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OBJECTIVES: To see if obesity, deaths from diabetes, and daily calorie intake are associated with income inequality among developed countries. DESIGN: Ecological study of 21 developed countries.Countries: Countries were eligible for inclusion if they were among the top 50 countries with the highest gross national income per capita by purchasing power parity in 2002, had a population over 3 million, and had available data on income inequality and outcome measures. MAIN OUTCOME MEASURES: Percentage of obese (body mass index >30) adult men and women, diabetes mortality rates, and calorie consumption per capita per day. RESULTS: Adjusting for gross national per capita income, income inequality was positively correlated with the percentage of obese men (r = 0.48, p = 0.03), the percentage of obese women (r = 0.62, p = 0.003), diabetes mortality rates per 1 million people (r = 0.46, p = 0.04), and average calories per capita per day (r = 0.50, p = 0.02). Correlations were stronger if analyses were weighted for population size. The effect of income inequality on female obesity was independent of average calorie intake. CONCLUSIONS: Obesity, diabetes mortality, and calorie consumption were associated with income inequality in developed countries. Increased nutritional problems may be a consequence of the psychosocial impact of living in a more hierarchical society. [ABSTRACT FROM AUTHOR]

Study objective: This study was designed to discover whether the relation between income inequality and population death rates within the United States was mediated by the degree of residential segregation between rich and poor.Design: Using data for 276 metropolitan areas in the USA, residential segregation was defined as the extent to which people with different levels of income live in the same or different census tracts. Two segregation measures were used: the ratio of income inequality between household within tracts to the inequality in average income between tracts, and the Jargowsky Neighbourhood Sorting Index.Main results: Results suggest that segregation within urban areas is associated with an additional mortality burden. However, the association between income inequality and mortality in these metropolitan statistical areas was found to be independent of the degree of economic segregation between their constituent neighbourhoods.Conclusions: Most of the association between income inequality and mortality is not mediated by the effects of greater residential segregation. [ABSTRACT FROM AUTHOR]

Aims: Having previously observed that slow growth in childhood is associated with subsequent labour market disadvantage, an attempt was made to determine whether family conflict is associated with slow growth to age 7 years, independently of material disadvantage.Methods: A total of 6574 children born between 3 and 9 March 1958 who were members of the British National Child Development Study were used in these analyses. Slow growth at age 7 years was indicated by short stature defined as the lowest fifth of the height distribution. In multivariate analysis, adjustment was made for fully attained adult height as a measure of genetically predetermined height.Results: A total of 31.1% of children who had experienced family conflict were of short stature compared with 20.2% of those who had not, representing relative odds of 1.79 (95% confidence interval (CI) 1.39 to 2.30). After adjustment for social class, crowding, sex, and predetermined height, the relative odds were slightly reduced to 1.62 (95% CI 1.18 to 2.23). A total of 44.0% of children from the most crowded households were of short stature compared with 16.4% of those from the least crowded. The unadjusted relative odds were 3.99 (95% CI 2.94 to 5.41) and after adjustment for the potential confounding variables they were 3.07 (95% CI 2.08 to 4.51). Low social class was also a risk for short stature at age 7 years, but this was not statistically significant after adjustment for the other confounding factors.Conclusions: Family conflict during childhood was independently associated with slow growth to age 7 years. [ABSTRACT FROM AUTHOR]

Crime is seldom considered as an outcome in public health research. Yet major theoretical and empirical developments in the field of criminology during the past 50 years suggest that the same social environmental factors which predict geographic variation in crime rates may also be relevant for explaining community variations in health and wellbeing. Understanding the causes of variability in crime across countries and across regions within a country will help us to solve one of the enduring puzzles in public health, viz. why some communities are healthier than others. The purpose of this paper is to present a conceptual framework for investigating the influence of the social context on community health, using crime as the indicator of collective wellbeing. We argue that two sets of societal characteristics influence the level of crime: the degree of relative deprivation in society (for instance, measured by the extent of income inequality), and the degree of cohesiveness in social relations among citizens (measured, for instance, by indicators of 'social capital' and 'collective efficacy'). We provided a test of our conceptual framework using state-level ecologic data on violent crimes and property crimes within the USA. Violent crimes (homicide, assault, robbery) were consistently associated with relative deprivation (income inequality) and indicators of low social capital. Among property crimes, burglary was also associated with deprivation and low social capital. Areas with high crime rates tend also to exhibit higher mortality rates from all causes, suggesting that crime and population health share the same social origins. Crime is thus a mirror of the quality of the social environment. [ABSTRACT FROM AUTHOR]

Background: Practice-based education is an essential component of pre-registration physiotherapy programs, and there is a need for a contemporary review of practice-based educational experiences., Purpose: The aim of this study was to explore physiotherapy practice educators' experiences of supporting learners to inform considerations for future workforce development., Methods: This was a mixed methods sequential explanatory study based in the United Kingdom (UK). Phase one of the study utilized an online survey disseminated via the Chartered Society of Physiotherapy (CSP) professional networks. Phase two consisted of three semi-structured focus group interviews with participants who expressed an interest via completion of the online survey. All were registered or associate CSP members who actively support practice-based education., Results: A total of 208 participants completed the online survey and a sub-set of 15 participated in online focus groups. Quantitative survey data were analyzed using descriptive statistics. Initial thematic analysis of qualitative data from both phases was undertaken by one researcher. Subsequent analyses were carried out independently by the remaining research team, and comparisons were made to agree on codes, categories, and themes. The practice educator is vital in developing the future workforce (30%, n  = 61, strongly agree). Identified challenges included supervising more than one learner (34%, n  = 67 not at all experienced) and using technology to provide alternative placement models (45%, n  = 87 not at all experienced)., Conclusion: Practice educators need accessible opportunities for professional development. Practice-based education should be embedded as an integral component of all staff roles. A team approach is essential to developing the future physiotherapy workforce.

