How landscapes change: integration of spatial patterns and human processes in temperate landscapes of southern Chile

A comprehensive understanding of the patterns that occur as human processes transform landscapes is necessary for sustainable development. We provide new evidence on how landscapes change by analysing the spatial patterns of human processes in three forest landscapes in southern Chile at different states of alteration (40%&#-90% of old-growth forest loss). Three phases of landscape alteration are distinguished. In Phase I (40%&amp;amp;-65% of old-growth forest loss), deforestation rates are < 1% yr&;8722#1, forests are increasingly degraded, and clearance for pastureland is concentrated on deeper soils. In Phase II (65%&#-80%), deforestation reaches its maximum rate of 1&amp;amp;-1.5% yr&;8722#1, with clearance for pastureland being the main human process, creating a landscape dominated by disturbed forest and shrubland. In this phase, clearance for pastureland is the primary driver of change, with pastures expanding onto poorer soils in more spatially aggregated patterns. In Phase III (80%&#-90%), deforestation rates are again relatively low (<1% yr&;8722#1) and forest regrowth is observed on marginal lands. During this phase, clearance is the dominant process and pastureland is the main land cover. As a forest landscape is transformed, the extent and intensity of human processes vary according to the existing state of landscape alteration, resulting in distinctive landscape patterns in each phase. A relationship between spatial patterns of land cover and human-related processes has been identified along the gradient of landscape alteration. This integrative framework can potentially provide insights into the patterns and processes of dynamic landscapes in other areas subjected to intensifying human use.European ComissionFONDECYT Chil

Families’ perceptions of and experiences related to a pediatric weight management program.

Objective: To examine parents' and children's perceptions of and experiences related to a Parents as Agents of Change (PAC) intervention for managing pediatric obesity. Methods: Ten families were recruited from a PAC intervention. Participants were interviewed before (10 adults and 9 children), during (9 adults and 8 children), and after (8 adults) the intervention. Results: Before the intervention, families reported goals to increase physical activity, plan and eat healthier meals, reduce screen time, and lose weight. During the intervention, families described different approaches to making behavior changes depending on who assumed responsibility (parent, child, or shared responsibility). After the intervention, group setting, goal setting, and portion size activities were viewed positively. Suggestions for improvement included engaging children and reducing intervention length. Conclusions and Implications: Practitioners delivering PAC interventions should discuss families' goals and concerns, and who is responsible for making lifestyle changes. Practical activities are valuable. The length of interventions and engagement of children should be considere

Using First Nations Children\u27s Perceptions of Food and Activity to Inform an Obesity Prevention Strategy

Obesity and associated health risks disproportionately affect Aboriginal (First Nations) children in Canada. The purpose of this research study was to elicit First Nations children’s perceptions of food, activity, and health to inform a community-based obesity prevention strategy. Fifteen 4th- and 5th-Grade students participated in one of three focus group interviews that utilized drawing and pile-sorting activities. We used an ecological lens to structure our findings. Analyses revealed that a variety of interdependent sociocultural factors influenced children’s perceptions. Embedded within a cultural/traditional worldview, children indicated a preference for foods and activities from both contemporary Western and traditional cultures, highlighted family members as their main sources of health information, and described information gaps in their health education. Informed by children’s perspectives, these findings offer guidance for developing an obesity prevention strategy for First Nations children in this community.</jats:p

An evaluation of injurious falls and Fall-Risk-Increasing-Drug (FRID) prescribing in ambulatory care in older adults

Background: Falls are a major public health problem affecting millions of older adults each year. Little is known about FRID prescribing behaviors after injurious falls occur. The primary objective of this study was to investigate whether an injurious fall is associated with being prescribed a new FRID. Methods: We conducted a cross-sectional analysis using data from the National Ambulatory Medical Care Survey (2016). We included visits from patients age ≥ 65 years and classified visits based on presence of an injurious fall. The outcome of interest was prescription of new FRID between those with and without an injurious fall. Multivariable logistic regression weighted for sampling and adjusted for demographics, health history and other medications was used. Age and Alzheimer’s disease were examined as potential effect measure modifiers. Odds ratios and 95% confidence intervals were reported. Bayes factor upper bounds were also reported to quantify whether the data were better predicted by the null hypothesis or the alternative hypothesis. Results: The sample included 239,016,482 ambulatory care visits. 5,095,734 (2.1%) of the visits were related to an injurious fall. An injurious fall was associated with a non-statistically significant increase in odds of at least one new FRID prescription: adjusted OR = 1.6 (95% CI 0.6, 4.0). However, there was non-statistically significant evidence that the association depended on patient age, with OR = 2.6 (95% CI 0.9, 7.4) for ages 65–74 versus OR = 0.4 (95% CI 0.1, 1.6) for ages ≥ 75. In addition to age, Alzheimer’s disease was also identified as a statistically significant effect measure modifier, but stratum specific estimates were not determined due to small sample sizes. Conclusions: Ambulatory care visits involving an injurious fall showed a non-statistically significant increase in odds of generating a new FRID prescription, but this association may depend on age

