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Public opinion on policy interventions for regulating four unhealthy commodity industries:A cross-sectional online survey of a representative sample of British adults 2023
No full textBackgroundTobacco, alcohol, unhealthy food and drink, and gambling are all unhealthy commodity industries which have profound public health consequences. The tactics of these industries intending to undermine policies and scientific evidence are often similar. To counter this, greater coherence in regulatory response is needed within, and across, policy spheres. Understanding public opinion is key in this context.ObjectivesThis study assessed public support for policies targeting unhealthy commodities and factors associated with support, including sociodemographic features, current smoking, excess alcohol consumption, obesity and daily gambling.DesignAcross-sectional design, where anonymous data was drawn from the annually commissioned Action on Smoking and Health Smokefree British survey conducted online between 22nd February and 15th March 2023.Participants12,271 British adults, invited to participate from the online YouGov panel. Weighted by sociodemographic characteristics to be representative of British adults.Outcome measuresPercentage support for policies to reduce harm from unhealthy commodities; and associations between the level of support, sociodemographic features, and exposure to unhealthy commodities.AnalysisMissing data were imputed using multiple imputations and data were weighted to match the British population. The degree of public support for policies were descriptively assessed and associations between this support, sociodemographic characteristics and the harmful consumption of unhealthy commodities, were measured using logistic regression.Main findingsRespondents strongly supported measures targeting industry interactions with government, and the majority believed that public health policy should be protected from industry influence (69.8% for alcohol, 75.6% for gambling, 75.0% for tobacco and 68.2% for unhealthy food and drinks manufacturers). There was also majority support for industry levies (77.1% for tobacco, 74.2% for gambling, 61.9% for alcohol, 59.5% for unhealthy food and drink), however, taxation and advertising bans received more mixed responses. Some sociodemographic factors (age and social grade) and exposure to some unhealthy commodities (current smoking, alcohol intake >14 units per week, daily gambling) were associated with differential levels of support for public health policies. However, sex and obesity did not have meaningful associations.ConclusionThe public are generally supportive of public health policies to reduce harm from tobacco, alcohol, gambling and unhealthy food and drink
A Chromosome-level Reference Assembly and Annotation for the White-faced Plover (Charadrius dealbatus) Genome
No full textThe Charadrius genus encompasses 36 species, each exhibiting a wide array of life histories and behaviors. Conspecific variations in mating systems and migratory behavior also exist in widely distributed species, such as the Kentish plover (Charadrius alexandrinus). Recent years have witnessed the establishment of new species from distinct populations, such as the identification of the snowy plover (C. nivosus) and the white-faced plover (C. dealbatus) as separate species from the Kentish plover (C. alexandrinus) species complex. Studies on the phylogenetic relationships across the entire genus, as well as population genetics and adaptation to various climatic conditions, necessitate the support of a high-quality reference genome. Here, we successfully assembled the first high-quality genome for the white-faced plover. The genome size is 1.25 Gb, anchored on 31 chromosomes, with a contig-level N50 size of 23.62 Mb and a scaffold-level N50 of 84.07 Mb. The completeness of the C. dealbatus genome assembly is supported by the 97.3% completeness (BUSCO) and ultraconserved element (UCE) (4,889/5,041; 97.0%) loci retrieved. A total of 17,641 protein-coding genes were predicted among 19,648 pseudogenes, and the completeness of the genome annotation is 94.7% (BUSCO). The chromosome-level genome provides the availability of permanent genomic resources for advancing evolutionary and conservation genomic studies on the genus Charadrius.</p
The Rape Clause:How Health and Social Care Professionals Administer the 'Non-Consensual Conception Exception' to the Two-Child Limit
No full textIn this report, Dr Rebecca Hewer critically interrogates the frontline administration of the UK government’s controversial ‘non-consensual conception exception’ to its two-child limit. This exception, colloquially known as the ‘rape clause’ allows survivors of sexual violence to claim otherwise unavailable subsistence level benefits, if they are prepared to ‘evidence’ that their third or subsequent was born following sexual violence. Drawing on interviews with thirteen health and social care practitioners, Hewer explores how professionals tasked with certifying eligibility for this ‘rape clause’ exception would go about doing so, in practice. She identifies numerous obstacles that stand between potential rape clause recipients and the timely, consistent, and equitable certification of their eligibility. In turn, she raises significant concerns regarding the design, implementation, and fundamental workability of this policy
