154 results
Intake of free sugars by 11–13-year-old schoolchildren living in Delhi, India
- A. Ivaturi, L. Giles, L.G. Do, M. Arora, T. Rawal, P.J. Moynihan
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE1 / April 2024
- Published online by Cambridge University Press:
- 07 May 2024, E153
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Intake of free sugars is associated with a risk of non-communicable diseases including dental caries, and authoritative organisations recommend limiting intake to <5% energy intake (E) or lower (1, 2). National surveys of schoolchildren in India indicate the prevalence of obesity is rising >10%/year(3) and that 52.5% of young adolescents are affected with dental caries(4), yet, there is a dearth of data on dietary intake of sugars by this population. The objective of this research was to assess the intake of total and free sugars, and the contribution of food sources to free sugars intake, in a random sample of 11–13-year-old schoolchildren in Delhi, India. The study was approved by The University of Adelaide Human Research Ethics Committee and the Independent Ethics Committee of the Centre for Chronic Disease Control, New Delhi. The target sample size of 360 was based on a ± 5% margin of error in estimated sugars intake. A statistician external to the research team generated a random sample of 150 schools stratified by district (n = 11). Schools were recruited in turn from the list until 10 schools had consented. Teachers shared study information with parents who were invited to complete an online consent form. Child assent was obtained before data collection. Participants recorded all food and drink consumed over three consecutive days, including one weekend day, in a food diary. The information recorded was entered into an online dietary assessment tool, Intake24 (Southeast Asia version), during an interview with each participant during which portion size was ascertained with reference to the database of over 2400 food photographs of more than 100 foods. The Intake24 database converted food and drink reported into the intake of total and free sugars through integrated food compositional tables. Of 514 pupils providing consent, 393 participants (76.5%) (169 girls, 224 boys) completed the study. In girls, the median (IQR) daily intakes of total and free sugars were 95.0 (70.1-120.2) g/day and 43.0 (28.1-68.5) g/day respectively. The corresponding values in boys were significantly higher at 104.0 (80.2-138.7) g/day and 53.1 (34.1-76.5) g/day (p = 0.004). No between-gender difference was observed in the median percent contribution of sugars to E: total and free sugars contributed 14.9% (IQR 11.4-18.1%) and 7.1% (IQR 4.8-10.1%) respectively. The percent contribution of the main sources of sugars to free sugars intake were: (i) Sugars Preserves and Syrups (31.2% (IQR. 9.6-51.7%)); (ii) Cakes and Biscuits (13.7% (IQR 0-26.4%)); (iii) Desserts (5.4% (0-17.5%)) and (iv) Sugar-Sweetened Beverages and Juices (2.1% (IQR 0-15.7%)). In conclusion, in this sample of 11-13-year-old schoolchildren from Delhi, free sugars intake was above the WHO <5% E threshold. Forms of sugars that are added to foods by the consumer made the largest contribution to intake.
Intake of energy and macronutrients in the diets of 11–13-year-old schoolchildren living in Delhi India
- P. Moynihan, A. Ivaturi, L. Giles, L. Do, T. Rawal, M. Arora
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- Journal:
- Proceedings of the Nutrition Society / Volume 83 / Issue OCE1 / April 2024
- Published online by Cambridge University Press:
- 07 May 2024, E145
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National surveys in India, through measures of anthropometry and biomarkers, have identified a triple burden of malnutrition (undernutrition, micronutrient deficiencies and overnutrition) in adolescents(1). However, there is a dearth of high-quality data on individual dietary behaviour of this population(2) and the importance of sub-national dietary surveys in filling this gap has been identified(3). The objective of this study was to assess the intake of energy (E) and macronutrients and the contribution of macronutrients to E in a random sample of 11–13-year-old schoolchildren in Delhi, India. Method: The study was approved by The University of Adelaide Human Research Ethics Committee and the Independent Ethics Committee of the Centre for Chronic Disease Control, New Delhi. The target sample size of 360 was based on a ± 5% margin of error in estimated sugars intakes. Using the list of private schools in Delhi (n = 1374), a statistician external to the research team generated a random sample of 150 schools stratified by districts (n = 11). Using this list, schools were invited to participate, and recruitment continued until 10 schools consented. Teachers shared study information with parents; interested parents filled in the online consent form. Assent was obtained from schoolchildren. Participants recorded all food and drink consumed over three consecutive days, including one weekend day, in a food diary. Information recorded was entered into an online dietary assessment tool, Intake24 Southeast Asia version, during an interview with each participant. The Intake24 database of over 2400 food photographs of more than 100 foods was used to ascertain portion size. The Intake24 database converts food and drink reported into the intake of nutrients through integrated food compositional tables. Of 514 pupils providing consent, 393 participants (76.4%) (169 girls, 224 boys) completed the study. The median daily E intake was 10.8 (IQR 9.0 −12.5) MJ for girls, and 12.3 (IQR 10.3- 15.2) MJ for boys. For the 97 girls and 144 boys providing body weight data, Physical Activity Level ratios were 2.0 and 2.1 respectively. The median daily intakes for girls were: protein 64.6 (IQR 54.8-79.3) g; carbohydrate 336.5 (IQR 285.3- 393.6) g; and saturated fat 45.6 (IQR 34.8-58.3) g. The respective values in boys were: protein 74.4 (IQR 61.4; 89.4) g; carbohydrate 379.6 (IQR 317.8; 461.8) g; and saturated fat 54.6 (IQR 41.9-69.5) g. There were no significant between-gender differences in percent E from protein (10.2 (IQR 9.2; 11.4)), or carbohydrate (52.4 (IQR 48.7; 56.7)). Girls obtained less E from saturated fat (16.1 (IQR 11.0-18.2) compared with boys 16.3 (IQR 14.2 - 19.1) (P<0.05). In conclusion, in this sample of adolescents from private schools in Delhi, E intake was above FAO recommended levels and median total fat intake exceeded the recommended threshold of 35%(4).
