Dietary guidelines are increasingly promoting mostly plant-based diets, limits on red meat consumption, and plant-based sources of protein for health and environmental reasons. It is unclear how the resulting food substitutions associate with insulin resistance, a risk factor for type 2 diabetes. We modelled the replacement of red and processed meat with plant-based alternatives and the estimated effect on insulin sensitivity. We included 783 participants (55 % female) from the Childhood Determinants of Adult Health study, a population-based cohort of Australians. In adulthood, diet was assessed at three time points using FFQ: 2004–2006, 2009–2011 and 2017–2019. We calculated the average daily intake of each food group in standard serves. Insulin sensitivity was estimated from fasting glucose and insulin concentrations in 2017–2019 (aged 39–49 years) using homoeostasis model assessment. Replacing red meat with a combination of plant-based alternatives was associated with higher insulin sensitivity (β = 10·5 percentage points, 95 % CI (4·1, 17·4)). Adjustment for waist circumference attenuated this association by 61·7 %. Replacing red meat with either legumes, nuts/seeds or wholegrains was likewise associated with higher insulin sensitivity. Point estimates were similar but less precise when replacing processed meat with plant-based alternatives. Our modelling suggests that regularly replacing red meat, and possibly processed meat, with plant-based alternatives may associate with higher insulin sensitivity. Further, abdominal adiposity may be an important mediator in this relationship. Our findings support advice to prioritise plant-based sources of protein at the expense of red meat consumption.

The pre-natal period is of critical importance in defining how individuals respond to their environment throughout life. Stress experienced by pregnant females has detrimental effects on offspring behaviour, health and productivity. The sheep (Ovis aries) has been used as a model to inform human studies; however, in a farming context, the consequences for the lamb of stress experienced by the ewe have received less attention. The stressors that pregnant ewes are most frequently exposed to include sub-optimal nutrition and acute and chronic stressors related to husbandry and the environment. This review focuses upon the young sheep, from around 100 days old until adulthood and uses material identified from a systematic survey of the literature relating to production-relevant maternal stressors and lamb outcomes. Overall, the results demonstrated that stressors imposed upon the ewe altered progeny behavioural and physiological responses. However, detailed analysis of the literature shows several deficiencies in the field, as a whole, which greatly limit the ability to draw conclusions as to how welfare may be affected by pre-natal challenges in commercial sheep. These deficiencies included a lack of consistency in response due to the variety of both stressors imposed and responses measured. Key gaps in knowledge include the impact of ewe disease during pregnancy on outcomes for their progeny and more generally how different commercially relevant stressors interact. Furthermore, there is a need to develop a systematic series of behavioural and physiological measures that can be integrated to provide a holistic and practically applicable picture of offspring welfare.

In a longitudinal cohort study of young Australian adults, we reported that for women higher baseline levels of fish consumption were associated with reduced incidence of new depressive episodes during the 5-year follow-up. Fish are high in both n-3 fatty acids and tyrosine. In this study, we seek to determine whether n-3 fatty acids or tyrosine explain the observed association. During 2004–2006, a FFQ (nine fish items) was used to estimate weekly fish consumption among 546 women aged 26–36 years. A fasting blood sample was taken and high-throughput NMR spectroscopy was used to measure 233 metabolites, including serum n-3 fatty acids and tyrosine. During 2009–2011, new episodes of depression since baseline were identified using the lifetime version of the Composite International Diagnostic Interview. Relative risks were calculated using log-binomial regression and indirect effects estimated using the STATA binary_mediation command. Potential mediators were added to separate models, and mediation was quantified as the proportion of the total effect due to the mediator. The n-3 DHA mediated 25·3 % of the association between fish consumption and depression when fish consumption was analysed as a continuous variable and 16·6 % when dichotomised (reference group: <2 serves/week). Tyrosine did not mediate the association (<0·1 %). Components in fish other than n-3 fatty acids and tyrosine might be beneficial for women’s mental health.

Over the past decades, Indigenous communities around the world have become more vocal and mobilized to address the health inequities they experience. Many Indigenous communities we work with in Canada, Australia, Latin America, the USA, New Zealand and to a lesser extent Scandinavia have developed their own culturally-informed services, focusing on the needs of their own community members. This paper discusses Indigenous healthcare innovations from an international perspective, and showcases Indigenous health system innovations that emerged in Canada (the First Nation Health Authority) and Colombia (Anas Wayúu). These case studies serve as examples of Indigenous-led innovations that might serve as models to other communities. The analysis we present suggests that when opportunities arise, Indigenous communities can and will mobilize to develop Indigenous-led primary healthcare services that are well managed and effective at addressing health inequities. Sustainable funding and supportive policy frameworks that are harmonized across international, national and local levels are required for these organizations to achieve their full potential. In conclusion, this paper demonstrates the value of supporting Indigenous health system innovations.