The increasing cost of milk production, in association with tighter manure N application regulations and challenges associated with ammonia emissions in many countries, has increased interest in feeding lower crude protein (CP) diets based on legume silages. Most studies have focused on alfalfa silage, and little information is available on low-CP diets based on red clover silage. Our objectives were to examine the effects of dietary CP content and supplementing a low-CP diet with dietary starch or rumen-protected Met (RPMet) on the performance, metabolism, and nitrogen use efficiency (NUE; milk N output/N intake) in dairy cows fed a red clover and grass silage-based diet. A total of 56 Holstein-Friesian dairy cows were blocked and randomly allocated to 1 of 4 diets over a 14-wk feeding period. Diets were based on red clover and grass silages at a ratio of 50:50 on a dry matter (DM) basis and were fed as a total mixed ration, with a 53:47 ratio of forage to concentrate (DM basis). The diets were formulated to supply a similar metabolizable protein (MP) content, and had a CP concentration of either 175 g/kg DM (control [CON]) or 150 g/kg DM (low-protein [LP]), or LP supplemented with either additional barley as a source of starch (LPSt; +64 g/kg DM) or RPMet (LPM; +0.3 g/100 g MP). At the end of the 14-wk feeding period, 20 cows (5 per treatment) continued to be fed the same diets for a further 6 d, and total urine output and fecal samples were collected. We observed that dietary treatment did not affect DM intake, with a mean of 21.5 kg/d; however, we also observed an interaction between diet and week with intake being highest in cows fed LPSt in wk 4 and CON in wk 9 and 14. Mean milk yield, 4% fat-corrected milk, and energy-corrected milk were not altered by treatment. Similarly, we found no effect of dietary treatment on milk fat, protein, or lactose content. In contrast, milk and plasma urea concentrations were highest in cows fed CON. The concentration of blood plasma β-hydroxybutyrate was highest in cows receiving LPM and lowest in LPSt. Apparent NUE was 28.6% in cows fed CON and was higher in cows fed any of the low-protein diets (LP, LPSt, or LPM), with a mean value of 34.2%. The sum of milk fatty acids with a chain length below C16:0 was also highest in cows fed CON. We observed that dietary treatment did not affect the apparent whole-tract nutrient digestibility of organic matter, N, neutral detergent fiber, and acid detergent fiber, with mean values of 0.785, 0.659, 0.660, and 0.651 kg/kg respectively, but urinary N excretion was approximately 60 g/d lower in cows fed the low-CP diets compared with CON. We conclude that reducing the CP content of red clover and grass silage-based diets from 175 to 150 g/kg DM while maintaining MP supply did not affect performance, but reduced the urinary N excretion and improved NUE, and that supplementing additional starch or RPMet had little further effect., (The Authors. Published by Elsevier Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Reducing the dietary crude protein (CP) concentration can decrease the financial cost and lower the environmental impact of milk production. Two studies were conducted to examine the effects of reducing the dietary CP concentration on animal performance, nutrient digestibility, milk fatty acid (FA) profile, and nitrogen use efficiency (NUE; milk N/N intake) in dairy cows fed legume silage-based diets. Thirty-six multiparous Holstein-Friesian dairy cows that were 76 ± 14 (mean ± SD) days in milk and 698 ± 54 kg body weight were used in a 3 × 3 Latin square design in each of 2 studies, with 3 periods of 28 d. In study 1, cows were fed diets based on a 50:50 ratio of red clover to grass silage [dry matter (DM) basis] containing 1 of 3 dietary CP concentrations: high (H) = 175 g of CP/kg of DM; medium (M) = 165 g of CP/kg of DM; or low (L) = 150 g of CP/kg of DM. In study 2, cows were fed 175 g of CP/kg of DM with a 50:50 ratio of alfalfa to corn silage (H50) or 1 of 2 diets containing 150 g of CP/kg of DM with either a 50:50 (L50) or a 60:40 (L60) ratio of alfalfa to corn silage. Cows in both studies were fed a total mixed ration with a forage-to-concentrate ratio of 52:48 (DM basis). All diets were formulated to meet the MP requirements, except L (95% of MP requirements). In study 1, cows fed L ate 1.6 kg of DM/d less than those fed H or M, but milk yield was similar across treatments. Mean milk protein, fat, and lactose concentrations were not affected by diet. However, the apparent total-tract nutrient digestibility was decreased in cows fed L. The NUE was 5.7 percentage units higher in cows fed L than H. Feeding L also decreased milk and plasma urea concentrations by 4.4 mg/dL and 0.78 mmol/L, respectively. We found no effect of dietary treatment on the milk saturated or monounsaturated FA proportion, but the proportion of polyunsaturated FA was increased, and milk odd- and branched-chain FA decreased in cows fed L compared with H. In study 2, DM intake was 2 kg/d lower in cows receiving L50 than H50. Increasing the alfalfa content and feeding a low-CP diet (L60) did not alter DMI but decreased milk yield and milk protein concentration by 2 kg/d and 0.6 g/kg, respectively, compared with H50. Likewise, milk protein and lactose yield were decreased by 0.08 kg/d in cows receiving L60 versus H50. Diet had no effect on apparent nutrient digestibility. Feeding the low-CP diets compared with H50 increased the apparent NUE by approximately 5 percentage units and decreased milk and plasma urea concentrations by 7.2 mg/dL and 1.43 mmol/L, respectively. Dietary treatment did not alter milk FA profile except cis-9,trans-11 conjugated linoleic acid, which was higher in milk from cows receiving L60 compared with H50. We concluded that reducing CP concentration to around 150 g/kg of DM in red clover and grass or alfalfa and corn silage-based diets increases the apparent NUE and has little effect on nutrient digestibility or milk performance in dairy cows., (The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

