Modifying the Recess Before Lunch Program: A Pilot Study in Kaneohe Elementary School

Moving recess before lunch (RBL), though a simple schedule change, may provide many benefits for both students and elementary schools. Having recess before lunch has been shown to decrease plate waste (Bergman, et al., 2003; Gettlinger, 1996; Montana OPI, 2003; Ruppenthal & Hogue, 1977), and may improve discipline problems. The RBL schedule change has not previously been implemented in Hawai‘i schools. The purpose of this pilot study was to assess the feasibility of implementing a modified version of RBL into elementary schools in Hawai‘i . The modified version of RBL allows for implementation into a three-bell lunch system, a system used by many elementary schools in Hawai‘i. A one-grade-per-lunch period RBL switch was assessed among 6th grade students for 1) shorter lunch line wait, 2) increased access to recess equipment 3) decrease in conduct-related referrals, and 4) moderate decrease in food and milk waste for the affected grade(s). Results indicate a significant decrease in lunch line wait, a decrease in discipline referrals, and a slight non-significant decrease in lunch waste. Additional comments from administrators and teaching staff indicate positive changes in student behavior on the playground, in the cafeteria, and in the classroom. One major finding was the reduction in discipline problems after the implementation of RBL, as seen in both the quantitative referral counts and qualitative teacher and administrator questionnaires. The positive results of this study support further implementation of RBL into schools in Hawai‘i. Kaneohe Elementary School has continued to apply recess before lunch to the sixth grade lunch periods and is considering further implementation into other grades. The Hawai‘i Action for Healthy Kids team plans to approach more schools in Hawai‘i about using the modified recess before lunch program

Early Identification of Developmental Coordination Disorder: Gender Differences in Performance of the Movement Assessment Battery in Preschool-age Children

Developmental coordination disorder (DCD) is a neurodevelopmental disorder often highlighted by a severe lack of motor coordination that interferes with activities of daily living. The prevalence of DCD in children ranges from 2 to 20% in the United States. Early identification and early intervention can help mitigate potential long term negative effects. The movement assessment battery for children (MABC-2) is a commonly used tool used to identify DCD. PURPOSE: This study examined gender differences in performance on the MABC-2 between preschool-age children. METHODS: 45 preschool-age children (26 girls and 19 boys, Mage = 4.0) were assessed using the MABC-2. The MABC-2 is comprised of 8 items across three subdomains (aiming and catching, manual dexterity, and balance). An independent samples t-test was conducted to observe the differences in each of the 3 sub domains of the MABC between boys and girls and by age. RESULTS: Overall, 39 of children were not at-risk for DCD, and 4 children were at-risk for DCD. The results show a significant difference in the balance domain with girls demonstrating more proficiency (p =0.03) than the boys. There were no significant differences found in manual dexterity (p = .76), aiming and catching (p =0.60), and overall test score (p = 0.18). There were no significant differences based on age across any of the domains. CONCLUSION: Early assessment of young children may be important as potential gender differences already exist by preschool-age. Separate norms may be necessary for boys and girls in this age band as several studies have consistently identified gender differences in the MABC-2. Further exploration of why these differences may exist at such an early age should be explored

The Association between Parent\u27s Perception and Child\u27s Actual Motor Skills in Preschool-age Children

The preschool years is a critical time for the optimal development of children\u27s fine and gross motor skills for future engagement in physical activity. Parents play a critical role in the development of these skills and early identification of potential developmental delays in their children. Early identification of developmental delay is essential for early intervention and rely on accurate child screenings that are often administered by parents. Few studies have compared the accuracy of parent’s perceptions across two different measurements with children\u27s actual motor skills. PURPOSE: This study compared parents\u27 perceptions of their child’s motor skills on two assessments with their actual performance on the MABC-2. METHODS: 45 preschool-age children across the metro DFW area participated in this study (26 girls and 19 boys, Mage = 4.0).  IRB approval was obtained for all participants. Children were assessed using the MABC-2. The MABC-2 is comprised of 8 items across three subdomains (aiming and catching, manual dexterity, and balance). Parents completed two separate surveys on the perception of their child\u27s motor skills (Ages and Stages Questionnaire (ASQ), and the Little Developmental Coordination Disorder questionnaire (LDCDQ). The ASQ ask parents to compare their child\u27s abilities against other children within the same age group across five different domains (communication, gross motor, fine motor, personal-social, and problem solving). The LDCDQ ask parents to rate their child’s gross and fine motor abilities across fifteen different items. Bivariate correlations were used to analyze the relationship between parent responses and children’s scores on the MABC-2. RESULTS: On the LDCDQ, parents rating on fine motor skills was significantly related to total MABC-2 score; (p = .006, R = 0.402), manual dexterity (p= .038, R = 0.310), and aiming and catching (p-value = .005, R = 0.407). On the ASQ, parent\u27s ratings on fine motor skills were significantly related to total MABC-2 scores (p= .048, R = 0.303). Parent’s ratings on their child’s ASQ personal social skills were significantly related to total MABC-2 scores (p= .011, R = 0.385), and aiming and catching (p = .013, R = 0.377). No other correlations were significant amongst the parent assessments and child’s MABC scores. CONCLUSION: While neither assessment appeared to be more related to children\u27s actual scores than the other, in both assessments fines motors skills were more closely related to children\u27s actual performance

