The Thumbs food classification system was developed to assist remote Australian communities to identify food healthiness. This study aimed to assess: (1) the Thumbs system’s alignment to two other food classification systems, the Health Star Rating (HSR) and the Northern Territory School Canteens Guidelines (NTSCG); (2) its accuracy in classifying ‘unhealthy’ (contributing to discretionary energy and added sugars) and ‘healthy’ products against HSR and NTSCG; (3) areas for optimisation. Food and beverage products sold between 05/2018 and 05/2019 in fifty-one remote stores were classified in each system. System alignment was assessed by cross-tabulating percentages of products, discretionary energy and added sugars sold assigned to the same healthiness levels across the systems. The system/s capturing the highest percentage of discretionary energy and added sugars sold in ‘unhealthy’ products and the lowest levels in ‘healthy’ products were considered the best performing. Cohen’s κ was used to assess agreement between the Thumbs system and the NTSCG for classifying products as healthy. The Thumbs system classified product healthiness in line with the HSR and NTSCG, with Cohen’s κ showing moderate agreement between the Thumbs system and the NTSCG (κ = 0·60). The Thumbs system captured the most discretionary energy sold (92·2 %) and added sugar sold (90·6 %) in unhealthy products and the least discretionary energy sold (0 %) in healthy products. Modifications to optimise the Thumbs system include aligning several food categories to the NTSCG criteria and addressing core/discretionary classification discrepancies of fruit juice/drinks. The Thumbs system offers a classification algorithm that could strengthen the HSR system.

In Indonesia, management practices that reduce soil fertility could be limiting cocoa (Theobroma cacao L.) production. To address this, we investigated the effects of fertilizers and organic amendments comprising different combinations of NPK + urea, dolomite, and manure-based compost on soil properties and cocoa productivity. We extended an existing field experiment in South Sulawesi, Indonesia, to assess these treatments’ effects on cocoa trees from the age of 2.9 years to 7.4 years. The treatments were first applied 5 months after planting and subsequently twice a year. Soil analyses were performed before planting, after 3 years, and finally after 7 years. Productivity was assessed yearly between the age of 3.5 and 7.4 years. The highest yields were obtained from the plots receiving compost, although the yield benefits diminished over time. Inorganic fertilizer alone doubled the yield compared to the control, while the yields with compost and compost + fertilizer were three times that of the control. With dolomite alone, the yield cumulated over 4 years was 41% higher than the control. The positive effect of compost on cocoa yields can potentially be attributed to (1) physical changes increasing soil water availability, (2) the chemical improvement of nutrient availability, and (3) biologically, by promoting the activity of beneficial organisms. The application of dolomite increased soil pH, Ca, and Mg contents. Soil organic carbon greatly declined in the composted treatments, even though 10 kg of compost was applied per tree per year, probably because of the low C:N ratio of the compost. Future studies should assess different fertilizer formulations and combinations with organic inputs and explore the mechanisms by which compost promotes cocoa productivity.

North-western Arabia is marked by thousands of prehistoric stone structures. Of these, the monumental, rectilinear type known as mustatils has received only limited attention. Recent fieldwork in AlUla and Khaybar Counties, Saudi Arabia, demonstrates that these monuments are architecturally more complex than previously supposed, featuring chambers, entranceways and orthostats. These structures can now be interpreted as ritual installations dating back to the late sixth millennium BC, with recent excavations revealing the earliest evidence for a cattle cult in the Arabian Peninsula. As such, mustatils are amongst the earliest stone monuments in Arabia and globally one of the oldest monumental building traditions yet identified.

