581 research outputs found
Trends in U.S. Local and Regional Food Systems: A Report to Congress
This report provides an overview of local and regional food systems across several dimensions. It details the latest economic information on local food producers, consumers, and policy, relying on findings from several national surveys and a synthesis of recent literature to assess the current size of and recent trends in local and regional food systems. Data are presented on producer characteristics, survival rates and growth, and prices. The local food literature on consumer willingness to pay, environmental impacts, food safety regulations, and local economic impacts is synthesized when nationally representative data are unavailable. Finally, this report provides an overview of Federal and selected State and regional policies designed to support local food systems and collaboration among market participants
Connecting urban food plans to the countryside: leveraging Denver's food vision to explore meaningful rural-urban linkages
Includes bibliographical references (pages 14-18).Cities are increasingly turning to food policy plans to support goals related to food access, food security, the environment, and economic development. This paper investigates ways that rural farmers, communities, and economies can both support and be supported by metropolitan food-focused initiatives. Specifically, our research question asked what opportunities and barriers exist to developing food policies that support urban food goals, particularly related to local procurement, as well as rural economic development. To address this question, we described and analyzed a meeting of urban stakeholders and larger-scale rural producers related to Coloradoâs Denver Food Vision and Plan. We documented and explored âfindingsâ gleaned from a supply chain diagraming and data compilation process that were then used to inform an event that brought together diverse supply chain partners. Three findings stand out. First, facilitating dialog between urban food policymakers and rural producers to understand potential tensions, mitigate such tensions, and capitalize on opportunities is essential. Second, perceptions and expectations surrounding âgood foodâ are nuancedâa timely finding given the number of preferred procurement programs emerging across the county. Third, critical evaluation is needed across a diverse set of value chain strategies (e.g., conventional and alternative distribution) if food policy intends to support heterogeneous producers, their communities, and urban food policy goals
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Evaluation of Pulmonary Fibrosis Outcomes by Race and Ethnicity in US Adults
Importance: Pulmonary fibrosis (PF) is characterized by progressive scarring of lung tissue and poor survival. Racial and ethnic minority populations face the greatest risk of morbidity and mortality from disparities impacting respiratory health, but the pattern of age at clinically relevant outcomes across diverse racial and ethnic populations with PF is unknown. Objective: To compare the age at PF-related outcomes and the heterogeneity in survival patterns among Hispanic, non-Hispanic Black, and non-Hispanic White participants. Design, setting, and participants: This cohort study included adult patients with a PF diagnosis and used data from prospective clinical registries: the Pulmonary Fibrosis Foundation Registry (PFFR) for the primary cohort and registries from 4 geographically distinct tertiary hospitals in the US for the external multicenter validation (EMV) cohort. Patients were followed between January 2003 and April 2021. Exposures: Race and ethnicity comparisons between Black, Hispanic, and White participants with PF. Main outcomes and measures: Age and sex distribution of participants were measured at the time of study enrollment. All-cause mortality and age at PF diagnosis, hospitalization, lung transplant, and death were assessed in participants over 14 389 person-years. Differences between racial and ethnic groups were compared using Wilcoxon rank sum tests, Bartlett 1-way analysis of variance, and Ï2 tests, and crude mortality rates and rate ratios were assessed across racial and ethnic categories using Cox proportional hazards