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Few studies have derived data-driven dietary patterns in youth in the United States (US). This study examined data-driven dietary patterns and their associations with BMI measures in predominantly low-income, racial/ethnic minority US youth. Data were from baseline assessments of the four Childhood Obesity Prevention and Treatment Research (COPTR) Consortium trials: NET-Works (N=534; 2–4-year-olds), GROW (N=610; 3–5-year-olds), GOALS (N=241; 7–11-year-olds), and IMPACT (N=360; 10–13-year-olds). Weight and height were measured. Children/adult proxies completed 3 24-hour dietary recalls. Dietary patterns were derived for each site from 24 food/beverage groups using k-means cluster analysis. Multivariable linear regression models examined associations of dietary patterns with BMI and percentage of the 95th BMI percentile. Healthy (produce and whole grains) and Unhealthy (fried food, savory snacks, and desserts) patterns were found in NET-Works and GROW. GROW additionally had a dairy and sugar-sweetened beverage based pattern. GOALS had a similar Healthy pattern and a pattern resembling a traditional Mexican diet. Associations between dietary patterns and BMI were only observed in IMPACT. In IMPACT, youth in the Sandwich (cold cuts, refined grains, cheese, and miscellaneous [e.g., condiments]) compared to Mixed (whole grains and desserts) cluster had significantly higher BMI [β=0.99 (95% CI: 0.01, 1.97)] and percentage of the 95th BMI percentile [β=4.17 (95% CI: 0.11, 8.24)]. Healthy and Unhealthy patterns were the most common dietary patterns in COPTR youth, but diets may differ according to age, race/ethnicity, or geographic location. Public health messages focused on healthy dietary substitutions may help youth mimic a dietary pattern associated with lower BMI.
Though previous research has shown that sentence repetition (SR) is an informative tool for identifying developmental language disorder (DLD) in bilinguals, little is understood about the skills that underlie children's performance on the task. With a population of 136 school-age Spanish–English bilinguals, the present study explores the contribution of verbal short-term memory, vocabulary, and language exposure on two SR tasks developed in English and Spanish. Results indicate that these skills may differentially underlie SR in typical versus disordered populations. Whereas the strongest predictors of English SR performance for typical bilingual children were expressive vocabulary and language exposure, bilingual children with DLD relied most heavily on verbal short-term memory. ROC curves to determine the classification accuracy of SR were conducted. Classification accuracy was excellent, with area under the curve reaching .92 for the English SR task and .87 for Spanish SR.
Antipsychotics are commonly used, and the rate of use is highest, among those aged 65 years or over, where the risk of adverse events is also high. Up to 20% of younger adults use more than one antipsychotic concurrently; however there are few studies on the prevalence of antipsychotic polypharmacy in older people. We aimed to analyze antipsychotic use in elderly Australians, focusing on the prevalence of antipsychotic polypharmacy and the use of medicines to manage adverse events associated with antipsychotics.
A cross-sectional study was conducted using Australian Department of Veterans’ Affairs (DVA) administrative claims data for the period 1 March 2014 to 30 June 2014. Veterans dispensed at least one antipsychotic medicine during the study period was included. We determined the number of participants dispensed antipsychotic polypharmacy and the number of participants dispensed medicines to manage antipsychotic side effects.
There were 7,412 participants with a median age of 86 years. Fifty-one percent (n=3,784) were women and 48% (n=3,569) lived in residential aged-care. Fifty one participants (0.7%) were dispensed anticholinergic medicines indicated for the management of antipsychotic-associated extrapyramidal movement disorders and eight (0.1%) were dispensed medicines for the management of hyperprolactinemia. Five percent of participants (n=365) received dual antipsychotics. Dual antipsychotic users were more likely to be under the care of a psychiatrist or to have had a mental health hospitalization than those using a single antipsychotic.
Antipsychotic polypharmacy occurred in one in 20 elderly persons, indicating that there is room for improvement in antipsychotic use in elderly patients.
The purpose of this paper is to describe the development and initial accomplishments of a training program of young leaders in community mental health research as part of a Latin American initiative known as RedeAmericas. RedeAmericas was one of five regional ‘Hubs’ funded by the National Institute of Mental Health (NIMH) to improve community mental health care and build mental health research capacity in low- and middle-income countries. It included investigators in six Latin American cities – Santiago, Chile; Medellín, Colombia; Rio de Janeiro, Brazil; and Córdoba, Neuquén, and Buenos Aires in Argentina – working together with a team affiliated with the Global Mental Health program at Columbia University in New York City. One component of RedeAmericas was a capacity-building effort that included an Awardee program for early career researchers in the mental health field. We review the aims of this component, how it developed, and what was learned that would be useful for future capacity-building efforts, and also comment on future prospects for maintaining this type of effort.