The particle size of the forage has been proposed as a key factor to ensure a healthy rumen function and maintain dairy cow performance, but little work has been conducted on ryegrass silage (GS). To determine the effect of chop length of GS and GS:maize silage (MS) ratio on the performance, reticular pH, metabolism and eating behaviour of dairy cows, 16 multiparous Holstein-Friesian cows were used in a 4×4 Latin square design with four periods each of 28-days duration. Ryegrass was harvested and ensiled at two mean chop lengths (short and long) and included at two ratios of GS:MS (100:0 or 40:60 dry matter (DM) basis). The forages were fed in mixed rations to produce four isonitrogenous and isoenergetic diets: long chop GS, short chop GS, long chop GS and MS and short chop GS and MS. The DM intake (DMI) was 3.2 kg/day higher (P<0.001) when cows were fed the MS than the GS-based diets. The short chop length GS also resulted in a 0.9 kg/day DM higher (P<0.05) DMI compared with the long chop length. When fed the GS:MS-based diets, cows produced 2.4 kg/day more (P<0.001) milk than when fed diets containing GS only. There was an interaction (P<0.05) between chop length and forage ratio for milk yield, with a short chop length GS increasing yield in cows fed GS but not MS-based diets. An interaction for DM and organic matter digestibility was also observed (P<0.05), where a short chop length GS increased digestibility in cows when fed the GS-based diets but had little effect when fed the MS-based diet. When fed the MS-based diets, cows spent longer at reticular pH levels below pH 6.2 and pH 6.5 (P<0.01), but chop length had little effect. Cows when fed the MS-based diets had a higher (P<0.05) milk fat concentration of C18 : 2n-6 and total polyunsaturated fatty acids compared with when fed the GS only diets. In conclusion, GS chop length had little effect on reticular pH, but a longer chop length reduced DMI and milk yield but had little effect on milk fat yield. Including MS reduced reticular pH, but increased DMI and milk performance irrespective of the GS chop length.

Anaerobic digestion was investigated as a potential method for on-farm disposal of fallen stock (pig carcases), degrading the carcase material to produce biogas and digestate. The effects of feedstock (sugar beet pulp or pig carcase material or a 50:50 mix) and organic loading rate (50 g-TS L -1 or 100 g-TS L -1 ), during mesophilic (35 °C) anaerobic digestion were investigated. Anaerobic digestion was achieved for all experimental treatments, however the pig carcase material at the higher organic loading rate produced the second highest methane yield (0.56 Nm 3 kg-VS -1 versus a range of 0.14-0.58 Nm 3 kg-VS -1 for other treatments), with the highest percentage of methane in total biogas (61.6% versus a range of 36.1-55.2% for all other treatments). Satisfactory pathogen reduction is a legislative requirement for disposal of carcase material. Pathogens were quantified throughout the anaerobic digestion process. Enterococcus faecalis concentrations decreased to negligible levels (2.8 log 10 CFU g-TS -1 ), whilst Clostridium perfringens levels remained unaffected by treatment throughout the digestion process (5.3 ± 0.2 log 10 CFU g-TS -1 )., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

It is well-established that altering the proportion of starch and fibre in ruminant diets can alter ruminal and post-ruminal digestion, although quantitative evidence that this reduces enteric methane (CH4) production in dairy cattle is lacking. The objective of this study was to examine the effect of varying grass-to-maize silage ratio (70 : 30 and 30 : 70 DM basis), offered ad libitum, with either a concentrate that was high in starch or fibre, on CH4 production, intake, performance and milk composition of dairy cows. A total of 20 cows were allocated to one of the four experimental diets in a two-by-two factorial design run as a Latin square with each period lasting 28 days. Measurements were conducted during the final 7 days of each period. Cows offered the high maize silage ration had a higher dry matter intake (DMI), milk yield, milk energy output and lower CH4 emissions when expressed per kg DMI and per unit of ingested gross energy, but there was no difference in total CH4 production. Several of the milk long-chain fatty acids (FA) were affected by forage treatment with the most notable being an increase in 18:0, 18:1 c9, 18:2 c9 c12 and total mono unsaturated FA, observed in cows offered the higher inclusion of maize silage, and an increase in 18:3 c9 c12 c15 when offered the higher grass silage ration. Varying the composition of the concentrate had no effect on DMI or milk production; however, when the high-starch concentrate was fed, milk protein concentration and milk FAs, 10:0, 14:1, 15:0, 16:1, increased and 18:0 decreased. Interactions were observed for milk fat concentration, being lower in cows offered high-grass silage and high-fibre concentrates compared with the high-starch concentrate, and FA 17:0, which was the highest in milk from cows fed the high-grass silage diet supplemented with the high-starch concentrate. In conclusion, increasing the proportion of maize silage in the diets of dairy cows increased intake and performance, and reduced CH4 production, but only when expressed on a DM or energy intake basis, whereas starch-to-fibre ratio in the concentrate had little effect on performance or CH4 production.

Background and Objectives: Child well-being is important for lifelong health and well-being. Although there is a robust evidence base linking social determinants of health (eg, relative poverty and income inequality) to child well-being, social and public health policy tends to focus on interventions to mitigate their effects, rather than remove the root causes. The goal of this study was to examine associations between child well-being and income inequality., Methods: We compared reported rates of childhood well-being in the 2007 and 2013 UNICEF reports on child well-being in wealthy countries. Twenty indicators of child well-being (excluding child poverty) were defined consistently in both the 2007 and 2013 reports. These variables were used to create an indicator of change in child well-being over the approximate decade 2000 to 2010. For our analyses of income inequality, we used the Organization for Economic Cooperation and Development Gini coefficient of income inequality for 2009 and change between 2000 and 2009, respectively., Results: The overall index of child well-being in 2013 was closely and negatively correlated with income inequality (r = -0.60, P = .004) but not with average income (r = -0.3460, P = .12). Adjustment for income inequality, children in relative poverty, and the child poverty gap did not change the lack of association between average income and child well-being in 2013 in wealthy countries. Between 2000 and 2010, child well-being scores improved most in Italy, Norway, Portugal, the United Kingdom, and Germany. The biggest declines were seen in Sweden, Canada, Japan, Switzerland, and France. Countries that experienced the largest increases in income inequality had significantly greater declines in child well-being (r = -0.51, P = .02)., Conclusions: Children born into socioeconomically disadvantaged families suffer worse child well-being and its lifelong implications, in all societies, worldwide. Our analyses show, however, that some wealthy societies are able to mitigate these inequalities; these societies have better child well-being, on average. This outcome has less to do with specific welfare policies or targeted interventions for poor children than to a societal commitment to greater equality., (Copyright © 2015 by the American Academy of Pediatrics.)