Leveraging deep learning models to increase the representation of nomadic pastoralists in health campaigns and demographic surveillance
Get PDFNomadic pastoralists are systematically underrepresented in the planning of health services and frequently missed by health campaigns due to their mobility. Previous studies have developed novel geospatial methods to address these challenges but rely on manual techniques that are too time and resource-intensive to scale on a national or regional level. To address this gap, we developed a computer vision-based approach to automatically locate active nomadic pastoralist settlements from satellite imagery. We curated labeled datasets of satellite images capturing approximately 1,000 historically active settlements in the Omo Valley of Ethiopia and the Samburu County of Kenya to train and evaluate deep learning models, studying their robustness to low spatial resolutions and limits in labeled training data. Using a novel training strategy that leveraged public road and water infrastructure data, we closed performance gaps introduced by shortages in labeled settlement data. We deployed our best model on a region spanning 5,400 square kilometers in the Omo Valley of Ethiopia, resulting in the identification of historical settlements with a 270-fold reduction in manual review volume. Our work serves as a promising framework for automating the localization of nomadic pastoralist settlements at a national scale for health campaigns and demographic surveillance.</p
dEBORA: Efficient Bilevel Optimization-based low-Rank Adaptation
Get PDFLow-rank adaptation methods are a popular approach for parameter-efficient fine-tuning of large-scale neural networks. However, selecting the optimal rank for each layer remains a challenging problem that significantly affects both performance and efficiency. In this paper, we introduce a novel bilevel optimization strategy that simultaneously trains both matrix and tensor low-rank adapters, dynamically selecting the optimal rank for each layer. Our method avoids the use of implicit differentiation in the computation of the hypergradient, and integrates a stochastic away-step variant of the Frank-Wolfe algorithm, eliminating the need for projection and providing identifiability guarantees of the optimal rank structure. This results in a highly efficient and cost-effective training scheme that adaptively allocates the parameter budget across the network layers. On top of a detailed theoretical analysis of the method, we provide different numerical experiments showcasing its effectiveness
Ethnographic and narrative methods of enquiry for researching intangible cultural heritage
Get PDFIntangible Cultural Heritage (ICH) related to tangible heritage sites includes contemporary meaningful human practices such as experiences, stories and embodied knowledge. These practices can deepen people’s connection to the past and prepare them for the future, especially in times of environmental crises and societal transformations. To facilitate preservation and sharing of such ICH, museums and other cultural institutions and agencies are increasingly interested in accounting for the living practices of communities and different social groups connected with heritage sites in creative and engaging ways. For attaining this, accessible methods of cultural research that are considerate of community engagement are needed. This article presents multisensory narrative methods that we have been adapting and developing in order to capture, present and share ICH associated with several ancient heritage sites across Europe in a multi- and trans-disciplinary context. In particular, we focus on two methods: (1) on-site walking interviews inspired by sensobiographic walking, and (2) a form of narrative workshop which combines storytelling circle with sensory activities. Through these creative and participatory methods, we have produced research data about the experiences, emotions and environmental dimensions related to the megalithic, standing stone sites in the Central Alentejo region of Portugal, and Calanais stone circles in the Outer Hebrides of Scotland. Our objective here is to share these knowledge generation methods so that they can be easily replicated by others, while taking into account the complexity and depth of human narratives of ICH.<br/
Evidence for causal links between known modifiable risk factors and dementia: A systematic review of Mendelian randomisation studies