regression models. Results: In total, 4792 participants with PF were assessed (mean [SD] age, 66.1 [11.2] years; 2779 [58.0%] male; 488 [10.2%] Black, 319 [6.7%] Hispanic, and 3985 [83.2%] White); 1904 were in the PFFR and 2888 in the EMV cohort. Black patients with PF were consistently younger than White patients (mean [SD] age at baseline, 57.9 [12.0] vs 68.6 [9.6] years; P Conclusions and relevance: In this cohort study of participants with PF, racial and ethnic disparities, especially among Black patients, were found in PF-related outcomes, including earlier onset of death. Further research is essential to identify and mitigate the underlying responsible factors.</p
Body size and shape changes and the risk of diabetes in the Diabetes Prevention Program
Prezentowane badanie przeprowadzono w celu
sprawdzenia hipotezy, zgodnie z ktĂłrÄ
ryzyko rozwoju
cukrzycy typu 2 zmniejsza siÄ wraz z redukcjÄ
masy ciaĆa i otyĆoĆci brzusznej. Do badania Diabetes
Prevention Program (DPP) wĆÄ
czono osoby, u ktĂłrych
rozpoznawano upoĆledzonÄ
tolerancjÄ glukozy,
i zakwalifikowano je do grup otrzymujÄ
cych placebo
lub metforminÄ albo wprowadzono tylko modyfikacjÄ
stylu ĆŒycia. U uczestnikĂłw badania okreĆlono
wzrost, masÄ ciaĆa oraz zmierzono tkankÄ tĆuszczowÄ
na poziomie L2-L3 i L4-L5 za pomocÄ
tomografii
komputerowej na poczÄ
tku badania oraz po roku. Zastosowano modele proporcjonalnego ryzyka Coxa
w celu oceny, zaleĆŒnie od pĆci, wpĆywu zmiany tych
parametrĂłw w ciÄ
gu roku na rozwĂłj cukrzycy
w okresie dalszej obserwacji, ktĂłrÄ
prowadzono
u 758 osĂłb. Modyfikacja stylu ĆŒycia doprowadziĆa
do redukcji trzewnej tkanki tĆuszczowej na poziomie
L2-L3 (mÄĆŒczyĆșni: -24,3%; kobiety: -18,2%) oraz
na poziomie L4-L5 (mÄĆŒczyĆșni: -22,4%, kobiety:
-17,8%), tkanki tĆuszczowej podskĂłrnej na poziomie
L2-L3 (mÄĆŒczyĆșni: -15,7%, kobiety: -11,4%) i L4-L5
(mÄĆŒczyĆșni: -16,7%, kobiety: -11,9%), do zmniejszenia
masy ciaĆa (mÄĆŒczyĆșni: -8,2%, kobiety: -7,8%),
wskaĆșnika masy ciaĆa (mÄĆŒczyĆșni: -8,2%, kobiety:
-7,8%) oraz obwodu talii (mÄĆŒczyĆșni: -7,5%, kobiety
-6,1%). W grupie otrzymujÄ
cej metforminÄ zaobserwowano
redukcjÄ masy ciaĆa (-2,9%) i obniĆŒenie
wskaĆșnika masy ciaĆa (-2,9%) u mÄĆŒczyzn oraz
zmniejszenie iloĆci podskĂłrnej tkanki tĆuszczowej
(-3,6% na poziomie L2-L3 i -4,7% na poziomie L4-L5), masy ciaĆa (-3,3%), wskaĆșnika masy ciaĆa
(-3,3%) oraz obwodu talii (-2,8%) u kobiet. Zmniejszenie
ryzyka rozwoju cukrzycy poprzez zmianÄ stylu ĆŒycia wiÄ
zaĆo siÄ z redukcjÄ
masy ciaĆa, wskaĆșnika
masy ciaĆa oraz rozkĆadu tkanki tĆuszczowej po
skorygowaniu wzglÄdem wieku oraz pochodzenia
etnicznego (ustalano je na podstawie informacji uzyskanej
od uczestnikĂłw). Zmniejszenie ryzyka rozwoju
cukrzycy poprzez zmianÄ stylu ĆŒycia moĆŒe nastÄ
piÄ
zarĂłwno poprzez wpĆyw na caĆÄ
tkankÄ tĆuszczowÄ
,
jak i brzusznÄ
tkankÄ tĆuszczowÄ
; wpĆyw metforminy
wydawaĆ siÄ niezaleĆŒny od zmian tkanki tĆuszczowej.The researchers conducted this study to test the
hypothesis that risk of type 2 diabetes is less following
reductions in body size and central adiposity.
The Diabetes Prevention Program (DPP) recruited and
randomized individuals with impaired glucose tolerance
to treatment with placebo, metformin, or lifestyle
modification. Height, weight, waist circumference,
and subcutaneous and visceral fat at L2-L3
and L4-L5 by computed tomography were measured
at baseline and at 1 year. Cox proportional hazards
models assessed by sex the effect of change
in these variables over the 1st year of intervention
upon development of diabetes over subsequent follow-
up in a subset of 758 participants. Lifestyle reduced
visceral fat at L2-L3 (men -24.3%, women
-18.2%) and at L4-L5 (men -22.4%, women -17.8%),
subcutaneous fat at L2-L3 (men -15.7%, women
-11.4%) and at L4-L5 (men -16.7%, women -11.9%),
weight (men –8.2%, women –7.8%), BMI (men -8.2%,
women -7.8%), and waist circumference (men
-7.5%, women -6.1%). Metformin reduced weight
(-2.9%) and BMI (-2.9%) in men and subcutaneous
fat (-3.6% at L2-L3 and -4.7% at L4-L5), weight
(-3.3%), BMI (-3.3%), and waist circumference
(-2.8%) in women. Decreased diabetes risk by lifestyle
intervention was associated with reductions of
body weight, BMI, and central body fat distribution
after adjustment for age and self-reported ethnicity.
