Communicating the effectiveness and ineffectiveness of government policies and their impact on public support: a systematic review with meta-analysis.

Low public support for government interventions in health, environment and other policy domains can be a barrier to implementation. Communicating evidence of policy effectiveness has been used to influence attitudes towards policies, with mixed results. This review provides the first systematic synthesis of such studies. Eligible studies were randomized controlled experiments that included an intervention group that provided evidence of a policy's effectiveness or ineffectiveness at achieving a salient outcome, and measured policy support. From 6498 abstracts examined, there were 45 effect sizes from 36 eligible studies. In total, 35 (N = 30 858) communicated evidence of effectiveness, and 10 (N = 5078) communicated evidence of ineffectiveness. Random effects meta-analysis revealed that communicating evidence of a policy's effectiveness increased support for the policy (SMD = 0.11, 95% CI [0.07, 0.15], p < 0.0001), equivalent to support increasing from 50% to 54% (95% CI [53%, 56%]). Communicating evidence of ineffectiveness decreased policy support (SMD = -0.14, 95% CI [-0.22, -0.06], p < 0.001), equivalent to support decreasing from 50% to 44% (95% CI [41%, 47%]). These findings suggest that public support for policies in a range of domains is sensitive to evidence of their effectiveness, as well as their ineffectiveness.

Public acceptability of nudging and taxing to reduce consumption of alcohol, tobacco, and food: A population-based survey experiment.

There is growing evidence for the effectiveness of choice architecture or 'nudge' interventions to change a range of behaviours including the consumption of alcohol, tobacco and food. Public acceptability is key to implementing these and other interventions. However, few studies have assessed public acceptability of these interventions, including the extent to which acceptability varies with the type of intervention, the target behaviour and with evidence of intervention effectiveness. These were assessed in an online study using a between-participants full factorial design with three factors: Policy (availability vs size vs labelling vs tax) x Behaviour (alcohol consumption vs tobacco use vs high-calorie snack food consumption) x Evidence communication (no message vs assertion of policy effectiveness vs assertion and quantification of policy effectiveness [e.g., a 10% change in behaviour]). Participants (N = 7058) were randomly allocated to one of the 36 groups. The primary outcome was acceptability of the policy. Acceptability differed across policy, behaviour and evidence communication (all ps < .001). Labelling was the most acceptable policy (supported by 78%) and Availability the least (47%). Tobacco use was the most acceptable behaviour to be targeted by policies (73%) compared with policies targeting Alcohol (55%) and Food (54%). Relative to the control group (60%), asserting evidence of effectiveness increased acceptability (63%); adding a quantification to this assertion did not significantly increase this further (65%). Public acceptability for nudges and taxes to improve population health varies with the behaviour targeted and the type of intervention but is generally favourable. Communicating that these policies are effective can increase support by a small but significant amount, suggesting that highlighting effectiveness could contribute to mobilising public demand for policies. While uncertainty remains about the strength of public support needed, this may help overcome political inertia and enable action on behaviours that damage population and planetary health.

Communicating quantitative evidence of policy effectiveness and support for the policy: Three experimental studies.

Increasing the prices of products that harm health is an effective intervention for changing behaviour to improve health but public support for such interventions is generally low. The current paper investigates whether communicating evidence of a policy's effectiveness at tackling the focal problem could increase support. Across three studies we develop an infographic for communicating quantitative evidence of the effectiveness of a hypothetical tax to tackle childhood obesity. We investigate first, whether communicating evidence of effectiveness increases (a) perceived effectiveness (Studies 1,2,3) and (b) support for the policy, and second, whether any increase in perceived effectiveness mediates an increase in support (Studies 1 & 3). In all three studies (combined N = 9654) communicating evidence of effectiveness for the intervention increased perceived effectiveness. In Study 1, communicating evidence did not change support for the policy. Variations of the infographic were developed in Study 2 with one emerging as clearer and easier to comprehend. This infographic was therefore used in Study 3 in which it increased support for the tax from 45% to 49%, an effect that was mediated by perceived effectiveness. The effect sizes were small but probably meaningful at a population level. The results of these three studies suggest the potential for presenting quantitative evidence of intervention effectiveness to increase public support. Much uncertainty remains about the most effective ways of presenting this evidence, whether similar effects are achieved by presenting unquantified evidence and whether larger effects might be achieved by presenting information other than effectiveness.

