A cross sectional study investigating the association between exposure to food outlets and childhood obesity in Leeds, UK.

Background: Current UK policy in relation to the influence of the ‘food environment’ on childhood obesity appears to be driven largely on assumptions or speculations because empirical evidence is lacking and findings from studies are inconsistent. The aim of this study was to investigate the number of food outlets and the proximity of food outlets in the same sample of children, without solely focusing on fast food. Methods: Cross sectional study over 3 years (n = 13,291 data aggregated). Body mass index (BMI) was calculated for each participant, overweight and obesity were defined as having a BMI >85th (sBMI 1.04) and 95th (sBMI 1.64) percentiles respectively (UK90 growth charts). Home and school neighbourhoods were defined as circular buffers with a 2 km Euclidean radius, centred on these locations. Commuting routes were calculated using the shortest straight line distance, with a 2 km buffer to capture varying routes. Data on food outlet locations was sourced from Leeds City Council covering the study area and mapped against postcode. Food outlets were categorised into three groups, supermarkets, takeaway and retail. Proximity to the nearest food outlet in the home and school environmental domain was also investigated. Age, gender, ethnicity and deprivation (IDACI) were included as covariates in all models. Results: There is no evidence of an association between the number of food outlets and childhood obesity in any of these environments; Home Q4 vs. Q1 OR = 1.11 (95% CI = 0.95-1.30); School Q4 vs. Q1 OR = 1.00 (95% CI 0.87 – 1.16); commute Q4 vs. Q1 OR = 0.1.00 (95% CI 0.83 – 1.20). Similarly there is no evidence of an association between the proximity to the nearest food outlet and childhood obesity in the home (OR = 0.77 [95% CI = 0.61 – 0.98]) or the school (OR = 1.01 [95% CI 0.84 – 1.23]) environment. Conclusions: This study provides little support for the notion that exposure to food outlets in the home, school and commuting neighbourhoods increase the risk of obesity in children. It seems that the evidence is not well placed to support Governmental interventions/recommendations currently being proposed and that policy makers should approach policies designed to limit food outlets with caution

Pharmacist-led adherence support in general practice: a qualitative interview study of adults with asthma.

OBJECTIVES: The National Health Service (NHS) in England recently introduced general practice pharmacists (GPPs) to provide medication-focused support to both patients and the general practice team. This healthcare model may benefit people with asthma, who currently receive suboptimal care and demonstrate low medication adherence. This study aimed to explore the perspectives of adults with asthma on the potential for pharmacist-led adherence support delivered in general practice, with a focus on how these perspectives are formed. DESIGN AND SETTING: The study was conducted in the United Kingdom (UK) utilising a qualitative interview methodology. Participants were invited to partake in a telephone-based semistructured interview, followed by an online questionnaire for demographic details and asthma history. Qualitative data were analysed using thematic analysis. PARTICIPANTS: Participants (n=17) were adults with asthma in the UK with a prescription for an inhaled corticosteroid. Participants did not have previous experience with GPPs and were asked to provide their views on a proposed GPP-led service. RESULTS: Participant perspectives of GPPs were determined by trust in pharmacists, perceived gaps in asthma care and the perceived strain on the NHS. Trust was based on pharmacists' perceived clinical competency, established over time, and gauged through a 'benchmarking' process. GPP's fit in current asthma care was assessed based on potential role overlap with other healthcare professionals, continuity of care and medication-related support needs. Participants navigated the NHS based on a perceived hierarchy of healthcare professionals (general practitioners on top, nurses, then pharmacists), and this influenced their perspectives of GPPs. CONCLUSION: While the GPP scheme shows promise based on the perspectives of people with asthma, the identified barriers to optimal patient engagement and service implementation will need to be addressed for the service to be effective.The research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care North Thames at Barts Health NHS Trust

A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control.

