The Farm Fresh Challenge: Formative Evaluation Results of a Multi-Component Farm-to-Grocery Store Program

Background: The 2015-2020 Dietary Guidelines for Americans recommend adults consume at least 4 and a half cups of fruits and vegetables (F/V) a day, yet research indicates these guidelines are not met. Furthermore, agricultural experts are concerned with the declining number of small farms and insufficient production of F/V. The primary purpose of this study was to conduct an assessment of a farm-to-grocery store program. Methods: Using the guiding foundations of community-based participatory research, the Farm Fresh Challenge (FFC) was developed. The FFC was a multi-component campaign designed to increase the availability of locally grown F/V in grocery stores, while challenging consumers to purchase, prepare, and consume local foods. A formative evaluation was conducted to assess adoption, implementation, reach, maintenance, and perceptions of the program. Results: Findings indicated: 1) more efforts are necessary to sustain grocer-farmer partnerships; 2) promotion of the program needed to be much more targeted in an effort to better promote local farmers and educate consumers on the benefits of supporting local food systems; and 3) consumers were largely unaware of the FFC. Conclusions: Farm and grocery store partnerships can serve as a feasible way to improve access to F/V while supporting the sustainability of small farms. However, efforts to educating the public on the benefits of supporting local food systems are warranted, and strategies for enhancing farmer-grocer relationships should be considered

Engaging Experts and Patients to Refine the Nutrition Literacy Assessment Instrument

Background An objective measure of nutrition literacy is unavailable for use in the primary care population. The Nutrition Literacy Assessment instrument (NLit) is a tool designed to measure nutrition literacy across six domains and has been previously piloted in breast cancer and parent populations. The purpose of this research was to engage nutrition experts and patients to guide revisions of the NLit for use in adult primary care. Methods Experts (n=5) reviewed each item in the NLit using a survey to assign rankings of their agreement according to relevance, clarity, and reading difficulty. Relevance rankings were used to calculate Scale Content Validity Index. After suggested revisions were made, patients (n=12) were recruited from urban primary care clinics of a University Medical Center located in the Midwestern United States and were interviewed by trained researchers using the cognitive interview approach to generate thoughts, feelings, and ideas regarding NLit items. Data analysis involved qualitative and quantitative methods. Results Content validity from expert review was confirmed with a total Scale Content Validity Index of 0.90. Themes emerging from the cognitive interviews resulted in changes in the NLit to improve instrument clarity. Conclusion These data suggest the NLit achieves its target constructs, is understood by the target audience, and is ready to undergo validity and reliability testing within the primary care population

Challenges and Opportunities to Updating Prescribing Information for Longstanding Oncology Drugs.

A number of important drugs used to treat cancer-many of which serve as the backbone of modern chemotherapy regimens-have outdated prescribing information in their drug labeling. The Food and Drug Administration is undertaking a pilot project to develop a process and criteria for updating prescribing information for longstanding oncology drugs, based on the breadth of knowledge the cancer community has accumulated with the use of these drugs over time. This article highlights a number of considerations for labeling updates, including selecting priorities for updating; data sources and evidentiary criteria; as well as the risks, challenges, and opportunities for iterative review to ensure prescribing information for oncology drugs remains relevant to current clinical practice

Estimation of Dietary Iron Bioavailability from Food Iron Intake and Iron Status

Currently there are no satisfactory methods for estimating dietary iron absorption (bioavailability) at a population level, but this is essential for deriving dietary reference values using the factorial approach. The aim of this work was to develop a novel approach for estimating dietary iron absorption using a population sample from a sub-section of the UK National Diet and Nutrition Survey (NDNS). Data were analyzed in 873 subjects from the 2000–2001 adult cohort of the NDNS, for whom both dietary intake data and hematological measures (hemoglobin and serum ferritin (SF) concentrations) were available. There were 495 men aged 19–64 y (mean age 42.7±12.1 y) and 378 pre-menopausal women (mean age 35.7±8.2 y). Individual dietary iron requirements were estimated using the Institute of Medicine calculations. A full probability approach was then applied to estimate the prevalence of dietary intakes that were insufficient to meet the needs of the men and women separately, based on their estimated daily iron intake and a series of absorption values ranging from 1–40%. The prevalence of SF concentrations below selected cut-off values (indicating that absorption was not high enough to maintain iron stores) was derived from individual SF concentrations. An estimate of dietary iron absorption required to maintain specified SF values was then calculated by matching the observed prevalence of insufficiency with the prevalence predicted for the series of absorption estimates. Mean daily dietary iron intakes were 13.5 mg for men and 9.8 mg for women. Mean calculated dietary absorption was 8% in men (50th percentile for SF 85 µg/L) and 17% in women (50th percentile for SF 38 µg/L). At a ferritin level of 45 µg/L estimated absorption was similar in men (14%) and women (13%). This new method can be used to calculate dietary iron absorption at a population level using data describing total iron intake and SF concentration

