Access to healthy foods: Part I. Barriers to accessing healthy foods: Differentials by gender, social class, income and mode of transport

This paper examines the issues of access to food and the influences people face when shopping for a healthy food basket. It uses data from the Health Edu cation Authority's 1993 Health and Lifestyles Survey to examine the barriers people face in accessing a healthy diet. The main findings are that access to food is primarily determined by income, and this is in turn closely related to physical resources available to access healthy food. There is an associated class bias over access to sources of healthy food. The poor have less access to a car, find it harder to get to out-of-town shopping centres and thus are less able to carry and transport food in bulk. The majority of people shop in supermarkets as they report that local shops do not provide the services people demand and that food choice and quality are limited. In tackling food poverty and pro moting healthy eating, health promotion practice needs to address these struc tural issues as opposed to relying on psycho-social models of education based on the provision of information and choice

Theorizing black (African) transnational masculinities

Just as masculinity is crucial in the construction of nationhood, masculinity is also significant in the making and unmaking of transnational communities. This article focuses on how black African men negotiate and perform respectable masculinity in transnational settings such as the workplace, community and family. Moving away from conceptualizations of black transnational forms of masculinities as in perpetual crisis and drawing on qualitative data collected from members of the new African diaspora in London, the article explores the diverse ways notions of masculinity and gender identities are being challenged, re-affirmed and reconfigured. The article argues that men experience a loss of status as breadwinners and a rupture of their sense of masculine identity in the reconstruction of life in the diaspora. Conditions in the hostland, in particular, women's breadwinner status and the changing gender relations, threaten men’s ‘hegemonic masculinity’ and consequently force men to negotiate respectable forms of masculinity

“Lest we forget” : An overview of Australia’s response to the recovery and identification of unrecovered historic military remains

Peer reviewedPostprin

NeuroSAFE PROOF randomised controlled feasibility study: brief report of perioperative outcomes, histological concordance, and feasibility

No abstract available

Cross-sectional and longitudinal neuroanatomical profiles of distinct clinical (adaptive) outcomes in autism

Individuals with autism spectrum disorder (henceforth referred to as autism) display significant variation in clinical outcome. For instance, across age, some individuals’ adaptive skills naturally improve or remain stable, while others’ decrease. To pave the way for ‘precision-medicine’ approaches, it is crucial to identify the cross-sectional and, given the developmental nature of autism, longitudinal neurobiological (including neuroanatomical and linked genetic) correlates of this variation. We conducted a longitudinal follow-up study of 333 individuals (161 autistic and 172 neurotypical individuals, aged 6–30 years), with two assessment time points separated by ~12–24 months. We collected behavioural (Vineland Adaptive Behaviour Scale-II, VABS-II) and neuroanatomical (structural magnetic resonance imaging) data. Autistic participants were grouped into clinically meaningful “Increasers”, “No-changers”, and “Decreasers” in adaptive behaviour (based on VABS-II scores). We compared each clinical subgroup’s neuroanatomy (surface area and cortical thickness at T1, ∆T (intra-individual change) and T2) to that of the neurotypicals. Next, we explored the neuroanatomical differences’ potential genomic associates using the Allen Human Brain Atlas. Clinical subgroups had distinct neuroanatomical profiles in surface area and cortical thickness at baseline, neuroanatomical development, and follow-up. These profiles were enriched for genes previously associated with autism and for genes previously linked to neurobiological pathways implicated in autism (e.g. excitation-inhibition systems). Our findings suggest that distinct clinical outcomes (i.e. intra-individual change in clinical profiles) linked to autism core symptoms are associated with atypical cross-sectional and longitudinal, i.e. developmental, neurobiological profiles. If validated, our findings may advance the development of interventions, e.g. targeting mechanisms linked to relatively poorer outcomes

Relationship between bacterial strain type, host biomarkers, and mortality in clostridium difficile infection

