S02-3 Physical activity policies and good practices in Europe

Background The establishment of the EU physical activity (PA) guidelines and the HEPA monitoring framework has had an impact on policy development and implementation across the region from 2015. This works presents results from the third round of monitoring in 2021 and discusses trends since 2015. Methods A questionnaire was distributed in 2021 to all EU Member States of the WHO European Region through the network of PA Focal Points, who were requested to collect data from national colleagues and complete the questionnaire. All EU Member States (27 in 2021) responded to the survey on the implementation of the 23 indicators of the HEPA monitoring framework. Results The results of the 2021 round of data collection on HEPA indicators showed an overall stabilization of the implementation of PA promotion policies. Besides important increases in several indicators, such as indicators 15 (HEPA in the training of physical education teachers), 20 (Schemes to promote physical activity at the workplace) and 21 (Schemes for community interventions to promote physical activity in older adults), many others decreased and others showed no progress. Most national physical activity policies or action plans were multi-sectoral, with good coverage of the sectors recognized as important for HEPA promotion. While some methodological aspects may have affected the results, this round also reflected policy implementation during the COVID-19 pandemic (2019–2021). COVID-19 has had a significant impact on all sectors of society but especially on health, sports, education and mobility, which are major areas for PA promotion and policy implementation. Conclusions There seems to be an overall stabilization of the implementation of PA promotion policies since 2015. Public health experts and decision makers could utilise the increase in public awareness of the health benefits of physical activity kindled by the COVID-19 crisis to implement new health-promoting policies. Policy design, development and implementation of HEPA promotion must be strengthened for post-COVID-19 social and economic recovery

Investigating Gender Disparities in Internal Medicine Residency Awards

Background: Significant gender disparities persist in career advancement for physicians. Studies have highlighted the lack of female representation in awards from both academic institutions and professional societies; these awards play a role in promotions, making them a fundamental building block of success. Objectives: We aim to explore the gender breakdown among resident awards presented by several Internal Medicine residency programs across the United States in this pilot study. Our ultimate goals are to define disparities in award selection, determine what variables contribute to these disparities, and work to mitigate these variables. Methods/Research: We generated a survey in REDCap to collect retrospective data about resident award selection from academic Internal Medicine residency programs across the country. This survey gathered awards data from 2009-2019 and included variables such as gender breakdown of the program, gender of resident award recipients, and details about how awards are selected. Eight programs completed the survey; these programs were from six different states in various geographic regions. Overall 43.1 percent of residents were female. Across all residency programs and years, there were 51 distinct resident awards with 290 (39.7%) female winners. Of the 51 distinct awards, there were 10 which were awarded to female residents with the same or higher frequency as males; 6 of these mentioned words that have been differentially associated with women in medicine such as “ambulatory,” “community,” “compassion,” and “humanism.” In the 41 awards favoring males, there was only a single mention of the word “compassion,” and no mention of the others. Conclusions/Impact: This data shows a concerning disparity in gender of award winners. In the future we will collect data from more residency programs and perform a thorough investigation of selection mechanisms that may help mitigate bias in order to ultimately propose strategies to reduce these gender disparities.https://jdc.jefferson.edu/sexandgenderhealth/1007/thumbnail.jp

IM with Her: Fostering Career Advancement of Female Internal Medicine Residents

Background: Despite the rising number of matriculating female medical students, a gender gap favoring men exists in multiple arenas within academic medicine. Prior studies suggest that gender-specifc professional networking groups increase the likelihood of women attaining leadership positions. Objectives: Our goal was to create a multidisciplinary group with a flat hierarchy within the Internal Medicine Department in order to foster mentorship, sponsorship, allyship, and scholarship to ultimately improve professional advancement opportunities for female internal medicine residents. Methods/Research: A group named “IM with Her” was created at Thomas Jefferson University Hospital in July 2018. IM with Her is composed of internal medicine residents and faculty of all genders. The group has hosted monthly onehour conferences called “Monday Mentors” that pair a resident with a faculty member to host a discussion surrounding a topic of their choosing related to adversity and disparity faced by female physicians. Additionally, the group has held periodic evening sessions discussing topics such as salary and contract negotiation. Conclusions/Impact: The IM with Her group has made significant progress toward its goals. The pairing of a resident and faculty member for Monday Mentors discussions allows for one-on-one mentorship regarding both personal and professional topics. These sessions also provide dedicated time for networking amongst residents and faculty, facilitating sponsorship and allyship. Additionally, the sessions often lead to further initiatives spearheaded by IM with Her members including scholarly projects and examinations of institutional policies (for example those surrounding sexual harassment and lactation room accessibility). In the future, IM with Her will focus on continuing to foster mentorship, sponsorship, and allyship, on advancing research related to gender disparities in medicine, and on developing institutional changes.https://jdc.jefferson.edu/sexandgenderhealth/1008/thumbnail.jp

