Associations among food security, BMI, diet diversity and food consumption patterns of women in rural Kenya

Enhancing food security is one of the United Nations Sustainable Development Goals. Improved agricultural production is an approach to addressing food insecurity. However, these efforts can result in significant changes that are associated with increased risk of non-communicable chronic diseases. Previous research with women in Central Kenya found that the number of years a woman-farmer was engaged in dairy development was associated with greater food security and energy (kJ) intake. No studies have examined food security and the nutrition transition among rural farm women involved in dairy development initiatives. A cross-sectional survey was conducted in 2009 and again in 2017. Chain referral sampling was used in 2009 to recruit 111 women in five groups based on how long they had been a dairy group member (non-members and members from one to more than 10 years). In 2017, 20 women were randomly selected from 85 of the dairy-group member households surveyed in 2009 and a comparison group of 20 women was randomly selected from a list that was generated by referral from the participants. In person one-on-one interviews were conducted with a translator. Demographic, household food security, and dietary intake were collected in both years. In 2009 women’s height and weight data were collected for BMI calculation. Associations among food security, BMI, dietary intake, and year of data collection were examined. Demographic characteristics were comparable between 2009 and 2017 and between food secure and food insecure  households. In both years, the majority of households were categorized as not food insecure (67% and 75%; 2009 and 2017, respectively). In 2009 almost half the women (49.4%) had BMIs in the overweight and obese category. Food secure women had a  significantly higher median BMI (26.5) compared with food insecure women (24.0). Diet diversity was low (<5) for all women and there was little evidence for a classic “western diet” of the nutrition transition. There was evidence of globalization in food availability and  greater purchasing capacity that was demonstrated by the high proportion of women that consumed sugar, refined fats and oils, refined maize and wheat flours, and bread. Household food security was associated with the consumption of sugar, cabbage, wheat  flour and bread. These findings support a unique rural nutrition transition, with food security, characterized by low dietary diversity, access to refined basic foods and high unhealthy BMI. Governments and non-governmental organizations need to support nutrition- sensitive agriculture and public health programs to curb the crisis of overweight, undernourishment and chronic diseases. Key words: agriculture, nutrition transition, rural, farm, Kenya, women, BMI, diet diversit

Promising Practices and Unfinished Business: Fostering Equity and Excellence for Black and Latino Males

Boston Public Schools (BPS) commissioned companion studies as part of its efforts to address achievement gaps for Black and Latino males. The first study revealed the increasing diversity of Black and Latino males and stark opportunity gaps throughout the system that contribute in large part to wide attainment gaps for these students. We hypothesized that in schools doing comparatively better with Black or Latino males than their counterparts, educators would be strategically and comprehensively implementing evidence-based cultural, structural, and instructional practices tailored to meet their the needs and aspirations of these students. Through qualitative case studies of four schools, we identified several cross-cutting themes that provide the district and school leaders with some positive news about effective practices found in all good schools: strong school cultures, professional collaboration, differentiated instruction, and, in the elementary schools, family engagement. While we observed pockets of best practices specific to Black and Latino male education, we also brought to light unfinished business, in that none of the four case study schools had an intentional and comprehensive schoolwide approach to educating Black and Latino males. This lack of intentionality resulted in a paucity of evidence that the school administration and faculty as a whole: (a) know and value students' cultural and linguistic backgrounds; (b) adopt explicit and responsive approaches to race and gender; and (c) develop and implement a comprehensive approach to culturally responsive curriculum and instruction. We posit that lack of knowledge, intentionality, and coherence impedes further progress in educating Black and Latino males, and has implications for educators in schools, for staff members in community partner organizations, and for family members of BPS students

Electron spin resonance spectra of some paramagnetic hydride complexes of niobium(IV) and tantalum(IV)