Objectives: Cognitive reserve moderates the effects of gray matter (GM) atrophy on cognitive function in neurological disease. Broadly speaking, Reserve explains how persons maintain function in the face of cerebral injury in cognitive and other functional domains (e.g., physical, social). Personality, as operationalized by the Five Factor Model (FFM), is also implicated as a moderator of this relationship. It is conceivable that these protective mechanisms are related. Prior studies suggest links between Reserve and personality, but the degree to which these constructs overlap and buffer the clinical effects of neuropathology is unclear. Methods: We evaluated Reserve and FFM traits—Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness—in a cohort of 67 multiple sclerosis (MS) patients. We also examined the extent to which FFM traits and aspects of Reserve interact in predicting cognitive processing speed. Results: Retrospectively reported educational/occupational achievement was associated with higher Openness, and childhood social engagement was associated with higher Extraversion, Agreeableness, and Conscientiousness. Current involvement in exercise activities and social activities was associated with Extraversion, current involvement in hobbies was associated with Neuroticism, and current receptive behaviors were associated with Agreeableness and Conscientiousness. When tested as predictors, Conscientiousness and childhood enrichment activities interacted in predicting cognitive processing speed after accounting for age, disease duration, disability, and GM volume. Conclusions: Childhood enrichment activities and Conscientiousness have a synergistic effect on cognitive processing speed. Current findings have implications for using psychological interventions to foster both Reserve and adaptive personality characteristics to stave off clinical symptoms in MS. (JINS, 2016, 22, 920–927)

Financial incentives have become a core component of private lands conservation programmes because of their ability to motivate stewardship behaviour. Concern exists about the durability of stewardship behaviours after payments end. Payments for performance may impact farmers' current and future engagement with an incentive programme to protect an at-risk ground-nesting grassland bird. Farmer motivations for participating in the programme, as well as their intention to continue the programme if the financial incentive no longer existed, were quantified. Although farmers did not report a high level of current involvement in the programme, most reported they would continue at a similar or higher level of engagement if the payments ended. These outcomes were related to their perception that their participation was driven by their internal motivation to help rather than the desire to obtain the financial reward. The perception that their behaviour was self-directed was positively influenced by the flexibility surrounding landowners’ engagement with the programme, a feeling of competence and achievement, and a feeling of connectedness to the organization implementing the programme. The success of conservation incentive programmes over the long term can be enhanced by explicitly accounting for the needs of landowners in programme design and administration.

The prenatal period is of critical importance in defining how individuals respond to their environment throughout life. Stress experienced by pregnant females has been shown to have detrimental effects on offspring behaviour, health and productivity. The sheep has been used extensively as a model species to inform human studies. However, in the farmed environment, the consequences for the lamb of the imposition of prenatal stresses upon the ewe have received much less attention. The stressors that pregnant ewes are most frequently exposed to include sub-optimal nutrition and those related to housing, husbandry and environment which may be either acute or chronic. A systematic review of the literature was adopted to identify material which had production-relevant maternal stressors and lamb outcomes. The current review focussed upon the lamb up to weaning around the age of 100 days and the results clearly demonstrate that stressors imposed upon the ewe have implications for offspring welfare and performance. Maternal under-nutrition (UN) in the last third of pregnancy consistently impaired lamb birth-weight and subsequent vigour and performance, while earlier UN had a variable effect on performance. Feeding the ewe above requirements did not have positive effects on lamb performance and welfare. Social and husbandry stressors such as transport, shearing, mixing and physiological treatments designed to mimic acute stress which would be considered disadvantageous for the ewe had positive or neutral effects for the lamb, highlighting a potential conflict between the welfare of the ewe and her lamb. This review also identified considerable gaps in knowledge, particularly in respect of the impact of disease upon the ewe during pregnancy and interactions between different stressors and the responses of ewe and lamb.

In a prospective cohort of 181 individuals followed up since childhood – when aged 9, 12 and 15 years – patients with a family history of premature coronary heart disease (n=18) had higher left ventricular mass index in adulthood – at mean age of 31 years – compared with those without (mean±standard error 39.1±1.9 versus 34.6±0.7 g/m2.7, p=0.04). The correlation between adult left ventricular mass index and child triglycerides (r=0.66, p=0.04 versus r=−0.03, p=0.75; pdiff=0.02) and diastolic blood pressure (r=0.65, p=0.02 versus r=0.16, p=0.07; pdiff=0.05) was stronger among those with a family history of coronary heart disease than in those without. Although preliminary, these data suggest that the higher left ventricular mass index among adults with a family history might be explained by their increased susceptibility to child cardio-metabolic risk factors.

In the 1960's and 1970's, the Adams Conjecture figured prominently both in homotopy theory and in geometric topology. Quillen sketched one way to attack the conjecture and then proved it with an entirely different line of argument. Both of his approaches led to spectacular and beautiful new mathematics.

In the fall of 2009, our hospital introduced a surveillance system to monitor the increase in cases of H1N1 pandemic influenza A virus infection. The system involved tracking cases of influenza-like illness in the emergency department, the outpatient clinics, and the inpatient wards as well as specimens with positive polymerase chain reaction results reported by the microbiology laboratory. Our data correlated well with national and regional data.