Characteristics of effective interventions promoting healthy eating for preschoolers in childcare settings: an umbrella review

Early Childhood Education and Care (ECEC) settings have a pivotal role in shaping children’s dietary food habits by providing the contextual environment within which they develop these behaviours. This study examines systematic reviews for (1) the effectiveness of interventions to promote healthy eating in children aged 2–5 years attending centre-based childcare; (2) intervention characteristics which are associated with promoting healthy eating and; (3) recommendations for child-health policies and practices. An Umbrella review of systematic reviews was undertaken using a standardized search strategy in ten databases. Twelve systematic reviews were examined using validated critical appraisal and data extraction tools. Children’s dietary food intake and food choices were significantly influenced. Interventions to prevent obesity did not significantly change children’s anthropometric measures or had mixed results. Evidence was more convincing if interventions were multi-component, addressed physical activity and diet, targeted individual-level and environmental-level determinants and engaged parents. Positive outcomes were mostly facilitated by researchers/external experts and these results were not replicated when implemented in centres by ECEC providers without this support. The translation of expert-led interventions into practice warrants further exploration of implementation drivers and barriers. Based on the evidence reviewed, recommendations are made to inform child-health directed practices and policies

Clinician-targeted interventions to reduce antibiotic prescribing for acute respiratory infections in primary care:An overview of systematic reviews

This is the protocol for a review and there is no abstract. The objectives are as follows: To systematically review the literature and appraise the existing evidence from systematic reviews regarding the effects of interventions, aimed at changing clinician behaviour, to reduce antibiotic prescribing for ARIs in primary care

Utilities associated with subcutaneous injections and intravenous infusions for treatment of patients with bone metastases

Introduction: Although cost−utility models are often used to estimate the value of treatments for metastatic cancer, limited information is available on the utility of common treatment modalities. Bisphosphonate treatment for bone metastases is frequently administered via intravenous infusion, while a newer treatment is administered as a subcutaneous injection. This study estimated the impact of these treatment modalities on health state preference. Methods: Participants from the UK general population completed time trade-off interviews to assess the utility of health state vignettes. Respondents first rated a health state representing cancer with bone metastases. Subsequent health states added descriptions of treatment modalities (ie, injection or infusion) to this basic health state. The two treatment modalities were presented with and without chemotherapy, and infusion characteristics were varied by duration (30 minutes or 2 hours) and renal monitoring. Results: A total of 121 participants completed the interviews (52.1% female, 76.9% white). Cancer with bone metastases had a mean utility of 0.40 on a standard utility scale (1 = full health; 0 = dead). The injection, 30-minute infusion, and 2-hour infusion had mean disutilities of −0.004, −0.02, and −0.04, respectively. The mean disutility of the 30-minute infusion was greater with renal monitoring than without. Chemotherapy was associated with substantial disutility (−0.17). When added to health states with chemotherapy, the mean disutilities of injection, 30-minute infusion, and 2-hour infusion were −0.02, −0.03, and −0.04, respectively. The disutility associated with injection was significantly lower than the disutility of the 30-minute and 2-hour infusions (P , 0.05), regardless of chemotherapy status. Conclusion: Respondents perceived an inconvenience with each type of treatment modality, but injections were preferred over infusions. The resulting utilities may be used in cost−utility models examining the value of treatments for the prevention of skeletal-related events in patients with bone metastases

Robust analysis of prokaryotic pangenome gene gain and loss rates with Panstripe

Horizontal gene transfer (HGT) plays a critical role in the evolution and diversification of many microbial species. The resulting dynamics of gene gain and loss can have important implications for the development of antibiotic resistance and the design of vaccine and drug interventions. Methods for the analysis of gene presence/absence patterns typically do not account for errors introduced in the automated annotation and clustering of gene sequences. In particular, methods adapted from ecological studies, including the pangenome gene accumulation curve, can be misleading as they may reflect the underlying diversity in the temporal sampling of genomes rather than a difference in the dynamics of HGT. Here, we introduce Panstripe, a method based on generalized linear regression that is robust to population structure, sampling bias, and errors in the predicted presence/absence of genes. We show using simulations that Panstripe can effectively identify differences in the rate and number of genes involved in HGT events, and illustrate its capability by analyzing several diverse bacterial genome data sets representing major human pathogens.Peer reviewe

