Explore the vast range of titles available.

Small-scale inland capture fisheries provide an important source of nutritious food, employment and income to millions of people in developing countries, particularly in rural environments where limited alternatives exist. However, the sector is one of most under-valued fisheries sectors and is increasingly experiencing environmental change. This study adopts a Sustainable Livelihoods Approach and investigates how important a fluctuating inland fishery is to livelihoods, and how local perceptions on challenges corresponds to global evidence. Through an innovative participatory method; photovoice, the lived experiences and perceptions of fishers are depicted. The findings illuminate the valuable role of the sector to food and nutrition security and the complex nexus with vulnerability to climate change. The study responds to the call for more local level assessments of the impacts of climate change on inland fisheries in data-limited environments, and the value of the sector in underpinning the Sustainable Development Goals.

There is increasing emphasis on the need for effective ways of sharing knowledge to enhance environmental management and sustainability. Knowledge exchange (KE) are processes that generate, share and/or use knowledge through various methods appropriate to the context, purpose, and participants involved. KE includes concepts such as sharing, generation, coproduction, comanagement, and brokerage of knowledge. This paper elicits the expert knowledge of academics involved in research and practice of KE from different disciplines and backgrounds to review research themes, identify gaps and questions, and develop a research agenda for furthering understanding about KE. Results include 80 research questions prefaced by a review of research themes. Key conclusions are: (1) there is a diverse range of questions relating to KE that require attention; (2) there is a particular need for research on understanding the process of KE and how KE can be evaluated; and (3) given the strong interdependency of research questions, an integrated approach to understanding KE is required. To improve understanding of KE, action research methodologies and embedding evaluation as a normal part of KE research and practice need to be encouraged. This will foster more adaptive approaches to learning about KE and enhance effectiveness of environmental management.

Earlier this year, the Australian federal election was touted as the \"climate election,\" where climate change surfaced as a key political focus. In parallel to election campaigning, the International Union for Health Promotion and Education (IUHPE) World Health Promotion Conference was held in Rotorua, New Zealand. The theme of the conference was Waiora: Promoting Planetary Health and Sustainable Development for All. We use this editorial as an opportunity to digest the outcomes of both the conference and the post-election results with respect to planetary health and the subsequent implications for health promotion policy and practice. An Associate Editor (RP) approached three leading climate and health experts (FA, AC and TH) and the Editor-in-Chief (JS) to discuss the political, policy, advocacy and research challenges of climate change, and what this means for health promotion policy and practice across the region.

Background: Nasal decolonization significantly decreases the incidence of Staphylococcus aureus surgical-site infections (SSIs). Patient adherence with self-administration of a decolonization ointment (ie, mupirocin) is low, especially among patients having urgent surgery. Povidone-iodine decolonization may overcome patient adherence challenges because povidone-iodine needs to be applied only on the day of surgery. We assessed the effectiveness and acceptability of povidone-iodine decolonization given on the day of surgery among patients having orthopedic trauma surgery. Methods: Adult patients who underwent operative fixation of traumatic lower extremity fractures were consented to receive 10% intranasal povidone-iodine solution. Povidone-iodine was applied ~1 hour before surgical incision and was reapplied the evening after surgery. Patients were tested for S. aureus nasal colonization before surgery, the evening after surgery (before povidone-iodine reapplication), and the day after surgery. Swabs were inoculated into Dey-Engley neutralizer and processed in a vortexer. A series of dilutions were performed and plated on mannitol salt agar plates. S. aureus cultures were quantitatively assessed to determine the reduction in S. aureus after povidone-iodine use. Reductions in S. aureus nasal growth were evaluated using the Skillings-Mack test. SSIs manifesting within 30 and 90 days of surgery were identified using NHSN definitions. A survey was administered the morning after surgery to determine the acceptability of intranasal povidone-iodine. Results: In total, 51 patients participated in this pilot study between February 2020 and June 2021. Nasal samples from 12 participants (23.5%) grew S. aureus . The S. aureus concentration decreased significantly across the time points ( P = .03) (Fig. 1). No SSIs were identified within 30 days of surgery. One SSI occurred within 90 days of surgery; this patient did not carry S. aureus , and cultures from the infected site were negative. Also, 31% of patients reported at least 1 mild side effect while using povidone-iodine: dripping (n = 7), itching (n = 6), dryness (n = 4), stinging (n = 4), staining (n = 3), unpleasant taste (n = 3), runny nose (n = 2), burning (n = 1), sneezing (n = 1), sore throat (n = 1), tickling (n = 1), and/or cough (n = 1). Also, 86% of patients stated that povidone-iodine felt neutral, pleasant, or very pleasant, and only 14% stated that it felt unpleasant or very unpleasant. Discussion: In this pilot study, 2 applications of nasal povidone-iodine on the day of surgery were acceptable for patients, and this protocol significantly reduced S. aureus concentration in nares of patients. Future large clinical trials should evaluate whether this 2-application regimen of povidone-iodine significantly decreases rates of SSI among orthopedic trauma surgery patients. Funding: PDI Healthcare Disclosures: None

