Paradoxical malnutrition in mother-child pairs: Untangling the phenomenon of over- and under-nutrition in underdeveloped economies

As economic development and urbanization proceed globally, the coexistence of under- and over-nutrition within the same household, sometimes termed [`]paradoxical' or [`]dual burden' malnutrition is increasingly being reported. We used Demographic and Health Survey data sets from 18 lower and middle income countries to explore paradoxical forms of malnutrition (maternal overweight with child underweight or stunting) in mother-child pairs. Multinomial logistic regression was used to estimate the odds of discordant pairs after adjusting for a number of important covariates. Several factors were significantly associated with an increased relative odds of discordant mother-child pairs, including working in subsistence agriculture, low levels of maternal education, more siblings in the household, and relative household poverty. However, many of these factors also predicted other combinations of poor nutritional status in mother-child pairs. We conclude that it is difficult to identify any specific factors that elevate risk above and beyond those that predict risk of maternal over-nutrition or child under-nutrition. Based on these analyses, it appears that paradoxical weight status between mothers and children can be best understood as a consequence of rapid secular increases in maternal weight, rather than a distinct nutritional condition with a discrete etiology.Health-general (I10) Obesity Maternal Children Malnutrition Poverty Household economics Paradoxical malnutrition

DOES WEIGHT STATUS INFLUENCE PERCEPTIONS OF PHYSICAL ACTIVITY BARRIERS AMONG AFRICAN-AMERICAN WOMEN?

Background: Many African-American women fail to participate in regular physical activity. Weight status may influence physical activity barriers. This study examined the frequency and type of barriers. Methods: Participants in this study were enrolled in Project EXE-L (Exercising Ladies Excel), a six-month, church-based, randomized trial of moderate-intensity physical activity based in Baltimore city and county in Maryland. Participants were composed of African-American women who attended one of the participating churches, had friends who were church members, or who lived in neighborhoods surrounding one of the churches. Individuals who were between the ages of 25 and 70 years, were not regularly physically active (defined as not engaging in moderate-intensity activity more than three times per week), and were able to participate inmoderate-intensity activity met eligibility criteria to participate in the trial. Barriers to physical activity were evaluated with the Steinhardt/Dishman Barriers for Habitual Physical Activity Scale at baseline. Results: One hundred twenty women were classified as normal weight (body mass index [BMI]: ,25 kg/m2), overweight (BMI: 25– 29.9 kg/m2), or obese (BMI: $30 kg/m2). Obese participants weremore likely to report ‘‘lack of motivation’’ as a barrier compared with normal-weight participants (63% vs 31%). Normal- weight and overweight participants were more likely to report no barriers compared with the obese (31%, 0%, 5%, respectively, P,.05). Conclusions: Barriers for African-American women may vary by BMI status. By defining these unique barriers, effective physical activity interventions can be developed

Street Food Stand Availability, Density, and Distribution Across Income Levels in Mexico City

Street food stands (SFS) are an understudied element of the food environment. Previous SFS studies have not used a rigorous approach to document the availability, density, and distribution of SFS across neighborhood income levels and points of access in Mexico City. A random sample (n = 761) of street segments representing 20 low-, middle-, and high-income neighborhoods were assessed using geographic information system (GIS) and ground-truthing methods. All three income levels contained SFS. However, SFS availability and density were higher in middle-income neighborhoods. The distribution of SFS showed that SFS were most often found near homes, transportation centers, and worksites. SFS availability near schools may have been limited by local school policies. Additional studies are needed to further document relationships between SFS availability, density, and distribution, and current structures and processes

COVID-19 healthcare demand projections: Arizona.

Beginning in March 2020, the United States emerged as the global epicenter for COVID-19 cases with little to guide policy response in the absence of extensive data available for reliable epidemiological modeling in the early phases of the pandemic. In the ensuing weeks, American jurisdictions attempted to manage disease spread on a regional basis using non-pharmaceutical interventions (i.e., social distancing), as uneven disease burden across the expansive geography of the United States exerted different implications for policy management in different regions. While Arizona policymakers relied initially on state-by-state national modeling projections from different groups outside of the state, we sought to create a state-specific model using a mathematical framework that ties disease surveillance with the future burden on Arizona's healthcare system. Our framework uses a compartmental system dynamics model using a SEIRD framework that accounts for multiple types of disease manifestations for the COVID-19 infection, as well as the observed time delay in epidemiological findings following public policy enactments. We use a compartment initialization logic coupled with a fitting technique to construct projections for key metrics to guide public health policy, including exposures, infections, hospitalizations, and deaths under a variety of social reopening scenarios. Our approach makes use of X-factor fitting and backcasting methods to construct meaningful and reliable models with minimal available data in order to provide timely policy guidance in the early phases of a pandemic

Serological survey to estimate SARS-CoV-2 infection and antibody seroprevalence at a large public university: A cross-sectional study

Objective This study investigated the seroprevalence of SARS-CoV-2 antibodies among adults over 18 years.Design Prospective cohort study.Settings A large public university.Participants This study took volunteers over 5 days and recruited 1064 adult participants.Primary outcome measures Seroprevalence of SARS-CoV-2-specific antibodies due to previous exposure to SARS-CoV-2 and/or vaccination.Results The seroprevalence of the antireceptor binding domain (RBD) antibody was 90% by a lateral flow assay and 88% by a semiquantitative chemiluminescent immunoassay. The seroprevalence for antinucleocapsid was 20%. In addition, individuals with previous natural COVID-19 infection plus vaccination had higher anti-RBD antibody levels compared with those who had vaccination only or infection only. Individuals who had a breakthrough infection had the highest anti-RBD antibody levels.Conclusion Accurate estimates of the cumulative incidence of SARS-CoV-2 infection can inform the development of university risk mitigation protocols such as encouraging booster shots, extending mask mandates or reverting to online classes. It could help us to have clear guidance to act at the first sign of the next surge as well, especially since there is a surge of COVID-19 subvariant infections