151398 research outputs found
Sort by
Sustainable diets reduce diet-related greenhouse gas emissions and improve diet quality: results from the MyPlanetDiet randomized controlled trial
No full textBackgroundDiet-related environmental impacts must be reduced to mitigate climate change. Although many sustainable diets have been proposed, the human and planetary impacts of following such diets have not been tested.ObjectiveThe aim of this study was to assess health and environmental outcomes related to following whole-diet sustainable dietary advice.MethodsThe MyPlanetDiet RCT was a 12-week single-blinded, parallel study testing the impacts of a more sustainable diet. Participants were randomly assigned to receive personalized advice based on a sustainable diet (intervention) or based on current healthy eating guidelines (control). Dietary assessments, fasted anthropometry, and fasted serum samples were collected at baseline and end point. The primary outcome was change in diet-related greenhouse gas emissions (GHGE) measured in kilograms carbon dioxide equivalents per day (kgCO2-eq/d). Secondary outcomes included changes in diet quality, macronutrient and food group intakes, diet-related water footprint, and health biomarkers. Data were analyzed using 2-way mixed analysis of covariance.ResultsStudy participants (n = 292) decreased diet-related GHGE over time (P < 0.001) with a significant time × group interaction between control (from 6.5 ± 0.2 to 5.7 ± 0.2 kgCO2-eq/d) and intervention groups (7.1 ± 0.2 to 4.8 ± 0.1 kgCO2-eq/d; P < 0.001). Diet quality increased in control (from 44.2 ± 0.8 to 52.9 ± 0.9) and intervention (from 44.7 ± 0.8 to 53.0 ± 0.9) groups (P < 0.001). Participants decreased red meat intakes (control: from 34.2 ± 2.9 to 25.7 ± 2.4 g/d; intervention: from 42.7 ± 3.4 to 12.8 ± 1.9 g/d; P < 0.001) and increased plant-based food intakes including beans, peas, and lentils (control: from 15.4 ± 1.9 to 18.3 ± 2.1 g/d; intervention: from 18.4 ± 2.1 to 49.2 ± 4.3 g/d; P < 0.001), fruit (control: from 164.8 ± 12.3 to 264.5 ± 13.9 g/d; intervention: from 188.5 ± 14.2 to 233.7 ± 13.5 g/d; P < 0.001), and vegetables (control: from 148.1 ± 6.5 to 163.1 ± 7.3 g/d; intervention: from 161.3 ± 5.9 to 201.9 ± 8.0 g/d; P < 0.001). No changes in anthropometry, serum biochemistry, or diet-related water footprint were observed.ConclusionsPersonalized sustainable dietary advice led to healthier diets and lower diet-related GHGE with no short-term negative health effects
Research recommendations from the 2024 Breakthrough T1D, Diabetes UK and Kidney Research UK, diabetes and kidney disease expert workshop
No full textAims: To develop a position statement which identifies research priorities in diabetic kidney disease and provides recommendations to researchers and research funders on how best to address them.Methods: A one-day research workshop was conducted, bringing together research experts in diabetes and kidney disease, healthcare professionals and people living with diabetes, to identify and prioritise research recommendations.Results: The following key areas were identified as needing increased focus:· Understanding causal mechanisms in diabetic kidney disease· Prevention of diabetic kidney disease· Addressing health inequalities· Improving diagnosis· Improving care· Supporting self-managementConclusions: This position statement outlines recommendations to address the urgent need to tackle diabetic kidney disease and calls on the diabetes and kidney research communities to act upon these recommendations to ensure future research works to eliminate unfair and avoidable disparities in health.<br/
Mapping the complex systems that connects the urban environment to cognitive decline in older adults: a group model building study
No full textThis study aimed to develop a Causal Loop Diagram (CLD) to visualise how urban environment factors impact dementia and cognitive decline, and potential causal mechanisms. In Group Model Building workshops with 12 researchers, a CLD was created to identify factors contributing to cognitive decline, and the dynamic interrelationships between these factors. The factors were classified in nine main themes: urban design, social environment, travel behaviours, urban design by-products, lifestyle, mental health conditions, disease/physiology, brain physiology, and cognitive decline outcomes. Five selected feedback loops illustrated some dynamics in the system. The workshops helped develop a shared language and understanding of different perspectives from an interdisciplinary team. The CLD creation was part of a comprehensive modelling approach based on experts’ knowledge which informed other research outputs such as an evidence gap map and an umbrella review, helped the identification of environmental variables for future studies and analyses, and helped to identify future possible systems-based interventions to prevent cognitive decline. The study highlights the utility of CLDs and Group Model Building workshops in interdisciplinary research projects investigating complex systems
A comprehensive review of sustainable geopolymer concrete using palm oil clinker: environmental and engineering aspects
