Exercise dependence, disordered eating behaviors, and general nutrition knowledge in female group fitness instructors employed at college and university recreation centers

Advisors: Josephine Umoren.Disordered eating behaviors (DEBs) may play a role in the development of eating disorders (EDs) in the general population. However, this has not been studied among female group fitness instructors. Several factors, such as exercise dependence and nutrition knowledge, may factor into the occurrence of DEBs. This cross-sectional study examined relationships between DEBs, exercise dependence, and nutrition knowledge. An internet-based survey was distributed to female group fitness instructors at Midwest colleges and universities in the Big Ten Conference. Fifty-six participants (mean age 25.48 +/-7.72 years) were included in the study. Pearson's correlations, linear regression, and MANOVA were conducted. The results indicated the majority (77.2%) of participants were at increased risk for exercise dependence and 50.9% of participants exhibited a clinical manifestation of DEBs based on the Disordered Eating Questionnaire (DEQ; mean score of 33.94 +/- 20.964). Statistically significant relationships between exercise dependence and DEBs (p<.001) and between DEBs and nutrition knowledge (p = .041) were found. These results suggest that nutrition knowledge and exercise dependence may influence DEBs in female group fitness instructors.M.S. (Master of Science

Safety of Rifampicin at High Dose for Difficult-to-Treat Tuberculosis: Protocol for RIAlta Phase 2b/c Trial

Rifampicin; Tuberculosis; Vulnerable populationRifampicina; Tuberculosis; Población vulnerableRifampicina; Tuberculosi; Població vulnerablePrevious clinical trials for drug-susceptible tuberculosis (DS-TB) have shown that first-line treatment with doses of rifampicin up to 40 mg/kg are safe and increase the early treatment response for young adults with pulmonary tuberculosis. This may lead to a shorter treatment duration for those persons with TB and a good baseline prognosis, or increased treatment success for vulnerable subgroups (age > 60, diabetes, malnutrition, HIV, hepatitis B or hepatitis C coinfection, TB meningitis, stable chronic liver diseases). Here, we describe the design of a phase 2b/c clinical study under the hypothesis that rifampicin at 35 mg/kg is as safe for these vulnerable groups as for the participants included in previous clinical trials. RIAlta is an interventional, open-label, multicenter, prospective clinical study with matched historical controls comparing the standard DS-TB treatment (isoniazid, pyrazinamide, and ethambutol) with rifampicin at 35 mg/kg (HR35ZE group) vs. rifampicin at 10 mg/kg (historical HR10ZE group). The primary outcome is the incidence of grade ≥ 3 Adverse Events or Severe Adverse Events. A total of 134 participants will be prospectively included, and compared with historical matched controls with at least a 1:1 proportion. This will provide a power of 80% to detect non-inferiority with a margin of 8%. This study will provide important information for subgroups of patients that are more vulnerable to TB bad outcomes and/or treatment toxicity. Despite limitations such as non-randomized design and the use of historical controls, the results of this trial may inform the design of future more inclusive clinical trials, and improve the management of tuberculosis in subgroups of patients for whom scientific evidence is still scarce. Trial registration: EudraCT 2020-003146-36, NCT04768231.This study is part of the European South American TB Research Collaborative Network (EUSAT-RCS), a project that has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No. 823890. A.S.M. is supported by a Juan Rodés (JR18/00022) postdoctoral fellowship from ISCIII

Excess tuberculosis risk during and following incarceration in Paraguay : a retrospective cohort study

Corresponding author. Cátedra de Salud Pública, Universidad Nacional de Asunción (UNA), Paraguay. E-mail address: [email protected] (G. Sequera).Background. The increased risk of tuberculosis (TB) among people deprived of liberty (PDL) is due to individual and institution-level factors. We followed a cohort of PDL from 5 prisons in Paraguay to describe the risk of TB during incarceration and after they were released. Methods. We linked a 2013 national census of prisons with TB records from the TB Program from 2010 to 2021 to identify TB notifications among incarcerated and formerly incarcerated individuals. We used multivariable Cox regression models to quantify the risk of TB during and following incarceration and to identify risk factors associated with TB. Findings. Among 2996 individuals incarcerated, 451 (15.1%) were diagnosed with TB. Of these, 262 (58.1%) cases occurred during incarceration and 189 (41.9%) occurred in the community after release. In prison, the hazard ratio of developing TB was 1.97 (95% CI: 1.52–2.61) after six months of incarceration and increased to 2.78 (95% CI: 1.82–4.24) after 36 months compared with the first six months. The overall TB notification rate was 2940 per 100,000 person-years. This rate increased with the duration of incarceration from 1335 per 100,000 person-years in the first year to 8455 per 100,000 person-years after 8 years. Among former prisoners, the rate of TB decreased from 1717 in the first year after release to 593 per 100 000 person-years after 8 years of follow up. Interpretation. Our study shows the alarming risk of TB associated with prison environments in Paraguay, and how this risk persists for years following incarceration. Effective TB control measures to protect the health of people during and following incarceration are urgently needed.Consejo Nacional de Ciencia y TecnologíaPrograma Paraguayo para el Desarrollo de la Ciencia y Tecnología. Proyectos de investigación y desarroll

