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Consumer enthusiasm in plant-based eating has resulted in the rapid expansion of plant-based meat (PBM) products. The extensive processing required to simulate meat warrants further investigation regarding PBMs nutritional quality and healthiness, particularly considering the health halo that has surrounded these products. An online audit of dominant UK supermarkets evaluated PBM (n = 209) against ‘standard’ (n = 2143) and ‘reduced’ (e.g. low fat) meat equivalents (n = 100), across eight product categories. This evaluation included NOVA categorisation, Nutritional Profiling Model (NPM) classification, on-pack claims, micronutrient content and product affordability. PBM products were typically more favourable than ‘standard’ meat equivalents for energy density, dietary fibre, total and saturated fat content. However, they contained significantly higher salt in most product categories. Differences between PBM and ‘reduced’ meat comparators were more nuanced. PBM products were significantly more expensive than ‘standard’ meat equivalents in four of the eight product categories (p < .05). Few PBM and zero meat-based products reported micronutrient information. While all PBM and most meat-based products were characterised as ultra-processed, PBM products demonstrated a lower (‘healthier’) NPM score compared to ‘standard’ meat equivalents across all product categories (p ≤ .001). Although no significant differences were detected between PBM and ‘reduced’ meat-based products, a greater proportion of PBM products were classified as ‘healthier’ according to NPM compared to ‘standard’ and ‘reduced’ meat equivalents. Thus PBM products may offer healthier alternatives with the potential to synergistically support public and planetary health. Future manufacturing practices should consider cost-effective fortification and reformulation strategies to improve nutritional quality and affordability of PBMs.
We study a size-structured tree growth model from [4–6], described by the nonlinear renewal equation $\phi(t) = \mathfrak{F} \phi_t, \ \phi_t \in L^1_\rho(\mathbb{R}_{-}),$ with reproduction, death, and growth rates $\beta$, $\mu$, and $g$. We prove that, under mild conditions on these rates, the equation generates a semiflow in $L^1_\rho(\mathbb{R}_{-})$ that is permanent and possesses a compact global attractor $\mathcal{A}$. If $\beta$ is monotone, $\mathcal{A}$ reduces to a single asymptotically stable equilibrium attracting all compact sets with positive initial data. Adapting an approach from [21], originally developed for simpler renewal equations, we investigate stability and persistence in this more complex setting via the one-dimensional recurrence $b_{n+1} = \mathfrak{F} b_n,$ thereby complementing the functional-analytic framework of [13].
Metabolic dysfunction-associated steatotic liver disease (MASLD) is the leading chronic liver disease worldwide. While total SFA intake has been linked to MASLD, the contribution of specific SFA and the mechanism underlying the SFA-MASLD association remain unclear. This study evaluated the associations of individual SFA with MASLD and the mediating roles of insulin resistance (IR) and serum albumin. We used data from seven National Health and Nutrition Examination Survey (NHANES) cycles (2005–2018) in a cross-sectional analysis. Associations between individual SFA and MASLD were estimated via logistic regression with restricted cubic splines (RCS). Weighted quantile sum (WQS) and quantile g-computation (QGC) models assessed the mixture associations. Mediation analysis evaluated the proportions of these associations accounted for by serum albumin and IR. Compared with the reference group, the highest tertile of intake was associated with increased odds of MASLD for C4:0 (OR = 1·12, 95 % CI 1·01, 1·25), C6:0 (OR = 1·15, 95 % CI 1·04, 1·28), C14:0 (OR = 1·20, 95 % CI 1·08, 1·33), C16:0 (OR = 1·24, 95 % CI 1·12, 1·38) and C18:0 (OR = 1·25, 95 % CI 1·12, 1·39). RCS models revealed largely linear dose–response relationships. Both WQS and QGC indicated a positive joint association of SFA with MASLD, with C16:0 identified as a major contributor. Among SFA significantly associated with MASLD, IR accounted for 30·0–47·4 % of the associations, while serum albumin accounted for 5·9–8·0 %. Higher intakes of short- and long-chain SFA, both individually and collectively, are associated with higher odds of MASLD. IR and serum albumin may partially explain these associations. These findings support the development of precision dietary strategies targeting specific SFA for MASLD prevention.