There is a very large literature examining income inequality in relation to health. Early reviews came to different interpretations of the evidence, though a large majority of studies reported that health tended to be worse in more unequal societies. More recent studies, not included in those reviews, provide substantial new evidence. Our purpose in this paper is to assess whether or not wider income differences play a causal role leading to worse health. We conducted a literature review within an epidemiological causal framework and inferred the likelihood of a causal relationship between income inequality and health (including violence) by considering the evidence as a whole. The body of evidence strongly suggests that income inequality affects population health and wellbeing. The major causal criteria of temporality, biological plausibility, consistency and lack of alternative explanations are well supported. Of the small minority of studies which find no association, most can be explained by income inequality being measured at an inappropriate scale, the inclusion of mediating variables as controls, the use of subjective rather than objective measures of health, or follow up periods which are too short. The evidence that large income differences have damaging health and social consequences is strong and in most countries inequality is increasing. Narrowing the gap will improve the health and wellbeing of populations., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Analyses of neighbourhood socioeconomic characteristics and health indicators consistently show that health is worse in poorer neighbourhoods. However, some studies that examined neighbourhood effects separately for individuals of different socioeconomic position found that poor people may derive health benefits from living in poor neighbourhoods where they are socioeconomically congruous. This study investigates whether such patterns may be driven by psychosocial factors. The sample consisted of 4871 mothers in the Millennium Cohort Study aged 14-53. The outcomes analysed were neighbourhood friendship, emotional support, self-esteem and depression or anxiety. Neighbourhood status was classified by residents' educational and occupational status derived from the 2001 Census. We used multilevel logistic regression, adjusting for mothers' socio-demographic characteristics: first analysing health by neighbourhood status separately for the highest and lowest status mothers, then testing for modification in the association between neighbourhood status and health, by individual status. Results show that for highest status mothers, living in mixed or high status neighbourhoods compared to low status neighbourhoods significantly reduced the odds of having no friends in the neighbourhood by 65%. Living in high status neighbourhoods compared to low status neighbourhoods also significantly reduced the odds of depression or anxiety for highest status mothers by 41%. No associations were found for emotional support or self-esteem amongst highest status mothers. No associations were found for any outcome among lowest status mothers. In conclusion, low status mothers in England did not have better social support, self-esteem, or mental health when living in low status neighbourhoods compared to high status neighbourhoods; any benefits of socioeconomic congruity may have been counteracted by neighbourhood deprivation. Nevertheless, we found that mothers of high status do have significantly better neighbourhood friendship and mental health when living in socioeconomic congruity within neighbourhoods. Whether these associations are causal or are another reflection of material advantage remains unclear., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: The 'ethnic density hypothesis' is a proposition that members of ethnic minority groups may have better mental health when they live in areas with higher proportions of people of the same ethnicity. Investigations into this hypothesis have resulted in a complex and sometimes disparate literature., Aims: To systematically identify relevant studies, summarise their findings and discuss potential explanations of the associations found between ethnic density and mental disorders., Method: A narrative review of studies published up to January 2011, identified through a systematic search strategy. Studies included have a defined ethnic minority sample; some measure of ethnic density defined at a geographical scale smaller than a nation or a US state; and a measure ascertaining mental health or disorder., Results: A total of 34 papers from 29 data-sets were identified. Protective associations between ethnic density and diagnosis of mental disorders were most consistent in older US ecological studies of admission rates. Among more recent multilevel studies, there was some evidence of ethnic density being protective against depression and anxiety for African American people and Hispanic adults in the USA. However, Hispanic, Asian-American and Canadian 'visible minority' adolescents have higher levels of depression at higher ethnic densities. Studies in the UK showed mixed results, with evidence for protective associations most consistent for psychoses., Conclusions: The most consistent associations with ethnic density are found for psychoses. Ethnic density may also protect against other mental disorders, but presently, as most studies of ethnic density have limited statistical power, and given the heterogeneity of their study designs, our conclusions can only be tentative.

Groups of 8 lambs were allocated to one of five concentrate diets supplemented with all-rac-α-tocopheryl acetate containing 30 (C30), 60 (C60), 120 (C120), 250 (C250) and 500 (C500) mg/kg dry matter. Two other groups were fed grass silage and 400 g/day concentrate with 60 (S60) or 500 (S500) mg α-tocopheryl acetate/kg dry matter. Within diet, vitamin E level did not affect growth performance or carcass characteristics. Basal diet did not affect final live weight, conformation and fatness scores. M. semimembranosus from S lambs contained more α-tocopherol than that of C lambs on the same intake and by day 6 in MAP (75%O2/25%CO2) chroma and a* were below acceptable levels in C30 lambs. TBARS were higher in C30 and C60 muscle than in other treatments (P<0.001) after 3 and 6 days display. Muscle fatty acid composition varied with basal diet but lipid oxidation depended more on vitamin E concentration with an initial concentration of 1.9 μg/g muscle preventing significant lipid oxidation., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Animal byproducts (ABP) are unavoidable byproduct of meat production that are categorized under EU legislation into category 1, 2, and 3 materials, which are normally treated by rendering. Rendering is a thermal process that produces rendered fat and protein. Heat is provided from the combustion of natural gas and self-produced rendered fat. The main objectives of the study were (i) to assess energy intensity in the UK rendering industry, and (ii) to quantify the greenhouse gas emissions associated with the production of mammalian rendered products using life cycle assessment. Thermal energy requirements were 2646 and 1357 kJ/kg, whereas electricity requirements were 260 and 375 kJ/kg for category 1 and 3 ABP respectively. Fossil CO(2) emissions were -0.77 and 0.15 kg CO(2)e/kg category 1 and 3 mammalian rendered fat respectively and 0.15 kg CO(2)e/kg processed animal protein. These were low relative to vegetable products such as palm oil and soya bean meal because (i) ABP were considered wastes that do not incur the environmental burden of their production, and (ii) the rendering process produces biofuels that can be used to generate energy that can be used to offset the use of fossil fuels in other systems.

