Comparative analysis of ascorbic acid in human milk and infant formula using varied milk delivery systems

<p>Abstract</p> <p>Background</p> <p>The expression of human milk for later use is on the rise. Bottle systems are used to deliver the expressed milk. Research has shown that storage of both human milk and artificial baby milk, or infant formula, leads to a loss of ascorbic acid (commonly called Vitamin C). As milk is removed from the bottle during feeding and replaced by ambient air, it is unknown if loss of ascorbic acid occurs during the course of a feeding. The purpose of this study is to investigate the effect of the milk delivery system on levels of ascorbic acid in human milk and infant formula. The objectives are to 1) determine changes in ascorbic acid concentration during a 20 minute "feed," 2) determine if there is a difference in ascorbic acid concentration between delivery systems, and 3) evaluate if any differences are of clinical importance.</p> <p>Methods</p> <p>Commonly available bottles were used for comparison of bottle delivery systems. Mature human milk was standardized to 42 mg/L of ascorbic acid. Infant formula with iron and infant formula with docosahexanoic acid were used for the formula samples. Each sample was analyzed for ascorbic acid concentration at baseline (0), 5, 10, 15, and 20 minutes. Each collection of samples was completed in triplicate. Samples were analyzed for ascorbic acid using normal-phase high performance liquid chromatography.</p> <p>Results</p> <p>Ascorbic acid concentration declined in all bottle systems during testing, Differences between the bottle systems were noted. Ascorbic acid concentrations declined to less than 40% of recommended daily intake for infants in 4 of the bottles systems at the 20 minute sampling.</p> <p>Conclusion</p> <p>The bottle systems used in this study had measurable decreases in the mean concentration of ascorbic acid. More research is needed to determine if the observed decreases are related to lower plasma ascorbic acid concentration in infants exclusively bottle fed. The decrease of ascorbic acid concentration observed in both human milk and infant formula using varied milk delivery systems may be of clinical importance. For infants who rely solely on bottle feeds there may be increased risk of deficiency. Bottle shape, size, and venting should be considered.</p

Issues in rural adolescent mental health in Australia

The mental health of adolescents living in rural Australia has received little research attention. In this article, the extant literature on rural adolescent mental health in Australia is reviewed. Given the lack of literature on this topic, the review is centered on a vignette presented at the beginning of the article. The case represented by the vignette is that of a young Australian growing up in a rural area. The issues raised – including the nature of mental health issues for rural adolescents and barriers to seeking professional help – are then discussed in terms of the available literature. The article concludes with a future focus for research efforts in the area of rural adolescent mental health.C

Epidemiology of Japanese Encephalitis in the Philippines prior to routine immunization.

BACKGROUND In 2015, we published our findings highlighting the endemicity of Japanese encephalitis (JE) in the Philippines. The policymakers responded by conducting an immunization campaign and strengthening the surveillance system. Using the data on the revitalized surveillance system, we updated the epidemiology of JE in the country METHODS: Electronic databases were searched, and conference proceedings related to JE in the Philippines were identified until 31 December 2018. We used surveillance data from 1 January 2014 to 31 December 2017. We used the 2015 population census to estimate the national and regional incidence for children <15 years old. RESULTS Four studies reported on the seroprevalence of JE in the Philippines, which showed increasing seroprevalence with increasing age. Seroprevalence rates were from zero for infants (<1 year old) to 65.7% in adolescents (12-18 years old) before the immunization campaign. Among five studies on clinical profile JE, case fatality ranged from zero to 21.1%, and neurologic sequelae ranged from 5.2% to 81.8% of diagnosed cases. In the surveillance data, JE cases peaked annually from July to October, coinciding with the wet season. The national incidence was estimated at 0.7 JE cases/100,000 among children <15 years at a minimum, but higher rates were seen in the northern regions of the country. CONCLUSION Improved surveillance affirmed the burden of JE in the Philippines. A subnational immunization campaign in April 2019 was conducted in the northern regions of the country. We highlight the importance of the inclusion of JE vaccine in the immunization program and sustained high-quality surveillance to monitor its impact on JE control