No full textAmidst the dual challenges of aggregate scarcity and the environmental impact of carbon dioxide (CO2) emissions from cement production, this study investigates the viability of palm oil clinker (POC) as a sustainable aggregate in geopolymer concrete (GPC). The lack of appropriate alternative coarse and fine aggregates essential in concrete production is one of the critical issues faced by the construction industry. This review evaluates its environmental benefits, chemical and physical attributes, and influence on GPC's microstructure. Previous studies have shown that incorporating POC in GPC significantly reduces density from 2345 to 1821 kg/m3 while maintaining competitive compressive strength, thus proving its applicability in various structural and nonstructural contexts. Moreover, GPC with POC demonstrates enhanced resistance to aggressive environmental conditions such as water absorption and resistance against acid and sulfate environments. Geopolymer mortar (GPM) exposed to sulfate attack recorded the lowest decrease in strength than GPM containing POC fine aggregates by about 20%. The use of 100% POC aggregates in GPC mix has a 3.2% water absorption, which is lower than the limit for high-performance concrete. The results advocate for the development of POC-aggregate GPC as an environmentally friendly construction material, contributing to the sustainable advancement of the building industry.<br/
A taxonomy for assessing whether HRQoL value sets are obsolete
No full textProviding health-related quality of life (HRQoL) value sets to enable estimation of quality adjusted life years (QALYs) is important in facilitating economic evaluation and in supporting reliable decision-making about healthcare. However, as the field matures, many value sets across a range of HRQoL instruments are now old, based on potentially outdated valuation methodologies and preference data from samples that no longer represent the contemporary population. Having a clear strategy for identification and mitigation of obsolescence is important to ensure policy makers retain confidence in their country-specific value sets. In this Current Opinion, we develop a taxonomy of value set obsolescence. We then explore how the different types of obsolescence might be identified and how methodologists might work with local policymakers to address obsolescence and therefore ensure HRQoL instruments remain relevant for use. The taxonomy of obsolescence consists of four main areas: (1) the value set no longer aligns with current normative health technology assessment (HTA) requirements; (2) the methods used to generate it are no longer considered robust or adequately close to best practice; (3) the population composition has moved too far from the characteristics of the sample in which the original value set was derived; and (4) even after controlling for population differences, preferences are likely to have changed since the original data collection. Through identification of the type of obsolescence that applies in a particular setting, we then suggest a range of possible solutions to each, ranging from recommending particular sensitivity analyses, through reweighting of existing data to better account for population differences, to collecting new data for an updated value set. Obsolescence of existing value sets is driven by more than just time since data collection is often a matter of judgment rather than based on a clear definition. The taxonomy presented here provides a tool for assessing whether value sets are obsolete and what the appropriate response to this obsolescence should be. Working closely with local policymakers and involving discussions regarding the ongoing appropriateness of existing value sets should form an important part of future activities. This should include the consideration of updating value sets in contemporary populations using current best-practice methods. However, the benefits of updating value sets have to be balanced against the cost of doing so, including the challenges faced by policymakers when new values sets require a transition to new local decision-making processes.</p
Four decades of overdose prevention centres: lessons for the future from a realist review
No full textBackground: Overdose prevention centres (OPCs) are spaces where people can consume previously obtained illicit drugs under the supervision of staff who can intervene to prevent and manage overdose. They have been provided in Europe and elsewhere for nearly 40 years, initially in response to the epidemic of HIV/AIDS. We can learn from their operation history to inform future developments in harm reduction services. Methods: We carried out a realist review of 391 documents, reported according to the RAMESES I guidelines, and carried out realist synthesis of these documents.Results: We present a full realist programme theory of OPCs, with a diagrammatic logic model, of how the contexts and mechanisms of OPCs combine to produce various outcomes for service users and their communities in different settings. Three specific causal pathways were evidenced through which