Lessons from bright-spots for advancing knowledge exchange at the interface of marine science and policy

Evidence-informed decision-making is in increasing demand given growing pressures on marine environments. A way to facilitate this is by knowledge exchange among marine scientists and decision-makers. While many barriers are reported in the literature, there are also examples whereby research has successfully informed marine decision-making (i.e., 'bright-spots'). Here, we identify and analyze 25 bright-spots from a wide range of marine fields, contexts, and locations to provide insights into how to improve knowledge exchange at the interface of marine science and policy. Through qualitative surveys we investigate what initiated the bright-spots, their goals, and approaches to knowledge exchange. We also seek to identify what outcomes/impacts have been achieved, the enablers of success, and what lessons can be learnt to guide future knowledge exchange efforts. Results show that a diversity of approaches were used for knowledge exchange, from consultative engagement to genuine knowledge co-production. We show that diverse successes at the interface of marine science and policy are achievable and include impacts on policy, people, and governance. Such successes were enabled by factors related to the actors, processes, support, context, and timing. For example, the importance of involving diverse actors and managing positive relationships is a key lesson for success. However, enabling routine success will require: 1) transforming the ways in which we train scientists to include a greater focus on interpersonal skills, 2) institutionalizing and supporting knowledge exchange activities in organizational agendas, 3) conceptualizing and implementing broader research impact metrics, and 4) transforming funding mechanisms to focus on need-based interventions, impact planning, and an acknowledgement of the required time and effort that underpin knowledge exchange activities.

Ultraviolet exposure to the face in patients with xeroderma pigmentosum and healthy controls: applying a novel methodology to define photoprotection behaviour

BACKGROUND

In Xeroderma Pigmentosum (XP), the main means of preventing skin and eye cancers is extreme protection against ultraviolet radiation (UVR). Protection is most important for the face.

OBJECTIVES

We aimed to assess how well patients with XP adhere to medical advice to protect against UVR by objectively estimating the mean daily dose of UVR to the face.

METHODS

We objectively estimated the UVR dose to the face in 36 XP patients and 25 healthy individuals over 3 weeks in the summer. We used a new methodology which combined UVR dose measurements from a wrist-worn dosimeter with an activity diary record of face photoprotection behaviour for each 15 minute period spent outside. A protection factor was associated with each behaviour, and the data analysed using a negative binomial mixed-effects model.

RESULTS

The mean daily UVR dose (weighted for DNA damage capacity) to the face in the XP patients was 0.13 Standard Erythemal Doses (SED) (mean in healthy individuals = 0.51 SED). There was wide variation between patients (range <0.01 - 0.48 SED/day). Self-caring adult patients had a very similar UV dose to the face to cared-for patients (0.13 vs 0.12 SED/day) despite photoprotecting much more poorly when outside, because the self-caring adults were outside in daylight much less.

CONCLUSIONS

Photoprotection behaviour varies widely within the XP group indicating that non-adherence to photoprotection advice is a significant issue. Timing and duration of going outside are as important as photoprotective measures taken when outside, to determine the UVR exposure to the face. This new methodology will be of value in identifying the sources of UVR exposure in other conditions where facial UV exposure is a key outcome, particularly in patients with multiple non-melanoma skin cancers.

Prevalence and predictors of weight loss maintenance: a retrospective population-based survey of European adults with overweight and obesity

BACKGROUND

The prevalence of weight loss attempts has increased worldwide, although the extent to which sustained weight loss is achieved is unknown. There is insufficient research into weight loss maintenance (WLM) in individuals with overweight or obesity who have recently lost clinically significant amounts of weight (≥5%), particularly in the European general population. The present study aimed to determine the prevalence and retrospective predictors of WLM in population-based samples of European adults with overweight or obesity who had made a recently completed weight loss attempt.

METHODS

Participants (N = 2000) in UK, Denmark and Portugal completed an online survey about loss and regain in their most recent completed weight loss attempt, features of their attempt (duration, self-weighing, lapses, strategies), as well as loss of control and binge eating. Multiple regression analysis was used to determine factors retrospectively associated with WLM in those who achieved clinically significant weight loss (n = 1272).

RESULTS

Mean (SD) self-reported weight loss was 9% (8%) and mean (SD) regain was 96.3% (9%) of participants' start weight. Twenty-three percent of the total sample had maintained weight loss of ≥5% for at least 1 month. Controlling for weight loss and time since attempt, predictors of better WLM were avoidance of a temporary lapse, infrequent/absent loss of control and binge eating, and use of a greater number of dietary strategies for WLM (r²  = 0.338, P < 0.001).