Australian rural adolescents’ experiences of accessing psychological help for a mental health problem

Objective: This study aims to explore Australian rural adolescents’ experiences of accessing help for a mental health problem in the context of their rural communities. Design and setting: A qualitative research design was used whereby university students who had sought help for a mental health problem during their adolescence were interviewed about their experiences. Interviews were conducted face-to-face at the university. Main outcome measures: A semi-structured interview schedule was designed around the study’s main research questions. Audio-taped interviews were transcribed and thematically coded using a constant comparative method. Participants: Participants were first-year undergraduate psychology students between the ages of 17 and 21 years who sought help for a mental health issue during their adolescence and who at that time resided in a rural area. Results: Participants highlighted various barriers to seeking help for mental health problems in the context of a rural community, including: social visibility, lack of anonymity, a culture of self-reliance, and social stigma of mental illness. Participants’ access to help was primarily school-based, and participants expressed a preference for supportive counselling over structured interventions. Characteristics of school-based helpers that made them approachable included: ‘caring’, ‘nonjudgemental’, ‘genuine’, ‘young’, and able to maintain confidentiality. Conclusions: The findings support previous research that reveals barriers to help seeking for mental health problems that are unique to the culture of rural communities. The study raises questions about the merit of delivery of primary mental health care to young people via GPs alone and suggests that school-based counsellors be considered as the first step in a young person’s access to mental health care.C

The Dynamics and Impact of Ocean Acidification and Hypoxia: Insights from Sustained Investigations in the Northern California Current Large Marine Ecosystem

Coastal upwelling ecosystems around the world are defined by wind-generated currents that bring deep, nutrient-rich waters to the surface ocean where they fuel exceptionally productive food webs. These ecosystems are also now understood to share a common vulnerability to ocean acidification and hypoxia (OAH). In the California Current Large Marine Ecosystem (CCLME), reports of marine life die-offs by fishers and resource managers triggered research that led to an understanding of the risks posed by hypoxia. Similarly, unprecedented losses from shellfish hatcheries led to novel insights into the coastal expression of ocean acidification. Partnership for Interdisciplinary Studies of Coastal Oceans (PISCO) scientists and other researchers in the CCLME responded to the rise of OAH with new ocean observations and experiments. This work revealed insights into the expression of OAH as coupled environmental stressors, their temporal and spatial variability, and impacts on species, ecological communities, and fisheries. Sustained investigations also deepened the understanding of connections between climate change and the intensification of hypoxia, and are beginning to inform the ecological and eco-evolutionary processes that can structure responses to the progression of ocean acidification and other pathways of global change. Moreover, because the severity of the die-offs and hatchery failures and the subsequent scientific understanding combined to galvanize public attention, these scientific advances have fostered policy advances. Across the CCLME, policymakers are now translating the evolving scientific understanding of OAH into new management actions

Estimating the abundance of marine mammal populations

Support for this project was provided by the Lenfest Ocean Program.Motivated by the need to estimate the abundance of marine mammal populations to inform conservation assessments, especially relating to fishery bycatch, this paper provides background on abundance estimation and reviews the various methods available for pinnipeds, cetaceans and sirenians. We first give an “entry-level” introduction to abundance estimation, including fundamental concepts and the importance of recognizing sources of bias and obtaining a measure of precision. Each of the primary methods available to estimate abundance of marine mammals is then described, including data collection and analysis, common challenges in implementation, and the assumptions made, violation of which can lead to bias. The main method for estimating pinniped abundance is extrapolation of counts of animals (pups or all-ages) on land or ice to the whole population. Cetacean and sirenian abundance is primarily estimated from transect surveys conducted from ships, small boats or aircraft. If individuals of a species can be recognized from natural markings, mark-recapture analysis of photo-identification data can be used to estimate the number of animals using the study area. Throughout, we cite example studies that illustrate the methods described. To estimate the abundance of a marine mammal population, key issues include: defining the population to be estimated, considering candidate methods based on strengths and weaknesses in relation to a range of logistical and practical issues, being aware of the resources required to collect and analyze the data, and understanding the assumptions made. We conclude with a discussion of some practical issues, given the various challenges that arise during implementation.Publisher PDFPeer reviewe

