Children’s Food and Drink Purchasing Behaviour ‘‘Beyond the School Gate’’ : The Development of a Survey Module

Copyright © 2013 Wendy J.Wills et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly citedMany children eat a diet which supplies a higher than recommended amount of nonmilk extrinsic sugars and saturated fatty acids. The school setting is often targeted for nutrition intervention as many children consume food at school. In Scotland, attempts have been made to improve the nutritional content of food in schools and attention has now turned to food and drink available “beyond the school gate.” This paper describes the development of a module on food and drink purchasing behaviour. The Food Purchasing Module was designed to collect data, for the first time, from a representative sample of children aged 8–16 years about food and drinks purchased on the way to/from school, during break time/free periods, and at lunchtime, from outlets around schools. Cognitive testing of the module highlighted that younger children find self-completion questionnaires problematic. Older children have fewer problems with self-completion questionnaires butmany do not follow question routing, which has implications for the delivery of future surveys. Development of this survey module adds much needed evidence about effectively involving children in surveys. Further research exploring food and drinks purchased beyond the school gate is needed to continue to improve the nutritional quality of children’s dietsPeer reviewe

Primary cutaneous Epstein-Barr virus-positive diffuse large B-cell lymphoma (DLBCL) in a patient taking fingolimod

A 55-year-old man with relapsing-remitting multiple sclerosis on fingolimod presented to the dermatology clinic with skin lesions on the left temple and cheek. Histopathology showed a diffuse infiltrate of enlarged, atypical lymphocytes throughout the dermis with an overlying grenz zone and a subpopulation of scattered smaller lymphocytes and plasma cells. Epstein-Barr virus-encoded RNA in situ hybridization stain was positive. Based on the morphologic and immunophenotypic findings, a diagnosis of EBV-positive diffuse large B-cell lymphoma was made. This case aims to raise awareness for the dermatologist that patients on fingolimod may be at increased risk of lymphoproliferative disorders

Sustaining the environment and visitor economy in Cornwall

This is the final version.The tourism industry, particularly in rural and coastal areas, is often heavily reliant on thriving ecosystems. Healthy ecosystems bring a range of benefits, not least the provision of food, water, and natural beauty for the visitor and local community alike. However, tourists can threaten the quality of the local environment, and the ‘burden’ of over-tourism is a growing concern in many parts of the world (Wood et al., 2019). The COVID-19 pandemic has heightened concern about the potential for over-tourism in Cornwall, as increasing numbers of people have taken their holidays ‘at home’ in the UK rather than abroad. At the time of writing, summer 2021 looks set to place further pressure on Cornwall’s local environment. However, the impacts of the pandemic also present an opportunity to explore ways of rebuilding the economy and society, to put nature’s recovery centre-stage. Funding from Research England’s Strategic Priorities Fund, administered through the University of Exeter, allowed partners and researchers to conduct a short project (running between January and March 2021) to explore potential policy ideas that could be further developed in the future. Our task was to identify, evaluate, and test the acceptance of locally-relevant evidence based ideas to: (1) Reduce any negative impact of tourism on nature in Cornwall; and (2) Generate understanding, funds, and volunteer time to protect and restore nature in Cornwall. Following a review of potential policy innovations, the partners and additional stakeholders agreed to focus on the development of nature-based activities, funding mechanisms, and appropriate organisational infrastructures to support nature and a sustainable visitor economy. This report outlines findings from investigations into these ideas, including recordings from a workshop, interviews with key stakeholders, and surveys conducted with nature-based activity providers, residents and visitors. Participation in nature-based activities is widely seen as a core attraction of Cornwall’s visitor economy. Ideas for their development initially focused on certification and standards as methods to ensure appropriate visitor engagement with nature, and to generate revenue for nature-focused organisations that would provide the expertise to train activity businesses, in return for qualified promotion. Given the diversity of activity provision and practical difficulty of standards enforcement, the support for such measures was not universal. However, opportunities were identified for training hospitality staff to effectively become front-line marketers for nature-based activities, and in developing nature recovery projects as a new type of attraction to which visitor contributions could produce tangible, shared benefits. Funding mechanisms to support the protection and restoration of nature aroused strong opinions in relation to the recurring topic of a tourism tax. Industry participants made clear their opposition to such a measure. Survey respondents, both residents and visitors, indicated a preference for visitors to contribute in comparison to locals, although the exact mechanism was generally unspecified. Best practice local examples of visitor gifting schemes point towards a solution to suit all parties, and this approach could be developed on a wider scale. Examples of networks at the local, regional, and sectoral scales were discussed, generating a variety of viewpoints about the best model for developing and delivering locally-led nature-based activities and visitor giving. Institutional support was advocated to encourage collaborative local endeavours, with the potential to benefit nature, communities, businesses, and visitors. Development of the rural visitor economy and the emergence of technological infrastructure were also raised as potential routes to mitigate the impact of overtourism and seasonality effects. These approaches have the potential to be further developed.UKRI Strategic Priorities Fun

The impact of changing cigarette smoking habits and smoke-free legislation on orofacial cleft incidence in the United Kingdom: Evidence from two time-series studies

