Web-Based Nutrition Education Intervention for African American Women Using the Theory of Planned Behavior

African American women have been disproportionately impacted for decades by the obesity epidemic, which frequently leads to severe chronic diseases such as cardiovascular disease, diabetes and hypertension. This increase in chronic diseases amongst African American women is the motivation for the design of a culturally tailored nutrition education (NE) program that combines a strong theoretical base with the use of technology such as the Internet, since its usage within the college aged African American community has rapidly increased. Little is known about the variables that motivate behavior change in regards to eating and physical activity habits among college aged African American women. The Online Nutrition Education for Sisters (ONES) program is a culturally tailored web-based nutrition education intervention for college aged African American women. Its theoretical framework includes health promotion constructs from the Theory of Planned Behavior, Social Cognitive Theory and Self-Determination Theory merged with instructional design principles from Cognitive Load Theory and Multimedia Learning. This one of a kind design can serve as a blueprint for other web-based nutrition education programs targeting minority populations with higher risk of overweight and obesity. Results from the 6-week pilot testing of ONES demonstrated that the intervention was well accepted and helped improve college aged African American women’s intention to change their eating related behaviors in the short-term; with participant satisfaction rates and motivation rates post intervention above 94%. Future research should explore the long-term effects of the ONES program to better determine how technology can be incorporated into nutrition education programs to enhance behavior change outcomes

Practicing psychologists’ accounts of demand avoidance and extreme demand avoidance in children and adolescents

The construct of pathological or extreme demand avoidance (EDA) is used to describe the experience of avoiding demands and having an extreme need for control. However, the EDA construct is contested by researchers and educational psychology practitioners. To investigate the utility and validity of the construct of EDA, this qualitative study explored psychologists’ experience and conceptualisation of demand avoidance and extreme demand avoidance, and their approach to working with children and adolescents who avoid demands. Online semi-structured interviews were conducted with 12 psychologists (female = 9) working in private, education and disability services. Thematic analysis yielded six themes: (i) reason for the psychologists’ involvement, (ii) psychologists understanding of child’s presentation, (iii) psychologists’ focus in supporting the child, (iv) challenges for psychologists, (v) enablers for psychologists and (vi) success for psychologists. Results indicated that psychologists do not view the construct of EDA as necessary for their work and achieve success with children who avoid demands by drawing on range of approaches focusing on the underlying needs of those children

Program Development and Implementation for South Carolina Youth through Expanded Food and Nutrition Education Program (EFNEP)

The Expanded Food Nutrition and Education Program (EFNEP) is a federally-funded program that aims at informing and educating limited-resource children, youth, and families in developing and maintaining a nutritionally sound diet, and a physically active lifestyle. Many of the intervention programs implemented through Youth EFNEP are created to be part of an existing school curriculum or as an after-school program. Currently, few programs exist that allow for easy transferability of these already existing curriculums to a summer camp setting.Therefore, the purpose of our Creative Inquiry was to develop the students\u27 abilities to design and implement a Nutrition Education program for youth audiences in a community setting. Students\u27 responsibilities comprised the analysis of lesson structure for grades K-12, development of lesson materials, implementation of the nutrition education lessons with youth audiences from surrounding community areas, and the application of Youth EFNEP evaluation tools.The 8-lesson curriculum is being pilot-tested during the fall of 2014 and spring of 2015 at Littlejohn Community Center in Clemson. The students have taken a leading role in the implementation of the nutrition education activities at the center, acquired the skills to work with low income audiences and have been actively providing the necessary feedback to improve the quality and content of the curriculum, so that one day it becomes a tool that can be used nationwide in summer camps by Youth EFNEP educators

Galleria mellonella Infection Model Identifies Both High and Low Lethality of Clostridium perfringens Toxigenic Strains and Their Response to Antimicrobials

Research progress into mechanisms of the anaerobe Clostridium perfringens and associated diseases has been frustrated by the lack of reliable infection models. Wax moth larvae (Galleria mellonella) have emerged as a viable alternative to other models of infection since they are economic, survive at 37�C and require no specialist equipment. This study aims to establish to what extent G. mellonella larvae can be used to study the virulence of C. perfringens strains and its suitability for studying novel treatment strategies by an improved time-lapse approach to data collection. Mortality and morbidity rates of larvae challenged with 105 CFU of C. perfringens isolates from various sources were observed over 72 h and dose response data obtained. Phenoloxidase enzyme activity was investigated as a marker for immune response and tissue burden assessed by histopathological techniques. Results demonstrate that C. perfringens is pathogenic toward G. mellonella although potency varies dramatically between C. perfringens isolates and the reference strain ATCC 13124 was shown to be avirulent. Infection with C. perfringens strains activated the melanisation pathway resulting in melanin deposition but no increase in enzyme activity was observed. Efficacy of antibiotic therapy (penicillin G, bacitracin, neomycin, and tetracycline) administered parenterally to some extent correlates with that of in vitro analysis. The findings suggest G. mellonella might be a useful in vivo model of infection and convenient as a prescreening assay for virulence of C. perfringens strains or as a simple, cheap and rapid in vivo assay in the first stage development of novel therapeutics against anaerobes

