An Assessment of US College Food Environments: From Food Service to College Students

Purpose: As obesity continues to increase among adolescents and young adults in the U.S. and these populations enter college, Institutions of Higher Learning (IHLs) are facing a changing set of student health issues. With these students comes an increased responsibility to address the nutritional environment of the campus. College health educators and food service programs are on the forefront of this issue and can provide important insights into the challenges and opportunities of providing and promoting healthy food options on IHLs. Method: Initially, a series of focus groups, primarily comprised of college health educators, were conducted. Topics included the discussion of the campus food environment, nutrition campaigns, comprehensive health campaigns, and food and nutritional policies influencing campus foods. Themes from the focus groups were used to design an interview script for IHL food service directors. Twenty-one IHL food service directors were interviewed about practices, policies, and strategies to promote a healthy nutritional environment. Results: Key topics included: educational and policy efforts for nutrition and healthy eating; healthy food choice availability and promotion; nutrition information distribution; nutrition programs led by registered dietitians; and education mechanisms using technology. The presence of a prominent champion for healthy foods was frequently cited as a factor for success. The most frequent medium for delivering nutrition and weight management education was the internet. Many participants cited a need for campus-wide policies addressing healthy food availability and nutrition and wellness promotion. Conclusion: Comprehensive wellness initiatives, food policies and environmental changes were reported as affective for improving healthy food availability for college students

Psychosocial concerns and needs of cancer survivors treated at a comprehensive cancer center and a community safety net hospital

The number of cancer survivors in the United States is expected to grow to 18 million by 2020 because of improved cancer treatment outcomes and the aging of the population.[1] Many cancer survivors are at increased risk for cancer recurrence and other adverse long-term physical and psychosocial conditions.[2-5] Disparities in survival are associated with inadequate or no health insurance coverage because individuals are more likely to be diagnosed with cancer at later stages,[6] and higher incidence for some cancers among African Americans.[7] Few studies have examined psychosocial health disparities during cancer survivorship,[8-13] and little is known about how psychosocial factors subsequent to diagnosis affect survival and long-term outcomes. [4,14] While clinical care relevant to survivorship outcomes is advancing, [15, 16] optimal practices for preparing survivors for treatment and transitioning off treatment have yet to be defined. [11, 15, 17] Furthermore, guidance is needed for serving minority and underserved survivor populations where health disparities exist.[7] More data are needed about incidence of adverse outcomes and their determinants, overall and in disparity populations to inform development of best practices for preventive interventions. The purpose of this study was to identify similarities and differences among two groups of survivors in (1) sources of information at time of cancer diagnosis, (2) sources of support used during and after treatment, (3) stressors and challenges during and after treatment, and (4) coping strategies[18] used during and following cancer treatment. These factors might be associated with health services use,[19] and with survivorship disparities.[20] One group was treated at Vanderbilt-Ingram Cancer Center (VICC), an NCI-designated comprehensive cancer center, and the other at Meharry Medical College (MMC), its partner medical setting that serves patients who are mostly publicly-insured and uninsured. Secondary analysis of data from focus group participants was undertaken to address the four study topics and to guide future development of interventions tailored to preferences and needs of diverse survivors

An evaluation of machine learning techniques to predict the outcome of children treated for Hodgkin-Lymphoma on the AHOD0031 trial: A report from the Children's Oncology Group

In this manuscript we analyze a data set containing information on children with Hodgkin Lymphoma (HL) enrolled on a clinical trial. Treatments received and survival status were collected together with other covariates such as demographics and clinical measurements. Our main task is to explore the potential of machine learning (ML) algorithms in a survival analysis context in order to improve over the Cox Proportional Hazard (CoxPH) model. We discuss the weaknesses of the CoxPH model we would like to improve upon and then we introduce multiple algorithms, from well-established ones to state-of-the-art models, that solve these issues. We then compare every model according to the concordance index and the brier score. Finally, we produce a series of recommendations, based on our experience, for practitioners that would like to benefit from the recent advances in artificial intelligence

From qualitative work to intervention development in pediatric oncology palliative care research

Qualitative methods can be particularly useful approaches to use with individuals who are experiencing a rare disease and thus who comprise a small sample (such as children with cancer) and are at points in care that few experience (such as end of life). This data-based methods article describes how findings from a qualitative study were used to guide and shape a pediatric oncology palliative care intervention. Qualitative data can lay a strong foundation for subsequent pilot intervention work by facilitating the development of an underlying study conceptualization, providing recruitment feasibility estimates, helping establish clinically meaningful inclusion criteria, establishing staff acceptability of a research intervention, and providing support for face validity of newly developed interventions. These benefits of preliminary qualitative research are described in the context of this study on legacy-making, which involves reports of children (7-12 years of age) living with advanced cancer and of their parent caregivers

How Position of Reading Questions Affects the Reading Comprehension of High and Low Ability Readers

This study investigates the optimum placement of reading questions in textbooks. Is it better to have reading questions embedded in chapters or placed at the end of chapters? One independent variable is reading question placement (embedded vs. end). Another independent variable is reading comprehension ability (higher vs. lower). Participants read a chapter from a statistics book, listened to stories as a distractor task, and then answered three types of questions about the statistics chapter. The dependent variable is the percent correct for each question type. Target questions tested the same content as a previous reading question. Related questions tested similar content. Non-target questions tested unrelated content. We will analyze our data with three 2 x 2 factorial ANOVAs. We expect embedded questions will help lower-ability readers on target and related questions. Further, embedded questions will hurt the performance of higher-ability readers on non-target questions. Higher and lower comprehenders differ in their ability to suppress irrelevant information. Embedded questions facilitate suppression processes by highlighting specific content in the reading. However, for high comprehenders who already suppress irrelevant information effectively, embedded questions may lead to “over suppression,” causing non-target information to be processed less well

