The Effect of Alternative Nutrition Menu Labels on Children’s Meals Purchases and Parent-Child Decision-Making

Children are one subpopulation that have seen a threefold increase in obesity over the last two decades but have received no attention in the menu labeling literature. The purpose of this study is to explore the effects of different menu labeling formats on purchases of children’s meals and parent-child decision-making at a family-oriented restaurant. The intervention consists of five children’s menus featuring six bundled, nutritionally diverse, and equally priced combinations that are implemented over about a year. Accompanying each menu is a survey postcard collecting information on the parent-child decision process in choosing the item. This is ongoing research and all data is not in but at this point, the very early evidence points toward child-menu labeling having very little impact on food choices and caloric intake. This result is likely due to low parental involvement in the decision process given that children are the main ones deciding what to eat.Consumer/Household Economics, Food Consumption/Nutrition/Food Safety,

Post-termination Effects of Cover Crop Monocultures and Mixtures on Soil Inorganic Nitrogen and Microbial Communities on Two Organic Farms in Illinois

Cover crops can continue to affect agricultural systems even after they have been terminated by influencing nitrogen dynamics and by altering soil microbial communities. These post-termination effects can influence soil fertility, weed pressure, and the dynamics of potential plant pathogens in the narrow window of time between cover crop termination and cash crop emergence. We evaluated the post-termination effects of 12 different spring-sown cover crop mixtures and monocultures on soil nitrogen and microbial communities on two different organic farms in Central Illinois (on Lawson silt loam soil) and Northern Illinois (on Virgil silt loam soil). In comparison to control plots with no cover crops, all cover crop treatments significantly reduced soil nitrate levels but increased the potentially mineralizable nitrogen pool following termination. Nitrate levels of cover crop plots approached those of controls after 2 and 4 weeks, respectively, but potentially mineralizable nitrogen levels in cover plots remained elevated for at least 4 weeks following termination. Monocultures of Brassica cover crops showed the greatest decrease in soil nitrate, while Brassicas and unplanted control plots containing high biomass of weeds showed the greatest increase in potentially mineralizable nitrogen in comparison to plant-free control plots. In contrast to their effect on soil nitrogen, cover crops had very limited impact on the composition of soil microbial communities. Overall microbial community composition varied across sites and years, and only soil fungi significantly responded to cover cropping treatments. Nevertheless, we found that some highly correlated groups of soil microbes showed significant responses to soil nitrate and to high plant biomass. Key members of these correlated groups included ammonia-oxidizing organisms and saprotrophic fungi. Our results suggest that cover crops may reduce the potential for springtime nitrogen leaching losses by retaining nitrogen in the soil organic pool, and they may also have impacts on the soil microbial community that are particularly relevant for nitrogen cycling and decomposition of plant residues

Post-termination Effects of Cover Crop Monocultures and Mixtures on Soil Inorganic Nitrogen and Microbial Communities on Two Organic Farms in Illinois

Cover crops can continue to affect agricultural systems even after they have been terminated by influencing nitrogen dynamics and by altering soil microbial communities. These post-termination effects can influence soil fertility, weed pressure, and the dynamics of potential plant pathogens in the narrow window of time between cover crop termination and cash crop emergence. We evaluated the post-termination effects of 12 different spring-sown cover crop mixtures and monocultures on soil nitrogen and microbial communities on two different organic farms in Central Illinois (on Lawson silt loam soil) and Northern Illinois (on Virgil silt loam soil). In comparison to control plots with no cover crops, all cover crop treatments significantly reduced soil nitrate levels but increased the potentially mineralizable nitrogen pool following termination. Nitrate levels of cover crop plots approached those of controls after 2 and 4 weeks, respectively, but potentially mineralizable nitrogen levels in cover plots remained elevated for at least 4 weeks following termination. Monocultures of Brassica cover crops showed the greatest decrease in soil nitrate, while Brassicas and unplanted control plots containing high biomass of weeds showed the greatest increase in potentially mineralizable nitrogen in comparison to plant-free control plots. In contrast to their effect on soil nitrogen, cover crops had very limited impact on the composition of soil microbial communities. Overall microbial community composition varied across sites and years, and only soil fungi significantly responded to cover cropping treatments. Nevertheless, we found that some highly correlated groups of soil microbes showed significant responses to soil nitrate and to high plant biomass. Key members of these correlated groups included ammonia-oxidizing organisms and saprotrophic fungi. Our results suggest that cover crops may reduce the potential for springtime nitrogen leaching losses by retaining nitrogen in the soil organic pool, and they may also have impacts on the soil microbial community that are particularly relevant for nitrogen cycling and decomposition of plant residues

