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OBJECTIVES/GOALS: There is increased recognition that patients and community members are critical to creating impactful research. To this end the UCLA CTSI Community Engagement & Research Program modified an established multidisciplinary team science communication module to train academic-community research teams. METHODS/STUDY POPULATION: Community partners who have had previous experience in participatory research provided input such as limiting the emphases of individual academic introductions to group icebreakers (to level the playing field), reduced academic jargon to lay language, reducing the amount of text to key principles, and changed academic team scenarios for the team activity to represent community-academic teams. Academic partners articulated institutional barriers to integrating community into institutional systems. Iterative testing and modifications occurred through pilots with eleven teams (49 individuals). RESULTS/ANTICIPATED RESULTS: Embedding community partners in team science training involved creating a level playing field with less emphasis on academic credentials, using lay language in the didactic sessions and ensuring accessibility in all aspects of the training. An example of modifications: communication scenarios were read out loud by participants, which community partners felt were not inclusive of potential varying literacy levels and all partners may not feel comfortable reading aloud in a group setting. The vignettes were replaced with short videos of the scenarios with audio recordings. Several modifications were made the training’s team activity of the training module. DISCUSSION/SIGNIFICANCE OF IMPACT: Traditional academic team science training required significant modifications for an academic/community-partnered team to allow for optimal collaboration, inclusion, and strategically reduce the power dynamics that can naturally occur. Long-term followup to assess their effectiveness is needed.
A primary barrier to translation of clinical research discoveries into care delivery and population health is the lack of sustainable infrastructure bringing researchers, policymakers, practitioners, and communities together to reduce silos in knowledge and action. As National Institutes of Healthʼs (NIH) mechanism to advance translational research, Clinical and Translational Science Award (CTSA) awardees are uniquely positioned to bridge this gap. Delivering on this promise requires sustained collaboration and alignment between research institutions and public health and healthcare programs and services. We describe the collaboration of seven CTSA hubs with city, county, and state healthcare and public health organizations striving to realize this vision together. Partnership representatives convened monthly to identify key components, common and unique themes, and barriers in academic–public collaborations. All partnerships aligned the activities of the CTSA programs with the needs of the city/county/state partners, by sharing resources, responding to real-time policy questions and training needs, promoting best practices, and advancing community-engaged research, and dissemination and implementation science to narrow the knowledge-to-practice gap. Barriers included competing priorities, differing timelines, bureaucratic hurdles, and unstable funding. Academic–public health/health system partnerships represent a unique and underutilized model with potential to enhance community and population health.
The present study describes the energy content of primary-school children’s lunchboxes and the proportion of lunchbox foods considered discretionary. Subgroup analyses by sex, socio-economic status, age and weight status were undertaken.
A cross-sectional study was conducted. Mean kilojoule content, number of items and categorisation of foods and drinks in lunchboxes as ‘everyday’ (healthy) or discretionary (sometimes) foods were assessed via a valid and reliable lunchbox observational audit.
Twelve Catholic primary schools (Kindergarten–Grade 6) located in the Hunter region of New South Wales, Australia.
Kindergarten to Grade 6 primary-school students.
In total, 2143 children (57 %) had parental consent to have their lunchboxes observed. School lunchboxes contained a mean of 2748 kJ, of which 61·2 % of energy was from foods consistent with the Australian Dietary Guidelines and 38·8 % of energy was discretionary foods. The proportion of lunchboxes containing only healthy foods was 12 %. Children in Kindergarten–Grade 2 packed more servings of ‘everyday’ foods (3·32 v. 2·98, P < 0·01) compared with children in Grades 3–6. Children in Grades 3–6 had a higher percentage of energy from discretionary foods (39·1 v. 33·8 %, P < 0·01) compared with children in Kindergarten–Grade 2 and children from the most socio-economically disadvantaged areas had significantly higher total kilojoules in the school lunchbox compared with the least disadvantaged students (2842 v. 2544 kJ, P = 0·03).