BACKGROUND: Both active and passive cigarette smoking have previously been associated with orofacial cleft aetiology. We aimed to analyse the impact of declining active smoking prevalence and the implementation of smoke-free legislation on the incidence of children born with a cleft lip and/or palate within the United Kingdom. METHODS AND FINDINGS: We conducted regression analysis using national administrative data in the United Kingdom between 2000–2018. The main outcome measure was orofacial cleft incidence, reported annually for England, Wales and Northern Ireland and separately for Scotland. First, we conducted an ecological study with longitudinal time-series analysis using smoking prevalence data for females over 16 years of age. Second, we used a natural experiment design with interrupted time-series analysis to assess the impact of smoke-free legislation. Over the study period, the annual incidence of orofacial cleft per 10,000 live births ranged from 14.2–16.2 in England, Wales and Northern Ireland and 13.4–18.8 in Scotland. The proportion of active smokers amongst females in the United Kingdom declined by 37% during the study period. Adjusted regression analysis did not show a correlation between the proportion of active smokers and orofacial cleft incidence in either dataset, although we were unable to exclude a modest effect of the magnitude seen in individual-level observational studies. The data in England, Wales and Northern Ireland suggested an 8% reduction in orofacial cleft incidence (RR 0.92, 95%CI 0.85 to 0.99; P = 0.024) following the implementation of smoke-free legislation. In Scotland, there was weak evidence for an increase in orofacial cleft incidence following smoke-free legislation (RR 1.16, 95%CI 0.94 to 1.44; P = 0.173). CONCLUSIONS: These two ecological studies offer a novel insight into the influence of smoking in orofacial cleft aetiology, adding to the evidence base from individual-level studies. Our results suggest that smoke-free legislation may have reduced orofacial cleft incidence in England, Wales and Northern Ireland

Socio-economic differences in diet, physical activity and leisure-time screen use among Scottish children in 2006 and 2010: are we closing the gap?

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.Objectives: To investigate socio-economic differences in children’s diet, activity and inactivity and changes in these differences over 4 years during which new policies on food in schools were introduced. Design: Two cross-sectional surveys in which diet was assessed by food frequency questionnaire and physical activity and inactivity were assessed by interviewer-administered questionnaire. Socio-economic status was assessed by the area-based Scottish Index of Multiple Deprivation. Setting: Scotland, 2006 and 2010. Subjects: 1,700 3-17 year olds in 2006 and 1,906 in 2010. Results: In both surveys there were significant linear associations between socio-economic deprivation and intakes of energy, non-milk extrinsic sugars (NMES) as % food energy, sugar-sweetened beverages, confectionery, crisps and savoury snacks and leisure-time screen use (all higher among children in more deprived areas) while intakes of fruit, fruit juice and vegetables showed the opposite trend. In 2010 children in more deprived areas engaged in more physical activity out of school than those in more affluent areas but between 2006 and 2010 there was an overall reduction in physical activity out of school. There was also a small but statistically significant overall reduction in intakes of confectionery, crisps and savoury snacks, energy and NMES and saturated fat as % food energy, but no statistically significant change in socio-economic gradients in diet or activity between the two surveys. Conclusions: Interventions to improve diet and physical activity in children in Scotland need to be designed so as to be effective in all socio-economic groups.Peer reviewedFinal Published versio

Enhancing encapsulation of hydrophobic phyto-drugs naringenin and baicalein in polymeric nano-micelles

Pluronic micelles hold great potential to act as hydrophobic drug delivery carriers; however, there is a pressing need to optimize their use in commercial formulations. This is the first report that describes the loading of phyto-drugs naringenin (NAR) and baicalein (BAC) in different Pluronics F108, F127 and P84 using solvent evaporation method (S.Ev.M) and Direct dissolution method (D.D.M.). Pluronic P84 micelles were able to encapsulate significantly higher amount of both phyto-drugs as compared to other Pluronic micelles. S.Ev.M appreciably enhanced the encapsulation of NAR (19.2 ± 0.438 mg/mL) and BAC (2.593 ± 0.223 mg/mL) compared to D.D.M. (NAR, 10.95 ± 0.212 mg/mL, and BAC, 1.058 ± 0.049 mg/mL) in 5% w/v and 12% w/v Pluronic P84, respectively. SEM (Scanning Electron Microscopy) results showed a spherical morphology after the incorporation of NAR into Pluronic micelles and evidenced that S.Ev.M did not affect the morphology. Sustained release behavior of phyto-drugs was observed from the loaded Pluronic micelles, which was conformed via in vitro release studies. Finally, antioxidant activity was analyzed by ABTS•+ (2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) scavenging assays, with both NAR and BAC loaded P84 micelles (IC50 7.185 and 28.90 μg/mL) showcasing a marked increase in antioxidant properties compared to the pure phyto-drugs NAR and BAC (IC50 13.25 and 53.68 μg/mL) or other Pluronic formulations. Interaction of phyto-drugs and Pluronic P84 has been screened using 1H NMR Spectroscopy (proton nuclear magnetic spectroscopy) and revealed that the whole NAR molecule was encapsulated within the Pluronic micelles. These phyto-drugs hold great potential for use as nutraceuticals and other pharmaceutical applications but currently can't be used due to poor solubilization. Therefore, it can be suggested that preparation of drug loaded Pluronic formulations using S.Ev.M. would be more convenient, fast, and efficient method over D.D.M