Pre-empting loss through ‘fashion memory’: a ‘postconservation’ perspective

Caring for modern materials and technologies used in contemporary fashion can become an archival dilemma, especially for museums collecting the intentionally ephemeral. Degradation becomes a focus, which is often evaluated via scientific research, empirical investigation, and interventional (physical) conservation. Quickening material degradation can often heighten anxiety in conservation and curatorial practice because this can limit the potential use of the artefact. In addition to using traditional modern materials some fashion designers are following sustainable design strategies in textile manufacturing, ones that challenge the growth model. Biodegradable materials have characteristics favoured by some designers, who intend for their creations to remain stable in use and wear before organic disposal. ‘Progressive fashion’ such as this raises questions and the need for new interpretive practices within fashion conservation. This paper examines how modern material degradation can lead to new ‘material relationships’, thus enabling future uses and users and hence allowing different aesthetic views and ‘fashion' memories’ to coexist. A ‘postconservation’ model is to extend the legacy and appreciation of fashion artefacts by moving from a representational conservation approach towards one that embraces documenting and preserving the performative, wearable, and renewable concepts. If a fashion item is designed to degrade, what are the archival implications in conserving, documenting processes and ‘performance’ of the applied characteristics of such artefacts? Methodological approaches using Material Engagement Theory and postphenomenology help to introduce temporal dynamic elements that postmodern materials often show during the transient process of degradation. Object studies of a wild rubber dress designed by Vivienne Westwood and Andreas Kronthaler c.2013, ‘ECCO’-Leather dress by Iris van Herpen, c.2010 and Rootbound #2 dress by Diana Scherer c.2017, highlight notions of pre-empting loss as a collection care approach, illustrating the potential benefits in archiving of the temporal aspects of contemporary fashion. Outcomes indicate creative practices of fashion designers using modern materials cannot be represented as being stable nor neutral

RESULTS FROM RECENT SCIENCE AND TECHNOLOGY INVESTIGATIONS TARGETING CHROMIUM IN THE 100D AREA HANFORD SITE WASHINGTON USA

Sodium dichromate was used in Hanford's 100D Area during the reactor operations period of 1950 to 1964 to retard corrosion in the reactor cooling systems. Some of the sodium dichromate was released to the environment by spills and/or leaks from pipelines used to deliver the chemical to water treatment plants in the area. As a result, hexavalent chromium [Cr(VI)] has migrated through the vadose zone to the groundwater and contaminated nearly 1 km{sup 2} of groundwater to above the drinking water standard of 48 {micro}g/L. Three technology tests have recently been completed in this area to characterize the source area of the plumes and evaluate alternative methods to remove Cr(VI) from groundwater. These are (1) refine the source area of the southern plume; (2) test electrocoagulation as an alternative groundwater treatment technology; and (3) test the ability to repair a permeable reactive barrier by injecting micron or nanometer-size zero-valent iron (ZVI). The projects were funded by the US Department of Energy as part of a program to interject new technologies and accelerate active cleanup. Groundwater monitoring over the past 10 years has shown that Cr(VI) concentrations in the southern plume have not significantly diminished, strongly indicating a continuing source. Eleven groundwater wells were installed in 2007 and 2008 near a suspected source area and monitored for Cr(VI) and groundwater levels. Interpretation of these data has led to refinement of the source area location to an area of less than 1 hectare (ha, 2.5 acres). Vadose zone soil samples collected during drilling did not discover significant concentrations of Cr(VI), indicating the source is localized, with a narrow wetted path from the surface to the water table. Electrocoagulation was evaluated through a pilot-scale treatability test. Over 8 million liters of groundwater were treated to Cr(VI) concentrations of {le}20 {micro}g/L. The test determined that this technology has the potential to treat Cr(VI) to these low levels, but system reliability and operational complexity rendered electrocoagulation less cost effective than the baseline technology of ion exchange. Laboratory and field tests were conducted to evaluate the practicality of injecting ZVI into the aquifer to increase the lifespan and effectiveness of an existing permeable reactive barrier. From a database of 30 ZVI materials, 6 were chosen and tested in the laboratory to determine their geochemical and physical performance under simulated 100D aquifer conditions. The best-performing ZVI was injected into the aquifer and met the primary goals of communicating the iron at least 7 meters from the injection point and reducing the aquifer to transform mobile Cr(VI) to trivalent chromium Cr(III), which is effectively immobile in the aquifer