A review of methods and tools to assess the implementation of government policies to create healthy food environments for preventing obesity and diet-related non-communicable diseases

BACKGROUND: Policies to create healthy food environments are recognized as critical components of efforts to prevent obesity and diet-related non-communicable diseases. There has not been a systematic review of existing methods and tools used to assess the implementation of these government policies. The purpose of this study was to review methods and tools used for assessing the implementation of government policies to create healthy food environments. The study conducted a systematic literature search. Multiple databases as well as the grey literature were searched. All study designs and review papers on assessing the implementation of government policies to create healthy food environments were included. A quality assessment of the methods and tools identified from relevant studies was carried out using the following four criteria: comprehensiveness, relevance, generalizability and feasibility. This quality assessment was completed by two independent reviewers. RESULTS: The review identified 52 studies across different policy areas, levels and settings. Self-administered questionnaires and policy checklists were most commonly applied to assess the extent of policy implementation, whereas semi-structured interviews were most commonly used to evaluate the implementation process. Measures varied widely, with the existence of policy implementation the aspect most commonly assessed. The most frequently identified barriers and facilitators for policy implementation were infrastructure support, resources and stakeholder engagement. The assessment of policy implementation on food environments was usually undertaken in combination with other policy areas, particularly nutrition education and physical activity. Three tools/methods were rated 'high' quality and 13 tools/methods received 'medium' quality ratings. CONCLUSIONS: Harmonization of the available high-quality methods and tools is needed to ensure that assessment of government policy implementation can be compared across different countries and settings and over time. This will contribute to efforts to increase government accountability for their actions to improve the healthiness of food environments.

Optimising technical skills and physical loading in small-sided basketball games

Differences in physiological, physical, and technical demands of small-sided basketball games related to the number of players, court size, and work-to-rest ratios are not well characterised. A controlled trial was conducted to compare the influence of number of players (2v2/4v4), court size (half/full court) and work-to-rest ratios (4x2.5 min/2x5 min) on the demands of small-sided games. Sixteen elite male and female junior players (aged 15-19 years) completed eight variations of a small-sided game in randomised order over a six-week period. Heart rate responses and rating of perceived exertion (RPE) were measured to assess the physiological load. Movement patterns and technical elements were assessed by video analysis. There were ∼60% more technical elements in 2v2 and ∼20% more in half court games. Heart rate (86 ± 4% & 83 ± 5% of maximum; mean ± SD) and RPE (8 ± 2 & 6 ± 2; scale 1-10) were moderately higher in 2v2 than 4v4 small-sided games, respectively. The 2v2 format elicited substantially more sprints (36 ±12%; mean ±90% confidence limits) and high intensity shuffling (75 ±17%) than 4v4. Full court games required substantially more jogging (9 ±6%) compared to half court games. Fewer players in small-sided basketball games substantially increases the technical, physiological and physical demands.

Quantifying the physical demands of a musical performance and their effects on performance quality

This study investigated the effects of fatigue on performance quality induced by a prolonged musical performance. Ten participants prepared 10 min of repertoire for their chosen wind instrument that they played three times consecutively. Prior to the performance and within short breaks between performances, researchers collected heart rate, respiratory rate, blood pressure, blood lactate concentration, rating of perceived exertion (RPE), and rating of anxiety. All performances were audio recorded and later analysed for performance errors. Reliability in assessing performance errors was assessed by typical error of measure (TEM) of 15 repeat performances. Results indicate all markers of physical stress significantly increased by a moderate to large amount (4.6 to 62.2%; d = 0.50 to 1.54) once the performance began, while heart rate, respirations, and RPE continued to rise by a small to large amount (4.9 to 23.5%; d = 0.28 to 0.93) with each performance. Observed changes in performance between performances were well in excess of the TEM of 7.4%. There was a significant small (21%, d = 0.43) decrease in errors after the first performance; after the second performance, there was a significant large increase (70.4%, d = 1.14). The initial increase in physiological stress with corresponding decrease in errors after the first performance likely indicates "warming up," while the continued increase in markers of physical stress with dramatic decrement in performance quality likely indicates fatigue. Musicians may consider the relevance of physical fitness to maintaining performance quality over the duration of a performance.

Grassland conservation and the plains-wanderer: A small brown bird makes an effective local flagship

This study explored whether the plains-wanderer (Pedionomus torquatus), a species lacking the criteria outlined in the traditional flagship model, is a suitable local flagship for the Northern Plains Grasslands of Victoria in Australia. Questionnaires and telephone interviews were used to survey residents and natural resource management professionals and volunteers ('NRM participants') in communities living close to the Northern Plains Grasslands. Questionnaires were completed by 146 residents and 69 NRM participants, and 15 interviews were conducted. Results suggest that a significant proportion of the local community was aware of, and valued, the plains-wanderer, and that the species is currently functioning as an effective flagship for the region. Recommendations are provided for the future selection of flagship species in ecosystems where traditional flagships are not present.

