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The history of maize in Central America and surrounding areas has implications for the slow transition from hunting and gathering to agriculture. The spread of early forms of domesticated maize from southern Mexico across Mesoamerica and into South America has been dated to about 8,700–6,500 years ago on the basis of a handful of studies relying primarily on the analysis of pollen, phytoliths, or starch grains. Recent genomic data from southern Belize have been used to identify Archaic period south-to-north population movements from lower Central America, suggesting this migration pattern as a mechanism that introduced genetically improved maize races from South America. Gradually, maize productivity increased to the point that it was suitable for use as a staple crop. Here we present a summary of paleoecological data that support the late and uneven entry of maize into the Maya area relative to other regions of Central America and identify the Pacific coastal margin as the probable route by which maize spread southward into Panama and South America. We consider some implications of the early appearance of maize for Late Archaic populations in these areas; for example, with respect to the establishment of sedentary village life.
Nutrition education and policy, systems and environmental (PSE) change interventions may be able to address food insecurity and obesity, conditions which are disproportionately experienced by African Americans. Work that seeks to address these disparities and advance social justice should uplift and learn from participant voices, particularly from marginalised groups. This scoping review aimed to summarise the available literature describing African Americans’ perceptions of and experiences participating in nutrition interventions. We conducted an electronic literature search with the assistance of a research librarian which encompassed six databases (MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX and ProQuest Dissertations & Theses) and identified thirty-five sources meeting our inclusion criteria. The majority of studies assessing African Americans’ satisfaction with interventions examined educational interventions alone, and about half of the included studies assessed satisfaction through quantitative methods alone. The only studies which found participants to be dissatisfied with interventions used qualitative methods and examined interventions providing education alone. Future work should evaluate African Americans’ experience with nutrition-focused PSE changes, interventions which may be better able to address racial disparities in obesity and food insecurity. Nutrition educators working with African Americans should also consider evaluating future interventions using qualitative inquiry, to obtain an in-depth understanding of participant experiences with interventions.
African Americans experience high rates of obesity and food insecurity in part due to structural racism, or overlapping discriminatory systems and practices in housing, education, employment, health care and other settings. Nutrition education and nutrition-focused policy, systems and environmental changes may be able to address structural racism in the food environment. This scoping review aimed to summarise the available literature regarding nutrition interventions for African Americans that address structural racism in the food environment and compare them with the ‘Getting to Equity in Obesity Prevention’ framework of suggested interventions. An electronic literature search was conducted with the assistance of a research librarian encompassing six databases: MEDLINE, PyscINFO, Agricola, ERIC, SocINDEX and ProQuest Dissertations & Theses. A total of thirty sources were identified detailing interventions addressing structural barriers to healthy eating. The majority of nutrition interventions addressing structural racism consisted of policy, systems and/or environmental changes in combination with nutrition education, strategies focused on proximal causes of racial health disparities. Only two articles each targeted the ‘reduce deterrents’ and ‘improve social and economic resources’ aspects of the framework, interventions which may be better suited to addressing structural racism in the food environment. Because African Americans experience high rates of obesity and food insecurity and encounter structural barriers to healthy eating in the food environment, researchers and public health professionals should address this gap in the literature.