Identification of Phthalates in Medications and Dietary Supplement Formulations in the United States and Canada

Background: In animal studies, some ortho-phthalates, including di(2-ethylhexyl) phthalate (DEHP) and di-n-butyl phthalate (DBP), have been shown to be reproductive and developmental toxicants. Human studies show widespread population exposure to background levels of phthalates. Limited evidence suggests that particularly high exposure levels may result from orally ingested medicinal products containing phthalates as excipients (inactive ingredients)

Unique Microbial Communities Persist in Individual Cystic Fibrosis Patients throughout a Clinical Exacerbation

Cystic fibrosis (CF) is caused by inherited mutations in the cystic fibrosis transmembrane conductance regulator gene and results in a lung environment that is highly conducive to polymicrobial infection. Over a lifetime, decreasing bacterial diversity and the presence of Pseudomonas aeruginosa in the lung are correlated with worsening lung disease. However, to date, no change in community diversity, overall microbial load or individual microbes has been shown to correlate with the onset of an acute exacerbation in CF patients. We followed 17 adult CF patients throughout the course of clinical exacerbation, treatment and recovery, using deep sequencing and quantitative PCR to characterize spontaneously expectorated sputum sample

TIGIT Marks Exhausted T Cells, Correlates with Disease Progression, and Serves as a Target for Immune Restoration in HIV and SIV Infection.

HIV infection induces phenotypic and functional changes to CD8+ T cells defined by the coordinated upregulation of a series of negative checkpoint receptors that eventually result in T cell exhaustion and failure to control viral replication. We report that effector CD8+ T cells during HIV infection in blood and SIV infection in lymphoid tissue exhibit higher levels of the negative checkpoint receptor TIGIT. Increased frequencies of TIGIT+ and TIGIT+ PD-1+ CD8+ T cells correlated with parameters of HIV and SIV disease progression. TIGIT remained elevated despite viral suppression in those with either pharmacological antiretroviral control or immunologically in elite controllers. HIV and SIV-specific CD8+ T cells were dysfunctional and expressed high levels of TIGIT and PD-1. Ex-vivo single or combinational antibody blockade of TIGIT and/or PD-L1 restored viral-specific CD8+ T cell effector responses. The frequency of TIGIT+ CD4+ T cells correlated with the CD4+ T cell total HIV DNA. These findings identify TIGIT as a novel marker of dysfunctional HIV-specific T cells and suggest TIGIT along with other checkpoint receptors may be novel curative HIV targets to reverse T cell exhaustion

Temporal Variability of Human Vaginal Bacteria and Relationship with Bacterial Vaginosis

Little is known about short-term bacterial fluctuations in the human vagina. This study used PCR to assess the variability in concentrations of key vaginal bacteria in healthy women and the immediate response to antibiotic treatment in women with bacterial vaginosis (BV).Twenty-two women assessed for BV using Amsel's criteria were evaluated daily for 7 or 14 days, then at 2, 3 and 4 weeks, using a panel of 11 bacterium-specific quantitative PCR assays. Participants with BV were treated with 5 days of intravaginal metronidazole. Participants without BV had vaginal biotas dominated by lactobacilli, whose levels fluctuated with menses. With onset of menstruation, quantities of Lactobacillus jensenii and Lactobacillus crispatus decreased and were found to be inversely related to Gardnerella vaginalis concentrations (p<0.001). Women with BV had a variety of fastidious bacteria whose concentrations dropped below detection thresholds 1-5 days after starting metronidazole. Recurrent BV was characterized by initial profound decreases of BV-associated bacteria after treatment followed by subsequent increases at relapse.The microbiota of the human vagina can be highly dynamic. Healthy women are colonized with Lactobacillus species, but levels can change dramatically over a month. Marked increases in G. vaginalis were observed during menses. Participants with BV have diverse communities of fastidious bacteria that are depleted by vaginal metronidazole therapy. Women with recurrent BV initially respond to antibiotic treatment with steep declines in bacterial concentrations, but these bacteria later reemerge, suggesting that antibiotic resistance in these bacteria is not an important factor mediating BV recurrence

Family Caregiver Perspectives on Symptoms and Treatments for Patients Dying From Complications of Cystic Fibrosis

Most patients with advanced cystic fibrosis (CF) die from respiratory failure and experience distressing symptoms as lung disease progresses. Little has been reported about symptom management and the continuation of disease-specific treatments near the end of life for patients with CF