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The objective of the current study was to identify factors across the socio-ecological model (SEM) associated with adolescents’ sugar-sweetened beverage (SSB) intake.
This cross-sectional study surveyed adolescents using previously validated instruments. Analyses included descriptive statistics, ANOVA tests and stepwise nonlinear regression models (i.e., two-part models) adjusted to be cluster robust. Guided by SEM, a four-step model was used to identify factors associated with adolescent SSB intake – step 1: demographics (i.e., age, gender), step 2: intrapersonal (i.e., theory of planned behaviour (attitudes, subjective norms, perceived behavioural control, behavioural intentions), health literacy, media literacy, public health literacy), step 3: interpersonal (i.e., caregiver’s SSB behaviours, caregiver’s SSB rules) and step 4: environmental (i.e., home SSB availability) level variables.
Eight middle schools across four rural southwest Virginia counties in Appalachia.
Seven hundred ninety seventh grade students (55·4 % female, 44·6 % males, mean age 12 (sd 0·5) years).
Mean SSB intake was 36·3 (sd 42·5) fluid ounces or 433·4 (sd 493·6) calories per day. In the final step of the regression model, seven variables significantly explained adolescent’s SSB consumption: behavioural intention (P < 0·05), affective attitude (P < 0·05), perceived behavioural control (P < 0·05), health literacy (P < 0·001), caregiver behaviours (P < 0·05), caregiver rules (P < 0·05) and home availability (P < 0·001).
SSB intake among adolescents in rural Appalachia was nearly three times above national mean. Home environment was the strongest predictor of adolescent SSB intake, followed by caregiver rules, caregiver behaviours and health literacy. Future interventions targeting these factors may provide the greatest opportunity to improve adolescent SSB intake.
As the pathophysiology of Covid-19 emerges, this paper describes dysphagia as a sequela of the disease, including its diagnosis and management, hypothesised causes, symptomatology in relation to viral progression, and concurrent variables such as intubation, tracheostomy and delirium, at a tertiary UK hospital.
During the first wave of the Covid-19 pandemic, 208 out of 736 patients (28.9 per cent) admitted to our institution with SARS-CoV-2 were referred for swallow assessment. Of the 208 patients, 102 were admitted to the intensive treatment unit for mechanical ventilation support, of which 82 were tracheostomised. The majority of patients regained near normal swallow function prior to discharge, regardless of intubation duration or tracheostomy status.
Dysphagia is prevalent in patients admitted either to the intensive treatment unit or the ward with Covid-19 related respiratory issues. This paper describes the crucial role of intensive swallow rehabilitation to manage dysphagia associated with this disease, including therapeutic respiratory weaning for those with a tracheostomy.
A classic example of microbiome function is its role in nutrient assimilation in both plants and animals, but other less obvious roles are becoming more apparent, particularly in terms of driving infectious and non-infectious disease outcomes and influencing host behaviour. However, numerous biotic and abiotic factors influence the composition of these communities, and host microbiomes can be susceptible to environmental change. How microbial communities will be altered by, and mitigate, the rapid environmental change we can expect in the next few decades remain to be seen. That said, given the enormous range of functional diversity conferred by microbes, there is currently something of a revolution in microbial bioengineering and biotechnology in order to address real-world problems including human and wildlife disease and crop and biofuel production. All of these concepts are explored in further detail throughout the book.
