Alien Registration- Garnett, Emma (Sanford, York County)

https://digitalmaine.com/alien_docs/3741/thumbnail.jp

The steaks are high: Reducing meat consumption by changing physical and economic environments to increase vegetarian sales

Livestock farming is responsible for ~15% of anthropogenic greenhouse gas emissions (GHGE) and is a leading cause of deforestation, biodiversity loss, water-use and pollution. To feed 10 billion people a healthy and sustainable diet, approximately 16kg of meat consumption per person per year has been recommended, compared with current mean consumption (including waste) of 81kg in the EU and UK. How might lower meat consumption be encouraged? Research in other domains suggests altering the physical and economic environments in which people make decisions holds promise for achieving socially desirable behaviour change, but very little research has experimentally tested such approaches for reducing meat consumption. In this thesis I present the results of three different interventions (order, availability, price) in college cafeterias at the University of Cambridge and examine their effects on vegetarian meal sales. I collected data from 1142 mealtimes and 213,627 meal selections, obtaining individual level purchase information for two out of three interventions. It is widely assumed – but largely untested – that food encountered first in cafeterias is preferentially selected. I investigated the effects of order and found placing the vegetarian (rather than meat) option first increased vegetarian sales by 4.5 to 6 percentage points when there was a long distance (181cm) between options. However, order effects were inconsistent when the distance between options was shorter (<85cm). In contrast, I found that increasing the proportion of vegetarian options available was consistently very effective. Doubling vegetarian availability from 25% to 50% (e.g. from 1 in 4 to 2 in 4 options) increased vegetarian meal sales by 14.5 to 14.9 percentage points in an observational study and by 7.8 percentage points in an experimental study. Individual-level data revealed that the largest relative effects were found in the quartile of diners with the lowest prior levels of vegetarian meal selection, but all quartiles of diners were more likely to select a vegetarian option when more were available. Price is an important consideration for citizens when purchasing food. I experimentally decreased the vegetarian option price and increased the meat option price (each by 20p) halfway through a university term. Vegetarian sales increased overall by 3.2 percentage points, and by 13.7 percentage points in the most vegetarian quartile of diners. The other three quartiles did not significantly change their meal selections. None of the three interventions tested substantially affected overall meal sales. In the final data chapter I used individual-level data to examine the effects of gender on meal selection. I found that men were consistently less likely to select vegetarian meals than women, significantly more likely to select meat meals, and men and women were equally likely to select fish meals. Consequently on average men’s meals had average GHG emissions 18% higher and land-use 28% higher than women’s. Men and women were similarly responsive to the availability and price interventions. These findings have important implications for catering policies, although these interventions should be tested in non-university populations and low and middle income countries. Placing vegetarian options first can increase their sales, but can also have no effect or even be counterproductive. A small change in price may only be enough to increase vegetarian selection for the most vegetarian quartile of diners. However, increasing the availability of vegetarian options appears to increase vegetarian selection by all quartiles of diners and is a relatively simple change to catering practices. My results provide robust evidence that – if implemented more broadly – increasing the proportion of vegetarian options available could make an important contribution to the global ambition for more sustainable diets

Tackling inequality is essential for behaviour change for net zero

Policies and psychological approaches often overemphasize individual agency, overlooking how socioeconomic inequality can constrain access to low-carbon alternatives. We argue that tackling these inequalities is urgent for impactful, equitable behaviour change

Evaluation of Graduated Driving Licence in the UK - Baseline Qualitative Study

Graduated Driver Licensing (GDL) schemes aim to reduce crash rates among young drivers by helping them to gradually build experience within a supportive environment. The introduction of a proposed GDL scheme in one country of the UK (Northern Ireland) provides an opportunity to determine the impact that these schemes have upon wellbeing outcomes by comparing crash rates and other outcomes before and after the intervention in the exposed population (Northern Ireland) and non-exposed population (other countries of the UK). This collection contains baseline qualitative data captured prior to the introduction of the proposed GDL scheme in Northern Ireland. It contains transcripts of 21 focus (natural) group interviews conducted with young adults aged 16-22 or their parents from Northern Ireland, England and Wales. Topics covered include the role of driving, giving and taking lifts, the local transport system and alternatives to driving

