District Regulated Nutrition Programs: Identifying the Gap Between Language in District Wellness Policies and Implementation Practices in Public Schools

BACKGROUND: The federal government requires that every school district taking part in the Federal Child Nutrition Program have a written district wellness policy of how the districts will address: nutrition education, nutrition guidelines, physical activity, physical education, and parent and community involvement. Although many aspects of school nutrition are federally regulated, there are specific food-related practices that can only be regulated at the district level. Policies concerning these “district-led” practices often appear in the district wellness policy. This study focuses specifically on three topics addressed in district wellness policies: (a) Is free potable drinking water available to students throughout the school day? (b) Are Smart Snacks nutrition standards applied to food sold during fundraisers hosted during school hours? and (c) How do districts address unpaid student balances in the meal program? The aim of this study is to assess how a sample of districts addresses each of these issues in their written district wellness policies and in actual implementation. METHODS: Through analyzing district wellness policies from 34 districts in Connecticut using the coding tool, the WellSAT 3.0, this study seeks to describe the strength and comprehensiveness of the language of school nutrition polices. The research will be furthered in 4 of these districts through the use of interviews in order to see if there is a difference in the strength of nutrition policy language between districts and the implementation of those nutrition practices in the respective school environments. RESULTS: Most frequently, school’s practices are stronger than the policy language representing them; however, there were examples of practices in schools that were stronger, weaker, or on par with the written policy. Each of the 4 schools had a policy and practice to address nutrition standards for in-school fundraisers. Only one school had a policy to make water available throughout the entire school day however each districts’ practice was strong. No school had a written policy to address unpaid student meal balances without stigmatizing the students involved, but each of the schools had strong practices. CONCLUSIONS: Schools are implementing stronger practices than their written policies present. A school’s written policy may not properly represent the strength of their practices

CNS and hormone control of lipid mobilization: interest and limits of comparative physiology

The mobilization of lipids stored in adipose tissue is closely controlled by neuro-humoral signals. The process of lipolysis, i.e. the hydrolysis of triglycerides stored in fat cells (or adipocytes) and release of glycerol and non-esterified fatty acids, is highly specific of the adipose tissue. No other tissue is able to provide notable amounts of non-esterified fatty acids, whether on a short-term or long-term basis. Once they reach the plasma where they bind to albumin, these fatty acids are used as preferred oxidative substrate by skeletal muscle, liver, kidney and myocardium. This article summarises the mechanisms of action of various neuro-humoral mediators (catecholamines,insulin, natriuretic peptides, adenosine, neuropeptide Y, peptide YY, prostaglandins) involved in the control of hormone-sensitive lipase activity and hydrolysis of triglycerides in fat cells in man and in various small mammal models used in laboratories. Species-specific differences and their potential consequences on extrapolation from animal models to man and clinical research are highlighted.Le contrôle de la mobilisation des lipides stockés dans le tissu adipeux est un processus étroitement contrôlé par le système neuro-humoral. La lipolyse, processus assurant l'hydrolyse des triglycérides stockés dans la gouttelette lipidique des adipocytes, et la libération du glycérol et des acides gras non estérifiés, est une fonction très spécifique du tissu adipeux. Il n'existe pas d'autre tissu capable de fournir à court et long terme des quantités notables d'acides gras non-estérifiés. Libérés dans le plasma où ils se lient à l'albumine, ils constituent un substrat oxydatif privilégié pour le muscle squelettique, le foie, le rein et le myocarde. Ce mémoire récapitule les mécanismes d'action des divers signaux neuro-humoraux (catécholamines, insuline, peptides natriurétiques, adénosine, neuropeptide Y, peptide YY, prostaglandines) impliqués dans le contrôle de la lipase hormono-sensible et de l'hydrolyse des triglycérides de l'adipocyte de l'homme et de divers petits mammifères utilisés dans les laboratoires. Nous insistons plus particulièrement sur les disparités interspécifiques et leurs conséquences potentielles pour l'extrapolation des données acquises sur les modèles animaux, à l'homme et à la recherche clinique

