Multiple dimensions of wellbeing in practice

In 2005 the Millennium Ecosystem Assessment (MA) placed the relationship between human wellbeing and ecosystems firmly at the centre of the agenda for academics and policy makers concerned with sustainable development for the following decades (MA, 2005). The decision to use the concept of human wellbeing was relatively novel and ambitious at the time. Four years later, that decision was decisively underlined by the Commission on the Measurement of Economic Performance (Stiglitz et al., 2009), commissioned by the then French President Nicolas Sarkozy and chaired by Joe Stiglitz, Amartya Sen and Jean-Paul Fitoussi. This report made a comprehensive case that if we are to achieve sustainable and inclusive development in our societies, then it is necessary to reform our major systems of statistical data collection from being focused on measuring progress in terms of production and consumption, to measuring it in terms of human wellbeing. Since that report there has been an explosion of initiatives to conceptualise and measure human wellbeing, and to put it into practice in academia and policy (Bache and Reardon, 2016; Helliwell et al., 2017)

Projected climate-induced faunal change in the western hemisphere

Climate change is predicted to be one of the greatest drivers of ecological change in the coming century. Increases in temperature over the last century have clearly been linked to shifts in species distributions. Given the magnitude of projected future climatic changes, we can expect even larger range shifts in the coming century. These changes will, in turn, alter ecological communities and the functioning of ecosystems. Despite the seriousness of predicted climate change, the uncertainty in climate-change projections makes it difficult for conservation managers and planners to proactively respond to climate stresses. To address one aspect of this uncertainty, we identified predictions of faunal change for which a high level of consensus was exhibited by different climate models. Specifically, we assessed the potential effects of 30 coupled atmosphere–ocean general circulation model (AOGCM) future-climate simulations on the geographic ranges of 2954 species of birds, mammals, and amphibians in the Western Hemisphere. Eighty percent of the climate projections based on a relatively low greenhouse-gas emissions scenario result in the local loss of at least 10% of the vertebrate fauna over much of North and South America. The largest changes in fauna are predicted for the tundra, Central America, and the Andes Mountains where, assuming no dispersal constraints, specific areas are likely to experience over 90% turnover, so that faunal distributions in the future will bear little resemblance to those of today

Evidence that the AGN dominates the radio emission in z ~ 1 radio-quiet quasars

This document is the Accepted Manuscript version of the following article: Sarah V. White, Matt J. Jarvis, Eleni Kalfoutnzou, Martin J. Hardcastle, Aprajita Verma, Mose M. Cao Orjales, and Jason Stevens, 'Evidence that the AGN dominates the radio emission in z ~ 1 radio quiet quasars', Monthly Notices of the Royal Astronomical Society, first published online 3 February 2017, DOI: https://doi.org/10.1093/mnras/stx284 Key results are presented in Table 4 and Figure 7, which illustrates where the RQQs lie in relation to the far-infrared--radio correlation © 2017 The Authors. Published by Oxford University Press on behalf of the Royal Astronomical Society.In order to understand the role of radio-quiet quasars (RQQs) in galaxy evolution, we must determine the relative levels of accretion and star-formation activity within these objects. Previous work at low radio flux-densities has shown that accretion makes a significant contribution to the total radio emission, in contrast with other quasar studies that suggest star formation dominates. To investigate, we use 70 RQQs from the Spitzer-Herschel Active Galaxy Survey. These quasars are all at $z$ ~ 1, thereby minimising evolutionary effects, and have been selected to span a factor of ~100 in optical luminosity, so that the luminosity dependence of their properties can be studied. We have imaged the sample using the Karl G. Jansky Very Large Array (JVLA), whose high sensitivity results in 35 RQQs being detected above 2 $\sigma$. This radio dataset is combined with far-infrared luminosities derived from grey-body fitting to Herschel photometry. By exploiting the far-infrared--radio correlation observed for star-forming galaxies, and comparing two independent estimates of the star-formation rate, we show that star formation alone is not sufficient to explain the total radio emission. Considering RQQs above a 2-$\sigma$ detection level in both the radio and the far-infrared, 92 per cent are accretion-dominated, and the accretion process accounts for 80 per cent of the radio luminosity when summed across the objects. The radio emission connected with accretion appears to be correlated with the optical luminosity of the RQQ, whilst a weaker luminosity-dependence is evident for the radio emission connected with star formation.Peer reviewedFinal Accepted Versio

Updates in the chronic kidney disease-mineral bone disorder show the role of osteocytic proteins, a potential mechanism of the bone-vascular paradox, a therapeutic target, and a biomarker