Comparison between low-dose, high-sort and high-dose, low-sort semen on conception and calf sex ratio in Jersey heifers and cows.

The objective of this clinical trial was to compare conception and newborn calf sex ratios among Jersey heifers and lactating cows inseminated with either standard sex-sorted semen (low-dose, high-sort; LDHS) containing 2.1 × 10(6) sorted sperm at 90% purity or high-dose, low-sort (HDLS) semen containing 10 × 10(6) sorted sperm at 75% purity. After a specified voluntary waiting period (VWP), female subjects, consisting of nulliparous heifers (VWP 10 mo of age) and lactating cows (VWP 50d in milk), received their first service and were systematically allocated to each treatment group in the order in which they presented for artificial insemination (AI). Females were bred to the same sire and type of sex-sorted semen for up to 2 additional services. Animals that were not pregnant after 3 breeding attempts were excluded. A total of 1,846 services were performed on 1,011 eligible females (LDHS; n=494, HDLS; n=517), which consisted of 516 nulliparous heifers and 495 lactating cows. Study groups were comparable with respect to the mean age at first AI for nulliparous heifers and the mean days in milk at first AI for parous cows. Insemination with HDLS semen did not result in a higher proportion of pregnancies per AI (P/AI) compared with LDHS semen for either nulliparous heifers (P/AI=43 vs. 38%) or parous cows (P/AI=47 vs. 43%). Insemination of nulliparous heifers using HDLS resulted in a lower proportion of newborn female calves compared with those bred to LDHS (76% vs. 87%). Similarly, lactating cows bred to HDLS gave birth to a lower proportion of newborn female calves compared with those bred to LDHS (79 vs. 90%). The odds ratio for a female calf to be born to an animal inseminated with HDLS compared with LDHS was 0.32 for nulliparous heifers and 0.19 for parous cows. Overall, the use of HDLS resulted in fewer females compared with LDHS, which may be explained by the lower concentration of X-bearing spermatozoa in HDLS compared with LDHS.

MicroRNA-34a upregulation during seizure-induced neuronal death.

MicroRNAs (miRNAs) are short, noncoding RNAs that function as posttranscriptional regulators of gene expression by controlling translation of mRNAs. A subset of miRNAs may be critical for the control of cell death, including the p53-regulated miRNA, miR-34a. Because seizures activate p53, and p53-deficient mice are reportedly resistant to damage caused by prolonged seizures, we investigated the role of miR-34a in seizure-induced neuronal death in vivo. Status epilepticus was induced by intra-amygdala microinjection of kainic acid in mice. This led to an early (2 h) multifold upregulation of miR-34a in the CA3 and CA1 hippocampal subfields and lower protein levels of mitogen-activated kinase kinase kinase 9, a validated miR-34a target. Immunoprecipitation of the RNA-induced silencing complex component, Argonaute-2, eluted significantly higher levels of miR-34a after seizures. Injection of mice with pifithrin-α, a putative p53 inhibitor, prevented miR-34a upregulation after seizures. Intracerebroventricular injection of antagomirs targeting miR-34a reduced hippocampal miR-34a levels and had a small modulatory effect on apoptosis-associated signaling, but did not prevent hippocampal neuronal death in models of either severe or moderate severity status epilepticus. Thus, prolonged seizures cause subfield-specific, temporally restricted upregulation of miR-34a, which may be p53 dependent, but miR-34a is probably not important for seizure-induced neuronal death in this model.

Adherens junctions and beta-catenin-mediated cell signalling in a non-metazoan organism.

