Implications and impacts of aligning regional agriculture with a healthy diet

One of the most intractable challenges currently facing agricultural systems is the need to produce sufficient food for all to enjoy a healthy balanced diet while minimising impacts to the environment. Balancing these competing goals is especially intractable because most food systems are not locally bounded. This study aims to investigate the likely impacts on production, profit and the environment that result from aligning food systems to a healthy diet, as defined by EAT-Lancet. For this, we consider two distinct areas of the UK, one in East Anglia and the other in South Wales. These two regions reflect different ecosystems and therefore differing specialisations in UK agriculture. We used the Rothamsted Landscape Model (a detailed agroecosystems process-based model) to predict soil carbon dynamics, nutrient flows and crop production for the dominant crops grown in these regions, and the IPCC inventory models to estimate emissions from six livestock systems. Two scenarios were considered, one in which the study regions had to meet healthy diet requirements independently of each other and another in which they could do so collectively. To map their production to healthy diets, both study areas require increases in the production of plant proteins and reductions in the production of red meat. While changes in production can feed more people a healthy diet compared to the business-as-usual state, the overall calories produced reduces dramatically. Emissions and leaching decrease under the healthy diet scenarios and pesticide impacts remain largely unchanged. We show that local infrastructure and environment have a bearing on how “localised” food systems can be without running into substantial constraints. Whilst isolation of the farming system to a regional level, as explored here, is unlikely to be practical, we nevertheless demonstrate that aligning agricultural production towards healthier diets can generate food systems with many associated benefits in terms of agroecosystems' health and resilience to shocks in the food supply chain

Understanding and responding to prescribing patterns of sodium valproate-containing medicines in pregnant women and women of childbearing age in Western Cape, South Africa

Growing evidence of the teratogenic potential of sodium valproate (VPA) has changed prescribing practices across the globe; however, the impact of this research and the consequent dissemination of a Dear Health Care Professional Letter (DHCPL) in December 2015, recommending avoidance of the teratogen VPA in women of childbearing age (WOCBA) and pregnant women in South Africa, is unknown. We explored trends and reasons for VPA use among pregnant women and WOCBA in the public sector in Western Cape Province from 1 January 2015 to 31 December 2017. Methods: Using the provincial health information exchange that collates routine electronic health data via unique patient identifiers, we analysed clinical and pharmacy records from 2015 to 2017 to determine prescription patterns of VPA and other antiepileptic drug (AED) and mood-stabilising medicine (MSM) use in WOCBA and pregnant women. Senior clinicians and policy makers were consulted to understand the determinants of VPA use. Results: At least one VPA prescription was dispensed to between 8205 (0.79%) and 9425 (0.94%) WOBCA from a cohort of approximately 1 million WOCBA attending provincial health care facilities per year

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Health Care System Accessibility

People who are deaf use health care services differently than the general population; little research has been carried out to understand the reasons. OBJECTIVE : To better understand the health care experiences of deaf people who communicate in American Sign Language. DESIGN : Qualitative analyses of focus group discussions in 3 U.S. cities. PARTICIPANTS : Ninety-one deaf adults who communicate primarily in American Sign Language. MEASUREMENTS : We collected information about health care communication and perceptions of clinicians' attitudes. We elicited stories of both positive and negative encounters, as well as recommendations for improving health care. RESULTS : Communication difficulties were ubiquitous. Fear, mistrust, and frustration were prominent in participants' descriptions of health care encounters. Positive experiences were characterized by the presence of medically experienced certified interpreters, health care practitioners with sign language skills, and practitioners who made an effort to improve communication. Many participants acknowledged limited knowledge of their legal rights and did not advocate for themselves. Some participants believed that health care practitioners should learn more about sociocultural aspects of deafness. CONCLUSIONS : Deaf people report difficulties using health care services. Physicians can facilitate change to improve this. Future research should explore the perspective of clinicians when working with deaf people, ways to improve communication, and the impact of programs that teach deaf people self-advocacy skills and about their legal rights.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72715/1/j.1525-1497.2006.00340.x.pd