents reported positive experiences of self-hypnosis and highlighted feelings of calmness, confidence and empowerment. They found the intervention to be beneficial and used a range of novel strategies to personalize their self-hypnosis practice. Occasionally women reported feeling frustrated or disappointed when their relaxed state was misinterpreted by midwives on admission or when their labour and birth experiences did not match their expectations. Conclusion The women in this study generally appreciated antenatal self-hypnosis training and found it to be beneficial during labour and birth. The state of focused relaxation experienced by women using the technique needs to be recognized by providers if the intervention is to be implemented into the maternity service

Body image, body dissatisfaction and weight status in south asian children: a cross-sectional study

Background Childhood obesity is a continuing problem in the UK and South Asian children represent a group that are particularly vulnerable to its health consequences. The relationship between body dissatisfaction and obesity is well documented in older children and adults, but is less clear in young children, particularly South Asians. A better understanding of this relationship in young South Asian children will inform the design and delivery of obesity intervention programmes. The aim of this study is to describe body image size perception and dissatisfaction, and their relationship to weight status in primary school aged UK South Asian children. Methods Objective measures of height and weight were undertaken on 574 predominantly South Asian children aged 5-7 (296 boys and 278 girls). BMI z-scores, and weight status (underweight, healthy weight, overweight or obese) were calculated based on the UK 1990 BMI reference charts. Figure rating scales were used to assess perceived body image size (asking children to identify their perceived body size) and dissatisfaction (difference between perceived current and ideal body size). The relationship between these and weight status were examined using multivariate analyses. Results Perceived body image size was positively associated with weight status (partial regression coefficient for overweight/obese vs. non-overweight/obese was 0.63 (95% CI 0.26-0.99) and for BMI z-score was 0.21 (95% CI 0.10-0.31), adjusted for sex, age and ethnicity). Body dissatisfaction was also associated with weight status, with overweight and obese children more likely to select thinner ideal body size than healthy weight children (adjusted partial regression coefficient for overweight/obese vs. non-overweight/obese was 1.47 (95% CI 0.99-1.96) and for BMI z-score was 0.54 (95% CI 0.40-0.67)). Conclusions Awareness of body image size and increasing body dissatisfaction with higher weight status is established at a young age in this population. This needs to be considered when designing interventions to reduce obesity in young children, in terms of both benefits and harms

The GABBR1 locus and the G1465A variant is not associated with temporal lobe epilepsy preceded by febrile seizures

BACKGROUND: Polymorphism G1465A in the GABBR1 gene has been suggested as a risk factor for non-lesional temporal lobe epilepsy (TLE); however, this genetic association study has not been independently replicated. We attempted to replicate this study in our cohort of patients with TLE. Furthermore, we also analyzed the coding sequence of this gene and searched for disease-causing mutations. METHODS: We included 120 unrelated individuals with TLE that was preceded by febrile seizures (FS) who did not have any evidence of structural lesions suggesting secondary epilepsy. 66 individuals had positive family history of TLE epilepsy and 54 were sporadic. Each patient was genotyped for the presence of G1465A polymorphism. All exons of the GABBR1 gene were screened by single strand confirmation polymorphism method. Genotypes were compared with two independent matched control groups. RESULTS: We detected two A alleles of the G1465A polymorphism in one homozygous control subject (0.87% of all alleles) and one A allele in a patient with TLE (0.45%, not significant). Other detected polymorphisms in coding regions had similar frequencies in epilepsy patients and control groups. No disease causing mutations in the GABBR1 gene were detected in patients with sporadic or familial TLE. CONCLUSION: Our results indicate that TLE preceded by FS is not associated with the polymorphisms or mutations in the GABBR1 gene, including the G1465A polymorphism. The proportion of TLE patients with FS in the original study, reporting this positive association, did not differ between allele A negative and positive cases. Thus, our failure to reproduce this result is likely applicable to all non-lesional TLE epilepsies

Pathways through the criminal justice system for prisoners with acute and serious mental illness

Purpose: To evaluate pathways through the criminal justice system for 63 prisoners under the care of prison mental health services. Results: Only a small number (3%) were acutely mentally ill on reception to prison, and this may reflect the successful operation of liaison and diversion services at earlier stages in the pathway. However, a third (33%) went onto display acute symptoms at later stages. Cases displaying suicide risk at arrest, with a history of in-patient care, were at increased risk of acute deterioration in the first weeks of imprisonment, with a general lack of health assessments for these cases prior to their imprisonment. Inconsistencies in the transfer of mental health information to health files may result in at-risk cases being overlooked, and a lack of standardisation at the court stage resulted in difficulties determining onward service provision and outcomes. Foreign national prisoners were under-represented in the sample. Conclusions: Greater consistency in access to pre-prison health services in the criminal justice system is needed, especially for those with pre-existing vulnerabilities, and it may have a role in preventing subsequent deterioration. A single system for health information flow across the whole pathway would be beneficial. Summary points: 1. Only 3% of cases were acutely mentally ill at prison reception. 2. Cases identified at arrest as presenting a high risk of suicide, with a history of in-patient care, may be at increased risk of acute deterioration in the first weeks of imprisonment; but they were over-looked for assessment prior to prison. 3. Inconsistencies in the transfer of mental health information into prison health files may result in overlooked at-risk cases

Association between Ambient Noise Exposure and School Performance of Children Living in An Urban Area: A Cross-Sectional Population-Based Study

