A global research priority agenda to advance public health responses to fatty liver disease

Background & aims An estimated 38% of adults worldwide have non-alcoholic fatty liver disease (NAFLD). From individual impacts to widespread public health and economic consequences, the implications of this disease are profound. This study aimed to develop an aligned, prioritised fatty liver disease research agenda for the global health community. Methods Nine co-chairs drafted initial research priorities, subsequently reviewed by 40 core authors and debated during a three-day in-person meeting. Following a Delphi methodology, over two rounds, a large panel (R1 n = 344, R2 n = 288) reviewed the priorities, via Qualtrics XM, indicating agreement using a four-point Likert-scale and providing written feedback. The core group revised the draft priorities between rounds. In R2, panellists also ranked the priorities within six domains: epidemiology, models of care, treatment and care, education and awareness, patient and community perspectives, and leadership and public health policy. Results The consensus-built fatty liver disease research agenda encompasses 28 priorities. The mean percentage of ‘agree’ responses increased from 78.3 in R1 to 81.1 in R2. Five priorities received unanimous combined agreement (‘agree’ + ‘somewhat agree’); the remaining 23 priorities had >90% combined agreement. While all but one of the priorities exhibited at least a super-majority of agreement (>66.7% ‘agree’), 13 priorities had 90% combined agreement. Conclusions Adopting this multidisciplinary consensus-built research priorities agenda can deliver a step-change in addressing fatty liver disease, mitigating against its individual and societal harms and proactively altering its natural history through prevention, identification, treatment, and care. This agenda should catalyse the global health community’s efforts to advance and accelerate responses to this widespread and fast-growing public health threat. Impact and implications An estimated 38% of adults and 13% of children and adolescents worldwide have fatty liver disease, making it the most prevalent liver disease in history. Despite substantial scientific progress in the past three decades, the burden continues to grow, with an urgent need to advance understanding of how to prevent, manage, and treat the disease. Through a global consensus process, a multidisciplinary group agreed on 28 research priorities covering a broad range of themes, from disease burden, treatment, and health system responses to awareness and policy. The findings have relevance for clinical and non-clinical researchers as well as funders working on fatty liver disease and non-communicable diseases more broadly, setting out a prioritised, ranked research agenda for turning the tide on this fast-growing public health threat

Reasons for visitor dissatisfaction with wildlife tourism experiences at highly visited national parks in Sri Lanka

Viewing of wildlife is a significant component of Sri Lanka's tourism industry with foreign visitation accounting for the larger share of income derived from national parks. Visitors posting reviews of their experiences in social media and travel websites is a growing global phenomenon. Such reviews serve as reliable and unbiased information sources for potential travellers as well as contemporary travel researchers. This study examined the major causes of visitor dissatisfaction during wildlife tourism experiences at five highly visited NPs in Sri Lanka. We examined 206 negative reviews posted in the travel website TripAdvisor. Analysis found 15 major causes of visitor dissatisfaction with nearly 75% of negative reviews linked to park management related problems, with the remainder stressing tour-operator related issues. Our findings raise concerns that require urgent attention by park management in order to foster more positive visitor experiences and sustainable tourism in popular Sri Lankan national parks Management implications: Managers need to ‘hear’ what tourists are saying with a view to enhancing visitor experiences and improving visitor management in protected areas. Major causes of visitor dissatisfaction are directly under the control of park management or tour operators. Ethical conduct, legal compliance, visitor safety and communication are key areas that need attention. Overcrowded conditions and congestion at wildlife sightings requires the introduction of maximum limits to reduce the number of vehicles entering high visitation parks. Necessary actions include improving professional standards of tour operators and guides via education and training for internal and contracted staff

Reasons for visitor dissatisfaction with wildlife tourism experiences at highly visited national parks in Sri Lanka

Viewing of wildlife is a significant component of Sri Lanka's tourism industry with foreign visitation accounting for the larger share of income derived from national parks. Visitors posting reviews of their experiences in social media and travel websites is a growing global phenomenon. Such reviews serve as reliable and unbiased information sources for potential travellers as well as contemporary travel researchers. This study examined the major causes of visitor dissatisfaction during wildlife tourism experiences at five highly visited NPs in Sri Lanka. We examined 206 negative reviews posted in the travel website TripAdvisor. Analysis found 15 major causes of visitor dissatisfaction with nearly 75% of negative reviews linked to park management related problems, with the remainder stressing tour-operator related issues. Our findings raise concerns that require urgent attention by park management in order to foster more positive visitor experiences and sustainable tourism in popular Sri Lankan national parks Management implications: Managers need to ‘hear’ what tourists are saying with a view to enhancing visitor experiences and improving visitor management in protected areas. Major causes of visitor dissatisfaction are directly under the control of park management or tour operators. Ethical conduct, legal compliance, visitor safety and communication are key areas that need attention. Overcrowded conditions and congestion at wildlife sightings requires the introduction of maximum limits to reduce the number of vehicles entering high visitation parks. Necessary actions include improving professional standards of tour operators and guides via education and training for internal and contracted staff

Lesson Study: professional development (PD) for beginning and experienced teachers

Central in this study is the professional development of beginning and experienced teachers collaborating in Lesson Study teams. Two high school teacher teams participated, a chemistry and a multidisciplinary team. Each team consisted of a beginning and an experienced teacher. Both teams went through the Lesson Study cycle twice. What and from what the beginning and experienced teachers learned, differences in teacher leaning and what Lesson Study elements contributed to this learning were studied in a qualitative multiple case study using interviews, reflective journals, and recordings . The Extended Interconnected Model for Professional Growth was used to interpret teacher learning. Our results show that two Lesson Study teams materialized in which participants shared experiences, thoughts, and ideas related to teaching and learning. Lesson Study contributed to both beginning and experienced teachers’ PCK development. The combination of two phases in this professional development program proved instrumental for this PCK development: a development phase in which participants meet new pedagogies, discuss these in the perspective of student learning, design a lesson plan and prepare for class use. Followed by a class enactment phase where the designed lesson is enacted, students are observed, subsequently salient results are discussed and the lesson plan revised

Metabolic fate of C-14-labelled chlorinated and non-chlorinated fatty acids in goldfish (Carassius auratus)

In order to study the metabolic fate of chlorinated fatty acids in fish, goldfish were fed either 9,10-dichlorostearic acid or oleic acid, chosen as the unchlorinated analogue, both radiolabelled at either the carboxyl (1st) or the terminal (18th) carbon of the fatty acid chain. By keeping the fish in hermetically closed aquaria, all the respired, assimilated and excreted radioactivity could be accounted for. Fish fed 9,10-dichlorostearic acid labelled in the terminal end respired radioactive CO2 to a much lower degree than fish fed the other test compounds. As a consequence, the radioactivity bound in lipids was higher in the group of fish fed dichlorostearic acid labelled in the terminal end. It is suggested that the chlorine atoms in the middle of the carbon chain obstruct the metabolic turn-over of 9,10-dichlorostearic acid, which may have an impact on the residence time of these compounds in the ecosystem