Diet modifies the risk of colorectal cancer (CRC), and inconclusive evidence suggests that yogurt may protect against CRC. We analysed the data collected from two separate colonoscopy-based case–control studies. The Tennessee Colorectal Polyp Study (TCPS) and Johns Hopkins Biofilm Study included 5446 and 1061 participants, respectively, diagnosed with hyperplastic polyp (HP), sessile serrated polyp, adenomatous polyp (AP) or without any polyps. Multinomial logistic regression models were used to derive OR and 95 % CI to evaluate comparisons between cases and polyp-free controls and case–case comparisons between different polyp types. We evaluated the association between frequency of yogurt intake and probiotic use with the diagnosis of colorectal polyps. In the TCPS, daily yogurt intake v. no/rare intake was associated with decreased odds of HP (OR 0·54; 95 % CI 0·31, 0·95) and weekly yogurt intake was associated with decreased odds of AP among women (OR 0·73; 95 % CI 0·55, 0·98). In the Biofilm Study, both weekly yogurt intake and probiotic use were associated with a non-significant reduction in odds of overall AP (OR 0·75; 95 % CI 0·54, 1·04) and (OR 0·72; 95 % CI 0·49, 1·06) in comparison with no use, respectively. In summary, yogurt intake may be associated with decreased odds of HP and AP and probiotic use may be associated with decreased odds of AP. Further prospective studies are needed to verify these associations.
Introduction: Identification of latent safety threats (LSTs) in the emergency department is an important aspect of quality improvement that can lead to improved patient care. In situ simulation (ISS) takes place in the real clinical environment and multidisciplinary teams can participate in diverse high acuity scenarios to identify LSTs. The purpose of this study is to examine the influence that the profession of the participant (i.e. physician, registered nurse, or respiratory therapist) has on the identification of LSTs during ISS. Methods: Six resuscitation- based adult and pediatric simulated scenarios were developed and delivered to multidisciplinary teams in the Kingston General Hospital ED. Each ISS session consisted of a 10- minute scenario, followed by 3-minutes of individual survey completion and a 7- minute group debrief led by ISS facilitators. An objective assessor recorded LSTs identified during each debrief. Surveys were completed prior to debrief to reduce response bias. Data was collected on participant demographics and perceived LSTs classified in the following categories: medication; equipment; resources and staffing; teamwork and communication; or other. Two reviewers evaluated survey responses and debrief notes to formulate a list of unique LSTs across scenarios and professions. The overall number and type of LSTs from surveys was identified and stratified by health care provider. Results: Thirteen ISS sessions were conducted with a total of 59 participants. Thirty- four unique LSTs (8 medication, 15 equipment, 5 resource, 4 communication, and 2 miscellaneous issues) were identified from surveys and debrief notes. Overall, MDs (n = 12) reported 19 LSTss (n = 41) reported 77 LSTs, and RTs (n = 6) reported 4 LSTs based on individual survey data. The most commonly identified category of LSTs reported by MDs (36.8%) and RTs (75%) was equipment issues while RNs most commonly identified medication issues (36.4%). Participants with □5 years of experience in their profession, on average identified more LSTs in surveys than participants with >5 years experience (1.9 LSTs vs 1.5 LSTs respectively). Conclusion: Nursing staff identified the highest number of LSTs across all categories. There was fairly unanimous identification of major LSTs across professions, however each profession did identify unique perspectives on LSTs in survey responses. ISS programs with the purpose of LST identification would benefit from multidisciplinary participation.
Knowledge of the effects of burial depth and burial duration on seed viability and, consequently, seedbank persistence of Palmer amaranth (Amaranthus palmeri S. Watson) and waterhemp [Amaranthus tuberculatus (Moq.) J. D. Sauer] ecotypes can be used for the development of efficient weed management programs. This is of particular interest, given the great fecundity of both species and, consequently, their high seedbank replenishment potential. Seeds of both species collected from five different locations across the United States were investigated in seven states (sites) with different soil and climatic conditions. Seeds were placed at two depths (0 and 15 cm) for 3 yr. Each year, seeds were retrieved, and seed damage (shrunken, malformed, or broken) plus losses (deteriorated and futile germination) and viability were evaluated. Greater seed damage plus loss averaged across seed origin, burial depth, and year was recorded for lots tested at Illinois (51.3% and 51.8%) followed by Tennessee (40.5% and 45.1%) and Missouri (39.2% and 42%) for A. palmeri and A. tuberculatus, respectively. The site differences for seed persistence were probably due to higher volumetric water content at these sites. Rates of seed demise were directly proportional to burial depth (α=0.001), whereas the percentage of viable seeds recovered after 36 mo on the soil surface ranged from 4.1% to 4.3% compared with 5% to 5.3% at the 15-cm depth for A. palmeri and A. tuberculatus, respectively. Seed viability loss was greater in the seeds placed on the soil surface compared with the buried seeds. The greatest influences on seed viability were burial conditions and time and site-specific soil conditions, more so than geographical location. Thus, management of these weed species should focus on reducing seed shattering, enhancing seed removal from the soil surface, or adjusting tillage systems.