Order of meals at the counter and distance between options affect student cafeteria vegetarian sales

Altering the order in which meals are presented at cafeteria counters has been proposed as a way of lowering meat consumption, but remains largely untested. To address this, we undertook two experimental studies involving 105,143 meal selections in the cafeterias of a British university. Placing vegetarian options first on the counter consistently increased their sales when choices were widely separated (>1.5 m; vegetarian sales as a percentage of total meal sales increased by 4.6 and 6.2 percentage points) but there was no evidence of an effect when the options were close together (<1.0 m). This suggests that order effects depend on the physical distance between options.This work was supported by E.E.G.’s NERC studentship grant number NE/L002507/1 and A.B.’s Royal Society Wolfson Research Merit awar

Discrepancies between two long-term dietary datasets in the United Kingdom

Background: Studying dietary trends can help monitor progress towards healthier and more sustainable diets but longitudinal data are often confounded by lack of standardized methods. Two main data sources are used for longitudinal analysis of diets: food balance sheets on food supply (FBS) and household budget surveys on food purchased (HBS). Methods: We used UK longitudinal dietary data on food supply, provided by the Food and Agriculture Organisation (FAO) (FAO-FBS, 1961-2018), and food purchases, provided by the Department for Environment, Food and Rural Affairs (Defra) (Defra-HBS, 1942-2018). We assessed how trends in dietary change per capita compared between FAO-FBS and Defra-HBS for calories, meat and fish, nuts and pulses, and dairy, and how disparities have changed over time. Results: Estimates made by FAO-FBS were significantly higher (p<0.001) than Defra-HBS for calorie intake and all food types, except nuts and pulses which were significantly lower (p<0.001). These differences are partly due to inclusion of retail waste in FAO-FBS data and under-reporting in Defra- HBS data. The disparities between the two datasets increased over time for calories, meat and dairy; did not change for fish; and decreased for nuts and pulses. Between 1961 and 2018, both FAO-FBS and Defra-FBS showed an increase in meat intake (+23.4% and +1.4%, respectively) and a decrease in fish (-7.1% and -3.2%, respectively). Temporal trends did not agree between the two datasets for dairy, calories, and nuts and pulses. Conclusions: Our finding raises questions over the robustness of both data sources for monitoring UK dietary change, especially when used for evidence-based decision making around health, climate change and sustainability

Metformin reduces airway glucose permeability and hyperglycaemia-induced Staphylococcus aureus load independently of effects on blood glucose

Background Diabetes is a risk factor for respiratory infection, and hyperglycaemia is associated with increased glucose in airway surface liquid and risk of Staphylococcus aureus infection. Objectives To investigate whether elevation of basolateral/blood glucose concentration promotes airway Staphylococcus aureus growth and whether pretreatment with the antidiabetic drug metformin affects this relationship. Methods Human airway epithelial cells grown at air–liquid interface (±18 h pre-treatment, 30 μM–1 mM metformin) were inoculated with 5×105 colony-forming units (CFU)/cm2 S aureus 8325-4 or JE2 or Pseudomonas aeruginosa PA01 on the apical surface and incubated for 7 h. Wild-type C57BL/6 or db/db (leptin receptor-deficient) mice, 6–10 weeks old, were treated with intraperitoneal phosphate-buffered saline or 40 mg/kg metformin for 2 days before intranasal inoculation with 1×107 CFU S aureus. Mice were culled 24 h after infection and bronchoalveolar lavage fluid collected. Results Apical S aureus growth increased with basolateral glucose concentration in an in vitro airway epithelia–bacteria co-culture model. S aureus reduced transepithelial electrical resistance (RT) and increased paracellular glucose flux. Metformin inhibited the glucose-induced growth of S aureus, increased RT and decreased glucose flux. Diabetic (db/db) mice infected with S aureus exhibited a higher bacterial load in their airways than control mice after 2 days and metformin treatment reversed this effect. Metformin did not decrease blood glucose but reduced paracellular flux across ex vivo murine tracheas. Conclusions Hyperglycaemia promotes respiratory S aureus infection, and metformin modifies glucose flux across the airway epithelium to limit hyperglycaemia-induced bacterial growth. Metformin might, therefore, be of additional benefit in the prevention and treatment of respiratory infection

Elevated Paracellular Glucose Flux across Cystic Fibrosis Airway Epithelial Monolayers Is an Important Factor for Pseudomonas aeruginosa Growth.

