Assessing Integrated Water Management Options for Urban Developments - Canberra case study

Urban water services in the Australian Capital Territory (ACT) are currently provided through conventional centralised systems, involving large scale water distribution, wastewater collection, water and wastewater treatment. A study was conducted to assist Environment ACT in setting broad policies for future water services in Canberra. This paper presents the outcomes of a study examining the effects of various water servicing options on water resources and the environment, for two townships in Canberra, one existing and one greenfield site. Three modelling tools were used to predict the effects of various alternative water servicing scenarios, including demand management options, rainwater tanks, greywater use, on-site detention tanks, gross pollutant traps, swales and ponds. The results show that potable water reductions are best achieved by demand management tools or a combination of greywater and rainwater use for existing suburbs, while 3rd pipe systems are preferred for greenfield sites. For this specific climatic region and end use demands, modelling predicted increased water savings from raintanks compared to greywater systems alone, with raintanks providing the additional benefit of reduced peak stormwater flows at the allotment scale. Rainwater and stormwater reuse from stormwater ponds within the catchments was found to provide the highest reduction in nutrient discharge from the case study areas. Environment ACT amended planning controls to facilitate installation of raintanks and greywater systems, and commenced a Government funded rebate scheme for raintanks as a result of this study

An exploration of the co-production of performance running bodies and natures within "Running Taskscapes"

This article explores the interrelationship between particular “natural” spaces and the production of middle- and long-distance performance running bodies. It argues that running bodies and nature are actively co-produced, thus blurring the commonly made distinction between the “social” and the “natural”. In doing so, the article extends the geography of sports literature by adopting a “post-constructivist” perspective on nature as elucidated in Tim Ingold's concepts of “dwelling” and “taskscape”. This illuminates the (re)production of sporting bodies through the materiality of nature and in turn contributes to research on embodiment within sports studies that highlights the importance of space and the natural environment. The article draws on ethnographic material and textual sources to illuminate the running taskscape associated with the production of performance running bodies and highlights how three forms and functions of nature are co-produced through this mode of dwelling

Chlamydia test-of-cure in pregnancy

Includes correction issued in August 2020 issue, page 554.Clinical Inquiries question: What is the optimal interval between treatment and test-of-cure (TOC) in pregnant women with Chlamydia trachomatis (CT)? Evidence-based answer: The optimal interval between treatment and TOC in pregnant women with CT is 3 to 4 weeks (strength of recommendation C: several small prospective and retrospective cohort studies; a high-quality nonsystematic review; and a consensus guideline). Testing before 3 weeks might give false-positive results, while waiting longer than 4 weeks might delay detecting new infections or result in treatment failure.Jessie Pettit, MD; Carol Howe, MD, MLS; Joshua Freeman, MDDr Freeman is Clinical Professor and Dr Pettit is Associate Professor in the Department of Family and Community Medicine at the University of Arizona in Tucson. Dr Howe is a librarian in the Health Sciences Library at the University of Arizona.Includes bibliographical reference

Hypoglycemia with insulin and sulfonylureas

Clinical Inquiries question: In patients with type 2 diabetes mellitus (T2DM), does the combination of insulin and sulfonylurea (SU) increase the risk of hypoglycemia? Evidence-based answer: The incidence of severe hypoglycemia in patients with T2DM taking insulin alone, SU alone, or the combination of insulin and SU is low (strength of recommendation [SOR] A based on a systematic review of randomized controlled trials). The combination of insulin and SU in patients with T2DM does increase the risk of hypoglycemia; however, the clinical significance of this risk is small (SOR B based on 4 large retrospective cohort studies). Of note, patients 65 years and older are at an increased risk of hypoglycemia compared with younger patients, although the clinical significance has not been specified (SOR B based on 2 large retrospective cohort studies).Karyn B. Kolman, MD; Joshua Freeman, MD; Carol L. Howe, MD, MLSDr Kolman is Assistant Professor and Dr Freeman is Clinical Professor in the Department of Family and Community Medicine at the University of Arizona in Tucson. Dr Howe is a librarian in the Health Sciences Library at the University of Arizona.Includes bibliographical reference

Assessing MyPlate Familiarity and Typical Meal Composition using Food Models in Children Aged 7-13

The Dietary Guidelines for Americans serve as a basis for developing federal nutrition education materials for the public, such as MyPlate. MyPlate is a visual cue that uses food groups as a guide to building healthy plates at mealtime. The objective of this study was to determine factors associated with child familiarity with MyPlate guidelines and to determine if typical meals met MyPlate guidelines using food models. A convenience sample of 250 children (aged 7-13 years) and their parent/guardian were recruited at a local science and history museum. Children viewed a picture of the MyPlate icon and were asked to identify the picture. Next, participants used a nine-inch plate to build a typical meal (meals that they would regularly consume) from a buffet of food and beverages models (>65 items to choose from). Research team members took photographs of the plates. A Registered Dietitian Nutritionist determined the percentage of plates that met MyPlate guidelines. Eighty-six percent of children recognized the MyPlate icon upon viewing the image; 7.6% could accurately identify the icon by name. When participants were asked to build a typical meal, however, only 3.43% met MyPlate guidelines. The results of this study suggest that despite being familiar with MyPlate, children built typical meals that did not meet MyPlate guidelines