BACKGROUND: Historically, the focus of Non Communicable Disease (NCD) prevention and control has been cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), cancer and chronic respiratory diseases. Collectively, these account for more deaths than any other NCDs. Despite recent calls to include the common mental disorders (CMDs) of depression and anxiety under the NCD umbrella, prevention and control of these CMDs remain largely separate and independent. DISCUSSION: In order to address this gap, we apply a framework recently proposed by the Centers for Disease Control with three overarching objectives: (1) to obtain better scientific information through surveillance, epidemiology, and prevention research; (2) to disseminate this information to appropriate audiences through communication and education; and (3) to translate this information into action through programs, policies, and systems. We conclude that a shared framework of this type is warranted, but also identify opportunities within each objective to advance this agenda and consider the potential benefits of this approach that may exist beyond the health care system

Laser Ultrasonic Thermoelastic/Ablation Generation with Laser Interferometric Detection in Graphite/Polymer Composites

Ultrasonic signals have been generated and detected in graphite/polymer composites by optical methods. A Doppler interferometric technique was used for detection. The output voltage of this type of interferometer is proportional to the surface velocity of a sample area which is illuminated by cw laser light. Ultrasonic signals were generated by thermoelastic and ablation processes which occur as a consequence of laser pulses incident on the opposite surface of the sample. The evolution of the magnitude and shape of the detected signals was measured as a function of the pulse energy of the generating laser. Low-energy laser pulses generated ultrasound without causing obvious surface damage. At higher energies surface damage was observable in post inspection but could also be detected by observing (through protective goggles) bright flashes near the illuminated area. The energy at which these processes first occur is qualitatively referred to as the ablation threshold. Changes in the observed waveform were evident at energies above the ablation threshold. The higher-energy waveforms were found to consist of a superposition of a thermoelastic component and an ablatic component, whose relative magnitudes changed with laser power. A delay in the initiation of the ablatic wave relative to the thermoelastic wave was observed to be of the order of 0.3 μs, consistent with observations in pure polymer. [1] Photoelectric detection measurements of the ablation plume also showed a clear threshold and a time scale for growth of the ablation products with a characteristic time scale on the order of 0.3 μs

On-site sanitation density and groundwater quality: Evidence from remote sensing and in situ observations in the thiaroye aquifer, Senegal

© 2020 The Authors. In rapidly urbanising low-income towns and cities, there remains an absence of scientific evidence and regulatory structures to sustain the quality and quantity of groundwater used for low-cost water supplies and to reconcile this with continued use of the subsurface for low-cost sanitation. Here, we analyse the relationship between the density of on-site sanitation and shallow groundwater quality in the Thiaroye aquifer of Quaternary sands in Dakar, Senegal. On-site sanitation was mapped using object-oriented classification and visual interpretation of high-resolution, optical satellite images and ground-truthing surveys. Groundwater quality was assessed over a three-year period (2017–2019) from a network of 61 sources comprising boreholes, dug-wells, hand tubewells and piezometers. More than 253,000 on-site sanitation facilities are identified over an area of 520 km2 with densities ranging from 1 to 70 per hectare. A moderate, statistically significant linear relationship (r2 = 0.55, p « 0.01) is found between the density of on-site sanitation facilities and nitrate concentrations in sampled groundwater sources. Groundwater contamination beyond the WHO drinking-water guideline value (50 mg/L) occurs where densities of on-site sanitation facilities exceed 4 (±4) per hectare, a threshold commonly surpassed in peri-urban areas underlain by the Thiaroye aquifer of Dakar