“Collaboration Toward One Collective Goal”: A Mixed-Methods Study of Short-Term Learning Outcomes and Long-Term Impacts Among Students Participating in an Undergraduate Community-Based Participatory Research (CBPR) Course

Background: Research shows positive learning outcomes for students participating in service learning. However, the impacts of undergraduate student participation in Community-Based Participatory Research (CBPR) courses are minimally studied.Methods: We used a triangulation mixed-methods design approach to analyze short- and long-term (1–5 years post-course) data collected from 59 undergraduate students across 5 cohorts of a CBPR course (2014–19). Thematic analysis was used to analyze the qualitative data and descriptive statistics and frequencies were generated to analyze the quantitative data.Results: We developed five key themes based on short-term qualitative data: integration of CBPR and traditional research skills; importance of community engagement in research; identity; accountability; and collaboration. Themes from qualitative course evaluations aligned with these findings. Long-term qualitative data revealed that former students gained research knowledge, research skills, and professional skills and then applied these in other settings. This aligns with quantitative findings, where >79% of respondents reported that course participation “extensively” improved their research skills. Post-course, students still reflected on the importance of community engagement in research and reported a substantially enhanced likelihood of civic engagement.Discussion/Conclusions: Students gained critical knowledge and skills that positively impact their ability to engage in community-based work well after the end of course participation. Some students reported considering research-oriented careers and graduate programs for the first time after course participation. Collaborative learning experiences with community partners and members encouraged students to reflect on research designs that center community voices. We stress here that community partnerships require extensive cultivation, but they can create opportunities to translate findings directly back to communities and provide numerous benefits to undergraduate students. We hope that our findings provide the information needed to consider pilot testing practice-based CBPR courses in a variety of public health training contexts

Plagiocephaly and Associated Head Deformities in the NICU: The PLAY Bundle

MNRS Student Poster Abstract EBP/QI Poster Title: Plagiocephaly and Associated Head Deformities in the NICU: The PLAY Bundle Authors: Ashley Kubik, RN, BSN & Jenna Welton, RN, BSN Description of Students\u27 Role: Two students are conducting this project for their DNP Capstone at the University of Nebraska Medical Center. Both are BSN to DNP students completing the dual Pediatric Acute & Primary Care Nurse Practitioner program. There is equal contribution from both for project development, implementation, data collection, and analysis. Nature and scope of the project: Premature infants in the Neonatal Intensive Care Unit (NICU) have a greater risk of head asymmetry and related complications. No standardized protocol for positional head deformities exists at Children’s Hospital of Omaha. The Electronic Health Record (EHR) doesn’t optimize head measurement documentation or flag concerning head measurements. Our goal is to reduce the progression of head deformities through education, prevention strategies, and earlier identification and treatment. Background: Numerous evidence-based interventions demonstrate successful prevention and treatment for head deformities with maximized success when combined. Authors developed an evidence-based bundle comprised of Positioning and PT/OT involvement, Learning, Assistive Devices, and You (PLAY). The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework is utilized. Project implementation: Data collected during weeks 1-13 (June-September 2022) were under the current standard of care, then the PLAY Bundle was implemented, and data collection will continue through week 26 (December 2022). All NICU patients are eligible for inclusion on a rolling basis. Evaluation Criteria: Paired t-tests will be used for nurse’s knowledge tool, caregiver comfort survey, and nurses’ practice and documentation. PT/OT involvement comparisons pre- and post-bundle will be analyzed using Fisher’s exact test. Descriptive statistics will be utilized for adherence and documentation rates with the addition of PT/OT involvement included. Bundle efficacy will be analyzed using repeated measures ANOVA. Outcomes: Since project inception, 33 infants have been measured for possible plagiocephaly and associated head deformities with 19 occurring after PLAY Bundle implementation. Under previous standard of care, 34% of patients (n=27) had plagiocephaly documentation while just 7% (n=6) received a PT consultation. Of the NICU patients diagnosed with head deformities since PLAY Bundle implementation, biweekly head measurements improved in 58%, worsened in 20%, worsened then improved in 8%, and stayed the same in 20%. Recommendations: Preliminary recommendations include EHR optimization and standardized parental education. There is a vital need for a nurse-driven releasable order set with intervention activation when infants meet criteria

Mobilization of genomic islands of Staphylococcus aureus by temperate bacteriophage