This paper critically engages Büscher and Fletcher’s The Conservation Revolution, an influential manifesto within contemporary critical conservation scholarship. While the book offers a powerful political–economic critique of fortress, neoliberal and neoprotectionist conservation paradigms and advances ‘convivial conservation’ as a transformative alternative, this paper evaluates both its intellectual contributions and limitations. The analysis examines the book’s citational politics, theoretical framing and empirical scope, arguing that its reliance on metropolitan critical theory and limited engagement with place-based case studies constrain its claim to global applicability. Particular attention is given to the book’s terrestrial bias and minimal engagement with marine socioecological systems, which restricts its capacity to address governance challenges in oceanic environments. Drawing on interdisciplinary literature, including Indigenous-led conservation in Papua New Guinea and community-based coexistence strategies in Botswana, the paper demonstrates that many practices aligned with convivial conservation already exist as grounded, relational and locally governed approaches. These cases suggest that conservation transformation often emerges through incremental, situated governance rather than universal political rupture. The paper concludes that while The Conservation Revolution re-politicizes conservation debates, future scholarship must integrate systemic critique with epistemic plurality, marine and terrestrial ecologies and empirically grounded understandings of conservation practice.
This paper presents new radiocarbon (14C) measurements from annual tree rings of English oak (Quercus robur L.) from Kujawy, Poland, spanning 1042–1062 CE. The results confirm an increase in Δ14C values between 1053 and 1055 CE, within the Oort Minimum of solar activity, consistent with literature values (Brehm et al. 2021a; Eastoe et al. 2019; Terrasi et al. 2020). The data reveal a sustained increase in Δ14C values between 1053 and 1055 CE, rising from −6.9 ± 1.8‰ to −2.6 ± 1.8‰. For the preceding period (1042–1052 CE), the average Δ14C value is −11.0 ± 1.9%, indicating a significant increase of 8.4 ± 2.6‰ toward 1055 CE. The study estimates the 14C production rate during this period and suggests the radiocarbon increase likely began before 1054 CE, indicating it is unlikely to be significantly attributed to the supernova in 1054 CE. The study contributes to refining the understanding of rapid changes in atmospheric radiocarbon and their potential causes.
Cocaine has become a paradigmatic case in the study of drugs and global histories, illuminating the interplay of bioprospecting, transcultural exchange, commodification, and legal regimes. Existing scholarship traces a trajectory from traditional Andean uses of kuka and Spanish colonial prohibitions to the nineteenth-century chemical research of Friedrich Wöhler and Albert Niemann, who isolated what is known today as cocaine. This narrative, however, is often framed through a teleological lens that moves from Indigenous “discovery,” through Catholic Spanish regulation, to Protestant Germanophone science. Such framing obscures alternative actors and circuits that were central to the making of cocaine’s modern history. This article examines one such neglected episodes: in 1858, the Italian pharmacist Enrique Pizzi announced his study of “Cocaïna” while working at his Botica y Droguería in La Paz. Samples of his preparation were delivered to Wöhler and Niemann’s laboratory in Göttingen by the Swiss naturalist Johann Jakob von Tschudi, routed through Vienna. Drawing on archival and primary sources from Bolivia, Peru, Italy, Germany, Switzerland and Austria, the article reconsiders this episode, which has often been dismissed in contemporary and later accounts as either fraudulent or failed. Rather than altering the canonical story of cocaine’s global emergence, Pizzi’s work highlights how selective archival survival and historiographical framing have created gaps in the global history of cocaine. By restoring this missing link, the article reflects on the silences and asymmetries that structure global drug histories and argues for a more plural account of scientific modernity in nineteenth-century Latin America.
This article considers a long-term stand-off between two forms of governance. Until the very end of British rule in India and Burma, a cluster of small polities effectively held imperialism at bay. Despite being surrounded, they remained independent and self-governing (in British parlance: ‘unadministered’) up until the eve of the Second World War. They have so far been overlooked in the historiography, and yet these rugged hills provide a unique vantage point from which to consider the limits of empire in the India-Burma borderlands. The martial Zo (‘Shendu’) inhabitants and their guerrilla tactics matched British aggression and bred anxiety in border officials. The British remained largely ignorant about this region. Under the restrictions of an imperial non-intervention policy, they could not enter it. This policy was inspired by the calculation that conquering these inaccessible mountains might cost more than it would yield in head tax and forest products. The result was a geopolitical rarity: an obstinate island of indigenous governance, cultural continuity, and micro-warfare enclosed by imperial territories.
This article focuses on the British annexation of the Dai territories in the border zone of Qing China and Burma in the late nineteenth century. It investigates the coercive force used by the British to secure control of the territory and its people, which was asserted on the basis of having had tributary relations with the earlier kingdom of Burma. In this case, I argue that the use of violence as a means to an end is better understood when separated into the mutually reinforcing forms of armed and bureaucratic violence. In these two forms, violent force shaped a practice—a mode of operation—that facilitated and secured British governance in the large territories separating the Chinese Qing state from British Burma. The article is part of a larger investigation that connects British operations on the empire’s much-varied northeastern frontier from the Brahmaputra eastwards into Yunnan, in two periods of its expansion in the early and late nineteenth century.
