The Impact of Traumatic Experiences on Risky Sexual Behaviors in Black and White Young Adult Women

Background

Trauma exposure has been linked to risky sexual behavior (RSB), but few studies have examined the impact of distinct trauma types on RSB in one model or how the association with trauma and RSB may differ across race.

Evaluating the Influence of Social Factors on Aged Residential Care Admission in a National Home Care Assessment Database of Older Adults

ObjectivesEvaluate the influence of social factors on admission to aged residential care (ARC) facilities using a national comprehensive geriatric assessment database in New Zealand.DesignTime-to-event analysis of a continuously recruited national cohort.Participants and settingAn anonymized data extract from a large national database for home care assessments (June 2012–December 2015) was matched with data on mortality and admissions into ARC.MethodsFour key components of psychosocial risk in relation to ARC admission were used for analysis: living alone, negative social interactions, perceived loneliness, and carer stress. Exploratory data analysis was conducted for each of the variables of interest and demographics. Unadjusted and adjusted competing risk regressions were then performed with admission into ARC being the primary outcome, death the competing risk, and remaining at home the survival case.ResultsAfter data cleaning, matching, and applying exclusions, the study population consisted of 54,345 eligible participants. Mean age of participants was 81.9 years (standard deviation 7.4), 62.1% were female, and 88.7% identified as European ethnicity. In the adjusted model, all 4 social factors remained significantly associated with ARC admission, namely: living alone [subhazard ratio (SHR) = 1.43 95% confidence interval (CI) 1.37–1.50]; negative social interactions (SHR = 1.22, 95% CI 1.15–1.30); perceived loneliness (SHR = 1.18, 95% CI 1.13–1.24); and carer stress (SHR = 1.28, 95% CI 1.23–1.34).Conclusions and implicationsInterventions targeted at social factors in the context of delaying ARC admission merit further development and evaluation.     

Frozen stored Leishmania tropica vaccine: the effects of dose,route of administration and storage on the evolution of the clinical lesion. Two field trials in the Israel Defense Forces

The first field trial of frozen vaccine against cutaneous leishmaniasis yielded a 100% take rate and a high ulceration rate at a dose of four million units. Two further trials were designed to investigate differences in response rates on the basis of duration of storage, sex of vaccinee, vaccination dose and method of administration.257 soliders (151 males and 106 females) were inoculated in 1978 with an isolate of Leishmania tropica major that had been stored at the temperature of liquid nitrogen for 11 months before use. Those inoculated with an intradermal jet injector and those receiving half a million units by conventional injection yielded very low take rates. For those receiving two million and one million units, no difference in response was demonstrated between males and females or between doses. The over-all take rate for these groups after six months of follow-up was 71·6% with an ulceration rate of only 23·7%.In a subsequent trial in 1979, 131 men were inoculated with one of two frozen isolates of L. tropica major that had been stored for 11 and 18 months, respectively, at doses of either two million or four million units. The take rate after 12 months of follow-up was 91% and 93% for the four and two million units dose, respectively. The corresponding ulceration rates were 39·5% and 25%. The lesions produced by the higher dose developed more rapidly than those produced by the lower dose. The ability of the parasites to produce lesions rapidly with high ulceration rates appears to decline during prolonged storage, even in the frozen state.     

Impact of the Updated USDA School Meal Standards,Chef-Enhanced Meals,and the Removal of Flavored Milk on School Meal Selection and Consumption

BackgroundIn Fall 2012, updated US Department of Agriculture school meal standards went into effect and did not result in increased food waste overall. However, consumption of school foods, especially fruits and vegetables, remains low. Therefore, strategies to improve school meal consumption are necessary.ObjectiveThis study evaluated the combined impact of the updated school meal standards and chef-enhanced, healthier meals, and the removal of flavored milk on students’ school food selection and consumption compared with students in control schools.DesignThe Project MEALS (Modifying Eating and Lifestyles at School) study was a cafeteria-based quasi-experimental intervention conducted during the 2012 to 2013 school year.Participants/settingParticipants were students (n=1,309) in grades 3 through 8 attending four intervention and four control schools in two low-income, urban school districts.InterventionChef-enhanced school meals and the removal of flavored milk combined with the updated US Department of Agriculture school meal standards.Main outcome measuresChanges in school meal selection and consumption were examined using plate waste methodology.Statistical analyses performedLogistic regression and mixed-model analysis of variance adjusting for student demographics and schools/students as a random effect (students nested within schools) were used to examine differences in selection and consumption before (Fall 2012) and after (Spring 2013) a chef-based intervention with the updated school meal standards.ResultsAfter the chef-based intervention was implemented, there were no significant differences in entrée, vegetable, or fruit selection. Significantly fewer students selected milk compared with students in control schools (56.8% vs 94.0%; P<0.0001) and milk consumption was significantly lower (54.8% vs 63.7%; P=0.004). However, consumption was significantly greater for vegetables (62.2% vs 38.2%; P=0.005) and fruits (75.2 vs 59.2%; P=0.04) in the intervention schools compared with control schools. There were no significant differences in entrée consumption.ConclusionsSchools collaborating with chefs can be an effective method to improve the consumption of fruits and vegetables with the updated US Department of Agriculture school meal standards. Further research should examine the longer-term impact of the removal of flavored milk from schools to determine whether the lower selection and consumption rates persist.     

“It’s a Feeling That One Is Not Worth Food”: A Qualitative Study Exploring the Psychosocial Experience and Academic Consequences of Food Insecurity Among College Students

BackgroundThe issue of food insecurity is one of growing concern among institutions of higher learning in the United States. In addition to studies on the prevalence and risk factors, research is needed to better understand the mechanisms by which food insecurity affects students' health and well-being.ObjectiveTo critically explore the experience of food insecurity among college students and its impact on psychosocial health and academic performance.DesignIn-depth qualitative interviews were conducted with college students to gain a better understanding of the mechanisms by which food insecurity affects their psychosocial health and academic performance.Participants/settingTwenty-five undergraduate students from a large public university in California who were recruited from a campus food pantry.ResultsStudents discussed several themes related to the psychosocial effects of food insecurity: the stress of food insecurity interfering with daily life, a fear of disappointing family, resentment of students in more stable food and financial situations, an inability to develop meaningful social relationships, sadness from reflecting on food insecurity, feeling hopeless or undeserving of help, and frustration directed at the academic institution for not providing enough support. Students also discussed how food insecurity affected their academic performance through physical manifestations of hunger and the mental trade-off between focusing on food and focusing on academics.ConclusionThese findings contribute to the understanding of what it means to experience food insecurity in higher education and can inform how universities support students’ basic needs.