SC83288 is a clinical development candidate for the treatment of severe malaria

Severe malaria is a life-threatening complication of an infection with the protozoan parasite Plasmodium falciparum, which requires immediate treatment. Safety and efficacy concerns with currently used drugs accentuate the need for new chemotherapeutic options against severe malaria. Here we describe a medicinal chemistry program starting from amicarbalide that led to two compounds with optimized pharmacological and antiparasitic properties. SC81458 and the clinical development candidate, SC83288, are fast-acting compounds that can cure a P. falciparum infection in a humanized NOD/SCID mouse model system. Detailed preclinical pharmacokinetic and toxicological studies reveal no observable drawbacks. Ultra-deep sequencing of resistant parasites identifies the sarco/endoplasmic reticulum Ca(2+) transporting PfATP6 as a putative determinant of resistance to SC81458 and SC83288. Features, such as fast parasite killing, good safety margin, a potentially novel mode of action and a distinct chemotype support the clinical development of SC83288, as an intravenous application for the treatment of severe malaria

Sodium and potassium intake patterns and trends in South Korea

We examined major trends and patterns regarding sodium and potassium intake and the ratio of sodium and potassium in the diets of South Koreans. We analyzed detailed 24-hour dietary recall data collected from 10,267; 8,819; and 9,264 subjects ages two years and older in the 1998, 2005, and 2009 Korean National Health and Nutrition Examination Surveys, respectively. Mean sodium intake did not change significantly between 1998 and 2009 (4.6 g/d vs 4.7 g/d), while potassium intake increased significantly [2.6 g/d vs. 2.9 g/d (p < 0.001)]. The major dietary sodium sources were kimchi, salt, soy sauce, and soybean paste, and most potassium came from unprocessed foods (white rice, vegetables, kimchi, and fruits). About 50 percent of the participants consumed 4 or more grams of sodium per capita per day. The proportion of respondents consuming 4 to 6 grams of potassium per capita per day increased from 10.3 percent in 1998 to 14.3 percent in 2009 (p < 0.001), and the sodium-potassium ratio decreased from 1.88 to 1.71 (p < 0.001). One major implication is that efforts to reduce sodium in processed foods will be ineffective and future efforts must focus on both education to reduce use of sodium in food preparation and sodium replacement in salt, possibly with potassium

Prevalence and energy intake from snacking in Brazil: analysis of the first nationwide individual survey

Snacking has increased globally. We examine snacking patterns and common snack foods in Brazil

Novel Endochin-Like Quinolones Exhibit Potent In Vitro Activity against Plasmodium knowlesi but Do Not Synergize with Proguanil.

Quinolones, such as the antimalarial atovaquone, are inhibitors of the malarial mitochondrial cytochrome bc1 complex, a target critical to the survival of both liver- and blood-stage parasites, making these drugs useful as both prophylaxis and treatment. Recently, several derivatives of endochin have been optimized to produce novel quinolones that are active in vitro and in animal models. While these quinolones exhibit potent ex vivo activity against Plasmodium falciparum and Plasmodium vivax, their activity against the zoonotic agent Plasmodium knowlesi is unknown. We screened several of these novel endochin-like quinolones (ELQs) for their activity against P. knowlesiin vitro and compared this with their activity against P. falciparum tested under identical conditions. We demonstrated that ELQs are potent against P. knowlesi (50% effective concentration, <117?nM) and equally effective against P. falciparum We then screened selected quinolones and partner drugs using a longer exposure (2.5 life cycles) and found that proguanil is 10-fold less potent against P. knowlesi than P. falciparum, while the quinolones demonstrate similar potency. Finally, we used isobologram analysis to compare combinations of the ELQs with either proguanil or atovaquone. We show that all quinolone combinations with proguanil are synergistic against P. falciparum However, against P. knowlesi, no evidence of synergy between proguanil and the quinolones was found. Importantly, the combination of the novel quinolone ELQ-300 with atovaquone was synergistic against both species. Our data identify potentially important species differences in proguanil susceptibility and in the interaction of proguanil with quinolones and support the ongoing development of novel quinolones as potent antimalarials that target multiple species

