Sheffield Hallam University

Importance Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). Conclusions and Relevance The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.

The Shock Doctrine is a critical review of the use and consequences of free-market economics. It takes its title from the application of Shock Therapy as a means to bring economic transformation, Shock and Awe, the military strategy of Donald Rumsfeld used in the invasion of Iraq, but also elsewhere, and of electric-shocks and the use of torture to sustain authoritarian governments. There are two recurring themes which run through the book: the allying of rapid free-market reforms as advocated by Chicago School economists, and specifically Milton Freedman, to authoritarian state strategies; and, contrary to free-market reforms, the rise of the corporate state and in particular the capture of political elites by large private corporations, especially US-controlled ones. Klein highlights how free-market economists have advanced the assumption that conditions of war,...

Materials exhibiting high energy/power density are currently needed to meet the growing demand of portable electronics, electric vehicles and large-scale energy storage devices. The highest energy densities are achieved for fuel cells, batteries, and supercapacitors, but conventional dielectric capacitors are receiving increased attention for pulsed power applications due to their high power density and their fast charge-discharge speed. The key to high energy density in dielectric capacitors is a large maximum but small remanent (zero in the case of linear dielectrics) polarization and a high electric breakdown strength. Polymer dielectric capacitors offer high power/energy density for applications at room temperature, but above 100 °C they are unreliable and suffer from dielectric breakdown. For high-temperature applications, therefore, dielectric ceramics are the only feasible alternative. Lead-based ceramics such as La-doped lead zirconate titanate exhibit good energy storage properties, but their toxicity raises concern over their use in consumer applications, where capacitors are exclusively lead free. Lead-free compositions with superior power density are thus required. In this paper, we introduce the fundamental principles of energy storage in dielectrics. We discuss key factors to improve energy storage properties such as the control of local structure, phase assemblage, dielectric layer thickness, microstructure, conductivity, and electrical homogeneity through the choice of base systems, dopants, and alloying additions, followed by a comprehensive review of the state-of-the-art. Finally, we comment on the future requirements for new materials in high power/energy density capacitor applications.

The CSCW community continues to grow. This year we received 575 papers which represents a 13% increase over the total submissions for the prior year. We had submissions from 24 countries covering all continents. This year was the fourth year of the Revise and Resubmit (R&R) process. Over the last four years the CSCW conference community has been conducting the review process in two rounds. In the first round reviewers are encouraged to review papers with an eye to improving the intellectual strength and contributions of the paper, making it clear which changes would be helpful and which are likely required to make the paper acceptable. In the second round, the same reviewers see the same paper and review to understand whether or not the revised paper now meets the standards of the CSCW community as acceptable. This two-round review model, with encouraging and intellectual give-andtake, is designed to improve papers of good quality but in need of work that might otherwise slip just below the bar in the more common one-shot reviewing conferences. As the Papers Co-Chairs we received numerous email commenting on the high quality of the reviewing, even from some authors whose work was not accepted. Of all the submissions, 262 were offered the opportunity to R&R, representing a little over 45% of the original submissions. A very small number of authors either withdrew their papers or otherwise declined to resubmit their papers. The Program Committee accepted 161 papers for an acceptance rate of 28% of the total.