Measuring nursing competencies in the operating theatre: instrument development and psychometric analysis using Item Response Theory

BACKGROUND: Concern about the process of identifying underlying competencies that contribute to effective nursing performance has been debated with a lack of consensus surrounding an approved measurement instrument for assessing clinical performance. Although a number of methodologies are noted in the development of competency-based assessment measures, these studies are not without criticism. RESEARCH AIM: The primary aim of the study was to develop and validate a Performance Based Scoring Rubric, which included both analytical and holistic scales. The aim included examining the validity and reliability of the rubric, which was designed to measure clinical competencies in the operating theatre. RESEARCH METHOD: The fieldwork observations of 32 nurse educators and preceptors assessing the performance of 95 instrument nurses in the operating theatre were used in the calibration of the rubric. The Rasch model, a particular model among Item Response Models, was used in the calibration of each item in the rubric in an attempt at improving the measurement properties of the scale. This is done by establishing the 'fit' of the data to the conditions demanded by the Rasch model. RESULTS: Acceptable reliability estimates, specifically a high Cronbach's alpha reliability coefficient (0.940), as well as empirical support for construct and criterion validity for the rubric were achieved. Calibration of the Performance Based Scoring Rubric using Rasch model revealed that the fit statistics for most items were acceptable. CONCLUSION: The use of the Rasch model offers a number of features in developing and refining healthcare competency-based assessments, improving confidence in measuring clinical performance. The Rasch model was shown to be useful in developing and validating a competency-based assessment for measuring the competence of the instrument nurse in the operating theatre with implications for use in other areas of nursing practice.

Bipolar disorder

Bipolar disorder is a recurrent chronic disorder characterised by fluctuations in mood state and energy. It affects more than 1% of the world's population irrespective of nationality, ethnic origin, or socioeconomic status. Bipolar disorder is one of the main causes of disability among young people, leading to cognitive and functional impairment and raised mortality, particularly death by suicide. A high prevalence of psychiatric and medical comorbidities is typical in affected individuals. Accurate diagnosis of bipolar disorder is difficult in clinical practice because onset is most commonly a depressive episode and looks similar to unipolar depression. Moreover, there are currently no valid biomarkers for the disorder. Therefore, the role of clinical assessment remains key. Detection of hypomanic periods and longitudinal assessment are crucial to differentiate bipolar disorder from other conditions. Current knowledge of the evolving pharmacological and psychological strategies in bipolar disorder is of utmost importance.

The diagnosis of attention-deficit/hyperactivity disorder in Australian children: current paediatric practice and parent perspective

Aims In a sample of newly diagnosed children with attention-deficit/hyperactivity disorder (ADHD), the aims were to examine (1) paediatrician assessment and management practices; (2) previous assessments and interventions; (3) correspondence between parent-report and paediatrician identification of comorbidities; and (4) parent agreement with diagnosis of ADHD. Methods Design: cross-sectional, multi-site practice audit with questionnaires completed by paediatricians and parents at the point of ADHD diagnosis. Setting: private/public paediatric practices in Western Australia and Victoria, Australia. Main outcome measures: paediatricians: elements of assessment and management were indicated on a study-designed data form. Parents: ADHD symptoms and comorbidities were measured using the Conners 3 ADHD Index and Strengths and Difficulties Questionnaire, respectively. Sleep problems, previous assessments and interventions, and agreement with ADHD diagnosis were measured by questionnaire. Results Twenty-four paediatricians participated, providing data on 137 patients (77% men, mean age 8.1 years). Parent and teacher questionnaires were used in 88% and 85% of assessments, respectively. Medication was prescribed in 75% of cases. Comorbidities were commonly diagnosed (70%); however, the proportion of patients identified by paediatricians with internalising problems (18%), externalising problems (15%) and sleep problems (4%) was less than by parent report (51%, 66% and 39%). One in seven parents did not agree with the diagnosis of ADHD. Conclusions Australian paediatric practice in relation to ADHD assessment is generally consistent with best practice guidelines; however, improvements are needed in relation to the routine use of questionnaires and the identification of comorbidities. A proportion of parents do not agree with the diagnosis of ADHD made by their paediatrician.

Maternal anxiety and children's laboratory pain: the mediating role of solicitousness

There has been limited empirical examination of how parent variables such as anxiety and solicitousness collectively impact child pain response. We sought to examine the relationships among maternal anxiety, solicitous parenting, and children's laboratory anxiety and pain intensity in children with chronic pain. Participants included 80 children and adolescents (ages 8-18) with chronic pain and their mothers. Children completed questionnaires and lab pain tasks measuring their parents' solicitous parenting, pressure, cold and heat pain anticipatory anxiety and pain intensity. Using bootstrapping analysis, maternal anxiety predicted child anticipatory anxiety and pain intensity in girls with chronic pain, which was mediated by the child's report of parental solicitousness. For boys with chronic pain, maternal anxiety predicted boys' anticipatory anxiety and pain intensity, with no support for mediation. This study adds to the growing literature demonstrating the impact of maternal anxiety on children's pain. The study highlights the importance of considering parents in treatment designed to reduce children's pain.

