Overweight/Obesity and Time Preference: Evidence from a Survey among Adults in the UK.

INTRODUCTION: Overweight and obesity is a global problem incurring substantial health and economic implications. This has also been highlighted by the ongoing COVID-19 pandemic which has disproportionately affected overweight and obese individuals. Most of the interventions have concentrated on promotion of physical activities and healthy eating which may involve current sacrifices for future health gains. The purpose of this study was to explore the relationship between bodyweight and how individuals state they would trade-off immediate income for higher amounts in the future (time preference). METHODS: An online survey was conducted targeting adults aged >16 years in the UK (England, Northern Ireland, Scotland, and Wales) from January 1, 2016 to July 31, 2016. Using paid online adverts, as well as personal and professional networks for distribution of links to the online survey, the questionnaire asked respondents to report socio-economic and demographic information, height, and weight and to complete a time preference exercise. Data were analysed using descriptive statistics; associations were explored between BMI and respondents' characteristics and time preference using Spearman rank-order correlation and χ2 tests as appropriate. We adopted STROBE guidelines for the reporting of the study. RESULTS: A total of 561 responses were analysed (female = 293, males = 268). The relationship between time preference and overweight/obesity, using BMI as the measure is highly significant (χ2 = 95.92: p < 0.001). Individuals of normal weight have low time preferences and are more likely to invest in activities in a bid to reap future health benefits. There are also significant relationships between BMI and employment status (χ2 = 37.03; p < 0.001), physical activities (p < 0.0001), income levels (χ2 = 6.68; p < 0.035), family orientation, i.e., with or without children (χ2 = 12.88; p < 0.012), and ethnicity (χ2 = 18.31; p < 0.001). These imply that individuals in employment and with children in their families are less likely to be overweight or obese compared to those who do not. People from black backgrounds are also more likely to be overweight or obese and have higher time preferences compared to people from white backgrounds. DISCUSSIONS/CONCLUSIONS: People's preventive behaviours today can be predicted by their time preference and this understanding could be vital in improving population's uptake and maintenance of overweight and obesity prevention actions. People who have low time preference are more likely to invest time and resources in physical activities and healthy lifestyles to reap future health benefits hence value utilities-in-anticipation. Public health programmes should therefore use the knowledge of the association between time preference and overweight/obesity to inform designs of intervention programmes.

Biogeochemical response of Pinus brutia and Olea europaea to lithological variations and Cu mineralisation in Cyprus.

Regional geochemical mapping programs are predominantly based on regolith materials as the sampling media. The use of plant organs has been more limited, despite potential advantages demonstrated in more localised studies that have examined biogeochemical responses to various types of mineralisation or contamination, or sought to identify species with phytoremediation potential. This study investigated the effects of variations in lithology and mining wastes on the multielement chemistry of Pinus brutia (pine) needles and O. europaea (olive) leaves, obtained from low-density traverses across Cyprus and detailed sampling around two Cyprus-style VHMS Cu-deposits. A total of 476 samples were analysed by a combination of inductively-coupled plasma mass spectrometry (ICP-MS) and portable X-ray fluorescence spectrometry (pXRF). At the regional scale there are substantial differences in the composition of the pine needles, especially for Ni, Ba, Sr, Mn and Zn, between the major lithological groups that range from the ultramafic and mafic units of the Troodos Ophiolite to the mineralised pillow basalts and various marine carbonate units. Both pine needles and olive leaves display intense Re anomalies in areas with mine wastes and consistently low concentrations in background areas. The response for Cu and other macro- or micronutrient elements to contamination is less pronounced and may reflect barriers to uptake by the plants. The relative magnitude of variations between the different lithologies in median plant metal concentrations is equivalent to that displayed in soils of the Geochemical Atlas of Cyprus (e.g. REE, Zn and Sr), but for some elements the patterns differ substantially. There is close correlation between the ICP-MS and pXRF data for elements where most values are above pXRF detection limits. The study further demonstrates the potential of plants in regional geochemical mapping for a range of applications, in combination with or as an alternative to conventional regolith media.

Siderophore-Assisted Dissolution of Iron(III) Hydroxide Oxides from Iron-Rich Fossil Matrices.

Current paleontological techniques to separate vertebrate fossils from encasing iron-rich cements by chemical means are limited by the low solubility of common iron(III) hydroxide oxides such as hematite and goethite. This study examines novel geochemical extractions capable of selectively dissolving iron(III) hydroxide oxides, in aqueous solutions of pH 9-11, without damaging fossilised bones or teeth (hydroxidecarbonate-apatite). This involves the siderophore ligands pyridoxal isonicotinoyl hydrazone (PIH), salicylaldehyde isonicotinoyl hydrazone (SIH), and acetohydroxamic acid (aHA), whose coordination complexes with iron(III) show exceptionally high formation stability constants. The methods have been tested on natural hematite and fossil containing samples from the Riversleigh World Heritage Area in Australia. Both 0.01 mol dm-3 aHA and 0.001 mol dm-3 PIH at pH 9.7 were able to dissolve over 0.1 mmol dm-3 of the goethite coating bone fragments.