BACKGROUND: Midwives are primary providers of care for childbearing women around the world. However, there is a lack of synthesised information to establish whether there are differences in morbidity and mortality, effectiveness and psychosocial outcomes between midwife-led continuity models and other models of care. OBJECTIVES: To compare midwife-led continuity models of care with other models of care for childbearing women and their infants. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (25 January 2016) and reference lists of retrieved studies. SELECTION CRITERIA: All published and unpublished trials in which pregnant women are randomly allocated to midwife-led continuity models of care or other models of care during pregnancy and birth. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. The quality of the evidence was assessed using the GRADE approach. MAIN RESULTS: We included 15 trials involving 17,674 women. We assessed the quality of the trial evidence for all primary outcomes (i.e. regional analgesia (epidural/spinal), caesarean birth, instrumental vaginal birth (forceps/vacuum), spontaneous vaginal birth, intact perineum, preterm birth (less than 37 weeks) and all fetal loss before and after 24 weeks plus neonatal death using the GRADE methodology: all primary outcomes were graded as of high quality.For the primary outcomes, women who had midwife-led continuity models of care were less likely to experience regional analgesia (average risk ratio (RR) 0.85, 95% confidence interval (CI) 0.78 to 0.92; participants = 17,674; studies = 14; high quality), instrumental vaginal birth (average RR 0.90, 95% CI 0.83 to 0.97; participants = 17,501; studies = 13; high quality), preterm birth less than 37 weeks (average RR 0.76, 95% CI 0.64 to 0.91; participants = 13,238; studies = eight; high quality) and less all fetal loss before and after 24 weeks plus neonatal death (average RR 0.84, 95% CI 0.71 to 0.99; participants = 17,561; studies = 13; high quality evidence). Women who had midwife-led continuity models of care were more likely to experience spontaneous vaginal birth (average RR 1.05, 95% CI 1.03 to 1.07; participants = 16,687; studies = 12; high quality). There were no differences between groups for caesarean births or intact perineum.For the secondary outcomes, women who had midwife-led continuity models of care were less likely to experience amniotomy (average RR 0.80, 95% CI 0.66 to 0.98; participants = 3253; studies = four), episiotomy (average RR 0.84, 95% CI 0.77 to 0.92; participants = 17,674; studies = 14) and fetal loss less than 24 weeks and neonatal death (average RR 0.81, 95% CI 0.67 to 0.98; participants = 15,645; studies = 11). Women who had midwife-led continuity models of care were more likely to experience no intrapartum analgesia/anaesthesia (average RR 1.21, 95% CI 1.06 to 1.37; participants = 10,499; studies = seven), have a longer mean length of labour (hours) (mean difference (MD) 0.50, 95% CI 0.27 to 0.74; participants = 3328; studies = three) and more likely to be attended at birth by a known midwife (average RR 7.04, 95% CI 4.48 to 11.08; participants = 6917; studies = seven). There were no differences between groups for fetal loss equal to/after 24 weeks and neonatal death, induction of labour, antenatal hospitalisation, antepartum haemorrhage, augmentation/artificial oxytocin during labour, opiate analgesia, perineal laceration requiring suturing, postpartum haemorrhage, breastfeeding initiation, low birthweight infant, five-minute Apgar score less than or equal to seven, neonatal convulsions, admission of infant to special care or neonatal intensive care unit(s) or in mean length of neonatal hospital stay (days).Due to a lack of consistency in measuring women's satisfaction and assessing the cost of various maternity models, these outcomes were reported narratively. The majority of included studies reported a higher rate of maternal satisfaction in midwife-led continuity models of care. Similarly, there was a trend towards a cost-saving effect for midwife-led continuity care compared to other care models. AUTHORS' CONCLUSIONS: This review suggests that women who received midwife-led continuity models of care were less likely to experience intervention and more likely to be satisfied with their care with at least comparable adverse outcomes for women or their infants than women who received other models of care.Further research is needed to explore findings of fewer preterm births and fewer fetal deaths less than 24 weeks, and all fetal loss/neonatal death associated with midwife-led continuity models of care.

The Spirit Level: Why More Equal Societies Almost Always Do Better R. Wilkinson and K. Pickett Publisher: Allen Lane, London 2009 ISBN Hardback 978-1-846-14039-6, £20, 336 pages Ever since the earl...

Poor adherence to treatment can have negative effects on outcomes and healthcare cost. However, little is known about the barriers to treatment adherence within physiotherapy. The aim of this systematic review was to identify barriers to treatment adherence in patients typically managed in musculoskeletal physiotherapy outpatient settings and suggest strategies for reducing their impact. The review included twenty high quality studies investigating barriers to treatment adherence in musculoskeletal populations. There was strong evidence that poor treatment adherence was associated with low levels of physical activity at baseline or in previous weeks, low in-treatment adherence with exercise, low self-efficacy, depression, anxiety, helplessness, poor social support/activity, greater perceived number of barriers to exercise and increased pain levels during exercise. Strategies to overcome these barriers and improve adherence are considered. We found limited evidence for many factors and further high quality research is required to investigate the predictive validity of these potential barriers. Much of the available research has focussed on patient factors and additional research is required to investigate the barriers introduced by health professionals or health organisations, since these factors are also likely to influence patient adherence with treatment.

