A High Polyphenol Diet Improves Psychological Well-Being: The Polyphenol Intervention Trial (PPhIT).

Mental ill health is currently one of the leading causes of disease burden worldwide. A growing body of data has emerged supporting the role of diet, especially polyphenols, which have anxiolytic and antidepressant-like properties. The aim of the present study was to assess the effect of a high polyphenol diet (HPD) compared to a low polyphenol diet (LPD) on aspects of psychological well-being in the Polyphenol Intervention Trial (PPhIT). Ninety-nine mildly hypertensive participants aged 40-65 years were enrolled in a four-week LPD washout period and then randomised to either an LPD or an HPD for eight weeks. Both at baseline and the end of intervention, participants' lifestyle and psychological well-being were assessed. The participants in the HPD group reported a decrease in depressive symptoms, as assessed by the Beck Depression Inventory-II, and an improvement in physical component and mental health component scores as assessed with 36-Item Short Form Survey. No differences in anxiety, stress, self-esteem or body image perception were observed. In summary, the study findings suggest that the adoption of a polyphenol-rich diet could potentially lead to beneficial effects including a reduction in depressive symptoms and improvements in general mental health status and physical health in hypertensive participants

Relationship between the Mediterranean dietary pattern and musculoskeletal health in children, adolescents, and adults: systematic review and evidence map

Context: An understanding of the modifiable effects of diet on bone and skeletal muscle mass and strength over the life course will help inform strategies to reduce age-related fracture risk. The Mediterranean diet is rich in nutrients that may be important for optimal musculoskeletal health. Objective: The aim of this systematic review was to investigate the relationship between a Mediterranean diet and musculoskeletal outcomes (fracture, bone density, osteoporosis, sarcopenia) in any age group. Data Sources: Ten electronic databases were searched. Study Selection: Randomized controlled trials and prospective cohort studies that investigated a traditional Mediterranean diet, published in any language, were eligible. Studies using other designs or other definitions of the Mediterranean diet were collated separately in an evidence map. Data Extraction: Details on study design, methods, population, dietary intervention or exposure, length of follow-up, and effect on or association with musculoskeletal outcomes were extracted. Results: The search yielded 1738 references. Data from eligible randomized controlled trials (n = 0) and prospective cohort studies (n = 3) were synthesized narratively by outcome for the systematic review. Two of these studies reported on hip fracture incidence, but results were contradictory. A third study found no association between the Mediterranean diet and sarcopenia incidence. Conclusions: Overall, the systematic review and evidence map demonstrate a lack of research to understand the relationship between the Mediterranean diet and musculoskeletal health in all ages. Systematic Review Registration: PROSPERO registration number IDCRD42016037038

Combining qualitative and quantitative understanding for exploring cross-sectoral climate change impacts, adaptation and vulnerability in Europe

Climate change will affect all sectors of society and the environment at all scales, ranging from the continental to the national and local. Decision-makers and other interested citizens need to be able to access reliable science-based information to help them respond to the risks of climate change impacts and assess opportunities for adaptation. Participatory integrated assessment (IA) tools combine knowledge from diverse scientific disciplines, take account of the value and importance of stakeholder ‘lay insight’ and facilitate a two-way iterative process of exploration of ‘what if’s’ to enable decision-makers to test ideas and improve their understanding of the complex issues surrounding adaptation to climate change. This paper describes the conceptual design of a participatory IA tool, the CLIMSAVE IA Platform, based on a professionally facilitated stakeholder engagement process. The CLIMSAVE (climate change integrated methodology for cross-sectoral adaptation and vulnerability in Europe) Platform is a user-friendly, interactive web-based tool that allows stakeholders to assess climate change impacts and vulnerabilities for a range of sectors, including agriculture, forests, biodiversity, coasts, water resources and urban development. The linking of models for the different sectors enables stakeholders to see how their interactions could affect European landscape change. The relationship between choice, uncertainty and constraints is a key cross-cutting theme in the conduct of past participatory IA. Integrating scenario development processes with an interactive modelling platform is shown to allow the exploration of future uncertainty as a structural feature of such complex problems, encouraging stakeholders to explore adaptation choices within real-world constraints of future resource availability and environmental and institutional capacities, rather than seeking the ‘right’ answers

Prognostic factors affecting survival after surgical resection of gastrointestinal stromal tumours: a two-unit experience over 10 years