Background: Certain nursing home (NH) resident care tasks have a higher risk for multidrug-resistant organisms (MDRO) transfer to healthcare personnel (HCP), which can result in transmission to residents if HCPs fail to perform recommended infection prevention practices. However, data on HCP-resident interactions are limited and do not account for intrafacility practice variation. Understanding differences in interactions, by HCP role and unit, is important for informing MDRO prevention strategies in NHs. Methods: In 2019, we conducted serial intercept interviews; each HCP was interviewed 6–7 times for the duration of a unit’s dayshift at 20 NHs in 7 states. The next day, staff on a second unit within the facility were interviewed during the dayshift. HCP on 38 units were interviewed to identify healthcare personnel (HCP)–resident care patterns. All unit staff were eligible for interviews, including certified nursing assistants (CNAs), nurses, physical or occupational therapists, physicians, midlevel practitioners, and respiratory therapists. HCP were asked to list which residents they had cared for (within resident rooms or common areas) since the prior interview. Respondents selected from 14 care tasks. We classified units into 1 of 4 types: long-term, mixed, short stay or rehabilitation, or ventilator or skilled nursing. Interactions were classified based on the risk of HCP contamination after task performance. We compared proportions of interactions associated with each HCP role and performed clustered linear regression to determine the effect of unit type and HCP role on the number of unique task types performed per interaction. Results: Intercept-interviews described 7,050 interactions and 13,843 care tasks. Except in ventilator or skilled nursing units, CNAs have the greatest proportion of care interactions (interfacility range, 50%–60%) (Fig. 1). In ventilator and skilled nursing units, interactions are evenly shared between CNAs and nurses (43% and 47%, respectively). On average, CNAs in ventilator and skilled nursing units perform the most unique task types (2.5 task types per interaction, Fig. 2) compared to other unit types (P < .05). Compared to CNAs, most other HCP types had significantly fewer task types (0.6–1.4 task types per interaction, P < .001). Across all facilities, 45.6% of interactions included tasks that were higher-risk for HCP contamination (eg, transferring, wound and device care, Fig. 3). Conclusions: Focusing infection prevention education efforts on CNAs may be most efficient for preventing MDRO transmission within NH because CNAs have the most HCP–resident interactions and complete more tasks per visit. Studies of HCP-resident interactions are critical to improving understanding of transmission mechanisms as well as target MDRO prevention interventions.
Funding: Centers for Disease Control and Prevention (grant no. U01CK000555-01-00)
Disclosures: Scott Fridkin, consulting fee, vaccine industry (spouse)
Attachment theory and family systems perspectives were used to explore the intergenerational origins of an overinvolved, symbiotic parenting pattern that hampers children's emerging autonomy. Consistent with principles of developmental psychopathology, the same underlying relationship disturbance was expected to manifest differently at different times in the developmental process. Specifically, links among maternal intrusiveness during infancy, overprotection during childhood, and mother-child role-reversal during young adulthood were explored. Forty-nine maternal grandmothers, mothers, and firstborn infants were visited in the mothers' homes when the infants were 6 and 9 months old. Grandmothers' memories of overprotection were related to observational ratings of high boundary dissolution and low positive affectivity with the mothers. No significant relationships were found between mothers' past and current relationships with the grandmothers. Yet, mothers' memories of overprotection during childhood or their current participation in unaffectionate, enmeshed, and role-reversed relationships with their mothers forecast their intrusive care with their own infants. Moreover, mothers' memories of overprotection related to their beliefs that others cannot be trusted and these beliefs were related, in turn, to observations of their intrusive care at 9 months. The implications of understanding the origins of maternal intrusiveness for developing prevention programs are discussed.
Ancient Mesoamerica is pleased to honor T. Patrick Culbert, one of
the foremost scholars in the field of Maya archaeology, in this Special
Section. A brief survey of Culbert's many contributions to Maya
studies reflects the general contours of the advances that have
occurred in Maya archaeology over the course of the past four decades,
and these patterns illustrate Culbert's role in the forefront of
In this issue's Special Section we offer the second part
of a group of studies dealing with the impact of climate change
on ancient Maya civilization. As mentioned in the Introduction
to the first part (Fowler 2002), Mayanists have been aware of
the possible effects of climatic factors on Maya culture since
the early decades of last century. At first, comments on the
effects of climate change in the Maya area were largely
speculative. By the 1980s such work became increasingly compelling
and sophisticated, including correlations of worldwide glacial,
palynological, and other climatological data, as reflected in
several publications (Dahlin 1983; Folan et al. 1983; Gunn and
Adams 1981). Soon after, Lewis Messenger provided a broad global
correlation with specific reference to archaeological sequences
in Mesoamerica and the Maya area (Messenger 1990). Perhaps it
would be fair to say that Maya paleoclimatological studies may
have peaked with the massive work of Richardson Gill (2000),
which has attracted much critical attention. David Webster
(2002:241–247), for example, praises the book for its
directness and clarity of purpose but expresses skepticism about
the climatological bias and stresses that much more research
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