The relationship between family and child weight status by household structure in South Korea: 2007–2010

Objective:Parental obesity has been identified as a predominant risk factor for childhood overweight and obesity. We investigated the relationship between parent and child obesity in South Korea, particularly linked with varying family structures.Subjects and methods:Data for households with children aged 2–18 years were taken from the pooled data of the Korea National Health and Nutrition Examination Survey (KNHANES) 2007–2010 conducted by the Korea Centers for Disease Control and Prevention (KCDC). The sample consisted of 17 453 individuals (7879 children and 9574 adults) from 5048 households with children for this study. Children's overweight and obesity prevalence was compared using both International Obesity Taskforce (IOTF) and KCDC cutoff points according to parental weight status and household structure. Logistic regression analysis was used.Results:Significantly greater odds of overweight and obesity existed among children living with both parents (odds ratio (OR)=3.5, 95% confidence interval (CI): 2.71, 4.65) or one parent (mother: OR=1.6, 95% CI: 1.22, 2.12; father: OR=1.7, 95% CI: 1.37, 1.99). The adjusted ORs for overweight and obesity among children living with overweight mother only or overweight grandparent only were approximately double that of children living with normal-weight mother (OR=2.2, 95% CI: 1.22–3.82) or normal-weight grandparent (OR=2.1, 95% CI: 1.06–4.05).Conclusion:Children living with overweight parent(s) or grandparent(s) were positively correlated with the risk for childhood overweight and obesity. Socioeconomic status did not affect the observed relationships in this population, whereas the role of genetic, dietary and activity patterns requires further exploration

LOCALIZED CORROSION OF AUSTENITIC STAINLESS STEELEXPOSED TO MIXTURES OF PLUTONIUM OXIDE AND CHLORIDE SALTS

Laboratory corrosion tests were conducted to investigate the corrosivity of moist plutonium oxide/chloride (PuO{sub 2}/Cl-) salt mixtures on 304L and 316L stainless steel coupons. The tests exposed flat coupons for pitting evaluation and 'teardrop' stressed coupons for stress corrosion cracking (SCC) evaluation at room temperature to various mixtures of PuO{sub 2} and chloride-bearing salts for periods up to 500 days. The two flat coupons were placed so that the solid oxide/salt mixture contacted about one half of the coupon surface. One teardrop coupon was placed in contact with solid mixture; the second teardrop was in contact with the headspace gas only. The mixtures were loaded with nominally 0.5 wt % water under a helium atmosphere. Observations of corrosion ranged from superficial staining to pitting and SCC. The extent of corrosion depended on the total salt concentration and on the composition of the salt. The most significant corrosion was found in coupons that were exposed to 98 wt % PuO{sub 2}, 2 wt % chloride salt mixtures that contained calcium chloride. SCC was observed in two 304L stainless steel teardrop coupons exposed in solid contact to a mixture of 98 wt % PuO{sub 2}, 0.9 wt % NaCl, 0.9 wt % KCl, and 0.2 wt % CaCl{sub 2}. The cracking was associated with the heat-affected zone of an autogenous weld that ran across the center of the coupon. Cracking was not observed in coupons exposed to the headspace gas, nor in coupons exposed to other mixtures with either 0.92 wt% CaCl{sub 2} or no CaCl{sub 2}. The corrosion results point to the significance of the interaction between water loading and the concentration of the hydrating salt CaCl{sub 2} in the susceptibility of austenitic stainless steels to corrosion