Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience; Comment on “Improving the World’s Health Through the Post-2015 Development Agenda: Perspectives from Rwanda”

Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economies

The burden of underweight and overweight among women in Addis Ababa, Ethiopia

Background Obesity and overweight are rising worldwide while underweight rates persist in low-income countries. The aim of this study was to examine changes in the prevalence of underweight and overweight/obesity among non-pregnant women aged 15-49 years, and its socio-demographic correlates in Addis Ababa, Ethiopia. Methods The data are from 2000, 2005 and 2011 nationally representative Ethiopian Demographic and Health Surveys in Addis Ababa. The dependent variable was women’s nutritional status measured in terms of body mass index coded in binary outcomes to examine risk of being underweight (\u3c18.5 kg/m2 vs. ≥18.5 kg/m2) or overweight/obese (\u3e25 kg/m2 vs. ≤25 kg/m2). Logistic regression models were used to estimate the strength of associations. Results The prevalence of overweight/obesity increased significantly by 28%; while underweight decreased by 21% between 2000 and 2011. Specifically, the prevalence of urban obesity increased by 43.3% i.e., from 3.0% to 4.3% in about 15 years. Overall, more than one-third (34.7%) of women in Addis Ababa were either under or overweight. Women’s age and proxies for high socio-economic status (i.e. household wealth quintile, educational attainment, access to improved source of drinking water, and television watching) were positively associated with being overweight. The correlates of underweight were young age and proxies for low socio-economic status (i.e. low wealth quintile, limited access to improved source of water or toilet facility). Conclusions There is a need for policies to recognize the simultaneous public health problems of under and overnutrition, and for programs to target the distinct populations that suffer from these nutrition problems in this urban area

A genetically encoded tool for reconstituting synthetic modulatory neurotransmission and reconnect neural circuits in vivo

© The Author(s), 2021. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Hawk, J. D., Wisdom, E. M., Sengupta, T., Kashlan, Z. D., & Colon-Ramos, D. A. A genetically encoded tool for reconstituting synthetic modulatory neurotransmission and reconnect neural circuits in vivo. Nature Communications, 12(1), (2021): 4795, https://doi.org/10.1038/s41467-021-24690-9.Chemogenetic and optogenetic tools have transformed the field of neuroscience by facilitating the examination and manipulation of existing circuits. Yet, the field lacks tools that enable rational rewiring of circuits via the creation or modification of synaptic relationships. Here we report the development of HySyn, a system designed to reconnect neural circuits in vivo by reconstituting synthetic modulatory neurotransmission. We demonstrate that genetically targeted expression of the two HySyn components, a Hydra-derived neuropeptide and its receptor, creates de novo neuromodulatory transmission in a mammalian neuronal tissue culture model and functionally rewires a behavioral circuit in vivo in the nematode Caenorhabditis elegans. HySyn can interface with existing optogenetic, chemogenetic and pharmacological approaches to functionally probe synaptic transmission, dissect neuropeptide signaling, or achieve targeted modulation of specific neural circuits and behaviors.This work was initiated in the Grass Laboratory at the Marine Biological Laboratories (MBL) with funding through a Grass Fellowship awarded to J.D.H. Thanks to Richard Goodman (OHSU) for encouragement during the conceptualization of the fellowship application, and the 2019 Grass Fellows, Mel Coleman (Grass Director), and Christophe Dupré (Associate Director) for advice and support during the summer fellowship. We thank the MBL Division of Education and participants in the Vendor Equipment Loan Program. Special thanks to Sutter Instruments, who generously provided all electrophysiology equipment and substantial on-site assistance, and Zeiss, who provided on-site assistance at MBL. We thank Zhao-Wen Wang and Ping Liu (UConn) for guidance and training in patch-clamp electrophysiology, as well as providing Neuro2a cells. We thank Rob Steele (UCI) for supplying Hydra, as well as advice and inspiration on Hydra biology. We thank members of the Colón-Ramos lab and Hari Shroff (NIH) for thoughtful comments on the manuscript. We thank Michael Koelle and Andrew Olson (Yale University) for advice and reagents regarding serotonin rewiring experiments. We also thank Steve Flavell (MIT) for ideas and reagents regarding the experiments associated with del-7. We thank Life Science Editors for editing assistance. D.A.C.-R. is an MBL Fellow. Research in the D.A.C.-R. lab was supported by NIH R01NS076558, DP1NS111778, and by an HHMI Scholar Award

