Human milk and direct breastfeeding provide the optimal, biologically normative nutrition for hospitalised infants, with well-established benefits for immune, gut, cardiac, brain, and maternal health. Despite these benefits, human milk and breastfeeding rates for infants with CHD in high-resource countries are typically low, and there are no formal guidelines to drive CHD breastfeeding practice. Our aim is to (1) summarise the evidence on breastfeeding for infants with CHD, (2) discuss key barriers to and facilitators of breastfeeding in this population, (3) identify critical research and practice gaps to improve breastfeeding care in CHD, and (4) provide recommendations for clinical practice and future research.

Primary breastfeeding barriers for infants with CHD include (1) concern for dysphagia/aspiration, (2) concerns related to weight gain, (3) clinical instability/sickness, (4) developmental considerations, (5) general breastfeeding challenges, and (6) workflow and implementation issues, with racism and health disparities also contributing. The evidence to support these barriers is limited and often conflicting. Breastfeeding facilitators for preterm infants are well described, but facilitators may require modification for infants with CHD. Most lactation interventions have not been tested in CHD populations. Current evidence does not support automatic withholding of breastfeeding from infants with CHD; rather, the benefits of breastfeeding likely outweigh many potential concerns. There is a critical need for research and quality improvement to identify interventions that equitably and effectively support breastfeeding for infants with CHD and to evaluate the effect of breastfeeding on short- and long-term physical, psychological, and developmental outcomes for infants and families.

The dhole Cuon alpinus is a large canid that is categorized as Endangered on the IUCN Red List and at risk of global extinction. Information on the spatial distribution of suitable habitat is important for conservation planning but is largely unavailable. We quantified the spatial distribution of potential range as well as the relative probability of dhole occurrence across large parts of the species’ global range. We used the MaxEnt algorithm to produce a multi-scale environmental niche model based on 24 environmental variables and dhole occurrence data from 12 countries. We identified three regions where dhole conservation should be focused: western India, central India, and across the Himalayan foothills through Southeast Asia. Connectivity between suitable areas was poor, so coordinated action among these regions should be a priority. For instance, transboundary dhole conservation initiatives across the Himalayas from southern China, Myanmar, north-east India, Nepal and Bhutan need to be initiated. We also highlight the value of improving dhole population viability on unprotected land and increasing monitoring in the northern parts of its historic distribution, in particular in areas within mainland China.

UK Biobank (UKB) is a large-scale, prospective resource offering significant opportunities for mental health research. Data include genetic and biological data, healthcare linkage, and mental health enhancements. Challenges arise from incomplete linkage of some sources and the incomplete coverage for enhancements, which also occur at different times post-baseline. We searched for publications using UKB for mental health research from 2016 to 2023 to describe and inspire future use. Papers were classified by mental health topic, ‘additional’ aspects, and the data used to define the mental health topic. We identified 480 papers, with 338 focusing on mental health disorder topics (affective, anxiety, psychotic, multiple, and transdiagnostic). The most commonly studied disorder was depression (41%). The most common single method of ascertaining mental disorder status was the Mental Health Questionnaire (26%), with genetic risk, for example, using polygenic risk scores, also frequent (21%). Common additional aspects included brain imaging, gene–environment interaction, and the relationship with physical health. The review demonstrates the value of UKB to mental health research. We explore the strengths and weaknesses, producing resources informed by the review. A strength is the flexibility: conventional epidemiological studies are present, but also genomics, imaging, and other tools for understanding mental health. A major weakness is selection effects. UKB continues to hold potential, especially with additional data continuing to become available.

Sustainable diets should promote good health for both the planet and the individual. While there is a clear association between lower environmental impact diets and better health outcomes, intervention studies are needed to determine the range of dietary changes and to understand inter-individual differences in response. Individuals having different responses to dietary interventions are underpinned by a variety of genetic, phenotypic and behavioural factors. The aim of this review is to apply the findings from previous literature examining inter-individual variation and phenotypic response to the future of sustainable healthy diets. Despite changing diets or improving diet quality, physiological responses are varied in randomised controlled trials. To better understand response, individuals can be grouped based on shared baseline characteristics or by their shared response to an intervention. Studies grouping individuals by shared characteristics use a metabolic phenotyping or metabotyping approach which demonstrates that some phenotypes are more predisposed to respond to a particular intervention. Tailoring dietary advice to metabolic phenotype shows promise for improving health and diet quality. However, more evidence is needed to understand the complexity that will come with whole dietary change in the context of sustainable healthy diets. We envisage a future where metabolic phenotyping is an integral element for prescribing personalised nutrition advice for sustainable healthy diets.