Soil and crop residue CO2-C emission under tillage systems in sugarcane-producing areas of southern Brazil

Appropriate management of agricultural crop residues could result in increases on soil organic carbon (SOC) and help to mitigate gas effect. To distinguish the contributions of SOC and sugarcane (Saccharum spp.) residues to the short-term CO2-C loss, we studied the influence of several tillage systems: heavy offset disk harrow (HO), chisel plow (CP), rotary tiller (RT), and sugarcane mill tiller (SM) in 2008, and CP, RT, SM, moldboard (MP), and subsoiler (SUB) in 2009, with and without sugarcane residues relative to no-till (NT) in the sugarcane producing region of Brazil. Soil CO2-C emissions were measured daily for two weeks after tillage using portable soil respiration systems. Daily CO2-C emissions declined after tillage regardless of tillage system. In 2008, total CO2-C from SOC and/or residue decomposition was greater for RT and lowest for CP. In 2009, emission was greatest for MP and CP with residues, and smallest for NT. SOC and residue contributed 47 % and 41 %, respectively, to total CO2-C emissions. Regarding the estimated emissions from sugarcane residue and SOC decomposition within the measurement period, CO2-C factor was similar to sugarcane residue and soil organic carbon decomposition, depending on the tillage system applied. Our approach may define new emission factors that are associated to tillage operations on bare or sugarcane-residue-covered soils to estimate the total carbon loss

First-order decay models to describe soil C-CO2 Loss after rotary tillage

To further understand the impact of tillage on CO2 emission, the applicability of two conceptual models was tested, which describe the CO2 emission after tillage as a function of the non-tilled emission plus a correction due to the tillage disturbance. Models assume that C in readily decomposable organic matter follows a first-order reaction kinetics equation as: dCsoil (t) / dt = -k Csoil (t), and that soil C-CO2 emission is proportional to the C decay rate in soil, where Csoil(t) is the available labile soil C (g m-2) at any time (t) and k is the decay constant (time-1). Two possible assumptions were tested to determine the tilled (F T) fluxes: the decay constants (k) of labile soil C before and after tillage are different (Model 1) or not (Model 2). Accordingly, C flux relationships between non-tilled (F NT) and tilled (F T) conditions are given by: F T = F NT + a1 e-a2t (model 1) and F T = a3 F NT e-a4t (model 2), where t is time after tillage. Predicted and observed CO2 fluxes presented good agreement based on the coefficient of determination (R² = 0.91). Model comparison revealed a slightly improved statistical fit of model 2, where all C pools are assigned with the same k constant. Rotary speed was related to increases in the amount of labile C available and to changes of the mean resident labile C pool available after tillage. This approach allows describing the temporal variability of tillage-induced emissions by a simple analytical function, including non-tilled emission plus an exponential term modulated by tillage and environmentally dependent parameters.Para entendimento do impacto do preparo do solo sobre as emissões de CO2 desenvolvemos e aplicamos dois modelos conceituais que são capazes de prever a emissão de CO2 do solo após seu preparo em função da emissão da parcela sem distúrbio, acrescida de uma correção devido ao preparo. Os modelos assumem que o carbono presente na matéria orgânica lábil segue uma cinética de decaimento de primeira ordem, dada pela seguinte equação: dCsoil (t) / dt = -k Csoil (t), e que a emissão de C-CO2 é proporcional a taxa de decaimento do C no solo, onde Csolo(t) é a quantidade de carbono lábil disponível no tempo (t) e k é a constante de decaimento (tempo-1). Duas suposições foram testadas para determinação das emissões após o preparo do solo (Fp): a constante de decaimento do carbono lábil do solo (k) antes e após o preparo é igual (Modelo 1) ou desigual (Modelo 2). Conseqüentemente, a relação entre os fluxos de C das parcelas sem distúrbio (F SD) e onde o preparo do solo foi conduzido (F P) são dadas por: F P = F SD + a1 e-a2t (modelo 1) e F P = a3 F SD e-a4t (modelo 2), onde t é o tempo após o preparo. Fluxos de CO2 previstos e observados relevam um bom ajuste dos resultados com coeficiente de determinação (R²) tão alto quanto 0,91. O modelo 2 produz um ajuste ligeiramente superior quando comparado com o outro modelo. A velocidade das pás da enxada rotativa foi relacionada a um aumento na quantidade de carbono lábil e nas modificações do tempo de residência médio do carbono lábil do solo após preparo. A vantagem desta metodologia é que a variabilidade temporal das emissões induzidas pelo preparo do solo pode ser descrita a partir de uma função analítica simples, que inclui a emissão da parcela sem distúrbio e um termo exponencial modulado por parâmetros dependentes do preparo e de condições ambientais onde o experimento foi conduzido

Quantifying brain development in the HEALthy Brain and Child Development (HBCD) Study: The magnetic resonance imaging and spectroscopy protocol.

