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Households with children accessing food aid in high-income countries are often food insecure. We aimed to review the evidence on food aid interventions in households with children and impact on food insecurity, diet quality and mental health.
Design:
A systematic search was conducted using Web of Science, MEDLINE, CINAHL and PsycINFO. Articles published from January 2008 to July 2022 including cross-sectional, cohort and interventional studies in high-income countries were eligible.
Setting:
Food aid is defined as the use of interventions providing free food items by community and/or charitable organisations.
Participants:
Two-parent, lone parent or households with a primary caregiver with at least one child ≤ 18 years.
Results:
From a total of 10 394 articles, nine were included. Food banks, mobile pantry combined with a free meal for children, backpack provision during school term and food parcel home delivery interventions were evaluated. Food bank models offering additional support such as community programmes, health and social services, cooking classes and free meals for children, client-choice-based models and programmes providing convenient access were associated with improved food security and diet quality (increased intake of wholegrains, fruit and vegetables). One study reported an improvement in mental health and food bank access at the end of 18 months but not at earlier timepoints and one study reported no change in parents’ mental health.
Conclusions:
Accessing food aid was linked to improved diet quality and reduced food insecurity in some studies. Allowing clients to choose food items and providing support services were most effective.
Amid resurgent geopolitical fissures and in the aftermath of the Covid-19 pandemic, there is a growing awareness in the sector of the need for, and concern about, national and international collaboration in archaeological projects. This article reflects on present-day challenges for international collaboration in central Eurasian archaeology and furthers a much-needed discussion about (re)integrating local narratives with inter-regional trends in future research. Responsible and practical proposals for bridging collaborator differences in institutional or publishing obligations, language capacities and access to resources are discussed.
The body of scientific knowledge accumulated by the scholarly disciplines such as Developmental Psychopathology can achieve meaningful public impact if wielded and used in policy decision-making. Scientific study of how policymakers use research evidence underscores the need for researchers’ policy engagement; however, barriers in the academy create conditions in which there is a need for infrastructure that increases the feasibility of researchers’ partnership with policymakers. This need led to the development of the Research-to-Policy Collaboration model, a systematic approach for developing “boundary spanning” infrastructure, which has been experimentally tested and shown to improve policymakers’ use of research evidence and bolster researchers’ policy skills and engagement. This paper presents original research regarding the optimization of the RPC model, which sought to better serve and engage scholars across the globe. Trial findings shed light on ways to improve conditions that make good use of researchers’ time for policy engagement via a virtual platform and enhanced e-communications. Future directions, implications, and practical guidelines for how scientists can engage in the political process and improve the impact of a collective discipline are also discussed.
To identify latent trajectories of IQ over time after pediatric traumatic brain injury (TBI) and examine the predictive value of risk factors within and across recovery trajectories.
Method:
206 children ages 3–7 years at injury were included: 87 TBI (23 severe, 21 moderate, 43 complicated mild) and 119 orthopedic injury (OI). We administered intelligence tests shortly after injury (1½ months), 12 months, and 6.8 years postinjury. Latent class growth modeling was used to identify latent subgroups. Separate models examined verbal and nonverbal IQ recovery trajectories following TBI versus OI. Variables included: age at injury, sex, race, socioeconomic status, injury severity, quality of the home environment, family functioning, and parenting style.
Results:
Both the TBI and OI analyses yielded different growth models for nonverbal (k = 3) and verbal IQ (k = 3). Although all models resulted in 3 latent classes (below average, average, and aboveaverage performance); trajectory shapes, contributors to class membership, and performance within each class varied by injury group and IQ domain. TBI severity was associated with class membership for nonverbal IQ, with less severe injuries associated with higher IQ scores; however, TBI severity did not influence verbal IQ class membership. Parenting style had a more prominent effect on verbal and nonverbal IQ within the TBI than OI trajectories.
Conclusions:
Findings suggest TBI severity is related to recovery trajectories for nonverbal but not verbal IQ and parenting style has stronger effects on recovery in TBI than OI. Results highlight the importance of parental factors on long-term recovery after TBI.