Language matters in shaping perceptions and guiding behaviour. The term stakeholder is widely used, yet little attention is paid to the possibility that its use may inadvertently perpetuate colonial narratives and reinforce systemic inequities. In this article, we critically examine the limitations of the stakeholder concept and its ambiguity, normativity, and exclusionary implications. We emphasise the importance of using language that gives a voice to marginalised groups, promotes inclusion and equity, and fosters meaningful and reflexive participation in decision-making processes. In critiquing the use of the term and calling for alternative practices, we aim to contribute to the decolonisation of research norms and the creation of more inclusive and equitable societies. Therefore, rather than advocating a single alternative term, we suggest a focus on the people, places, and species affected by decisions, interventions, projects, and issues.

Background: Patients undergoing hemodialysis are at high risk for healthcare-associated infections; they are at 100 times the risk of Staphylococcus aureus bloodstream infections (BSI) compared with U.S. adults not on hemodialysis. Prior studies found that nasal decolonization with mupirocin prevented S. aureus BSI among hemodialysis patients. We implemented a nasal decolonization intervention in which patients self-administered povidone-iodine (PVI) at each dialysis session. We aimed to assess: 1) hemodialysis patients’ knowledge of their infection risk and their willingness to take an active role in infection prevention; 2) the acceptability of the PVI nasal decolonization intervention. Methods: We performed a stepped wedge cluster randomized trial at 16 outpatient hemodialysis centers. Patients were surveyed: before starting PVI, 1 month after their center started using PVI, and ~6 months after starting PVI. We used a chi-square test to compare results. Results: 469 patients completed at least 1 survey: 400 pre-intervention, 237 at 1 month and 201 at 6 months. Overall, 56% of patients thought that their risk of infection was average or below average compared with an average person in the U.S. (Figure). Over 98% agreed with the statement “One of the most important things I can do for my health is to take an active role in my health care.\" In the pre-intervention survey, 73% were willing to do “a lot of effort” to prevent an infection. This proportion was similar (73%) in the 2nd survey, but decreased to 63% in the final survey (p < 0 .01). Among 106 patients who reported starting PVI, 85% reported that PVI felt neutral or pleasant, 9.4% reported a side effect, and 79% reported using it during the past 3 dialysis sessions. Among 102 patients who reported using PVI at 6 months, 87% said it felt neutral/pleasant, 3.9% reported a side effect and 75% reported using it during the past 3 dialysis sessions. Side effects included nasal dripping, congestion or burning/stinging, unpleasant smell, headache, yellow tears, and minor nose bleeding. Conclusions: Hemodialysis patients are not aware of their high risk of infection. Although many were willing to expend a lot of effort to prevent an infection, this willingness decreased during an infection prevention intervention. There were few PVI side effects and most patients stated that PVI felt neutral/pleasant, yet many patients chose to not use PVI. Future research should aim to improve patient education on their risk of infection and assess barriers to adherence with infection prevention interventions. Disclosure: Marin Schweizer: Speaker- 3M; Contracted research-3M; Anitha Vijayan: Honoraria - Quanta, Baxter, Fresenius Consulting, Astute, NxStage

