Search Results (7)

Background: Dietary assessment in inflammatory bowel disease (IBD) is moving away from individual food and nutrient analyses and towards dietary patterns (e.g., Mediterranean diet, Western diet) and diet quality assessment that are increasingly implicated in IBD onset and course. However, an IBD-specific diet quality index (DQI) does not exist. This review aimed to identify current DQIs and assess their suitability for an IBD population. Methods: MEDLINE and EmCare databases were systematically searched for a-priori, food-based DQI reflecting current dietary guidelines and/or nutrition science. Data extracted were adapted from optimal DQI criteria, including quality measures of adequacy, moderation, variety and balance and DQI evaluation. Results: Twenty-four DQI were identified. No DQI included all optimal DQI criteria. The Dietary Guideline Index 2013 (DGI-2013) most closely met the criteria, followed by the Dutch Healthy Diet Index-2015 (DHD-Index 2015), Planetary Health Diet Index (PHDI) and Healthy Eating Index for Australian Adults-2013 (HEIFA-2013). Most DQI assessed adequacy (22/24, 92%) and moderation (21/24, 88%), half assessed balance (12/24) while few assessed variety (8/24, 33%). Application of other optimal DQI criteria varied. Food frequency questionnaire (13/24) and 24 h diet recall (12/24) were the most common dietary assessment methods used. Most DQI (17/24, 71%) were validated; however, not for an IBD population. Few were evaluated for reliability (6/24) or reproducibility (1/24). Conclusions: No DQI meets all optimal criteria for an IBD-specific DQI. The DGI-2013 met the most criteria, followed by the DHD Index-2015, PHDI and HEIFA-2013 and may be most appropriate for an IBD population. An IBD-specific DQI is lacking and needed. Full article

Background: Prompt administration of optimal antibiotic therapy is essential in the management of bacteraemia to reduce morbidity and mortality and to facilitate antibiotic stewardship. To identify the most effective therapy, rapid and accurate antimicrobial susceptibility testing (AST) is essential. ASTar is an automated AST system that delivers minimum inhibitory concentrations (MICs) for 23 antimicrobials and is designed for testing Gram-negative bacteria directly from positive blood cultures, with results available after 6 h. Methods: The ASTar system was evaluated with 64 positive blood cultures from patients with bacteraemia and 56 simulated blood cultures inoculated with a range of antibiotic-resistant isolates. The ASTar results for 12 antibiotics commonly used in our hospitals were compared with the results derived from three different methods of disc susceptibility testing and MICs determined by broth microdilution (BMD). Results: For 121 isolates of Gram-negative bacteria, ASTar showed an average essential agreement of 87.2% and an average categorical agreement of 94%, when compared with BMD. Very major errors (false susceptibility) and major errors (false resistance) were associated with 0.9% and 3.4% of results, respectively. The results were at least as accurate as those obtained from EUCAST disc susceptibility methods (both rapid and overnight methods). Conclusions: The ASTar system is an effective method for delivering accurate and rapid (6 h) AST results for Gram-negative bacteria by the direct testing of positive blood cultures. Full article

Background: In May 2019, Ulaanbaatar, Mongolia introduced a city-wide raw coal ban (RCB) to improve ambient air quality. Air pollution exposure particularly affects child health and is associated with acute respiratory disease. We assessed the effects of the RCB on air quality and child respiratory health. Methods: An interrupted time-series analysis was conducted on air quality (PM_2.5, PM₁₀, SO₂, CO) and child (<5 y) severe acute respiratory disease, adjusting for coinciding co-events (COVID-19) where necessary. The subgroup analysis focussed on peak pollution months (November–February). Results: PM₁₀ significantly decreased by −34.3 µg/m³ (95% CI −62.9, −5.8, p = 0.02) and PM_2.5 by −17.1 µg/m³ (95% CI −26.3, −7.9, p < 0.01), immediately post-intervention. The subgroup analysis showed SO₂ increased by 81.6 µg/m³ (95% CI 45.2, 117.9, p < 0.01) in the first month and by 4.9 µg/m³ (95% CI 2.6, 7.3, p < 0.01) monthly afterwards. CO increased by 56.1 µg/m³ (95% CI 13.5, 98.7, p = 0.01). Child respiratory health showed no significant change after adjusting for the COVID-19 effect. Discussion: The RCB successfully reduced key pollutants (PM), almost instantly. Long-term increases in SO₂ and CO and limited health effects highlight the need for further air quality improvements. Outputs from Mongolia’s continuous air quality mitigation efforts provide useful insights for countries facing similar challenges. Full article