Biogeochemical mapping of metal contamination from mine tailings using field-portable XRF.

Trace and major element composition of selected plant species and parts may be used to map geochemical dispersion from mineral deposits and contaminated areas. This study examines the application of field-portable X-ray fluorescence spectrometry (fpXRF) in obtaining real-time biogeochemical data. In situ analysis of parts of black and silver wattle (Acacia mearnsii De Wild. and Acacia dealbata Link) was conducted to map the extent of contamination surrounding the former Woodlawn base metal mine. High levels of ore-related elements were detected in the bark of these species in a zone extending up to 1 km down-drainage from the tailing ponds. Major elements are more elevated in bark on the side of the trees facing the tailings ponds and correlations between trace and major elements indicate dust contamination. The penetration distance for X-rays is dependent on the energy of the secondary X-rays measured, with the maximum depth of penetration in bark and leaf material <30 mm. There was a close correlation for most elements between the fpXRF and laboratory-based XRF analysis but with element-dependent attenuation by the organic matrix. Providing there is consistency in sampling and analytical methodology, in situ fpXRF analysis of vegetation is an effective method in both contamination surveys and biogeochemical mineral exploration for a range of trace and major elements.

A comparison of fractal methods and probability plots in identifying and mapping soil metal contamination near an active mining area, Iran.

Mining activities may contribute significant amounts of metals to surrounding soils. Assessing the potential effects and extent of metal contamination requires the differentiation between geogenic and additional anthropogenic sources. This study compares the use of conventional probability plots with two forms of fractal analysis (number-size and concentration-area) to separate geochemical populations of ore-related elements in agricultural area soils adjacent to Pb-Zn mining operations in the Irankuh Mountains, central Iran. The two general approaches deliver similar spatial groupings of univariate geochemical populations, but the fractal methods provide more distinct separation between populations and require less data manipulation and modeling than the probability plots. The concentration-area fractal approach was more effective than the number-size fractal and probability plotting methods at separating sub-populations within the samples affected by contamination from the mining operations. There is a general lack of association between major elements and ore-related metals in the soils. The background populations display higher relative variation in the major elements than the ore-related metals whereas near the mining operations there is far greater relative variation in the ore-related metals. The extent of the transport of contaminants away from the mine site is partly a function of the greater dispersion of Zn compared with Pb and As, however, the patterns indicate dispersion of contaminants from the mine site is via dust and not surface/groundwater. A combination of geochemical and graphical assessment, with different methods of threshold determination, is shown to be effective in separating geogenic and anthropogenic geochemical patterns.

Geochemical patterns in the soils of Cyprus.

The soil geochemical atlas of Cyprus is a recent addition to the series of national to continental-scale geochemical mapping programmes implemented over the last two decades for environmental and resource applications. The study has been conducted at the high sampling density of 1 site per 1km(2), with multi-element and multi-method analysis performed on samples of top soil (0-25cm) and sub soil (50-75cm) from a grid of over 5350 sites across a major portion of Cyprus. Major and most trace elements display sharp concentration changes across the main geological boundaries but a high degree of spatial continuity and consistency of values within those boundaries. Some elements display one to two orders of magnitude difference in median concentrations between the soils developed over ultramafic or mafic units and those developed over sedimentary rocks or alluvial units. The ratio of aqua regia-extractable to total metal contents provides an indication of the general mineralogical host for a number of trace elements. The majority of soils are near-neutral to alkaline with the small proportion of areas with soil pH<5 largely restricted to the major Cu deposits. There is strong correlation between top soil and sub soil geochemical values. Where the concentrations of some elements (including Pb, Hg and Sn) are indicative of contamination, the values are typically higher in the top soil samples in these areas. Variations in the concentration of elements with strong redox controls on mobility are linked to changes in sedimentary environment between deep and shallow marine conditions. Some element patterns can be related to the effects of urbanisation and sulphide mining operations; however the dominant control on soil geochemistry is the parent geology and regolith forming processes. The atlas demonstrates the effectiveness of high-density sampling in mapping local to regional-scale features of the geochemical landscape.

Feasibility of using routinely collected inpatient data to monitor quality and inform choice: a case study using the UK inflammatory bowel disease audit.