Analysis 1.17.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 17 Perineal laceration requiring suturing. . . . . . . . . . . . . . . . . . . . . .Analysis 1.18.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 18 Mean labour length (hrs). . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 1.19.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 19 Postpartum haemorrhage (as defined by trial authors). . . . . . . . . . . . . . . .Analysis 1.20.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 20 Breastfeeding initiation. . . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 1.21.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 21 Duration of postnatal hospital stay (days). . . . . . . . . . . . . . . . . . . .Analysis 1.22.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 22 Low birthweight (< 2500 g). . . . . . . . . . . . . . . . . . . . . . . . .Analysis 1.23.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 23 5-minute Apgar score below or equal to 7. . . . . . . . . . . . . . . . . . . .Analysis 1.24.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 24 Neonatal convulsions (as defined by trial authors). . . . . . . . . . . . . . . . .Analysis 1.25.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 25 Admission to special care nursery/neonatal intensive care unit. . . . . . . . . . . . .Analysis 1.26.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 26 Mean length of neonatal hospital stay (days).. . . . . . . . . . . . . . . . . .Analysis 1.27.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 27 Fetal loss less than 24 weeks and neonatal death. . . . . . . . . . . . . . . . . .Analysis 1.28.Comparison 1 Midwife-led versus other models of care for childbearing women and their infants (all), Outcome 28 Fetal loss equal to/after 24 weeks and neonatal death. . . . . . . . . . . . . . . .Analysis 2.1.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 1 Regional analgesia (epidural/spinal). . . . . . . . . . . . . . . . .Analysis 2.2.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 2 Caesarean birth. . . . . . . . . . . . . . . . . . . . . . . .Analysis 2.3.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 3 Instrumental vaginal birth (forceps/vacuum). . . . . . . . . . . . . .Analysis 2.4.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 4 Spontaneous vaginal birth (as defined by trial authors). . . . . . . . . .Analysis 2.5.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 5 Intact perineum. . . . . . . . . . . . . . . . . . . . . . . .Analysis 2.6.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 6 Preterm birth (< 37 weeks). . . . . . . . . . . . . . . . . . . .Analysis 2.7.Comparison 2 Midwife-led versus other models of care: variation in midwifery models of care (caseload/oneto-one or team), Outcome 7 All fetal loss before and after 24 weeks plus neonatal death. . . . . . . . .Analysis 3.1.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 1 Regional analgesia (epidural/spinal). . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 3.2.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 2 Caesarean birth. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 3.3.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 3 Instrumental vaginal birth (forceps/vacuum). . . . . . . . . . . . . . . . . . . . . . .Analysis 3.4.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 4 Spontaneous vaginal birth (as defined by trial authors). . . . . . . . . . . . . . . . . . . .Analysis 3.5.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 5 Intact perineum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 3.6.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 6 Preterm birth (< 37 weeks). . . . . . . . . . . . . . . . . . . . . . . . . . . . .Analysis 3.7.Comparison 3 Midwife-led versus other models of care: variation in risk status (low versus mixed), Outcome 7 All fetal loss before and after 24 weeks plus neonatal death. . . . . . . . . . . . . . . . . .

Tailored and effective governance is a key requirement for implementing sustainable tourism: it can enhance democratic processes, provide direction and offer the means to make practical progress. This introduction explains how the papers in this collection provide critical assessments of the theory and practice of tourism governance and sustainability. It argues that theoretical frameworks are crucial to research on the subject as they affect the issues examined and the policy recommendations made. Several papers in the collection focus on relevant theoretical frameworks and concepts, while others consider governance at different geographical scales and the interconnections between those scales. The temporal dimensions of governance are also explored because sustainable development relates to long time horizons. Governance is also considered in relation to trade-offs, policy failures, learning processes, adaptive management, the public sphere and the principle of subsidiarity.

