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Tourism wildlife interactions are controversial, the debate hinging largely on the compromised welfare of the animals used. Despite this, lion cub (Panthera leo) interactions are popular, and there is a need to understand what motivates interactors to participate in the activity, their perceptions and expectations. We surveyed the attitudes of 300 visitors to three lion cub interaction facilities in South Africa. Whilst 38% of interactors were aware of the controversy around lion cub interactions, 69% desired the experience regardless. It is widely assumed that lion cub interaction opportunities are big attractions, yet 74% of respondents said that they would still have visited if lion cub interactions were not offered. Whilst 84% of interactors felt that their expectations were met, 61% said that the interaction had no impact on them. Several of those interviewed interacted with multiple species, and 34% determined that their favourite engagement was with animals that interacted back voluntarily. Most of those interviewed chose the interaction for their children (69%). Whilst 58% felt the experience was educational, only 2% of these had learnt about the plight of lions in the wild. When asked to reflect on the welfare of the lion cubs they had interacted with, ‘Freedom from discomfort’ was seen as the most important factor, as well as ‘Freedom to express natural behaviour’. Interactions were viewed with a variety of emotions and generated a range of beliefs. We conclude that the findings can be used by facilities to better prepare visitors for the experience, ensuring that interaction animals are better able to serve in their role as ambassador representatives.
Lion (Panthera leo) cubs are used in wildlife interaction tourism but the effects on cub welfare are unknown. We assessed the behaviour of three cohorts of lion cubs, twelve animals in total, at three different interaction facilities, using continuous and scan-sampling methodologies for the entire duration of cub utilisation for human interactions. Cubs spent most time inactive (62%), particularly sleeping (38%), but also spent a substantial amount of time playing (13%) and being alert (12%). A generalised linear mixed model revealed that cub behaviour was similar in two facilities but different from cubs in the third. In these two similar facilities, as human interactions increased, the time spent resting, sleeping and playing with other cubs decreased, and alert behaviour, grooming of humans and flight responses increased. In the third facility, cubs had an abnormal activity budget, with high levels of inactivity (80%) accompanied by a lack of response to human interactions. We conclude that in some facilities normal cub behaviour cannot be achieved and may be compromised by a high frequency of human interactions, which therefore needs to be controlled to limit adverse effects on cub behaviour.
Studies have reported mixed findings regarding the impact of the coronavirus disease 2019 (COVID-19) pandemic on pregnant women and birth outcomes. This study used a quasi-experimental design to account for potential confounding by sociodemographic characteristics.
Methods
Data were drawn from 16 prenatal cohorts participating in the Environmental influences on Child Health Outcomes (ECHO) program. Women exposed to the pandemic (delivered between 12 March 2020 and 30 May 2021) (n = 501) were propensity-score matched on maternal age, race and ethnicity, and child assigned sex at birth with 501 women who delivered before 11 March 2020. Participants reported on perceived stress, depressive symptoms, sedentary behavior, and emotional support during pregnancy. Infant gestational age (GA) at birth and birthweight were gathered from medical record abstraction or maternal report.
Results
After adjusting for propensity matching and covariates (maternal education, public assistance, employment status, prepregnancy body mass index), results showed a small effect of pandemic exposure on shorter GA at birth, but no effect on birthweight adjusted for GA. Women who were pregnant during the pandemic reported higher levels of prenatal stress and depressive symptoms, but neither mediated the association between pandemic exposure and GA. Sedentary behavior and emotional support were each associated with prenatal stress and depressive symptoms in opposite directions, but no moderation effects were revealed.
Conclusions
There was no strong evidence for an association between pandemic exposure and adverse birth outcomes. Furthermore, results highlight the importance of reducing maternal sedentary behavior and encouraging emotional support for optimizing maternal health regardless of pandemic conditions.
To describe the clinical impact of healthcare-associated (HA) respiratory syncytial virus (RSV) in hospitalized adults.
Design:
Retrospective cohort study within a prospective, population-based, surveillance study of RSV-infected hospitalized adults during 3 respiratory seasons: October 2017–April 2018, October 2018–April 2019, and October 2019–March 2020.
Setting:
The study was conducted in 2 academically affiliated medical centers.