A single-institutional experience with 36 children less than 5 kilograms supported with the Berlin Heart: Comparison of congenital versus acquired heart disease
- Mark S. Bleiweis, Omar M. Sharaf, Joseph Philip, Giles J. Peek, Yuriy Stukov, Gregory M. Janelle, Andrew D. Pitkin, Kevin J. Sullivan, Connie S. Nixon, Dan Neal, Jeffrey P. Jacobs
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- Journal:
- Cardiology in the Young , First View
- Published online by Cambridge University Press:
- 16 February 2024, pp. 1-8
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Objectives:
We reviewed outcomes in all 36 consecutive children <5 kg supported with the Berlin Heart pulsatile ventricular assist device at the University of Florida, comparing those with acquired heart disease (n = 8) to those with congenital heart disease (CHD) (n = 28).
Methods:The primary outcome was mortality. The Kaplan-Meier method and log-rank tests were used to assess group differences in long-term survival after ventricular assist device insertion. T-tests using estimated survival proportions were used to compare groups at specific time points.
Results:Of 82 patients supported with the Berlin Heart at our institution, 49 (49/82 = 59.76%) weighed <10 kg and 36 (36/82 = 43.90%) weighed <5 kg. Of 36 patients <5 kg, 26 (26/36 = 72.22%) were successfully bridged to transplantation. (The duration of support with ventricular assist device for these 36 patients <5 kg was [days]: median = 109, range = 4–305.) Eight out of 36 patients <5 kg had acquired heart disease, and all eight [8/8 = 100%] were successfully bridged to transplantation. (The duration of support with ventricular assist device for these 8 patients <5 kg with acquired heart disease was [days]: median = 50, range = 9–130.) Twenty-eight of 36 patients <5 kg had congenital heart disease. Eighteen of these 28 [64.3%] were successfully bridged to transplantation. (The duration of support with ventricular assist device for these 28 patients <5 kg with congenital heart disease was [days]: median = 136, range = 4–305.) For all 36 patients who weighed <5 kg: 1-year survival estimate after ventricular assist device insertion = 62.7% (95% confidence interval = 48.5–81.2%) and 5-year survival estimate after ventricular assist device insertion = 58.5% (95% confidence interval = 43.8–78.3%). One-year survival after ventricular assist device insertion = 87.5% (95% confidence interval = 67.3–99.9%) in acquired heart disease and 55.6% (95% confidence interval = 39.5–78.2%) in CHD, P = 0.036. Five-year survival after ventricular assist device insertion = 87.5% (95% confidence interval = 67.3–99.9%) in acquired heart disease and 48.6% (95% confidence interval = 31.6–74.8%) in CHD, P = 0.014.
Conclusion:Pulsatile ventricular assist device facilitates bridge to transplantation in neonates and infants weighing <5 kg; however, survival after ventricular assist device insertion in these small patients is less in those with CHD in comparison to those with acquired heart disease.
Protecting and promoting editorial independence
- Kamaldeep Bhui, Aileen O'Brien, Rachel Upthegrove, Alexander C. Tsai, Mustafa Soomro, Giles Newton-Howes, Matthew R. Broome, Andrew Forrester, Patricia Casey, Anne M. Doherty, William Lee, Kenneth R. Kaufman
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- The British Journal of Psychiatry , FirstView
- Published online by Cambridge University Press:
- 15 February 2024, pp. 1-3
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We argue that editorial independence, through robust practice of publication ethics and research integrity, promotes good science and prevents bad science. We elucidate the concept of research integrity, and then discuss the dimensions of editorial independence. Best practice guidelines exist, but compliance with these guidelines varies. Therefore, we make recommendations for protecting and strengthening editorial independence.
1 Ototoxicity and Cognitive Outcomes among Children Treated for Brain Tumors in Infancy
- Nicole A. Salman, Johnnie K. Bass, Jie Huang, Arzu Onar-Thomas, Jason M. Ashford, Jeanelle S. Ali, Thomas E. Merchant, Giles W. Robinson, Amar Gajjar, Heather M. Conklin
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, p. 312
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Objective:
Treatment of childhood central nervous system (CNS) tumors can lead to sensorineural hearing loss (SNHL), with prior research indicating associations between SNHL and cognitive difficulties. Infants (0-3 years) treated for CNS tumors are at particular risk for neurocognitive deficits due to increased vulnerability of the developing brain and missed developmental opportunities secondary to prolonged treatment. This study expands upon existing research by examining the association between treatment-related SNHL and later neurocognitive outcomes among infants.
Participants and Methods:Serial audiology and neurocognitive assessments were conducted as part of a prospective, multisite, longitudinal trial (SJYC07). Children with newly diagnosed CNS tumors were treated with chemotherapy, with or without focal proton or photon radiation therapy (RT). SNHL was dichotomized based on hearing in the better ear as present versus not present (Chang grade ≥1a vs. <1a). Neurocognitive assessments included intellectual functioning (IQ), and parent ratings of executive functioning and behavioral functioning. Demographic and clinical variables investigated included: sex, age at diagnosis (years), treatment type (chemotherapy only vs. chemotherapy + RT), risk group (low vs. intermediate vs. high), and socioeconomic status (SES, continuous). Logistic regression models were used to identify factors associated with SNHL. Change point longitudinal models were used to examine the effect of each covariate individually and the potential impact of SNHL on trajectories of neurocognitive outcomes.