OBJECTIVE: To assess the utility and cost of using routinely collected inpatient data for large-scale audit. DESIGN: Comparison of audit data items collected nationally in a designed audit of inflammatory bowel disease (UK IBD audit) with routinely collected inpatient data; surveys of audit sites to compare costs. SETTING: National Health Service hospitals across England, Wales and Northern Ireland that participated in the UK IBD audit. PATIENTS: Patients in the UK IBD audit. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Percentage agreement between designed audit data items collected for the UK IBD audit and routine inpatient data items; costs of conducting the designed UK IBD audit and the routine data audit. RESULTS: There were very high matching rates between the designed audit data and routine data for a small subset of basic important information collected in the UK IBD audit, including mortality; major surgery; dates of admission, surgery, discharge and death; principal diagnoses; and sociodemographic patient characteristics. There were lower matching rates for other items, including source of admission, primary reason for admission, most comorbidities, colonoscopy and sigmoidoscopy. Routine data did not cover most detailed information collected in the UK IBD audit. Using routine data was much less costly than collecting designed audit data. CONCLUSION: Although valuable for large population-based studies, and less costly than designed data, routine inpatient data are not suitable for the evaluation of individual patient care within a designed audit.

Involving patients in primary care consultations: assessing preferences using discrete choice experiments.

BACKGROUND: Shared decision making (SDM) involves patients and doctors contributing as partners to treatment decisions. It is not known whether or to what extent SDM contributes to the welfare arising from a consultation, and how important this contribution is relative to other attributes of a consultation. AIM: To identify patient preferences for SDM relative to other utility bearing attributes of a consultation. DESIGN OF STUDY: In parallel with a randomised trial in training GPs in SDM competencies and risk communication skills, a discrete choice experiment exercise was conducted to assess patients' utilities. SETTING: Twenty general practices in South Wales, UK. METHOD: Five hundred and eighty-four responders from 747 patients attending the randomised trial (response rate = 78%). All patients had one of four conditions (atrial fibrillation, menorrhagia, menopausal symptoms or prostatism) and attended a consultation with a doctor in their own practice. Patients were randomised to attend a consultation either with a doctor who had received no training in the study or risk communication training alone or SDM training alone, or both combined. RESULTS: Five key utility bearing attributes of a consultation were identified. All significantly influenced patient's choice of preferred consultation style (P<0.001). Larger increases in utility were associated with changes on "doctor listens" attribute, followed by easily understood information, a shared treatment decision, more information and longer consultation. Utilities were influenced by whether the doctor had received risk communication training alone or SDM training alone, or both combined, prior to the consultations. The randomised trial itself had identified that the communication processes of these consultations changed significantly, with greater patient involvement in decision making, after the training interventions. CONCLUSION: Shared treatment decisions were valued less than some other attributes of a consultation. However, patient utilities for such involvement appeared responsive to changes in experiences of consultations. This suggests that SDM may gain greater value among patients once they have experienced it.

The MYSound Project: building an estuary-wide monitoring network for Long Island Sound, USA.

A network of five water quality monitoring stations has been established in Long Island Sound, measuring temperature, salinity, and dissolved oxygen since 1999. The stations are located in areas of extreme water quality degradation (western Long Island Sound) as well as in pristine areas (eastern Long Island Sound). The data from these stations are collected every 15 minutes and posted to the project web site in real time as provisional data. After subsequent quality assurance procedures, the data are archived to the project File Transfer Protocol (FSP) site for downloading by the user community. The network of stations is in part supported logistically by a number of partners, including state and local agencies, schools, and non-governmental organizations. Data from the monitoring programs of some of these partners are also published to the project website providing a more comprehensive and complete picture of the status of the Sound than can be provided independently. This repository of information is used by marine educators, resource managers, scientists, and the general public, each with a different end purpose. We use the data from two of the stations to show that these high frequency time series measurements can be used to complement and enhance other monitoring programs within the Sound, documenting in greater detail the occurrence and duration of hypoxic events.

General practitioners' use of magnetic resonance imaging: an open randomized trial comparing telephone and written requests and an open randomized controlled trial of different methods of local guideline dissemination.

AIM: To determine the impact and cost-effectiveness of telephone versus written access to magnetic resonance imaging (MRI), and of different strategies for disseminating locally produced guidelines, upon requests by general practitioners (GPs) for knee and lumbar spine investigation. MATERIAL AND METHODS: Two sequential pragmatic open cluster-randomized trials were conducted within 39 general practices. The outcome measure in each trial was concordance of request with local guidelines. Trial 1: practices requested MRI by telephone or in writing. Trial 2: all practices received guidelines, plus either: a practice-based seminar, practice-specific audit feedback, both seminar and feedback, or neither. RESULTS: A total of 414 requests were assessed in the two trials. Trial 1: telephone access cost pound4.86 more per request but rates of concordant requests were equivalent (65%/64%: telephone/written). Trial 2: compared to the control group, costs per practice were pound1911 higher in seminar group, pound1543 higher in feedback group and pound3578 higher for those receiving both. Concordance was greater following the intervention (74% vs 65%; P < 0.05), but there was no difference between the four study groups. CONCLUSIONS: Method of access did not affect concordance. Written access was more cost-effective. Seminars and feedback were no more effective in modifying practice than guidelines alone, which was thus the most cost-effective option.