Foods packed within school lunchboxes may contribute to energy imbalance. The development of school policies and population-based strategies to support parents overcome barriers to packing healthy lunchboxes are warranted.
Stone tool producers in the Maya Lowlands had several types of raw materials from which to choose. Limestone, chert, and obsidian are the most naturally abundant, whereas chert and obsidian outnumber limestone in archaeological contexts. The presence of flaked-stone tools made of limestone is typically attributed to the scarcity of more suitable raw materials. Nevertheless, in chert-rich areas, such as the upper Belize River valley, limestone bifaces and production debitage are present. To understand their presence, we examine limestone biface production and use at Buenavista del Cayo.
To develop and pilot a clinician-rated outcome scale to evaluate symptomatic outcomes in liaison psychiatry services. Three hundred and sixty patient contacts with 207 separate individuals were rated using six subscales (mood, psychosis, cognition, substance misuse, mind–body problems and behavioural disturbance) plus two additional items (side-effects of medication and capacity to consent for medical treatment). Each item was rated on a five-point scale from 0 to 5 (nil, mild, moderate, severe and very severe).
The liaison outcome measure was acceptable and easy to use. All subscales showed acceptable interrater reliability, with the exception of the mind–body subscale. Overall, the measure appears to show stability and sensitivity to change.
The measure provides a useful and robust way to determine symptomatic change in a liaison mental health setting, although the mind–body subscale requires modification.
Despite evidence linking regular nut consumption with reduced chronic disease risk, population-level intakes remain low. Research suggests nut-promoting advice from doctors facilitates regular nut consumption. However, there is no information on current nut recommendation practices of health professionals. The aim of the present study was to examine the advice provided by health professionals regarding nut consumption.
In this cross-sectional study, participants were invited to complete a survey including questions about their nut recommendation practices.
New Zealand (NZ).
The NZ Electoral Roll was used to identify dietitians, general practitioners and practice nurses.
In total 318 dietitians, 292 general practitioners and 149 practice nurses responded. Dietitians were more likely (82·7 %) to recommend patients increase consumption of nuts than general practitioners (55·5 %) and practice nurses (63·1 %; both P<0·001). The most popular nuts recommended were almonds, Brazil nuts and walnuts, with most health professionals recommending raw nuts. The most common recommendation for frequency of consumption by dietitians and practice nurses was to eat nuts every day, while general practitioners most frequently recommended 2–4 times weekly, although not statistically significantly different between professions. Dietitians recommended a significantly greater amount of nuts (median 30 g/d) than both general practitioners and practice nurses (20 g/d; both P<0·001).
Dietitians were most likely to recommend consumption of nuts in accordance with current guidelines, but there are opportunities to improve the adoption of nut consumption recommendations for all professions. This may be a viable strategy for increasing population-level nut intakes to reduce chronic disease.
Despite considerable evidence supporting the health benefits of regular nut consumption, nut intakes remain lower than recommended among many populations. Understanding how the general population perceives nuts could inform strategies to promote regular nut consumption and increase intakes among the general public.
Cross-sectional study. Participants were invited to complete a questionnaire which included information on nut consumption and knowledge and perceptions of nuts.
The study was set in New Zealand (NZ).
Participants (n 1600), aged 18 years or over, were randomly selected from the NZ electoral roll.
A total of 710 participants completed the questionnaire (response rate 44 %). More than half of the respondents believed that nuts are healthy, filling, high in protein and high in fat. The most common reason cited by consumers for eating nuts was taste (86 % for nuts, 85 % for nut butters), while dental issues was the most frequent reason for avoidance. About 40 % of respondents were not aware of the effects of nut consumption on lowering blood cholesterol and CVD risk.
Despite overall basic knowledge of the nutritional value of nuts, a substantial proportion of the general population was unaware of the cardioprotective effects of nuts. The present study identified common motivations for eating and avoiding nuts, as well as perceptions of nuts which could affect intake. These should guide the content and direction of public health messages to increase regular nut consumption. The public’s knowledge gaps should also be addressed.
