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The World Health Organization (WHO) has a global initiative to eliminate industrially produced trans fatty acids (iTFAs) from the food supply (1). Formed via the partial hydrogenation of vegetable oils to create hardened vegetable fat, iTFAs can be found in processed foods including fried foods and baked goods. Even small amounts of iTFAs can increase the risk of coronary heart disease. These can be successfully eliminated from the food supply with the WHO recommending a ban on partially hydrogenated oils or to limit iTFA in food to a maximum of 2% of total fat (1). As of June 2024, over 50 countries had one of these regulatory measures in place. The trans-Tasman Food Regulation System is considering policy options to ensure iTFAs are eliminated or reduced as much as possible from the food supply in Australia and New Zealand. Up to date data on the presence of iTFAs in the New Zealand food supply is needed to inform this work as this was last measured in New Zealand in 2007/09 for packaged food and 2013 for fast food. The aim of this survey was to determine the presence and levels of iTFAs in the New Zealand food supply. Since it is not possible to analytically quantify iTFA separately from trans-fats that occur naturally in food products of ruminant origin, such as dairy, beef and lamb products, the sampling plan was designed to target products likely to contain predominately iTFA and adapted from the WHO global protocol for measuring trans fatty acid profiles of foods(2) to the New Zealand context. The survey analysed the trans-fat content of 627 products across national supermarkets (275 products), international supermarkets specialising in imported foods (149 products) and ready-to-eat food outlets (203 products from three regions). One hundred and six products (16.9%) contained trans-fat that exceeded 2% of total fat. Twenty-five (4%) of these products were likely to contain predominately iTFA. The 25 products predominately containing iTFA included eight products from national supermarkets (mostly bakery products), nine products from international supermarkets (mostly curry pastes and biscuits) and eight products from ready-to-eat food outlets (all fried foods). The median trans-fat content of these 25 products was 3.2% of total fat (assumed to be all iTFA). Over a third of these products contained more than double the recommended WHO limit, with five products containing over four times the limit and one product containing more than 16 times the WHO limit. The remaining 81 products may contain some iTFA, but we were unable to quantify the amount. The results from this survey will be used by New Zealand Food Safety to inform the consideration of regulatory options for reducing iTFAs in foods in New Zealand.
The objective of the food safety system is to provide safe and suitable food in New Zealand(1). This is of particular importance for our youngest members– infants and young children. During the first 2000 days of life, food and nutrition have crucial roles. Nutrient requirements are high, and children often have an increased vulnerability to hazards associated with chemical and microbiological contamination. Foods targeted to this age group typically have strict regulations, as the quality and safety of foods for infants and young children is of great concern to caregivers, public health authorities and regulatory bodies worldwide. The recent First Foods New Zealand Study (FFNZ) and Young Foods New Zealand (YFNZ) Study have provided important data into what, and how, we feed our infants and young children under four years of age(2). Insights from the dietary intakes and health of 925 infants and young children from these studies are being used by NZFS to inform its work on food monitoring surveillance and food policy. Currently New Zealand Food Safety (NZFS) is conducting the 2024 New Zealand Total Diet Study (NZTDS) (Infants and Toddlers)(3). The NZTDS is a food monitoring and surveillance programme which aims to evaluate the risk to New Zealanders from exposure to certain chemicals such as agricultural chemicals, contaminants (including from food packaging), and nutrients. The 2024 NZTDS will, for the first time, focus exclusively on infants and young children. The FFNZ and YFNZ studies informed the selection of 117 foods to be tested from four New Zealand regions throughout 2024/2025. The dietary intake data will then be used to estimate the dietary exposure to each of the 362 chemicals analysed. This monitoring programme informs policy decision-making and food standard setting and provides assurance on the safety of our food supply. Concerns around the nutrient quality and labelling of some commercial products for infants and young children have been identified in Australia and New Zealand. Within the joint food regulatory system, consultation is underway to consider regulatory and non-regulatory options for improving commercial foods for infants and young children(4). This presentation will discuss NZFS’s role in monitoring foods and diets of infants and young children in Aotearoa New Zealand, the importance of, and application of evidence to inform policy, food safety, and potential regulatory and non-regulatory options to ensure that the food safety system continues to deliver safe and suitable food in New Zealand.