In this chapter we will explore active labour market interventions in employment and health. We will look back at those interventions offered to people with health conditions as well as the role of local authorities and their place as partner with the employability sector. This chapter will conclude by focusing on those programmes that prioritise people. This begins with a mapping of those key employment support policies of the last 30 years or so, leading up to the current day.
Employment support interventions
Supported Employment: Traditionally, employment interventions targeting people with health conditions and disabilities were delivered by local authorities, often at a county council level, as part of their then statutory duties to provide services for people with learning disabilities. These were usually focused on Day Service facilities, but from this emerged the Supported Employment policy. Supported Employment had set the scene for all future health and disability provisions and became a model for supporting people with significant disabilities to secure and retain paid employment (Wilson and Finch, 2021). This was based on the premise that anyone could be employed if they wanted paid employment and if they were provided sufficient support. Supported Employment has sometimes been called the ‘place, train and maintain’ model of vocational rehabilitation. Supported Employment providers use a five-stage process itself based on a model of Customer Engagement, Vocational Profiling, Employer Engagement, Job Matching, In-work Support and Career Development.
In the contemporary period, many local authorities still fund Supported Employment services, others have ended these services due to lack of funding and, in some instances, has been picked up by national and local third sector organisations. There has been some Department of Work and Pensions (DWP) interest in Supported Employment with a DWP Proof of Concept Pilot which followed the publication of the ‘Improving Lives: The Work, Health and Disability Green Paper’ consultation in 2017. This, however, has been overshadowed by nationally procured programmes and those of the devolved commissioners.
The District Managers Discretionary Fund: In the mid-1990s there were some locally procured Employment Service contracts (now known as DWP Jobcentre Plus), these contracts tested approaches by community based organisations delivering services to people with health conditions and disabilities.
To evaluate the clinical impact of the BioFire FilmArray Pneumonia Panel (PNA panel) in critically ill patients.
Design:
Single-center, preintervention and postintervention retrospective cohort study.
Setting:
Tertiary-care academic medical center.
Patients:
Adult ICU patients.
Methods:
Patients with quantitative bacterial cultures obtained by bronchoalveolar lavage or tracheal aspirate either before (January–March 2021, preintervention period) or after (January–March 2022, postintervention period) implementation of the PNA panel were randomly screened until 25 patients per study month (75 in each cohort) who met the study criteria were included. Antibiotic use from the day of culture collection through day 5 was compared.
Results:
The primary outcome of median time to first antibiotic change based on microbiologic data was 50 hours before the intervention versus 21 hours after the intervention (P = .0006). Also, 56 postintervention regimens (75%) were eligible for change based on PNA panel results; actual change occurred in 30 regimens (54%). Median antibiotic days of therapy (DOTs) were 8 before the intervention versus 6 after the intervention (P = .07). For the patients with antibiotic changes made based on PNA panel results, the median time to first antibiotic change was 10 hours. For patients who were initially on inadequate therapy, time to adequate therapy was 67 hours before the intervention versus 37 hours after the intervention (P = .27).
Conclusions:
The PNA panel was associated with decreased time to first antibiotic change and fewer antibiotic DOTs. Its impact may have been larger if a higher percentage of potential antibiotic changes had been implemented. The PNA panel is a promising tool to enhance antibiotic stewardship.
Coronavirus Disease 2019 (COVID-19) instigated a flurry of clinical research activity. The unprecedented pace with which trials were launched left an early void in data standardization, limiting the potential for subsequent data pooling. To facilitate data standardization across emerging studies, the National Heart, Lung, and Blood Institute (NHLBI) charged two groups with harmonizing data collection, and these groups collaborated to create a concise set of COVID-19 Common Data Elements (CDEs) for clinical research.