BackgroundOutdoor play promotes healthy development in children, fostering physical, social and cognitive growth. Play involving age-appropriate challenges is an important aspect of child development. Physical activity injuries from play are a frequent reason for paediatric emergency department (ED) presentation. Balancing injury prevention with the developmental benefits of risky play is essential for promoting child health and safety.AimThe aim of this study was to describe the circumstances of injury (risky or dangerous play), injuries sustained while playing outdoors and attendance at a large regional paediatric ED service.MethodsThe electronic medical record system was searched to identify cases of outdoor play-related injuries in children aged ≤16 years over a 2-year time frame, from 1 May 2020 to 30 April 2022. A hazard is a danger in the environment that could seriously injure or endanger the child and is beyond the child’s capacity to recognise.ResultsA total of 6470 attendances met the inclusion criteria. Outdoor play was responsible for 3.5% of the total ED presentations. The majority of injuries involved children aged between 4–7 and 8–12 years. Dangerous play was implicated in 613 (9.5%) preschool (0–3 years) children. The play equipment implicated most frequently was wheeled equipment and trampolines. Regression analysis of trampolining injuries related to age suggested that the risk of injury decreases with increasing age. 298 (0.16%) of total presentations required admission.ConclusionsOpportunity lies in the screening of trauma data from a regional service to inform future public health measures and targeting local department measures in young families to avoid situations in which dangerous play is a factor in an injury resulting from outdoor play.

Background: Understanding the determinants of children’s outdoor play is an important element for child development and broader public health outcomes. There is growing evidence that children’s opportunities for play, particularly outdoor risky play, are diminishing. Parents are concerned with keeping their child safe while affording them independence to play. This study explored parents’ attitudes to risky play and practices around children’s independent mobility in Ireland with the aim of informing public health strategies promoting healthy childhood environments. Methods: An online survey comprising validated scales and standardised questions was completed by a nationally represented sample of 376 parents of children up to 16 years. Data was analysed via descriptive statistics, chi-square tests, and regression analysis. Results: A total of 376 participants accessed the survey, of which 349 completed it. A total of 84% of participants were female. A total of 74% agreed that children need regular exposure to actual risk to develop risk management skills, and 71% trusted their children to play safely. Chi-square tests reveal significant associations between outdoor play in the rain and school travel (p < 0.01), and appropriate age to begin activities at home and in educational settings (p < 0.05). A moderate association was found between the method of school travel and children’s permission to play in the rain (Cramer’s V = 0.51). Respondents considered supervision to be a necessity to ensure their children’s safety. Overall, the results indicate that parents were risk-averse in three of the six categories of risky play, namely, play near dangerous elements, play with adult tools, and out-of-sight play. Conclusions: This study presents a descriptive analysis of findings from the Ireland State of Play Survey. Findings indicate that although parents recognise the benefits of risky play, there is some contradiction between parental attitudes and actual practices, with a lack of willingness or confidence in permitting their children to participate in all such activities.

The activation by abscisic acid (ABA) of current through outward-rectifying K+ channels and its dependence on cytoplasmic pH (pHi) was examined in stomatal guard cells of Vicia faba L. Intact guard cells were impaled with multibarrelled and H+-selective microelectrodes to record membrane potentials and pHi during exposures to ABA and the weak acid butyrate. Potassium channel currents were monitored under voltage clamp and, in some experiments, guard cells were loaded with pH buffers by iontophoresis to suppress changes in pHi. Following impalements, stable pHi values ranged between 7.53 and 7.81 (7.67 ± 0.04, n = 17). On adding 20 μM ABA, pHi rose over periods of 5—8 min to values 0.27 ± 0.03 pH units above the pHi before ABA addition, and declined slowly thereafter. Concurrent voltage-clamp measurements showed a parallel rise in the outward-rectifying K+ channel current (IK,out) and, once evoked, both pHi and IK,out responses were unaffected by ABA washout. Acid loads, imposed with external butyrate, abolished the ABA-evoked rise in IK,out. Butyrate concentrations of 10 and 30 mM (pH0 6.1) caused pHi to fall to values near 7.0 and below, both before and after adding ABA, consistent with a cytoplasmic buffer capacity of 128 ± 12 mM per pH unit (n = 10) near neutrality. Butyrate washout was characterised by an appreciable alkaline overshoot in pHi and concomitant swell in the steady-state conductance of IK,out. The rise in pHi and IK,out in ABA were also virtually eliminated when guard cells were first loaded with pH buffers to raise the cytoplasmic buffer capacity four- to sixfold; however, buffer loading was without appreciable effect on the ABA-evoked inactivation of a second, inward-rectifying class of K+ channels (IK,in). The pHi dependence of IK,out was consistent with a cooperative binding of at least 2H+ (apparent pKa = 8.3) to achieve a voltage-independent block of the channel. These results establish a causal link previously implicated between cytoplasmic alkalinisation and the activation of IK,out in ABA and, thus, affirm a role for H+ in signalling and transport control in plants distinct from its function as a substrate in H+-coupled transport. Additional evidence implicates a coordinate control of IK,in by cytoplasmic-free [Ca2+] and pHi.