The perceived influence of cost-offset community-supported agriculture on food access among low-income families

Objective To examine perspectives on food access among low-income families participating in a cost-offset community-supported agriculture (CO-CSA) programme.Design Farm Fresh Foods for Healthy Kids (F3HK) is a multicentre randomized intervention trial assessing the effect of CO-CSA on dietary intake and quality among children from low-income families. Focus groups were conducted at the end of the first CO-CSA season. Participants were interviewed about programme experiences, framed by five dimensions of food access: Availability, accessibility, affordability, acceptability and accommodation. Transcribed data were coded on these dimensions plus emergent themes.Setting Nine communities in the US states of New York, North Carolina, Washington and Vermont.Subjects Fifty-Three F3HK adults with children.Results CSA models were structured by partner farms. Produce quantity was abundant; however, availability was enhanced for participants who were able to select their own produce items. Flexible CSA pick-up times and locations made produce pick-up more accessible. Despite being affordable to most, payment timing was a barrier for some. Unfamiliar foods and quick spoilage hindered acceptability through challenging meal planning, despite accommodations that included preparation advice.Conclusions Although CO-CSA may facilitate increased access to fruits and vegetables for low-income families, perceptions of positive diet change may be limited by the ability to incorporate share pick-up into regular travel patterns and meal planning. Food waste concerns may be particularly acute for families with constrained resources. Future research should examine whether CO-CSA with flexible logistics and produce self-selection are sustainable for low-income families and CSA farms

Outcome of radiotherapy in T1 glottic carcinoma: A population-based study

We evaluated the radiation outcome and prognostic factors in a population-based study of early (T1N0M0) glottic carcinoma. Survival parameters and prognostic factors were evaluated by uni- and multivariate analysis in 316 consecutive irradiated patients with T1 glottic carcinoma in the Comprehensive Cancer Center West region of the western Netherlands. Median follow-up was 70 months (range 1-190 months). Five and ten-year local control was 86 and 84%. Disease specific survival was 97% at 5 and 10 years. In multivariate analysis, pre-existent laryngeal hypertrophic laryngitis was the only predictive factor for local control (relative risk = 3.0, P = 0.02). Comorbidity was prognostic for overall survival. No factor was predictive for disease specific survival. Pre-existent laryngeal hypertrophic laryngitis is a new risk factor associated with reduced local control in T1 glottic carcinoma treated with radiotherapy

Contemporary management of cancer of the oral cavity

Oral cancer represents a common entity comprising a third of all head and neck malignant tumors. The options for curative treatment of oral cavity cancer have not changed significantly in the last three decades; however, the work up, the approach to surveillance, and the options for reconstruction have evolved significantly. Because of the profound functional and cosmetic importance of the oral cavity, management of oral cavity cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction. The purpose of this review is to discuss the most current management options for oral cavity cancers

Finding New Genes for Non-Syndromic Hearing Loss through an In Silico Prioritization Study

At present, 51 genes are already known to be responsible for Non-Syndromic hereditary Hearing Loss (NSHL), but the knowledge of 121 NSHL-linked chromosomal regions brings to the hypothesis that a number of disease genes have still to be uncovered. To help scientists to find new NSHL genes, we built a gene-scoring system, integrating Gene Ontology, NCBI Gene and Map Viewer databases, which prioritizes the candidate genes according to their probability to cause NSHL. We defined a set of candidates and measured their functional similarity with respect to the disease gene set, computing a score () that relies on the assumption that functionally related genes might contribute to the same (disease) phenotype. A Kolmogorov-Smirnov test, comparing the pair-wise distribution on the disease gene set with the distribution on the remaining human genes, provided a statistical assessment of this assumption. We found at a p-value that the former pair-wise is greater than the latter, justifying a prioritization strategy based on the functional similarity of candidate genes respect to the disease gene set. A cross-validation test measured to what extent the ranking for NSHL is different from a random ordering: adding 15% of the disease genes to the candidate gene set, the ranking of the disease genes in the first eight positions resulted statistically different from a hypergeometric distribution with a p-value and a power. The twenty top-scored genes were finally examined to evaluate their possible involvement in NSHL. We found that half of them are known to be expressed in human inner ear or cochlea and are mainly involved in remodeling and organization of actin formation and maintenance of the cilia and the endocochlear potential. These findings strongly indicate that our metric was able to suggest excellent NSHL candidates to be screened in patients and controls for causative mutations