Trans-10,cis-12 conjugated linoleic acid (CLA) inhibits milk fat synthesis in dairy ewes, but the effects under varying dietary metabolizable protein (MP) levels when energy-limited diets are fed have not been examined. The objectives of the study were to evaluate the response of lactating dairy ewes to CLA supplementation when fed diets limited in metabolizable energy (ME) and with either a low or high MP content. Twelve multiparous ewes in early lactation were randomly allocated to 1 of 4 dietary treatments: a high MP (110% of daily MP requirement) or low MP (93% of daily MP requirement) diet unsupplemented or supplemented with a lipid-encapsulated CLA to provide 2.4 g/d of trans-10,cis-12 CLA, in each of 4 periods of 25 d each in a 4×4 Latin square design. All diets were restricted to supply each ewe with 4.6 Mcal of ME/d (equivalent to 75% of ME requirement). Supplementation with CLA decreased milk fat percentage and yield by 33% and 24%, respectively, and increased milk, milk protein, and lactose yields by 16, 13, and 17%, respectively. Feeding the high MP diet increased the yields of milk, fat, protein, and lactose by 18, 15, 19, and 16%, respectively. Milk fat content of trans-10,cis-12 CLA (g/100g) was 0.09 and <0.01 for the CLA-supplemented and unsupplemented ewes, respectively. Ewes supplemented with CLA had a reduced yield (mmol/d) of fatty acids of C16, although the effect was greatest for C16. Plasma urea concentrations were lowest in ewes supplemented with CLA compared with those unsupplemented (6.5 vs. 7.4 mmol/L, respectively) and receiving low compared with high MP diets (5.6 vs. 8.3 mmol/L, respectively). In conclusion, dairy ewes fed energy-limited diets and supplemented with CLA repartitioned nutrients to increase yields of milk, protein, and lactose, with the response to CLA supplementation and additional MP intake being additive., (Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)

Two experiments were conducted to investigate the effect of inclusion of whole-crop pea (WCP) silages, differing in condensed tannin content, as a substitute for grass silage (GS) and soybean meal on lamb metabolism, performance, plasma metabolites, digestibility, and carcass characteristics. In both experiments lambs were offered either solely GS or a 50:50 mix on a DM basis of GS with either low-tannin (LTPS) or high-tannin (HTPS) pea silage ad libitum. Each forage mix was fed with either 400 g/d of low-protein (LP) concentrate or 400 g/d of LP with an additional 200 g/d of pelletized soybean meal (HP), resulting in 6 dietary treatments. Experiment 1 examined the effects of the diets on metabolism, digestibility, and N balance using 6 lambs in 4 periods of 21 d in an incomplete crossover design. Experiment 2 used 48 lambs and examined the effects of the diets on ADG, plasma metabolites, and carcass characteristics over 56 d. Both experiments were analyzed using a 3 × 2 factorial arrangement of treatments. In Exp. 1, lambs offered the LTPS diets had a greater (P < 0.05) digestibility of DM and OM than those offered the GS diets. Lambs offered the WCP silages had an increased (P < 0.05) N intake, N output, and digestibility of GE compared with those offered GS. Mean N digestibility was greatest (P < 0.05) in lambs offered LTPS. Lambs offered HP diets had increased (P < 0.001) digestibility of DM, OM, GE and N, and N- intake, output, retention, and digestibility compared with those offered the LP diets. In Exp. 2, there was no effect (P > 0.05) of forage type on intake, slaughter BW, or feed conversion efficiency (FCE). However, lambs offered the LTPS had a greater (P < 0.05) ADG than those offered the GS diets. Feeding diets containing HP increased (P < 0.001) total DMI, slaughter BW, ADG, and FCE. Lambs offered the WCP had a greater (P < 0.05) plasma β-hydroxybutyrate and urea concentration compared with those offered the GS diets. Feeding lambs HP diets increased (P < 0.05) plasma urea and total protein. Forage mix had no effect (P > 0.05) on carcass composition except for fat depth, which was greater (P < 0.05) in lambs offered WCP silage. Diets containing the HP increased (P < 0.05) carcass weight, hind leg circumference, chop dimensions, and kidney weight. It was concluded that lambs offered LTPS performed better than those offered GS and that LTPS has a concentrate sparing effect. Additionally, the increased tannin concentration in HTPS did not increase performance over lambs offered either GS or LTPS.

Conjugated linoleic acids (CLA) have been demonstrated to be a potent inhibitor of milk fat synthesis in ruminants, but effects on carcass composition and organ weight are unknown. Our objectives in this experiment were to determine the dose response of ruminally protected CLA on the performance, organ weight, and fatty acid (FA) composition of early lactation dairy ewes. Twenty-four multiparous dairy ewes were fed a basal diet for 10 wk that was supplemented with a lipid-encapsulated CLA at 1 of 3 levels: no CLA (control, CON), low CLA (L-CLA), or high CLA (H-CLA) to supply 0, 1.5, or 3.8 g/d, respectively, of both trans-10, cis-12 and cis-9, trans-11 CLA. Dry matter intake was not affected (P > 0.05) by dietary treatment. Ewes fed H-CLA had a 13% higher milk yield compared with those receiving either CON or L-CLA. Compared with CON, milk fat yield (g/d) was 14 and 24% lower in ewes fed L-CLA or H-CLA, respectively. Supplementing ewes with CLA did not affect carcass or organ weights, carcass composition, or organ FA content. Compared with ewes receiving the CON diet, CLA supplementation had little effect on the FA composition of the Longissimus dorsi, although cis-9, trans-11 and trans-10, cis-12 CLA were increased in ewes receiving H-CLA. The current findings are consistent with the view that the energy spared by the CLA reduction in milk fat content was mainly partitioned to milk yield and there was no evidence of organ hypertrophy or liver steatosis.

Objectives: We investigated whether mothers from ethnic minority groups have better pregnancy outcomes when they live in counties with higher densities of people from the same ethnic group-despite such areas tending to be more socioeconomically deprived., Methods: In a population-based US study, we used multilevel logistic regression analysis to test whether same-ethnic density was associated with maternal smoking in pregnancy, low birthweight, preterm delivery, and infant mortality among 581 151 Black and 763 201 Hispanic mothers and their infants, with adjustment for maternal and area-level characteristics., Results: Higher levels of same-ethnic density were associated with reduced odds of infant mortality among Hispanic mothers, and reduced odds of smoking during pregnancy for US-born Hispanic and Black mothers. For Black mothers, moderate levels of same-ethnic density were associated with increased risk of low birthweight and preterm delivery; high levels of same ethnic density had no additional effect., Conclusions: Our results suggest that for Hispanic mothers, in contrast to Black mothers, the advantages of shared culture, social networks, and social capital protect maternal and infant health.