The virulence of Staphylococcus aureus, in both human and animal hosts, is largely influenced by the acquisition of mobile genetic elements (MGEs). Most S. aureus strains carry a variety of MGEs, including three genomic islands (νSaα, νSaβ, νSaγ) that are diverse in virulence gene content but conserved within strain lineages. Although the mobilization of pathogenicity islands, phages and plasmids has been well studied, the mobilization of genomic islands is poorly understood. We previously demonstrated the mobilization of νSaβ by the adjacent temperate bacteriophage ϕSaBov from strain RF122. In this study, we demonstrate that ϕSaBov mediates the mobilization of νSaα and νSaγ, which are located remotely from ϕSaBov, mostly to recipient strains belonging to ST151. Phage DNA sequence analysis revealed that chromosomal DNA excision events from RF122 were highly specific to MGEs, suggesting sequence-specific DNA excision and packaging events rather than generalized transduction by a temperate phage. Disruption of the int gene in ϕSaBov did not affect phage DNA excision, packaging, and integration events. However, disruption of the terL gene completely abolished phage DNA packing events, suggesting that the primary function of temperate phage in the transfer of genomic islands is to allow for phage DNA packaging by TerL and that transducing phage particles are the actual vehicle for transfer. These results extend our understanding of the important role of bacteriophage in the horizontal transfer and evolution of genomic islands in S. aureus

In Vivo Imaging of Tau Pathology Using Magnetic Resonance Imaging Textural Analysis

BACKGROUND: Non-invasive characterization of the pathological features of Alzheimer's disease (AD) could enhance patient management and the development of therapeutic strategies. Magnetic resonance imaging texture analysis (MRTA) has been used previously to extract texture descriptors from structural clinical scans in AD to determine cerebral tissue heterogeneity. In this study, we examined the potential of MRTA to specifically identify tau pathology in an AD mouse model and compared the MRTA metrics to histological measures of tau burden. METHODS: MRTA was applied to T2 weighted high-resolution MR images of nine 8.5-month-old rTg4510 tau pathology (TG) mice and 16 litter matched wild-type (WT) mice. MRTA comprised of the filtration-histogram technique, where the filtration step extracted and enhanced features of different sizes (fine, medium, and coarse texture scales), followed by quantification of texture using histogram analysis (mean gray level intensity, mean intensity, entropy, uniformity, skewness, standard-deviation, and kurtosis). MRTA was applied to manually segmented regions of interest (ROI) drawn within the cortex, hippocampus, and thalamus regions and the level of tau burden was assessed in equivalent regions using histology. RESULTS: Texture parameters were markedly different between WT and TG in the cortex (E, p < 0.01, K, p < 0.01), the hippocampus (K, p < 0.05) and in the thalamus (K, p < 0.01). In addition, we observed significant correlations between histological measurements of tau burden and kurtosis in the cortex, hippocampus and thalamus. CONCLUSIONS: MRTA successfully differentiated WT and TG in brain regions with varying degrees of tau pathology (cortex, hippocampus, and thalamus) based on T2 weighted MR images. Furthermore, the kurtosis measurement correlated with histological measures of tau burden. This initial study indicates that MRTA may have a role in the early diagnosis of AD and the assessment of tau pathology using routinely acquired structural MR images

Emerging pharmacotherapy for cancer patients with cognitive dysfunction

Advances in the diagnosis and multi-modality treatment of cancer have increased survival rates for many cancer types leading to an increasing load of long-term sequelae of therapy, including that of cognitive dysfunction. The cytotoxic nature of chemotherapeutic agents may also reduce neurogenesis, a key component of the physiology of memory and cognition, with ramifications for the patient's mood and other cognition disorders. Similarly radiotherapy employed as a therapeutic or prophylactic tool in the treatment of primary or metastatic disease may significantly affect cognition. A number of emerging pharmacotherapies are under investigation for the treatment of cognitive dysfunction experienced by cancer patients. Recent data from clinical trials is reviewed involving the stimulants modafinil and methylphenidate, mood stabiliser lithium, anti-Alzheimer's drugs memantine and donepezil, as well as other agents which are currently being explored within dementia, animal, and cell culture models to evaluate their use in treating cognitive dysfunction

eRAPID electronic patient self-Reporting of Adverse-events: Patient Information and aDvice: a pilot study protocol in pelvic radiotherapy.