Public policies contribute to structural racism and health inequities. To dismantle structural racism and advance health equity, methods aligning scientific evidence, community priorities, and political will are needed to implement equity-focused interventions. This study combined community-based participatory research and legal epidemiology methods to inform local policy in East Point, Georgia. The community informed a comprehensive policy approach to address social determinants of health (SDOH) and advance health equity and identified East Point’s Comprehensive Plan Update as an opportunity to advance health equity through policy. Key findings informed a legal epidemiology study to assess variation in including equity and health equity in comprehensive plans across 32 jurisdictions. Limited adoption of equity and health equity provisions were found, revealing opportunities to inform the East Point policymaking process. Research findings were summarized and disseminated to the community and policymakers. In 2023, East Point adopted equity, health, and health equity into its comprehensive plan for the first time. This case study demonstrates that collaborative, multi-sector, community-centered approaches can support policy interventions that address historical race-based, health-harming policies, and thereby dismantle structural racism. Inclusion of health equity in East Point’s comprehensive plan provides a foundation for future implementation of policies that address SDOH and health inequities.
England’s Family Hubs and Start for Life (SfL) Programme Guidance recommends strengthening early years services by increasing workforce capacity and capability through innovative skill mix models. However, evidence regarding how different innovative early years skill mix workforce models operate, function, and influence outcomes remains limited. To address this gap, five local authorities in England that are existing SfL sites received funding from the Department of Health and Social Care (DHSC) to design and pilot innovative early years skill mix workforce models to enhance their Family Hub offers and better support families with children under two.
Methods:
The evaluation is guided by each site’s Theory of Change and uses a mixed-methods design. The study consists of five workstreams. First, pilot models will be mapped through documentary analysis, including content analysis of role descriptions and audits of workforce activities recorded in clinical diaries. Second, system-level mechanisms, facilitators, and barriers to implementation will be examined through reviews of service and management data and semi-structured interviews with key stakeholders. Third, relational structures underpinning effective practice will be explored using 75 family-level case studies and Social Network Analysis to assess professional networks and their influence on family and practitioner experiences. Fourth, impacts will be estimated using Synthetic Control Methods to assess effects on Healthy Child Programme outcomes, alongside cost and cost-benefit analyses. Finally, the broader application of skill mix working will be explored through semi-structured interviews and case studies across additional local authorities.
This paper explores a dilemma often faced by marginalized groups: how to cope with oppression when doing so necessitates a choice between safeguarding immediate personal well-being and fighting for structural change. While mainstream conceptions of coping take it to be an individual-level phenomenon aimed at maintaining/restoring personal well-being through emotion regulation processes, a recent plea in psychology calls for the “decolonization” of coping, such that collective efforts aimed at liberatory change be construed as genuine instances of coping as well. We provide the first philosophical treatment of “decolonial coping” and assess its merits and drawbacks as compared to mainstream coping. Our focus on coping double binds contributes to the philosophical literature on double binds by broadening the range of scenarios that can plausibly be understood as instances of double binds and the normative analysis of the costs associated with each horn of the dilemma and with the double bind itself. We identify the affective injustice of apt ambivalence, thereby also addressing for the first time the relation between double binds and affective injustice.
People with complex emotional needs (CEN) often receive poor care and struggle to access the evidence-based therapy they require. As part of community transformation, the Help to Overcome Personal and Emotional problems (H.O.P.E) team in Northumberland, and the Relational and Emotional Difficulties Service (REDS) in Cambridge, were set up to ensure that people with CEN could receive timely therapy without accessing secondary or tertiary services. Both services focus on providing adapted versions of dialectical behaviour therapy (DBT). The present study aims to understand the process followed to establish the two teams, identify whether they have been able to deliver accessible and acceptable treatment, and reflect on shared learning points for other services to consider. The study provides descriptions of the two service designs, further to quantitative and qualitative feedback from participants that completed treatment with the services. The results confirm that people in Northumberland and Cambridgeshire who accessed the services found the therapy to be acceptable and reported significant improvement in their ability to regulate their emotions, a decrease in symptoms associated with CEN, and a greater sense of progress towards achieving meaningful goals in their lives. However, in line with the broader literature, a high number of people dropped out and did not complete the interventions. The results suggest that the H.O.P.E team and REDS are providing acceptable and accessible evidence-based treatment for people with CEN. Reflections for future services to consider regarding reducing drop-out rates, the length of treatment, inclusion criteria, engaging people from minority groups and the use of online vs face-to-face therapy are provided.