To examine the potential links between activity spaces, the food retail environment and food shopping behaviours for the population of young, urban adults.
Participants took part in the Canada Food Study, which collected information on demographics, food behaviour, diet and health, as well as an additional smartphone study that included a seven-day period of logging GPS (global positioning system) location and food purchases. Using a time-weighted, continuous representation of participant activity spaces generated from GPS trajectory data, the locations of food purchases and a geocoded food retail data set, negative binomial regression models were used to explore what types of food retailers participants were exposed to and where food purchases were made.
Toronto, Montreal, Vancouver, Edmonton and Halifax, Canada.
Young adults aged 16–30 years (n 496). These participants were a subset of the larger Canada Food Study.
Demographics, household food shopper status and city of residence were significantly associated with different levels of exposure to various types of food retailers. Food shopping behaviours were also statistically significantly associated with demographics, the activity space-based food environment, self-reported health and city of residence.
The study confirms that food behaviours are related to activity space-based food environment measures, which provide a more comprehensive accounting of food retail exposure than home-based measures. In addition, exposure to food retail and food purchasing behaviours of an understudied population are described.
We present multi–epoch VLBI observations of the methanol and water masers in the high–mass star formation region G 339.884−1.259, made using the Australian Long Baseline Array (LBA). Our sub–milliarcsecond precision measurements trace the proper motions of individual maser features in the plane of the sky. When combined with the direct line–of–sight radial velocity (vlsr), these measure the 3 D gas kinematics of the associated high–mass star formation region, allowing us to probe the dynamical processes to within 1000 AU of the core.
Circumstellar SiO masers can be observed in red giant evolved stars throughout the Galaxy. Since stellar masers are not affected by non-gravitational forces, they serve as point-mass probes of the gravitational potential and form an excellent sample for studies of the Galactic structure and dynamics. Compared to optical studies, the non-obscured masers are in particular valuable when observed close to the highly obscured Galactic Bulge and Plane. Their line-of-sight velocities can easily be obtained with high accuracy, proper motions can be measured and distances can be estimated. Furthermore, when different mass and metallicity effects can be accounted for, such a large sample will highlight asymmetries and evolutionary traces in the sample. In our Bulge Asymmetries and Dynamic Evolution (BAaDE) survey we have searched 20,000 infrared selected evolved stars for 43 GHz SiO masers with the VLA in the northern Bulge and Plane and are in the process of observing another 10,000 stars for 86 GHz SiO masers with ALMA in the southern Bulge. Our instantaneous detection rate in the Bulge is close to 70%, both at 43 and 86 GHz, with occasionally up to 7 simultaneous SiO transitions observed in a single star. Here we will outline the BAaDE survey, its first results and some of the peculiar maser features we have observed. Furthermore we will discuss the prospects for obtaining proper motions and parallaxes for individual maser stars to reconstruct individual stellar orbits.