The chronic kidney disease-mineral bone disorder (CKD-MBD) is a complex multi-component syndrome occurring during kidney disease and its progression. Here, we update progress in the components of the syndrome, and synthesize recent investigations, which suggest a potential mechanism of the bone-vascular paradox. The discovery that calcified arteries in chronic kidney disease inhibit bone remodeling lead to the identification of factors produced by the vasculature that inhibit the skeleton, thus providing a potential explanation for the bone-vascular paradox. Among the factors produced by calcifying arteries, sclerostin secretion is especially enlightening. Sclerostin is a potent inhibitor of bone remodeling and an osteocyte specific protein. Its production by the vasculature in chronic kidney disease identifies the key role of vascular cell osteoblastic/osteocytic transdifferentiation in vascular calcification and renal osteodystrophy. Subsequent studies showing that inhibition of sclerostin activity by a monoclonal antibody improved bone remodeling as expected, but stimulated vascular calcification, demonstrate that vascular sclerostin functions to brake the Wnt stimulation of the calcification milieu. Thus, the target of therapy in the chronic kidney disease-mineral bone disorder is not inhibition of sclerostin function, which would intensify vascular calcification. Rather, decreasing sclerostin production by decreasing the vascular osteoblastic/osteocytic transdifferentiation is the goal. This might decrease vascular calcification, decrease vascular stiffness, decrease cardiac hypertrophy, decrease sclerostin production, reduce serum sclerostin and improve skeletal remodeling. Thus, the therapeutic target of the chronic kidney disease-mineral bone disorder may be vascular osteoblastic transdifferentiation, and sclerostin levels may be a useful biomarker for the diagnosis of the chronic kidney disease-mineral bone disorder and the progress of its therapy

Autistic adolescents show atypical activation of the brain′s mentalizing system even without a prior history of mentalizing problems

AbstractSome autistic children pass classic Theory of Mind (ToM) tasks that others fail, but the significance of this finding is at present unclear. We identified two such groups of primary school age (labelled ToM+ and ToM−) and a matched comparison group of typically developing children (TD). Five years later we tested these participants again on a ToM test battery appropriate for adolescents and conducted an fMRI study with a story based ToM task. We also assessed autistic core symptoms at these two time points. At both times the ToM− group showed more severe social communication impairments than the ToM+ group, and while showing an improvement in mentalizing performance, they continued to show a significant impairment compared to the NT group. Two independent ROI analyses of the BOLD signal showed activation of the mentalizing network including medial prefrontal cortex, posterior cingulate and lateral temporal cortices. Strikingly, both ToM+ and ToM− groups showed very similar patterns of heightened activation in comparison with the NT group. No differences in other brain regions were apparent. Thus, autistic adolescents who do not have a history of mentalizing problems according to our ToM battery showed the same atypical neurophysiological response during mentalizing as children who did have such a history. This finding indicates that heterogeneity at the behavioural level may nevertheless map onto a similar phenotype at the neuro-cognitive level

Differential Effects of Oral vs. Intravenous Fluid Administration on Bioelectrical Impedance During Dehydration Induced by Exercise and Heat

There is continued debate regarding optimal evaluation of hydration. Bioimpedance analysis has been utilized to evaluate hydration status, but there is limited information regarding the ability of this technology to detect physiological changes occurring during acute dehydration. PURPOSE: To evaluate whether bioimpedance spectroscopy (BIS) detects changes in bioelectrical resistance (R) in response to dehydration induced by exercising in the heat, assess whether these changes are related to body mass changes, and determine if the route of fluid administration during the dehydration protocol influences these observations. METHODS: Twelve males (mean ± SD; age: 28.6 ± 12.4 y; body mass: 74.7 ± 7.9 kg; height: 179.4 ± 7.0 cm; VO2max: 49.8 ± 6.6 mL/kg/min) completed two randomized experimental trials, each consisting of 90 minutes of continuous cycling exercise at 55% VO2maxfollowed by a 12 km time trial in the heat (ambient temperature: 34.9 ± 0.6 °C; relative humidity: 30.3 ± 0.9 %; wind speed: 3.4 mile×h-1). During each trial, fluid was administered either orally (DRINK) or intravenously (IV). During the DRINK trial, participants drank 25 mL of water every 5 minutes. During the IV trial, participants received 25 mL of isotonic saline solution through their IV catheter every 5 minutes. Nude body mass and BIS data were collected before and after trials to assess hydration status. Data were analyzed using Pearson’s correlations and paired t-tests with p-values corrected via false discovery rate. RESULTS: Body mass decreased, without differences between conditions (IV: -2.3 ± 0.5%; DRINK: -2.4 ± 0.9%; p=0.85). However, significant differences were observed for changes in predicted R at zero frequency (R0; IV: -3.6 ± 4.6%; DRINK: 1.3 ± 5.6%; p=0.02) and R at 50 kHz (R50; IV: -3.2 ± 4.1%; DRINK: -0.2 ± 4.1%; p=0.04), without differences in predicted R at infinite frequency (R∞; IV: -2.4 ± 6.1%; DRINK: -1.1 ± 3.7%; p=0.45). In the IV condition, significant correlations between body mass changes and R changes were observed for R0 (r=-0.80; p=0.002), R50 (r=-0.85; p\u3c0.001), and R∞ (r=-0.84; p\u3c0.001); however, no correlations were observed in the DRINK condition (r=-0.06 to 0.13; p≥0.69 for each). CONCLUSION: Differences between oral and intravenous fluid administration were seemingly detected by bioelectrical resistance at low-to-moderate, but not high, frequencies. With intravenous administration, negative correlations between changes in body mass and changes in R at all frequencies were observed, unlike with oral fluid administration. These findings suggest a potential sensitivity of bioimpedance technologies for monitoring intravenous fluid administration in the context of acute dehydration. However, additional investigation is needed to confirm their utility during distinct fluid loss scenarios and to confirm if these technologies are useful in the context of oral intake of fluids varying in composition