Promotion of Drinking Water Among Latino Immigrant Youth

Objective: To design an innovative intervention to increase drinking water behaviors among Latino immigrant youth. Methods: We conducted two rounds of focus groups, totaling 10 sessions (n=61), with Latino immigrant youth, aged 6-18 years, living in Langley Park, Maryland. Participants were stratified into focus groups by age group (elementary, middle, and high school) and language preference (Spanish and English). A professional, bilingual-speaking moderator used a semistructured discussion guide to examine: (1) what youth preferred to drink in different settings and why, (2) their reactions to promotional messages, (3) slogans that would entice them to drink more water in school and at home, and (4) concept testing. The design and analyses were grounded on the social environmental framework to understand how various environments shape drink preferences. The sessions were audio-recorded, transcribed verbatim and translated into English. Two independent coders analyzed the data using an inductive approach to categorize texts according to recurring themes, concepts, and terms. Data were analyzed separately for each age group and language preference. After inter-rater agreement was achieved, final codes and sub-codes were defined in a coding dictionary. All transcribed discussions were entered into the software Atlas.ti and coded using the developed coding dictionary. Results: Beverage behaviors and preferences depended on (a) availability of water and other drinks, (b) perceived health benefits, (c) level of thirst, and (d) perceptions of taste and safety. There were no major differences in recurrent themes across age groups. Availability: Youth described that they preferred to drink bottled water at home, since this was what their parents made available to them. At school, however, most youth preferred chocolate milk, which is what was most available to them at lunch time. Youth described that they would not drink fountain water because it did not taste good, and that other forms of water were not available in the cafeteria. Older youth reported that water was often unavailable in vending machines at school. Perceived health benefits: Youth preferred to drink water to be attractive and to have energy. Concepts emerged around topics related to water makes you run, and athletes that drink water. Reactions to promotional messages that use celebrities were positive, but they did remark that some Latino celebrities endorse soda. Level of thirst: When really thirsty, youth preferred to drink water and only water to quench their thirst. They also recounted preferring water when it is hot outside. Promotional materials with these concepts received positive reactions. Taste and safety of tap water: Tap water was considered unsafe and distasteful both at home and at school. Having both English and Spanish represented in branding and slogans was considered important. Promotional materials were considered appealing if they were visually interesting, included a celebrity or an athlete, and were informative about water. Conclusions: A bilingual school- and home-based water promotion intervention that highlights (a) the health benefits of drinking water, (b) the power of water to quench true thirst, and (c) the safety, taste and benefits of drinking tap water is a promising strategy to target some of the barriers around drinking water behaviors among Latino immigrant youth

Awareness, Use, and Perceptions of Low-Carbohydrate Diets

Introduction Low-carbohydrate diets (LCDs) have regained popularity in recent years, but public awareness and perceived healthfulness of LCDs have not been explored. We describe population awareness, use, and perceptions of the healthfulness of LCDs and examine differences by socio-demographic and communication variables. Methods Nationally representative data from the Health Information National Trends Survey (HINTS 2005) were analyzed by using multivariate logistic regression to examine independent correlates of awareness, use, and perceptions of the healthfulness of LCDs. Results Awareness of LCDs in the United States was high (86.6%). Independent correlates of awareness included being a college graduate, being non-Hispanic white, and having a high body mass index (BMI). Among respondents who were aware of LCDs, approximately 17% had tried LCDs during the last year. Independent correlates of LCD use included being a woman and having a high BMI. One-third of respondents who were aware of LCDs agreed that they are a healthy way to lose weight. Independent correlates of perceived LCD healthfulness included not being a high school graduate and being likely to change behavior in response to new nutrition recommendations. Conclusion This study is among the first to explore correlates of awareness, use, and perceptions of LCDs in a nationally representative sample. Despite high levels of awareness of LCDs, these diets are not used frequently and are not perceived as being healthy

Hábitos de estudios y rendimiento académico en los estudiantes de computación e informática del instituto superior tecnológico público Alexander Von Humboldt, Villa Rica 2020

La presente investigación tuvo como propósito determinar la relación existente entre los hábitos de estudio y el rendimiento académico de los estudiantes de computación e informática del Instituto Superior Tecnológico Público Alexander Von Humboldt, Villa Rica 2020-I. El estudio se desarrolló siguiendo el enfoque cuantitativo, de tipo descriptivo y Correlacional. La muestra fue no probabilística y estuvo conformada por el total de la población 83 estudiantes. Los instrumentos de recojo de información para la variable hábitos de estudios fue el Inventario de hábitos de estudio CASM- 85 revisado en el 2014 y elaborado por Vicuña Peri (1985) que se evaluó las dimensiones: como estudia usted, como hace sus tareas, como se prepara para los exámenes, como escucha las clases y que acompaña sus momentos de estudio, por otro lado, para la variable rendimiento académico se utilizaron los registros de notas finales del ciclo 2020-I. Cabe destacar que la presente investigación arrojó un coeficiente de correlación entre hábitos de estudios y rendimiento académico de 0, 363 considerada en la escala de positiva débil por Hernández (2018). Al momento de contrastar cada hipótesis nos percatamos que el grado de correlación resulto positivo débil lo que se traduce en una correlación entre hábitos de estudios y rendimiento académico positivo débil, además tenemos estudiantes con calificaciones en su mayoría en la categoría de bueno, algunos en deficiente y absolutamente nada dentro de la categoría de sobresaliente, eso nos dice que debe mejorar sus hábitos de estudios para mejorar su rendimiento académico de forma notable.Tesi

Aplicación de estrategias heurísticas en la solución de problemas que se modelan mediante ecuaciones algebraicas en estudiantes de una institución educativa