Results:Of 135 patients (median age at diagnosis= 1.5 years), 67% had mild-to-severe SNHL as defined by Chang grade ≥1a at last follow-up. SNHL occurred early after treatment with a 1-year cumulative incidence 63.0% ±4.3%. SNHL was associated with age at diagnosis (p <.001) but not sex, treatment exposure or study risk arm (p >.10). At pretreatment baseline, IQ was associated with age at diagnosis (older age= higher IQ) and SES (higher SES= higher IQ) with a change in the trajectory of IQ after SNHL (stable prior to SNHL and declined 1.46 points/year after SNHL), which was impacted by tumor location (patients with supratentorial tumors stable prior to SNHL and declined 2.84 points/year after SNHL; whereas, patients with infratentorial tumors increased 1.93 points/year prior to SNHL and were stable after SNHL). At pre-treatment baseline, adaptive functioning was associated with age at diagnosis (older age= higher skills) with a change in adaptive functioning after SNHL that varied by age. There was a change in trajectory of attention problems (stable before SNHL and worsening 1.39 points/year after SNHL). SNHL was not associated with parent report of emerging executive functioning.
Conclusions:Children with brain tumors experience SNHL and cognitive difficulties early in treatment that can worsen over time. Younger age at diagnosis is associated with greater risk for SNHL and cognitive difficulties. Analyses of the time course between the emergence of SNHL and cognitive late effects suggests even mild SNHL is associated with a clinically signficant decline in IQ and attention problems. These findings have notable implications with respect to refining monitoring guidelines, informing modifications to treatment, advocating for interventions, and helping educate parents, teachers, and providers about the significant impact of mild SNHL.
6 Feasibility and Perceived Benefit of an Interdisciplinary Rehabilitation Approach within a Tertiary Pediatric Hematology/Oncology Setting
- Darcy Raches, Jason M Ashford, Martina Bryndziar, Taylor Mule, April Huggins, Sherry Lockett, Allison Harris, Hannah Taylor, Ellen Bursi, Regina Winfrey, Sue B Lynn, Amar Gajjar, Giles W Robinson, Heather M Conklin
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- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 8-9
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Objective:
Medulloblastoma is the most common pediatric malignant brain tumor. Approximately 29% of medulloblastoma patients experience postoperative posterior fossa syndrome (PFS) characterized by impairments in speech, motor, and mood. An interdisciplinary rehabilitation approach is associated with greater rehabilitation gains than a single discipline approach for brain injury patients with significant rehabilitation needs. However, literature regarding the feasibility and utility of this approach within a tertiary care pediatric hematology/oncology setting is lacking. The Acute Neurological Injury (ANI) service was developed to coordinate care for neurologically complex hematology/oncology patients receiving active cancer treatment, including those with PFS. ANI care coordination includes bimonthly interdisciplinary team meetings, interdisciplinary goal implementation for each patient, parent psychoeducation about applicable brain-behavior relationships (including PFS) at treatment initiation, neuropsychological assessment at transition times throughout treatment, cognitive remediation, and coordinated end of treatment transition planning. We gathered caregiver perspective on this approach within a tertiary care pediatric hematology/oncology setting.
Participants and Methods:Parents of children and young adults (ages 4-20) with PFS after medulloblastoma resection who received coordinated care as part of the ANI program (n=20) were interviewed at least 4 months following completion of cancer treatment. 75% experienced postoperative mutism while the remainder experienced significantly decreased speech without mutism. All received cranial-spinal irradiation and focal boosts to tumor sites followed by chemotherapy per multi-institutional treatment protocol. Caregivers were interviewed regarding perceived feasibility and utility of ANI program components including parent psychoeducation, neuropsychological assessment, cognitive remediation, and interdisciplinary team coordination/goal setting, as well as parental supports. Yes/no responses were gathered as well as responses regarding the perceived utility of aspects of the interdisciplinary ANI program approach via a five-point Likert scale.
Results:Surveys were completed by 66% of families contacted. Mean age at first contact with neuropsychology as part of the ANI program was 9.45 years (SD=4.4 years). Mean time between end of treatment and parent interview was 3.20 years (SD=2.01 years). Most parents reported that initial psychoeducation about PFS helped to decrease their concerns (81%) and increased their understanding of their child’s functioning in the context of PFS (88%). They reported benefit from neuropsychological assessment reports prior to initiating adjuvant treatment (92%), at end of treatment (90%), and one year following initiation of cancer treatment (100%), though they perceived less benefit from assessments intended to inform provider interventions during treatment (81% and 66%). Reports were shared most often with schools (75%), behavioral therapists (50%), physicians (50%), and rehabilitation specialists (25%). Parents indicated that the interdisciplinary ANI program approach was helpful (94%) and the coordinated interdisciplinary goal was beneficial (92%). Most parents favored the weekly frequency of cognitive remediation sessions (83%). Much interest was voiced in establishing a formal mentoring program to offer peer support by parents whose children have previously experienced PFS to those acutely managing a new PFS diagnosis (95%). Of note, all participants indicated that they would be willing to serve in a peer mentor role (100%).
Conclusions:The interdisciplinary ANI program approach is feasible with perceived benefits to families managing new PFS and medulloblastoma diagnoses and receiving active cancer treatment.