Methods:
Our iterative approach followed three guiding principles: 1) draw from existing multi-center COVID-19 clinical trials as precedents, 2) incorporate existing data elements and data standards whenever possible, and 3) alignment to data standards that facilitate data sharing and regulatory submission. We also supported rapid implementation of the CDEs in NHLBI-funded studies and iteratively refined the CDEs based on feedback from those study teams
Results:
The NHLBI COVID-19 CDEs are publicly available and being used for current COVID-19 clinical trials. CDEs are organized into domains, and each data element is classified within a three-tiered prioritization system. The CDE manual is hosted publicly at https://nhlbi-connects.org/common_data_elements with an accompanying data dictionary and implementation guidance.
Conclusions:
The NHLBI COVID-19 CDEs are designed to aid data harmonization across studies to achieve the benefits of pooled analyses. We found that organizing CDE development around our three guiding principles focused our efforts and allowed us to adapt as COVID-19 knowledge advanced. As these CDEs continue to evolve, they could be generalized for use in other acute respiratory illnesses.
Agri-environmental schemes (AES) are used to enhance pollinator diversity on agricultural farms within the UK. Though the impacts of these schemes on archetypal pollinator species such as the bumblebee (Bombus) and honeybee (Apis) are well-studied, the effects on non-target bee species like solitary bees, in the same environment, are generally lacking. One goal of AES is to alter floral provision and taxonomic composition of plant communities to provide better forage for pollinators, however, this may potentially impact other ecological communities such as fungal diversity associated with plant-bee communities. Fungi are integral in these bee communities as they can impact bee species both beneficially and detrimentally. We test the hypothesis that alteration of the environment through provision of novel plant communities has non-target effects on the fungi associated with solitary bee communities. We analyse fungal diversity and ecological networks formed between fungi and solitary bees present on 15 agricultural farms in the UK using samples from brood cells. The farms were allocated to two categories, low and high management, which differ in the number of agri-environmental measures implemented. Using internal transcribed spacer metabarcoding, we identified 456 fungal taxa that interact with solitary bees. Of these, 202 (approximately 44%) could be assigned to functional groups, the majority being pathotrophic and saprotrophic species. A large proportion was Ascosphaeraceae, a family of bee-specialist fungi. We considered the connectance, nestedness, modularity, nestedness overlap and decreasing fill, linkage density and fungal generality of the farms' bee–fungi ecological networks. We found no difference in the structure of bee–fungi ecological networks between low and high management farms, suggesting floral provision by AES has no significant impact on interactions between these two taxonomic groups. However, bee emergence was lower on the low management farms compared to high management, suggesting some limited non-target effects of AES. This study characterizes the fungal community associated with solitary bees and provides evidence that floral provision through AES does not impact fungal interactions.
Little is known about Se intakes and status in very young New Zealand children. However, Se intakes below recommendations and lower Se status compared with international studies have been reported in New Zealand (particularly South Island) adults. The Baby-Led Introduction to SolidS (BLISS) randomised controlled trial compared a modified version of baby-led weaning (infants feed themselves rather than being spoon-fed), with traditional spoon-feeding (Control). Weighed 3-d diet records were collected and plasma Se concentration measured using inductively coupled plasma mass spectrometry (ICP-MS). In total, 101 (BLISS n 50, Control n 51) 12-month-old toddlers provided complete data. The OR of Se intakes below the estimated average requirement (EAR) was no different between BLISS and Control (OR: 0·89; 95 % CI 0·39, 2·03), and there was no difference in mean plasma Se concentration between groups (0·04 μmol/l; 95 % CI −0·03, 0·11). In an adjusted model, consuming breast milk was associated with lower plasma Se concentrations (–0·12 μmol/l; 95 % CI −0·19, −0·04). Of the food groups other than infant milk (breast milk or infant formula), ‘breads and cereals’ contributed the most to Se intakes (12 % of intake). In conclusion, Se intakes and plasma Se concentrations of 12-month-old New Zealand toddlers were no different between those who had followed a baby-led approach to complementary feeding and those who followed traditional spoon-feeding. However, more than half of toddlers had Se intakes below the EAR.