Four plastic additives reduce larval growth and survival in the sea urchin Strongylocentrotus purpuratus.

Plastic additives are utilized during the production of plastic to modify the attributes and stability of the polymer. As oceanic plastic waste degrades, these additives can leach, and are harmful to global marine ecosystems. Despite the high abundance of additives leached into the marine environment, little is known about their direct impact on marine zooplankton. Here we test for impacts of four plastic additives, UV-327, Irganox 1010, DEHP, and methylparaben, all commonly used in plastic manufacturing, on purple sea urchin (Strongylocentrotus purpuratus) larval growth and survival in a serial dose response for 4 days. Methylparaben, UV-327, and Irganox 1010 significantly reduced larval body length by about 5% for at least one dose. In contrast, all compounds reduced larval survival by 20-70% with strongest effects at intermediate rather than high doses. Our results highlight that plastic additives should be tested for their effects on marine organisms.

Implementation Factors and Teacher Experience of the Integrated Nutrition Education Program: A Mixed Methods Program Evaluation.

BACKGROUND: School-based programs are widely implemented to address childhood obesity. Despite the promise of these programs, evidence on their effectiveness is mixed. Adopting a dissemination and implementation (D&I) science focus utilizing mixed methods can provide a broader understanding and more robust details about these programs. The goal of this evaluation is to understand how implementation factors and teacher experience influence implementation success and outcomes of the Integrated Nutrition Education Program (INEP), an elementary school-based nutrition program, using a mixed-methods design. METHODS: Reach, effectiveness, adoption, implementation, maintenance (RE-AIM) framework guided the development of the evaluation and multiple methods were deployed. Hierarchical linear regression was used to assess the association between D&I construct variables within levels of influence and teacher perception of INEP impact from a quantitative end-of-year teacher survey. Follow-up qualitative interviews with teachers were analyzed using constant comparison analysis. RESULTS: Workload and burden emerged as significant factors related to implementation in the quantitative analysis. The follow-up qualitative data collection identified other factors teachers found important to the adoption, implementation, and maintenance of INEP. CONCLUSION: Results of this evaluation can be used to inform program improvement efforts for INEP and provide information on ways to promote reach, effectiveness, adoption, implementation, and maintenance of similar school-based health promotion programs.

Understanding the experience of the implementer: teachers' perspectives on implementing a classroom-based nutrition education program.

School-based programs are widely implemented to combat childhood obesity, but these programs have mixed results. Dissemination and implementation science approaches to evaluation using qualitative methods can provide more robust details about program functioning that may be able to help explain the variation in the impact of these programs. Fourteen in-depth interviews were conducted with classroom teachers implementing a school-based program, the Integrated Nutrition Education Program (INEP), to explore their experience. Factors related to organization, individual and intervention levels emerged as facilitators and barriers to program implementation. Key factors were school culture at the organization level, individual perception and belief in the intervention at the individual level and program content, perceived complexity and adaptability at the intervention level. Socioeconomic status of the community and family involvement were contextual factors identified across all levels. Findings from this qualitative evaluation can be used for the quality improvement of INEP, but beyond this these can also be informative for other school-based programs to promote adoption, implementation and maintenance.

Microplastics reduce net population growth and fecal pellet sinking rates for the marine copepod, Acartia tonsa.

Microplastics (<5 mm) are ubiquitous in the global environment and are increasingly recognized as a biological hazard, particularly in the oceans. Zooplankton, at the base of the marine food web, have been known to consume microplastics. However, we know little about the impacts of microplastics across life history stages and on carbon settling. Here, we investigated the effects of ingestion of neutrally buoyant polystyrene beads (6.68 µm) by the copepod Acartia tonsa on (1) growth and survival across life history stages, (2) fecundity and egg quality, (3) and fecal characteristics. We found that microplastic exposure reduced body length and survival for nauplii and resulted in smaller eggs when copepods were exposed during oogenesis. Combining these life history impacts, our models estimate a 15% decrease in population growth leading to a projected 30-fold decrease in abundance over 1 year or 20 generations with microplastic exposure. In addition, microplastic-contaminated fecal pellets were 2.29-fold smaller and sinking rates were calculated to be 1.76-fold slower, resulting in an estimated 4.03-fold reduction in fecal volume settling to the benthos per day. Taken together, declines in population sizes and fecal sinking rates suggest that microplastic consumption by zooplankton could have cascading ecosystem impacts via reduced trophic energy transfer and slower carbon settling.

Cost-effectiveness of infliximab for the treatment of active and progressive psoriatic arthritis.

BACKGROUND: Despite its proven efficacy, infliximab is often considered to be an expensive treatment for patients with psoriatic arthritis. OBJECTIVES: To estimate the cost-effectiveness of infliximab among patients with active and progressive psoriatic arthritis. METHODS: A decision analytic model was constructed to simulate disease progression in hypothetical cohorts of patients with psoriatic arthritis receiving infliximab maintenance treatment. The primary response measure was change in Health Assessment Questionnaire score from a baseline estimated from mixed treatment models drawn from published clinical trials. Palliative care, comprising nonbiologic disease-modifying antirheumatic drugs, was used as a comparator. The primary outcome was quality-adjusted life years. The dose of infliximab was estimated for a range of 60 to 80 kg per patient body weight. The costs and outcomes were discounted at 3.5% for a period of 40 years. Uncertainty around the results was explored with probabilistic sensitivity analysis. RESULTS: The mixed treatment comparison showed a significant reduction in Health Assessment Questionnaire score across all patients. The tumor necrosis factor α inhibitors were significantly superior to palliative care but comparable with one another. The incremental cost-effectiveness ratios for etanercept, adalimumab, and infliximab relative to palliative care were £17,327; £19,246; and £16,942 to £23,022, respectively, across all patients with psoriatic arthritis and £16,613; £18,170; and £15,788 to £21,736, respectively, in the subgroup with significant psoriasis. CONCLUSION: Infliximab represents a cost-effective treatment option well within the National Institute for Health and Clinical Excellence threshold relative to palliative care. In light of equivalent outcomes with other tumor necrosis factor α inhibitors, its position in the treatment pathway is likely to be governed by treatment costs.