The Bulge Asymmetries and Dynamical Evolution (BAaDE) project aims to map the positions and velocities of up to ~20,000 late-type stars with SiO maser emission along the full Galactic plane, with a large concentration in the Galactic Bulge and inner Galaxy. Both J = 1 → 0 and J = 2 → 1 transitions using the Very Large Array (VLA) and the Atacama Large Millimeter Array (ALMA) are being observed. In the VLA observing setup, in addition to the 28SiO, v = 1 and v = 2J = 1 → 0 maser transitions, the bandwidth was wide enough to include the J = 1 → 0 transitions of the rare isotopologues of the SiO molecule in both the ground and vibrationally excited states: 29SiO, v = 0, 30SiO, v = 0, 29SiO, v = 1, and 29SiO, v = 2. Approximately 10% of the initial ~3500 targets of the project show maser emission from at least one of these lines. Some of these stars (with isotopic maser emission) show high radial velocities which implies that they are indeed in the Galactic Bulge or inner Galaxy (i.e. not foreground objects). We present line profiles, refined detection statistics, and the implications of the detection of the isotopic maser emission on pumping schemes that have been previously presented.
We present polarimetric observations of the 4 ground-state transitions of OH, toward a sample of maser-emitting planetary nebulae (PNe) using the Australia Telescope Compact Array. This sample includes confirmed OH-emitting PNe, confirmed and candidate H2O-maser-emitting PNe. Polarimetric observations provide information related to the magnetic field of these sources. Maser-emitting PNe are very young PNe and magnetic fields are a key ingredient in the early evolution and shaping process of PNe. Our preliminary results suggest that magnetic field strengths may change very rapidly in young PNe.
The full theory of polarized SiO maser emission from the near-circumstellar environment of Asymptotic Giant Branch stars has been the subject of debate, with theories ranging from classical Zeeman origins to predominantly non-Zeeman anisotropic excitation or propagation effects. Features with an internal electric vector position angle (EVPA) rotation of ∼π/2 offer unique constraints on theoretical models. In this work, results are presented for one such feature that persisted across five epochs of SiO ν = 1, J = 1 − 0 VLBA observations of TX Cam. We examine the fit to the predicted dependence of linear polarization and EVPA on angle (θ) between the line of sight and the magnetic field against theoretical models. We also present results on the dependence of mc on θ and their theoretical implications. Finally, we discuss potential causes of the observed differences, and continuing work.
Our 2015-2016 ALMA 1.3 to 0.87 mm observations (resolution ~200 au) of the massive protocluster NGC6334I revealed that an extraordinary outburst had occurred in the dominant millimeter dust core MM1 (luminosity increase of 70×) when compared with earlier SMA data. The outburst was accompanied by the flaring of ten maser transitions of three species. We present new results from our recent JVLA observations of Class II 6.7 GHz methanol masers and 6 GHz excited OH masers in this region. Class II masers had not previously been detected toward MM1 in any interferometric observations recorded over the past 30 years that targeted the bright masers toward other members of the protocluster (MM2 and MM3=NGC6334F). Methanol masers now appear both toward and adjacent to MM1 with the strongest spots located in a dust cavity ~1 arcsec (1300 au) north of the MM1B hypercompact HII region. In addition, new excited OH masers appear on the non-thermal source CM2. These data reveal the dramatic effects of episodic accretion onto a deeply-embedded high mass protostar and demonstrate its ongoing impact on the surrounding protocluster.
We present subarcsecond resolution pre- and post-outburst JVLA continuum and water maser observations of the massive protostellar outburst source NGC6334I-MM1. The continuum data at 5 and 1.4 cm reveal that the free-free emission powered by MM1B, modeled as a hypercompact HII region from our 2011 JVLA data, has dropped by a factor of 5.4. Additionally, the water maser emission toward MM1, which had previously been strong (500 Jy) has dramatically reduced. In contrast, the water masers in other locations in the protocluster have flared, with the strongest spots associated with CM2, a non-thermal radio source that appears to mark a shock in a jet emanating 2″ (2600 au) northward from MM1. The observed quenching of the HCHII region suggests a reduction in uv photon production due to bloating of the protostar in response to the episodic accretion event.