Frozen solution electron spin resonance spectra show that the unpaired electron is in a dx2-y2 orbital on the metal in the complexes TaCl2H2(drnpe)2, TaCl2H2(PMe3)4 and NbCl2 H2 (dmpe)2, (dmpe = Me2- PCH2CH2PMe2).Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/26235/1/0000315.pd

Person-centred deprescribing for patients living with frailty: a qualitative interview study and proposal of a collaborative model

Objectives (1) Present deprescribing experiences of patients living with frailty, their informal carers and healthcare professionals; (2) interpret whether their experiences are reflective of person-centred/collaborative care; (3) complement our findings with existing evidence to present a model for person-centred deprescribing for patients living with frailty, based on a previous collaborative care model. Methods Qualitative design in English primary care (general practice). Semi-structured interviews were undertaken immediately post-deprescribing and 5/6 weeks later with nine patients aged 65+ living with frailty and three informal carers of patients living with frailty. Fourteen primary care professionals with experience in deprescribing were also interviewed. In total, 38 interviews were conducted. A two-staged approach to data analysis was undertaken. Key findings Three themes were developed: attitudes, beliefs and understanding of medicines management and responsibility; attributes of a collaborative, person-centred deprescribing consultation; organisational factors to support person-centred deprescribing. Based on these findings and complementary to existing evidence, we offer a model for person-centred deprescribing for patients living with frailty. Conclusions Previous models of deprescribing for patients living with frailty while, of value, do not consider the contextual factors that govern the implementation and success of models in practice. In this paper, we propose a novel person-centred model for deprescribing for people living with frailty, based on our own empirical findings, and the wider evidence base

Systematic techniques for assisting recruitment to trials (START): study protocol for embedded, randomized controlled trials

BACKGROUND: Randomized controlled trials play a central role in evidence-based practice, but recruitment of participants, and retention of them once in the trial, is challenging. Moreover, there is a dearth of evidence that research teams can use to inform the development of their recruitment and retention strategies. As with other healthcare initiatives, the fairest test of the effectiveness of a recruitment strategy is a trial comparing alternatives, which for recruitment would mean embedding a recruitment trial within an ongoing host trial. Systematic reviews indicate that such studies are rare. Embedded trials are largely delivered in an ad hoc way, with interventions almost always developed in isolation and tested in the context of a single host trial, limiting their ability to contribute to a body of evidence with regard to a single recruitment intervention and to researchers working in different contexts. METHODS/DESIGN: The Systematic Techniques for Assisting Recruitment to Trials (START) program is funded by the United Kingdom Medical Research Council (MRC) Methodology Research Programme to support the routine adoption of embedded trials to test standardized recruitment interventions across ongoing host trials. To achieve this aim, the program involves three interrelated work packages: (1) methodology - to develop guidelines for the design, analysis and reporting of embedded recruitment studies; (2) interventions - to develop effective and useful recruitment interventions; and (3) implementation - to recruit host trials and test interventions through embedded studies. DISCUSSION: Successful completion of the START program will provide a model for a platform for the wider trials community to use to evaluate recruitment interventions or, potentially, other types of intervention linked to trial conduct. It will also increase the evidence base for two types of recruitment intervention. TRIAL REGISTRATION: The START protocol covers the methodology for embedded trials. Each embedded trial is registered separately or as a substudy of the host trial

Regulation of hepatic cytochrome P450 expression in mice with intestinal or systemic infections of citrobacter rodentium.

