Assessment of the role of gut health in childhood stunting in a multisite, longitudinal study in India, Indonesia and Senegal: a UKRI GCRF Action Against Stunting Hub protocol.

INTRODUCTION: Childhood stunting has a complex aetiology, with poor gut health being an important contributor. This study will assess inter-relationships between maternal and infant gut health indices and infant linear growth. Inter-relationships between gut health indices, systemic inflammation and growth hormones in early childhood will also be assessed. METHODS AND ANALYSIS: A longitudinal observational study of cohorts of 600 newborns and their mothers in India, Indonesia and Senegal will be conducted. Women will be recruited during pregnancy and their children followed up to age 24 months. Stool, urine and blood samples will be collected from the women and children for assessments of helminthic and protozoal parasites, bacterial pathogens, faecal microbiota taxa, biomarkers of environmental enteric dysfunction, systemic inflammation and growth hormones. Child anthropometric measurements will be collected at birth and at ages 3, 6, 9, 12, 18 and 24 months. The gut health indices will be integrated with cohort data from other Action Against Stunting Hub (AASH) workstreams for interdisciplinary analyses of childhood stunting and the development of a new typology of stunting. DISCUSSION: This study will advance scientific understanding of the role of gut health in childhood stunting and will contribute to a broader knowledge of the complex aetiology of this condition as part of the interdisciplinary AASH research to reduce the global burden of childhood stunting. ETHICS AND DISSEMINATION: This study has been approved by the relevant Ethics Committees in Senegal, India, and Indonesia and LSHTM. The results will be submitted for publication in peer-reviewed journals.

Assessment of Sport Nutrition Knowledge, Dietary Practices, and Sources of Nutrition Information in NCAA Division III Collegiate Athletes.

Nutrition knowledge is a critical component of meeting sport nutrition guidelines. The present study aimed to evaluate the sport nutrition knowledge of National Collegiate Athletic Association (NCAA) Division III (DIII) athletes using a validated questionnaire, and to assess the dietary practices and sources of nutrition information in this population. A total of 331 student-athletes (n = 149 males, n = 181 females, n = 1 no sex indicated) completed the questionnaire. The mean score for total sport nutrition knowledge was 6.49 ± 8.9 (range -49 to 49) with a mean percent (%) correct score of 36.9 ± 19.1%. Athletes who had a previous college-level nutrition course (n = 62) had significantly higher (p < 0.05) total sport nutrition, carbohydrate, and hydration knowledge compared to those who did not (n = 268). Individual sport athletes (n = 90) scored significantly higher (p < 0.05) on hydration and micronutrients knowledge than team sport athletes (n = 237), while females scored higher than males for hydration knowledge (p < 0.05). The majority of athletes reported sensible dietary habits, such as not frequently skipping meals and eating carbohydrate and protein foods peri-workout. Athletes also reported their primary sources of nutrition information, the top three sources being social media, coaches, and athletic trainers, despite most frequently rating registered dietitians/nutritionists as "extremely knowledgeable". Despite low sport nutrition knowledge, NCAA DIII collegiate athletes practiced seemingly prudent dietary habits but lacked exposure to high-quality sources of nutrition information.

Understanding unequal ageing: towards a synthesis of intersectionality and life course analyses.

Intersectionality has received an increasing amount of attention in health inequalities research in recent years. It suggests that treating social characteristics separately-mainly age, gender, ethnicity, and socio-economic position-does not match the reality that people simultaneously embody multiple characteristics and are therefore potentially subject to multiple forms of discrimination. Yet the intersectionality literature has paid very little attention to the nature of ageing or the life course, and gerontology has rarely incorporated insights from intersectionality. In this paper, we aim to illustrate how intersectionality might be synthesised with a life course perspective to deliver novel insights into unequal ageing, especially with respect to health. First we provide an overview of how intersectionality can be used in research on inequality, focusing on intersectional subgroups, discrimination, categorisation, and individual heterogeneity. We cover two key approaches-the use of interaction terms in conventional models and multilevel models which are particularly focussed on granular subgroup differences. In advancing a conceptual dialogue with the life course perspective, we discuss the concepts of roles, life stages, transitions, age/cohort, cumulative disadvantage/advantage, and trajectories. We conclude that the synergies between intersectionality and the life course hold exciting opportunities to bring new insights to unequal ageing and its attendant health inequalities.