Mechanical forces between cells have a principal role in the organization of animal tissues. Adherens junctions are an important component of these tissues, connecting cells through their actin cytoskeleton and allowing the assembly of tensile structures. At least one adherens junction protein, beta-catenin, also acts as a signalling molecule, directly regulating gene expression. To date, adherens junctions have only been detected in metazoa, and therefore we looked for them outside the animal kingdom to examine their evolutionary origins. The non-metazoan Dictyostelium discoideum forms a multicellular, differentiated structure. Here we describe the discovery of actin-associated intercellular junctions in Dictyostelium. We have isolated a gene encoding a beta-catenin homologue, aardvark, which is a component of the junctional complex, and, independently, is required for cell signalling. Our discovery of adherens junctions outside the animal kingdom shows that the dual role of beta-catenin in cell-cell adhesion and cell signalling evolved before the origins of metazoa.

Use of chlorhexidine-releasing nylon fibres to reduce device-related uterine infections.

Implantation of intrauterine devices (IUDs) is associated with an increased incidence of uterine infection, probably as a result of vaginal bacteria entering the uterus at the time of insertion. To reduce the incidence of IUD-related infections, the incorporation of antimicrobial agents into the tail of the device was studied. Chlorhexidine was shown to be released from within nylon hollow fibres at a rate of approximately 114 microg x day(-1) for 10 days. This rate of release was sufficient to exhibit a biocidal effect on bacteria embedded within a mucus gel in vitro. When these devices were implanted transcervically into the guinea-pig uterus they significantly reduced the extent of uterine bacterial contamination within 24 h. These findings indicate that chlorhexidine-releasing devices are potentially useful in the reduction of device-related infections.

Effects of antimicrobial treatment at the end of lactation on milk yield, somatic cell count, and incidence of clinical mastitis during the subsequent lactation in a dairy herd with a low prevalence of contagious mastitis.

OBJECTIVE: To determine whether treating cows with antimicrobials at the end of lactation would lower the incidence of clinical mastitis, improve milk production, and decrease somatic cell count (SCC) in the subsequent lactation. DESIGN: Randomized blind field trial. ANIMALS: 233 Holstein cows from a single herd. All cows were in lactation 2 or greater. PROCEDURE: Cows were randomly assigned to treatment groups. Treated cows were given procaine penicillin G and novobiocin by intramammary infusion. Control cows were not treated. Farm personnel recorded cases of clinical mastitis. Milk yield and SCC were recorded during the subsequent lactation. RESULTS: Treatment did not significantly reduce the incidence of clinical mastitis when data for all cows were grouped or when data were stratified by lactation groups (lactation 2 vs lactation > or = 3) or by last SCC (< or = 500,000 cells/ml vs > 500,000 cells/ml). Somatic cell counts (first, mean of first 5, maximum of first 5) for treated and control cows were similar, and proportions of treated and control cows with SCC > 500,000 cells/ml at least once were not significantly different. Treated cows produced 179 kg (394 lb) more milk during the first 17 weeks of lactation than did control cows. CLINICAL IMPLICATIONS: Treating cows with antimicrobials at the end of lactation increased 17-week milk production during the subsequent lactation and, at current milk prices, was financially preferable to not treating them.

Evidence of vertical transmission of Neospora sp infection in dairy cattle.

OBJECTIVE: To determine whether heifers with naturally acquired congenital exposure to Neospora sp would transmit the infection to their offspring during gestation. DESIGN: Prospective cohort study. ANIMALS: Neonatal heifers on a dairy with a history of Neospora sp infections were selected for the study on the basis of their serum titers to Neospora sp, as determined by the use of indirect fluorescent antibody testing. Seropositive heifers (n = 25) had titers > or = 1:5,120 and seronegative heifers (25) had titers < or = 1:80. All heifers were raised and bred on the dairy, and samples were obtained from heifers and their calves at the time of calving. PROCEDURE: Blood samples were tested for Neospora sp antibodies. Histologic evaluations, Neospora sp immunohistochemical examinations, and protozoal culturing were performed on samples obtained from selected offspring (second-generation calves). RESULTS: Seropositive heifers gave birth to calves with titers > or = 1:1,280 to Neospora sp. All offspring from seropositive heifers that were necropsied had evidence of Neospora sp infection. All seronegative heifers and their offspring had titers < 1:80 to Neospora sp. CLINICAL IMPLICATIONS: Congenitally acquired Neospora sp infection can persist in clinically normal heifers and be transmitted transplacentally to their offspring. Vertical transmission can be a way by which neosporosis is maintained in herds.