We report the discovery of widespread millimeter-wavelength Class I methanol maser emission associated with protostellar molecular outflows in the massive (proto)cluster G11.92−0.61. Our ~0.5″-resolution SMA and ALMA observations of the 229 GHz and 278 GHz Class I transitions reveal seven and twelve candidate masers, respectively: all 229 GHz masers have 278 GHz counterparts, and five are also coincident with 44 GHz Class I masers previously detected with the VLA. For paired masers, the peak intensities at 229 GHz and 278 GHz are correlated. We also find tentative evidence for a correlation between the strength of millimeter-wavelength Class I maser emission and the energy of the associated molecular outflow.
Radio astrometric campaigns using VLBI have provided distances and proper motions for masers associated with young massive stars (BeSSeL survey). The ongoing BAaDE project plans to obtain astrometric information of SiO maser stars located in the inner Galaxy. These stars are associated with evolved, mass-losing stars. By overlapping optical (Gaia), infrared (2MASS, MSX and WISE) and radio (BAaDE) sources, we expect to obtain important clues on the intrinsic properties and population distribution of late-type stars. Moreover, a comparison of the Galactic parameters obtained with Gaia and VLBI can be done using radio observations on different targets: young massive stars (BeSSeL) and evolved stars (BAaDE).
The final stages of low-mass stellar evolution are characterized by significant mass loss due to stellar pulsations during the AGB phase, which lead to the development of planetary nebulae. Molecular masers of H2O, SiO, and ground state OH transitions are commonly detected in oxygen-rich late-type stars (OH/IR objects). In contrast, excited OH maser transitions are rare. We discuss our study of the carbon-rich pre-planetary nebula CRL618 (a prototypical post-AGB star). Observations conducted in May 2008 with the 305m Arecibo Telescope resulted in the first detection of a 4765MHz OH maser line in a late-type stellar object; the detection was confirmed a few months later also with Arecibo. Subsequent observations in 2015 and 2017 resulted in non-detection of the 4765MHz OH line. Our observations indicate that the 4765MHz OH maser in CRL 618 is highly variable, possibly tracing a short-lived phenomenon during the development of a pre-planetary nebula.
Using the VLBA, the BeSSeL survey has provided distances and proper motions of young massive stars, allowing an accurate measure of the Galactic spiral structure. By the same technique, we are planning to map the inner Galaxy using positions and velocities of evolved stars (provided by the BAaDE survey). These radio astrometric measurements (BeSSeL and BAaDE) will be complementary to Gaia results and the overlap will provide important clues on the intrinsic properties and population distribution of the stars in the bulge.
Dietary intake of PUFA has been associated with colorectal neoplasm risk; however, results from observational studies have been inconsistent. Most prior studies have utilised self-reported dietary measures to assess fatty acid exposure which might be more susceptible to measurement error and biases compared with biomarkers. The purpose of this study was to determine whether erythrocyte phospholipid membrane PUFA percentages are associated with colorectal adenoma risk. We included data from 904 adenoma cases and 835 polyp-free controls who participated in the Tennessee Colorectal Polyp Study, a large colonoscopy-based case–control study. Erythrocyte membrane PUFA percentages were measured using GC. Conditional logistic regression was used to calculate adjusted OR for risk of colorectal adenomas with erythrocyte membrane PUFA. Higher erythrocyte membrane percentages of arachidonic acid was associated with an increased risk of colorectal adenomas (adjusted OR 1·66; 95 % CI 1·05, 2·62, Ptrend=0·02) comparing the highest tertile to the lowest tertile. The effect size for arachidonic acid was more pronounced when restricting the analysis to advanced adenomas only. Higher erythrocyte membrane EPA percentages were associated with a trend towards a reduced risk of advanced colorectal adenomas (Ptrend=0·05). Erythrocyte membrane arachidonic acid percentages are associated with an increased risk of colorectal adenomas.