The HEALthy Brain and Child Development (HBCD) Study, a multi-site prospective longitudinal cohort study, will examine human brain, cognitive, behavioral, social, and emotional development beginning prenatally and planned through early childhood. The acquisition of multimodal magnetic resonance-based brain development data is central to the study's core protocol. However, application of Magnetic Resonance Imaging (MRI) methods in this population is complicated by technical challenges and difficulties of imaging in early life. Overcoming these challenges requires an innovative and harmonized approach, combining age-appropriate acquisition protocols together with specialized pediatric neuroimaging strategies. The HBCD MRI Working Group aimed to establish a core acquisition protocol for all 27 HBCD Study recruitment sites to measure brain structure, function, microstructure, and metabolites. Acquisition parameters of individual modalities have been matched across MRI scanner platforms for harmonized acquisitions and state-of-the-art technologies are employed to enable faster and motion-robust imaging. Here, we provide an overview of the HBCD MRI protocol, including decisions of individual modalities and preliminary data. The result will be an unparalleled resource for examining early neurodevelopment which enables the larger scientific community to assess normative trajectories from birth through childhood and to examine the genetic, biological, and environmental factors that help shape the developing brain

Genetic insights into resting heart rate and its role in cardiovascular disease

Resting heart rate is associated with cardiovascular diseases and mortality in observational and Mendelian randomization studies. The aims of this study are to extend the number of resting heart rate associated genetic variants and to obtain further insights in resting heart rate biology and its clinical consequences. A genome-wide meta-analysis of 100 studies in up to 835,465 individuals reveals 493 independent genetic variants in 352 loci, including 68 genetic variants outside previously identified resting heart rate associated loci. We prioritize 670 genes and in silico annotations point to their enrichment in cardiomyocytes and provide insights in their ECG signature. Two-sample Mendelian randomization analyses indicate that higher genetically predicted resting heart rate increases risk of dilated cardiomyopathy, but decreases risk of developing atrial fibrillation, ischemic stroke, and cardio-embolic stroke. We do not find evidence for a linear or non-linear genetic association between resting heart rate and all-cause mortality in contrast to our previous Mendelian randomization study. Systematic alteration of key differences between the current and previous Mendelian randomization study indicates that the most likely cause of the discrepancy between these studies arises from false positive findings in previous one-sample MR analyses caused by weak-instrument bias at lower P-value thresholds. The results extend our understanding of resting heart rate biology and give additional insights in its role in cardiovascular disease development

Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

Background Healthy life expectancy (HALE) and disability-adjusted life-years (DALYs) provide summary measures of health across geographies and time that can inform assessments of epidemiological patterns and health system performance, help to prioritise investments in research and development, and monitor progress toward the Sustainable Development Goals (SDGs). We aimed to provide updated HALE and DALYs for geographies worldwide and evaluate how disease burden changes with development. Methods We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015) for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2015. We calculated DALYs by summing years of life lost (YLLs) and years of life lived with disability (YLDs) for each geography, age group, sex, and year. We estimated HALE using the Sullivan method, which draws from age-specific death rates and YLDs per capita. We then assessed how observed levels of DALYs and HALE differed from expected trends calculated with the Socio-demographic Index (SDI), a composite indicator constructed from measures of income per capita, average years of schooling, and total fertility rate. Findings Total global DALYs remained largely unchanged from 1990 to 2015, with decreases in communicable, neonatal, maternal, and nutritional (Group 1) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). Much of this epidemiological transition was caused by changes in population growth and ageing, but it was accelerated by widespread improvements in SDI that also correlated strongly with the increasing importance of NCDs. Both total DALYs and age-standardised DALY rates due to most Group 1 causes significantly decreased by 2015, and although total burden climbed for the majority of NCDs, age-standardised DALY rates due to NCDs declined. Nonetheless, age-standardised DALY rates due to several high-burden NCDs (including osteoarthritis, drug use disorders, depression, diabetes, congenital birth defects, and skin, oral, and sense organ diseases) either increased or remained unchanged, leading to increases in their relative ranking in many geographies. From 2005 to 2015, HALE at birth increased by an average of 2·9 years (95% uncertainty interval 2·9–3·0) for men and 3·5 years (3·4–3·7) for women, while HALE at age 65 years improved by 0·85 years (0·78–0·92) and 1·2 years (1·1–1·3), respectively. Rising SDI was associated with consistently higher HALE and a somewhat smaller proportion of life spent with functional health loss; however, rising SDI was related to increases in total disability. Many countries and territories in central America and eastern sub-Saharan Africa had increasingly lower rates of disease burden than expected given their SDI. At the same time, a subset of geographies recorded a growing gap between observed and expected levels of DALYs, a trend driven mainly by rising burden due to war, interpersonal violence, and various NCDs. Interpretation Health is improving globally, but this means more populations are spending more time with functional health loss, an absolute expansion of morbidity. The proportion of life spent in ill health decreases somewhat with increasing SDI, a relative compression of morbidity, which supports continued efforts to elevate personal income, improve education, and limit fertility. Our analysis of DALYs and HALE and their relationship to SDI represents a robust framework on which to benchmark geography-specific health performance and SDG progress. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform financial and research investments, prevention efforts, health policies, and health system improvement initiatives for all countries along the development continuum. Funding Bill &amp; Melinda Gates Foundation

Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

Background Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures. Methods We estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GBD 2015 estimation processes, as well as data sources, in accordance with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER). Findings Globally, life expectancy from birth increased from 61·7 years (95% uncertainty interval 61·4–61·9) in 1980 to 71·8 years (71·5–72·2) in 2015. Several countries in sub-Saharan Africa had very large gains in life expectancy from 2005 to 2015, rebounding from an era of exceedingly high loss of life due to HIV/AIDS. At the same time, many geographies saw life expectancy stagnate or decline, particularly for men and in countries with rising mortality from war or interpersonal violence. From 2005 to 2015, male life expectancy in Syria dropped by 11·3 years (3·7–17·4), to 62·6 years (56·5–70·2). Total deaths increased by 4·1% (2·6–5·6) from 2005 to 2015, rising to 55·8 million (54·9 million to 56·6 million) in 2015, but age-standardised death rates fell by 17·0% (15·8–18·1) during this time, underscoring changes in population growth and shifts in global age structures. The result was similar for non-communicable diseases (NCDs), with total deaths from these causes increasing by 14·1% (12·6–16·0) to 39·8 million (39·2 million to 40·5 million) in 2015, whereas age-standardised rates decreased by 13·1% (11·9–14·3). Globally, this mortality pattern emerged for several NCDs, including several types of cancer, ischaemic heart disease, cirrhosis, and Alzheimer's disease and other dementias. By contrast, both total deaths and age-standardised death rates due to communicable, maternal, neonatal, and nutritional conditions significantly declined from 2005 to 2015, gains largely attributable to decreases in mortality rates due to HIV/AIDS (42·1%, 39·1–44·6), malaria (43·1%, 34·7–51·8), neonatal preterm birth complications (29·8%, 24·8–34·9), and maternal disorders (29·1%, 19·3–37·1). Progress was slower for several causes, such as lower respiratory infections and nutritional deficiencies, whereas deaths increased for others, including dengue and drug use disorders. Age-standardised death rates due to injuries significantly declined from 2005 to 2015, yet interpersonal violence and war claimed increasingly more lives in some regions, particularly in the Middle East. In 2015, rotaviral enteritis (rotavirus) was the leading cause of under-5 deaths due to diarrhoea (146 000 deaths, 118 000–183 000) and pneumococcal pneumonia was the leading cause of under-5 deaths due to lower respiratory infections (393 000 deaths, 228 000–532 000), although pathogen-specific mortality varied by region. Globally, the effects of population growth, ageing, and changes in age-standardised death rates substantially differed by cause. Our analyses on the expected associations between cause-specific mortality and SDI show the regular shifts in cause of death composition and population age structure with rising SDI. Country patterns of premature mortality (measured as years of life lost [YLLs]) and how they differ from the level expected on the basis of SDI alone revealed distinct but highly heterogeneous patterns by region and country or territory. Ischaemic heart disease, stroke, and diabetes were among the leading causes of YLLs in most regions, but in many cases, intraregional results sharply diverged for ratios of observed and expected YLLs based on SDI. Communicable, maternal, neonatal, and nutritional diseases caused the most YLLs throughout sub-Saharan Africa, with observed YLLs far exceeding expected YLLs for countries in which malaria or HIV/AIDS remained the leading causes of early death. Interpretation At the global scale, age-specific mortality has steadily improved over the past 35 years; this pattern of general progress continued in the past decade. Progress has been faster in most countries than expected on the basis of development measured by the SDI. Against this background of progress, some countries have seen falls in life expectancy, and age-standardised death rates for some causes are increasing. Despite progress in reducing age-standardised death rates, population growth and ageing mean that the number of deaths from most non-communicable causes are increasing in most countries, putting increased demands on health systems. Funding Bill &amp; Melinda Gates Foundation