Climate change and mental health: risks, impacts and priority actions.

BACKGROUND: This article provides an overview of the current and projected climate change risks and impacts to mental health and provides recommendations for priority actions to address the mental health consequences of climate change. DISCUSSION AND CONCLUSION: The authors argue the following three points: firstly, while attribution of mental health outcomes to specific climate change risks remains challenging, there are a number of opportunities available to advance the field of mental health and climate change with more empirical research in this domain; secondly, the risks and impacts of climate change on mental health are already rapidly accelerating, resulting in a number of direct, indirect, and overarching effects that disproportionally affect those who are most marginalized; and, thirdly, interventions to address climate change and mental health need to be coordinated and rooted in active hope in order to tackle the problem in a holistic manner. This discussion paper concludes with recommendations for priority actions to address the mental health consequences of climate change.

Investigations of the nutritive value of meals of double-low rapeseed and its influence on growth performance of broiler chickens.

Four experiments were carried out to study the possible differences in metabolizable energy (ME) of meals (RSM) or expeller meals (RSE) from double-low rapeseed (Expt. 1), the influence of processing on ME (Expt. 2) and on relative phosphorus (P) bioavailability (Expt. 3) in RSM, and effect of RSM inclusion on growth performance of broilers (Expt. 4). For Expt. 1, diets with 300 g/kg RSM from 11 RSM and 4 RSE varieties were fed to broilers from d 14 to 21, with excreta collection on d 19 to 21. Each treatment had 8 replicates and 3 birds per replicate. Energy metabolizability of RSM of a specialized high glucosinolate variety (V275OL) was greater (P < 0.05) than all the other varieties. In Expt. 2, two RSM varieties were processed with mild or conventional processing condition. There were no variety effects on ME, but ME and MEn were greater (P < 0.01) for RSM processed by mild processing condition. In Expt. 3, P bioavailability of RSM was determined, relative to MSP, using growth performance and tibia ash as responses. Phosphorus relative bioavailability values were greater (P < 0.05) in RSM of DK Cabernet variety processed using the mild processing condition. In Expt. 4, two RSM varieties were added to wheat-soybean meal-based diet at the rates of 50, 100, 150, or 200 g/kg and fed to broilers from d 0 to 42. Inclusion of 150 and 200 g/kg of RSM resulted in reduced weight gain and increased feed conversion ratio (FCR) compared (P < 0.01) with the lower inclusion levels during the starter phase. For the entire trial (d 0 to 42), weight gain was greater (P < 0.01) for birds receiving diets with RSM from PR46W21 variety. It was concluded from the experiments that apart from the residual ether extract content, variety differences had no impact on ME of RSM, conventional processing reduced ME and relative bio-availability of P; and that the maximum level of RSM inclusion depends on maximum growth performance level desired.

Noninvasive mechanical body contouring: (Endermologie) a one-year clinical outcome study update.

LPG Endermologie is a machine-assisted massage system that allows positive pressure rolling, in conjunction with applied negative pressure to the skin and subcutaneous tissues (LPG Endermologie U.S. A. (800-222-3911). Endermologie was originally developed in the late 1970s in France to soften scars and standardize physical therapy; however, patients treated with the LPG machine also showed improvement in body contour and skin texture. Since then, Endermologie machines have been used in France, the United States, and many other nations as an alternative method to altering fat distribution in the subcutaneous plane. The authors have continued their study of determining the safety and efficacy of this machine. Since our last report in March 1997 (Ersek RA et al., Aesth. Plast. Surg. 21(2):61-67, 1997), we have compiled records of 85 additional patients. With this larger patient pool, we can expect more statistically accurate results. This study is composed of 85 women between the ages of 21 to 61. The study group exhibited a wide range of body habitus, initial weights, and final results. Out of 85 patients, 46 patients completed seven sessions of treatment and showed a mean index reduction in body circumference of 1.34 cm, while 39 patients who completed 14 sessions of treatments showed a mean index reduction in body circumference of 1.83 cm. A decrease in mean body circumference index was seen regardless of loss or gain in patients' weight in most cases.

A targetted intervention research on traditional healer perspectives of sexually transmitted illnesses in urban Zambia. Current research.