COMPASS is an educational intervention aimed at supporting individualised goal setting for students on the autism spectrum. Although its effectiveness is supported by quantitative data, little qualitative research has explored the perceived benefits and challenges of implementing COMPASS with community consultants. In the present qualitative study, we explored the benefits and challenges of COMPASS from the perspectives of stakeholders including parents/caregivers, teachers, and consultants. Semistructured interviews and focus groups were recorded and analysed using reflexive thematic analysis. Participants felt COMPASS (a) brings the right information to the table, (b) sets the scene for collaboration, and (c) uses a quality tool for data collection. The fourth theme reflected participants’ concerns around how (d) time could be a barrier. The data for this study has implications for the individualised planning process for students on the autism spectrum, a process directly linked to critical student outcomes. Overall, stakeholders spoke positively about student outcomes, which they linked directly to participation in the COMPASS program. The standardised process for individualised planning provided by COMPASS was particularly valued. Results of the study provide further understanding about the COMPASS intervention and offer a direction for future replications of COMPASS.
Biodiversity is in rapid decline, but the extent of loss is not well resolved for poorly known groups. We estimate the number of extinctions for Australian non-marine invertebrates since the European colonisation of the continent. Our analyses use a range of approaches, incorporate stated uncertainties and recognise explicit caveats. We use plausible bounds for the number of species, two approaches for estimating extinction rate, and Monte Carlo simulations to select combinations of projected distributions from these variables. We conclude that 9,111 (plausible bounds of 1,465 to 56,828) Australian species have become extinct over this 236-year period. These estimates dwarf the number of formally recognised extinctions of Australian invertebrates (10 species) and of the single invertebrate species listed as extinct under Australian legislation. We predict that 39–148 species will become extinct in 2024. This is inconsistent with a recent pledge by the Australian government to prevent all extinctions. This high rate of loss is largely a consequence of pervasive taxonomic biases in community concern and conservation investment. Those characteristics also make it challenging to reduce that rate of loss, as there is uncertainty about which invertebrate species are at the most risk. We outline conservation responses to reduce the likelihood of further extinctions.
The Zones of Regulation (The Zones) is an 18-lesson curriculum that is aimed at helping students develop an awareness of emotions and skills for regulation. Although used by schools globally, no peer-reviewed evidence currently exists to support the use of The Zones. The purpose of this study was to examine the experiences of teachers implementing The Zones curriculum with autistic students. Feedback was gathered from 26 teachers throughout their implementation of The Zones. In this study, we employed a qualitative methodology to analyse the feedback from teachers. Descriptive statistics were used to report on acceptability, appropriateness, and feasibility. Our findings revealed that teachers described high levels of acceptability, appropriateness, and feasibility when reflecting on the delivery of The Zones. However, teachers reported that The Zones was not suitable for all students and classrooms. For students for whom The Zones was deemed appropriate, teachers modified the lessons and required peer support to deliver these modifications. With modifications, the teachers observed growth in areas such as students’ comprehension of others’ emotions and improved language around emotions. This study highlights the importance of further research to refine and tailor interventions like The Zones to better meet the diverse needs of autistic students in educational settings.
Oceania is currently facing a substantial challenge: to provide sustainable and ethical food systems that support nutrition and health across land and water. The Nutrition Society of Australia and the Nutrition Society of New Zealand held a joint 2023 Annual Scientific Meeting on ‘Nutrition and Wellbeing in Oceania’ attended by 408 delegates. This was a timely conference focussing on nutrition challenges across the Pacific, emphasising the importance of nutrition across land and water, education settings, women’s health and gut health. Cutting-edge, multi-disciplinary and collaborative research was presented in a 4-day programme of keynote presentations, workshops, oral and poster sessions, breakfast and lunch symposiums and early career researcher sessions. The conference highlighted the importance of collaboration between nations to address the challenge facing nutrition and wellbeing across Oceania. A systems approach of collaboration among scientists, industry and government is vital for finding solutions to this challenge.
Accelerating COVID-19 Treatment Interventions and Vaccines (ACTIV) was initiated by the US government to rapidly develop and test vaccines and therapeutics against COVID-19 in 2020. The ACTIV Therapeutics-Clinical Working Group selected ACTIV trial teams and clinical networks to expeditiously develop and launch master protocols based on therapeutic targets and patient populations. The suite of clinical trials was designed to collectively inform therapeutic care for COVID-19 outpatient, inpatient, and intensive care populations globally. In this report, we highlight challenges, strategies, and solutions around clinical protocol development and regulatory approval to document our experience and propose plans for future similar healthcare emergencies.