People with cystic fibrosis (CF) who develop related diabetes (CFRD) have accelerated pulmonary decline, increased infection with antibiotic-resistant Pseudomonas aeruginosa and increased pulmonary exacerbations. We have previously shown that glucose concentrations are elevated in airway surface liquid (ASL) of people with CF, particularly in those with CFRD. We therefore explored the hypotheses that glucose homeostasis is altered in CF airway epithelia and that elevation of glucose flux into ASL drives increased bacterial growth, with an effect over and above other cystic fibrosis transmembrane conductance regulator (CFTR)-related ASL abnormalities. The aim of this study was to compare the mechanisms governing airway glucose homeostasis in CF and non-CF primary human bronchial epithelial (HBE) monolayers, under normal conditions and in the presence of Ps. aeruginosa filtrate. HBE-bacterial co-cultures were performed in the presence of 5 mM or 15 mM basolateral glucose to investigate how changes in blood glucose, such as those seen in CFRD, affects luminal Ps. aeruginosa growth. Calu-3 cell monolayers were used to evaluate the potential importance of glucose on Ps. aeruginosa growth, in comparison to other hallmarks of the CF ASL, namely mucus hyperviscosity and impaired CFTR-dependent fluid secretions. We show that elevation of basolateral glucose promotes the apical growth of Ps. aeruginosa on CF airway epithelial monolayers more than non-CF monolayers. Ps. aeruginosa secretions elicited more glucose flux across CF airway epithelial monolayers compared to non-CF monolayers which we propose increases glucose availability in ASL for bacterial growth. In addition, elevating basolateral glucose increased Ps. aeruginosa growth over and above any CFTR-dependent effects and the presence or absence of mucus in Calu-3 airway epithelia-bacteria co-cultures. Together these studies highlight the importance of glucose as an additional factor in promoting Ps. aeruginosa growth and respiratory infection in CF disease

Commissioning through competition and cooperation in the English NHS under the Health and Social Care Act 2012: evidence from a qualitative study of four clinical commissioning groups.

OBJECTIVE: The Health and Social Care Act 2012 ('HSCA 2012') introduced a new, statutory, form of regulation of competition into the National Health Service (NHS), while at the same time recognising that cooperation was necessary. NHS England's policy document, The Five Year Forward View ('5YFV') of 2014 placed less emphasis on competition without altering the legislation. We explored how commissioners and providers understand the complex regulatory framework, and how they behave in relation to competition and cooperation. DESIGN: We carried out detailed case studies in four clinical commissioning groups, using interviews and documentary analysis to explore the commissioners' and providers' understanding and experience of competition and cooperation. SETTING/PARTICIPANTS: We conducted 42 interviews with senior managers in commissioning organisations and senior managers in NHS and independent provider organisations (acute and community services). RESULTS: Neither commissioners nor providers fully understand the regulatory regime in respect of competition in the NHS, and have not found that the regulatory authorities have provided adequate guidance. Despite the HSCA 2012 promoting competition, commissioners chose mainly to use collaborative strategies to effect major service reconfigurations, which is endorsed as a suitable approach by providers. Nevertheless, commissioners are using competitive tendering in respect of more peripheral services in order to improve quality of care and value for money. CONCLUSIONS: Commissioners regard the use of competition and cooperation as appropriate in the NHS currently, although collaborative strategies appear more helpful in respect of large-scale changes. However, the current regulatory framework contained in the HSCA 2012, particularly since the publication of the 5YFV, is not clear. Better guidance should be issued by the regulatory authorities