Fontan survivors have depressed cardiac index that worsens over time. Serum biomarker measurement is minimally invasive, rapid, widely available, and may be useful for serial monitoring. The purpose of this study was to identify biomarkers that correlate with lower cardiac index in Fontan patients.
Methods and results
This study was a multi-centre case series assessing the correlations between biomarkers and cardiac magnetic resonance-derived cardiac index in Fontan patients ⩾6 years of age with biochemical and haematopoietic biomarkers obtained ±12 months from cardiac magnetic resonance. Medical history and biomarker values were obtained by chart review. Spearman’s Rank correlation assessed associations between biomarker z-scores and cardiac index. Biomarkers with significant correlations had receiver operating characteristic curves and area under the curve estimated. In total, 97 cardiac magnetic resonances in 87 patients met inclusion criteria: median age at cardiac magnetic resonance was 15 (6–33) years. Significant correlations were found between cardiac index and total alkaline phosphatase (−0.26, p=0.04), estimated creatinine clearance (0.26, p=0.02), and mean corpuscular volume (−0.32, p<0.01). Area under the curve for the three individual biomarkers was 0.63–0.69. Area under the curve for the three-biomarker panel was 0.75. Comparison of cardiac index above and below the receiver operating characteristic curve-identified cut-off points revealed significant differences for each biomarker (p<0.01) and for the composite panel [median cardiac index for higher-risk group=2.17 L/minute/m2 versus lower-risk group=2.96 L/minute/m2, (p<0.01)].
Higher total alkaline phosphatase and mean corpuscular volume as well as lower estimated creatinine clearance identify Fontan patients with lower cardiac index. Using biomarkers to monitor haemodynamics and organ-specific effects warrants prospective investigation.
Lower and middle income countries (LMICs) are home to >80% of the global population, but mental health researchers and LMIC investigator led publications are concentrated in 10% of LMICs. Increasing research and research outputs, such as in the form of peer reviewed publications, require increased capacity building (CB) opportunities in LMICs. The National Institute of Mental Health (NIMH) initiative, Collaborative Hubs for International Research on Mental Health reaches across five regional ‘hubs’ established in LMICs, to provide training and support for emerging researchers through hub-specific CB activities. This paper describes the range of CB activities, the process of monitoring, and the early outcomes of CB activities conducted by the five research hubs.
The indicators used to describe the nature, the monitoring, and the early outcomes of CB activities were developed collectively by the members of an inter-hub CB workgroup representing all five hubs. These indicators included but were not limited to courses, publications, and grants.
Results for all indicators demonstrate a wide range of feasible CB activities. The five hubs were successful in providing at least one and the majority several courses; 13 CB recipient-led articles were accepted for publication; and nine grant applications were successful.
The hubs were successful in providing CB recipients with a wide range of CB activities. The challenge remains to ensure ongoing CB of mental health researchers in LMICs, and in particular, to sustain the CB efforts of the five hubs after the termination of NIMH funding.
We investigate and quantify stirring due to chaotic advection within a steady, three-dimensional, Ekman-driven, rotating cylinder flow. The flow field has vertical overturning and horizontal swirling motion, and is an idealization of motion observed in some ocean eddies. The flow is characterized by strong background rotation, and we explore variations in Ekman and Rossby numbers,
, over ranges appropriate for the ocean mesoscale and submesoscale. A high-resolution spectral element model is used in conjunction with linear analytical theory, weakly nonlinear resonance analysis and a kinematic model in order to map out the barriers, manifolds, resonance layers and other objects that provide a template for chaotic stirring. As expected, chaos arises when a radially symmetric background state is perturbed by a symmetry-breaking disturbance. In the background state, each trajectory lives on a torus and some of the latter survive the perturbation and act as barriers to chaotic transport, a result consistent with an extension of the KAM theorem for three-dimensional, volume-preserving flow. For shallow eddies, where
, the flow is dominated by thin resonant layers sandwiched between KAM-type barriers, and the stirring rate is weak. On the other hand, eddies with moderately small
experience thicker resonant layers, wider-spread chaos and much more rapid stirring. This trend reverses for sufficiently small
, corresponding to deep eddies, where the vertical rigidity imposed by strong rotation limits the stirring. The bulk stirring rate, estimated from a passive tracer release, confirms the non-monotonic variation in stirring rate with
. This result is shown to be consistent with linear Ekman layer theory in conjunction with a resonant width calculation and the Taylor–Proudman theorem. The theory is able to roughly predict the value of
at which stirring is maximum. For large disturbances, the stirring rate becomes monotonic over the range of Ekman numbers explored. We also explore variation in the eddy aspect ratio.