Book Reviews

Reviews of the following books: The Lobster Coast: Rebels, Rusticators, and the Struggle for Forgotten Frontier by Colin Woodard; Writing on Stone: Scenes from a Maine Island Life by Christina Marsden Gillis; photographs by Peter Ralston and Forward by Philip Conkling; Owascoag, Black Poynt, Mayne: History of Black Point (Scarborough) Maine, ca. 1600-1800: A Narrative by Patricia Bowden Corey; Continental Liar from the State of Maine: James G. Blaine by Neil Rolde; No Flies on Bill : The Story of an Uncontrollable Old Woman, My Grandmother, Ethel Billie Gammon by Darcy Wakefield; An Upriver Passamaquoddy by Allan J. Sockabasin; Rug Hooking in Maine, 1838 - 1940 by Mildred Cole Peladea

Dosimetric Selection for Helical Tomotherapy Based Stereotactic Ablative Radiotherapy for Early-Stage Non-Small Cell Lung Cancer or Lung Metastases

Background No selection criteria for helical tomotherapy (HT) based stereotactic ablative radiotherapy (SABR) to treat early stage non-small cell lung cancer (NSCLC) or solitary lung metastases has been established. In this study, we investigate the dosimetric selection criteria for HT based SABR delivering 70 Gy in 10 fractions to avoid severe toxicity in the treatment of centrally located lesions when adequate target dose coverage is desired. Materials and Methods 78 HT-SABR plans for solitary lung lesions were created to prescribe 70 Gy in 10 fractions to the planning target volume (PTV). The PTV was set to have ≥95% PTV receiving 70 Gy in each case. The cases for which dose constraints for ≥1 OAR could not be met without compromising the target dose coverage were compared with cases for which all target and OAR dose constraints were met. Results There were 23 central lesions for which OAR dose constraints could not be met without compromising PTV dose coverage. Comparing to cases for which optimal HT-based SABR plans were generated, they were associated with larger tumor size (5.72±1.96 cm vs. 3.74±1.49 cm, p\u3c0.0001), higher lung dose, increased number of immediately adjacent OARs ( 3.45±1.34 vs. 1.66±0.81, p\u3c0.0001), and shorter distance to the closest OARs (GTV: 0.26±0.22 cm vs. 0.88±0.54 cm, p\u3c0.0001; PTV 0.19±0.18 cm vs. 0.48±0.36 cm, p = 0.0001). Conclusion Delivery of 70 Gy in 10 fractions with HT to meet all the given OAR and PTV dose constraints are most likely when the following parameters are met: lung lesions ≤3.78 cm (11.98 cc), ≤2 immediately adjacent OARs which are ≥0.45 cm from the gross lesion and ≥0.21 cm from the PTV

A Scoping Review of Health Research with Racially/Ethnically Minoritized Adults with Intellectual and Developmental Disabilities

Living with intersectional identities, having a disability, and being a member of a racial or ethnic minoritized group in the U.S., contributes to marginalization that may result in health disparities and health inequities. The purpose of this scoping review is to describe health research regarding adult racial/ethnic minoritized individuals in the U.S with intellectual and developmental disabilities (I/DD). Eight electronic databases were searched to identify literature on the topic published since 2000. Of the 5,229 records, 35 articles were included in the review. Eligible studies included research conducted in the U.S., published in English, and research focused on adults with I/DD with race and/or ethnicity information. The 35 articles included racial/ethnic minoritized individuals who were Black, Latinx/Hispanic, American Indian, and Asian. Twenty-nine of the 35 articles identified health disparities experienced by adults with I/DD from racial/ethnic minoritized groups. Many health disparities were demonstrated in the articles, where adult racial/ ethnic minoritized individuals with I/DD fared worse compared to White adults with I/DD. Additionally, four articles describe differences in health experiences by those from racial or ethnic minoritized backgrounds. Results of this scoping review highlight the need for research that incorporates intentional inclusion of racial/ethnic minoritized people with I/DD and include novel methodologies that allow for the contributions of historically marginalized voices. Future research with an intersectionality approach is recommended to promote equity

Parent Involvement in Diet or Physical Activity Interventions to Treat or Prevent Childhood Obesity: An Umbrella Review

Parents substantially influence children’s diet and physical activity behaviors, which consequently impact childhood obesity risk. Given this influence of parents, the objective of this umbrella review was to synthesize evidence on effects of parent involvement in diet and physical activity treatment and prevention interventions on obesity risk among children aged 3–12 years old. Ovid/MEDLINE, Elsevier/Embase, Wiley/Cochrane Library, Clarivate/Web of Science, EBSCO/CINAHL, EBSCO/PsycInfo, and Epistemonikos.org were searched from their inception through January 2020. Abstract screening, full-text review, quality assessment, and data extraction were conducted independently by at least two authors. Systematic reviews and meta-analyses of diet and physical activity interventions that described parent involvement, included a comparator/control, and measured child weight/weight status as a primary outcome among children aged 3–12 years old were included. Data were extracted at the level of the systematic review/meta-analysis, and findings were narratively synthesized. Of 4158 references identified, 14 systematic reviews and/or meta-analyses (eight treatment focused and six prevention focused) were included and ranged in quality from very low to very high. Our findings support the inclusion of a parent component in both treatment and prevention interventions to improve child weight/weight status outcomes. Of note, all prevention-focused reviews included a school-based component. Evidence to define optimal parent involvement type and duration and to define the best methods of involving parents across multiple environments (e.g., home, preschool, school) was inadequate and warrants further research