Food Access and Security During Coronavirus: A Vermont Study

Key Findings 1. Respondents reported a 33% increase in food insecurity since the coronavirus outbreak began in Vermont (from 18% to 24%). 2. 45% of respondents with jobs experienced a job disruption or loss. 3. Respondents said the most helpful actions for meeting their food needs would be increased trust in the safety of going to stores and more food in stores. 4. Respondents worried most about food becoming unaffordable and running out of food if they were unable to go out. 5. Vermonters are using a variety of strategies to adapt: a majority of respondents are at least somewhat likely to buy foods that don\u27t go bad quickly (90%); buy different, cheaper foods (69%); and stretch the food they have by eating less (52%)

Employment and Food During Coronavirus

Key Findings 1. 45% of respondents with jobs experienced some type of job disruption or loss. 19.7% had a reduction in hours or income, 9.3% had been furloughed, and 15.5% had lost their job since the coronavirus outbreak. 2. 38.5% of respondents experiencing job loss or disruption since the outbreak were classified as food insecure. 3. Respondents experiencing job disruption or loss were significantly more likely to be already implementing food purchasing or eating changes and concerned about food access compared to those who did not experience a change in employment. 4. Respondents with job disruption or loss were significantly more likely to need higher amounts of money per week to help meet their basic needs if they could no longer afford food ($100 with a reduction in hours/income,$107 furloughed, $158 with job loss, compared to$82 with no job impact)

The Impact of Coronavirus on Vermonters Experiencing Food Insecurity

Key Findings 1. Respondents experiencing food insecurity were more likely to be people of color, female, live in households with children, and live in larger households. 2. 84.2% of respondents who experienced food insecurity at some point in the year before the coronavirus pandemic remained food insecure during the early days of the outbreak. 3. The majority of respondents experiencing food insecurity are not utilizing food assistance programs. 4. ⅔ of respondents experiencing food insecurity are already buying different, cheaper foods or eating less to make their food last. 5. ⅔ of respondents experiencing food insecurity with a job had job disruption or loss since the coronavirus outbreak. 6. Vermonters are helping each other – there was a reported doubling in the percentage of people receiving their food via delivery from other people

3rd Annual Conference of the Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH), Developing methods in agriculture and health research, London, 13–14 June 2013

Non-PRIFPRI3; ISI; CRP4; B Promoting healthy food systemsPHND; A4NHCGIAR Research Program on Agriculture for Nutrition and Health (A4NH

Lithium alters brain activation in bipolar disorder in a task- and state-dependent manner: an fMRI study

BACKGROUND: It is unknown if medications used to treat bipolar disorder have effects on brain activation, and whether or not any such changes are mood-independent. METHODS: Patients with bipolar disorder who were depressed (n = 5) or euthymic (n = 5) were examined using fMRI before, and 14 days after, being started on lithium (as monotherapy in 6 of these patients). Patients were examined using a word generation task and verbal memory task, both of which have been shown to be sensitive to change in previous fMRI studies. Differences in blood oxygenated level dependent (BOLD) magnitude between the pre- and post-lithium results were determined in previously defined regions of interest. Severity of mood was determined by the Hamilton Depression Scale for Depression (HAM-D) and the Young mania rating scale (YMRS). RESULTS: The mean HAM-D score at baseline in the depressed group was 15.4 ± 0.7, and after 2 weeks of lithium it was 11.0 ± 2.6. In the euthymic group it was 7.6 ± 1.4 and 3.2 ± 1.3 respectively. At baseline mean BOLD signal magnitude in the regions of interest for the euthymic and depressed patients were similar in both the word generation task (1.56 ± 0.10 and 1.49 ± 0.10 respectively) and working memory task (1.02 ± 0.04 and 1.12 ± 0.06 respectively). However, after lithium the mean BOLD signal decreased significantly in the euthymic group in the word generation task only (1.56 ± 0.10 to 1.00 ± 0.07, p < 0.001). Post-hoc analysis showed that these differences were statistically significant in Broca's area, the left pre-central gyrus, and the supplemental motor area. CONCLUSION: This is the first study to examine the effects of lithium on brain activation in bipolar patients. The results suggest that lithium has an effect on euthymic patients very similar to that seen in healthy volunteers. The same effects are not seen in depressed bipolar patients, although it is uncertain if this lack of change is linked to the lack of major improvements in mood in this group of patients. In conclusion, this study suggests that lithium may have effects on brain activation that are task- and state-dependent. Given the small study size and the mildness of the patient's depression these results require replication

A qualitative study of factors related to cardiometabolic risk in rural men

Abstract Background Rural men are known to have poor health behaviors, which contribute to their elevated burden of cardiometabolic disorders in the United States. Although regular physical activity, healthy eating, and avoiding tobacco can reduce cardiometabolic risk, little is known about how to engage rural men in health promotion programs. To bridge this gap in evidence, we investigate knowledge of modifiable cardiometabolic risk factors among rural men in the western United States, identify their concerns related to heart health and motivation to reduce risk, and explore individual, social, and community-level influences on heart-healthy behaviors, specifically diet, physical activity, and tobacco use. Methods We conducted seven focus groups with 54 sedentary, overweight/obese men (mean body mass index [BMI] = 31.3 ± 4.6) aged 43–88 residing in government-designated “medically underserved” rural Montana towns in September and October 2014. All sessions were audio-recorded and transcribed verbatim. Transcripts were coded and analyzed thematically using Nvivo software. Participants also completed a brief questionnaire about personal characteristics and health behaviors. These data were explored descriptively. Results Despite being classified as overweight/obese and sedentary, no participants reported to be in poor health. Many men described health relative to self-reliance and the ability to participate in outdoor recreation; concern with health appeared to be related to age. Participants were generally knowledgeable of heart-healthy behaviors, but many felt fatalistic about their own risk. Catalysts for behavior change included a serious medical event in the household and desire to reduce aging-associated functional decline. Barriers to adopting and maintaining healthy eating and physical activity habits and abstaining from tobacco included normative beliefs around masculinity and individual liberty, the limited social universe of small towns, winter weather, time constraints, and preferences for unhealthy foods. Facilitators included behavioral self-monitoring, exercising with a partner, and opportunities for preferred activities, such as hunting and team sports. Conclusions These findings provide important insight about influences on rural men’s health behaviors and provide guidance for possible intervention strategies to promote cardiometabolic health. Trial registration ClinicalTrials.gov NCT02499731 . Registered 1 July 2015

