Operational Implementation of the Healthy Communities Study How Communities Shape Children’s Health

The Healthy Communities Study (HCS) is examining how characteristics of community programs and policies targeting childhood obesity are related to childhood diet, physical activity, and obesity outcomes. The study involves selected districts and public schools in 130 communities; families recruited through schools; and data collected at the community, school, household, and child levels. Data collection took place in two waves—Wave 1 in Spring 2012 and Wave 2 from 2013 to 2015—with analysis to be completed by August 2016. This paper describes operational elements of the HCS, including recruitment activities, field operations, training of data collectors, human subjects protection, and quality assurance and quality control procedures. Experienced trainers oversaw and conducted all training, including training of: (1) district and school recruitment staff; (2) telephone interviewers for household screening and recruitment; (3) field data collectors for conducting household data collection; and (4) community liaisons for conducting key informant interviews, document abstraction, and community observations. The study team developed quality assurance and quality control procedures that were implemented for all aspects of the study. Planning and operationalizing a study of this complexity and magnitude, with multiple functional teams, required frequent communication and strong collaboration among all study partners to ensure timely and effective decision making

Association of Multisetting Community Programs and Policies With Child Body Mass Index: The Healthy Communities Study

INTRODUCTION: Expert opinion suggests that efforts to address childhood obesity should seek to transform the environments in which children operate. The objective of this study was to describe the extent to which multisetting programs and policies interact with community and child predictors and are associated with child body mass index (BMI) in the 130 US communities participating in the Healthy Communities Study. METHODS: For 2 years beginning in fall 2013, we collected data through key informant interviews on community programs and policies related to healthy weight among children that occurred in the 10 years before the interview. We characterized community programs and policies by intensity of efforts and the number of settings in which a program or policy was implemented. Child height and weight were measured during household data collection. We used multilevel modeling to examine associations of community programs and policies in multiple settings and child and community predictors with BMI z scores of children. RESULTS: The mean number of settings in which community policies and programs were implemented was 7.3 per community. Of 130 communities, 31 (23.8%) implemented community programs and policies in multiple settings. Higher-intensity community programs and policies were associated with lower BMI in communities that used multiple settings but not in communities that implemented programs and policies in few settings. CONCLUSION: Efforts to prevent childhood obesity may be more effective when community programs and policies are both intensive and are implemented in multiple settings in which children live, learn, and play

A TNF-JNK-Axl-ERK signaling axis mediates primary resistance to EGFR inhibition in glioblastoma.

Aberrant epidermal growth factor receptor (EGFR) signaling is widespread in cancer, making the EGFR an important target for therapy. EGFR gene amplification and mutation are common in glioblastoma (GBM), but EGFR inhibition has not been effective in treating this tumor. Here we propose that primary resistance to EGFR inhibition in glioma cells results from a rapid compensatory response to EGFR inhibition that mediates cell survival. We show that in glioma cells expressing either EGFR wild type or the mutant EGFRvIII, EGFR inhibition triggers a rapid adaptive response driven by increased tumor necrosis factor (TNF) secretion, which leads to activation in turn of c-Jun N-terminal kinase (JNK), the Axl receptor tyrosine kinase and extracellular signal-regulated kinases (ERK). Inhibition of this adaptive axis at multiple nodes rendered glioma cells with primary resistance sensitive to EGFR inhibition. Our findings provide a possible explanation for the failures of anti-EGFR therapy in GBM and suggest a new approach to the treatment of EGFR-expressing GBM using a combination of EGFR and TNF inhibition

Famílies botàniques de plantes medicinals

Facultat de Farmàcia, Universitat de Barcelona. Ensenyament: Grau de Farmàcia, Assignatura: Botànica Farmacèutica, Curs: 2013-2014, Coordinadors: Joan Simon, Cèsar Blanché i Maria Bosch.Els materials que aquí es presenten són els recull de 175 treballs d’una família botànica d’interès medicinal realitzats de manera individual. Els treballs han estat realitzat per la totalitat dels estudiants dels grups M-2 i M-3 de l’assignatura Botànica Farmacèutica durant els mesos d’abril i maig del curs 2013-14. Tots els treballs s’han dut a terme a través de la plataforma de GoogleDocs i han estat tutoritzats pel professor de l’assignatura i revisats i finalment co-avaluats entre els propis estudiants. L’objectiu principal de l’activitat ha estat fomentar l’aprenentatge autònom i col·laboratiu en Botànica farmacèutica