Assessment of the quality of European silver eels and tentative approach to trace the origin of contaminants - A European overview.

The European eel is critically endangered. Although the quality of silver eels is essential for their reproduction, little is known about the effects of multiple contaminants on the spawning migration and the European eel management plan does not take this into account. To address this knowledge gap, we sampled 482 silver eels from 12 catchments across Europe and developed methods to assess three aspects of eel quality: muscular lipid content (N = 169 eels), infection with Anguillicola crassus (N = 482), and contamination by persistent organic pollutants (POPs, N = 169) and trace elements (TEs, N = 75). We developed a standardized eel quality risks index (EQR) using these aspects for the subsample of 75 female eels. Among 169 eels, 33% seem to have enough muscular lipids content to reach the Sargasso Sea to reproduce. Among 482 silver eels, 93% were infected by A. crassus at least once during their lifetime. All contaminants were above the limit of quantification, except the 1,2-bis(2,4,6-tribromophenoxy)ethane (BTBPE), Ag and V. The contamination by POPs was heterogeneous between catchments while TEs were relatively homogeneous, suggesting a multi-scale adaptation of management plans. The EQR revealed that eels from Warwickshire were most impacted by brominated flame-retardants and agricultural contaminants, those from Scheldt were most impacted by agricultural and construction activities, PCBs, coal burning, and land use, while Frémur eels were best characterized by lower lipid contents and high parasitic and BTBPE levels. There was a positive correlation between EQR and a human footprint index highlighting the capacity of silver eels for biomonitoring human activities and the potential impact on the suitability of the aquatic environment for eel population health. EQR therefore represents a step forward in the standardization and mapping of eel quality risks, which will help identify priorities and strategies for restocking freshwater ecosystems.

Social Quality and Health: Examining Individual and Neighbourhood Contextual Effects Using a Multilevel Modelling Approach.

Social quality focusses on the nature of 'the social', arguing that people are realised as social beings through interacting with a range of collectives, both from the formal world of systems and the informal lifeworld. Four conditional factors are necessary for this to occur, which at the same time are assumed to influence health and well-being: socio-economic security, social cohesion, social inclusion and social empowerment. In this paper we test the utility of social quality in explaining self-rated health as a response to arguments that the social determinants of health (SDH) framework often lacks a theoretical basis. We use multilevel models to analyse national English and Welsh data (the Citizenship Survey) to test for both individual- and neighbour-level affects. Our key findings are that (1) neighbourhood contextual (cross-level) effects are present with respect to collective action, personal trust, cross-cutting ties, income sufficiency, and income security; (2) measures of national, community and personal identity as indicators of social cohesion show clear associations with health alongside more common measures such as trust; (3) the security aspects of socioeconomic determinants are especially important (housing security, income sufficiency, and income security); (4) social rights, including institutional rights but especially civil rights have effects of particularly large magnitude. Social quality offers a theoretically-driven perspective on the SDH which has important policy implications and suggests a number of promising avenues for future research.

Assessment of the influence of intrinsic environmental and geographical factors on the bacterial ecology of pit latrines.

Improving the rate and extent of faecal decomposition in basic forms of sanitation such as pit latrines would benefit around 1.7 billion users worldwide, but to do so requires a major advance in our understanding of the biology of these systems. As a critical first step, bacterial diversity and composition was studied in 30 latrines in Tanzania and Vietnam using pyrosequencing of 16S rRNA genes, and correlated with a number of intrinsic environmental factors such as pH, temperature, organic matter content/composition and geographical factors. Clear differences were observed at the operational taxonomic unit, family and phylum level in terms of richness and community composition between latrines in Tanzania and Vietnam. The results also clearly show that environmental variables, particularly substrate type and availability, can exert a strong structuring influence on bacterial communities in latrines from both countries. The origins and significance of these environmental differences are discussed. This work describes the bacterial ecology of pit latrines in combination with inherent latrine characteristics at an unprecedented level of detail. As such, it provides useful baseline information for future studies that aim to understand the factors that affect decomposition rates in pit latrines.

The impact of different DNA extraction kits and laboratories upon the assessment of human gut microbiota composition by 16S rRNA gene sequencing.