Physical Activity and Exercise for Hot Flashes: Trigger or Treatment?

Importance and Objective: Hot flashes (HFs) are a prevalent feature of menopause. Hot flashes can be bothersome and affect quality of life. However, HFs have also been associated with the risk for cardiovascular disease. Therefore, providing current evidence on the effect of therapies to reduce HFs can help patients and providers with decision making. This review provides details on the scientific evidence to date related to the effect of physical activity (PA) and exercise to alter the HF experience in women Methods: The PubMed database was searched between June 2020 and June 2022 for currently available evidence regarding the relation between PA and exercise and HFs. Our analysis included randomized control trials on exercise training, epidemiological studies, and studies evaluating acute exercise on the self-reported and objectively measured HF experience in addition to systematic reviews on the topic published as of June 2022. Discussion and Conclusions: The majority of evidence from randomized control trials indicates that aerobic and resistance exercise training lead to a decrease in subjectively experienced HFs. The limited available studies on acute exercise indicate that a bout of moderate-intensity exercise may decrease objectively measured and self-reported HFs but acute increases in PA intensity above accustomed levels may influence subjective HF experience. Some evidence suggests that for those with depression, habitual PA may be an effective way to reduce HF symptoms. Weighing the avail- able evidence, for people who experience HFs, engaging in regular moderate-intensity PA, including aerobic and resistance exercise, may be an effective therapy to reduce HFs and women should be counseled on the benefits of regular, moderate exercise. However, significant gaps in knowledge remain about the optimal exercise prescription, effectiveness for a diverse population, meaning of differences between objective and subjective experience, and mechanisms that lead to changes in HFs

Planning a method for covariate adjustment in individually randomised trials: a practical guide

Background: It has long been advised to account for baseline covariates in the analysis of confirmatory randomised trials, with the main statistical justifications being that this increases power and, when a randomisation scheme balanced covariates, permits a valid estimate of experimental error. There are various methods available to account for covariates but it is not clear how to choose among them. // Methods: Taking the perspective of writing a statistical analysis plan, we consider how to choose between the three most promising broad approaches: direct adjustment, standardisation and inverse-probability-of-treatment weighting. // Results: The three approaches are similar in being asymptotically efficient, in losing efficiency with mis-specified covariate functions and in handling designed balance. If a marginal estimand is targeted (for example, a risk difference or survival difference), then direct adjustment should be avoided because it involves fitting non-standard models that are subject to convergence issues. Convergence is most likely with IPTW. Robust standard errors used by IPTW are anti-conservative at small sample sizes. All approaches can use similar methods to handle missing covariate data. With missing outcome data, each method has its own way to estimate a treatment effect in the all-randomised population. We illustrate some issues in a reanalysis of GetTested, a randomised trial designed to assess the effectiveness of an electonic sexually transmitted infection testing and results service. // Conclusions: No single approach is always best: the choice will depend on the trial context. We encourage trialists to consider all three methods more routinely

“For review and management”: The role of the referral letter in surgical consultations

Background: The referral letter serves a central role in the transfer of patients from referring doctors to specialist care in Australia. Aim: We analysed the form and function of referral letters and examined their role in surgical consultations to better understand the information in the letter and what impact that may or may not have on consultation openings. Methods: Thirteen referral letters and their associated recorded surgical consultations were analysed with an iterative, multi-methods qualitative approach. Using inductive and deductive linguistic methods, we considered clinical and paraclinical information as well as contextual factors in the letters’ alignment with referral guidelines as well as overall relevance to the consultation. Results: The analysis showed that surgeons tend to have a “set piece” when opening a consultation that is independent of the content or style of the referral. While referral letters fell short of guidelines, additional patient information was frequently discussed in the consultation. Discussion: Patients and surgeons are generally able to work around interactional challenges related to patient information. However, recognising the need to supplement referral information particularly around paraclinical information and contextual factors is important. Conclusions: Future changes to referral letter guidelines could reflect these realities