Long-term outcomes of the global tuberculosis and COVID-19 co-infection cohort

Background: Longitudinal cohort data of patients with tuberculosis (TB) and coronavirus disease 2019 (COVID-19) are lacking. In our global study, we describe long-term outcomes of patients affected by TB and COVID-19. Methods: We collected data from 174 centres in 31 countries on all patients affected by COVID-19 and TB between 1 March 2020 and 30 September 2022. Patients were followed-up until cure, death or end of cohort time. All patients had TB and COVID-19; for analysis purposes, deaths were attributed to TB, COVID-19 or both. Survival analysis was performed using Cox proportional risk-regression models, and the log-rank test was used to compare survival and mortality attributed to TB, COVID-19 or both. Results: Overall, 788 patients with COVID-19 and TB (active or sequelae) were recruited from 31 countries, and 10.8% (n=85) died during the observation period. Survival was significantly lower among patients whose death was attributed to TB and COVID-19 versus those dying because of either TB or COVID-19 alone (p&lt;0.001). Significant adjusted risk factors for TB mortality were higher age (hazard ratio (HR) 1.05, 95% CI 1.03-1.07), HIV infection (HR 2.29, 95% CI 1.02-5.16) and invasive ventilation (HR 4.28, 95% CI 2.34-7.83). For COVID-19 mortality, the adjusted risks were higher age (HR 1.03, 95% CI 1.02-1.04), male sex (HR 2.21, 95% CI 1.24-3.91), oxygen requirement (HR 7.93, 95% CI 3.44-18.26) and invasive ventilation (HR 2.19, 95% CI 1.36-3.53). Conclusions: In our global cohort, death was the outcome in &gt;10% of patients with TB and COVID-19. A range of demographic and clinical predictors are associated with adverse outcomes

Prevalence of tuberculosis respiratory symptoms and associated factors in the indigenous populations of Paraguay (2012)

BACKGROUND: The prevalence of respiratory symptoms and confirmed tuberculosis (TB) among indigenous groups in Paraguay is unknown. METHODS: This study assessed the prevalence of respiratory symptoms, confirmed pulmonary TB, and associated socio-economic factors among indigenous Paraguayan populations. Indigenous persons residing in selected communities were included in the study. A total of 24,352 participants were interviewed at home between October and December 2012. Respiratory symptomatic individuals were defined as those with respiratory symptoms of TB. A hierarchical Poisson regression analysis was performed with four levels: individual characteristics, living conditions and environmental characteristics, source of food, and type of nutrition. FINDINGS: In this study, 1,383 participants had respiratory symptoms (5.7%), but only 10 had culture-confirmed TB (41/100,000 inhabitants). The small number of cases did not allow evaluation of the risk factors for TB. Age older than 37 years was associated with a two-fold increased risk of symptoms. Female sex; family history of TB; type of housing; home heating; a lack of hunting, fishing, or purchasing food; and a lack of vegetable consumption were also associated with the presence of symptoms. A lack of cereal consumption had a protective effect. Members of the Ayoreo or Manjui ethnic groups had a three-fold increased risk of symptoms. MAIN CONCLUSION: Individual characteristics, dietary habits, and belonging to specific ethnic groups were associated with respiratory symptoms.Fil: Aguirre, Sarita. Ministerio de Salud Pública y Bienestar Social; ParaguayFil: Martínez Cuellar, Celia. Universidad Nacional de Asunción; ParaguayFil: Herrero, María Belén. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Facultad Latinoamericana de Ciencias Sociales. Sede Académica Argentina Buenos Aires. Área de Relaciones Internacionales; ArgentinaFil: Cortesi, Gustavo Chamorro. Ministerio de Salud Pública y Bienestar Social; ParaguayFil: de Romero, Nilda Gimenez. Ministerio de Salud Pública y Bienestar Social; ParaguayFil: Alvarez, Mirian. Ministerio de Salud Pública y Bienestar Social; ParaguayFil: Braga, Jose Ueleres. Fundación Oswaldo Cruz; Brasil. Universidade Federal do Rio de Janeiro; Brasi