Background: An estimated 17,000 patients are treated annually in the UK with radical radiotherapy (RT) for pelvic cancer. New treatment approaches in RT have increased survivorship and changed the subjective toxicity profile for patients who experience acute and long-term pelvic-related adverse events (AE). Multi-disciplinary follow-up creates difficulty for monitoring and responding to these events during treatment and beyond. Originally developed for use in systemic oncology therapy eRAPID (electronic patient self-Reporting of Adverse-events: Patient Information and aDvice) is an online system for patients to report AEs from home. eRAPID enables patient data to be integrated into the electronic patient records for use in clinical practice, provides patient management advice for mild and moderate AE and advice to contact the hospital for severe AE. The system has now been developed for pelvic RT patients, and we aim to test the intervention in a pilot study with staff and patients to inform a future randomised controlled trial (RCT). Methods: Eligible patients are those attending St James's University hospital cancer centre and The Christie Hospital Manchester undergoing pelvic radiotherapy+/-chemotherapy/hormonotherapy for prostate, lower gastrointestinal and gynaecological cancers. A prospective 1:1 randomised (intervention or usual care) parallel group design with repeated measures and mixed methods will be employed. We aim to recruit 168 patients following recommendations for sample size estimates for pilot studies. Participants using eRAPID will report AE (at least weekly) from home weekly for 6 weeks and 6 weeks post-treatment (12-week total) then at 18 and 24 weeks. Hospital staff will review eRAPID reports and use information during consultations. Notifications will be sent to the relevant clinical team when severe symptoms are reported. We will measure patient-reported outcomes using validated questionnaires (Functional Assessment in Cancer Therapy Scale-General (FACT-G), European Organisation for Research and Treatment of Cancer Core Quality of Life questionnaire (EORTC-QLQ-C30), process of care impact (hospital records of patient contacts and admissions) and economic variables (EQ5D-5L, patient use of resources)). Staff and patient experiences will be explored via semi-structured interviews. Discussion: The objectives are to establish feasibility, recruitment, integrity of the system and attrition rates, determine effect sizes and aid selection of the primary outcome measure for a future RCT. We will also refine the intervention by exploring staff and patient views. The overall goal of this complex intervention is to improve the safe delivery of cancer treatments, enhance patient care and standardise documentation of AE within the clinical datasets. Trial registration: ClinicalTrials.gov NCT02747264

DOMINO-AD protocol: donepezil and memantine in moderate to severe Alzheimer's disease - a multicentre RCT.

BACKGROUND: Alzheimer's disease (AD) is the commonest cause of dementia. Cholinesterase inhibitors, such as donepezil, are the drug class with the best evidence of efficacy, licensed for mild to moderate AD, while the glutamate antagonist memantine has been widely prescribed, often in the later stages of AD. Memantine is licensed for moderate to severe dementia in AD but is not recommended by the England and Wales National Institute for Health and Clinical Excellence. However, there is little evidence to guide clinicians as to what to prescribe as AD advances; in particular, what to do as the condition progresses from moderate to severe. Options include continuing cholinesterase inhibitors irrespective of decline, adding memantine to cholinesterase inhibitors, or prescribing memantine instead of cholinesterase inhibitors. The aim of this trial is to establish the most effective drug option for people with AD who are progressing from moderate to severe dementia despite treatment with donepezil. METHOD: DOMINO-AD is a pragmatic, 15 centre, double-blind, randomized, placebo controlled trial. Patients with AD, currently living at home, receiving donepezil 10 mg daily, and with Standardized Mini-Mental State Examination (SMMSE) scores between 5 and 13 are being recruited. Each is randomized to one of four treatment options: continuation of donepezil with memantine placebo added; switch to memantine with donepezil placebo added; donepezil and memantine together; or donepezil placebo with memantine placebo. 800 participants are being recruited and treatment continues for one year. Primary outcome measures are cognition (SMMSE) and activities of daily living (Bristol Activities of Daily Living Scale). Secondary outcomes are non-cognitive dementia symptoms (Neuropsychiatric Inventory), health related quality of life (EQ-5D and DEMQOL-proxy), carer burden (General Health Questionnaire-12), cost effectiveness (using Client Service Receipt Inventory) and institutionalization. These outcomes are assessed at baseline, 6, 18, 30 and 52 weeks. All participants will be subsequently followed for 3 years by telephone interview to record institutionalization. DISCUSSION: There is considerable debate about the clinical and cost effectiveness of anti-dementia drugs. DOMINO-AD seeks to provide clear evidence on the best treatment strategies for those managing patients at a particularly important clinical transition point. TRIAL REGISTRATION: Current controlled trials ISRCTN49545035.RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are