Shift workers in Australia constitute approximately 16% of the workforce, with nearly half working a rotating shift pattern(1). Whilst poor dietary habits of shift workers have been extensively reported, along with increased risk of metabolic health conditions such as obesity, cardiovascular disease and diabetes compared to non-shift workers(2,3,4), studies on shift working populations rarely control for individual and lifestyle factors that might influence dietary profiles. While rotating shift work schedules have been linked with higher energy intake than daytime schedules(5), little is known about the impact of different night shift schedules (e.g., fixed night vs rotating schedules) on the diets of shift workers, including differences in 24-hour energy intake and nutrient composition. This observational study investigated the dietary habits of night shift workers with overweight/obesity and compared the impact of rotating and fixed night shift schedules on dietary profiles. The hypothesis was posited, that shift workers’ diets overall would deviate from national nutrition recommendations, and those working rotating shift schedules compared with fixed night schedules would have higher energy consumption. Participants were from the Shifting Weight using Intermittent Fasting in night shift workers (SWIFt) trial, a randomised controlled weight loss trial, and provided 7-day food diaries upon enrolment. Mean energy intakes (EI) and the percentage of EI from macronutrients, fibre, saturated fat, added sugar, alcohol, and the amount of sodium were evaluated against Australian adult recommendations. Total group and subgroup analysis of fixed night vs rotating schedules’ dietary profiles were conducted, including assessment of plausible and non-plausible energy intake reporters. Hierarchical regression analysis were conducted on nutrient intakes, controlling for individual and lifestyle factors of age, gender, BMI, physical activity, shift work exposure, occupation and work schedule. Overall, night shift workers (n = 245) had diets characterised by high fat/saturated fat/sodium content and low carbohydrate/fibre intake compared to nutrition recommendations, regardless of shift schedule type. Rotating shift workers (n = 121) had a higher mean 24-hour EI than fixed night workers (n = 122) (9329 ± 2915 kJ vs 8025 ± 2383 kJ, p < 0.001), with differences remaining when only plausible EI reporters were included (n = 130) (10968 ± 2411 kJ vs 9307 ± 2070 kJ, p < 0.001). These findings highlight poor dietary choices among this population of shift workers, and higher energy intakes of rotating shift workers, which may contribute to poor metabolic health outcomes often associated with working nightshift.

Approximately 15% of Australia’s workforce are shift workers, who are at greater risk for obesity and related conditions, such as type 2 diabetes and cardiovascular disease.(1,2,3) While current guidelines for obesity management prioritise diet-induced weight loss as a treatment option, there are limited weight-loss studies involving night shift workers and no current exploration of the factors associated with engagement in weight-loss interventions. The Shifting Weight using Intermittent Fasting in night shift workers (SWIFt) study was a randomised controlled trial that compared three, 24-week weight-loss interventions: continuous energy restriction (CER), and 500-calorie intermittent fasting (IF) for 2-days per week; either during the day (IF:2D), or the night shift (IF:2N). This current study provided a convergent, mixed methods, experimental design to: 1) explore the relationship between participant characteristics, dietary intervention group and time to drop out for the SWIFt study (quantitative); and 2) understand why some participants are more likely to drop out of the intervention (qualitative). Participant characteristics included age, gender, ethnicity, occupation, shift schedule, number of night shifts per four weeks, number of years in shift work, weight at baseline, weight change at four weeks, and quality of life at baseline. A Cox regression model was used to specify time to drop out from the intervention as the dependent variable and purposive selection was used to determine predictors for the model. Semi-structured interviews at baseline and 24-weeks were conducted and audio diaries every two weeks were collected from participants using a maximum variation sampling approach, and analysed using the five steps of framework analysis.(4) A total of 250 participants were randomised to the study between October 2019 and February 2022. Two participants were excluded from analysis due to retrospective ineligibility. Twenty-nine percent (n = 71) of participants dropped out of the study over the 24-week intervention. Greater weight at baseline, fewer years working shift work, lower weight change at four weeks, and women compared to men were associated with a significant increased rate of drop out from the study (p < 0.05). Forty-seven interviews from 33 participants were conducted and 18 participants completed audio diaries. Lack of time, fatigue and emotional eating were barriers more frequently reported by women. Participants with a higher weight at baseline more frequently reported fatigue and emotional eating barriers, and limited guidance on non-fasting days as a barrier for the IF interventions. This study provides important considerations for refining shift-worker weight-loss interventions for future implementation in order to increase engagement and mitigate the adverse health risks experienced by this essential workforce.