It is now known that health benefits associated with diets rich in fruit and vegetables may be partly derived from intake of polyphenols. Berry polyphenols may influence carbohydrate metabolism and absorption and hence postprandial glycaemia. To date, studies related to polyphenol effects on the glycaemic response have been completed only in liquids using either monosaccharides or disaccharides. It remains to be determined whether berries known to be rich in polyphenols can reduce the glycaemic response (GR) to a solid polysaccharide meal. The aim of the present study was to investigate whether berries alter postprandial hyperglycaemia and consequently the GR to a starchy food. Blood glucose was tested on seven occasions, on three occasions using a reference food and on four occasions using pancakes supplemented with either raspberries or blueberries or control pancakes containing similar amounts of fructose and glucose. Results showed that there were no differences in GR (blueberry 51·3 (sem 5·7); raspberry 54·7 (sem 5·6); blueberry control 43·9 (sem 4·2); raspberry control 41·8 (sem 6·4)), GR area under the curve or satiety index between any of the tests. The present study indicates that the ability of berries to reduce blood glucose from starch-based foods is unsubstantiated.
To explore why there is a lack of acceptance among Western Australian (WA) adults of the Go for 2&5®fruit and vegetable social marketing message to consume at least five servings of vegetables per day.
A series of focus group discussions comprised of homogeneous groups varied by sex and age, until saturation of themes was achieved, followed by thematic analysis.
Part of qualitative research for the Go for 2&5® fruit and vegetable social marketing campaign in WA (2009 population: 2·2 million).
WA adults stratified by sex and age groups (18–29 and 30–55 years) drawn from the second and third quartiles of socio-economic disadvantage.
Familiarity with the Go for 2&5® message was excellent. Understanding of what constitutes ‘two servings of fruit’ was excellent and regarded by participants as highly achievable. Understanding of what constitutes ‘five servings of vegetables’ was suboptimal with widespread overestimation contributing to the belief that it is unrealistic. Participants did not know how the 2&5 recommendation was formulated and believed that daily consumption of two servings of fruit and five of vegetables would confer no greater health benefit than one of fruit and three of vegetables. Participants assumed that the 2&5 recommendation was ‘aspirational’ in the sense that it was purposely exaggerated to simply encourage greater overall consumption.
A convincing case needs to be presented to WA adults as to why they should consume five servings of vegetables per day. Continuing efforts to educate incorporating what constitutes a serving will assist perceptions that the recommendation is realistic.
This anthology provides insightful data on and discussions of a wide array of popular cultural manifestations and theoretical perspectives, covering such issues as kinship, religion, conflict resolution, music, cinema, drama, and literary texts. The issues cohere around the understanding that culture is situational and political. Going beyond merely challenging popular stereotypes and representations of Africans and African related practices in various outlets, the book reveals how popular cultural practices are instruments that have been manipulated for personal and collective survival. The book is distinctive in its codification and explication of aspects of popular practices that are based on data from countries in Africa, Europe, and the Americas that showcase cultural negotiations either with reference to how notions, values, norms, and images of Africans have been packaged and exploited over the years or how popular cultures are used as tools of resistance and agitation by the various focal groups that are discussed. The topics are presented and illustrated in ways easily accessible to readers of all backgrounds. Toyin Falola is the Frances Higginbotham Nalle Centennial Professor in History at the University of Texas at Austin as well as a University Distinguished Teaching Professor. Augustine Agwuele is an assistant professor of linguistics in the Department of Anthropology, Texas State University, San Marcos. Contributors: Arinpe Adejumo, Augustine Agwuele, Antoinette Tidjani Alou, Maurice N. Amutabi, Tokunbo A. Ayoola, Nicholas M. Creary, Toyin Falola, Celeste A. Fisher, Denise Amy-Rose Forbes-Erickson, Hetty ter Haar, Debra L. Klein, Emmanuel M. Mbah, Sarah Steinbock-Pratt, and Asonzeh Ukah.