This article offers support and guidance for students undertaking a literature review as part of their dissertation during an undergraduate or Masters course. A literature review is a summary of a subject field that supports the identification of specific research questions. A literature review needs to draw on and evaluate a range of different types of sources including academic and professional journal articles, books, and web-based resources. The literature search helps in the identification and location of relevant documents and other sources. Search engines can be used to search web resources and bibliographic databases. Conceptual frameworks can be a useful tool in developing an understanding of a subject area. Creating the literature review involves the stages of: scanning, making notes, structuring the literature review, writing the literature review, and building a bibliography.

Begins with a critical review of the literature on knowledge management, arguing that its focus on IT to create a network structure may limit its potential for encouraging knowledge sharing across social communities. Two cases of interactive innovation are contrasted. One focused almost entirely on using IT (intranet) for knowledge sharing, resulting in a plethora of independent intranets which reinforced existing organizational and social boundaries with electronic “fences”. In the other, while IT was used to provide a network to encourage sharing, there was also recognition of the importance of face‐to‐face interaction for sharing tacit knowledge. The emphasis was on encouraging active networking among dispersed communities, rather than relying on IT networks. Argues for a community‐based model of knowledge management for interactive innovation and contrasts this with the cognitive‐based view that underpins many IT‐led knowledge management initiatives.

Carbapenem resistance is a major and an on-going public health problem globally. It occurs mainly among Gram-negative pathogens such as Klebsiella pneumoniae, Pseudomonas aeruginosa and Acinetobacter baumannii, and may be intrinsic or mediated by transferable carbapenemase-encoding genes. This type of resistance genes are already widespread in certain parts of the world, particularly Europe, Asia and South America, while the situation in other places such as sub-Saharan Africa is not well documented. In this paper, we provide an in-depth review of carbapenem resistance providing up-to-date information on the subject.