Studies have suggested that members of ethnic minority groups might be healthier when they live in areas with a high concentration of people from their own ethnic group - in spite of higher levels of material deprivation typically found within such areas. We investigated the effects of area-level same-ethnic density on maternal and infant health, independent of area deprivation and individual socioeconomic status, in five ethnic minority groups. The study was a cross-sectional analysis within the UK Millennium Cohort Study and included mothers in five ethnic minority groups (Black African n=367, Bangladeshi n=369, Black Caribbean n=252, Indian n=462 and Pakistani n=868) and their 9-month-old infants. Outcome measures included: low birth weight, preterm delivery, maternal depression, self-rated health and limiting long-standing illness. Compared to those who live in areas with less than 5% of people from the same-ethnic minority population, Indian and Pakistani mothers were significantly less likely to report ever being depressed in areas with high same-ethnic density. There was a protective effect of ethnic density for limiting long-term illness among Bangladeshi mothers at 5-30% density and Pakistani mothers at all higher densities. Ethnic density was unrelated to infant outcomes and maternal self-rated health, and unrelated to any outcomes in Black African and Black Caribbean mothers and infants, possibly because no families in these groups lived at higher levels of same-ethnic density. Results were similar whether we examined smaller or larger residential areas. We conclude that, among ethnic minority mothers and infants in England, the relationship of ethnic density to health varies by ethnicity and outcome. For some measures of maternal health, in some ethnic groups, the psychosocial advantages of shared culture, social networks and social capital may override the adverse effects of material deprivation.

Background: Although pregnancy is a time when women have increased motivation to quit smoking, approximately half of female smokers persist in smoking throughout their pregnancies. Persistent pregnancy smokers are known to be more nicotine dependent and to have greater sociodemographic disadvantage. Less is known about the psychosocial context of persistent pregnancy smokers and factors that distinguish them from pregnancy quitters., Methods: A cross-sectional study was conducted within the UK Millennium Cohort Study. Participants were 18 225 women, including 13.3% quitters, 12% light smokers and 8% heavy smokers. Data were collected when the infants were 9 months old. Maternal psychosocial problems were assessed in three domains: interpersonal, adaptive functioning and health-related behaviours., Results: In general, psychosocial problems in all domains increased across the pregnancy smoking continuum (non-smoker, quitter, light smoker, heavy smoker). All three psychosocial domains added incremental utility to prediction of pregnancy smoking status, after adjustment for sociodemographic risk., Conclusion: Problems in multiple psychosocial domains systematically distinguish women along a pregnancy smoking gradient, with heavy smokers having the most problematic psychosocial context. This subgroup of pregnant smokers is unlikely to be able to benefit from usual-care antenatal cessation interventions, which rely on women's capacity for self-initiation, self-control and social resources. Consideration should be given to tiered interventions that provide more intensive and targeted interventions to pregnant women unable to quit with usual care.

In order to determine the effect of dietary vitamin E level and basal diet on vitamin E status, performance and tissue fatty acid content, five groups of eight Suffolk × Charollais wether lambs with an initial live weight of 28.4 (s.d. 1.6) kg were allocated to one of five concentrate-based diets supplemented with all-rac-α-tocopheryl acetate to contain 30 mg (C-30), 60 mg (C-60), 120 mg (C-120), 250 mg (C-250) or 500 mg (C-500) α-tocopheryl acetate/kg dry matter (DM), for 63 days. Two additional groups of eight lambs entered the study at 31.2 (s.d. 3.3) kg and were fed grass silage and 400 g/day concentrate for 56 days, with the whole diet providing the equivalent of 60 mg (S-60) or 500 mg (S-500) α-tocopheryl acetate/kg DM. Lambs were weighed and blood samples obtained by venipuncture weekly. Dietary vitamin E level did not affect performance (P > 0.05), but lambs fed grass silage grew more slowly (P < 0.001) and had a higher (P < 0.001) feed conversion ratio (kg feed/kg gain) than those fed concentrates. At day 0 plasma α-tocopherol concentrations were 0.8 μg/ml and did not differ between treatments (P > 0.05). Plasma α-tocopherol concentrations then decreased in all lambs except for those fed S-500, which increased, and at slaughter were (μg/ml) 0.07, 0.23, 0.39, 0.76 and 1.57 in C-30, C-60, C-120, C-250 and C-500 and 1.18 and 1.93 in S-60 and S-500, respectively. At slaughter, muscle and liver α-tocopherol concentrations were in the deficiency range for lambs fed C-30, C-60 or C-120, whereas plasma creatine kinase and tissue polyunsaturated fatty acids were unaffected by dietary vitamin E level, but creatine kinase levels were higher (P < 0.05) and glutathione peroxidise levels lower (P < 0.001) in lambs fed grass silage than concentrates alone. Muscle and liver α-tocopherol concentrations were 1.8- and 4.1-fold higher in lambs fed S-60 than C-60, but there was less of a difference between lambs fed S-500 or C-500 with muscle and liver differences of 0.4- and 0.7-fold, respectively. Tissue n-3 polyunsaturated fatty acid concentrations were higher (P < 0.05) and n-6 fatty acids lower in lambs receiving the grass silage compared to concentrate-based diets, but were not affected by dietary vitamin E level. It is concluded that lower plasma and tissue levels of α-tocopherol are present in lambs supplemented with all-rac-α-tocopheryl acetate on a concentrate compared to a mixed diet of silage and concentrates, and that normal growth can be achieved at tissue levels previously considered to represent deficiency.

Studies examining the effects of neighbourhood characteristics have reported what has been called a 'group density' effect on health, such that members of low status minority communities living in an area with a higher proportion of their own racial or ethnic group tend to have better health than those who live in areas with a lower proportion. In this paper we survey published research on ethnic group density and health with the aim of stimulating further research. We situate the research question in the context of contemporary social epidemiology and provide a narrative review of studies of ethnic density and health. We go on to discuss processes which may underlie ethnic density effects, and highlight gaps in the literature and opportunities for further research. Although first recognised in studies of mental illness, 'group density' effects on physical health have been shown more recently. Generally, given individual material circumstances, living in a poorer area is associated with worse health. Members of ethnic minorities who live in areas where there are few like themselves are likely to be materially better off, and living in better neighbourhoods, than those who live in areas with a higher concentration. However, through the eyes of the majority community, they may be made more aware of belonging to a low status minority group, and the psychosocial effects of stigma may offset any advantage. If the psychological effects of stigma are sometimes powerful enough to override material advantage, this may have implications for our understanding of how low social status affects health more generally. As well as highlighting the importance of low social status, cultural isolation and social support to health and quality of life, this paper shows how an understanding of group density effects also has something to offer to our understanding of issues of prejudice, segregation, assimilation and integration in diverse societies.