Racial and Sex Differences in 24 Hour Urinary Hydration Markers among Male and Female Emerging Adults: A Pilot Study

The purpose of this study was to examine 24 h urinary hydration markers in non-Hispanic White (WH) and non-Hispanic Black (BL) males and females. Thirteen males (BL, n = 6; WH, n = 7) and nineteen females (BL, n = 16, WH, n = 3) (mean ± SD; age, 20 ± 4 y; height, 169.2 ± 12.2 cm; body mass, 71.3 ± 12.2 kg; body fat, 20.8 ± 9.7%) provided a 24 h urine sample across 7 (n = 13) or 3 (n = 19) consecutive days (148 d total) for assessment of urine volume (UVOL), urine osmolality (UOSM), urine specific gravity (USG), and urine color (UCOL). UVOL was significantly lower in BL (0.85 ± 0.43 L) compared to WH college students (2.03 ± 0.70 L) (p < 0.001). Measures of UOSM, USG, and UCOL, were significantly greater in BL (716 ± 263 mOsm∙kg−1, 1.020 ± 0.007, and 4.2 ± 1.4, respectively) compared to WH college students (473 ± 194 mOsm∙kg−1, 1.013 ± 0.006, 3.0 ± 1.2, and respectively) (p < 0.05). Differences in 24 h urinary hydration measures were not significantly different between males and females (p > 0.05) or between the interaction of sex and race/ethnicity (p > 0.05). Non-Hispanic Black men and women were inadequately hydrated compared to their non-Hispanic White counterparts. Our findings suggest that development of targeted strategies to improve habitual fluid intake and potentially overall health are needed

Influence of Nutrient Intake on 24 Hour Urinary Hydration Biomarkers Using a Clustering-Based Approach

Previous work focusing on understanding nutrient intake and its association with total body water homeostasis neglects to consider the collinearity of types of nutrients consumed and subsequent associations with hydration biomarkers. Therefore, the purpose of this study was to analyze consumption patterns of 23 a priori selected nutrients involved in osmotic homeostasis, as well as their association with 24 h urinary hydration markers among fifty African–American first-year college students through a repeated measures observation in a daily living setting. Through application of hierarchical clustering, we were able to identity four clusters of nutrients based on 24 h dietary recalls: (1) alcohol + pinitol, (2) water + calcium + magnesium + erythritol + inositol + sorbitol + xylitol, (3) total calories + total fat + total protein + potassium + sodium + zinc + phosphorous + arginine, and (4) total carbohydrates + total fiber + soluble fiber + insoluble fiber + mannitol + betaine. Furthermore, we found that consumption of nutrients in Cluster #2 was significantly predictive of urine osmolality (p = 0.004); no other clusters showed statistically significant associations with 24 h urinary hydration biomarkers. We conclude that there may be some nutrients that are commonly consumed concomitantly (at the day level), across a variety of settings and populations, and that a limited subset of the clustering of these nutrients may associate with body water status

A Mixed Methods Comparison of Urban and Rural Retail Corner Stores

Efforts to transform corner stores to better meet community dietary needs have mostly occurred in urban areas but are also needed in rural areas. Given important contextual differences between urban and rural areas, it is important to increase our understanding of the elements that might translate successfully to similar interventions involving stores in more rural areas. Thus, an in-depth examination and comparison of corner stores in each setting is needed. A mixed methods approach, including windshield tours, spatial visualization with analysis of frequency distribution, and spatial regression techniques were used to compare a rural North Carolina and large urban (Los Angeles) food environment. Important similarities and differences were seen between the two settings in regards to food environment context, spatial distribution of stores, food products available, and the factors predicting corner store density. Urban stores were more likely to have fresh fruits (Pearson chi2 = 27.0423; p < 0.001) and vegetables (Pearson chi2 = 27.0423; p < 0.001). In the urban setting, corner stores in high income areas were more likely to have fresh fruit (Pearson chi2 = 6.00; p = 0.014), while in the rural setting, there was no difference between high and low income area in terms of fresh fruit availability. For the urban area, total population, no vehicle and Hispanic population were significantly positively associated (p < 0.05), and median household income (p < 0.001) and Percent Minority (p < 0.05) were significantly negatively associated with corner store count. For the rural area, total population (p < 0.05) and supermarket count were positively associated (p < 0.001), and median household income negatively associated (P < 0.001), with corner store count. Translational efforts should be informed by these findings, which might influence the success of future interventions and policies in both rural and urban contexts