In 2013, New York State mandated that, during influenza season, unvaccinated healthcare personnel (HCP) wear a surgical mask in areas where patients are typically present. We found that this mandate was associated with increased HCP vaccination and decreased HCP visits to the hospital Workforce Health and Safety Department with respiratory illnesses and laboratory-confirmed influenza.
Recent findings show that experience with a syntactic structure has long-term consequences for how that structure will be processed in the future, which suggests that linguistic representations are not static entities that can be probed reliably without alteration. Thus, leveraging the effect of previous exposure to a syntactic structure appears to be an inappropriate method for studying invariant properties of language.
To estimate the folate status of New Zealand women of childbearing age following the introduction, in 2010, of a new voluntary folic acid fortification of bread programme.
The 2011 Folate and Women’s Health Survey was a cross-sectional survey of women aged 18–44 years carried out in 2011. The survey used a stratified random sampling technique with the Electoral Roll as the sampling frame. Women were asked about consumption of folic-acid-fortified breads and breakfast cereals in a telephone interview. During a clinic visit, blood was collected for serum and erythrocyte folate measurement by microbiological assay.
A North Island (Wellington) and South Island (Dunedin) city centre in New Zealand.
Two hundred and eighty-eight women, of whom 278 completed a clinic visit.
Geometric mean serum and erythrocyte folate concentrations were 30 nmol/l and 996 nmol/l, respectively. Folate status was 30–40 % higher compared with women of childbearing age sampled as part of a national survey in 2008/09, prior to the introduction of the voluntary folic acid bread fortification programme. In the 2011 Folate and Women’s Health Survey, reported consumption of fortified bread and fortified breakfast cereal in the past week was associated with 25 % (P=0·01) and 15 % (P=0·04) higher serum folate concentrations, respectively.
Serum and erythrocyte folate concentrations have increased in New Zealand women of childbearing age since the number of folic-acid-fortified breads was increased voluntarily in 2010. Consumption of fortified breads and breakfast cereals was associated with a higher folate status.
Psychopharmacology is an increasingly important aspect of child and adolescent psychiatry. The evidence base for the psychopharmacological treatment of depression, anxiety, schizophrenia, bipolar disorder, obsessive—compulsive disorder (OCD) and attention-deficit hyperactivity disorder (ADHD) is increasing. This article presents a synthesis of the information from randomised controlled trials, meta-analyses and the UK NICE guidelines as an aid to practical psychopharmacology.
A limited number of studies have examined associations between nut consumption and nutrient intakes or diet quality. None has investigated these associations in the Southern Hemisphere. The purpose of this study was to examine associations between nut consumption and nutrient intakes among adult New Zealanders. Data from the 24-h recalls of 4721 participants from the cross-sectional 2008/09 New Zealand Adult Nutrition Survey (2008/09 NZANS) were used to determine whole nut intake and total nut intake from all sources as well as nutrient intakes. Regression models, both unadjusted and adjusted for potential confounders, were used to estimate differences in nutrient intakes between those consuming and those not consuming nuts. From adjusted models, compared with non-whole nut consumers, whole nut consumers had higher intakes of energy and percentage of energy from total fat, MUFA and PUFA, whereas percentage of energy from SFA and carbohydrate was lower (all P≤0·025). After the additional adjustment for energy intake, whole nut consumers had higher intakes of dietary fibre, vitamin E, folate, Cu, Mg, K, P and Zn (all P≤0·044), whereas cholesterol and vitamin B12 intakes were significantly lower (both P≤0·013). Total nut consumption was associated with similar nutrient profiles as observed in whole nut consumers, albeit less pronounced. Nut consumption was associated with better nutrient profiles, especially a lower intake of SFA and higher intakes of unsaturated fats and a number of vitamins and minerals that could collectively reduce the risk for chronic disease, in particular for CVD.