Preservative efficacy tests in formulated nasal products: reproducibility and factors affecting preservative activity.

Preservative efficacy tests were performed in triplicate on each of three batches of three formulated nasal spray preparations to assess the inter- and intra-batch variation in preservative performance which typically results from these procedures, and to assess the relative importance of factors influencing preservative performance in nasal products. Tests were conducted using procedures conforming, as far as possible, to both the European and the US pharmacopoeias and the results interpreted using the performance criteria of both. Despite the adoption of practices designed to maximize reproducibility, a marked variation in the degree of microbial inactivation was observed, both within and between batches of product. A preservative system comprising benzalkonium chloride and phenylethyl alcohol was found to be far superior to combinations of either benzalkonium chloride plus disodium edetate or potassium sorbate plus disodium edetate, both of which failed to satisfy the EP performance criteria on a number of occasions. Proposals are made for the adoption of inactivation criteria which incorporate realistic error limits reflecting the inherent problems of reproducibility of the viable counting procedures involved.

Sensitivity and specificity analysis for somatic cell count (SCC) used to predict bacteriologically positive subclinical mastitis at calving in a dairy herd with low SCC.

OBJECTIVE: Validate, by sensitivity and specificity analyses, use of somatic cell count (SCC) to predict bacteriologically positive subclinical mastitis in a California dairy herd with low SCC. DESIGN: Study of monthly dairy herd improvement SCC obtained from the immediate preceding lactation and individual cow composite milk sample microbiologic isolates collected at calving. ANIMALS: 515 California dairy cows with SCC and culture data. PROCEDURE: Somatic cell count sensitivity and specificity analyses with combinations of SCC parameter and at various thresholds were done, using the bacterial isolates as the standard. RESULTS: Combination of SCC threshold and SCC parameters could not be developed that had sufficient sensitivity and specificity to be a useful predictor of cows that would calve with subclinical mastitis. CLINICAL IMPLICATIONS: Under the conditions at this particular dairy, SCC could not be used as a basis of prediction of cows that would calve with bacteriologically positive subclinical mastitis or require selective nonlactating-cow antibiotic treatment.

Patterns of uterine prolapse in dairy cows and prognosis after treatment.

A 12-month study was undertaken in a 9-veterinarian dairy practice to determine patterns of uterine prolapse and factors associated with posttreatment survival. Of 220,000 cows in herds visited by veterinarians from the practice, 200 (0.09%) developed prolapses mostly (155/169 with data) in the first 24 hours after calving. Most cows (130/200) had prolapses during fall and winter months, and assistance was required in 47 of 200 calvings that resulted in prolapses. Treatment of affected cows (n = 196) consisted of cleansing and replacement of the uterus, insertion of perivulvar retention sutures, local and systemic administration of antibiotics, and parenteral administration of dexamethasone and oxytocin. Calcium was administered to cows with milk fever (n = 117) and to multiparous cows without milk fever attended by veterinarian 9 (n = 8). Crude recovery rate after 2 weeks was 72.4%, but recovery was significantly better if the calf was born alive (P = 0.001), the cow was primiparous (P = 0.03), the cow did not have stage-3 milk fever (P = 0.003), or if the cow was attended by veterinarian 9 (P = 0.01). Time to treatment was not significantly associated with recovery, but affected cows were treated mostly (127/156) within 2 hours of occurrence of the prolapse. By multivariable analysis, presence of a liveborn calf, parity, and lack of stage-3 milk fever, but not attending veterinarian, were significant (P less than 0.05) prognostic indicators of 2-week survival.

Uterine prolapse and hypocalcemia in dairy cows.