Ten new insights in climate science 2023
- Mercedes Bustamante, Joyashree Roy, Daniel Ospina, Ploy Achakulwisut, Anubha Aggarwal, Ana Bastos, Wendy Broadgate, Josep G. Canadell, Edward R. Carr, Deliang Chen, Helen A. Cleugh, Kristie L. Ebi, Clea Edwards, Carol Farbotko, Marcos Fernández-Martínez, Thomas L. Frölicher, Sabine Fuss, Oliver Geden, Nicolas Gruber, Luke J. Harrington, Judith Hauck, Zeke Hausfather, Sophie Hebden, Aniek Hebinck, Saleemul Huq, Matthias Huss, M. Laurice P. Jamero, Sirkku Juhola, Nilushi Kumarasinghe, Shuaib Lwasa, Bishawjit Mallick, Maria Martin, Steven McGreevy, Paula Mirazo, Aditi Mukherji, Greg Muttitt, Gregory F. Nemet, David Obura, Chukwumerije Okereke, Tom Oliver, Ben Orlove, Nadia S. Ouedraogo, Prabir K. Patra, Mark Pelling, Laura M. Pereira, Åsa Persson, Julia Pongratz, Anjal Prakash, Anja Rammig, Colin Raymond, Aaron Redman, Cristobal Reveco, Johan Rockström, Regina Rodrigues, David R. Rounce, E. Lisa F. Schipper, Peter Schlosser, Odirilwe Selomane, Gregor Semieniuk, Yunne-Jai Shin, Tasneem A. Siddiqui, Vartika Singh, Giles B. Sioen, Youba Sokona, Detlef Stammer, Norman J. Steinert, Sunhee Suk, Rowan Sutton, Lisa Thalheimer, Vikki Thompson, Gregory Trencher, Kees van der Geest, Saskia E. Werners, Thea Wübbelmann, Nico Wunderling, Jiabo Yin, Kirsten Zickfeld, Jakob Zscheischler
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- Journal:
- Global Sustainability / Volume 7 / 2024
- Published online by Cambridge University Press:
- 01 December 2023, e19
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Non-technical summary
We identify a set of essential recent advances in climate change research with high policy relevance, across natural and social sciences: (1) looming inevitability and implications of overshooting the 1.5°C warming limit, (2) urgent need for a rapid and managed fossil fuel phase-out, (3) challenges for scaling carbon dioxide removal, (4) uncertainties regarding the future contribution of natural carbon sinks, (5) intertwinedness of the crises of biodiversity loss and climate change, (6) compound events, (7) mountain glacier loss, (8) human immobility in the face of climate risks, (9) adaptation justice, and (10) just transitions in food systems.
Technical summaryThe Intergovernmental Panel on Climate Change Assessment Reports provides the scientific foundation for international climate negotiations and constitutes an unmatched resource for researchers. However, the assessment cycles take multiple years. As a contribution to cross- and interdisciplinary understanding of climate change across diverse research communities, we have streamlined an annual process to identify and synthesize significant research advances. We collected input from experts on various fields using an online questionnaire and prioritized a set of 10 key research insights with high policy relevance. This year, we focus on: (1) the looming overshoot of the 1.5°C warming limit, (2) the urgency of fossil fuel phase-out, (3) challenges to scale-up carbon dioxide removal, (4) uncertainties regarding future natural carbon sinks, (5) the need for joint governance of biodiversity loss and climate change, (6) advances in understanding compound events, (7) accelerated mountain glacier loss, (8) human immobility amidst climate risks, (9) adaptation justice, and (10) just transitions in food systems. We present a succinct account of these insights, reflect on their policy implications, and offer an integrated set of policy-relevant messages. This science synthesis and science communication effort is also the basis for a policy report contributing to elevate climate science every year in time for the United Nations Climate Change Conference.
Social media summaryWe highlight recent and policy-relevant advances in climate change research – with input from more than 200 experts.
Protective factors for psychosocial outcomes following cumulative childhood adversity: systematic review
- Mary Buchanan, Grace Walker, Joseph M. Boden, Zara Mansoor, Giles Newton-Howes
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- BJPsych Open / Volume 9 / Issue 6 / November 2023
- Published online by Cambridge University Press:
- 19 October 2023, e197
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Background
The long-term cumulative impact of exposure to childhood adversity is well documented. There is an increasing body of literature examining protective factors following childhood adversity. However, no known reviews have summarised studies examining protective factors for broad psychosocial outcomes following childhood adversity.
AimsTo summarise the current evidence from longitudinal studies of protective factors for adult psychosocial outcomes following cumulative exposure to childhood adversity.
MethodWe conducted a formal systematic review of studies that were longitudinal; were published in a peer-reviewed journal; examined social, environmental or psychological factors that were measured following a cumulative measure of childhood adversity; and resulted in more positive adult psychosocial outcomes.
ResultsA total of 28 studies from 23 cohorts were included. Because of significant heterogeneity and conceptual differences in the final sample of articles, a meta-analysis was not conducted. The narrative review identified that social support is a protective factor specifically for mental health outcomes following childhood adversity. Findings also suggest that aspects of education are protective factors to adult socioeconomic, mental health and social outcomes following childhood adversity. Personality factors were protective for a variety of outcomes, particularly mental health. The personality factors were too various to summarise into meaningful combined effects. Overall GRADE quality assessments were low and very low, although these scores mostly reflect that all observational studies are low quality by default.
ConclusionsThese findings support strategies that improve connection and access to education following childhood adversity exposure. Further research is needed for the roles of personality and dispositional factors, romantic relationship factors and the combined influences of multiple protective factors.
Quality analysis of publicly available information about hypoplastic left heart syndrome
- Zachary Brennan, Omar M. Sharaf, John A. Treffalls, Natalia Roa-Vidal, Douglas J. Weinstein, Jonah S. Bassuk, Yuriy Stukov, Giles J. Peek, Mark S. Bleiweis, Jeffrey P. Jacobs
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- Journal:
- Cardiology in the Young / Volume 33 / Issue 7 / July 2023
- Published online by Cambridge University Press:
- 22 August 2023, pp. 1079-1085
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Purpose:
Publicly available health information is increasingly important for patients and their families. While the average US citizen reads at an 8th-grade level, electronic educational materials for patients and families are often advanced. We assessed the quality and readability of publicly available resources regarding hypoplastic left heart syndrome (HLHS).
Methods:We queried four search engines for “hypoplastic left heart syndrome”, “HLHS”, and “hypoplastic left ventricle”. The top 30 websites from searches on Google, Yahoo!, Bing, and Dogpile were combined into a single list. Duplicates, commercial websites, physician-oriented resources, disability websites, and broken links were removed. Websites were graded for accountability, content, interactivity, and structure using a two-reviewer system. Nonparametric analysis of variance was performed.