A Content Analysis of Social Media Discussions on THC-OAcetate

Novel cannabinoids require systematic research to inform policies and practices. There is a growing interest in semi-synthetic cannabinoids by consumers, manufacturers, and regulators. However, there is a scarcity of research on these substances. Online discussion forums can provide guidance for research questions when current knowledge is scarce. The current project investigates the topics and issues covered in a social media forum devoted to THC-O-acetate (THCO), a semi-synthetic cannabinoid with rapidly rising popularity. Reddit comments posted on the THCO subreddit from June 2021 through November 2021 were coded for major and minor themes by a team of five coders and a supervisor. Major themes were established and clarified through group discussions. A second round of coding confirmed major themes and identified minor themes. The analysis identified several future research topics for THC-O-acetate, including the extent of variation in product composition, the characteristics of user experiences and comparisons with other substances, whether THC-O-acetate produces psychedelic effects, concerns and adverse experiences, and user harm reduction practices. As an acetate ester, THC-O-acetate may break down when heated and release toxic ketene gas. Although several users expressed safety concerns regarding THC-O-acetate, some explicitly mentioning ketene risk, the most common administration method reported was heated inhalation

Testing KiDS cross-correlation redshifts with simulations

Measuring cosmic shear in wide-field imaging surveys requires accurate knowledge of the redshift distribution of all sources. The clustering-redshift technique exploits the angular cross-correlation of a target galaxy sample with unknown redshifts and a reference sample with known redshifts. It represents an attractive alternative to colour-based methods of redshift calibration. Here we test the performance of such clustering redshift measurements using mock catalogues that resemble the Kilo-Degree Survey (KiDS). These mocks are created from the MICE simulation and closely mimic the properties of the KiDS source sample and the overlapping spectroscopic reference samples. We quantify the performance of the clustering redshifts by comparing the cross-correlation results with the true redshift distributions in each of the five KiDS photometric redshift bins. Such a comparison to an informative model is necessary due to the incompleteness of the reference samples at high redshifts. Clustering mean redshifts are unbiased at |Δz|< 0.006 under these conditions. The redshift evolution of the galaxy bias of the reference and target samples represents one of the most important systematic errors when estimating clustering redshifts. It can be reliably mitigated at this level of precision using auto-correlation measurements and self-consistency relations, and will not become a dominant source of systematic error until the arrival of Stage-IV cosmic shear surveys. Using redshift distributions from a direct colour-based estimate instead of the true redshift distributions as a model for comparison with the clustering redshifts increases the biases in the mean to up to |Δz|∼0.04. This indicates that the interpretation of clustering redshifts in real-world applications will require more sophisticated (parameterised) models of the redshift distribution in the future. If such better models are available, the clustering-redshift technique promises to be a highly complementary alternative to other methods of redshift calibration

In-situ fluorescence spectroscopy indicates total bacterial abundance and dissolved organic carbon

We explore in-situ fluorescence spectroscopy as an instantaneous indicator of total bacterial abundance and faecal contamination in drinking water. Eighty-four samples were collected outside of the recharge season from groundwater-derived water sources in Dakar, Senegal. Samples were analysed for tryptophan-like (TLF) and humic-like (HLF) fluorescence in-situ, total bacterial cells by flow cytometry, and potential indicators of faecal contamination such as thermotolerant coliforms (TTCs), nitrate, and in a subset of 22 samples, dissolved organic carbon (DOC). Significant single-predictor linear regression models demonstrated that total bacterial cells were the most effective predictor of TLF, followed by on-site sanitation density; TTCs were not a significant predictor. An optimum multiple-predictor model of TLF incorporated total bacterial cells, nitrate, nitrite, on-site sanitation density, and sulphate (r2 0.68). HLF was similarly related to the same parameters as TLF, with total bacterial cells being the best correlated (ρs 0.64). In the subset of 22 sources, DOC clustered with TLF, HLF, and total bacterial cells, and a linear regression model demonstrated HLF was the best predictor of DOC (r2 0.84). The intergranular nature of the aquifer, timing of the study, and/or non-uniqueness of the signal to TTCs can explain the significant associations between TLF/HLF and indicators of faecal contamination such as on-site sanitation density and nutrients but not TTCs. The bacterial population that relates to TLF/HLF is likely to be a subsurface community that develops in-situ based on the availability of organic matter originating from faecal sources. In-situ fluorescence spectroscopy instantly indicates a drinking water source is impacted by faecal contamination but it remains unclear how that relates specifically to microbial risk in this setting

