Tackling inequalities in obesity: a protocol for a systematic review of the effectiveness of public health interventions at reducing socioeconomic inequalities in obesity among adults

Background: Socioeconomic inequalities in obesity and associated risk factors for obesity are widening throughout developed countries worldwide. Tackling obesity is high on the public health agenda both in the United Kingdom and internationally. However, what works in terms of interventions that are able to reduce inequalities in obesity is lacking. Methods/Design: The review will examine public health interventions at the individual, community and societal level that might reduce inequalities in obesity among adults aged 18 years and over, in any setting and in any country. The following electronic databases will be searched: MEDLINE, EMBASE, CINAHL, PsycINFO, Social Science Citation Index, ASSIA, IBSS, Sociological Abstracts, and the NHS Economic Evaluation Database. Database searches will be supplemented with website and gray literature searches. No studies will be excluded based on language, country or publication date. Randomized and non-randomized controlled trials, prospective and retrospective cohort studies (with/without control groups) and prospective repeat cross-sectional studies (with/without control groups) that have a primary outcome that is a proxy for body fatness and have examined differential effects with regard to socioeconomic status (education, income, occupation, social class, deprivation, poverty) or where the intervention has been targeted specifically at disadvantaged groups or deprived areas will be included. Study inclusion, data extraction and quality appraisal will be conducted by two reviewers. Meta-analysis and narrative synthesis will be conducted. The main analysis will examine the effects of 1) individual, 2) community and 3) societal level public health interventions on socioeconomic inequalities in adult obesity. Interventions will be characterized by their level of action and their approach to tackling inequalities. Contextual information on how such public health interventions are organized, implemented and delivered will also be examined. Discussion: The review will provide evidence, and reveal any gaps in the evidence base, of public health strategies which reduce and prevent inequalities in the prevalence of obesity in adults and provide information on the organization, implementation and delivery of such interventions. Systematic review registration: PROSPERO registration number: CRD4201300361

Optically thick clumps: not the solution to the Wolf-Rayet wind momentum problem?

The hot star wind momentum problem η = Mν∞/(L/c)» much greater than 1 is revisited, and it is shown that the conventional belief, that it can be solved by a combination of clumping of the wind and multiple scattering of photons, is not self-consistent for optically thick clumps. Clumping does reduce the mass loss rate M, and hence the momentum supply, required to generate a specified radio emission measure epsilon, while multiple scattering increases the delivery of momentum from a specified stellar luminosity L. However, in the case of thick clumps, when combined the two effects act in opposition rather than in unison since clumping reduces multiple scattering. From basic geometric considerations, it is shown that this reduction in momentum delivery by clumping more than offsets the reduction in momentum required, for a specified ε. Thus the ratio of momentum deliverable to momentum required is maximal for a smooth wind and the momentum problem remains for the thick clump case. In the case of thin clumps, all of the benefit of clumping in reducing η lies in reducing M for a given ε so that extremely small filling factors f ≈ 10-4 are needed. It is also shown that clumping affects the inference of M from radio ε not only by changing the emission measure per unit mass but also by changing the radio optical depth unity radius Rrad, and hence the observed wind volume, at radio wavelengths. In fact, for free-free opacity proportional to αn2, contrary to intuition, Rrad increases with increasing clumpiness

Blobs in Wolf-Rayet Winds: Random Photometric and Polarimetric Variability

Some isolated Wolf-Rayet stars present random variability in their optical flux and polarization. We make the assumption that such variability is caused by the presence of regions of enhanced density, i.e. blobs, in their envelopes. In order to find the physical characteristics of such regions we have modeled the stellar emission using a Monte Carlo code to treat the radiative transfer in an inhomogeneous electron scattering envelope. We are able to treat multiple scattering in the regions of enhanced density as well as in the envelope itself. The finite sizes of the source and structures in the wind are also taken into account. Most of the results presented here are based on a parameter study of models with a single blob. The effects due to multiple blobs in the envelope are considered to a more limited extent. Our simulations indicate that the density enhancements must have a large geometric cross section in order to produce the observed photopolarimetric variability. The sizes must be of the order of one stellar radius and the blobs must be located near the base of the envelope. These sizes are the same inferred from the widths of the sub-peaks in optical emission lines of Wolf-Rayet stars. Other early-type stars show random polarimetric fluctuations with characteristics similar to those observed in Wolf-Rayet stars, which may also be interpreted in terms of a clumpy wind. Although the origin of such structures is still unclear, the same mechanism may be working in different types of hot stars envelopes to produce such inhomogeneities.Comment: Accepted to ApJ. 17 pages + 6 figure

