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101.

Background

Few U.S. studies have explored how children experience a parent's mobility disability and its effects on their daily lives.

Objective

We aimed to engage youth ages 13–17 who had at least one parent with mobility disability in describing their perceptions of their parent's disability and its consequences for their daily and family life.

Methods

Participants videoed and photographed their experiences following general guidelines from the researchers about topics of interest. Participants made their own choices about what they submitted. We used conventional content analysis to identify broad themes.

Results

The mean (standard deviation) age of the 10 participants was 15.2 (1.9) years; 5 were male; 9 participants were white. All 5 girls submitted multiple self-focused (selfie) videos made in their bedrooms; the 5 boys submitted more diverse data files. Several broad themes or topics emerged including: the effects of timing and trajectory of the parent's disability; perceptions of early maturity and responsibility; fears and frustrations relating to the parent's disability; support and emerging resilience; and sense of social justice. Participants generally felt their parents' disability made them become – compared to their peers – more mature, responsible, capable of performing household tasks, and aware of disability civil rights.

Conclusions

Participants raised many issues that health care providers should be aware of when youth have parents with mobility disability. A parent's mobility disability may be associated with resilience but also may pose challenges for youth. More research is needed to understand better adolescents' experiences and how clinicians might best assist these youth.  相似文献   
102.

Background

Little is known about zinc intakes and status during complementary feeding. This is particularly true for baby-led approaches, which encourage infants to feed themselves from the start of complementary feeding, although self-feeding may restrict the intake of zinc-rich foods.

Objective

To determine the zinc intakes, sources, and biochemical zinc status of infants following Baby-Led Introduction to SolidS (BLISS), a modified version of Baby-Led Weaning (BLW), compared with traditional spoon-feeding.

Design

Secondary analysis of the BLISS randomized controlled trial.

Participants/setting

Between 2012 and 2014, 206 community-based participants from Dunedin, New Zealand were randomized to a Control or BLISS group.

Intervention

BLISS participants received eight study visits (antenatal to 9 months) providing education and support regarding BLISS (ie, infant self-feeding from 6 months with modifications to address concerns about iron, choking, and growth).

Main outcome measures

Dietary zinc intakes at 7 and 12 months (weighed 3-day diet records) and zinc status at 12 months (plasma zinc concentration).

Statistical analyses performed

Regression analyses were used to investigate differences in dietary intakes and zinc status by group, adjusted for maternal education and parity and infant age and sex.

Results

There were no significant differences in zinc intakes between BLISS and Control infants at 7 (median: 3.5 vs 3.5 mg/day; P=0.42) or 12 (4.4 vs 4.4 mg/day; P=0.86) months. Complementary food groups contributing the most zinc at 7 months were “vegetables” for Control infants, and “breads and cereals” for BLISS infants, then “dairy” for both groups at 12 months. There was no significant difference in mean±standard deviation plasma zinc concentration between the Control (62.8±9.8 μg/dL [9.6±1.5 μmol/L]) and BLISS (62.8±10.5 μg/dL [9.6±1.6 μmol/L]) groups (P=0.75).

Conclusions

BLISS infants achieved similar zinc intake and status to Control infants. However, the BLISS intervention was modified to increase iron intake, which may have improved zinc intake, so these results should not be generalized to infants following unmodified BLW.  相似文献   
103.

Background

In 2016, the US Department of Agriculture (USDA)’s Supplemental Nutrition Assistance Program (SNAP) Retailer Rule proposed several changes for SNAP-authorized retailers, including: requiring retailers to have at least 85% of their food sales come from items that are not cooked or heated on site before or after purchase; requiring stores to stock seven varieties of qualifying foods from four staple food groups; requiring stores to carry perishable foods in three of the four staple groups; requiring stores to carry six units of qualifying foods at all times (depth of stock); disqualifying multiple ingredient foods and accessory foods from counting toward depth of stock requirements.

Objectives

To better understand arguments used to support or oppose the USDA’s proposed rule that all SNAP-authorized retailers carry more nutritious foods.

Design

We conducted a qualitative content analysis of a random sample of public comments posted to the US Federal Register (a publicly available database) in response to the USDA’s proposed rule.

Participants/setting

A random sample of 20% of all public comments submitted by individuals and organizations to the US Federal Register were analyzed (n=303) for this study.

Results

Three main themes were discussed: 1) arguments used in opposition to the rule; 2) arguments used in support of the rule; and 3) facilitators to assist stores in implementing the rule. Some of the subthemes included focusing on definitions used in the rule, reduced food access caused by stores leaving the SNAP program, lack of space and equipment for healthy foods, and the potential for increasing healthy food access.

