Strength and Comprehensiveness of Mandated School District Wellness Policies in Relation to Health-related Student Fitness Measured by Fitnessgram�

School wellness policies (SWPs) are documents developed by school districts with the objective of addressing nutrition and physical activity. The Child Nutrition and WIC Reauthorization Act of 2004 (CNRA) was passed by the U.S. Congress which required schools to possess a SWP by the 2006-2007 school year. Since passage of the CNRA, health outcomes of students such as obesity, have been of interest. This study sought to see if there is a connection between the strength and comprehensiveness of SWPs and physical fitness in students, as measured by Fitnessgram�. Physical fitness assessed by Fitnessgram� is determined by conducting six tests with the goal of meeting the healthy fitness zone (HFZ) for each test. Students (N=747) were obtained from twenty-seven districts that received funding from Physical Education Program (PEP) grants to conduct Fitnessgram� testing and review SWPs. SWPs were evaluated using the Wellness School Assessment tool (WellSAT), generating two scores, strength and comprehensiveness (Rudd Center, n.d.). Data was analyzed using two methods: 1) Linear regression analysis with clustered robust standard error at the individual level, and 2) Bivariate correlation analysis with student fitness scores aggregated at the district level. Mean SWP strength (x?=24.13) and comprehensiveness (x?=48.91) from schools assessed in Oklahoma were lower than other states (Schwartz et al., 2012). Regression analysis showed there was no relationship between attainment of the HFZ and strength (p=0.18) or comprehensiveness (p=0.18), however gender and attainment of the HFZ was significantly correlated (p=0.04). The correlation analysis further confirmed that there was no relationship between mean attainment of the HFZ and strength (r=0.14, p=0.48) or comprehensiveness (r=0.14, p=0.48). Although physical fitness can be related to childhood obesity, results from this study suggest SWPs in Oklahoma are not strong or comprehensive enough to facilitate change in student fitness. School districts should consider enhancing opportunities for physical activity and physical education not only in the school, but also among the home and community environments.Nutritional Scienc

Redesign, Field-Testing, and Validation of the Physical Activity Campus Environmental Supports (PACES) Audit.

This paper describes the redesign, field-testing, and convergent validity of a practical tool-Physical Activity Campus Environmental Supports (PACES) audit. Methods. The audit includes two parts: (1) PACES-Programs, which is comprised of questions regarding populations served, fees, programs (recreation/fitness classes and intramurals), proximity, adequacy of facilities, and marketing, and (2) PACES-Facilities, which is comprised of questions regarding built environment (aesthetics, bike racks, stairs, and universal design), recreation equipment, staff, amenities, and access. Each item criterion is specifically scored using a five-point, semantic-differential scale ranging from limited to extensive environmental support. A few questions utilize select all that apply for a summed score. PACES training, interrater reliability, and data collection are all accessible via an online portal. PACES was tested on 76 college campuses. Convergent validity was examined by comparing the PACES-Programs questions to Healthy Campus Initiatives-Programs questions (HCI-Programs) and comparing the PACES-Facilities questions to questions contained in the Physical Activity Resource Assessment (PARA) Instrument. Statistical analyses included Cronbach\u27s alpha, ANOVA, latent profile analysis, and Spearman correlations. Results.The PACES-Programs audit includes 10 items for a potential total of 73 points (α = 0.72) and PACES-Facilities audit includes 15 items for a potential total of 77 points (α = 0.837). Most (77.8%) of the 153 facilities assessed scored in the most healthful range (20-42), which was mainly due to the extensiveness of the aerobic equipment/amenities and the competence/accessibility of staff. Significant differences in PACES-Total and PACES-Programs scores were associated with campus size and PACES-Facilities across regions. For the paired validation assessments, correlations were significant between PACES-Programs and HCI-Programs ((n=41) r=0.498, p \u3c 0.001) and PACES-Facilities and PARA (n=29) for both features (r=0.417, p=0.024) and amenities (r=0.612, p \u3c 0.001), indicating moderate convergent validity. Conclusion. The PACES audit is a valid, reliable tool for assessing the quality of recreation facilities and programs in a variety of college campus environments

Social theory and the politics of big data and method

This article is an intervention in the debate on big data. It seeks to show, firstly, that behind the wager to make sociology more relevant to the digital there lies a coherent if essentially unstated vision and a whole stance which are more a symptom of the current world than a resolute endeavour to think that world through; hence the conclusion that the perspective prevailing in the debate lacks both the theoretical grip and the practical impulse to initiate a much needed renewal of social theory and sociology. Secondly, and more importantly, the article expounds an alternative view and shows by thus doing that other possibilities of engaging the digital can be pursued. The article is thus an invitation to widen the debate on big data and the digital and a call for a more combative social theory

