466 research outputs found
Parent and household influences on calcium intake among early adolescents.
Background
Calcium intake during early adolescence falls short of requirements for maximum bone accretion. Parents and the home food environment potentially influence childrenâs calcium intakes. This study aimed to quantify parental psychosocial factors (PSF) predicting calcium intakes of Asian, Hispanic, and non-Hispanic white (NHW) early adolescent children from a parental perspective.
Methods
This was a cross-sectional study involving the administration of a validated calcium-specific food frequency questionnaire to a convenience sample of children aged 10â13âyears and the primary individual responsible for food acquisition in the childâs household. Based on Social Cognitive Theory, parental factors potentially associated with childrenâs calcium intake were also assessed via parent questionnaires. The total study sample consisted of 633 parent-child pairs (Asianâ=â110, Hispanicâ=â239, NHWâ=â284). Questionnaires were completed at community-based centers/sites. Outcome measures were the association between parent-child calcium (mg), milk (cups/day), and soda (cans/day) intakes and the predictive value of significant parental PSF towards calcium intakes of their children. Sex-adjusted linear regression and multivariate analyses were performed.
Results
Calcium intakes of parent-child pairs were positively associated among all ethnic groups (râ=â0.296; Pâ<â0.001). Soda intakes were positively associated among Hispanic parent-child pairs only (râ=â0.343; Pâ<â0.001). Home availability of calcium-rich foods (CRF), parental rules and expectations for their childâs intake of beverages, and parentsâ calcium intake/role modeling were positively associated with childrenâs calcium intake and overwhelmed all other PSF in multivariate analyses. Significant cultural differences were observed. Parental role modeling was a significant factor among Hispanic dyads only. Multivariate models explained 19â21% of the variance in childrenâs calcium intakes.
Conclusions
Nutrition interventions to improve childrenâs calcium intakes should focus on parents and provide guidance on improving home availability of CRF and increasing rules and expectations for the consumption of CRF. Among Hispanic families, interventions promoting parental modeling of desired dietary behaviors may be most successful
Effect of a multi-site trial using short message service (SMS) on infant feeding practices and weight gain in low-income minorities.
Objective: To test the effects of weekly SMS for improving infant
feeding practices and infant weight.
Methods: This was a multi-site randomized clinical trial in a
convenience sample of 202 caregivers of healthy term infants 0â2 months
participating in the WIC program in Puerto Rico and Hawaii. Participants
were randomized to receive SMS about infant's general health issues
(control) or SMS for improving feeding practices (intervention) for four
months. Weight, length and infant feeding practices were assessed at
baseline and four months later.
Results: A total of 170 participants completed the study (n = 86 control
and n = 84 intervention). Baseline characteristics were similar between
groups. At the end, exclusive breastfeeding rates were similar between
groups (67.4% control and 59.1% intervention). Introduction of other
foods and beverages, addition of foods to the bottle, placing infants to
sleep with milk bottles, caregiver's method and response to feeding
infants and distractions while feeding infants were similar between
groups. Also, weight status or rate of weight gain was similar between
groups.
Conclusion: There were no significant improvements in feeding practices
or in weight with the intervention. The timeline of the messages in
relation to the targeted behavior may have affected the effectiveness of
the intervention. Earlier dissemination of messages, higher level of
intensity, longer intervention, additional contacts and inclusion of
other caregivers may be needed to achieve the desired effects
A triangulated perspective for understanding CAM use in Lebanon: a qualitative study.
Background: Existing evidence marked a prevalent use of Complementary and Alternative Medicine (CAM) therapies in Lebanon that is concomitant with low rates of disclosure to health care providers and limited knowledge among the general public of safety and side effects of CAM use.
Objectives: To examine the perspectives of Lebanese CAM users, CAM providers, and health care providers (HCPs) regarding their understanding of CAM and of the Push and Pull factors that drive its use.
Methods: A qualitative research study was conducted using in-depth interviews, targeting Lebanese adults (CAM users; 18-65 years) (n=14), CAM providers such as yoga instructors, owners of CAM product outlets, herbalists, and religious figures (n=13); and HCPs including physicians, nurses, dietitians, and pharmacists (n=14). The topic guide covered, in addition to the understanding of CAM, the Push and Pull factors driving CAM use. The adults were recruited by convenient sampling, and CAM providers and HCPs using a purposive sampling approach. Interviews were audiotaped, transcribed, and translated into English. Analysis was performed using a qualitative thematic approach. Similarities and differences in the perceptions of the participants with regards to factors that influence CAM use were charted and contrasted, using a triangulated approach.