Effectiveness of moving on: an Australian designed generic self-management program for people with a chronic illness

Background: This paper presents the evaluation of “Moving On”, a generic self-management program for people with a chronic illness developed by Arthritis NSW. The program aims to help participants identify their need for behavior change and acquire the knowledge and skills to implement changes that promote their health and quality of life. Method: A prospective pragmatic randomised controlled trial involving two group programs in community settings: the intervention program (Moving On) and a control program (light physical activity). Participants were recruited by primary health care providers across the north-west region of metropolitan Sydney, Australia between June 2009 and October 2010. Patient outcomes were self-reported via pre- and post-program surveys completed at the time of enrolment and sixteen weeks after program commencement. Primary outcomes were change in self-efficacy (Self-efficacy for Managing Chronic Disease 6-Item Scale), self-management knowledge and behaviour and perceived health status (Self-Rated Health Scale and the Health Distress Scale). Results: A total of 388 patient referrals were received, of whom 250 (64.4%) enrolled in the study. Three patients withdrew prior to allocation. 25 block randomisations were performed by a statistician external to the research team: 123 patients were allocated to the intervention program and 124 were allocated to the control program. 97 (78.9%) of the intervention participants commenced their program. The overall attrition rate of 40.5% included withdrawals from the study and both programs. 24.4% of participants withdrew from the intervention program but not the study and 22.6% withdrew from the control program but not the study. A total of 62 patients completed the intervention program and follow-up evaluation survey and 77 patients completed the control program and follow- up evaluation survey. At 16 weeks follow-up there was no significant difference between intervention and control groups in self-efficacy; however, there was an increase in self-efficacy from baseline to follow-up for the intervention participants (t=−1.948, p=0.028). There were no significant differences in self-rated health or health distress scores between groups at follow-up, with both groups reporting a significant decrease in health distress scores. There was no significant difference between or within groups in self-management knowledge and stage of change of behaviours at follow-up. Intervention group attenders had significantly higher physical activity (t=−4.053, p=0.000) and nutrition scores (t=2.315, p= 0.01) at follow-up; however, these did not remain significant after adjustment for covariates. At follow-up, significantly more participants in the control group (20.8%) indicated that they did not have a self-management plan compared to those in the intervention group (8.8%) (X2=4.671, p=0.031). There were no significant changes in other self-management knowledge areas and behaviours after adjusting for covariates at follow-up. Conclusions: The study produced mixed findings. Differences between groups as allocated were diluted by the high proportion of patients not completing the program. Further monitoring and evaluation are needed of the impact and cost effectiveness of the program. Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN1260900029821

Radioactive 26Al and massive stars in the Galaxy

Gamma-rays from radioactive 26Al (half life ~7.2 10^5 yr) provide a 'snapshot' view of ongoing nucleosynthesis in the Galaxy. The Galaxy is relatively transparent to such gamma-rays, and emission has been found concentrated along the plane of the Galaxy. This led to the conclusion1 that massive stars throughout the Galaxy dominate the production of 26Al. On the other hand, meteoritic data show locally-produced 26Al, perhaps from spallation reactions in the protosolar disk. Furthermore, prominent gamma-ray emission from the Cygnus region suggests that a substantial fraction of Galactic 26Al could originate in localized star-forming regions. Here we report high spectral resolution measurements of 26Al emission at 1808.65 keV, which demonstrate that the 26Al source regions corotate with the Galaxy, supporting its Galaxy-wide origin. We determine a present-day equilibrium mass of 2.8 (+/-0.8) M_sol of 26Al. We use this to estimate that the frequency of core collapse (i.e. type Ib/c and type II) supernovae to be 1.9(+/- 1.1) events per century.Comment: accepted for publication in Nature, 24 pages including Online Supplements, 11 figures, 1 tabl