Patients:
Each HA-RSV patient (in whom RSV was detected by PCR test ≥4 days after hospital admission) was matched (age, sex, season) with 2 community-onset (CO) RSV patients (in whom RSV was detected ≤3 days of admission).
Methods:
Risk factors and outcomes were compared among HA-RSV versus CO-RSV patients using conditional logistic regression. Escalation of respiratory support associated with RSV detection (day 0) from day −2 to day +4 was explored among HA-RSV patients.
Results:
In total, 84 HA-RSV patients were matched to 160 CO-RSV patients. In HA-RSV patients, chronic kidney disease was more common, while chronic respiratory conditions and obesity were less common. HA-RSV patients were not more likely to be admitted to an ICU or require mechanical ventilation, but they more often required a higher level of care at discharge compared with CO-RSV patients (44% vs 14%, respectively). Also, 29% of evaluable HA-RSV patients required respiratory support escalation; these patients were older and more likely to have respiratory comorbidities, to have been admitted to intensive care, and to die during hospitalization.
Conclusions:
HA-RSV in adults may be associated with escalation in respiratory support and an increased level of support in living situation at discharge. Infection prevention and control strategies and RSV vaccination of high-risk adults could mitigate the risk of HA-RSV.
The mother–child breastfeeding dyad is a powerful force for achieving healthy, secure and sustainable food systems. However, food system reports exclude breastfeeding and mother’s milk. To help correct this omission and give breastfeeding women greater visibility in food systems dialogue and action, we illustrate how to estimate mother’s milk production and incorporate this into food surveillance systems, drawing on the pioneering experience of Norway to show the potential value of such analysis.
Design:
The estimates use data on the proportion of children who are breastfed at each month of age (0–24 months), annual number of live births and assumptions on daily human milk intake at each month. New indicators for temporal and cross-country comparisons are considered.
Setting:
It is assumed that a breastfeeding mother on average produces 306 l of milk during 24 months of lactation.
Participants:
The annual number of live births is from Statistics Norway. Data for any breastfeeding at each month of age, between 0 and 24 months, are from official surveys in 1993, 1998–1999, 2006–2007, 2013 and 2018–2019.
Results:
Estimated total milk production by Norwegian mothers increased from 8·2 to 10·1 million l per year between 1993 and 2018–2019. Annual per capita production increased from 69 to 91 l per child aged 0–24 months.
Conclusions:
This study shows it is feasible and useful to include human milk production in food surveillance systems as an indicator of infant and young child food security and dietary quality. It also demonstrates significant potential for greater milk production.
The impact of dietary phosphorus on chronic renal disease in cats, humans and other species is receiving increasing attention. As Ca and P metabolism are linked, the ratio of Ca:P is an important factor for consideration when formulating diets for cats and other animals. Here, we describe a fully randomised crossover study including twenty-four healthy, neutered adult cats, investigating postprandial responses in plasma P, ionised Ca and parathyroid hormone (PTH) following one meal (50 % of individual metabolic energy requirement) of each of six experimental diets. Diets were formulated to provide P at either 0·75 or 1·5 g/1000 kcal (4184 kJ) from the soluble phosphorus salt sodium tripolyphosphate (STPP, Na5P3O10), variable levels of organic Ca and P sources, and an intended total Ca:P of about 1·0, 1·5 or 2·0. For each experimental diet, baseline fasted blood samples were collected prior to the meal, and serial blood samples collected hourly for 6 h thereafter. For all diets, a significant increase from baseline was observed at 120 min in plasma PTH (P < 0·001). The diet containing the highest STPP inclusion level and lowest Ca:P induced the highest peaks in postprandial plasma P and PTH levels (1·8 mmol/l and 27·2 pg/ml, respectively), and the longest duration of concentrations raised above baseline were observed at 3 h for P and 6 h for PTH. Data indicate that Ca:P modulates postprandial plasma P and PTH. Therefore, when formulating diets containing soluble P salts for cats, increasing the Ca:P ratio should be considered.