Results: The three study groups exhibited a similar understanding of CAM, referring to non-conventional therapies used to prevent/treat diseases or to enhance wellbeing. CAM users and CAM providers identified "distrust in HCPs", "lack of patient-centered care in CM", and "limitations and side effects of CM" as important Push factors. All study groups highlighted the limited CAM knowledge of HCPs as a main reason for the lack of patient-centered care. All three groups also underscored the affordability and the social and cultural support for CAM as main enablers of its prevalent use. Unlike HCPs who were skeptical about the safety and effectiveness of CAM, CAM users and CAM providers indicated that most of CAM therapies are safe and efficient.
Conclusions: The triangulation of perspectives (CAM users, CAM providers, and HCPs) in this study allowed a comprehensive appraisal of CAM use and its drivers. Improving the HCPs' CAM-related knowledge, promoting patient-centered care and fostering an open dialogue between HCPs and CAM providers are among the recommendations of the study.
Background: Existing evidence marked a prevalent use of Complementary and Alternative Medicine (CAM) therapies in Lebanon that is concomitant with low rates of disclosure to health care providers and limited knowledge among the general public of safety and side effects of CAM use.
Objectives: To examine the perspectives of Lebanese CAM users, CAM providers, and health care providers (HCPs) regarding their understanding of CAM and of the Push and Pull factors that drive its use.
Methods: A qualitative research study was conducted using in-depth interviews, targeting Lebanese adults (CAM users; 18-65 years) (n=14), CAM providers such as yoga instructors, owners of CAM product outlets, herbalists, and religious figures (n=13); and HCPs including physicians, nurses, dietitians, and pharmacists (n=14). The topic guide covered, in addition to the understanding of CAM, the Push and Pull factors driving CAM use. The adults were recruited by convenient sampling, and CAM providers and HCPs using a purposive sampling approach. Interviews were audiotaped, transcribed, and translated into English. Analysis was performed using a qualitative thematic approach. Similarities and differences in the perceptions of the participants with regards to factors that influence CAM use were charted and contrasted, using a triangulated approach.
Results: The three study groups exhibited a similar understanding of CAM, referring to non-conventional therapies used to prevent/treat diseases or to enhance wellbeing. CAM users and CAM providers identified "distrust in HCPs", "lack of patient-centered care in CM", and "limitations and side effects of CM" as important Push factors. All study groups highlighted the limited CAM knowledge of HCPs as a main reason for the lack of patient-centered care. All three groups also underscored the affordability and the social and cultural support for CAM as main enablers of its prevalent use. Unlike HCPs who were skeptical about the safety and effectiveness of CAM, CAM users and CAM providers indicated that most of CAM therapies are safe and efficient.
Conclusions: The triangulation of perspectives (CAM users, CAM providers, and HCPs) in this study allowed a comprehensive appraisal of CAM use and its drivers. Improving the HCPs' CAM-related knowledge, promoting patient-centered care and fostering an open dialogue between HCPs and CAM providers are among the recommendations of the study
Novel targets for immune-checkpoint inhibition in cancer.