Acquiring Knowledge about the Use of a Newly Developed Electronic Fetal Heart Rate Monitor: A Qualitative Study Among Birth Attendants in Tanzania

In an effort to reduce newborn mortality, a newly developed strap-on electronic fetal heart rate monitor was introduced at several health facilities in Tanzania in 2015. Training sessions were organized to teach staff how to use the device in clinical settings. This study explores skilled birth attendants’ perceptions and experiences acquiring and transferring knowledge about the use of the monitor, also called Moyo. Knowledge about this learning process is crucial to further improve training programs and ensure correct, long-term use. Five Focus group discussions (FGDs) were carried out with doctors and nurse-midwives, who were using the monitor in the labor ward at two health facilities in Tanzania. The FGDs were analyzed using qualitative content analysis. The study revealed that the participants experienced the training about the device as useful but inadequate. Due to high turnover, a frequently mentioned challenge was that many of the birth attendants who were responsible for training others, were no longer working in the labor ward. Many participants expressed a need for refresher trainings, more practical exercises and more theory on labor management. The study highlights the need for frequent trainings sessions over time with focus on increasing overall knowledge in labor management to ensure correct use of the monitor over time

Perceptions and experiences of skilled birth attendants on using a newly developed strap-on electronic fetal heart rate monitor in Tanzania

Background: Regular fetal heart rate monitoring during labor can drastically reduce fresh stillbirths and neonatal mortality through early detection and management of fetal distress. Fetal monitoring in low-resource settings is often inadequate. An electronic strap-on fetal heart rate monitor called Moyo was introduced in Tanzania to improve intrapartum fetal heart rate monitoring. There is limited knowledge about how skilled birth attendants in low-resource settings perceive using new technology in routine labor care. This study aimed to explore the attitude and perceptions of skilled birth attendants using Moyo in Dar es Salaam, Tanzania. Methods: A qualitative design was used to collect data. Five focus group discussions and 10 semi-structured indepth interviews were carried out. In total, 28 medical doctors and nurse/midwives participated in the study. The data was analyzed using qualitative content analysis. Results: The participants in the study perceived that the device was a useful tool that made it possible to monitor several laboring women at the same time and to react faster to fetal distress alerts. It was also perceived to improve the care provided to the laboring women. Prior to the introduction of Moyo, the participants described feeling overwhelmed by the high workload, an inability to adequately monitor each laboring woman, and a fear of being blamed for negative fetal outcomes. Challenges related to use of the device included a lack of adherence to routines for use, a lack of clarity about which laboring women should be monitored continuously with the device, and misidentification of maternal heart rate as fetal heart rate. Conclusion: The electronic strap-on fetal heart rate monitor, Moyo, was considered to make labor monitoring easier and to reduce stress. The study findings highlight the importance of ensuring that the device’s functions, its limitations and its procedures for use are well understood by users

Characterization of Au/Au, Au/Ru and Ru/Ru ohmic contacts in MEMS switches improved by a novel methodology

International audienceComparisons between several pairs of contact materials are done with a new methodology using a commercial nanoindenter coupled with electrical measurements on test vehicles specially designed to investigate microscale contact physics. Experimental measurements are obtained to characterize the response of a 5-μm2-square contact bump under electromechanical stress with increased applied current. The data provide a better understanding of microcontact behavior related to the impact of current at low- to medium-power levels. Contact temperature rise is observed, leading to shifts of the mechanical properties of contact materials and modifications of the contact surface. The stability of the contact resistance, when the contact force increases, is studied for contact pairs of soft (Au/Au contact), harder (Ru/Ru contact), and mixed material configuration (Au/Ru contact). An enhanced stability of the bimetallic contact Au/Ru is demonstrated, onsidering sensitivity to power increase related to creep effects and topological modifications of the contact surfaces. These results are compared to previous ones and discussed in a theoretical way by considering the temperature distribution around the hottest area at the contact interface