Created in London c. 1340, the Auchinleck manuscript (Edinburgh, National Library of Scotland Advocates MS 19.2.1) is of crucial importance as the first book designed to convey in the English language an ambitious range of secular romance and chronicle. Evidently made in London by professional scribes for a secular patron, this tantalizing volume embodies a massive amount of material evidence as to London commercial book production and the demand for vernacular texts in the early fourteenth century. But its origins are mysterious: who were its makers? its users? how was it made? what end did it serve? The essays in this collection define the parameters of present-day Auchinleck studies. They scrutinize the manuscript's rich and varied contents; reopen theories and controversies regarding the book's making; trace the operations and interworkings of the scribes, compiler, and illuminators; tease out matters of patron and audience; interpret the contested signs of linguisticand national identity; and assess Auchinleck's implied literary values beside those of Chaucer. Geography, politics, international relations and multilingualism become pressing subjects, too, alongside critical analyses of literary substance.
Susanna Fein is Professor of English at Kent State University (Kent, Ohio) and editor of The Chaucer Review.
Contributors: Venetia Bridges, Patrick Butler, Siobhain Bly Calkin, A. S. G. Edwards, Ralph Hanna, Ann Higgins, Cathy Hume, Marisa Libbon, Derek Pearsall, Helen Phillips, Emily Runde, Timothy A. Shonk, M-l F. Vaughan.
High dietary phosphorus (P), particularly soluble salts, may contribute to chronic kidney disease development in cats. The aim of the present study was to assess the safety of P supplied at 1 g/1000 kcal (4184kJ) from a highly soluble P salt in P-rich dry format feline diets. Seventy-five healthy adult cats (n 25/group) were fed either a low P control (1·4 g/1000 kcal [4184kJ]; Ca:P ratio 0·97) or one of two test diets with 4 g/1000 kcal (4184 kJ); Ca:P 1·04 or 5 g/1000 kcal (4184kJ); Ca:P 1·27, both incorporating 1 g/1000 kcal (4184 kJ) sodium tripolyphosphate (STPP) – for a period of 30 weeks in a randomised parallel-group study. Health markers in blood and urine, glomerular filtration rate, renal ultrasound and bone density were assessed at baseline and at regular time points. At the end of the test period, responses following transition to a commercial diet (total P – 2·34 g/1000 kcal [4184kJ], Ca:P 1·3) for a 4-week washout period were also assessed. No adverse effects on general, kidney or bone (skeletal) function and health were observed. P and Ca balance, some serum biochemistry parameters and regulatory hormones were increased in cats fed test diets from week 2 onwards (P ≤ 0·05). Data from the washout period suggest that increased serum creatinine and urea values observed in the two test diet groups were influenced by dietary differences during the test period, and not indicative of changes in renal function. The present data suggest no observed adverse effect level for feline diets containing 1 g P/1000 kcal (4184 kJ) from STPP and total P level of up to 5 g/1000 kcal (4184 kJ) when fed for 30 weeks.
Background: Contaminated surfaces within patient rooms and on shared equipment is a major driver of healthcare-acquired infections (HAIs). The emergence of Candida auris in the New York City metropolitan area, a multidrug-resistant fungus with extended environmental viability, has made a standardized assessment of cleaning protocols even more urgent for our multihospital academic health system. We therefore sought to create an environmental surveillance protocol to detect C. auris and to assess patient room contamination after discharge cleaning by different chemicals and methods, including touch-free application using an electrostatic sprayer. Surfaces disinfected using touch-free methods may not appear disinfected when assessed by fluorescent tracer dye or ATP bioluminescent assay. Methods: We focused on surfaces within the patient zone which are touched by the patient or healthcare personnel prior to contact with the patient. Our protocol sampled the over-bed table, call button, oxygen meter, privacy curtain, and bed frame using nylon-flocked swabs dipped in nonbacteriostatic sterile saline. We swabbed a 36-cm2 surface area on each sample location shortly after the room was disinfected, immediately inoculated the swab on a blood agar 5% TSA plate, and then incubated the plate for 24 hours at 36°C. The contamination with common environmental bacteria was calculated as CFU per plate over swabbed surface area and a cutoff of 2.5 CFU/cm2 was used to determine whether a surface passed inspection. Limited data exist on acceptable microbial limits for healthcare settings, but the aforementioned cutoff has been used in food preparation. Results: Over a year-long period, terminal cleaning had an overall fail rate of 6.5% for 413 surfaces swabbed. We used the protocol to compare the normal application of either peracetic acid/hydrogen peroxide or bleach using microfiber cloths to a new method using sodium dichloroisocyanurate (NaDCC) applied with microfiber cloths and electrostatic sprayers. The normal protocol had a fail rate of 9%, and NaDCC had a failure rate of 2.5%. The oxygen meter had the highest normal method failure rate (18.2%), whereas the curtain had the highest NaDCC method failure rate (11%). In addition, we swabbed 7 rooms previously occupied by C. auris–colonized patients for C. auris contamination of environmental surfaces, including the mobile medical equipment of the 4 patient care units that contained these rooms. We did not find any C. auris, and we continue data collection. Conclusions: A systematic environmental surveillance system is critical for healthcare systems to assess touch-free disinfection and identify MDRO contamination of surfaces.