Immune-checkpoint inhibitors have revolutionized cancer therapy, yet many patients either do not derive any benefit from treatment or develop a resistance to checkpoint inhibitors. Intrinsic resistance can result from neoantigen depletion, defective antigen presentation, PD-L1 downregulation, immune-checkpoint ligand upregulation, immunosuppression, and tumor cell phenotypic changes. On the other hand, extrinsic resistance involves acquired upregulation of inhibitory immune-checkpoints, leading to T-cell exhaustion. Current data suggest that PD-1, CTLA-4, and LAG-3 upregulation limits the efficacy of single-agent immune-checkpoint inhibitors. Ongoing clinical trials are investigating novel immune-checkpoint targets to avoid or overcome resistance. This review provides an in-depth analysis of the evolving landscape of potentially targetable immune-checkpoints in cancer. We highlight their biology, emphasizing the current understanding of resistance mechanisms and focusing on promising strategies that are under investigation. We also summarize current results and ongoing clinical trials in this crucial field that could once again revolutionize outcomes for cancer patients
Conception et rĂ©alisation des capteurs hybrides photovoltaĂŻque-thermiques sous vide ou avec lame dâair confinĂ©e
Cette Ă©tude fait lâanalyse des performances thermiques et Ă©lectriques de deux types de capteurs solaires hybrides photovoltaĂŻque-thermiques Ă air intĂ©grables en toitures des bĂątiments. Pour ces capteurs hybrides, les cellules PV sont isolĂ©es soit avec une lame dâair confinĂ©e ou soit avec un gap vide. La modĂ©lisation des transferts de chaleur dans les systĂšmes est effectuĂ©e en 2D et en rĂ©gime transitoire, suivant lâapproche nodale. Le code numĂ©rique dĂ©veloppĂ© a Ă©tĂ© validĂ© et a permis dâanalyser les comportements thermiques ainsi que les efficacitĂ©s thermique et Ă©lectrique des capteurs. Lâoptimisation des paramĂštres fonctionnels est ensuite effectuĂ©e et prĂ©sentĂ©e.Mots-clĂ©s: Ă©nergie solaire, cellules photovoltaĂŻques, capteurs solaires hybrides (PV/T), transferts thermiques. Conception and realization of hybrid photovoltaic thermal collectors with empty gap or with enclosed air cavityThe present work reports thermal and electrical efficiencies for two solar hybrid photovoltaic-thermal air collectors integrated into the roof of the buildings. In these hybrid collectors, the PV cells are insulated with the enclosed air film or with the empty gap cavity. The unsteady and two-dimensional heat transfer equations are proposed and these equations are discretized using nodal method. The numerical model developed is validated. Then thermal and electrical efficiencies are analyzed for the collectors. The optimization of the characteristics parameters is studied in detail.Keywords: solar energy, photovoltaic cells, hybrid solar collector, heat transfer, nodal method
Factors associated with food safety knowledge and practices among meat handlers in Bangladesh: a cross-sectional study.
Background
Food handlers can play a vital role into reducing foodborne diseases by adopting appropriate food handling and sanitation practices in working plants. This study aimed to assess the factors associated with food safety knowledge and practices among meat handlers who work at butcher shops in Bangladesh.
Methods
A cross-sectional study was conducted among 300 meat handlers from January to March, 2021. Data were collected through in-person interviews using a structured questionnaire. The questionnaire consisted of three parts; socio-demographic characteristics, assessments of food safety knowledge, and food safety practices. A multiple logistic regression model was used to identify the factors associated with food safety knowledge and practices.
Results
Only 20% [95% confidence interval, (CI) 15.7â24.7] and 16.3% (95% CI 12.3â20.7) of the respondents demonstrated good levels of food safety knowledge and practices, respectively. The factors associated with good levels of food safety knowledge were: having a higher secondary education [adjusted odds ratio (AOR) = 4.57, 95% CI 1.11â18.76], income above 25,000 BDT/month (AOR = 10.52, 95% CI 3.43â32.26), work experience of > 10 years (AOR = 9.31, 95% CI 1.92â45.09), â„ 8 h per day of work (AOR = 6.14, 95% CI 2.69â13.10), employed on a daily basis (AOR = 4.05, 95% CI 1.16â14.14), and having food safety training (AOR = 8.98 95% CI 2.16â37.32). Good food safety knowledge (AOR = 5.68, 95% CI 2.33â13.87) and working â„ 8 h per day (AOR = 8.44, 95% CI 3.11â22.91) were significantly associated with a good level of food safety practice.
Conclusions
Poor knowledge and practices regarding food safety were found among Bangladeshi meat handlers. Findings may help public health professionals and practitioners develop targeted strategies to improve food safety knowledge and practices among this population. Such strategies may include education and sensitization on good food safety practices
Parent and Household Influences on Calcium Intake Among Early Adolescents
Background: Calcium intake during early adolescence falls short of requirements for maximum bone accretion. Parents and the home food environment potentially influence childrenâs calcium intakes. This study aimed to quantify parental psychosocial factors (PSF) predicting calcium intakes of Asian, Hispanic, and non-Hispanic white (NHW) early adolescent children from a parental perspective.
Methods: This was a cross-sectional study involving the administration of a validated calcium-specific food frequency questionnaire to a convenience sample of children aged 10â13âyears and the primary individual responsible for food acquisition in the childâs household. Based on Social Cognitive Theory, parental factors potentially associated with childrenâs calcium intake were also assessed via parent questionnaires. The total study sample consisted of 633 parent-child pairs (Asianâ=â110, Hispanicâ=â239, NHWâ=â284). Questionnaires were completed at community-based centers/sites. Outcome measures were the association between parent-child calcium (mg), milk (cups/day), and soda (cans/day) intakes and the predictive value of significant parental PSF towards calcium intakes of their children. Sex-adjusted linear regression and multivariate analyses were performed.