Expanding the clinical and genetic spectrum of ALPK3 variants: Phenotypes identified in pediatric cardiomyopathy patients and adults with heterozygous variants

Introduction: Biallelic damaging variants in ALPK3, encoding alpha-protein kinase 3, cause pediatric-onset cardiomyopathy with manifestations that are incompletely defined. Methods and Results: We analyzed clinical manifestations of damaging biallelic ALPK3 variants in 19 pediatric patients, including nine previously published cases. Among these, 11 loss-of-function (LoF) variants, seven compound LoF and deleterious missense variants, and one homozygous deleterious missense variant were identified. Among 18 live-born patients, 8 exhibited neonatal dilated cardiomyopathy (44.4%; 95% CI: 21.5%-69.2%) that subsequently transitioned into ventricular hypertrophy. The majority of patients had extracardiac phenotypes, including contractures, scoliosis, cleft palate, and facial dysmorphisms. We observed no association between variant type or location, disease severity, and/or extracardiac manifestations. Myocardial histopathology showed focal cardiomyocyte hypertrophy, subendocardial fibroelastosis in patients under 4 years of age, and myofibrillar disarray in adults. Rare heterozygous ALPK3 variants were also assessed in adult-onset cardiomyopathy patients. Among 1548 Dutch patients referred for initial genetic analyses, we identified 39 individuals with rare heterozygous ALPK3 variants (2.5%; 95% CI: 1.8%-3.4%), including 26 missense and 10 LoF variants. Among 149 U.S. patients without pathogenic variants in 83 cardiomyopathy-related genes, we identified six missense and nine LoF ALPK3 variants (10.1%; 95% CI: 5.7%-16.1%). LoF ALPK3 variants were increased in comparison to matched controls (Dutch cohort, P = 1.6×10−5; U.S. cohort, P = 2.2×10−13). Conclusion: Biallelic damaging ALPK3 variants cause pediatric cardiomyopathy manifested by DCM transitioning to hypertrophy, often with poor contractile function. Additional extracardiac features occur in most patients, including musculoskeletal abnormalities and cleft palate. Heterozygous LoF ALPK3 variants are enriched in adults with cardiomyopathy and may contribute to their cardiomyopathy. Adults with ALPK3 LoF variants therefore warrant evaluations for cardiomyopathy

Still getting it on online: Thirty years of queer male spaces brokered through digital technologies

Research across the social sciences testifies to an ongoing relationship between queerness and digital technology. This article tracks how different online spaces for queer men have changed as the internet has developed over the past 30 years. It argues that queer spaces have become increasingly dominated by, and predicated on, internet technology. I review early interpretations of cyberspace as a liberatory space freed from heteronormativity and later more critical assessments of its potential, positioning arguments for and against the internet's status as a protective space. I then evaluate the huge popularity of mobile phone-based dating and hook-up apps such as Grindr and Tinder. These platforms have developed from static desktop offerings including Gaydar and PlanetRomeo, but emphasise a distinctly hybridised socio-technical experience in partner seeking. Finally, I consider the impact of locative media on more traditional queer concepts of cruising and community, concluding that contemporary apps refigure both structures in distinctive ways reflecting larger changes in sexuality and space studies

Negotiating identity and alterity: Cultural competence, colonization and cultural voyeurism in students’ work-based learning

yesThere is increasing demand for work-based learning experiences to form part of undergraduate degrees concerned with working with people. Social justice and anti-oppressive practice underpin the philosophies of many such degrees which attract students with the promise of working within diverse communities and with the marginalized and vulnerable. Benefits to students include the development of a professional identity, an anti-oppressive approach and culturally competent practices. Despite this, critical approaches to work-based learning highlight ways in which the student can be colonized by dominant values via ‘cultural voyeurism’. This can lead to power inequalities being replicated and perpetuated by the student rather than challenged. The roles of identity and alterity in these learning processes are examined and the concept of professional identity is questioned. The article concludes that the tasks of negotiating identity and alterity are characterized by uncertainty and unfinalizability, and that the notion of cultural competence is itself problematic

Role of drug transporters and drug accumulation in the temporal acquisition of drug resistance