Community-engaged research is essential to advance the implementation of evidence-based practices, but engagement quality is rarely assessed. We evaluated community health centers’ (CHCs) experiences partnering with the Implementation Science Center for Cancer Control Equity (ISCCCE) using an online survey of 59 CHC staff. Of 38 respondents (64.4% response rate), most perceived their engagement positively, with over 92% feeling respected by ISCCCE collaborators and perceiving projects as beneficial. Limited staff time and resources were the main challenges identified. This study suggests the utility of gathering feedback to evaluate community research engagement and inform adaptations of research processes to optimize partnership quality.

Environmental impacts of food systems have stimulated research to examine how to create healthy diets that will be more sustainable while meeting nutrient requirements. Increasing compliance with existing food-based dietary guidelines in most jurisdictions could be a first step to improve health and reduce environmental impact. MyPlanetDiet was an all-Ireland 12-week randomised controlled trial designed to inform sustainable healthy dietary guidelines. Healthy adults (n 355) aged 18–64 years with moderate-to-high greenhouse gas emitting (GHGE) diets were recruited from three study sites on the island of Ireland. The aim of this research is to assess the relationship between dietary intakes, diet-related environmental impacts and metabolic health using baseline data collected during the MyPlanetDiet study. Dietary assessments collected using Foodbook24 were used to calculate diet-related GHGE, adherence to healthy eating guidelines (HEG) and healthy eating index (HEI) score. Anthropometrics and metabolic health markers (e.g. lipids, glucose and insulin) were included. Overall HEG adherence was low, with 43 % meeting zero or one HEG food group recommendations. Adherence to 4 + HEG food group targets was associated with 31 % lower diet-related GHGE compared with those with lowest adherence. Higher HEG adherence was associated with lower BMI and waist circumference and higher HEI scores. While our findings suggest HEG adherence is associated with positive health and environmental impacts, substantial behaviour change will be needed to meet existing HEG. Further research is needed to assess response and acceptability to HEG. However, adherence to HEG may be an important first step to reducing the environmental impact of food consumption.

Psychologists and psychological research have shaped sleep and circadian science for over a century. Yet, psychology has not fully embraced sleep as a core area of inquiry, and sleep medicine has not distinctly acknowledged the foundational role psychology plays in understanding sleep and circadian rhythms. This Question Paper invites submissions exploring psychology’s profound impact on the study, measurement and intervention strategies in sleep and circadian science, as well as reciprocal influences. Manuscripts may include historiographies of key contributors, laboratory milestones, theoretical advancements and methodological innovations within a historical context. We aim to capture the full scope of sleep psychology from its origins to a vision of its future.

Levofloxacin prophylaxis reduces bloodstream infections in neutropenic patients with acute myeloid leukemia or relapsed acute lymphoblastic leukemia. A retrospective, longitudinal cohort study compares incidence of bacteremia, multidrug-resistant organisms (MDRO), and Clostridioides difficile (CDI) between time periods of levofloxacin prophylaxis implementation. Benefits were sustained without increasing MDRO or CDI.