Reduced diabetes risk with lifestyle intervention
may have been through effects upon both overall
body fat and central body fat but with metformin
appeared to be independent of body fat
The VicGeneration study - a birth cohort to examine the environmental, behavioural and biological predictors of early childhood caries: background, aims and methods
Background
Dental caries (decay) during childhood is largely preventable however it remains a significant and costly public health concern, identified as the most prevalent chronic disease of childhood. Caries in children aged less than five years (early childhood caries) is a rapid and progressive disease that can be painful and debilitating, and significantly increases the likelihood of poor child growth, development and social outcomes. Early childhood caries may also result in a substantial social burden on families and significant costs to the public health system. A disproportionate burden of disease is also experienced by disadvantaged populations.
Methods/Design
This study involves the establishment of a birth cohort in disadvantaged communities in Victoria, Australia. Children will be followed for at least 18 months and the data gathered will explore longitudinal relationships and generate new evidence on the natural history of early childhood caries, the prevalence of the disease and relative contributions of risk and protective biological, environmental and behavioural factors. Specifically, the study aims to:
1. Describe the natural history of early childhood caries (at ages 1, 6, 12 and 18 months), tracking pathways from early bacterial colonisation, through non-cavitated enamel white spot lesions to cavitated lesions extending into dentine.
2. Enumerate oral bacterial species in the saliva of infants and their primary care giver.
3. Identify the strength of concurrent associations between early childhood caries and putative risk and protective factors, including biological (eg microbiota, saliva), environmental (fluoride exposure) and socio-behavioural factors (proximal factors such as: feeding practices and oral hygiene; and distal factors such as parental health behaviours, physical health, coping and broader socio-economic conditions).
4. Quantify the longitudinal relationships between these factors and the development and progression of early childhood caries from age 1-18 months.
Discussion
There is currently a lack of research describing the natural history of early childhood caries in very young children, or exploring the interactions between risk and protective factors that extend to include contemporary measures of socio-behavioural factors. This study will generate knowledge about pathways, prevalence and preventive opportunities for early childhood caries, the most prevalent child health inequality
Splash!: a prospective birth cohort study of the impact of environmental, social and family-level influences on child oral health and obesity related risk factors and outcomes
Background: Dental caries (decay) is the most prevalent disease of childhood. It is often left untreated and can impact negatively on general health, and physical, developmental, social and learning outcomes. Similar to other health issues, the greatest burden of dental caries is seen in those of low socio-economic position. In addition, a number of diet-related risk factors for dental caries are shared risk factors for the development of childhood obesity. These include high and frequent consumption of refined carbohydrates (predominately sugars), and soft drinks and other sweetened beverages, and low intake of (fluoridated) water. The prevalence of childhood obesity is also at a concerning level in most countries and there is an opportunity to determine interventions for addressing both of these largely preventable conditions through sustainable and equitable solutions. This study aims to prospectively examine the impact of drink choices on child obesity risk and oral health status.Methods/Design: This is a two-stage study using a mixed methods research approach. The first stage involves qualitative interviews of a sub-sample of recruited parents to develop an understanding of the processes involved in drink choice, and inform the development of the Discrete Choice Experiment analysis and the measurement instruments to be used in the second stage. The second stage involves the establishment of a prospective birth cohort of 500 children from disadvantaged communities in rural and regional Victoria, Australia (with and without water fluoridation). This longitudinal design allows measurement of changes in the child’s diet over time, exposure to fluoride sources including water, dental caries progression, and the risk of childhood obesity.Discussion: This research will provide a unique contribution to integrated health, education and social policy and program directions, by providing clearer policy relevant evidence on strategies to counter social and environmental factors which predispose infants and children to poor health, wellbeing and social outcomes; and evidence-based strategies to promote health and prevent disease through the adoption of healthier lifestyles and diet. Further, given the absence of evidence on the processes and effectiveness of contemporary policy implementation, such as community water fluoridation in rural and regional communities it’s approach and findings will be extremelyinformative.<br /
The biology of color
Coloration mediates the relationship between an organism and its environment in important ways, including social signaling, antipredator defenses, parasitic exploitation, thermoregulation, and protection from ultraviolet light, microbes, and abrasion. Methodological breakthroughs are accelerating knowledge of the processes underlying both the production of animal coloration and its perception, experiments are advancing understanding of mechanism and function, and measurements of color collected noninvasively and at a global scale are opening windows to evolutionary dynamics more generally. Here we provide a roadmap of these advances and identify hitherto unrecognized challenges for this multi- and interdisciplinary field
Transformations of self: a phenomenological investigation into the lived experience of survivors of critical illness
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