We reported previously that infection of C3H/HeOuJ (HeOu) mice with the murine intestinal pathogen Citrobacter rodentium caused a selective modulation of hepatic cytochrome P450 (P450) gene expression in the liver that was independent of the Toll-like receptor 4. However, HeOu mice are much more sensitive to the pathogenic effects of C. rodentium infection, and the P450 down-regulation was associated with significant morbidity in the animals. Here, we report that oral infection of C57BL/6 mice with C. rodentium, which produced only mild clinical signs and symptoms, produced very similar effects on hepatic P450 expression in this strain. As in HeOu mice, CYP4A mRNAs and proteins were among the most sensitive to down-regulation, whereas CYP4F18 was induced. CYP2D9 mRNA was also induced 8- to 9-fold in the C57BL/6 mice. The time course of P450 regulation followed that of colonic inflammation and bacterial colonization, peaking at 7 to 10 days after infection and returning to normal at 15 to 24 days as the infection resolved. These changes also correlated with the time course of significant elevations in the serum of the proinflammatory cytokines interleukin (IL)-6 and tumor necrosis factor-alpha, as well as of interferon-gamma and IL-2, with serum levels of IL-6 being markedly higher than those of the other cytokines. Intraperitoneal administration of C. rodentium produced a rapid down-regulation of P450 enzymes that was quantitatively and qualitatively different from that of oral infection, although CYP2D9 was induced in both models, suggesting that the effects of oral infection on the liver are not due to bacterial translocation

Reexamining evidence-based practice in community corrections: beyond 'a confined view' of what works

This article aims to reexamine the development and scope of evidence-based practice (EBP) in community corrections by exploring three sets of issues. Firstly, we examine the relationships between the contested purposes of community supervision and their relationships to questions of evidence. Secondly, we explore the range of forms of evidence that might inform the pursuit of one purpose of supervision—the rehabilitation of offenders—making the case for a fuller engagement with “desistance” research in supporting this process. Thirdly, we examine who can and should be involved in conversations about EBP, arguing that both ex/offenders’ and practitioners’ voices need to be respected and heard in this debate

A system of ODEs for a Perturbation of a Minimal Mass Soliton

We study soliton solutions to a nonlinear Schrodinger equation with a saturated nonlinearity. Such nonlinearities are known to possess minimal mass soliton solutions. We consider a small perturbation of a minimal mass soliton, and identify a system of ODEs similar to those from Comech and Pelinovsky (2003), which model the behavior of the perturbation for short times. We then provide numerical evidence that under this system of ODEs there are two possible dynamical outcomes, which is in accord with the conclusions of Pelinovsky, Afanasjev, and Kivshar (1996). For initial data which supports a soliton structure, a generic initial perturbation oscillates around the stable family of solitons. For initial data which is expected to disperse, the finite dimensional dynamics follow the unstable portion of the soliton curve.Comment: Minor edit

How to Test Mandatory Text Templates: The European Patient Information Leaflet

The structure of patient information leaflets (PILs) supplied with medicines in the European Union is largely determined by a regulatory template, requiring a fixed sequence of pre-formulated headings and sub-headings. The template has been criticized on various occasions, but it has never been tested with users. This paper proposes an alternative template, informed by templates used in the USA and Australia, and by previous user testing.The main research question is whether the revision better enables users to find relevant information. Besides, the paper proposes a methodology for testing templates. Testing document templates is complex, as they are “empty”. For both the current and the alternative template, we produced a document with bogus text and real headings (reflecting the empty template) and a real-life document with readable text (reflecting the “filled” template). The documents were tested both in Dutch and in English, with 64 British and 64 Dutch users. The test used a set of scenario questions that covers the full range of template (sub)topics; users needed to indicate the text locations where they expected each question to be answered. The revised template improved findability of information; this effect was strongest for the “filled” template with readable text. When participants were shown both filled templates, there was a clear preference for the revised template. A closer analysis of the findability data revealed question-specific effects of topic grouping, topic ordering, subtopic granularity and wording of headings. Most of these favoured the revised template, but our revision led to adverse effects as well, for instance in the new heading Check with your doctor. Language-specific effects showed that the wording of the headings is a delicate task. Generally, we conclude that document template designs can be analyzed in terms of the four parameters grouping, ordering, granularity and wording. Furthermore, they need to be tested on their effects on information findability, with template translations requiring separate testing. The methodology used in this study seems an appropriate one for such tests. More specifically, we find that the new patient information leaflet template proposed here provides better information findability