Aim: To examine the association of social ties and income with self reported health, in order to investigate if social ties have a greater impact on the health of people on low incomes compared to those financially better off., Methods: A nationally representative cross-sectional study of 5205 French adults using data from questionnaires which asked about health, income and relationships with family and friends etc., Results: Less than good self-rated health (SRH) is twice as frequently reported by people in the lowest income group than those in the highest income group. People with low incomes are also more likely to have felt alone on the previous day, received no phone call during the last week, have no friends, not be a member of a club, and to live alone. Socially isolated people report lower SRH. Likelihood ratio tests for interaction vs. main effect models were statistically significant for 2 of the measures of social ties, borderline for 2 others and non-significant for one. For 4 of the 5 indicators of social ties, larger odd ratios show that social isolation is more strongly associated with less than good SRH among people on low incomes compared to those with a higher income., Conclusion: Social isolation is associated with 'less than good' self-rated health. This effect appears to be more important for people on a low income.

Objectives: We investigated whether the processes underlying the association between income inequality and population health are related to those responsible for the socioeconomic gradient in health and whether health disparities are smaller when income differences are narrower., Methods: We used multilevel models in a regression analysis of 10 age- and cause-specific US county mortality rates on county median household incomes and on state income inequality. We assessed whether mortality rates more closely related to county income were also more closely related to state income inequality. We also compared mortality gradients in more- and less-equal states., Results: Mortality rates more strongly associated with county income were more strongly associated with state income inequality: across all mortality rates, r= -0.81; P=.004. The effect of state income inequality on the socioeconomic gradient in health varied by cause of death, but greater equality usually benefited both wealthier and poorer counties., Conclusions: Although mortality rates with steep socioeconomic gradients were more sensitive to income distribution than were rates with flatter gradients, narrower income differences benefit people in both wealthy and poor areas and may, paradoxically, do little to reduce health disparities.

This study investigated the influence of five sources of dietary oil (linseed oil (LO), fish oil (FO), a protected lipid supplement (PLS, 18:2 to 18:3 ratio 3:1), fish oil/marine algae (FOMA) and PLSMA) on the colour and lipid stability of lamb muscle and the flavour of grilled loin chops. LO produced the highest proportion of 18:3n-3 in muscle phospholipid, the highest ratings for lamb flavour intensity and overall liking and the lowest ratings for abnormal flavour intensity. PLS increased the proportion of 18:2n-6 which reduced lamb flavour intensity and increased abnormal lamb flavour intensity. Diets containing FO or MA increased proportions of the longer chain n-3 fatty acids and similar reduced ratings for lamb flavour as the PLS diet. FO-containing diets increased fishy flavour notes, especially when in combination with MA. 'Putty' and 'fish oil' odours were recognised as being present more frequently in cooked subcutaneous lamb fat from lambs fed FO and FOMA than other diets. Lambs fed MA, FO and the combination of the two produced meat that was oxidatively less stable and had a reduced colour and lipid oxidative shelf-life, which was at least partially due to the lower vitamin E content of the muscle. These results have significant implications for the formulation of diets that may improve nutritional ratios in lamb meat but which adversely affect flavour and meat stability.

Objectives: To examine associations between child wellbeing and material living standards (average income), the scale of differentiation in social status (income inequality), and social exclusion (children in relative poverty) in rich developed societies., Design: Ecological, cross sectional studies., Setting: Cross national comparisons of 23 rich countries; cross state comparisons within the United States., Population: Children and young people., Main Outcome Measures: The Unicef index of child wellbeing and its components for rich countries; eight comparable measures for the US states and District of Columbia (teenage births, juvenile homicides, infant mortality, low birth weight, educational performance, dropping out of high school, overweight, mental health problems)., Results: The overall index of child wellbeing was negatively correlated with income inequality (r=-0.64, P=0.001) and percentage of children in relative poverty (r=-0.67, P=0.001) but not with average income (r=0.15, P=0.50). Many more indicators of child wellbeing were associated with income inequality or children in relative poverty, or both, than with average incomes. Among the US states and District of Columbia all indicators were significantly worse in more unequal states. Only teenage birth rates and the proportion of children dropping out of high school were lower in richer states., Conclusions: Improvements in child wellbeing in rich societies may depend more on reductions in inequality than on further economic growth.

In this paper, we present evidence which suggests that key processes of social status differentiation, affecting health and numerous other social outcomes, take place at the societal level. Understanding them seems likely to involve analyses and comparisons of whole societies. Using income inequality as an indicator and determinant of the scale of socioeconomic stratification in a society, we show that many problems associated with relative deprivation are more prevalent in more unequal societies. We summarise previously published evidence suggesting that this may be true of morbidity and mortality, obesity, teenage birth rates, mental illness, homicide, low trust, low social capital, hostility, and racism. To these we add new analyses which suggest that this is also true of poor educational performance among school children, the proportion of the population imprisoned, drug overdose mortality and low social mobility. That ill health and a wide range of other social problems associated with social status within societies are also more common in more unequal societies, may imply that income inequality is central to the creation of the apparently deep-seated social problems associated with poverty, relative deprivation or low social status. We suggest that the degree of material inequality in a society may not only be central to the social forces involved in national patterns of social stratification, but also that many of the problems related to low social status may be amenable to changes in income distribution. If the prevalence of these problems varies so much from society to society according to differences in income distribution, it suggests that the familiar social gradients in health and other outcomes are unlikely to result from social mobility sorting people merely by prior characteristics. Instead, the picture suggests that their frequency in a population is affected by the scale of social stratification that differs substantially from one society to another.