In a global society experiencing an increasing shortage of qualified workers and the recognition that individuals with autism spectrum disorder (ASD) can be effective employees, there is an uptick in private sector initiatives to address employment needs through the recruitment of workers with ASD. A case study methodology with consensual qualitative research analysis was used to gain a rich understanding of employment of people with ASD at a medium-sized clothier in collaboration with a service provider for people with ASD. Perceptions of implementation and effectiveness were collected. Results suggest the hiring of people with ASD was positively perceived by employees. Components of this success included changes to the physical work environment, diversity training specific to individuals with disabilities, and a company climate of engaging and supporting employees with ASD. This research suggests that the collaborative initiative may prove a meaningful model for other companies interested in employing people with ASD.
To draw lessons from Fiji regarding the challenges and opportunities for policy initiatives to restrict (i) food marketing to children and (ii) marketing of breast milk substitutes, to inform policy for the double burden of malnutrition.
Design:
Qualitative political economy analysis of two policy case studies.
Setting:
Fiji.
Participants:
Eleven key informants from relevant sectors, representing public health, economic and consumer interests.
Results:
This study used two policy initiatives as case studies to examine factors influencing decision-making: Marketing Controls (Foods for Infants and Young Children) Regulations 2010, amended in 2016 to remove guidelines and restrictions on marketing in the form of labelling, and the draft Advertising and Promotion of Unhealthy Foods and Non-Alcoholic Beverages to Children Regulation developed in 2014 but awaiting review by the Solicitor General’s Office. Factors identified included: a policy paradigm in which regulation of business activity contradicts economic policy goals; limited perception by key policy actors of links between nutrition and marketing of breast milk substitutes, foods and beverages; and a power imbalance between industry and public health stakeholders in policymaking. Regulation of marketing for health purposes sits within the health sector’s interest but not its legislative remit, while within the economic sector’s remit but not interest. Opportunities to strengthen restrictions on marketing to improve nutrition and health include reframing the policy issue, strategic advocacy and community engagement.
Conclusions:
Restricting marketing should be recognised by public health actors as a public health and an industry policy issue, to support strategic engagement with economic policy actors.
To explore the formal and informal ways in which different actors involved in shaping trade agreements pursue their interests and understand the interactions with nutrition, in order to improve coherence between trade and nutrition policy goals.
Design:
The paper draws on empirical evidence from Australian key informant interviews that explore the underlying political dimensions of trade agreements that act as barriers or facilitators to getting nutrition objectives on trade agendas.
Setting:
Countries experiencing greater availability and access to diets full of energy-dense and nutrient-poor foods through increased imports, greater foreign direct investment and increasing constraints on national health policy space as a result of trade agreements.
Participants:
Interviews took place with Australian government officials, industry, public-interest non-government organizations and academics.
Results:
The analysis reveals the formal and informal mechanisms and structures that different policy actors use both inside and outside trade negotiations to pursue their interests. The analysis also identifies the discourses used by the different actors, as they attempt to influence trade agreements in ways that support or undermine nutrition-related goals.
Conclusions:
Moving forward requires policy makers, researchers and health advocates to use various strategies including: reframing the role of trade agreements to include health outcomes; reforming the process to allow greater access and voice to health arguments and stakeholders; establishing cross-government partners through accountable committees; and building circles of consensus and coalitions of sympathetic public-interest actors.