BACKGROUND: For more than three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has provided a framework to quantify health loss due to diseases, injuries, and associated risk factors. This paper presents GBD 2023 findings on disease and injury burden and risk-attributable health loss, offering a global audit of the state of world health to inform public health priorities. This work captures the evolving landscape of health metrics across age groups, sexes, and locations, while reflecting on the remaining post-COVID-19 challenges to achieving our collective global health ambitions. METHODS: The GBD 2023 combined analysis estimated years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 375 diseases and injuries, and risk-attributable burden associated with 88 modifiable risk factors. Of the more than 310 000 total data sources used for all GBD 2023 (about 30% of which were new to this estimation round), more than 120 000 sources were used for estimation of disease and injury burden and 59 000 for risk factor estimation, and included vital registration systems, surveys, disease registries, and published scientific literature. Data were analysed using previously established modelling approaches, such as disease modelling meta-regression version 2.1 (DisMod-MR 2.1) and comparative risk assessment methods. Diseases and injuries were categorised into four levels on the basis of the established GBD cause hierarchy, as were risk factors using the GBD risk hierarchy. Estimates stratified by age, sex, location, and year from 1990 to 2023 were focused on disease-specific time trends over the 2010-23 period and presented as counts (to three significant figures) and age-standardised rates per 100 000 person-years (to one decimal place). For each measure, 95% uncertainty intervals [UIs] were calculated with the 2·5th and 97·5th percentile ordered values from a 250-draw distribution. FINDINGS: Total numbers of global DALYs grew 6·1% (95% UI 4·0-8·1), from 2·64 billion (2·46-2·86) in 2010 to 2·80 billion (2·57-3·08) in 2023, but age-standardised DALY rates, which account for population growth and ageing, decreased by 12·6% (11·0-14·1), revealing large long-term health improvements. Non-communicable diseases (NCDs) contributed 1·45 billion (1·31-1·61) global DALYs in 2010, increasing to 1·80 billion (1·63-2·03) in 2023, alongside a concurrent 4·1% (1·9-6·3) reduction in age-standardised rates. Based on DALY counts, the leading level 3 NCDs in 2023 were ischaemic heart disease (193 million [176-209] DALYs), stroke (157 million [141-172]), and diabetes (90·2 million [75·2-107]), with the largest increases in age-standardised rates since 2010 occurring for anxiety disorders (62·8% [34·0-107·5]), depressive disorders (26·3% [11·6-42·9]), and diabetes (14·9% [7·5-25·6]). Remarkable health gains were made for communicable, maternal, neonatal, and nutritional (CMNN) diseases, with DALYs falling from 874 million (837-917) in 2010 to 681 million (642-736) in 2023, and a 25·8% (22·6-28·7) reduction in age-standardised DALY rates. During the COVID-19 pandemic, DALYs due to CMNN diseases rose but returned to pre-pandemic levels by 2023. From 2010 to 2023, decreases in age-standardised rates for CMNN diseases were led by rate decreases of 49·1% (32·7-61·0) for diarrhoeal diseases, 42·9% (38·0-48·0) for HIV/AIDS, and 42·2% (23·6-56·6) for tuberculosis. Neonatal disorders and lower respiratory infections remained the leading level 3 CMNN causes globally in 2023, although both showed notable rate decreases from 2010, declining by 16·5% (10·6-22·0) and 24·8% (7·4-36·7), respectively. Injury-related age-standardised DALY rates decreased by 15·6% (10·7-19·8) over the same period. Differences in burden due to NCDs, CMNN diseases, and injuries persisted across age, sex, time, and location. Based on our risk analysis, nearly 50% (1·27 billion [1·18-1·38]) of the roughly 2·80 billion total global DALYs in 2023 were attributable to the 88 risk factors analysed in GBD. Globally, the five level 3 risk factors contributing the highest proportion of risk-attributable DALYs were high systolic blood pressure (SBP), particulate matter pollution, high fasting plasma glucose (FPG), smoking, and low birthweight and short gestation-with high SBP accounting for 8·4% (6·9-10·0) of total DALYs. Of the three overarching level 1 GBD risk factor categories-behavioural, metabolic, and environmental and occupational-risk-attributable DALYs rose between 2010 and 2023 only for metabolic risks, increasing by 30·7% (24·8-37·3); however, age-standardised DALY rates attributable to metabolic risks decreased by 6·7% (2·0-11·0) over the same period. For all but three of the 25 leading level 3 risk factors, age-standardised rates dropped between 2010 and 2023-eg, declining by 54·4% (38·7-65·3) for unsafe sanitation, 50·5% (33·3-63·1) for unsafe water source, and 45·2% (25·6-72·0) for no access to handwashing facility, and by 44·9% (37·3-53·5) for child growth failure. The three leading level 3 risk factors for which age-standardised attributable DALY rates rose were high BMI (10·5% [0·1 to 20·9]), drug use (8·4% [2·6 to 15·3]), and high FPG (6·2% [-2·7 to 15·6]; non-significant). INTERPRETATION: Our findings underscore the complex and dynamic nature of global health challenges. Since 2010, there have been large decreases in burden due to CMNN diseases and many environmental and behavioural risk factors, juxtaposed with sizeable increases in DALYs attributable to metabolic risk factors and NCDs in growing and ageing populations. This long-observed consequence of the global epidemiological transition was only temporarily interrupted by the COVID-19 pandemic. The substantially decreasing CMNN disease burden, despite the 2008 global financial crisis and pandemic-related disruptions, is one of the greatest collective public health successes known. However, these achievements are at risk of being reversed due to major cuts to development assistance for health globally, the effects of which will hit low-income countries with high burden the hardest. Without sustained investment in evidence-based interventions and policies, progress could stall or reverse, leading to widespread human costs and geopolitical instability. Moreover, the rising NCD burden necessitates intensified efforts to mitigate exposure to leading risk factors-eg, air pollution, smoking, and metabolic risks, such as high SBP, BMI, and FPG-including policies that promote food security, healthier diets, physical activity, and equitable and expanded access to potential treatments, such as GLP-1 receptor agonists. Decisive, coordinated action is needed to address long-standing yet growing health challenges, including depressive and anxiety disorders. Yet this can be only part of the solution. Our response to the NCD syndemic-the complex interaction of multiple health risks, social determinants, and systemic challenges-will define the future landscape of global health. To ensure human wellbeing, economic stability, and social equity, global action to sustain and advance health gains must prioritise reducing disparities by addressing socioeconomic and demographic determinants, ensuring equitable health-care access, tackling malnutrition, strengthening health systems, and improving vaccination coverage. We live in times of great opportunity. FUNDING: Gates Foundation and Bloomberg Philanthropies.