PIP: Interviews with 81 traditional healers from 4 Copperbelt towns in Zambia (Chililabombwe, Chingola, Luanshya, and Mufulira) investigated healers' understanding of, attitudes toward, and management of sexually transmitted diseases (STDs). In general, Zambian traditional healers had detailed constructs of the physiology and infective processes underlying syphilis, gonorrhea, chancroid, and AIDS. STDs were considered to be caused by "dirt" or contamination residing in sperm or vaginal fluids and were closely linked to violations of moral codes. Healers shared complex nosologies based on distinctions between symptoms of different STD pathologies that were more inclusive than biomedical categories. Although condom use was not promoted, healers understood the importance of preventing an infective agent from passing from one person to another. Except for AIDS, STDs were considered curable by expelling the dirt through purgatives or emetics. Modern medicine was perceived as treating only STD symptoms, not curing. Most traditional healers insisted that the infected partner bring the other partner for consultation or treatment was withheld. Since these findings identified some areas of compatibility between indigenous and biomedical models of STDs, the Traditional Medicine Unit of the Ministry of Health and the HIV/AIDS Prevention Project of the Morehouse School of Medicine (Lusaka) established a program in which traditional healers receive AIDS training and learn to counsel clients on safer sex behaviors. Follow-up entails monthly meetings between health professionals and traditional healers. Since program initiation in June 1994, 800 traditional healers and 70 health professionals have participated. Traditional healers now sell condoms to their clients through a social marketing program.^ieng

Methods to prevent colonic injury in pelvic radiation.

PURPOSE: Radiation has become an adjunct in the treatment of pelvic malignancies. Attempts to prevent adjacent tissue injury have met with varying degrees of success, and the purpose of this study was to investigate potential radioprotective effects of an elemental diet, sodium meclofenamate, and vitamin A in an animal model of acute and chronic pelvic radiation previously described. METHODS: Female Sprague-Dawley rats, 200-250 grams, were anesthetized and then received 900 rads of pelvic radiation once per week for five weeks for a total of 4500 rads. Animals were divided into five groups. Treatment groups received radiation and elemental diet, radiation and vitamin A, radiation and sodium meclofenamate. Control animals received anesthesia only and no radiation. Vitamin A was given as a supplement to (662 IU/kg) standard rat chow. Elemental diet was given as a commercially available formula, whereas sodium meclofenamate was given as a postoperative supplement (5 mg/kg/day). All animals were given these treatments during the course of radiation therapy only. Histology of distal colon was measured at one week, five weeks, six months, and one year postradiation therapy. The distal two cm of colon were removed at necropsy and fixed in 10 percent formalin at each of the above time points. Histologic grade was determined by a previously described grading scale. RESULTS: Results showed a qualitative radiation injury that could be documented at one and five weeks postradiation. Elemental diet, vitamin A, and sodium meclofenamate prevented histologic changes that occurred at these time points. No difference in histologic grade was seen between any groups at six months and one year postradiation therapy. CONCLUSION: In summary, our model of pelvic radiation produces a definable radiation injury within the colon at one and five weeks postradiation. Use of elemental diet, vitamin A, and sodium meclofenamate prevented these changes.

Prediction of the apparent metabolizable energy content of fats fed to broiler chickens.

Soybean oil and tallow acid oil were blended in the ratio 75:25, 50:50, and 25:75 to give 3 blends (A, B, and C) of increasing free fatty acid (FFA) content but decreasing ratio of unsaturated to saturated fatty acids (U:S). Tallow and soybean acid oil were blended in similar proportions to give three blends (D, E, and F) of increasing FFA content and increasing U:S ratio. The six fats were incorporated into a basal diet at rates of 40, 80, and 120 g/kg. Experimental diets were evaluated for apparent available fat (AAF) with broilers aged 1.5 and 7.5 wk of age. The AAF of fats was calculated from extrapolation of the regression of AAF of diets to rate of inclusion of fats. The AME of fats was determined as the product of AAF and gross energy. Increasing FFA content but reducing U:S ratio lowered the AME giving 31.1, 28.7, and 21.7 MJ/kg (1 MJ = .239 Mcal) and 33.2, 31.5, and 28.4 MJ/kg, respectively, for A, B, and C for young and old birds. Corresponding data for D, E, and F (increasing FFA content and U:S ratio) were 27.7, 28.0, and 29.4 MJ/kg and 31.8, 32.9, and 33.3 MJ/kg, respectively, for young and old birds. Data generated, together with results from previous reports, were subject to regression analysis. The AME of fats could be predicted from knowledge of U:S ratio and FFA content with equations accounting for .816 and .925 of the variation in AME values for young and old birds, respectively.