Get PDFBackgroundWe aimed to systematically review the evidence for associations between the known modifiable risk factors and dementia based on Mendelian randomisation (MR) studies.MethodFive databases were searched from inception to April 2024 investigating the association between the 12 risk factors identified in the Lancet Commission and dementia. Evaluable analyses were categorized into one of four levels (robust, probable, suggestive, insufficient) based on estimate significance level and concordance of direction of effect between main and sensitivity analyses. Evidence from clinically diagnosed dementia outcomes was synthesized separately from proxy outcomes. A post hoc sensitivity analysis excluded estimates with concerns over construct validity.ResultsA total of 47 studies were included, representing 240 MR associations (185 unique and evaluable). Over half (73.5%) of evaluable analyses were graded as providing insufficient evidence for a causal association. Among clinically diagnosed outcomes, the strongest evidence was for educational attainment (mainly probable evidence in a protective direction) and type 2 diabetes-related dysfunction (probable evidence in the risk direction). Smoking showed probable evidence of a protective association. Other risk factors, produced inconclusive or insufficient evidence. Proxy outcome analyses yielded weaker findings; in particular, the association between education and Alzheimer's disease reversed direction.ConclusionMR evidence for most Lancet Commission risk factors remains insufficient or inconclusive. The most consistent support for causal associations was observed for lower educational attainment and type 2 diabetes. Null findings should be interpreted cautiously given limitations in GWAS phenotyping, sample composition, and MR methodology.<br/
An unbiased comparison of 14 epigenetic clocks in relation to 174 incident disease outcomes
Get PDFEpigenetic Clocks have been trained to predict chronological age, healthspan and lifespan. Such clocks are often analysed in relation to disease outcomes –typically using small datasets and a limited number of clocks. Here, we presenta large-scale (n = 18,859), unbiased comparison of 14 widely used clocks as predictors of 174 incident disease outcomes and all-cause mortality over 10-years of follow up. Second- and third-generation clocks significantly outperform first-generation clocks, which have limited applications in disease settings. Of the 176 Bonferroni significant (P < 0.05/174) associations from fully-adjusted Cox regression models controlling for lifestyle and socioeconomic measures, there are 27 diseases (including primary lung cancer and diabetes) where the hazard ratio for the clock exceeds the clock’s association with all-cause mortality. Furthermore, for 32 of the 176 findings, adding the clock to a null classification model with traditional risk factors significantly increases the classification accuracy by >1%. However, there is minimal evidence for interactions between the clocks and sex or smoking (ever/never) status. Second- and third-generation epigenetic clocks show promise for disease risk prediction, particularly in relation to respiratory and liver-based conditions.<br/
Acceptability of pulmonary rehabilitation in Malawi:A qualitative study
Get PDFBackground Pulmonary rehabilitation (PR) is an effective non-pharmacological intervention for people with chronic respiratory diseases (CRDs), but its acceptability in Malawi was unknown. Objectives To explore patients' acceptability of PR at Queen Elizabeth Central Hospital, Blantyre, Malawi. Methods This was a pre-post cohort study where participants were offered a two times per week hospital-based PR programme for 6 weeks, consisting of endurance and strengthening exercises. Following programme completion, face-to-face semistructured in-depth interviews with the participants were conducted. Interview transcripts were thematically analysed using a deductive approach. Results 10 adults (five females and five males) out of 14 invited (∼70% uptake) participated in the PR programme and subsequent in-depth interviews. Five key themes emerged: (1) debilitating symptom experience of CRD prior to PR; (2) positive impact of PR on living with CRD; (3) contextual programme design improved participants' experience with PR; (4) one size does not fit all and (5) challenges and opportunities for home-based PR. Participants reported experiencing improvements in physical, psychological and social health associated with PR programme participation. The provision of transport was considered a key facilitator for PR programme completion. Realising the gained PR benefits, participants were willing to continue exercising at their homes. Conclusion The PR programme improved the participants' perceived health status and was well-accepted. Addressing barriers related to transport facilitated immediate implementation while providing a challenge for the scaling and sustainability of PR beyond the project duration. These findings support the drive for shifting chronic care, including rehabilitation, towards primary care and community. Trial registration number Prospective; 27 August 2021; ISRCTN13836793.</p
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