Results:Fifty-two websites were analysed. Inter-rater agreement was high (Kappa = 0.874). Website types included 35 hospital/healthcare organisation (67.3%), 12 open access (23.1%), 4 governmental agency (7.7%), and 1 professional medical society (1.9%). Median total score was 19 of 39 (interquartile range = 15.8–25.3): accountability 5.5 of 17 (interquartile range = 2.0–9.3), content 8 of 12 (interquartile range = 6.4–10.0), interactivity 2 of 6 (interquartile range = 2.0–3.0), and structure 3 of 4 (interquartile range = 2.8–4.0). Accountability was low with 32.7% (n = 17) of sites disclosing authorship and 26.9% (n = 14) citing sources. Forty-two percent (n = 22) of websites were available in Spanish. Total score varied by website type (p = 0.03), with open access sites scoring highest (median = 26.5; interquartile range = 20.5–28.6) and hospital/healthcare organisation websites scoring lowest (median = 17.5; interquartile range = 13.5–21.5). Score differences were driven by differences in accountability (p = 0.001) – content scores were similar between groups (p = 0.25). Overall readability was low, with median Flesch–Kincaid Grade Level of 11th grade (interquartile range = 10th–12th grade).
Conclusions:Our evaluation of popular websites about HLHS identifies multiple opportunities for improvement, including increasing accountability by disclosing authorship and citing sources, enhancing readability by providing material that is understandable to readers with the full spectrum of educational background, and providing information in languages besides English, all of which would enhance health equity.
Interface behaviour of the slow diffusion equation with strong absorption: Intermediate-asymptotic properties
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- John R. King, Giles W. Richardson, Jamie M. Foster
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- Journal:
- European Journal of Applied Mathematics / Volume 34 / Issue 5 / October 2023
- Published online by Cambridge University Press:
- 14 June 2023, pp. 1099-1132
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The dynamics of interfaces in slow diffusion equations with strong absorption are studied. Asymptotic methods are used to give descriptions of the behaviour local to a comprehensive range of possible singular events that can occur in any evolution. These events are: when an interface changes its direction of propagation (reversing and anti-reversing), when an interface detaches from an absorbing obstacle (detaching), when two interfaces are formed by film rupture (touchdown) and when the solution undergoes extinction. Our account of extinction and self-similar reversing and anti-reversing is built upon previous work; results on non-self-similar reversing and anti-reversing and on the various types of detachment and touchdown are developed from scratch. In all cases, verification of the asymptotic results against numerical solutions to the full PDE is provided. Self-similar solutions, both of the full equation and of its asymptotic limits, play a central role in the analysis.
Never too early: the impact of a shadowing programme in paediatric and congenital cardiac surgery for undergraduate college students
- Zachary Brennan, Matthew Purlee, Omar M. Sharaf, Isabella E. Badhwar, Colton Brown, Liam Kugler, Douglas J. Weinstein, Jonah S. Bassuk, Yasmine Baydoun, Dan Neal, Yuriy Stukov, Kirsten Freeman, Tyler Wallen, Giles J. Peek, Mark S. Bleiweis, Jeffrey P. Jacobs
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- Cardiology in the Young / Volume 33 / Issue 4 / April 2023
- Published online by Cambridge University Press:
- 03 May 2023, pp. 514-519
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Purpose:
Diversification of the medical and cardiothoracic surgical workforce represents an ongoing need. A congenital cardiac surgery shadowing programme for undergraduate students was implemented at the University of Florida Congenital Heart Center.
Methods:Students shadowing in the Congenital Heart Center from 17 December 2020 through 20 July 2021 were sent a survey through Qualtrics to evaluate the impact of their shadowing experience. The main objectives of the survey were to determine the personal relationship(s) of the students to physicians prior to shadowing, how the presence or absence of physicians in the family of a given student related to the exposure of the student to a medical setting prior to shadowing, and the interest of the students in medicine and cardiothoracic surgery prior to and after the shadowing experience. Survey responses included “Yes/No” questions, scaled responses using a Likert scale, selection lists, and free text responses. When applicable, t-tests were utilised to assess differences between student groups.
Results:Of the 37 students who shadowed during the study period, 26 (70%) responded. Most students were female (58%, n = 15), and the mean age was 20.9 ± 2.4 years. Students spent a mean duration of 95 ± 138 hours shadowing providers as part of the shadowing programme. Likert scale ratings of interest in the professions of medicine, surgery, and cardiothoracic surgery all increased after the shadowing experience (p < 0.01). Students with a family member in medicine had more clinical exposure prior to the shadowing programme (p < 0.01).
Conclusion:A surgical shadowing programme at a Congenital Heart Center may have an important formative impact on the views of undergraduate students regarding potential careers in surgery and medicine. Additionally, students without family members in medicine tend to have less prior exposure to medicine and could likely benefit more from this type of shadowing programme.