Influence of age, chemical composition and rate of inclusion on the apparent metabolisable energy of fats fed to broiler chicks.

1. Vegetable oil (VO) and tallow (T) were evaluated at rates of 25, 50, 75, 100 and 125g/kg in a basal diet with broiler chicks aged 1.5, 3.5, 5.5 and 7.5 weeks of age using a total collection period of 72 h. 2. Apparent metabolisable energy, corrected to zero nitrogen retention (AMEN, MJ/kg) and apparent fat availability (AFA, g/kg) of the experimental diets were employed to estimate the dietary energy values of fats, by linear and quadratic regression. 3. AME of fats, determined from AFA, had smaller standard errors than those determined from AMEN. 4. There was a marked increase in the AME of fats from 1.5 to 3.5 weeks of age; thereafter, the improvement was less pronounced. 5. Rate of improvement in fat AME with age was greater with T than VO.

Interactions between fats of differing chemical content: apparent metabolisable energy values and apparent fat availability.

1. Tallow (A) and rape oil (E) were obtained for evaluation. They were blended in the ratios A95:E5, A90:E10 and A80:E20. The three blends together with the two pure fats were each included at 40, 80 and 120 g/kg into a basal diet. 2. The experimental diets were evaluated for apparent metabolisable energy corrected to zero nitrogen retention (AMEN MJ/kg) and apparent fat availability (g/kg) using 6 replicates of a cage of two male broiler chicks 14 d old and 8 replicates of a cage of one Rhode Island cross cockerel approximately 1 year old. Diets were fed for 72 h then removed for 24 h. This was followed by a 48 h period when food was available ad libitum and a further 24 h of starvation. A total collection of excreta was undertaken each 24 h for the latter 72 h period. 3. Evaluation of AMEN and apparent fat availability for the individual fat blends was achieved through both linear and quadratic regression. 4. Synergism, as demonstrated by a higher determined than calculated AMEN value, was detected with fat blends fed to chicks but not cockerels and only at rates of inclusion beyond 80 g/kg. 5. No consistent differences between AMEN determined through calorimetry or AME determined with reference to apparent fat availability multiplied by fat gross energy were detected.

Interactions between fats of differing chemical content: apparent availability of fatty acids.

1. Tallow (A) and rape oil (E) were obtained for evaluation. They were blended in the ratios A95:E5, A90:E10 and A80:E20. The three blends together with the two pure fats were each included at 40, 80 and 120 g/kg into a basal diet. 2. The experimental diets were evaluated for apparent availability (g/kg) of the fatty acids palmitic (C16:0), stearic (C18:0), oleic (C18:1) and linoleic (C18:2) using 6 replicates of a cage of two male broiler chicks 14 d old and 8 replicates of a cage of one Rhode Island cross cockerel approximately 1 year old. Diets were fed for 72 h then removed for 24 h. This was followed by a 48 h period when food was available ad libitum and a further 24 h starvation. A total collection of excreta was undertaken for the latter 72 h period. 3. Evaluation of apparent available fatty acid (AAFA g/kg fatty acid) was achieved by linear regression. 4. All results indicated a progressive increase in AAFA with both chicks and adults for C16:0 and C18:0 with increasing proportions of the more unsaturated rape oil in the fat blends and for C18:1 and C18:2 with chicks. 5. Evaluation of AAFA by quadratic regression indicated an additional effect of rate of inclusion for C16:0 and C18:0 with chicks and adults and for C18:1 with chicks.

Two cases of lymphoma of the parotid gland following ablative radioiodine therapy for thyroid carcinoma.

Two adult patients are described in whom 131I therapy thyroid carcinoma was followed by the development of non-Hodgkin's lymphoma in salivary glands. Histologically one was lymphocytic and the other histiocytic. The total doses of 131I given were 27 GBq (675 mCi) and 14GBq (350 mCi), lymphoma presenting 10 and 3 years respectively after the initial therapeutic dose of 131I. We suggest that the relationship is a causal one, because of the rarity of salivary gland lymphoma and the high dose or radiation to the salivary glands with this mode of therapy.