Radiation-Related Treatment Effects Across the Age Spectrum: Differences and Similarities or What the Old and Young Can Learn from Each Other

Radiation related effects in children and adults limit the delivery of effective radiation doses and result in long-term morbidity affecting function and quality of life. Improvements in our understanding of the etiology and biology of these effects, including the influence of clinical variables, dosimetric factors, and the underlying biologic processes has made treatment safer and more efficacious. However, the approach to studying and understanding these effects differs between children and adults. By using the pulmonary and skeletal organ systems as examples, comparisons are made across the age spectrum for radiation related effects including pneumonitis, pulmonary fibrosis, osteonecrosis and fracture. Methods for dosimetric analysis, incorporation of imaging and biology as well a length of follow-up are compared, contrasted and discussed for both organ systems in children and adults. Better understanding of each age specific approach and how it differs may improve our ability to study late effects of radiation across the age

Enhancing Cancer Care of Rural Dwellers through Telehealth and Engagement (ENCORE): Protocol to Evaluate Effectiveness of a Multi-Level Telehealth-Based Intervention to Improve Rural Cancer Care Delivery

BACKGROUND: Despite lower cancer incidence rates, cancer mortality is higher among rural compared to urban dwellers. Patient, provider, and institutional level factors contribute to these disparities. The overarching objective of this study is to leverage the multidisciplinary, multispecialty oncology team from an academic cancer center in order to provide comprehensive cancer care at both the patient and provider levels in rural healthcare centers. Our specific aims are to: 1) evaluate the clinical effectiveness of a multi-level telehealth-based intervention consisting of provider access to molecular tumor board expertise along with patient access to a supportive care intervention to improve cancer care delivery; and 2) identify the facilitators and barriers to future larger scale dissemination and implementation of the multi-level intervention. METHODS: Coordinated by a National Cancer Institute-designated comprehensive cancer center, this study will include providers and patients across several clinics in two large healthcare systems serving rural communities. Using a telehealth-based molecular tumor board, sequencing results are reviewed, predictive and prognostic markers are discussed, and treatment plans are formulated between expert oncologists and rural providers. Simultaneously, the rural patients will be randomized to receive an evidence-based 6-week self-management supportive care program, Cancer Thriving and Surviving, versus an education attention control. Primary outcomes will be provider uptake of the molecular tumor board recommendation and patient treatment adherence. A mixed methods approach guided by the Consolidated Framework for Implementation Research that combines qualitative key informant interviews and quantitative surveys will be collected from both the patient and provider in order to identify facilitators and barriers to implementing the multi-level intervention. DISCUSSION: The proposed study will leverage information technology-enabled, team-based care delivery models in order to deliver comprehensive, coordinated, and high-quality cancer care to rural and/or underserved populations. Simultaneous attention to institutional, provider, and patient level barriers to quality care will afford the opportunity for us to broadly share oncology expertise and develop dissemination and implementation strategies that will enhance the cancer care delivered to patients residing within underserved rural communities. TRIAL REGISTRATION: Clinicaltrials.gov , NCT04758338 . Registered 17 February 2021 - Retrospectively registered, http://www.clinicaltrials.gov/

The alpha subunit of RNA polymerase and transcription antitermination

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72225/1/j.1365-2958.1996.451409.x.pd

Fetal Epidermal Differentiation and Barrier Development In Vivo is Accelerated by Nuclear Hormone Receptor Activators1

Nuclear receptors which interact with the retinoid X receptor are involved in the regulation of epidermal differentiation and development. We have recently shown that activators of the peroxisome proliferator-activated receptor and of the farnesoid X-activated receptor accelerate epidermal barrier maturation in fetal rat skin in vitro. In this study we asked whether cutaneous development in utero was affected by peroxisome proliferator-activated receptor or farnesoid X-activated receptor activators, or by an activator of another retinoid X receptor partner, liver X receptor. Activators of the peroxisome proliferator-activated receptor (clofibrate or linoleic acid), farnesoid X-activated receptor (farnesol or juvenile hormone III), or liver X receptor (22R-hydroxycholesterol), were injected into the amniotic fluid of fetal rats on gestational day 17. Fetal epidermal barrier function and morphology was assessed on day 19. Whereas vehicle-treated fetal rats displayed no measurable barrier (transepidermal water loss > 10 mg per cm2 per h), a measurable barrier was induced by the intra-amniotic administration of all activators tested (transepidermal water loss range 4.0–8.5 mg per cm2 per h). By light microscopy, control pups lacked a well-defined stratum corneum, whereas a distinct stratum corneum and a thickened stratum granulosum were present in treated pups. By electron microscopy, the extracellular spaces of the stratum corneum in control pups revealed a paucity of mature lamellar unit structures, whereas these structures filled the stratum corneum interstices in treated pups. Additionally, protein and mRNA levels of loricrin and filaggrin, two structural proteins of stratum corneum, were increased in treated epidermis, as were the activities of two lipid catabolic enzymes critical to stratum corneum function, β-glucocerebrosidase and steroid sulfatase. Finally, peroxisome proliferator-activated receptor-α and -δ and liver X receptor-α and -β mRNAs were detected in fetal epidermis by reverse transcriptase–polymerase chain reaction and northern analyses. The presence of these receptors and the ability of their activators to stimulate epidermal barrier and stratum corneum development suggest a physiologic role for peroxisome proliferator-activated receptor and liver X receptor and their endogenous ligands in the regulation of cutaneous development