Food cravings are one of several important complexities between psychological and physiological triggers for food consumption. Cravings are commonly cited as contributing to over-consumption of hyperpalatable foods (sugary, salty, and fatty foods) and may be causal in obesity(1). The Mediterranean dietary pattern (MedDiet) is linked to reduced disease risk and improved health and wellbeing(2). Despite a lower intake of sugary and salty foods compared to a Western diet, free-living adults switching to the MedDiet find it satiating and achieve high adherence in Western countries. The MedDiet is known to improve mood and wellbeing, is high in fibre, monounsaturated fat and low in added sugar, and has a low glycaemic load, which could separately and synergistically reduce food cravings. The relationship between adherence to the MedDiet and food cravings has never been investigated. In the MedLey randomised controlled trial, we investigated the effects of a MedDiet on food cravings, compared with a habitual Australian diet (HabDiet)(3). Adherence to the MedDiet was scored out of 15 (maximum adherence). Participants completed three food cravings questionnaires at baseline and 6-months. The State questionnaire measures momentary cravings and has a maximum score of 75, indicating maximum food cravings. The Trait-reduced questionnaire measures general cravings and has a maximum score of score of 126, indicating more frequent and intense cravings for foods. The Food Cravings Inventory (FCI) measures cravings for four food domains: fatty foods, fast foods, sugary foods, and high carbohydrate (CHO) foods. MedDiet group (n = 58) responses were compared with the HabDiet group (n = 53) across visits using linear mixed effects modelling. Predicted differences were obtained for adherence scores of ≤8 (median adherence) and ≥9. Means ± SD or CIs are presented. Mean adherence increased from 7.1 ± 1.8 to 10.7 ± 1.48 in the MedDiet group (P<0.01), with no change in the HabDiet group (P = 1.00). Trait-reduced scores were not significantly different between groups at 6-months (P = 0.11), although there was a 5.57-point reduction within the MedDiet group (CI −12.56, −1.96, P = 0.04). State score was significantly lower in the MedDiet group than the HabDiet at 6-months (−4.4 (CI −7.53, −0.39), P = 0.03), and was significantly lower than at baseline (−5.9 (CI −9.33, −0.24,) P = 0.04). There were no differences between groups for the four domains of the FCI (P>0.05). Cravings for sugary foods was significantly reduced within the MedDiet group (−0.26 (CI −0.46, −0.05) P = 0.01). The predictive modelling suggested moving from an adherence score of 8 to 9 was associated with lower cravings for sugar (−0.03 ± 0.01, P = 0.03), fast food (−0.04 ± 0.02, P = 0.02) and CHO foods (−0.05 ± 0.02, P = 0.02). These results are suggestive that higher adherence to a MedDiet could reduce cravings compared to the Australian diet and suggest that the MedDiet may specifically reduce sugar cravings. Further investigation is warranted, through observational and intervention trials.

Land-use change for crop production is one of the key drivers of habitat loss and fragmentation and consequently biodiversity loss and change in tropical regions. This may impact biodiversity-regulated ecosystem services; birds are important to crop health regulating services (e.g. seed dispersal, pest control) and disservices (e.g. seed predation, grain herbivory). However, knowledge is limited on how birds use heterogeneous agricultural landscapes and the consequences for spatial distribution and flow of services and disservices. We studied crop and non-crop–habitat associations of birds in forest–agricultural landscapes of the Kilombero Valley, Tanzania. We focused on dietary preference as a key trait impacting bird responses to land-use change, services, and disservices to crops. We surveyed birds across four main habitat types using repeated point counts, recording a total of 148 species. We found that crop habitats supported higher species richness and larger communities of potentially beneficial species to crop health, whereby 34.5% of invertebrate-feeding species were recorded in cropland. We found that habitat heterogeneity within the landscape supports bird functional diversity and that each habitat type supported unique communities of species. Furthermore, the number of species unique to forest habitats increased with increasing forest canopy closure. Our findings suggest that management strategies for maintaining trees and shrubs, and enhancing tree cover within the crop production landscape, can be effective approaches for maintaining bird diversity and services. However, in-depth studies on trade-offs with disservices need further exploration to mitigate negative impacts of birds on crop yields.