The Effects of Clumps in Explaining X-ray Emission Lines from Hot Stars

It is now well established that stellar winds of hot stars are fragmentary and that the X-ray emission from stellar winds has a strong contribution from shocks in winds. Chandra high spectral resolution observations of line profiles of O and B stars have shown numerous properties that had not been expected. Here we suggest explanations by considering the X-rays as arising from bow shocks that occur where the stellar wind impacts on spherical clumps in the winds. We use an accurate and stable numerical hydrodynamical code to obtain steady-state physical conditions for the temperature and density structure in a bow shock. We use these solutions plus analytic approximations to interpret some major X-ray features: the simple power-law distribution of the observed emission measure derived from many hot star X-ray spectra and the wide range of ionization stages that appear to be present in X-ray sources throughout the winds. Also associated with the adiabatic cooling of the gas around a clump is a significant transverse velocity for the hot plasma flow around the clumps, and this can help to understand anomalies associated with observed line widths, and the differences in widths seen in stars with high and low mass-loss rates. The differences between bow shocks and the planar shocks that are often used for hot stars are discussed. We introduce an ``on the shock'' (OTSh) approximation that is useful for interpreting the X-rays and the consequences of clumps in hot star winds and elsewhere in astronomy.Comment: to appear in the Astrophysical Journa

Reducing the Salt Added to Takeaway Food: Within-Subjects Comparison of Salt Delivered by Five and 17 Holed Salt Shakers in Controlled Conditions

Objectives To determine if the amount of salt delivered by standard salt shakers commonly used in English independent takeaways varies between those with five and 17 holes; and to determine if any differences are robust to variations in: the amount of salt in the shaker, the length of time spent shaking, and the person serving. Design Four laboratory experiments comparing the amount of salt delivered by shakers. Independent variables considered were: type of shaker used (five or 17 holes), amount of salt in the shaker before shaking commences (shaker full, half full or nearly empty), time spent shaking (3s, 5s or 10s), and individual serving. Setting Controlled, laboratory, conditions. Participants A quota-based convenience sample of 10 participants (five women) aged 18–59 years. Main Outcome Measures Amount of salt delivered by salt shakers. Results Across all trials, the 17 holed shaker delivered a mean (SD) of 7.86g (4.54) per trial, whilst the five holed shaker delivered 2.65g (1.22). The five holed shaker delivered a mean of 33.7% of the salt of the 17 holed shaker. There was a significant difference in salt delivered between the five and 17 holed salt shakers when time spent shaking, amount of salt in the shaker and participant were all kept constant (p<0.001). This difference was robust to variations in the starting weight of shakers, time spent shaking and participant shaking (p

Comparison of sodium content of meals served by independent takeaways using standard versus reduced holed salt shakers: cross-sectional study

Background Takeaway food has a relatively poor nutritional profile. Providing takeaway outlets with reduced-holed salt shakers is one method thought to reduce salt use in takeaways, but effects have not been formally tested. We aimed to determine if there was a difference in sodium content of standard fish and chip meals served by Fish & Chip Shops that use standard (17 holes) versus reduced-holed (5 holes) salt shakers, taking advantage of natural variations in salt shakers used. Methods We conducted a cross-sectional study of all Fish & Chip Shops in two local government areas (n = 65), where servers added salt to meals as standard practice, and salt shaker used could be identified (n = 61). Standard fish and chip meals were purchased from each shop by incognito researchers and the purchase price and type of salt shaker used noted. Sodium content of full meals and their component parts (fish, chips, and fish batter) was determined using flame photometry. Differences in absolute and relative sodium content of meals and component parts between shops using reduced-holed versus standard salt-shakers were compared using linear regression before and after adjustment for purchase price and area. Results Reduced-holed salt shakers were used in 29 of 61 (47.5 %) included shops. There was no difference in absolute sodium content of meals purchased from shops using standard versus reduced-holed shakers (mean = 1147 mg [equivalent to 2.9 g salt]; SD = 424 mg; p > 0.05). Relative sodium content was significantly lower in meals from shops using reduced-holed (mean = 142.5 mg/100 g [equivalent to 0.4 g salt/100 g]; SD = 39.0 mg/100 g) versus standard shakers (mean = 182.0 mg/100 g; [equivalent to 0.5 g salt/100 g]; SD = 68.3 mg/100 g; p = 0.008). This was driven by differences in the sodium content of chips and was extinguished by adjustment for purchase price and area. Price was inversely associated with relative sodium content (p < 0.05). Conclusions Using reduced-holed salt shakers in Fish & Chip Shops is associated with lower relative sodium content of fish and chip meals. This is driven by differences in sodium content of chips, making our results relevant to the wide range of takeaways serving chips. Shops serving higher priced meals, which may reflect a more affluent customer base, may be more likely to use reduced-holed shakers

Time Dependent Monte Carlo Radiative Transfer Calculations For 3-Dimensional Supernova Spectra, Lightcurves, and Polarization

We discuss Monte-Carlo techniques for addressing the 3-dimensional time-dependent radiative transfer problem in rapidly expanding supernova atmospheres. The transfer code SEDONA has been developed to calculate the lightcurves, spectra, and polarization of aspherical supernova models. From the onset of free-expansion in the supernova ejecta, SEDONA solves the radiative transfer problem self-consistently, including a detailed treatment of gamma-ray transfer from radioactive decay and with a radiative equilibrium solution of the temperature structure. Line fluorescence processes can also be treated directly. No free parameters need be adjusted in the radiative transfer calculation, providing a direct link between multi-dimensional hydrodynamical explosion models and observations. We describe the computational techniques applied in SEDONA, and verify the code by comparison to existing calculations. We find that convergence of the Monte Carlo method is rapid and stable even for complicated multi-dimensional configurations. We also investigate the accuracy of a few commonly applied approximations in supernova transfer, namely the stationarity approximation and the two-level atom expansion opacity formalism.Comment: 16 pages, ApJ accepte