Semaglutide and cardiovascular outcomes in patients with obesity and prevalent heart failure: a prespecified analysis of the SELECT trial

Background: Semaglutide, a GLP-1 receptor agonist, reduces the risk of major adverse cardiovascular events (MACE) in people with overweight or obesity, but the effects of this drug on outcomes in patients with atherosclerotic cardiovascular disease and heart failure are unknown. We report a prespecified analysis of the effect of once-weekly subcutaneous semaglutide 2·4 mg on ischaemic and heart failure cardiovascular outcomes. We aimed to investigate if semaglutide was beneficial in patients with atherosclerotic cardiovascular disease with a history of heart failure compared with placebo; if there was a difference in outcome in patients designated as having heart failure with preserved ejection fraction compared with heart failure with reduced ejection fraction; and if the efficacy and safety of semaglutide in patients with heart failure was related to baseline characteristics or subtype of heart failure. Methods: The SELECT trial was a randomised, double-blind, multicentre, placebo-controlled, event-driven phase 3 trial in 41 countries. Adults aged 45 years and older, with a BMI of 27 kg/m2 or greater and established cardiovascular disease were eligible for the study. Patients were randomly assigned (1:1) with a block size of four using an interactive web response system in a double-blind manner to escalating doses of once-weekly subcutaneous semaglutide over 16 weeks to a target dose of 2·4 mg, or placebo. In a prespecified analysis, we examined the effect of semaglutide compared with placebo in patients with and without a history of heart failure at enrolment, subclassified as heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, or unclassified heart failure. Endpoints comprised MACE (a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death); a composite heart failure outcome (cardiovascular death or hospitalisation or urgent hospital visit for heart failure); cardiovascular death; and all-cause death. The study is registered with ClinicalTrials.gov, NCT03574597. Findings: Between Oct 31, 2018, and March 31, 2021, 17 604 patients with a mean age of 61·6 years (SD 8·9) and a mean BMI of 33·4 kg/m2 (5·0) were randomly assigned to receive semaglutide (8803 [50·0%] patients) or placebo (8801 [50·0%] patients). 4286 (24·3%) of 17 604 patients had a history of investigator-defined heart failure at enrolment: 2273 (53·0%) of 4286 patients had heart failure with preserved ejection fraction, 1347 (31·4%) had heart failure with reduced ejection fraction, and 666 (15·5%) had unclassified heart failure. Baseline characteristics were similar between patients with and without heart failure. Patients with heart failure had a higher incidence of clinical events. Semaglutide improved all outcome measures in patients with heart failure at random assignment compared with those without heart failure (hazard ratio [HR] 0·72, 95% CI 0·60-0·87 for MACE; 0·79, 0·64-0·98 for the heart failure composite endpoint; 0·76, 0·59-0·97 for cardiovascular death; and 0·81, 0·66-1·00 for all-cause death; all pinteraction>0·19). Treatment with semaglutide resulted in improved outcomes in both the heart failure with reduced ejection fraction (HR 0·65, 95% CI 0·49-0·87 for MACE; 0·79, 0·58-1·08 for the composite heart failure endpoint) and heart failure with preserved ejection fraction groups (0·69, 0·51-0·91 for MACE; 0·75, 0·52-1·07 for the composite heart failure endpoint), although patients with heart failure with reduced ejection fraction had higher absolute event rates than those with heart failure with preserved ejection fraction. For MACE and the heart failure composite, there were no significant differences in benefits across baseline age, sex, BMI, New York Heart Association status, and diuretic use. Serious adverse events were less frequent with semaglutide versus placebo, regardless of heart failure subtype. Interpretation: In patients with atherosclerotic cardiovascular diease and overweight or obesity, treatment with semaglutide 2·4 mg reduced MACE and composite heart failure endpoints compared with placebo in those with and without clinical heart failure, regardless of heart failure subtype. Our findings could facilitate prescribing and result in improved clinical outcomes for this patient group. Funding: Novo Nordisk