The marketing of unhealthy foods has been implicated in poor diet and rising levels of obesity. Rapid developments in the digital food marketing ecosystem and associated research mean that contemporary review of the evidence is warranted. This preregistered (CRD420212337091)1 systematic review and meta-analysis aimed to provide an updated synthesis of the evidence for behavioural and health impacts of food marketing on both children and adults, using the 4Ps framework (Promotion, Product, Price, Place). Ten databases were searched from 2014 to 2021 for primary data articles of quantitative or mixed design, reporting on one or more outcome of interest following food marketing exposure compared with a relevant control. Reviews, abstracts, letters/editorials and qualitative studies were excluded. Eighty-two studies were included in the narrative review and twenty-three in the meta-analyses. Study quality (RoB2/Newcastle–Ottawa scale) was mixed. Studies examined ‘promotion’ (n 55), ‘product’ (n 17), ‘price’ (n 15) and ‘place’ (n 2) (some > 1 category). There is evidence of impacts of food marketing in multiple media and settings on outcomes, including increased purchase intention, purchase requests, purchase, preference, choice, and consumption in children and adults. Meta-analysis demonstrated a significant impact of food marketing on increased choice of unhealthy foods (OR = 2·45 (95 % CI 1·41, 4·27), Z = 3·18, P = 0·002, I2 = 93·1 %) and increased food consumption (standardised mean difference = 0·311 (95 % CI 0·185, 0·437), Z = 4·83, P < 0·001, I2 = 53·0 %). Evidence gaps were identified for the impact of brand-only and outdoor streetscape food marketing, and for data on the extent to which food marketing may contribute to health inequalities which, if available, would support UK and international public health policy development.

The cornerstone of obesity treatment is behavioural weight management, resulting in significant improvements in cardio-metabolic and psychosocial health. However, there is ongoing concern that dietary interventions used for weight management may precipitate the development of eating disorders. Systematic reviews demonstrate that, while for most participants medically supervised obesity treatment improves risk scores related to eating disorders, a subset of people who undergo obesity treatment may have poor outcomes for eating disorders. This review summarises the background and rationale for the formation of the Eating Disorders In weight-related Therapy (EDIT) Collaboration. The EDIT Collaboration will explore the complex risk factor interactions that precede changes to eating disorder risk following weight management. In this review, we also outline the programme of work and design of studies for the EDIT Collaboration, including expected knowledge gains. The EDIT studies explore risk factors and the interactions between them using individual-level data from international weight management trials. Combining all available data on eating disorder risk from weight management trials will allow sufficient sample size to interrogate our hypothesis: that individuals undertaking weight management interventions will vary in their eating disorder risk profile, on the basis of personal characteristics and intervention strategies available to them. The collaboration includes the integration of health consumers in project development and translation. An important knowledge gain from this project is a comprehensive understanding of the impact of weight management interventions on eating disorder risk.

Hercules Dome, Antarctica, has long been identified as a prospective deep ice core site due to the undisturbed internal layering, climatic setting and potential to obtain proxy records from the Last Interglacial (LIG) period when the West Antarctic ice sheet may have collapsed. We performed a geophysical survey using multiple ice-penetrating radar systems to identify potential locations for a deep ice core at Hercules Dome. The surface topography, as revealed with recent satellite observations, is more complex than previously recognized. The most prominent dome, which we term ‘West Dome’, is the most promising region for a deep ice core for the following reasons: (1) bed-conformal radar reflections indicate minimal layer disturbance and extend to within tens of meters of the ice bottom; (2) the bed is likely frozen, as evidenced by both the shape of the measured vertical ice velocity profiles beneath the divide and modeled ice temperature using three remotely sensed estimates of geothermal flux and (3) models of layer thinning have 132 ka old ice at 45–90 m above the bed with an annual layer thickness of ~1 mm, satisfying the resolution and preservation needed for detailed analysis of the LIG period.

X-ray laboratory diffraction contrast tomography (LabDCT) produces three-dimensional (3D) maps of crystallographic orientation. The non-destructive nature of the technique affords the key benefit of full 3D context of these, and other, in situ measurements. This study is the first to apply the technique to any material other than a metal or silicon. We report the first 3D measurements of the crystallographic orientation of olivine, which also makes this study the first to apply LabDCT to (1) a non-metallic, non-cubic system and (2) geological material. First, we scanned fragments of olivine set in resin alongside glass microbeads using LabDCT and absorption contrast tomography (ACT). Then we reconstructed these data assuming an orthorhombic crystal system. We show that: (1) the regions within the sample that index well according to the orthorhombic system correspond to olivine fragments in the ACT image; (2) crystalline regions not corresponding to olivine are not indexed assuming the same lattice parameters; and (3) the diffraction data discriminates crystalline from non-crystalline materials as expected. Finally, we demonstrate that the method resolves sub-degree orientation differences between distinct regions within individual olivine fragments. We conclude that DCT can be applied to the study of rocks and other crystalline materials, and offers advantages over conventional techniques. We also note that LabDCT may offer a solution to the crystallographic measurement of substances that would otherwise be difficult to measure due to challenges in obtaining a perfect sample polish. Future developments to accommodate larger experimental volumes and additional crystallographic systems within a sample promises to expand the applicability and impact of DCT.

The ventricular assist device is being increasingly used as a “bridge-to-transplant” option in children with heart failure who have failed medical management. Care for this medically complex population must be optimised, including through concomitant pharmacotherapy. Pharmacokinetic/pharmacodynamic alterations affecting pharmacotherapy are increasingly discovered in children supported with extracorporeal membrane oxygenation, another form of mechanical circulatory support. Similarities between extracorporeal membrane oxygenation and ventricular assist devices support the hypothesis that similar alterations may exist in ventricular assist device-supported patients. We conducted a literature review to assess the current data available on pharmacokinetics/pharmacodynamics in children with ventricular assist devices. We found two adult and no paediatric pharmacokinetic/pharmacodynamic studies in ventricular assist device-supported patients. While mechanisms may be partially extrapolated from children supported with extracorporeal membrane oxygenation, dedicated investigation of the paediatric ventricular assist device population is crucial given the inherent differences between the two forms of mechanical circulatory support, and pathophysiology that is unique to these patients. Commonly used drugs such as anticoagulants and antibiotics have narrow therapeutic windows with devastating consequences if under-dosed or over-dosed. Clinical studies are urgently needed to improve outcomes and maximise the potential of ventricular assist devices in this vulnerable population.

Emergency Medical Services (EMS) providers face many ethical issues while providing prehospital care to children and adults. Although provider judgment plays a large role in the resolution of conflicts at the scene, it is important to establish protocols and policies, when possible, to address these high-risk and complex situations. This article describes some of the common situations with ethical underpinnings encountered by EMS personnel and managers including denying or delaying transport of patients with non-emergency conditions, use of lights and sirens for patient transport, determination of medical futility in the field, termination of resuscitation, restriction of EMS provider duty hours to prevent fatigue, substance abuse by EMS providers, disaster triage and difficulty in switching from individual care to mass-casualty care, and the challenges of child maltreatment recognition and reporting. A series of ethical questions are proposed, followed by a review of the literature and, when possible, recommendations for management.

BeckerTK, Gausche-HillM, AsweganAL, BakerEF, BookmanKJ, BradleyRN, De LorenzoRA, SchoenwetterDJ for the American College of Emergency Physicians’ EMS Committee. Ethical Challenges in Emergency Medical Services: Controversies and Recommendations. Prehosp Disaster Med. 2013;28(5):1-10.