Glass sponge reefs on the continental shelf of western Canada and south-east Alaska are considered stable deep-sea habitats that do not change significantly over time. Research cruises using a remotely operated vehicle equipped with accurate GPS positioning have allowed us to observe the same sponges at two reefs in the Strait of Georgia, British Columbia to document recruitment, growth and response to damage over time. Spermatocysts and putative embryos found in winter suggest annual, asynchronous reproduction. Juvenile sponges (2–10 cm in osculum diameter) in densities up to 1 m−2 were more concentrated near live sponges and sponge skeletons than away (Spearman rank correlations, P < 0.0001 for live cover and for skeletons), suggesting that recruitment occurs in particular regions using sponge skeletons as substrate. Most sponges showed no change in shape or size over 2–3 years, but some had died while others showed growth of 1–9 cm year−1. Deposition rates of reef-cementing sediments were 97 mm year−1 at Galiano Reef and 137 mm year−1 at Fraser Reef, but sediments eroded so that there was no net gain or loss over time. Sponges recovered within 1 year from small-scale damage that mimicked bites by fish or nudibranchs; however sponges did not recover from crushing of a large area (1.5 × 2 m2) even 3 years later. These observations and experiments show that while recruitment and growth of sponge reefs is more dynamic than previously thought, the reefs are not resilient in the face of larger-scale disturbances such as might be inflicted by trawling.
Babies with CHDs are a particularly vulnerable population with significant mortality in their 1st year. Although most deaths occur in the hospital within the early postoperative period, around one-fifth of postoperative deaths in the 1st year of life may occur after hospital discharge in infants who have undergone apparently successful cardiac surgery.
To systematically review the published literature and identify risk factors for adverse outcomes, specifically deaths and unplanned re-admissions, following hospital discharge after infant surgery for life-threatening CHDs.
A systematic search was conducted in MEDLINE, EMBASE, CINAHL, Cochrane Library, Web of Knowledge, and PsycINFO electronic databases, supplemented by manual searching of conference abstracts.
A total of 15 studies were eligible for inclusion. Almost exclusively, studies were conducted in single US centres and focussed on children with complex single ventricle diagnoses. A wide range of risk factors were evaluated, and those more frequently identified as having a significant association with higher mortality or unplanned re-admission risk were non-Caucasian ethnicity, lower socio-economic status, co-morbid conditions, age at surgery, operative complexity and procedure type, and post-operative feeding difficulties.
Studies investigating risk factors for adverse outcomes post-discharge following diverse congenital heart operations in infants are lacking. Further research is needed to systematically identify higher risk groups, and to develop interventions targeted at supporting the most vulnerable infants within an integrated primary and secondary care pathway.
Regular nut consumption is associated with reduced CVD risk. Insight into nut consumption patterns provides important information to help design strategies to encourage intake. The present study aimed to describe nut consumption in terms of the percentage of consumers, mean grams eaten among the population and nut consumers, and to identify the predictors of nut consumption. Data from the 24 h dietary recalls of the 2008/09 New Zealand Adult Nutrition Survey (n 4721) were used to measure nut consumption. On the recall day, the percentages of consumers of whole nuts, nut butters and nuts from hidden sources were 6·9 % (n 240), 7·2 % (n 346) and 19·2 % (n 732), respectively (28·9 % (n 1167) combined (total)). The mean grams consumed by the population were relatively low for whole nuts (2·8 g/d), nut butters (0·9 g/d), nuts from hidden sources (1·5 g/d) and total nuts (5·2 g/d). Among consumers, the mean daily grams of whole nuts, nut butters, nuts from hidden sources and total nuts eaten were 40·3, 12·9, 7·8 and 17·9 g/d, respectively. Those aged 15–18 years had the lowest whole nut consumption, but had the highest nut butter consumption. The consumption of total nuts was positively associated with education and socio-economic status, while whole nut consumption was inversely associated with BMI. In conclusion, the low percentage of nut consumers is of concern and new strategies to increase nut consumption are required. Future public health initiatives should be mindful of these patterns and predictors. In particular, different forms of nuts may appeal to different age and socio-economic groups.