Conclusions

Nutrition and dietetics practitioners may be tasked with working with stores to implement healthy changes. Nutrition and dietetics practitioners must understand the role that the USDA has in food policy. In addition, understanding how federal food policy influences the environments in which dietetics professionals’ clients are making food choices is important.  相似文献   
104.
Prevalence of obesity, an established risk factor for many cancers, has increased dramatically over the past 50 years in the United States and across the globe. Relative to normoweight cancer patients, obese cancer patients often have poorer prognoses, resistance to chemotherapies, and are more likely to develop distant metastases. Recent progress on elucidating the mechanisms underlying the obesity?cancer connection suggests that obesity exerts pleomorphic effects on pathways related to tumor development and progression and, thus, there are multiple opportunities for primary prevention and treatment of obesity-related cancers. Obesity-associated alterations, including systemic metabolism, adipose inflammation, growth factor signaling, and angiogenesis, are emerging as primary drivers of obesity-associated cancer development and progression. These obesity-associated host factors interact with the intrinsic molecular characteristics of cancer cells, facilitating several of the hallmarks of cancer. Each is considered in the context of potential preventive and therapeutic strategies to reduce the burden of obesity-related cancers. In addition, this review focuses on emerging mechanisms behind the obesity?cancer link, as well as relevant dietary interventions, including calorie restriction, intermittent fasting, low-fat diet, and ketogenic diet, that are being implemented in preclinical and clinical trials, with the ultimate goal of reducing incidence and progression of obesity-related cancers.  相似文献   
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108.
This work is focused on the synthesis of polycaprolactone nanoparticles, coated with chitosan, in a confined impinging jet reactor using the solvent displacement method. The role of the various reacting species was investigated, evidencing that a biocompatible polymer, for example, polycaprolactone, is required to support chitosan to obtain a monomodal particle size distribution, with low particle diameters. A surfactant is required to reduce the nanoparticle size (down to a mean diameter of about 260 nm) and obtain a positive zeta potential (about +31 mV), perfectly suitable for pharmaceutical applications. Different surfactants were tested, and Poloxamer 388 appeared to be preferable to polyvinyl alcohol. The effect of the concentration of Poloxamer 388 (in the range 0.5-5 mg mL?1) and of chitosan (in the range 1.5-5 mg mL?1) on both the mean particle size and zeta potential was also investigated, evidencing that chitosan concentration has the strongest effect on both parameters. Finally, the effect of solvent evaporation, quenching and feed flow rate was investigated, showing that the evaporation stage does not affect particle characteristics, quenching is required to avoid particle aggregation, and a minimum liquid flow rate of 80 mL min?1 is required in the considered reactor to minimize the particle size.  相似文献   
109.
Four P-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) substrates with human cerebrospinal fluid (CSF) concentrations and preclinical neuropharmacokinetics were used to assess in vitroin vivo extrapolation of brain penetration in preclinical species and the ability to predict human brain penetration. Unbound brain (Cb,u), unbound plasma (Cp,u), and CSF compound concentrations (CCSF) were measured in rats and nonhuman primates (NHPs), and the unbound partition coefficients (Cb,u/Cp,u and CCSF/Cp,u) were used to assess brain penetration. The results indicated that for P-gp and BCRP dual substrates, brain penetration was severally impaired in all species. In comparison, for P-gp substrates that are weak or non-BCRP substrates, improved brain penetration was observed in NHPs and humans than in rats. Overall, NHP appears to be more predictive of human brain penetration for P-gp substrates with weak or no interaction with BCRP than rat. Although CCSF does not quantitatively correspond to Cb,u for efflux transporter substrates, it is mostly within 3-fold higher of Cb,u in rat and NHP, suggesting that CCSF can be used as a surrogate for Cb,u. Taken together, a holistic approach including both in vitro transporter and in vivo neuropharmacokinetics data enables a better estimation of human brain penetration of P-gp/BCRP substrates.  相似文献   
110.
Daily oral antiretroviral therapy regimens produce limited drug exposure in tissues where residual HIV persists and suffer from poor patient adherence and disparate drug kinetics, which all negatively impact outcomes. To address this, we developed a tissue- and cell-targeted long-acting 4-in-1 nanosuspension composed of lopinavir (LPV), ritonavir, tenofovir (TFV), and lamivudine (3TC). In 4 macaques dosed subcutaneously, drug levels over 5 weeks in plasma, lymph node mononuclear cells (LNMCs), and peripheral blood mononuclear cells (PBMCs) were analyzed by liquid chromatography–tandem mass spectrometry. Plasma and PBMC levels of the active drugs (LPV, TFV, and 3TC) were sustained for 5 weeks; PBMC exposures to LPV, ritonavir, and 3TC were 12-, 16-, 42-fold higher than those in plasma. Apparent T1/2z of LPV, TFV, and 3TC were 219.1, 63.1, and 136.3 h in plasma; 1045.7, 105.9, and 127.7 h in PBMCs. At day 8, LPV, TFV, and 3TC levels in LNMCs were 4.1-, 5.0-, and 1.9-fold higher than in those in PBMCs and much higher than in plasma. Therefore, 1 dose of a 4-drug nanosuspension exhibited persistent drug levels in LNMCs, PBMCs, and plasma for 5 weeks. With interspecies scaling and dose adjustment, this 4-in-1 HIV drug-combination could be a long-acting treatment with the potential to target residual virus in tissues and improve patient adherence.  相似文献   
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