Key learning aims
(1) Understand the process followed to establish two different CEN services in primary care settings.
(2) Identify whether two CEN services have delivered accessible and acceptable treatment.
(3) Compare how two CEN services are structured, and highlight shared learning points for other services.
Palliative psychiatry is an approach that aims to prevent and/or alleviate suffering and improve the quality of life of patients and their families through timely assessment and treatment when faced with physical, psychological, social, and spiritual problems associated with serious life-threatening mental illness. However, the need for psychiatric palliative care for individuals with serious mental illness has remained in the background and only became possible in the early 21st century. Therefore, it is essential that nurses, one of the most important actors of patient-centered care, assume the responsibility of providing palliative psychiatric care as a requirement of their patient advocacy role. The aim of this study was to determine the perception of palliative psychiatric care by psychiatric nurses in a country where palliative psychiatry has not yet emerged.
Methods
A study in qualitative descriptive design with semi-structured interviews. Fifteen psychiatric nurses participated in individual interviews. The data were analyzed using thematic analysis.
Results
Four themes (Perception of palliative psychiatric care, Palliative psychiatric care practices, Barriers to palliative psychiatric care, and Recommendations for providing palliative psychiatric care) and 14 sub-themes were identified.
Significance of results
Psychiatric nurses are not familiar with the concept of palliative psychiatric care and associate it with holistic and individualized care. Nurses stated that palliative psychiatric care targets serious psychiatric disorders, treatment-resistant conditions, comorbidities and end-of-life care. In order to overcome barriers to palliative psychiatric care, suggestions were made for reorganizing the health system, establishing palliative care centers, training professionals in this field, and efforts to combat stigma.
Listening ability in second language (L2) assessment is elicited through test methods that often require other abilities, which may introduce construct-irrelevant variance and threaten the validity of the test. While previous research has examined the effects of item presentation and item format on test performance, studies on test-takers’ cognitive processing remain exploratory. This study investigates the effects of two test method variables, item presentation (operationalized as while-listening performance [WLP] vs. post-listening performance [PLP]) and item format (operationalized as multiple-choice questions [MCQs] vs. open-ended questions [OEQs]), on test-takers’ cognitive processing, using gaze behaviors as real-time indicators. A Graeco-Latin square design was employed to administer four psychometrically validated short-talk listening testlets across the test conditions. Eye-tracking data were collected while controlling for word count and typing speed as covariates. Linear mixed-effects modeling revealed higher total fixation duration, fixation counts, total visit duration, and visit counts in the WLP condition than in the PLP condition. Interaction effects for all four metrics further indicated that these differences were more pronounced for MCQs than for OEQs. Additionally, typing speed and word count contributed to the variance in eye-tracking measures. The findings contribute to our growing understanding of how test methods shape listening processes and offer implications for the design and interpretation of L2 listening assessments.
To understand how the workflows and infection prevention and control (IPC) practices of certified nursing assistants (CNAs) during high-contact resident care activities contribute to multidrug-resistant organism (MDRO) transmission in nursing homes.
Methods:
We conducted 10 high-fidelity simulations of two high-contact resident care activities, bed bathing and incontinence care, with CNAs from long-term or mixed-care units. Four genetic variants of λ phage were applied to select surfaces prior to simulations and subsequently sampled from the environment, residents, supplies, and CNAs. Simulations were video recorded and analyzed for patterns of hand-to-surface contact and performance of IPC practices, including hand hygiene, personal protective equipment use, and environmental surface cleaning or disinfection.
Results:
A median of 11.5 transmission events occurred per simulation. Most events (60%) occurred within residents’ immediate environments, reflecting how CNAs frequently transitioned between a resident, their surroundings, and care supplies, combined with infrequent hand hygiene and surface disinfection. Contamination of CNA scrubs and hands accounted for 24% of events, primarily from bed bathing, which involved frequent contact without a gown. Transmission to shared objects (e.g., linen bin, trash can, wheelchair) accounted for 16% of events and created additional opportunities for transmission between residents. Transmission between residents or their immediate environments was rare but typically associated with workflow disruptions from limited-supply availability.
Conclusions:
In high-fidelity simulations of high-contact resident care activities, transmission of surrogate markers for MDROs closely followed the workflows of CNAs. This method identifies potential transmission pathways and interventions for mitigating MDRO spread in nursing homes.