INTRODUCTION: Determining bacterial community structure in fecal samples through DNA sequencing is an important facet of intestinal health research. The impact of different commercially available DNA extraction kits upon bacterial community structures has received relatively little attention. The aim of this study was to analyze bacterial communities in volunteer and inflammatory bowel disease (IBD) patient fecal samples extracted using widely used DNA extraction kits in established gastrointestinal research laboratories. METHODS: Fecal samples from two healthy volunteers (H3 and H4) and two relapsing IBD patients (I1 and I2) were investigated. DNA extraction was undertaken using MoBio Powersoil and MP Biomedicals FastDNA SPIN Kit for Soil DNA extraction kits. PCR amplification for pyrosequencing of bacterial 16S rRNA genes was performed in both laboratories on all samples. Hierarchical clustering of sequencing data was done using the Yue and Clayton similarity coefficient. RESULTS: DNA extracted using the FastDNA kit and the MoBio kit gave median DNA concentrations of 475 (interquartile range 228-561) and 22 (IQR 9-36) ng/µL respectively (p<0.0001). Hierarchical clustering of sequence data by Yue and Clayton coefficient revealed four clusters. Samples from individuals H3 and I2 clustered by patient; however, samples from patient I1 extracted with the MoBio kit clustered with samples from patient H4 rather than the other I1 samples. Linear modelling on relative abundance of common bacterial families revealed significant differences between kits; samples extracted with MoBio Powersoil showed significantly increased Bacteroidaceae, Ruminococcaceae and Porphyromonadaceae, and lower Enterobacteriaceae, Lachnospiraceae, Clostridiaceae, and Erysipelotrichaceae (p<0.05). CONCLUSION: This study demonstrates significant differences in DNA yield and bacterial DNA composition when comparing DNA extracted from the same fecal sample with different extraction kits. This highlights the importance of ensuring that samples in a study are prepared with the same method, and the need for caution when cross-comparing studies that use different methods.

Eradication and control of livestock ticks: biological, economic and social perspectives.

Comparisons of successful and failed attempts to eradicate livestock ticks reveal that the social context of farming and management of the campaigns have greater influence than techniques of treatment. The biology of ticks is considered principally where it has contributed to control of ticks as practiced on farms. The timing of treatments by life cycle and season can be exploited to reduce numbers of treatments per year. Pastures can be managed to starve and desiccate vulnerable larvae questing on vegetation. Immunity to ticks acquired by hosts can be enhanced by livestock breeding. The aggregated distribution of ticks on hosts with poor immunity can be used to select animals for removal from the herd. Models of tick population dynamics required for predicting outcomes of control methods need better understanding of drivers of distribution, aggregation, stability, and density-dependent mortality. Changing social circumstances, especially of land-use, has an influence on exposure to tick-borne pathogens that can be exploited for disease control.

Commentary: the emergence and application of active aging in Europe.

Active aging is established as the leading global policy strategy in response to population aging. In practice, however, the term active aging serves as a convenient shelter for a wide range of policy discourses and initiatives concerning demographic change. The twin purposes of this article are, first, to examine its European origins and how it has been applied in the world's oldest region. This policy analysis illustrates the contrast between the primarily European discourse on active aging, which emphasizes health, participation, and well-being, and the U.S. discourse that prioritizes productivity. The application of active aging in Europe has, nonetheless, been predominantly in the productivist mold. The examination of the emergence of this key policy concept in Europe is contextualized by an outline of the changing politics of aging in this region. The second purpose of the article is to set out a new, comprehensive strategy on active aging that is intended to realize the full potential of the concept. Understanding of the need for this broad vision of active aging is facilitated by the historical policy review.

From Chinese model to U.S. symptoms: the paradox of China's health system.

This article explains the paradox of China's recent failure to secure significant improvements in the health of its people despite once being the envy of the developing world for its successful health policies and its huge sustained increases in both economic growth and expenditure on health care. The authors begin with an outline of the organization and financing of China's health services, then track the recent upward trend in health spending and examine its structural features in conjunction with those of spending in other, comparable countries. The main discussion consists of an evaluation of health service system performance in China during the reform era and an explanation of its health paradox. The key elements in this account are the waste of resources, the neglect of proven health interventions, and the lack of fairness in allocation of medical resources--all of which are underpinned by the neoliberal orientation of policy in the reform era. The authors conclude with some policy proposals centering on the restoration of social justice in the health system. The article draws on material previously unavailable in English.