(1993). Sustainable Tourism: An Evolving Global Approach. Journal of Sustainable Tourism: Vol. 1, No. 1, pp. 1-5.

This article assumes that brands should be managed as valuable, long‐term corporate assets. It is proposed that for a true brand asset mindset to be achieved, the relationship between brand loyalty and brand value needs to be recognised within the management accounting system. It is also suggested that strategic brand management is achieved by having a multi‐disciplinary focus, which is facilitated by a common vocabulary. This article seeks to establish the relationships between the constructs and concepts of branding, and to provide a framework and vocabulary that aids effective communication between the functions of accounting and marketing. Performance measures for brand management are also considered, and a model for the management of brand equity is provided.

Plastics have revolutionized modern life, but have created a global waste crisis driven by our reliance and demand for low-cost, disposable materials. New approaches are vital to address challenges related to plastics waste heterogeneity, along with the property reductions induced by mechanical recycling. Chemical recycling and upcycling of polymers may enable circularity through separation strategies, chemistries that promote closed-loop recycling inherent to macromolecular design, and transformative processes that shift the life-cycle landscape. Polymer upcycling schemes may enable lower-energy pathways and minimal environmental impacts compared with traditional mechanical and chemical recycling. The emergence of industrial adoption of recycling and upcycling approaches is encouraging, solidifying the critical role for these strategies in addressing the fate of plastics and driving advances in next-generation materials design.

Most women in the United States do not meet the recommendations for healthful nutrition and weight before and during pregnancy. Women and providers often ask what a healthy diet for a pregnant woman should look like. The message should be "eat better, not more." This can be achieved by basing diet on a variety of nutrient-dense, whole foods, including fruits, vegetables, legumes, whole grains, healthy fats with omega-3 fatty acids that include nuts and seeds, and fish, in place of poorer quality highly processed foods. Such a diet embodies nutritional density and is less likely to be accompanied by excessive energy intake than the standard American diet consisting of increased intakes of processed foods, fatty red meat, and sweetened foods and beverages. Women who report "prudent" or "health-conscious" eating patterns before and/or during pregnancy may have fewer pregnancy complications and adverse child health outcomes. Comprehensive nutritional supplementation (multiple micronutrients plus balanced protein energy) among women with inadequate nutrition has been associated with improved birth outcomes, including decreased rates of low birthweight. A diet that severely restricts any macronutrient class should be avoided, specifically the ketogenic diet that lacks carbohydrates, the Paleo diet because of dairy restriction, and any diet characterized by excess saturated fats. User-friendly tools to facilitate a quick evaluation of dietary patterns with clear guidance on how to address dietary inadequacies and embedded support from trained healthcare providers are urgently needed. Recent evidence has shown that although excessive gestational weight gain predicts adverse perinatal outcomes among women with normal weight, the degree of prepregnancy obesity predicts adverse perinatal outcomes to a greater degree than gestational weight gain among women with obesity. Furthermore, low body mass index and insufficient gestational weight gain are associated with poor perinatal outcomes. Observational data have shown that first-trimester gain is the strongest predictor of adverse outcomes. Interventions beginning in early pregnancy or preconception are needed to prevent downstream complications for mothers and their children. For neonates, human milk provides personalized nutrition and is associated with short- and long-term health benefits for infants and mothers. Eating a healthy diet is a way for lactating mothers to support optimal health for themselves and their infants.