PRINCIPAL CONCLUSIONS

Factors associated with recent successful WLM indicate the importance of the continued use of dietary and other strategies for WLM, particularly in the face of a lapse, as well as the need to manage dysfunctional eating behaviours.

Food knowledge and psychological state predict adherence to a gluten-free diet in a survey of 5310 Australians and New Zealanders with coeliac disease

BACKGROUND

A gluten-free diet treats coeliac disease, but its efficacy depends on strict adherence. A variety of patient factors may influence adherence but have not been well described at a population level.

AIM

To comprehensively assess the patient factors that influence gluten-free diet adherence in patients with coeliac disease.

METHODS

Patients with coeliac disease completed an online survey comprising the validated Celiac Dietary Adherence Test in addition to data on demographics, details of diagnosis and management and assessment of diet knowledge, quality of life and psychological distress. Survey data were analysed for predictors of adherence and quality of life.

RESULTS

Of 7393 responses, 5310 completed the Celiac Dietary Adherence Test and 3230 (61%) were adherent to a gluten-free diet. Multivariate regression showed older age, being male, symptoms after gluten ingestion, better food knowledge and lower risk of psychological distress were independent predictors of adherence (each P ≤ 0.008). Additionally, dietary adherence was associated with better quality of life (P < 0.001; multiple regression). Respondents who considered themselves to have poor food knowledge were more likely to incorrectly identify gluten-free foods, but could still recognise gluten-containing foods, suggesting that poor knowledge may lead to over-restriction of diet.

CONCLUSIONS

Poor knowledge of a gluten-free diet and psychological wellbeing were independent modifiable risk factors for inadequate adherence to a gluten-free diet in patients with coeliac disease. Involvement of both a dietitian and mental health care professional, in the presence of psychological distress, is likely to be necessary to improve adherence and health outcomes.

Eco-label conveys reliable information on fish stock health to seafood consumers

Concerns over fishing impacts on marine populations and ecosystems have intensified the need to improve ocean management. One increasingly popular market-based instrument for ecological stewardship is the use of certification and eco-labeling programs to highlight sustainable fisheries with low environmental impacts. The Marine Stewardship Council (MSC) is the most prominent of these programs. Despite widespread discussions about the rigor of the MSC standards, no comprehensive analysis of the performance of MSC-certified fish stocks has yet been conducted. We compared status and abundance trends of 45 certified stocks with those of 179 uncertified stocks, finding that 74% of certified fisheries were above biomass levels that would produce maximum sustainable yield, compared with only 44% of uncertified fisheries. On average, the biomass of certified stocks increased by 46% over the past 10 years, whereas uncertified fisheries increased by just 9%. As part of the MSC process, fisheries initially go through a confidential pre-assessment process. When certified fisheries are compared with those that decline to pursue full certification after pre-assessment, certified stocks had much lower mean exploitation rates (67% of the rate producing maximum sustainable yield vs. 92% for those declining to pursue certification), allowing for more sustainable harvesting and in many cases biomass rebuilding. From a consumer’s point of view this means that MSC-certified seafood is 3–5 times less likely to be subject to harmful fishing than uncertified seafood. Thus, MSC-certification accurately identifies healthy fish stocks and conveys reliable information on stock status to seafood consumers.

A sham-controlled trial of left and right temporal rTMS for the treatment of auditory hallucinations

BACKGROUND

Several studies have reported reduction of auditory hallucinations (AH) after repetitive transcranial magnetic stimulation (rTMS) to the left temporal cortex. This study explored the effects of rTMS to the left and right temporal cortex.

METHOD

Eighteen subjects with schizophrenia and frequent AH were enrolled in a double-blind, cross-over trial of 3 days of active rTMS to the left or right temporal cortex, or sham rTMS to the vertex (control condition), followed by an open treatment phase. The effects on AH were assessed by a blinded rater, using the Auditory Hallucination Rating Scale (AHRS).

RESULTS

During the double-blind phase, active temporal rTMS did not result in significantly greater improvement in hallucination scores than sham rTMS to the vertex, apart from a reduction in distress scores. Hallucination scores improved during the open continued treatment phase.

CONCLUSIONS

This study did not demonstrate an advantage for left temporal rTMS compared to right temporal and sham stimulation, over a 3-day stimulation period, but found modest improvement in hallucinations during continued open label treatment.