16 pages Article disponible à l'adresse suivante : http://link.springer.com/article/10.1007%2Fs11524-013-9843-6International audienceMost of the studies investigating the effects of the external noise on children's school performance have concerned pupils in schools exposed to high levels due to aircraft or freeway traffic noise. However, little is known about the consequences of the chronic ambient noise exposure at a level commonly encountered in residential urban areas. This study aimed to assess the relationship between the school performance of 8- to 9-year-old-children living in an urban environment and their chronic ambient noise exposure at home and at school. The children's school performances on the national standardized assessment test in French and mathematics were compared with the environmental noise levels. Children's exposure to ambient noise was calculated in front of their bedrooms (Lden) and schools (LAeq,day) using noise prediction modeling. Questionnaires were distributed to the families to collect potential confounding factors. Among the 746 respondent children, 586 were included in multilevel analyses. On average, the LAeq,day at school was 51.5 dB (SD= 4.5 dB; range = 38-58 dB) and the outdoor Lden at home was 56.4 dB (SD= 4.4 dB; range = 44-69 dB). LAeq,day at school was associated with impaired mathematics score (p = 0.02) or impaired French score (p = 0.01). For a + 10 dB gap, the French and mathematics scores were on average lower by about 5.5 points. Lden at home was significantly associated with impaired French performance when considered alone (p < 10(-3)) and was borderline significant when the combined home-school exposure was considered (p = 0.06). The magnitude of the observed effect on school performance may appear modest, but should be considered in light of the number of people who are potentially chronically exposed to similar environmental noise levels

Emerging themes to support ambitious UK marine biodiversity conservation

Healthy marine ecosystems provide a wide range of resources and services that support life on Earth and contribute to human wellbeing. Marine Protected Areas (MPAs) are accepted as an important tool for the restoration and maintenance of marine ecosystem structure, function, health and ecosystem integrity through the conservation of significant species, habitats, or entire ecosystems. In recent years there has been a rapid expansion in the area of ocean designated as an MPA. Despite this progress in spatial protection targets and the progressive knowledge of the essential interdependence between the human and the ocean system, marine biodiversity continues to decline, placing in jeopardy the range of ecosystem services benefits humans rely on. There is a need to address this shortcoming. Ambitious marine conservation:• Requires a shift from managing individual marine features within MPAs to whole-sites to enable repair and renewal of marine systems;• Reflects an ambition for sustainable livelihoods by fully integrating fisheries management with conservation (Ecosystem Based Fisheries Management) as the two are critically interdependent;• Establishes a world class and cost effective ecological and socio-economic monitoring and evaluation framework that includes the use of controls and sentinel sites to improve sustainability in marine management; and• Challenges policy makers and practitioners to be progressive by integrating MPAs into the wider seascape as critical functional components rather than a competing interest and move beyond MPAs as the only tool to underpin the benefits derived from marine ecosystems by identifying other effective area-based conservation measures (OECMs) to establish synergies with wider governance frameworks

Integrating human and ecosystem health through ecosystem services frameworks

The pace and scale of environmental change is undermining the conditions for human health. Yet the environment and human health remain poorly integrated within research, policy and practice. The ecosystem services (ES) approach provides a way of promoting integration via the frameworks used to represent relationships between environment and society in simple visual forms. To assess this potential, we undertook a scoping review of ES frameworks and assessed how each represented seven key dimensions, including ecosystem and human health. Of the 84 ES frameworks identified, the majority did not include human health (62%) or include feedback mechanisms between ecosystems and human health (75%). While ecosystem drivers of human health are included in some ES frameworks, more comprehensive frameworks are required to drive forward research and policy on environmental change and human health

Mineral Preservatives in the Wood of Stradivari and Guarneri

Following the futile efforts of generations to reach the high standard of excellence achieved by the luthiers in Cremona, Italy, by variations of design and plate tuning, current interest is being focused on differences in material properties. The long-standing question whether the wood of Stradivari and Guarneri were treated with wood preservative materials could be answered only by the examination of wood specimens from the precious antique instruments. In a recent communication (Nature, 2006), we reported about the degradation of the wood polymers in instruments of Stradivari and Guarneri, which could be explained only by chemical manipulations, possibly by preservatives. The aim of the current work was to identify the minerals from the small samples of the maple wood which were available to us from the antique instruments. The ashes of wood from one violin and one cello by Stradivari, two violins by Guarneri, one viola by H. Jay, one violin by Gand-Bernardel were analyzed and compared with a variety of commercial tone woods. The methods of analysis were the following: back-scattered electron imaging, X-ray fluorescence maps for individual elements, wave-length dispersive spectroscopy, energy dispersive X-ray spectroscopy and quantitative microprobe analysis. All four Cremonese instruments showed the unmistakable signs of chemical treatments in the form of chemicals which are not present in natural woods, such as BaSO4, CaF2, borate, and ZrSiO4. In addition to these, there were also changes in the common wood minerals. Statistical evaluation of 12 minerals by discriminant analysis revealed: a. a difference among all four Cremona instruments, b. the difference of the Cremonese instruments from the French and English antiques, and c. only the Cremonese instruments differed from all commercial woods. These findings may provide the answer why all attempts to recreate the Stradivarius from natural wood have failed. There are many obvious implications with regard to how the green tone wood should be treated, which chould lead to changes in the practice of violin-making. This research should inspire others to analyze more antique violins for their chemical contents