Maximising synergies and minimising conflicts (i.e. building policy coherence) between trade and nutrition policy is an important objective. One understudied driver of policy coherence is the alignment in the frames, discourses and values of actors involved in the respective sectors. In the present analysis, we aim to understand how such actors interpret (i.e. ‘frame’) nutrition and the implications for building trade–nutrition policy coherence.
Design:
We adopted a qualitative single case study design, drawing on key informant interviews with those involved in trade policy.
Setting:
We focused on the Australian trade policy sub-system, which has historically emphasised achieving market growth and export opportunities for Australian food producers.
Participants:
Nineteen key informants involved in trade policy spanning the government, civil society, business and academic sectors.
Results:
Nutrition had low ‘salience’ in Australian trade policy for several reasons. First, it was not a domestic political priority in Australia nor among its trading partners; few advocacy groups were advocating for nutrition in trade policy. Second, a ‘productivist’ policy paradigm in the food and trade policy sectors strongly emphasised market growth, export opportunities and deregulation over nutrition and other social objectives. Third, few opportunities existed for health advocates to influence trade policy, largely because of limited consultation processes. Fourth, the complexity of nutrition and its inter-linkages with trade presented difficulties for developing a ‘broader discourse’ for engaging the public and political leaders on the topic.
Conclusions:
Overcoming these ‘ideational challenges’ is likely to be important to building greater coherence between trade and nutrition policy going forward.
‘Active and healthy ageing’, with the goal of staying as independent as possible for as long as possible, has continued to be the policy focus in many countries (WHO, 2015). ‘Ageing in place’ and individual responsibility have also become enshrined in policy, reinforcing the importance of designing age-friendly communities that support independent living. To feel safe and comfortable in one's local neighbourhood with access to a variety of activities are crucial factors in retaining independence in later life. ‘Ageing in place’ and ‘place attachment’, another concept well used in ageing research (Smith, 2009), however, assumes some familiarity over time with that place.
Age-friendly cities are viewed as sensitive to age from the perspective of older residents living there. Although this is a critical component, which should be at the heart of all considerations of town planning, increasingly there is a need to assess the environment from the perspective of a visitor or someone who is unfamiliar with the environment. There are three major reasons that older people are increasingly experiencing environments that can be unfamiliar to them. This may be because of travelling as tourists to new areas; urban regeneration; or as a result of cognitive decline, where the familiar becomes unfamiliar.
The central aim of the project was to determine the mechanisms and strategies used by older people to navigate unfamiliar spaces as pedestrians (‘unfamiliar’ defined as new spaces to the older person or spaces that have become unfamiliar). Although there are many studies on accessibility (Granborn et al, 2016; I’DGO, no date), there is less research on the impact and effects of architecture and town design on older people's walkability, usability or their perception of the unfamiliar built environment.
The effects of the built environment and use of space on older people's self-perception and identity are being increasingly recognised (Peace et al, 2006). As people go through the life course, their use of space changes (Rowles, 1978).
A series of ice cores from sites with different snow-accumulation rates across Law Dome, East Antarctica, was investigated for methanesulphonic acid (MSA) movement. the precipitation at these sites (up to 35 km apart) is influenced by the same air masses, the principal difference being the accumulation rate. At the low-accumulation-rate W20k site (0.17m ice equivalent), MSAwas completely relocated from the summer to winter layer. Moderate movement was observed at the intermediate-accumulation-rate site (0.7m ice equivalent), Dome Summit South (DSS), while there was no evidence of movement at the high-accumulation-rate DE08 site (1.4m ice equivalent). the main DSS record of MSA covered the epoch AD 1727–2000 and was used to investigate temporal post-depositional changes. Co-deposition of MSA and sea-salt ions was observed in the surface layers, outside of the main summer MSA peak,which complicates interpretation of these peaks as evidence of movement in deeper layers. A seasonal study of the 273 year DSS record revealed MSA migration predominantly from summer into autumn (in the up-core direction), but this migration was suppressed during the Tambora (1815) and unknown (1809) volcanic eruption period, and enhanced during an epoch (1770–1800) with high summer nitrate levels. A complex interaction between the gradients in nss-sulphate, nitrate and sea salts (which are influenced by accumulation rate) is believed to control the rate and extent of movement of MSA.