The purpose of the research was to provide strategies applicable in the process of troubleshooting algebraic equations to determine whether there was a significant difference in the academic performance of the groups under investigation. A pilot study and a problem and discrimination analysis were conducted. The sample of the three groups was 26 students enrolled in a general math course as a requirement of their curriculum. A pre- and post-test was given to the control group 1 (C1) and the experimental group (E). The post-test was administered to groups C1, C2 and E. Treatment was carried out where the control groups received traditional teaching and the experimental group teaching based on the application of heuristic strategies. A normality test and a discrepancy and difficulty analysis were performed. The average pretest administration was calculated. It was concluded that C1 and E had similar performance and knowledge in problem solving and algebraic equations at the beginning of research, there was significant difference after treatment in groups C1 and E, it was shown that groups C1 and E were homogeneous, and that there was significant difference between the three groups participating in the posttest of academic performance. A research tool, an educational module for students and a strategic guide for the teacher were provided.El propósito de la investigación fue proveer estrategias aplicables en el proceso de solución de problemas que se modelan mediante ecuaciones algebraicas para determinar si hubo diferencia significativa en el rendimiento académico de los grupos bajo investigación. Se realizó un estudio piloto y un análisis de dificultad y discriminación. La muestra de los tres grupos fueron 26 estudiantes matriculados en un curso general de matemáticas como requisito de su programa de estudios. Se le administró una preprueba y una posprueba al grupo de control 1 (C1) y al grupo experimental (E). La posprueba se administró a los grupos C1, C2 y E. Se llevó a cabo el tratamiento en el que los grupos de control recibieron enseñanza tradicional y el grupo experimental, enseñanza basada en la aplicación de estrategias heurísticas. Se realizó una prueba de normalidad y un análisis de discrepancia y dificultad. Se calculó la media de la administración de la preprueba. Se concluyó que C1 y E tenían similar rendimiento y conocimiento en la solución de problemas y ecuaciones algebraicas al inicio de la investigación, y que existió una diferencia significativa después del tratamiento en los grupos C1 y E, se mostró que los grupos C1 y E eran homogéneos, y que existió una diferencia significativa entre los tres grupos participantes en la posprueba de rendimiento académico. Se aportó un instrumento de investigación, un módulo educativo para estudiantes y una guía estratégica para el profesor

Residents’ Insights on Their Local Food Environment and Dietary Behaviors: A Cross-City Comparison Using Photovoice in Spain

Perceptions of local food environments and the ability of citizens to engage in participatory research may vary, even if participants share similar cultural and socioeconomic contexts. In this study, we aimed to describe participants’ narratives about their local food environment in two cities in Spain. We used the participatory methodology of Photovoice to engage participants in Madrid (n = 24) and Bilbao (n = 17) who took and discussed photographs about their local food environment (Madrid; n = 163 and Bilbao; n = 70). Common themes emerged across both cities (food insecurity, poverty, use of public spaces for eating and social gathering, cultural diversity and overconsumption of unhealthy foods); however, in Bilbao citizens perceived that there was sufficient availability of healthy foods despite that living in impoverished communities. Photovoice was a useful tool to engage participating citizens to improve their local food environments in both cities. This new approach allowed for a photovoice cross-city comparison that could be useful to fully understand the complexity and diversity of residents’ perceptions regardless of their place of residence.This research was funded by The European Research Council under the European Union’s Seventh Framework Programme (FP7/2007–2013/ERC Starting Grant Heart Healthy Hoods Agreement no. 336893) and the University of the Basque Country (16/35, 2016). “The Photovoice project in Madrid was co-funded by an “Ignacio Hernando de Llarramendi” research grant 2014 of the MAPFRE Foundation”

Moving Toward Universal Health Coverage (UHC) to Achieve Inclusive and Sustainable Health Development: Three Essential Strategies Drawn From Asian Experience Comment on “Improving the World’s Health Through the Post-2015 Development Agenda: Perspectives from Rwanda”

Binagwaho and colleagues’ perspective piece provided a timely reflection on the experience of Rwanda in achieving the Millennium Development Goals (MDGs) and a proposal of 5 principles to carry forward in post-2015 health development. This commentary echoes their viewpoints and offers three lessons for health policy reforms consistent with these principles beyond 2015. Specifically, we argue that universal health coverage (UHC) is an integrated solution to advance the global health development agenda, and the three essential strategies drawn from Asian countries’ health reforms toward UHC are: (1) Public financing support and sequencing health insurance expansion by first extending health insurance to the extremely poor, vulnerable, and marginalized population are critical for achieving UHC; (2) Improved quality of delivered care ensures supply-side readiness and effective coverage; (3) Strategic purchasing and results-based financing creates incentives and accountability for positive changes. These strategies were discussed and illustrated with experience from China and other Asian economie

Commentary: Selecting synaptic partners: GRASPing the role of UNC- 6/netrin

Forming synaptic connections of the appropriate strength between specific neurons is crucial for constructing neural circuits to control behavior. A recent paper in Neural Development describes the use of a synapse-specific label in Caenorhabditis elegans to implicate local UNC-6/netrin signaling in this developmental process. Thus, as well as their well known roles in cell migration and axon guidance, UNC-6/netrin signals distinguish an appropriate synaptic partner from other potential targets