BACKGROUND: Interdisciplinary team work is increasingly prevalent, supported by policies and practices that bring care closer to the patient and challenge traditional professional boundaries. To date, there has been a great deal of emphasis on the processes of team work, and in some cases, outcomes. METHOD: This study draws on two sources of knowledge to identify the attributes of a good interdisciplinary team; a published systematic review of the literature on interdisciplinary team work, and the perceptions of over 253 staff from 11 community rehabilitation and intermediate care teams in the UK. These data sources were merged using qualitative content analysis to arrive at a framework that identifies characteristics and proposes ten competencies that support effective interdisciplinary team work. RESULTS: Ten characteristics underpinning effective interdisciplinary team work were identified: positive leadership and management attributes; communication strategies and structures; personal rewards, training and development; appropriate resources and procedures; appropriate skill mix; supportive team climate; individual characteristics that support interdisciplinary team work; clarity of vision; quality and outcomes of care; and respecting and understanding roles. CONCLUSIONS: We propose competency statements that an effective interdisciplinary team functioning at a high level should demonstrate.

Quantitative research enjoys heightened esteem among policy-makers, media, and the general public. Whereas qualitative research is frequently dismissed as subjective and impressionistic, statistics are often assumed to be objective and factual. We argue that these distinctions are wholly false; quantitative data is no less socially constructed than any other form of research material. The first part of the paper presents a conceptual critique of the field with empirical examples that expose and challenge hidden assumptions that frequently encode racist perspectives beneath the façade of supposed quantitative objectivity. The second part of the paper draws on the tenets of Critical Race Theory (CRT) to set out some principles to guide the future use and analysis of quantitative data. These ‘QuantCrit’ ideas concern (1) the centrality of racism as a complex and deeply rooted aspect of society that is not readily amenable to quantification; (2) numbers are not neutral and should be interrogated for their role in promoting deficit analyses that serve White racial interests; (3) categories are neither ‘natural’ nor given and so the units and forms of analysis must be critically evaluated; (4) voice and insight are vital: data cannot ‘speak for itself’ and critical analyses should be informed by the experiential knowledge of marginalized groups; (5) statistical analyses have no inherent value but can play a role in struggles for social justice.

Our understanding of the relationship between physical activity and health is constantly evolving. Therefore, the British Association of Sport and Exercise Sciences convened a panel of experts to review the literature and produce guidelines that health professionals might use. In the ABC of Physical Activity for Health, A is for All healthy adults, B is for Beginners, and C is for Conditioned individuals. All healthy adults aged 18-65 years should aim to take part in at least 150 min of moderate-intensity aerobic activity each week, or at least 75 min of vigorous-intensity aerobic activity per week, or equivalent combinations of moderate- and vigorous-intensity activities. Moderate-intensity activities are those in which heart rate and breathing are raised, but it is possible to speak comfortably. Vigorous-intensity activities are those in which heart rate is higher, breathing is heavier, and conversation is harder. Aerobic activities should be undertaken in bouts of at least 10 min and, ideally, should be performed on five or more days a week. All healthy adults should also perform muscle-strengthening activities on two or more days a week. Weight training, circuit classes, yoga, and other muscle-strengthening activities offer additional health benefits and may help older adults to maintain physical independence. Beginners should work steadily towards meeting the physical activity levels recommended for all healthy adults. Even small increases in activity will bring some health benefits in the early stages and it is important to set achievable goals that provide success, build confidence, and increase motivation. For example, a beginner might be asked to walk an extra 10 min every other day for several weeks to slowly reach the recommended levels of activity for all healthy adults. It is also critical that beginners find activities they enjoy and gain support in becoming more active from family and friends. Conditioned individuals who have met the physical activity levels recommended for all healthy adults for at least 6 months may obtain additional health benefits by engaging in 300 min or more of moderate-intensity aerobic activity per week, or 150 min or more of vigorous-intensity aerobic activity each week, or equivalent combinations of moderate- and vigorous-intensity aerobic activities. Adults who find it difficult to maintain a normal weight and adults with increased risk of cardiovascular disease or type 2 diabetes may in particular benefit from going beyond the levels of activity recommended for all healthy adults and gradually progressing towards meeting the recommendations for conditioned individuals. Physical activity is beneficial to health with or without weight loss, but adults who find it difficult to maintain a normal weight should probably be encouraged to reduce energy intake and minimize time spent in sedentary behaviours to prevent further weight gain. Children and young people aged 5-16 years should accumulate at least 60 min of moderate-to-vigorous-intensity aerobic activity per day, including vigorous-intensity aerobic activities that improve bone density and muscle strength.