BACKGROUND: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal neoplasm of the gastrointestinal (GI) tract which has only been recently described based on their specific immunohistochemistry and the presence of particular KIT-related mutations which potentially make them targets for tyrosine kinase inhibition. METHODS: Sixty-one patients (29 M; 32 F, median age 60 years; range: 23–86 years) between June 1994 and March 2005, were analyzed from two allied institutions. Patient, tumour, and treatment variables were analyzed to identify factors affecting survival. RESULTS: Of the 61 patients, 55 (90%) underwent complete surgical resection of macroscopic disease. The 5-year overall survival (OS) rate in the 61 patients was 88% and the 5-year disease-free survival (DFS) in the 55 cases completely resected was 75%. Univariate analysis revealed that R0 resection was strongly associated with a better OSrate (p < 0.0001). Likewise, univariate analysis also showed high mitotic count of > 10 mitoses/per 50 HPF was a significant variable in worse prognosis for OS (≤ 10 mitoses/per 50 HPF 95% 5-year OS vs. > 10 mitoses/per 50 HPF 74% 5-year OS, respectively; p = 0.013). On subsequent multivariate analysis, only high mitotic count remained as a significant negative prognostic variable for OS (p = 0.029). Among patients resected for cure, there were 8 recurrences during follow-up. The mean time to recurrence was 21 ± 10 months (range: 4–36 months). Univariate analysis revealed that mitotic count of > 10 mitoses per 50 high power fields, intratumoural necrosis, and pathological tumour size (> 10 cm in maximal diameter) significantly correlated with DFS (p = 0.006, 0.002 and 0.02, respectively), with tumour necrosis and high mitotic count remaining as independent predictive variables affecting prognosis on subsequent multivariate analysis. CONCLUSION: Most GISTs are resectable with survival principally dependent upon mitotic count and completeness of resection. Future metabolic and genetic analyses will define the role of and resistance to induction or postoperative adjuvant targeted kinase inhibition therapy

The Adaptive Marine Policy (AMP) toolbox: Supporting policy-makers developing adaptive policies in the Mediterranean and Black Sea

Adaptive management is essential to the practical application of the Ecosystem-Based Approach (EBA). Despite there are frequent assertions that adaptive management is being used, evidence on its success is still limited. Indeed, it is difficult to bring the different elements of adaptive management together in a robust way and to choose the appropriate tools to do it. Therefore, it is necessary to provide a practical framework for adaptive policy action, consistent with the EBA. Accordingly, to operationalize the design and implementation of adaptive policies on the basis of the EBA, the Adaptive Marine Policy toolbox has been developed. The objective of the toolbox is to provide policy-makers a practical framework to design and implement adaptive policies. To show the functionality of the toolbox, the guidelines and resources provided within the toolbox have been applied to the marine litter issue in the Mediterranean and Black Sea as an example. The example application has shown that the toolbox is a useful and operational framework to build a science-policy interface according to the EBA. Despite some resources could be missing from the toolbox, they provide a practical and useful starting point to support the application of the different steps and key activities

Adherence to a Mediterranean-like dietary pattern in children from eight European countries : the IDEFICS study

BACKGROUND: Despite documented benefits of a Mediterranean-like dietary pattern, there is a lack of knowledge about how children from different European countries compare with each other in relation to the adherence to this pattern. In response to this need, we calculated the Mediterranean diet score (MDS) in 2-9-year-old children from the Identification and prevention of dietary-and lifestyle-induced health effects in children and infants (IDEFICS) eight-country study. SUBJECTS AND METHODS: Using 24 h dietary recall data obtained during the IDEFICS study (n = 7940), an MDS score was calculated based on the age- and sex-specific population median intakes of six food groups (vegetables and legumes, fruit and nuts, cereal grains and potatoes, meat products and dairy products) and the ratio of unsaturated to saturated fats. For fish and seafood, which was consumed by 10% of the population, one point was given to consumers. The percentages of children with high MDS levels (43) were calculated and stratified by sex, age and by having at least one migrant parent or both native parents. Demographic (sex and age) and socioeconomic characteristics (parental education and income) of children showing high (43) vs low (<= 3) MDS levels were examined. RESULTS: The highest prevalence of children with MDS 43 was found among the Italian pre-school boys (55.9%) and the lowest among the Spanish school-aged girls (26.0%). Higher adherence to a Mediterranean-like dietary pattern was not associated with living in a Mediterranean country or in a highly educated or high-income family, although with some exceptions. Differences in adherence between boys and girls or age groups varied between countries without any general pattern. CONCLUSIONS: With the exception of Italian pre-schoolers, similar adherence levels to a Mediterranean-like dietary pattern have been observed among European children