The ILA Study Group began its work by identifying guiding principles that should frame and inform state practices with respect to children in migration. These principles included, but were not limited to, non-discrimination; the best interests of the child; the right to life, survival, and development; the right of the child to express their views on all matters affecting them; and the right to an effective remedy. The Study Group identified some of the most common rights violations for children in migration such as arbitrary age assessment practices; inadequate and age-inappropriate reception policies and facilities; and immigration detention of children and other coercive practices. The Study Group undertook a multidisciplinary approach by summarizing the research documenting the harmful effects of these practices on child health and well-being. It surveyed (1) treaties and international instruments that might recognize a right or remedy for children on the move; (2) regional and international fora where the claims of children could be heard; and (3) the growing body of regional and international jurisprudence upholding the rights of children in migration. Finally, it identified gaps in the international and regional frameworks and formulated recommendations as to how to ensure children in migration are able to enforce their rights and access justice. Full article

Physical activity (PA) is central to maintaining health and wellbeing as we age. Valid, reliable measurement tools are vital for understanding, and evaluating PA. There are limited options for comprehensively, accurately and affordably measuring older adults’ PA at scale at present. We aimed to develop a digital PA measurement tool specifically for adults aged 65+ using a person-based approach. We collated evidence from target users, field experts and the relevant literature to learn how older adults comprehend PA and would accept a digital tool. Findings suggest that older adults’ PA is often integrated into their daily life activities and that commonly applied terminology (e.g., moderate and vigorous) can be difficult to interpret. We also found that there is increasing familiarity with digital platforms amongst older adults, and that technological simplicity is valued. These findings informed the development of a digital tool that asks users to report their activities across key PA domains and dimensions from the previous 7-days. Users found the tool easy to navigate and comprehensive in terms of activity reporting. However, real-world usability testing revealed that users struggled with seven-day recall. Further work will address the identified issues, including creating a single-day reporting option, before commencing work to validate this new tool. Full article

Given the increase in resistance to antibacterial agents, there is an urgent need for the development of new agents with novel modes of action. As an interim solution, it is also prudent to reinvestigate old or abandoned antibacterial compounds to assess their efficacy in the context of widespread resistance to conventional agents. In the 1970s, much work was performed on the development of peptide mimetics, exemplified by the phosphonopeptide, alafosfalin. We investigated the activity of alafosfalin, di-alanyl fosfalin and β-chloro-L-alanyl-β-chloro-L-alanine against 297 bacterial isolates, including carbapenemase-producing Enterobacterales (CPE) (n = 128), methicillin-resistant Staphylococcus aureus (MRSA) (n = 37) and glycopeptide-resistant enterococci (GRE) (n = 43). The interaction of alafosfalin with meropenem was also examined against 20 isolates of CPE. The MIC₅₀ and MIC₉₀ of alafosfalin for CPE were 1 mg/L and 4 mg/L, respectively and alafosfalin acted synergistically when combined with meropenem against 16 of 20 isolates of CPE. Di-alanyl fosfalin showed potent activity against glycopeptide-resistant isolates of Enterococcus faecalis (MIC₉₀; 0.5 mg/L) and Enterococcus faecium (MIC₉₀; 2 mg/L). Alafosfalin was only moderately active against MRSA (MIC₉₀; 8 mg/L), whereas β-chloro-L-alanyl-β-chloro-L-alanine was slightly more active (MIC₉₀; 4 mg/L). This study shows that phosphonopeptides, including alafosfalin, may have a therapeutic role to play in an era of increasing antibacterial resistance. Full article

Chaplin F (Chp F) is a secreted surface-active peptide involved in the aerial growth of Streptomyces. While Chp E demonstrates a pH-responsive surface activity, the relationship between Chp F structure, function and the effect of solution pH is unknown. Chp F peptides were found to self-assemble into amyloid fibrils at acidic pH (3.0 or the isoelectric point (pI) of 4.2), with ~99% of peptides converted into insoluble fibrils. In contrast, Chp F formed short assemblies containing a mixture of random coil and β-sheet structure at a basic pH of 10.0, where only 40% of the peptides converted to fibrils. The cysteine residues in Chp F did not appear to play a role in fibril assembly. The interfacial properties of Chp F at the air/water interface were altered by the structures adopted at different pH, with Chp F molecules forming a higher surface-active film at pH 10.0 with a lower area per molecule compared to Chp F fibrils at pH 3.0. These data show that the pH responsiveness of Chp F surface activity is the reverse of that observed for Chp E, which could prove useful in potential applications where surface activity is desired over a wide range of solution pH. Full article