Mothers with histories of alcohol and drug addiction have shown greater difficulty parenting young children than mothers with no history of substance misuse. This study was the second randomized clinical trial testing the efficacy of Mothering From the Inside Out (MIO), a 12-week mentalization-based individual therapy designed to address psychological deficits commonly associated with chronic substance use that also interfere with the capacity to parent young children. Eighty-seven mothers caring for a child between 11 and 60 months of age were randomly assigned to receive 12 sessions of MIO versus 12 sessions of parent education (PE), a psychoeducation active control comparison. Maternal reflective functioning, representations of caregiving, mother–child interaction quality, and child attachment were evaluated at baseline and posttreatment and 3-month follow-up. Mother–child interaction quality was assessed again at 12-month follow-up. In comparison with PE mothers, MIO mothers demonstrated a higher capacity for reflective functioning and representational coherence at posttreatment and 3-month follow-up. At 12-month follow-up, compared to PE cohorts, MIO mothers demonstrated greater sensitivity, their children showed greater involvement, and MIO dyads showed greater reciprocity. As addiction severity increased, MIO also appeared to serve as a protective factor for maternal reflective functioning, quality of mother–child interactions, and child attachment status. Results demonstrate the promise of mentalization-based interventions provided concomitant with addiction treatment for mothers and their young children.

Widely-held, untested assumptions in many prairies are that high-intensity fires conducted during droughts will decrease native herbaceous species richness and lead to rapid invasions by alien species. We compared native and exotic herbaceous species richness and aboveground herbaceous biomass one year following the application of high-intensity growing-season fires in Texas coastal prairie. Fires were conducted in June 2008, when precipitation was 96% below the long-term monthly average, at the end of a severe 5-mo drought, resulting in high fire intensities within treatment units. Native forb species richness was greater in burned than unburned areas. In contrast, species richness of native grasses, exotic forbs, and the frequency of King Ranch (KR) bluestem [Bothriochloa ischaemum (L.) Keng.] did not significantly differ between burned and unburned treatments. The potential to use prescribed extreme fire to maintain native herbaceous species richness while not increasing KR bluestem provides preliminary evidence that growing season fires conducted during droughts can be a viable management strategy in coastal prairies.

This longitudinal study of affluent suburban youth (N = 319) tracked from 6th to 12th grade is parsed into two segments examining prospective associations concerning emotional–behavioral difficulties and academic achievement. In Part 1 of the investigation, markers of emotional–behavioral difficulty were used to cluster participants during 6th grade. Generalized estimating equations were then used to document between-cluster differences in academic competence from 6th to 12th grade. In Part 2 of the study, indicators of academic competence were used to cluster the same students during 6th grade, and generalized estimating equations were used to document between-cluster differences in emotional–behavioral difficulty from 6th to 12th grade. The results from Part 1 indicated that patterns of emotional–behavioral difficulty during 6th grade were concurrently associated with poorer grades and classroom adjustment with some group differences in the rate of change in classroom adjustment over time. In Part 2, patterns of academic competence during 6th grade were concurrently associated with less emotional–behavioral difficulty and some group differences in the rate of change in specific forms of emotional–behavioral difficulty over time. These results suggest that the youth sampled appeared relatively well adjusted and any emotional–behavioral–achievement difficulty that was evident at the start of middle school was sustained through the end of high school.

Mbau forest covers much of the Congo, and shifts in its composition could have a large impact on the African tropics. The Ituri forest in east Congo is near a boundary between the monodominant mbau type and non-mbau mixed forest, and two 20-ha censuses of trees ≥ 1 cm diameter were carried out over 12 y to monitor forest change. Based on published diameter allometry, mbau forest had 535 Mg ha−1 biomass above ground and gained 1.1 Mg ha−1 y−1. Mixed forest had 399 Mg ha−1 and gained 3 Mg ha−1 y−1. The mbau tree (Gilbertiodendron dewevrei) increased its share of biomass from 4.1% to 4.4% in mixed forest; other common species also increased. Sapling density declined at both sites, likely because increased biomass meant shadier understorey, but the mbau tree increased in sapling density, suggesting it will become more important in the future. Tree mortality and growth rates were low relative to other tropical forests, especially in the mbau plots. Shifting toward G. dewevrei would represent a large gain in carbon in the mixed forest, but mbau is presently more important as a high-carbon stock: biomass lost during forest harvest could not recuperate for centuries due to slow community dynamics.