A televideo exercise and nutrition program for children with acute lymphoblastic leukemia in maintenance therapy: design and methods

Changes in nutrient intake and decreased exercise resulting from cancer therapies as well as their side effects may be contributing factors in the increased body weight and differences in physical fitness observed in survivors of childhood acute lymphoblastic leukemia (ALL). This article will describe the study protocol for an intervention program designed to improve the physical activity and nutrition behaviors of ALL survivors. Twenty-four children aged between 4 years and 12 years with ALL will be randomized to a 6-month technology-based exercise and nutrition program (TLC4ALLKids) or to enhanced usual care (eUC). The participants randomized to the TLC4ALLKids will participate in weekly, 1-hour coaching sessions on nutrition and physical activity and 1-hour physical activity classes delivered by group video conferencing. Participants will be provided with iPad tablets loaded with video conferencing software and the Healthy Lifestyle Tracking calendar to track daily nutrition and physical activity goals and weight. Both groups will be provided with Fitbit™ Zip to monitor physical activity. To assess feasibility, participant recruitment (achievement of proposed sample size), attendance (per weekly online sessions/assessment sessions), and adherence (number of families at 3 and 6 months) will be evaluated. Outcome measures to assess the intervention will include anthropometrics (weight, height, and waist circumference), physical activity (accelerometry), energy and macronutrient intake (food records), sleep habits (Children's Sleep Habits Questionnaire), and quality of life (Pediatric Quality of Life Inventory) will be obtained at baseline, 3 months, and 6 months. Semi-structured interviews will be used to gather information about ways to improve the program and overcome barriers to participation. If successful, the TLC4ALLKids intervention will provide a means to educate and improve the health behaviors of ALL survivors that can be delivered remotely and conveniently to participants

Effects of traumatic brain injury and posttraumatic stress disorder on development of Alzheimer's disease in Vietnam Veterans using the Alzheimer's Disease Neuroimaging Initiative: Preliminary report

Introduction Traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD) have previously been reported to be associated with increased risk of Alzheimer's disease (AD). We are using biomarkers to study Vietnam Veterans with/without mild cognitive impairment with a history of at least one TBI and/or ongoing PTSD to determine whether these contribute to the development of AD. Methods Potential subjects identified by Veterans Administration records underwent an initial telephone screen. Consented subjects underwent clinical evaluation, lumbar puncture, structural magnetic resonance imaging, and amyloid positron emission tomography (PET) scans. Results We observed worse cognitive functioning in PTSD and TBI + PTSD groups, worse global cognitive functioning in the PTSD group, lower superior parietal volume in the TBI + PTSD group, and lower amyloid positivity in the PTSD group, but not the TBI group compared to controls without TBI/PTSD. Medial temporal lobe atrophy was not increased in the PTSD and/or TBI groups. Discussion Preliminary results do not indicate that TBI or PTSD increase the risk for AD measured by amyloid PET. Additional recruitment, longitudinal follow-up, and tau-PET scans will provide more information in the future

The Ox on the Roof (Le Boeuf Sur le Toit)

Program for the third annual RISD Cabaret held in the Cellar of the Providence Art Club. Design and layout by Treva Offutt.https://digitalcommons.risd.edu/liberalarts_cabaret_programs/1002/thumbnail.jp

Gatekeepers of financial power: from London to Lagos

The main premise of this paper is that, until recently, African elites did not regulate or control financial flows moving across the continent. They were not financial gatekeepers. In Africa Since 1940, Cooper identified African elites as gatekeepers regulating access to resources and opportunities passing through strategic sites. This paper makes a case for revision of existing notions of the gatekeeper state in an ongoing effort to (re)negotiate the continent’s colonial past through two new arguments. The first is that financial power was never located at a ‘peripheral’ African gate, but resolutely held onto within leading financial centres, circumventing any opportunity for African elites to control financial flows. Failure to distinguish between types of flows distorts analysis of African political economic power under colonialism. It is only in the post-2000 period, that we see powerful African states driving the integration of African markets into the global financial system. The second argument is that these African goals to control financial flows correspond more to ‘gateway’ strategies than to gatekeeper. Drawing on the case of Lagos, I demonstrate how this ‘gateway’ concept better captures trans-scalar processes of new financial clustering in Africa’s emerging markets than a concept associated with ‘gates’ under Empire