DENTAL FLUOROSIS PREVALENCE IN 6 TO 15 YEARS OLD SCHOLARS FROM THE CITY OF BUCARAMANGA

Purpose: To establish dental fluorosis prevalence in 6 to 15 years old students, registered in public and private schools of Bucaramanga.Material and methods: A cluster randomized sampling to select the institution. Age, gender, and TF index by Thysltrup and Fejerskov criteria were considered. Associations with gender, age and institution were evaluated by patient and dental structure applying X2 and Fisher exact test considering α = 0.05.Results: Twenty-eight clusters were analyzed. One hundred ninety six children, 6 to 15 years old with 1562 teeth. Dental fluorosis prevalence was 77%, CI 95% (69.6% - 84.4%), TFI range between TFI 0 - 1 to TFI 0 - 6. The patients with TFI 0 to 3 were the highest frequency in 29.1%, CI 95% (19.37% - 38.8%). The prevalence in 9 to11 years old group was 87.2%, and in the public schools 94%, both statically significant (p = 0.001, 0.003), respectively. The analyses by tooth showed fluorosis in 52.8% of teeth.Conclusions: In 6 to 15 years Bucaramanga scholars, the fluorosis prevalence was 77%, and 52.8% teeth had fluorosis; however, the severity level in teeth was TFI level 0 (without fluorosis) 47% and TFI 1 to 3, 48%.Objetivo: Determinar la prevalencia de fluorosis dental en escolares entre 6 y 15 años de edad, de instituciones educativas públicas y privadas, del área urbana de Bucaramanga.Materiales y métodos: Se seleccionaron 196 escolares entre los 6 y 15 años de edad, en forma aleatoria, mediante un muestreo por conglomerados. Se consideró la edad, el género, el tipo de institución educativa a la que estaban vinculados y el nivel TFI en cada molar, premolar e incisivo superior, de acuerdo a los criterios de Thylstrup y Fejeskov. Se analizaron las posibles asociaciones entre edad, género y tipo de institución con la prevalencia de fluorosis, y se consideró como unidad de análisis el sujeto y la estructura dentaria, aplicando la prueba de Chi2 y el test exacto de Fischer, con un nivel de significancia α = 0.05.Resultados: Se evaluaron en 28 conglomerados, 196 escolares entre los 6 y los 15 años de edad y 1562 dientes, el 77% con IC 95% (69.6% - 84.4%) de los pacientes registraron espectros de fluorosis entre TFI 0 a 1 y TFI 0 a 6. Los pacientes que registraron espectros de fluorosis entre TFI 0 a 3, fueron los de mayor frecuencia en un 29.1% de los examinados con IC 95% (19.37% - 38.8%). La prevalencia de fluorosis fue mayor en el grupo de 9 a 11 años 87.2% (p = 0.001) y en instituciones públicas 94% (p = 0.03). Al análisis por diente, se encontró que el 52.8% de los dientes examinados registraron fluorosis. Hubo diferencias estadísticamente significativas al analizarlos por edad, con una proporción del 77.6% en el grupo de 6 a 8 años (p < 0.000), y por institución educativa, del 42.8%; en colegios privados en el grupo de 12 a 15 años (p = 0.006), y del 69.1% en colegios públicos en el grupo de 9 a 11 años (p < 0.001). Al analizar por tipo de diente, se encontró que los incisivos centrales fueron los más frecuentemente afectados con TFI 1 en el 25.8% de los pacientes. El diente más severamente afectado fue el primer premolar con TFI 3 en el 15.3% de la muestra.Conclusiones: Se registró una prevalencia de fluorosis del 77% y una proporción del 52.8% de dientes con fluorosis, en los escolares de 6 a 15 años matriculados en instituciones públicas y privadas; sin embargo, su severidad muestra que en los niveles de TFI 0 está el 47% de los dientes y TFI de 1 a 3 en el 48% de los dientes.[Concha SC, Celedón Y, Vera W, Muñoz C, Vergel T, Luna D, Rodríguez LM, Arteaga C, Camargo DM. Prevalencia de fluorosis dental en escolares de 6 a 15 años de edad de la zona urbana de Bucaramanga. Ustasalud Odontologia 2003: 2: 73 - 82

Overview of the obesity intervention taxonomy and pooled analysis working group.

The National Heart, Lung, and Blood Institute and the National Institutes of Health Office of Disease Prevention convened a meeting on August 29-30, 2013 entitled "Obesity Intervention Taxonomy and Pooled Analysis." The overarching goals of the meeting were to understand how to decompose interventions targeting behavior change, and in particular, those that focus on obesity and to combine data from groups of related intervention studies to supplement what can be learned from the individual studies. This paper summarizes the workshop recommendations and provides an overview of the two other papers that originated from the workshop and that address decomposition of behavioral change interventions and pooling of data across diverse studies within a consortium

Measurement challenges for childhood obesity research within and between Latin America and the United States

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/168362/1/obr13242.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/168362/2/obr13242_am.pd

Desafíos de medición para la investigación de la obesidad infantil en y entre América Latina y Estados Unidos.

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/170820/1/obr13353.pd