Ten new insights in climate science 2022
- Maria A. Martin, Emmanuel A. Boakye, Emily Boyd, Wendy Broadgate, Mercedes Bustamante, Josep G. Canadell, Edward R. Carr, Eric K. Chu, Helen Cleugh, Szilvia Csevár, Marwa Daoudy, Ariane de Bremond, Meghnath Dhimal, Kristie L. Ebi, Clea Edwards, Sabine Fuss, Martin P. Girardin, Bruce Glavovic, Sophie Hebden, Marina Hirota, Huang-Hsiung Hsu, Saleemul Huq, Karin Ingold, Ola M. Johannessen, Yasuko Kameyama, Nilushi Kumarasinghe, Gaby S. Langendijk, Tabea Lissner, Shuaib Lwasa, Catherine Machalaba, Aaron Maltais, Manu V. Mathai, Cheikh Mbow, Karen E. McNamara, Aditi Mukherji, Virginia Murray, Jaroslav Mysiak, Chukwumerije Okereke, Daniel Ospina, Friederike Otto, Anjal Prakash, Juan M. Pulhin, Emmanuel Raju, Aaron Redman, Kanta K. Rigaud, Johan Rockström, Joyashree Roy, E. Lisa F. Schipper, Peter Schlosser, Karsten A. Schulz, Kim Schumacher, Luana Schwarz, Murray Scown, Barbora Šedová, Tasneem A. Siddiqui, Chandni Singh, Giles B. Sioen, Detlef Stammer, Norman J. Steinert, Sunhee Suk, Rowan Sutton, Lisa Thalheimer, Maarten van Aalst, Kees van der Geest, Zhirong Jerry Zhao
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- Journal:
- Global Sustainability / Volume 5 / 2022
- Published online by Cambridge University Press:
- 10 November 2022, e20
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Non-technical summary
We summarize what we assess as the past year's most important findings within climate change research: limits to adaptation, vulnerability hotspots, new threats coming from the climate–health nexus, climate (im)mobility and security, sustainable practices for land use and finance, losses and damages, inclusive societal climate decisions and ways to overcome structural barriers to accelerate mitigation and limit global warming to below 2°C.
Technical summaryWe synthesize 10 topics within climate research where there have been significant advances or emerging scientific consensus since January 2021. The selection of these insights was based on input from an international open call with broad disciplinary scope. Findings concern: (1) new aspects of soft and hard limits to adaptation; (2) the emergence of regional vulnerability hotspots from climate impacts and human vulnerability; (3) new threats on the climate–health horizon – some involving plants and animals; (4) climate (im)mobility and the need for anticipatory action; (5) security and climate; (6) sustainable land management as a prerequisite to land-based solutions; (7) sustainable finance practices in the private sector and the need for political guidance; (8) the urgent planetary imperative for addressing losses and damages; (9) inclusive societal choices for climate-resilient development and (10) how to overcome barriers to accelerate mitigation and limit global warming to below 2°C.
Social media summaryScience has evidence on barriers to mitigation and how to overcome them to avoid limits to adaptation across multiple fields.
Ten new insights in climate science 2021: a horizon scan
- Maria A. Martin, Olga Alcaraz Sendra, Ana Bastos, Nico Bauer, Christoph Bertram, Thorsten Blenckner, Kathryn Bowen, Paulo M. Brando, Tanya Brodie Rudolph, Milena Büchs, Mercedes Bustamante, Deliang Chen, Helen Cleugh, Purnamita Dasgupta, Fatima Denton, Jonathan F. Donges, Felix Kwabena Donkor, Hongbo Duan, Carlos M. Duarte, Kristie L. Ebi, Clea M. Edwards, Anja Engel, Eleanor Fisher, Sabine Fuss, Juliana Gaertner, Andrew Gettelman, Cécile A.J. Girardin, Nicholas R. Golledge, Jessica F. Green, Michael R. Grose, Masahiro Hashizume, Sophie Hebden, Helmke Hepach, Marina Hirota, Huang-Hsiung Hsu, Satoshi Kojima, Sharachchandra Lele, Sylvia Lorek, Heike K. Lotze, H. Damon Matthews, Darren McCauley, Desta Mebratu, Nadine Mengis, Rachael H. Nolan, Erik Pihl, Stefan Rahmstorf, Aaron Redman, Colleen E. Reid, Johan Rockström, Joeri Rogelj, Marielle Saunois, Lizzie Sayer, Peter Schlosser, Giles B. Sioen, Joachim H. Spangenberg, Detlef Stammer, Thomas N.S. Sterner, Nicola Stevens, Kirsten Thonicke, Hanqin Tian, Ricarda Winkelmann, James Woodcock
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- Journal:
- Global Sustainability / Volume 4 / 2021
- Published online by Cambridge University Press:
- 18 October 2021, e25
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Non-technical summary
We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding about the remaining options to achieve the Paris Agreement goals, through overcoming political barriers to carbon pricing, taking into account non-CO2 factors, a well-designed implementation of demand-side and nature-based solutions, resilience building of ecosystems and the recognition that climate change mitigation costs can be justified by benefits to the health of humans and nature alone. We consider new insights about what to expect if we fail to include a new dimension of fire extremes and the prospect of cascading climate tipping elements.
Technical summaryA synthesis is made of 10 topics within climate research, where there have been significant advances since January 2020. The insights are based on input from an international open call with broad disciplinary scope. Findings include: (1) the options to still keep global warming below 1.5 °C; (2) the impact of non-CO2 factors in global warming; (3) a new dimension of fire extremes forced by climate change; (4) the increasing pressure on interconnected climate tipping elements; (5) the dimensions of climate justice; (6) political challenges impeding the effectiveness of carbon pricing; (7) demand-side solutions as vehicles of climate mitigation; (8) the potentials and caveats of nature-based solutions; (9) how building resilience of marine ecosystems is possible; and (10) that the costs of climate change mitigation policies can be more than justified by the benefits to the health of humans and nature.
Social media summaryHow do we limit global warming to 1.5 °C and why is it crucial? See highlights of latest climate science.
Do women with differing levels of trait eating pathology experience daily stress and body dissatisfaction differently?
- A. Dang, M. Fuller-Tyszkiewicz, S. De La Harpe, V. Rozenblat, S. Giles, L. Kiropoulos, I. Krug
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- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, pp. S704-S705
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Introduction
Studies have suggested that stress predicts both body dissatisfaction (BD) and disordered eating (DE) patterns. However, the mechanisms of this process are not entirely clear and could be elucidated through further exploration in daily life.
ObjectivesThe purpose of this study was to 1) explore the concurrent and lagged relationship between stress and BD in the daily life of individuals with differing levels of trait eating pathology (EP) and 2) to investigate whether maladaptive coping moderated these relationships.