Integrating plant- and animal- based perspectives for more effective restoration of biodiversity

Ecological restoration of modified and degraded landscapes is an important challenge for the 21st century, with potential for major gains in the recovery of biodiversity. However, there is a general lack of agreement between plant- and animal- based approaches to restoration, both in theory and practice. Here, we review these approaches, identify limitations from failing to effectively integrate their different perspectives, and suggest ways to improve outcomes for biodiversity recovery in agricultural landscapes. We highlight the need to strengthen collaboration between plant and animal ecologists, to overcome disciplinary and cultural differences, and to achieve a more unified approach to restoration ecology. Explicit consideration of key ecosystem functions, the need to plan at multiple spatial and temporal scales, and the importance of plant-animal interactions can provide a bridge between plant- and animal- based methods. A systematic approach to restoration planning is critical to achieving effective biodiversity outcomes while meeting long- term social and economic needs.

Previous land use and climate influence differences in soil organic carbon following reforestation of agricultural land with mixed-species plantings

Reforestation of agricultural land with mixed-species environmental plantings (native trees and shrubs) can contribute to mitigation of climate change through sequestration of carbon. Although soil carbon sequestration following reforestation has been investigated at site- and regional-scales, there are few studies across regions where the impact of a broad range of site conditions and management practices can be assessed. We collated new and existing data on soil organic carbon (SOC, 0-30 cm depth, N = 117 sites) and litter (N = 106 sites) under mixed-species plantings and an agricultural pair or baseline across southern and eastern Australia. Sites covered a range of previous land uses, initial SOC stocks, climatic conditions and management types. Differences in total SOC stocks following reforestation were significant at 52% of sites, with a mean rate of increase of 0.57 ± 0.06 Mg C ha-1 y-1. Increases were largely in the particulate fraction, which increased significantly at 46% of sites compared with increases at 27% of sites for the humus fraction. Although relative increase was highest in the particulate fraction, the humus fraction was the largest proportion of total SOC and so absolute differences in both fractions were similar. Accumulation rates of carbon in litter were 0.39 ± 0.02 Mg C ha-1 y-1, increasing the total (soil + litter) annual rate of carbon sequestration by 68%. Previously-cropped sites accumulated more SOC than previously-grazed sites. The explained variance differed widely among empirical models of differences in SOC stocks following reforestation according to SOC fraction and depth for previously-grazed (R2 = 0.18-0.51) and previously-cropped (R2 = 0.14-0.60) sites. For previously-grazed sites, differences in SOC following reforestation were negatively related to total SOC in the pasture. By comparison, for previously-cropped sites, differences in SOC were positively related to mean annual rainfall. This improved broad-scale understanding of the magnitude and predictors of changes in stocks of soil and litter C following reforestation is valuable for the development of policy on carbon markets and the establishment of future mixed-species environmental plantings.

Prevalence and risk factors for mild and high-frequency bilateral sensorineural hearing loss at age 11 years old:a UK prospective cohort study

OBJECTIVE: This study aimed to assess prevalence and risk factors for mild/high-frequency bilateral sensorineural hearing loss within a UK population of children at age 11 years. DESIGN: Prospective birth cohort study. STUDY SAMPLE: Repeat hearing thresholds were measured in 5032 children, as part of the Avon Longitudinal Study of Parents and Children (ALSPAC) at age 7, 9, and 11 years. Pregnancy, birth, and early medical history were obtained prospectively through parental questionnaires and medical records. RESULTS: Twenty children had mild and seven had high-frequency bilateral sensorineural hearing loss, giving a combined prevalence of 0.5% (95% CI 0.4-0.8%). These children were more likely than the rest of the study sample to have been admitted to hospital at 6-18 months (OR 2.7, 95% CI 1.00-7.30). Parents of these children were more likely to have suspected a hearing problem when the children were 3 years old (OR 2.4, 95% CI 1.05-5.60). CONCLUSIONS: This is the first UK prospective cohort study to investigate the prevalence of mild and high-frequency hearing loss. This study, which has the advantage of a large sample size and repeat hearing measures over a four year period, reports lower prevalence values than US cross-sectional studies.