OPCs produce their outcomes for particular groups in specific contexts of housing status, gender identity and ethnicity, and local drug markets, with frequency of use, legal and political contexts, and stigma as overlapping contextual factors. Key OPC interventions include the provision of a safe and hygienic consumption space, safe consumption education, timely overdose response, and protection from drug scene and gender-based violence. These can trigger the underlying mechanisms of safety, trust, social inclusion, engagement, autonomy, and empowerment when supported with health care and other services, including detoxification and opioid agonist treatment. The combinations of these contexts and mechanisms create important outcomes for individual service users, for the communities they live in, and for wider society. We also describe causal pathways that can lead to unintended, adverse outcomes. Conclusion: This review provides useful information for policy makers, practitioners, and researchers on how to implement and evaluate OPCs in future to maximise their benefits; an important task in the context of the ongoing public health crises of drug poisoning deaths in North America and the UK, and the possibility of increasing deaths from synthetic opioids in Europe and elsewhere. <br/
Applications for cell-free fetal DNA testing beyond common aneuploidy
No full textKey content• Cell-free fetal DNA (cffDNA) screening test performance for sex chromosome aneuploidies (SCAs), copy number variants (CNVs), rare autosomal trisomies (RATs) and single gene disorders.•cffDNA screening for detection of pre-eclampsia and malignancy.•Investigation of recurrent miscarriage using cffDNA.•Alternative approaches to interrogating free fetal DNA.Learning objectives•To appreciate there is a lack of robust evidence regarding cffDNA screening test performance for expanded applications.•To understand that some but not all countries endorse SCA screening and screening for some CNVs such as 22q.11.2 microdeletion syndrome.•To be aware that expanded applications of cffDNA screening pose interpretational and ethical challenges.•To be aware that the diagnostic confirmatory test of choice following a high-chance screening result for the aforementioned conditions is an amniocentesis.Ethical issues•Indirect sex determination may occur with SCA screening.•Expanded applications for cffDNA screening in the UK fall outside recommendations.<br/
The effect of geographical denomination on the uptake of fungus-resistant grapes
No full textGrape production for wine making is of great economic and cultural importance in Europe, but is heavily dependent on pesticides. Reducing pesticide use and associated risks is a policy goal in several countries, particularly in Europe. The most effective strategy to substantially reduce pesticide use in grape production is the planting of fungus-resistant varieties, which are less susceptible to common fungal infections and thus allow a massive reduction in pesticide treatments. However, their use remains low. One possible reason may be that planting new varieties may conflict with policies supporting geographical denomination systems, which tend to focus on traditional varieties. We provide the first study of how geographical denomination systems directly affect the adoption of fungus-resistant varieties. Using a novel and uniquely detailed dataset of 54,483 variety-level observations from 381 vineyards in Switzerland, we find that fungus-resistant grape varieties are 2% more likely to be adopted by growers if they can be sold under geographical denominations. Thus, expanding the eligibility of fungus-resistant varieties in geographical denomination lists could be a straightforward policy measure to stimulate their adoption. However, the effects are small, so complementary policies are needed
Extended recommendations on the nomenclature for microbial catabolites of dietary (poly)phenols, with a focus on isomers
No full textThere is an increasing body of evidence indicating that phenolic compounds derived from microbiota-mediated breakdown of dietary (poly)phenolics in the colon are at least partially responsible for the beneficial effects of a plant-based diet. Investigating the role of these catabolites and defining their particular biological effects is challenging due to the complex microbial pathways and the diversity of structures that are produced. When reviewing the data this is further exacerbated by the inconsistency and lack of standardization in naming the microbial phenolics. Here we update the nomenclature of colonic catabolites of dietary (poly)phenols, extending the proposals of Kay et al. (Am. J. Clin. Nutr. 112 (2020) 1051-1068, https://doi.org/10.1093/ajcn/nqaa204), by providing additional structures, and addressing the difficulties that can arise when investigating regioisomers and stereoisomers, where subtle differences in structure can have a substantial impact on bioactivity. The information provided will help to better harmonize the literature, facilitate data retrieval and provide a reference for researchers in several fields, especially nutrition and biochemistry