Francisella tularensis in the United States

Subpopulations A.I and A.II. of Francisella tularensis subsp. tularensis are associated with unique biotic and abiotic factors that maintain disease foci

Robustness of potential biological removal to monitoring, environmental, and management uncertainties

Support for this project was provided by the Lenfest Ocean Program.The potential biological removal (PBR) formula used to determine a reference point for human-caused mortality of marine mammals in the United States has been shown to be robust to several sources of uncertainty. This study investigates the consequences of the quality of monitoring on PBR performance. It also explores stochastic and demographic uncertainty, catastrophic events, sublethal effects of interactions with fishing gear, and the situation of a marine mammal population subject to bycatch in two fisheries, only one of which is managed. Results are presented for two pinniped and two cetacean life histories. Bias in abundance estimates and whether there is a linear relationship between abundance estimates and true abundance most influence conservation performance. Catastrophic events and trends in natural mortality have larger effects than environmental stochasticity. Managing only one of two fisheries with significant bycatch leads, as expected, to a lower probability of achieving conservation management goals, and better outcomes would be achieved if bycatch in all fisheries were managed. The results are qualitatively the same for the four life histories, but estimates of the probability of population recovery differ.Publisher PDFPeer reviewe

Estimating bycatch mortality for marine mammals : concepts and best practices

Support for this project was provided by the Lenfest Ocean Program (Contract ID: #31008).Fisheries bycatch is the greatest current source of human-caused deaths of marine mammals worldwide, with severe impacts on the health and viability of many populations. Recent regulations enacted in the United States under the Fish and Fish Product Import Provisions of its Marine Mammal Protection Act require nations with fisheries exporting fish and fish products to the United States (hereafter, “export fisheries”) to have or establish marine mammal protection standards that are comparable in effectiveness to the standards for United States commercial fisheries. In many cases, this will require estimating marine mammal bycatch in those fisheries. Bycatch estimation is conceptually straightforward but can be difficult in practice, especially if resources (funding) are limiting or for fisheries consisting of many, small vessels with geographically-dispersed landing sites. This paper describes best practices for estimating bycatch mortality, which is an important ingredient of bycatch assessment and mitigation. We discuss a general bycatch estimator and how to obtain its requisite bycatch-rate and fisheries-effort data. Scientific observer programs provide the most robust bycatch estimates and consequently are discussed at length, including characteristics such as study design, data collection, statistical analysis, and common sources of estimation bias. We also discuss alternative approaches and data types, such as those based on self-reporting and electronic vessel-monitoring systems. This guide is intended to be useful to managers and scientists in countries having or establishing programs aimed at managing marine mammal bycatch, especially those conducting first-time assessments of fisheries impacts on marine mammal populations.Publisher PDFPeer reviewe

Planning for Change: Assessing the Potential Role of Marine Protected Areas and Fisheries Management Approaches for Resilience Management in a Changing Ocean

Despite progressive policies and continued advances in ocean management, numerous shifts associated with global changes have been observed in marine ecosystems in recent years, including warming, ocean acidification, and deoxygenation. As global change accelerates, science is needed to inform evidence-based management strategies for continued ecosystem services. Resilience management, in which actions are undertaken to promote the resistance and recovery responses of populations and ecosystems to disturbance, has been suggested as a possible strategy. However, empirical evidence for effective resilience management is still limited. To inform effective management strategies, mechanisms that underlie resilience to global change that can be influenced by management-ready actions must be identified and tested through observations, experiments, and modeling. Here, we discuss the potential links between three common management strategies (i.e., spatial restrictions such as marine protected areas, coordinated spatial protections, and fisheries management approaches) and potential mechanisms of resilience for marine populations and ecosystems, and provide guidance for future research on resilience management for a changing ocean drawing on insight gained by the Partnership for Interdisciplinary Studies of Coastal Oceans’ work at the science-policy interface in the California Current Large Marine Ecosystem