Prevalence and profile of alcohol consumption among university students in Ecuador

Alcohol consumption is one of the main health and social problems in Ecuador. The aim of this study was to explore gender differences in the prevalence and psychosocial profile of problematic consumers among university students. We surveyed 3,232 students by using the AUDIT and psychosocial scales. To discriminate the explanatory value of each variable, a CHAID segmentation analysis was used. The prevalence of alcohol consumption was 92.24% in men and 82.86% in women. In total, 49.73% of men and 23.80% of women reported problematic consumption. In men, the profile of problematic consumption was defined by higher scores in anxiety and depression, especially if they showed higher levels of psychological stress and lower life engagement. In women, problematic consumption showed a tendency towards psychological inflexibility, especially in those with lower life engagement. There is a need to prioritise attention to alcohol consumption in university students and to design different interventions for men and women.

Urban heritage, development and sustainability: international frameworks, national and local governance

More than half of the world’s population now live in urban areas, and cities provide the setting for contemporary challenges such as population growth, mass tourism and unequal access to socio-economic opportunities. Urban Heritage, Development and Sustainability examines the impact of these issues on urban heritage, considering innovative approaches to managing developmental pressures and focusing on how taking an ethical, inclusive and holistic approach to urban planning and heritage conservation may create a stronger basis for the sustainable growth of cities in the future.This volume is a timely analysis of current theories and practises in urban heritage, with particular reference to the conflict between, and potential reconciliation of, conservation and development goals. A global range of case studies detail a number of distinct practical approaches to heritage on international, national and local scales. Chapters reveal the disjunctions between international frameworks and national implementation and assess how internationally agreed concepts can be misused to justify unsustainable practices or to further economic globalisation and political nationalism. The exclusion of many local communities from development policies, and the subsequent erosion of their cultural heritage, is also discussed, with the collection emphasising the importance of ‘grass roots’ heritage and exploring more inclusive and culturally responsive conservation strategies. Contributions from an international group of authors, including practitioners as well as leading academics, deliver a broad and balanced coverage of this topic. Addressing the interests of both urban planners and heritage specialists, Urban Heritage, Development and Sustainability is an important addition to the field that will encourage further discourse.

Social structure and landscape genetics of the endemic New Caledonian ant Leptomyrmex pallens Emery, 1883 (Hymenoptera: Formicidae: Dolichoderinae), in the context of fire-induced rainforest fragmentation

Habitat fragmentation is a major threat to biodiversity, as it can alter ecological processes at various spatial and trophic scales. At the species level, fragmentation leading to the isolation of populations can trigger reductions in genetic diversity, potentially having detrimental effects on population fitness, adaptability and ultimately population persistence. Leptomyrmex pallens is a widespread rainforest ant endemic to New Caledonia but now confined to habitat patches that have been fragmented by anthropogenic fire regimes over the last 200 years. We investigated the social structure of L. pallens in the Aoupinié region (c.a. 4900 ha), and assessed the impacts of habitat fragmentation on its population genetic structure. Allele frequencies at 13 polymorphic microsatellite loci were compared among 411 worker ants from 21 nests distributed across the region. High within-nest relatedness (r = 0.70 ± 0.02), and a single queen found in 38 % of the nests by pedigree analysis indicate that the species is monogynous to weakly polygynous. Estimates of gene flow and genetic structure across the region were subsequently determined using a combined dataset of single workers per nest and of unrelated foraging workers. These estimates coupled with a comprehensive landscape genetic analysis revealed no evidence of significant population structure or habitat effects, suggesting that the Aoupinié region harbours a single panmictic population. In contrast, analyses of mitochondrial DNA sequence data revealed a high degree of genetic structuring, indicating limited maternal gene flow and suggesting that gene flow among nests is driven primarily by winged males. Overall these findings suggest that fire-induced habitat fragmentation has had little impact on the population dynamics of L. pallens. Additional studies of less mobile species should therefore be conducted to gain further insights into fire related disturbances on the unique biodiversity and function of New Caledonian ecosystems.

Comparison of small remotely operated vehicles and diver-operated video of circalittoral benthos

Underwater video transect methods using small remotely operated vehicles (ROVs) and diveroperated video (DOV) are commonly used in benthic biodiversity assessments. Constraints posed by deeper waters have made surveys of the circalittoral zone ([30 m depth), a particularly challenging problem. Here we compare benthic diversity metrics and cluster analyses obtained with ROV and DOV between 45 and 65 m depth off southwest Iberia, across local (tens to hundreds of meters) and regional scales (tens of kilometers). Results showed no difference between methods in terms of the benthic species richness, taxonomic distinctness, and beta diversity, but only minor differences in the spatial structure depicted at the regional level. At the local scale, DOV performed better at discriminating patterns likely because of the divers visual acuity. We found that small ROV and DOV are reliable and comparable methods for the study of circalittoral benthic assemblages and can be used in a complimentary way to detect the greatest amount of variation in benthic ecosystems. Our study facilitates the understanding of capabilities and limitations of two underwater video methods and provides important insight into choice of the most appropriate technique.