Supplementation of pregnant ewes with long-chain n-3 polyunsaturated fatty acids (PUFA) demonstrably improves indicators of neonatal lamb vigour, potentially improving the number of lambs reared per ewe. The present study investigated the effect of supplementing ewes with fish oil and vitamin E (α-tocopherol acetate) throughout both pregnancy and lactation on the performance of lactating ewes and sucking lambs. Forty-eight ewes were supplemented with one of four concentrates containing either Megalac or fish oil plus a basal (50 mg/kg) or supranutritional (500 mg/kg) concentration of vitamin E from 6 weeks pre-partum until 4 weeks post partum in a two-by-two factorial randomised-block design. All concentrates were formulated to contain approximately 60 g/kg supplemental fatty acids. Ewes were housed, penned on sawdust and offered straw ad libitum. Blood samples were taken from ewes and lambs at intervals throughout the experiment and milk samples were obtained at 21 days into lactation. There was no notable effect of dietary vitamin E concentration upon ewe or lamb performance. Ewe dry-matter (DM) intake and yield were unaffected by dietary treatment, although ewes fed fish oil lost less weight during lactation (-1.88 kg compared with -3.97 kg for Megalac-supplemented ewes; P < 0.01). Milk fat concentrations (67.3 g/kg compared with 91.8 g/kg; P < 0.01) and yields (6.65 g/h v. 9.26 g/h; P < 0.01) were reduced in ewes fed fish oil and these decreases were associated with lower litter-growth rates (0.49 g/day compared with 0.54 g/day; P < 0.05). Milk protein yield was increased by fish oil supplementation (3.82 g/h) compared with Megalac supplementation (3.28 g/h; P < 0.05); moreover, there was an interaction between fat source and vitamin E concentration in that both protein concentration and yield were significantly lower in milk from ewes fed treatment with Megalac + basal vitamin E (MB) compared with the other three treatments. Fish oil supplementation increased the concentrations of C18:1 trans-, cis-9, trans-11 conjugated linoleic acid (CLA), C20:5 (n-3) and C22:6 (n-3) within ewe plasma, milk and lamb plasma. The mechanisms by which fish oil supplementation affects milk composition warrants further investigation.

Background: Prior studies on social capital and health have assessed social capital in residential neighbourhoods and communities, but the question whether the concept should also be applicable in workplaces has been raised. The present study reports on the psychometric properties of an 8-item measure of social capital at work., Methods: Data were derived from the Finnish Public Sector Study (N = 48,592) collected in 2000-2002. Based on face validity, an expert unfamiliar with the data selected 8 questionnaire items from the available items for a scale of social capital. Reliability analysis included tests of internal consistency, item-total correlations, and within-unit (interrater) agreement by rwg index. The associations with theoretically related and unrelated constructs were examined to assess convergent and divergent validity (construct validity). Criterion-related validity was explored with respect to self-rated health using multilevel logistic regression models. The effects of individual level and work unit level social capital were modelled on self-rated health., Results: The internal consistency of the scale was good (Cronbach's alpha = 0.88). The rwg index was 0.88, which indicates a significant within-unit agreement. The scale was associated with, but not redundant to, conceptually close constructs such as procedural justice, job control, and effort-reward imbalance. Its associations with conceptually more distant concepts, such as trait anxiety and magnitude of change in work, were weaker. In multilevel models, significantly elevated age adjusted odds ratios (ORs) of poor self-rated health (OR = 2.42, 95% confidence interval (CI): 2.24-2.61 for the women and OR = 2.99, 95% CI: 2.56-3.50 for the men) were observed for the employees in the lowest vs. highest quartile of individual level social capital. In addition, low social capital at the work unit level was associated with a higher likelihood of poor self-rated health., Conclusion: Psychometric techniques show our 8-item measure of social capital to be a valid tool reflecting the construct and displaying the postulated links with other variables.

Whether or not the scale of a society's income inequality is a determinant of population health is still regarded as a controversial issue. We decided to review the evidence and see if we could find a consistent interpretation of both the positive and negative findings. We identified 168 analyses in 155 papers reporting research findings on the association between income distribution and population health, and classified them according to how far their findings supported the hypothesis that greater income differences are associated with lower standards of population health. Analyses in which all adjusted associations between greater income equality and higher standards of population health were statistically significant and positive were classified as "wholly supportive"; if none were significant and positive they were classified as "unsupportive"; and if some but not all were significant and supportive they were classified as "partially supportive". Of those classified as either wholly supportive or unsupportive, a large majority (70 per cent) suggest that health is less good in societies where income differences are bigger. There were substantial differences in the proportion of supportive findings according to whether inequality was measured in large or small areas. We suggest that the studies of income inequality are more supportive in large areas because in that context income inequality serves as a measure of the scale of social stratification, or how hierarchical a society is. We suggest three explanations for the unsupportive findings reported by a minority of studies. First, many studies measured inequality in areas too small to reflect the scale of social class differences in a society; second, a number of studies controlled for factors which, rather than being genuine confounders, are likely either to mediate between class and health or to be other reflections of the scale of social stratification; and third, the international relationship was temporarily lost (in all but the youngest age groups) during the decade from the mid-1980s when income differences were widening particularly rapidly in a number of countries. We finish by discussing possible objections to our interpretation of the findings.

The objectives of the study were to determine whether supplementation of pregnant ewes with long-chain (n-3) fatty acids present in fish oil, in combination with dietary vitamin E, would alter neonatal behavior in sheep. Twin- (n=36) and triplet- (n=12) bearing ewes were allocated at d 103 of gestation to 1 of 4 dietary treatments containing 1 of 2 fat sources [Megalac, a calcium soap of palm fatty acid distillate or a fish oil mixture, high in 20:5(n-3) and 22:6(n-3)] and 1 of 2 dietary vitamin E concentrations (50 or 500 mg/kg) in a 2 x 2 factorial design. Feeding fish oil increased gestation length by 2 d and increased the proportion of 22:6(n-3) within neonatal plasma by 5.1-fold and brain by 10%, whereas brain 20:5(n-3) was increased 5-fold. Supranutritional dietary vitamin E concentrations decreased the latency of lambs to stand in ewes fed fish oil but not Megalac, whereas latency to suckle was decreased from 43 to 34 min by fish oil supplementation. Supplementation with fish oil also substantially decreased the secretion rate (mL/h) of colostrum and the yield (g/h) of fat and protein. We conclude that supplementation of ewes with fish oil decreases the latency to suckle, increases gestation length and the 22:6(n-3):20:4(n-6) ratio in the neonatal brain, and may improve lamb survival rate. However, further work is required to determine how to mitigate the negative effects of fish oil on colostrum production.