Methods107 female participants (mean age = 26.92) completed an online survey about stress, coping strategies and trait EP. Participants used a smartphone app to report on state stress, BD and DE six times a day for seven days
ResultsIndividuals with elevated trait EP experienced a significantly higher frequency of stress events (b = 0.04). Participants’ use of maladaptive coping significantly increased state stress (b = 0.41), but was not moderated by EP. Participants’ state stress and BD measured at the same time point (concurrent assessment) were significantly related (b = 0.13). Either stress or BD at the previous time point did not significantly predict changes in the other (lagged assessment, b = 0.02, b = -0.09, respectively). The aforementioned state-based associations were not moderated by trait EP
ConclusionsWomen with more severe EP were found to experience stress more frequently. Maladaptive coping strategies were related to stress, but not moderated by EP. The association between stress and BD from concurrent but not lagged assessment highlights the importance of assessing and targeting momentary stress levels.
DisclosureNo significant relationships.
Mental health attendances in Australia during the COVID-19 pandemic: A telehealth success story?
- S. Giles, S. Sreedharan, M. Mian
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S698
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Introduction
The COVID-19 pandemic has significantly impacted the delivery of mental health services globally. Within Australia, the COVID-19 pandemic and subsequent containment measures have led to reduced face-to-face attendances. To maintain access to mental health consultations, new telehealth services were introduced by the Australian Government in late March 2020.
ObjectivesWe aimed to quantify the impact of the COVID-19 pandemic on patterns of mental health attendances in Australia using an interrupted time series model.
MethodsTo characterise patterns of mental health service utilisation, monthly mental health attendances between January 2016 and June 2020 were extracted from the Medicare database, stratified by clinician type: general practitioner (GP), psychiatrist, and allied health. We used triple exponential smoothing to model attendances between January 2017 and December 2019. Observed and predicted attendances between January and June 2020 were compared with 95% confidence (p<0.05).
ResultsOur models showed decreased mental health attendances in March and April, consistent with all healthcare services during this time. While uptake of telehealth was significant, it only partially covered the reduction in mental health attendances.
ConclusionsOur modelling highlights the significant impacts of the COVID-19 pandemic on mental health services in Australia, with telehealth only partially compensating for the reduction in face-to-face attendances. These results suggest that telehealth services may not be suitable for all individuals (e.g. those without reliable internet access). Given that telehealth will likely remain a feature of mental health service provision, outreach and face-to-face services should be considered for vulnerable groups
DisclosureNo significant relationships.
An examination of the direct and indirect effect of self-objectification and disordered eating
- S. Giles, J. Rabinowicz, C. Raux, M. Fuller-Tyszkiewicz, I. Krug
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S705
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Introduction
Objectification theory argues that self-objectification confers risk for disordered eating (DE) both directly, and indirectly through a cascade of negative psychological consequences (e.g. low mood and self-conscious body monitoring). Robust cross-sectional evidence supports these relationships. However, these cross-sectional studies do not provide evidence for the complex intraindividual psychological processes outlined in objectification theory which purportedly contribute to DE.
ObjectivesUsing an ecological momentary assessment design, the current study investigated the direct within-person effect between state self-objectification and DE and examined the indirect within-person effect of negative mood and body comparisons, on the relationship between state self-objectification and DE.
MethodsTwo-hundred female participants (M=20.43 years, SD=4.60) downloaded a smartphone app which assessed momentary experiences of self-objectification, mood, body comparisons, and DE six times per day at random intervals for seven days.
ResultsIndicated that self-objectification significantly predicted DE behaviours [95% CI 0.01, 0.03] and body comparisons [95% CI 0.32, 0.41]. However, the indirect effect of body comparisons on the relationship between state self-objectification and DE was not significant [95% CI -0.01, 0.00]. In the second mediation model, self-objectification significantly predicted DE behaviours [95% CI 0.01, 0.03], but did not significantly predict mood [95% CI -0.06, 0.03]. Similarly, the indirect effect of mood on the relationship between state self-objectification and DE was not significant [95% CI -0.00, 0.00].
ConclusionsThese results enhance our understanding of objectification theory and suggest that self-objectification confers risk to DE directly. However, our findings do not support the indirect effect of self-objectification on DE through low mood or body comparisons.
DisclosureNo significant relationships.
A systematic review and meta-analysis on the DSM-5 severity specifiers for eating disorders
- A. Dang, S. Giles, F. Fernandez-Aranda, L. Kiropoulos, M. Fuller-Tyszkiewicz
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- Journal:
- European Psychiatry / Volume 64 / Issue S1 / April 2021
- Published online by Cambridge University Press:
- 13 August 2021, p. S704
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Introduction
The DSM-5 introduced severity indicies for the first time.
ObjectivesWe conducted a systematic review and synthesis the frequency of each DSM-5 severity categories (i.e., mild, moderate, severe and extreme severe) for Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorders (BED), and to evaluate studies that assess the clinical utility of these severity specifiers for all eating disorders (ED) subtypes.
MethodsFive databases (EMBASE, MEDLINE, PsycARTICLES, PsycINFO, and ProQuest) were used to identify for both academic and grey literature published from 2013 until July 8, 2020. Twenty-five studies were retrieved for the systematic review based on the inclusion and exclusion criteria, and up to six studies were qualified for meta-analysis
ResultsWe found limited support for the current DSM-5 severity ratings for all ED indices, as the majority of ED severity groups were not significantly distinguishable in overall ED psychopathology (mean effect size ranged from .02 to .5). The value of the DSM-5 severity ratings was further devalued as 56.91% to 80.52% of individuals with AN, BN, and BED were categorized into mild and moderate groups. However, there was significant heterogeneity between the studies (p< .001), and some of these heterogeneities were explained by differences in study settings and measurement of eating disorder psychopathology.