Background: Despite substantial interest in biomarkers, their impact on clinical outcomes and variation with bacterial strain has rarely been explored using integrated databases. Methods: From September 2006 to May 2011, strains isolated from Clostridium difficile toxin enzyme immunoassay (EIA)-positive fecal samples from Oxfordshire, United Kingdom (approximately 600 000 people) underwent multilocus sequence typing. Fourteen-day mortality and levels of 15 baseline biomarkers were compared between consecutive C. difficile infections (CDIs) from different clades/sequence types (STs) and EIA-negative controls using Cox and normal regression adjusted for demographic/clinical factors. Results: Fourteen-day mortality was 13% in 2222 adults with 2745 EIA-positive samples (median, 78 years) vs 5% in 20 722 adults with 27 550 EIA-negative samples (median, 74 years) (absolute attributable mortality, 7.7%; 95% CI, 6.4%-9.0%). Mortality was highest in clade 5 CDIs (25% [16 of 63]; polymerase chain reaction (PCR) ribotype 078/ST 11), then clade 2 (20% [111 of 560]; 99% PCR ribotype 027/ST 1) versus clade 1 (12% [137 of 1168]; adjusted P <. 0001). Within clade 1, 14-day mortality was only 4% (3 of 84) in ST 44 (PCR ribotype 015) (adjusted P =. 05 vs other clade 1). Mean baseline neutrophil counts also varied significantly by genotype: 12.4, 11.6, and 9.5 × 109 neutrophils/L for clades 5, 2 and 1, respectively, vs 7.0 × 109 neutrophils/L in EIA-negative controls (P <. 0001) and 7.9 × 109 neutrophils/L in ST 44 (P =. 08). There were strong associations between C. difficile-type-specific effects on mortality and neutrophil/white cell counts (rho = 0.48), C-reactive-protein (rho = 0.43), eosinophil counts (rho =-0.45), and serum albumin (rho =-0.47). Biomarkers predicted 30%-40% of clade-specific mortality differences. Conclusions: C. difficile genotype predicts mortality, and excess mortality correlates with genotype-specific changes in biomarkers, strongly implicating inflammatory pathways as a major influence on poor outcome after CDI. PCR ribotype 078/ST 11 (clade 5) leads to severe CDI; thus ongoing surveillance remains essential

SARS-CoV-2 RNA detected in blood products from patients with COVID-19 is not associated with infectious virus

Background: Laboratory diagnosis of SARS-CoV-2 infection (the cause of COVID-19) uses PCR to detect viral RNA (vRNA) in respiratory samples. SARS-CoV-2 RNA has also been detected in other sample types, but there is limited understanding of the clinical or laboratory significance of its detection in blood. Methods: We undertook a systematic literature review to assimilate the evidence for the frequency of vRNA in blood, and to identify associated clinical characteristics. We performed RT-PCR in serum samples from a UK clinical cohort of acute and convalescent COVID-19 cases (n=212), together with convalescent plasma samples collected by NHS Blood and Transplant (NHSBT) (n=462 additional samples). To determine whether PCR-positive blood samples could pose an infection risk, we attempted virus isolation from a subset of RNA-positive samples. Results: We identified 28 relevant studies, reporting SARS-CoV-2 RNA in 0-76% of blood samples; pooled estimate 10% (95%CI 5-18%). Among serum samples from our clinical cohort, 27/212 (12.7%) had SARS-CoV-2 RNA detected by RT-PCR. RNA detection occurred in samples up to day 20 post symptom onset, and was associated with more severe disease (multivariable odds ratio 7.5). Across all samples collected ≥28 days post symptom onset, 0/494 (0%, 95%CI 0-0.7%) had vRNA detected. Among our PCR-positive samples, cycle threshold (ct) values were high (range 33.5-44.8), suggesting low vRNA copy numbers. PCR-positive sera inoculated into cell culture did not produce any cytopathic effect or yield an increase in detectable SARS-CoV-2 RNA. Conclusions: vRNA was detectable at low viral loads in a minority of serum samples collected in acute infection, but was not associated with infectious SARS-CoV-2 (within the limitations of the assays used). This work helps to inform biosafety precautions for handling blood products from patients with current or previous COVID-19

Vegetation and ecological characteristics of mixed-conifer and Red Fir forests at the Teakettle Experimental Forest

Detailed analysis of mixed-conifer and red fir forests were made from extensive, large vegetation sampling, systematically conducted throughout the Teakettle Experimental Forest. Mixed conifer is characterized by distinct patch conditions of closed-canopy tree clusters, persistent gaps and shrub thickets. This heterogeneous spatial structure provides contrasting microclimate, habitat and resource conditions probably associated with the high diversity of understory plants, fungi, and invertebrates found in ongoing studies in the Teakettle Experiment. In contrast, red fir forests are more homogeneous with continuous high canopy cover, cooler, more consistent microclimate conditions and fewer plant species. In both forests, annual fluctuations in available soil moisture resulting from El Niño influences on snow pack depth may have a significant influence on tree establishment and understory diversity. In depth descriptions of Teakettle’s mixed conifer may provide a target of historic old-growth conditions for forest management

Vegetation and ecological characteristics of mixed-conifer and red fir forests at the Teakettle Experimental Forest

Detailed analysis of mixed-conifer and red fir forests were made from extensive, large vegetation sampling, systematically conducted throughout the Teakettle Experimental Forest. Mixed conifer is characterized by distinct patch conditions of closed-canopy tree clusters, persistent gaps and shrub thickets. This heterogeneous spatial structure provides contrasting microclimate, habitat and resource conditions probably associated with the high diversity of understory plants, fungi, and invertebrates found in ongoing studies in the Teakettle Experiment. In contrast, red fir forests are more homogeneous with continuous high canopy cover, cooler, more consistent microclimate conditions and fewer plant species. In both forests, annual fluctuations in available soil moisture resulting from El Niño influences on snow pack depth may have a significant influence on tree establishment and understory diversity. In depth descriptions of Teakettle’s mixed conifer may provide a target of historic old-growth conditions for forest management