This manuscript addresses a critical topic: navigating complexities of conducting clinical trials during a pandemic. Central to this discussion is engaging communities to ensure diverse participation. The manuscript elucidates deliberate strategies employed to recruit minority communities with poor social drivers of health for participation in COVID-19 trials. The paper adopts a descriptive approach, eschewing analysis of data-driven efficacy of these efforts, and instead provides a comprehensive account of strategies utilized. The Accelerate COVID-19 Treatment Interventions and Vaccines (ACTIV) public–private partnership launched early in the COVID-19 pandemic to develop clinical trials to advance SARS-CoV-2 treatments. In this paper, ACTIV investigators share challenges in conducting research during an evolving pandemic and approaches selected to engage communities when traditional strategies were infeasible. Lessons from this experience include importance of community representatives’ involvement early in study design and implementation and integration of well-developed public outreach and communication strategies with trial launch. Centralization and coordination of outreach will allow for efficient use of resources and the sharing of best practices. Insights gleaned from the ACTIV program, as outlined in this paper, shed light on effective strategies for involving communities in treatment trials amidst rapidly evolving public health emergencies. This underscores critical importance of community engagement initiatives well in advance of the pandemic.
The immune system is a highly dynamic element of physiology, sensitive to both the external environment and organism-intrinsic factors. Inflammatory responses of sufficient magnitude are required to maintain homeostasis and protect from disease, but must be resolved on an appropriate timescale to prevent excessive damage and chronic inflammation. The circadian clock is a critical regulator of immune function and circadian disruption is a known risk factor in multiple diseases, disturbing physiological processes and exacerbating inflammation. Interactions between the circadian clock and immune system are bidirectional, as pathogens and inflammatory molecules can themselves disrupt local rhythms in cells and tissues. Here, we discuss the evidence linking circadian disruption with maladaptive immune function, including studies of shift work, sleep deficiency, genetic disruption of rhythms, and animal models of inflammatory diseases.
We record 392 species or morphospecies of bees (Hymenoptera: Apoidea) for Manitoba, Canada, which is 154 more species than reported in 2015 and includes five new generic records since 2015 (Ashmeadiella, Brachymelecta, Eucera, Neolarra, and Triepeolus). Thirteen new records reported here are new for Canada: Calliopsis (Nomadopsis) australior Cockerell, Perdita (Perdita) tridentata Stevens, Brachymelecta interrupta (Cresson), Diadasia (Dasiapis) ochracea (Cockerell), Melissodes bidentis Cockerell, Nomada crawfordi crawfordi Cockerell, Nomada fuscicincta Swenk, Nomada sphaerogaster Cockerell, Nomada xantholepis Cockerell, Triepeolus cf. grindeliae Cockerell, Dianthidium (Dianthidium) parvum (Cresson), Coelioxys (Xerocoelioxys) nodis Baker, and Megachile (Megachiloides) dakotensis Mitchell. We remove the following species from the list of Manitoba bees based on re-examination of voucher material: Andrena (Ptilandrena) geranii Robertson, Andrena (Rhacandrena) robertsonii Dalla Torre, Andrena (Simandrena) nasonii Robertson, Andrena (Trachandrena) ceanothi Viereck, Andrena (Trachandrena) quintilis Robertson, Lasioglossum (Hemihalictus) pectoraloides (Cockerell), Lasioglossum (Lasioglossum) forbesii (Robertson), and Dianthidium (Dianthidium) concinnum (Cresson). We propose that Nomada alpha paralpha Cockerell, 1921 and N. alpha dialpha Cockerell, 1921 are junior synonyms of N. alpha Cockerell, 1905. Nomada arenicola Swenk, 1912 is considered a junior synonym of N. fervida Smith, 1854. Protandrena albertensis (Cockerell) and Neolarra mallochi Michener are recognised as valid species. We provide additional notes on taxonomy, nomenclature, and behaviour for select species in the list.
Early in the COVID-19 pandemic, the World Health Organization stressed the importance of daily clinical assessments of infected patients, yet current approaches frequently consider cross-sectional timepoints, cumulative summary measures, or time-to-event analyses. Statistical methods are available that make use of the rich information content of longitudinal assessments. We demonstrate the use of a multistate transition model to assess the dynamic nature of COVID-19-associated critical illness using daily evaluations of COVID-19 patients from 9 academic hospitals. We describe the accessibility and utility of methods that consider the clinical trajectory of critically ill COVID-19 patients.
In response to the 2014–2016 West Africa Ebola virus disease (EVD) epidemic, the Centers for Disease Control and Prevention (CDC) designated 56 US hospitals as Ebola treatment centers (ETCs) with high-level isolation capabilities. We sought to determine the ongoing sustainability of ETCs and to identify how ETC capabilities have affected hospital, local, and regional coronavirus disease 2019 (COVID-19) readiness and response.
Design:
An electronic survey included both qualitative and quantitative questions and was structured into 2 sections: operational sustainability and role in the COVID-19 response.
Setting and participants:
The survey was distributed to site representatives from the 56 originally designated ETCs, and 37 (66%) responded.