ConclusionsOverall, the current study provided little support for the DSM-5 severity ratings for EDs, thus it is suggested that further exploration in alternative severity classification approach is needed.
DisclosureNo significant relationships.
Methamphetamine use and psychotic symptoms: findings from a New Zealand longitudinal birth cohort
- Joseph M. Boden, James A. Foulds, Giles Newton-Howes, Rebecca McKetin
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- Journal:
- Psychological Medicine / Volume 53 / Issue 3 / February 2023
- Published online by Cambridge University Press:
- 17 June 2021, pp. 987-994
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Background
This study examined the association between methamphetamine use and psychotic symptoms in a New Zealand general population birth cohort (n = 1265 at birth).
MethodsAt age 18, 21, 25, 30, and 35, participants reported on their methamphetamine use and psychotic symptoms in the period since the previous interview. Generalized estimating equations modelled the association between methamphetamine use and psychotic symptoms (percentage reporting any symptom, and number of symptoms per participant). Confounding factors included childhood individual characteristics, family socioeconomic circumstances and family functioning. Long term effects of methamphetamine use on psychotic symptoms were assessed by comparing the incidence of psychotic symptoms at age 30–35 for those with and without a history of methamphetamine use prior to age 30.
ResultsAfter adjusting for confounding factors and time-varying covariate factors including concurrent cannabis use, methamphetamine use was associated with a modest increase in psychosis risk over five waves of data (adjusted odds ratio (OR) 1.33, 95% confidence interval (CI) 1.03–1.72 for the percentage measure; and IRR 1.24, 95% CI 1.02–1.50 for the symptom count measure). The increased risk of psychotic symptoms was concentrated among participants who had used at least weekly at any point (adjusted OR 2.85, 95% CI 1.21–6.69). Use of methamphetamine less than weekly was not associated with increased psychosis risk. We found no evidence for a persistent vulnerability to psychosis in the absence of continuing methamphetamine use.
ConclusionMethamphetamine use is associated with increased risk of psychotic symptoms in the general population. Increased risk is chiefly confined to people who ever used regularly (at least weekly), and recently.
Radiographic appearance of extracorporeal membrane oxygenations versus left ventricular assist device
- Phillip M Mackie, Giles J Peek, Jeffrey P Jacobs, Mark S Bleiweis
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- Cardiology in the Young / Volume 31 / Issue 5 / May 2021
- Published online by Cambridge University Press:
- 20 May 2021, pp. 831-832
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Chest radiography compares left ventricular decompression in the same patient supported with extracorporeal membrane oxygenation with atrial septal fenestration and subsequently supported with left ventricular assist device with apical cannulation.
Ten new insights in climate science 2020 – a horizon scan
- Erik Pihl, Eva Alfredsson, Magnus Bengtsson, Kathryn J. Bowen, Vanesa Cástan Broto, Kuei Tien Chou, Helen Cleugh, Kristie Ebi, Clea M. Edwards, Eleanor Fisher, Pierre Friedlingstein, Alex Godoy-Faúndez, Mukesh Gupta, Alexandra R. Harrington, Katie Hayes, Bronwyn M. Hayward, Sophie R. Hebden, Thomas Hickmann, Gustaf Hugelius, Tatiana Ilyina, Robert B. Jackson, Trevor F. Keenan, Ria A. Lambino, Sebastian Leuzinger, Mikael Malmaeus, Robert I. McDonald, Celia McMichael, Clark A. Miller, Matteo Muratori, Nidhi Nagabhatla, Harini Nagendra, Cristian Passarello, Josep Penuelas, Julia Pongratz, Johan Rockström, Patricia Romero-Lankao, Joyashree Roy, Adam A. Scaife, Peter Schlosser, Edward Schuur, Michelle Scobie, Steven C. Sherwood, Giles B. Sioen, Jakob Skovgaard, Edgardo A. Sobenes Obregon, Sebastian Sonntag, Joachim H. Spangenberg, Otto Spijkers, Leena Srivastava, Detlef B. Stammer, Pedro H. C. Torres, Merritt R. Turetsky, Anna M. Ukkola, Detlef P. van Vuuren, Christina Voigt, Chadia Wannous, Mark D. Zelinka
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- Journal:
- Global Sustainability / Volume 4 / 2021
- Published online by Cambridge University Press:
- 27 January 2021, e5
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Non-technical summary
We summarize some of the past year's most important findings within climate change-related research. New research has improved our understanding of Earth's sensitivity to carbon dioxide, finds that permafrost thaw could release more carbon emissions than expected and that the uptake of carbon in tropical ecosystems is weakening. Adverse impacts on human society include increasing water shortages and impacts on mental health. Options for solutions emerge from rethinking economic models, rights-based litigation, strengthened governance systems and a new social contract. The disruption caused by COVID-19 could be seized as an opportunity for positive change, directing economic stimulus towards sustainable investments.
Technical summaryA synthesis is made of ten fields within climate science where there have been significant advances since mid-2019, through an expert elicitation process with broad disciplinary scope. Findings include: (1) a better understanding of equilibrium climate sensitivity; (2) abrupt thaw as an accelerator of carbon release from permafrost; (3) changes to global and regional land carbon sinks; (4) impacts of climate change on water crises, including equity perspectives; (5) adverse effects on mental health from climate change; (6) immediate effects on climate of the COVID-19 pandemic and requirements for recovery packages to deliver on the Paris Agreement; (7) suggested long-term changes to governance and a social contract to address climate change, learning from the current pandemic, (8) updated positive cost–benefit ratio and new perspectives on the potential for green growth in the short- and long-term perspective; (9) urban electrification as a strategy to move towards low-carbon energy systems and (10) rights-based litigation as an increasingly important method to address climate change, with recent clarifications on the legal standing and representation of future generations.
Social media summaryStronger permafrost thaw, COVID-19 effects and growing mental health impacts among highlights of latest climate science.