Analysis of the Flux and Polarization Spectra of the Type Ia Supernova SN 2001el: Exploring the Geometry of the High-velocity Ejecta

SN 2001el is the first normal Type Ia supernova to show a strong, intrinsic polarization signal. In addition, during the epochs prior to maximum light, the CaII IR triplet absorption is seen distinctly and separately at both normal photospheric velocities and at very high velocities. The high-velocity triplet absorption is highly polarized, with a different polarization angle than the rest of the spectrum. The unique observation allows us to construct a relatively detailed picture of the layered geometrical structure of the supernova ejecta: in our interpretation, the ejecta layers near the photosphere (v \approx 10,000 km/s) obey a near axial symmetry, while a detached, high-velocity structure (v \approx 18,000-25,000 km/s) with high CaII line opacity deviates from the photospheric axisymmetry. By partially obscuring the underlying photosphere, the high-velocity structure causes a more incomplete cancellation of the polarization of the photospheric light, and so gives rise to the polarization peak and rotated polarization angle of the high-velocity IR triplet feature. In an effort to constrain the ejecta geometry, we develop a technique for calculating 3-D synthetic polarization spectra and use it to generate polarization profiles for several parameterized configurations. In particular, we examine the case where the inner ejecta layers are ellipsoidal and the outer, high-velocity structure is one of four possibilities: a spherical shell, an ellipsoidal shell, a clumped shell, or a toroid. The synthetic spectra rule out the spherical shell model, disfavor a toroid, and find a best fit with the clumped shell. We show further that different geometries can be more clearly discriminated if observations are obtained from several different lines of sight.Comment: 14 pages (emulateapj5) plus 18 figures, accepted by The Astrophysical Journa

Saturn's icy satellites and rings investigated by Cassini - VIMS. III. Radial compositional variability

In the last few years Cassini-VIMS, the Visible and Infared Mapping Spectrometer, returned to us a comprehensive view of the Saturn's icy satellites and rings. After having analyzed the satellites' spectral properties (Filacchione et al. (2007a)) and their distribution across the satellites' hemispheres (Filacchione et al. (2010)), we proceed in this paper to investigate the radial variability of icy satellites (principal and minor) and main rings average spectral properties. This analysis is done by using 2,264 disk-integrated observations of the satellites and a 12x700 pixels-wide rings radial mosaic acquired with a spatial resolution of about 125 km/pixel. The comparative analysis of these data allows us to retrieve the amount of both water ice and red contaminant materials distributed across Saturn's system and the typical surface regolith grain sizes. These measurements highlight very striking differences in the population here analyzed, which vary from the almost uncontaminated and water ice-rich surfaces of Enceladus and Calypso to the metal/organic-rich and red surfaces of Iapetus' leading hemisphere and Phoebe. Rings spectra appear more red than the icy satellites in the visible range but show more intense 1.5-2.0 micron band depths. The correlations among spectral slopes, band depths, visual albedo and phase permit us to cluster the saturnian population in different spectral classes which are detected not only among the principal satellites and rings but among co-orbital minor moons as well. Finally, we have applied Hapke's theory to retrieve the best spectral fits to Saturn's inner regular satellites using the same methodology applied previously for Rhea data discussed in Ciarniello et al. (2011).Comment: 44 pages, 27 figures, 7 tables. Submitted to Icaru

The Possibility of Thermal Instability in Early-Type Stars Due to Alfven Waves

It was shown by dos Santos et al. the importance of Alfv\'en waves to explain the winds of Wolf-Rayet stars. We investigate here the possible importance of Alfv\'en waves in the creation of inhomogeneities in the winds of early-type stars. The observed infrared emission (at the base of the wind) of early-type stars is often larger than expected. The clumping explains this characteristic in the wind, increasing the mean density and hence the emission measure, making possible to understand the observed infrared, as well as the observed enhancement in the blue wing of the $H_\alpha$ line. In this study, we investigate the formation of these clumps a via thermal instability. The heat-loss function used, $H(T,n)$, includes physical processes such as: emission of (continuous and line) recombination radiation; resonance line emission excited by electron collisions; thermal bremsstrahlung; Compton heating and cooling; and damping of Alfv\'en waves. As a result of this heat-loss function we show the existence of two stable equilibrium regions. The stable equilibrium region at high temperature is the diffuse medium and at low temperature the clumps. Using this reasonable heat-loss function, we show that the two stable equilibrium regions can coexist over a narrow range of pressures describing the diffuse medium and the clumps.Comment: 21 pages (psfig.sty), 5 figures (included), ApJ accepted. Also available at http://www.iagusp.usp.br/preprints/preprint.htm