Methods:
Data were coded and analyzed using descriptive statistics.
Results:
Of the 37 responding ETCs, 33 (89%) reported that they were still operating, and 4 had decommissioned. ETCs that maintain high-level isolation capabilities incurred a mean of $234,367 in expenses per year. All but 1 ETC reported that existing capabilities (eg, trained staff, infrastructure) before COVID-19 positively affected their hospital, local, and regional COVID-19 readiness and response (eg, ETC trained staff, donated supplies, and shared developed protocols).
Conclusions:
Existing high-level isolation capabilities and expertise developed following the 2014–2016 EVD epidemic were leveraged by ETCs to assist hospital-wide readiness for COVID-19 and to support responses by other local and regional hospitals However, ETCs face continued challenges in sustaining those capabilities for high-consequence infectious diseases.
The COVID-19 pandemic led to changes in how healthcare was accessed and delivered. It was suggested that COVID-19 will lead to an increased delirium burden in its acute phase, with variable effect on mental health in the longer term. Despite this, there are limited data on the direct effects of the pandemic on psychiatric care.
Objectives
1) describe the mental health presentations of a diverse acute inpatient population, 2) compare findings with the same period in 2019, 3) characterise the SARS-CoV-2 positive cohort of patients.
Methods
We present a descriptive summary of the referrals to a UK psychiatric liaison department during the exponential phase of the pandemic, and compare this to the same period in 2019.
Results
show a 40.3% reduction in the number of referrals in 2020, with an increase in the proportion of referrals for delirium and psychosis. One third (28%) of referred patients tested positive for COVID-19 during their admission, with 39.7% of these presenting with delirium as a consequence of their COVID-19 illness. Our data indicate decreased clinical activity for our service during the pandemic’s peak. There was a marked increase in delirium, though in no other psychiatric presentations.
Conclusions
In preparation for further exponential rises in COVID-19 cases, we would expect seamless integration of liaison psychiatry teams in general hospital wards to optimise delirium management in patients with COVID-19. Further consideration should be given to adequate staffing of community and crisis mental health teams to safely manage the potentially increasing number of people reluctant to visit the emergency department.
Unemployment and being not in the labour force (NILF) are risk factors for suicide, but their association with self-harm is unclear, and there is continuing debate about the role of confounding by prior mental health conditions. We examine associations between employment status and self-harm and suicide in a prospective cohort, taking into account prior mental-health-related factors.
Methods
We used linked data from the New Zealand Integrated Data Infrastructure. The outcomes were chosen to be hospital presentation for self-harm and death by suicide. The exposure was employment status, defined as employed, unemployed, or NILF, measured at the 2013 Census. Confounders included demographic factors and mental health history (use of antidepressant medication, use of mental health services, and prior self-harm). Logistic regression was used to model effects. Analyses were stratified by gender.
Results
For males, unemployment was associated with an increased risk of suicide [odds ratio (OR): 1.48, 95% confidence interval (CI): 1.20–1.84] and self-harm (OR: 1.55, 95% CI: 1.45–1.68) after full adjustment for confounders. NILF was associated with an increased risk of self-harm (OR: 1.43, 95% CI: 1.32–1.55), but less of an association was seen with suicide (OR: 1.19, 95% CI: 0.94–1.49). For females, unemployment was associated with an increased risk of suicide (OR: 1.30, 95% CI: 0.93–1.80) and of self-harm (OR: 1.52, 95% CI: 1.43–1.62), and NILF was associated with a similar increase in risk for suicide (OR: 1.31, 95% CI: 0.98–1.75) and self-harm (OR: 1.32, 95% CI: 1.26–1.40).
Discussion
Exclusion from employment is associated with a considerably heightened risk of suicide and self-harm for both men and women, even among those without prior mental health problems.
Throughout the eighteenth century and into the nineteenth century, enslaved people in the Caribbean and South, Central, and North America performed Jonkanoo, a masked parade of dance and song. This Christmas tradition was rooted in the memory of armed resistance to imperialism in the figure of‘John Cannu’, also known as ‘John Konny’, a West African tribal chief who rebelled against Dutch settlers in the 1720s. After being captured and sent as a slave to Jamaica, he became a folk hero featured in Jonkanoo performances. Merging African dance and masquerade traditions with English carnivalesque mummery, these performances were tolerated by slave owners as a ‘temporary suspension of all hierarchic distinctions and barriers among men’, as Mikhail Bakhtin posited. Jonkanoo was nonetheless a form of resistance against white oppression and persists today in Jamaica and the Bahamas as vernacular performances of resistance, freedom, and memory that represent a fluidity between formal theatre, music, and street performances.