“I Was Relieved to Know That My Baby Was Safe”: Women’s Attitudes and Perceptions on Using a New Electronic Fetal Heart Rate Monitor during Labor in Tanzania

To increase labor monitoring and prevent neonatal morbidity and mortality, a new wireless, strap-on electronic fetal heart rate monitor called Moyo was introduced in Tanzania in 2016. As part of the ongoing evaluation of the introduction of the monitor, the aim of this study was to explore the attitudes and perceptions of women who had worn the monitor continuously during their most recent delivery and perceptions about how it affected care. This knowledge is important to identify barriers towards adaptation in order to introduce new technology more effectively. We carried out 20 semi-structured individual interviews post-labor at two hospitals in Tanzania. A thematic content analysis was used to analyze the data. Our results indicated that the use of the monitor positively affected the women’s birth experience. It provided much-needed reassurance about the wellbeing of the child. The women considered that wearing Moyo improved care due to an increase in communication and attention from birth attendants. However, the women did not fully understand the purpose and function of the device and overestimated its capabilities. This highlights the need to improve how and when information is conveyed to women in labor

Human alpha 2A-adrenergic receptor gene expressed in transgenic mouse adipose tissue under the control of its regulatory elements.

Catecholamines regulate white adipose tissue function and development by acting through beta- and alpha2-adrenergic receptors (ARs). Human adipocytes express mainly alpha 2A- but few or no beta 3-ARs while the reverse is true for rodent adipocytes. Our aim was to generate a mouse model with a human-like alpha2/beta-adrenergic balance in adipose tissue by creating transgenic mice harbouring the human alpha 2A-AR gene under the control of its own regulatory elements in a combined mouse beta 3-AR-/- and human beta 3-AR+/+ background. Transgenic mice exhibit functional human alpha 2A-ARs only in white fat cells. Interestingly, as in humans, subcutaneous adipocytes expressed higher levels of alpha2-AR than perigonadal fat cells, which are associated with a better antilipolytic response to epinephrine. High-fat-diet-induced obesity was observed in transgenic mice in the absence of fat cell size modifications. In addition, analysis of gene expression related to lipid metabolism in isolated adipocytes suggested reduced lipid mobilization and no changes in lipid storage capacity of transgenic mice fed a high-fat diet. Finally, the development of adipose tissue in these mice was not associated with significant modifications of glucose and insulin blood levels. Thus, these transgenic mice constitute an original model of diet-induced obesity for in vivo physiological and pharmacological studies with respect to the alpha2/beta-AR balance in adipose tissue

Adipocyte pyruvate dehydrogenase kinase 4 expression is associated with augmented PPARγ upregulation in early-life programming of later obesity

We studied adipocytes from 8-week-old control rat offspring (CON) or rat offspring subjected to maternal low (8%) protein (MLP) feeding during pregnancy/lactation, a procedure predisposing to obesity. Acute exposure to isoproterenol or adenosine enhanced PDK4 and PPARc mRNA gene expression in CON and MLP adipocytes. Enhanced adipocyte Pdk4 expression orrelated with increased PPARc expression. Higher evels of PDK4 and PPARc were observed in MLP adipocytes. SCD1 is a PPARc target. Isoproterenol enhanced adipocyte PDK4 and SCD1 gene expression in parallel. This could reflect augmented PPARc expression together with enhanced lipolytic stimulation to supply endogenous PPARc ligands, allowing enhanced adipocyte PDK4 and SCD1 expression via PPARc activation. In contrast, the effect of adenosine to increase PDK4 expression is independent of stimulation of lipolysis and, as SCD1 expression was unaffected by adenosine, unlikely to reflect PPARc activation. Increased adipocyte expression of both PDK4 and SCD1 in the MLP model could participate as components of a ‘‘thrifty’’ phenotype, favouring the development of obesit