Blood samples were collected from 53 dairy cows with uterine prolapse and from 53 cows with normal parturition (no uterine prolapse) matched by dairy as controls for various management programs among dairies. Cows with uterine prolapse had significantly lower total serum calcium content than did controls (P less than 0.01). Mean (+/- SEM) serum calcium content (mg/dl) for affected cows and controls were 6.08 (+/- 0.25) and 6.96 (+/- 0.20), respectively. Severe hypocalcemia (less than 4 mg/dl) was found in 10 (19%) of the affected cows, compared with 1 (1.8%) of the controls. Fifteen (28%) of the affected cows had moderate hypocalcemia (4.1 to 6.0 mg/dl), compared with 14 (26%) of the controls; 19 (36%) of the affected cows were mildly hypocalcemic (6.1 to 7.9 mg/dl), compared with 25 (47%) of the controls. Nine (17%) of the affected cows and 13 (25%) of the controls were within the normal range of calcium content (greater than 8 mg/dl). Nine of the affected cows were first-calf cows. The serum of these animals did not have significantly lower calcium concentrations, compared with controls matched by parity. Serum calcium values (mg/dl) for 9 first-calf cows and the 9 matched controls were 7.24 (+/- 0.42) and 7.00 (+/- 0.39), respectively. It was concluded that hypocalcemia was associated with uterine prolapse in multiparous dairy cows and, along with other factors, is involved as an etiologic factor for this puerperal condition.

Clot retraction: evaluation in dilute suspensions of platelet-rich plasma and gel-separated platelets.

Suspensions of platelet-rich plasma (PRP) or gel-separated platelets (GSP) can be used to evaluate clot retraction subsequent to platelet aggregation and fibrin formation. PRP (200,000 per cubic millimeter) or GSP (200,000 or 100,000 per cubic millimeter) are diluted 1:10 (PRP) or 1:8 (GSP) in phosphate buffer, pH 7.4, and clotted with a high concentration (2.5 U. per milliliter) of thrombin. Human fibrinogen (25 mg. per cent) is added to GSP prior to dilution. Clot retraction is 91 to 100 per cent completed in 1 hour and is quantified by measurement of residual fluid volume. Test conditions are unfavorable for fibrinolysis. Very low concentrations of fibrin/fibrinogen degradation products D and E are detected in residual fluid, and no erythrocyte fall-out occurs. Furthermore, the extent of retraction in the dilute systems is related only to platelet numbers and platelet function. The dilute PRP and GSP methods allow evaluation of clot retraction in the presence of PGE1, the most potent inhibitor of platelet aggregation induced by conventional concentrations of collagen, ADP, epinephrine, and thrombin (0.1 to 0.5 U. per milliliter). High concentrations of PGE1 (to 6 x 10(-6) M) do not inhibit aggregation of GSP, fibrin formation, or platelet-fibrin interaction induced by 2.5 U. per milliliter of thrombin. In contrast, PGE1 concentrations as low as 1.5 to 3.0 x 10(-8) M inhibit clot retraction in both the dilute PRP and GSP systems. Thus, using dilute PRP or GSP the effects of platelet aggregation inhibitors on clot retraction can be determined independently of effects on platelet aggregation.

The variable prevalence of junctional-complex-associated bodies in the human sweat gland.

Sweat gland biopsies have been examined for their content of junctional-complex-associated (JCA) bodies. These bodies have been observed at the lumen of the gland as well as the intercellular canaliculi. A JCA body was encountered in each of two dark cells with uncondensed secretory granules; one of these cells was from a specimen in which no other bodies could be found after an extensive search. All other JCA bodies occurred in either clear or undifferentiated cells. Junctional-complex-associated bodies occupied pairs of adjacent cells rather frequently, but no cell revealed more than one body. The prevalence of JCA bodies varied widely among specimens. Glands lacking morphologic abnormalities, and others with some atypical features, disclosed few or no such bodies. Some glands that contained JCA bodies also contained coil cells with extensive vacuolization, which occurred as a manifestation of Hurler's disease or on an unexplained basis. Glands from a patient with cystic fibrosis exhibited the highest prevalence of JCA bodies. Some of the coil profiles in glands near a scar in one specimen were composed of undifferentiated cells with rare mitotic figures and no identifiable clear or dark cells. Numerous JCA bodies, particularly at the lumen, were found in sweat glands in this and another specimen containing frequent undifferentiated cells.