Predictors and outcomes of crossover to surgery from physical therapy for meniscal tear and osteoarthritis a randomized trial comparing physical therapy and surgery

BACKGROUND: Arthroscopic partial meniscectomy (APM) combined with physical therapy (PT) have yielded pain relief similar to that provided by PT alone in randomized trials of subjects with a degenerative meniscal tear. However, many patients randomized to PT received APM before assessment of the primary outcome. We sought to identify factors associated with crossing over to APM and to compare pain relief between patients who had crossed over to APM and those who had been randomized to APM. METHODS: We used data from the MeTeOR (Meniscal Tear in Osteoarthritis Research) Trial of APM with PT versus PT alone in subjects ≥45 years old who had mild-to-moderate osteoarthritis and a degenerative meniscal tear. We assessed independent predictors of crossover to APM among those randomized to PT. We also compared pain relief at 6 months among those randomized to PT who crossed over to APM, those who did not cross over, and those originally randomized to APM. RESULTS: One hundred and sixty-four subjects were randomized to and received APM and 177 were randomized to PT, of whom 48 (27%) crossed over to receive APM in the first 140 days after randomization. In multivariate analyses, factors associated with a higher likelihood of crossing over to APM among those who had originally been randomized to PT included a baseline Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Score of ≥40 (risk ratio [RR] = 1.99; 95% confidence interval [CI] = 1.00, 3.93) and symptom duration of <1 year (RR = 1.74; 95% CI = 0.98, 3.08). Eighty-one percent of subjects who crossed over to APM and 82% of those randomized to APM had an improvement of ≥10 points in their pain score at 6 months, as did 73% of those who were randomized to and received only PT. CONCLUSIONS: Subjects who crossed over to APM had presented with a shorter symptom duration and greater baseline pain than those who did not cross over from PT. Subjects who crossed over had rates of surgical success similar to those of the patients who had been randomized to surgery. Our findings also suggest that an initial course of rigorous PT prior to APM may not compromise surgical outcome. LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence

Cocaine- and Amphetamine-Regulated Transcript (CART) Signaling within the Paraventricular Thalamus Modulates Cocaine-Seeking Behaviour

Background: Cocaine- and amphetamine-regulated transcript (CART) has been demonstrated to play a role in regulating the rewarding and reinforcing effects of various drugs of abuse. A recent study demonstrated that i.c.v. administration of CART negatively modulates reinstatement of alcohol seeking, however, the site(s) of action remains unclear. We investigated the paraventricular thalamus (PVT) as a potential site of relapse-relevant CART signaling, as this region is known to receive dense innervation from CART-containing hypothalamic cells and to project to a number of regions known to be involved in mediating reinstatement, including the nucleus accumbens (NAC), medial prefrontal cortex (mPFC) and basolateral amygdala (BLA). Methodology/Principal Findings: Male rats were trained to self-administer cocaine before being extinguished to a set criterion. One day following extinction, animals received intra-PVT infusions of saline, tetrodotoxin (TTX; 2.5 ng), CART (0.625 µg or 2.5 µg) or no injection, followed by a cocaine prime (10 mg/kg, i.p.). Animals were then tested under extinction conditions for one hour. Treatment with either TTX or CART resulted in a significant attenuation of drug-seeking behaviour following cocaine-prime, with the 2.5 µg dose of CART having the greatest effect. This effect was specific to the PVT region, as misplaced injections of both TTX and CART resulted in responding that was identical to controls. Conclusions/Significance: We show for the first time that CART signaling within the PVT acts to inhibit drug-primed reinstatement of cocaine seeking behaviour, presumably by negatively modulating PVT efferents that are important for drug seeking, including the NAC, mPFC and BLA. In this way, we identify a possible target for future pharmacological interventions designed to suppress drug seeking

Gaining and maintaining a competitive edge: Evidence from CSA members and farmers on local food marketing strategies

Community-supported agriculture (CSA) is a widely-used approach for farmers to sell directly to consumers. We used the product, place, price, and promotion (4P) marketing mix framework to examine characteristics that help farms offering CSA maintain member satisfaction and thus competitiveness. We conducted semi-structured interviews with 20 CSA members and 24 CSA farmers in four states. CSA members additionally completed a modified choice experiment. Qualitative data were coded iteratively, and choice experiment data were summarized and compared across scenarios. CSA members and farmers were motivated by a range of personal, social, environmental, and economic objectives. Members favored high-quality staple vegetables (e.g., lettuce, green beans), ideally produced organically. Trust and a sense of personal connection with the farmer comprised part of the value added of CSA participation. Time and location of share pick-up were very important; thus, farmers tried to offer convenient sites or an enriched pick-up experience. Small changes in price appeared unlikely to impact participation among current members. Social networks and word-of-mouth were powerful for marketing, but may limit the ability to reach diverse populations. Future research should examine the ability of CSAs to meet the needs of those who do not currently participate