Results: Calcium intakes of parent-child pairs were positively associated among all ethnic groups (râ=â0.296; Pâ\u3câ0.001). Soda intakes were positively associated among Hispanic parent-child pairs only (râ=â0.343; Pâ\u3câ0.001). Home availability of calcium-rich foods (CRF), parental rules and expectations for their childâs intake of beverages, and parentsâ calcium intake/role modeling were positively associated with childrenâs calcium intake and overwhelmed all other PSF in multivariate analyses. Significant cultural differences were observed. Parental role modeling was a significant factor among Hispanic dyads only. Multivariate models explained 19â21% of the variance in childrenâs calcium intakes.
Conclusions: Nutrition interventions to improve childrenâs calcium intakes should focus on parents and provide guidance on improving home availability of CRF and increasing rules and expectations for the consumption of CRF. Among Hispanic families, interventions promoting parental modeling of desired dietary behaviors may be most successful
Chemotherapy and diffuse low-grade gliomas: a survey within the European Low-Grade Glioma Network.
Diffuse low-grade gliomas (DLGGs) are rare and incurable tumors. Whereas maximal safe, functional-based surgical resection is the first-line treatment, the timing and choice of further treatments (chemotherapy, radiation therapy, or combined treatments) remain controversial.
An online survey on the management of DLGG patients was sent to 28 expert centers from the European Low-Grade Glioma Network (ELGGN) in May 2015. It contained 40 specific questions addressing the modalities of use of chemotherapy in these patients.
The survey demonstrated a significant heterogeneity in practice regarding the initial management of DLGG patients and the use of chemotherapy. Interestingly, radiation therapy combined with the procarbazine, CCNU (lomustine), and vincristine regimen has not imposed itself as the gold-standard treatment after surgery, despite the results of the Radiation Therapy Oncology Group 9802 study. Temozolomide is largely used as first-line treatment after surgical resection for high-risk DLGG patients, or at progression.
The heterogeneity in the management of patients with DLGG demonstrates that many questions regarding the postoperative strategy and the use of chemotherapy remain unanswered. Our survey reveals a high recruitment potential within the ELGGN for retrospective or prospective studies to generate new data regarding these issues
Instrumental activities of daily living in older patients with metastatic prostate cancer: results from the meet-URO network ADHERE prospective study
Instrumental activities of daily living (IADL) are significant health indicators closely related to executive functions and able to detect mild cognitive impairment. A decline in IADL usually precedes ADL limitation, including taking medications, and may therefore predict a cognitive decline. We aimed to investigate the association of patientsâ IADL score with other clinical factors, with a particular focus on the presence of a caregiver, and the impact on adherence to androgen receptor pathway inhibitors (ARPIs) and survival outcomes within the Meet-URO 5âADHERE study. It was a large prospective multicentre observational cohort study monitoring adherence to ARPIs in 234 metastatic castrate-resistant PC (mCRPC) patients aged â„ 70. We observed an association between impaired IADL and lower geriatric G8 scores (p < 0.01), and lower adherence to ARPIs whether assessed by pill counting (p = 0.01) or self-reported by the patient himself (p = 0.03). The combination of an IADL < 6 and the absence of a caregiver resulted in a significantly high risk of non-adherence to the ARPIs at the multivariable analysis (HR 9.23, 95% confidence interval 2.28â37.43, p = 0.01). IADL alongside the geriatric G8 scales represent essential tools to identify frail and less auto-sufficient patients who are extremely vulnerable particularly if not supported by a caregiver and have the highest risk of nonadherence to ARPIs
A Valid and Reliable Instrument for Cognitive Complexity Rating Assignment of Chemistry Exam Items
The design and use of a valid and reliable instrument for the assignment of cognitive complexity ratings to chemistry exam items is described in this paper. Use of such an instrument provides a simple method to quantify the cognitive demands of chemistry exam items. Instrument validity was established in two different ways: statistically significant correlations between expert-based cognitive complexity ratings and student performance (as measured through statistical difficulty of items), and statistically significant correlations between expert-based cognitive complexity ratings and student mental effort ratings. Key benefits associated with instrument use include an enhanced understanding of the cognitive complexity of chemistry assessment tasks and as a means for characterizing exam content for the measurement of cognitive development
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