<p>Abstract</p> <p>Background</p> <p>Anthracyclines and taxanes are commonly used in the treatment of breast cancer. However, tumor resistance to these drugs often develops, possibly due to overexpression of drug transporters. It remains unclear whether drug resistance <it>in vitro </it>occurs at clinically relevant doses of chemotherapy drugs and whether both the onset and magnitude of drug resistance can be temporally and causally correlated with the enhanced expression and activity of specific drug transporters. To address these issues, MCF-7 cells were selected for survival in increasing concentrations of doxorubicin (MCF-7_DOX-2), epirubicin (MCF-7_EPI), paclitaxel (MCF-7_TAX-2), or docetaxel (MCF-7_TXT). During selection cells were assessed for drug sensitivity, drug uptake, and the expression of various drug transporters.</p> <p>Results</p> <p>In all cases, resistance was only achieved when selection reached a specific threshold dose, which was well within the clinical range. A reduction in drug uptake was temporally correlated with the acquisition of drug resistance for all cell lines, but further increases in drug resistance at doses above threshold were unrelated to changes in cellular drug uptake. Elevated expression of one or more drug transporters was seen at or above the threshold dose, but the identity, number, and temporal pattern of drug transporter induction varied with the drug used as selection agent. The pan drug transporter inhibitor cyclosporin A was able to partially or completely restore drug accumulation in the drug-resistant cell lines, but had only partial to no effect on drug sensitivity. The inability of cyclosporin A to restore drug sensitivity suggests the presence of additional mechanisms of drug resistance.</p> <p>Conclusion</p> <p>This study indicates that drug resistance is achieved in breast tumour cells only upon exposure to concentrations of drug at or above a specific selection dose. While changes in drug accumulation and the expression of drug transporters does occur at the threshold dose, the magnitude of resistance cannot be attributed solely to changes in drug accumulation or the activity of drug transporters. The identities of these additional drug-transporter-independent mechanisms are discussed, including their likely clinical relevance.</p

Toward a new ‘EPOCH’: optimising treatment outcomes with phosphodiesterase type 5 inhibitors for erectile dysfunction

Despite the marked adverse impacts of erectile dysfunction (ED) on quality of life and well-being, many patients (and/or their partners) do not seek medical attention for this problem, do not receive treatment or discontinue such treatment even when it has effectively restored erectile responses to sexual stimulation. Phosphodiesterase type 5 (PDE5) inhibitors are considered first-line therapies for men with ED. To help physicians maximise the likelihood of treatment success with these agents, we conducted an English-language PubMed search of articles involving approved PDE5 inhibitors dating from 1 January 1998 (the year in which sildenafil citrate was introduced), through 31 August 2008. In addition to sildenafil, tadalafil and vardenafil, search terms included ‘adhere*’, ‘couple*’, ‘effect*’, ‘effic*’, ‘partner*’, ‘satisf*’, ‘succe*’ and ‘treatment outcome.’ Based on our analysis, physician activities to promote favourable treatment outcomes may be captured under the mnemonic ‘EPOCH’: (i) Evaluating and educating patients and partners to ensure realistic expectations of therapy; (ii) Prescribing a treatment individualised to the couple’s lifestyle needs and other preferences; (iii) Optimising treatment outcomes by scheduling follow-up visits with the patient to ‘fine-tune’ dosages and revisit key educational messages; (iv) Controlling comorbidities via lifestyle counselling, medications and/or referrals and (v) Helping patients and their partners to meet their health and psychosocial needs, potentially referring them to a specialist for other forms of therapy if they are not satisfied with PDE5 inhibitors

Clinical Sequencing Exploratory Research Consortium: Accelerating Evidence-Based Practice of Genomic Medicine

Despite rapid technical progress and demonstrable effectiveness for some types of diagnosis and therapy, much remains to be learned about clinical genome and exome sequencing (CGES) and its role within the practice of medicine. The Clinical Sequencing Exploratory Research (CSER) consortium includes 18 extramural research projects, one National Human Genome Research Institute (NHGRI) intramural project, and a coordinating center funded by the NHGRI and National Cancer Institute. The consortium is exploring analytic and clinical validity and utility, as well as the ethical, legal, and social implications of sequencing via multidisciplinary approaches; it has thus far recruited 5,577 participants across a spectrum of symptomatic and healthy children and adults by utilizing both germline and cancer sequencing. The CSER consortium is analyzing data and creating publically available procedures and tools related to participant preferences and consent, variant classification, disclosure and management of primary and secondary findings, health outcomes, and integration with electronic health records. Future research directions will refine measures of clinical utility of CGES in both germline and somatic testing, evaluate the use of CGES for screening in healthy individuals, explore the penetrance of pathogenic variants through extensive phenotyping, reduce discordances in public databases of genes and variants, examine social and ethnic disparities in the provision of genomics services, explore regulatory issues, and estimate the value and downstream costs of sequencing. The CSER consortium has established a shared community of research sites by using diverse approaches to pursue the evidence-based development of best practices in genomic medicine