The Radiological Protection Institute of Ireland has monitored levels of anthropogenic radionuclides in the Irish marine environment for over 20 years. While the primary objective of the monitoring programme is to assess the exposure of the Irish population resulting from the presence of these radionuclides in the marine environment, the programme also aims to assess the geographical distribution and temporal variations of the radionuclides. The programme involves the routine sampling of and testing for radioactivity in fish, shellfish, seaweed, sediments and seawater. The data generated in the course of this programme, as well as in a separate study of changing plutonium isotopic ratios in Fucus vesiculosus from the west coast of Ireland, were used to estimate transport times from the Sellafield nuclear fuel reprocessing plant to various locations on the Irish coastline. For conservative radionuclides, transit times of 5-6 months to the NE coast of Ireland, 1-3 years to the south coast of Ireland and 3-8 years to the west coast were calculated. In contrast, for plutonium, the Sellafield signal was not observed on the west coast until the late 1980s/early 1990s.

Objectives: To investigate the indications for, and outcome of, cardiac catheterisation in infants weighing less than 2500 g at a single institution over an 8-year period. Patients and Methods: We assessed all infants who were less than 2500 g at the time of cardiac catheterisation at Texas Children's Hospital from January 1993 to January 2001. Comparisons of morbidity and mortality were drawn with an equivalent number of infants of similar age weighing greater than 2500 g seen over the same period of time. Results: We performed interventional procedures in 22, and diagnostic catheterisations in 12 infants weighing less than 2500 g. Interventions included pulmonary valvoplasty in six patients, balloon angioplasty of critical coarctation in one, aortic valvoplasty in two, septostomy in ten, and coil occlusion of an arteriovenous malformation, redirection of a subclavian venous line, and coil occlusion of a patent arterial duct in one patient each. The median age at catheterisation was 5 days for children less than 2500 g, and 10 days for those above 2500 g. The median weights were 2.3 kg and 3.3 kg, and the median gestational ages were 35 weeks and 38 weeks, for the two respective groups. Of those weighing less than 2500 g, two died (6%), with no deaths occurring in those weighing more than 2500 g. In 3 patients weighing less than 2500 g (9%), there was vascular compromise, one child with bilateral femoral venous obstruction requiring fasciotomy compared, to one in the group weighing greater than 2500 g (2%). Conclusion: There is a significantly increased risk of mortality and vascular compromise in infants weighing less than 2500 g. Interventional catheterisation in these infants may be lifesaving, but given the aforementioned risks, diagnostic catheterisation should be deferred if possible in favor of noninvasive modalities.

Background: In recent years, the diagnosis of infective endocarditis has been enhanced by the use of echocardiography. We sought, therefore, to review its effect on the management of endocarditis in children. Methods: We reviewed all the patients presenting to our institution for evaluation for infective endocarditis from May 1994 to January 2002. The patients were stratified according to whether or not they had congenitally malformed hearts. Results: Of the 90 referred patients identified, 46 (51%) had positive ultrasonic findings. Of these, we excluded 26 patients because of the presence of indwelling lines. The remaining 20 patients with features of endocarditis had a median age of 6.5 years, and a range from 0.14 to 8.5 years. There were 4 patients with normal hearts, and 16 with congenital cardiac malformations. We identified rupture of a sinus of Valsalva in four patients, with rupture into the left ventricle in two, and into the right ventricle and right atrium in one each. The mitral valve was involved in six patients, the aortic valve in another six, including all four with rupture of the sinus of Valsalva, both mitral and aortic valves in three, the pulmonary trunk in three patients, and the tricuspid valve and a Blalock-Taussig shunt in one patient each. Organisms isolated included Streptococcus mitis in 4 patients, Streptococcus pneumoniae in 2 patients, Streptococcus sanguis in 1, Staphylococcus aureus in 3, Staphylococcus epidermidis in 1, and Enteroccocus in 2. Cultures proved negative in 7 patients. Surgical intervention was needed in 12 patients, and one died (5%). Only the left-sided chambers were involved in those with normal hearts. Both patients infected with Streptococcus pneumoniae had rupture of a sinus of Valsalva. Conclusion: Involvement of the left-sided chambers is more likely in structurally normal hearts, and in cases with rupture of a sinus of Valsalva, in which case infection with Streptococcus pneumonia should be suspected.