Use of a Model Wellness Policy May Not Increase the Strength and Comprehensiveness of Written School Wellness Policies

BACKGROUND

Many state agencies have developed model wellness policies (MWPs) to serve as examples for schools when writing their own school wellness policy (SWP). The purpose of this study was to evaluate if a MWP aids schools in writing stronger, more comprehensive SWPs.

METHODS

For this cross‐sectional study, 91 school districts submitted their current SWP and completed a survey that classified districts into either districts that utilized the state MWP (N = 56; 61.5%) or those that did not (NMWP, N =35; 38.5%). The Wellness School Assessment Tool (WellSAT) was used to assess the strength, comprehensiveness, total overall score, and subsection scores of each policy. Dependent variables were compared between groups using t tests. Statistical significance was set at p ≤ .05. Data are presented as mean ±SD.

RESULTS

No significant differences were found between groups in total overall (MWP 76.8 ± 37.9; NMWP 62.1 ± 34.3), strength (MWP 25.3 ± 17.6; NMWP 19.1 ± 12.8), or comprehensiveness scores (MWP 51.5 ± 21.2; NMWP 43.0 ± 22.1). The only subsection score difference identified between groups was the Nutrition Standards comprehension score (p = .02).

CONCLUSIONS

These data suggest MWPs may not improve the quality of written SWPs. Further research is needed to better understand the needs of school districts in SWP development.

     

HIV controllers: how do they tame the virus?

HIV controllers are rare, chronically HIV-1-infected patients in whom viral replication is undetectable in the absence of antiretroviral treatment. Most such patients are nonetheless infected by replication-competent viruses. An effective, multifunctional HIV-specific CD8(+) T-cell response is thought to be central to viral control in these individuals. The mechanisms underlying this spontaneous control of HIV infection and the particular characteristics of the CD8(+) T-cell response in HIV controllers are the focus of intensive investigations, because they should help to unravel the pathogenesis of AIDS and to provide new clues for the design of effective vaccine strategies. In this review, we examine recent findings from these studies.     

Posttransfusion thrombocytopenia associated with passive transfusion of a platelet-specific antibody

A transfusion reaction in a 76-year-old man was followed by severe but transient thrombocytopenia after infusion of whole blood. A high-titer platelet-specific antibody (anti-PLA) was demonstrated in the plasma of the implicated unit and in the serum of the blood donor. In addition, three previous recipients of blood from the implicated donor had posttransfusion episodes of unexplained thrombocytopenia. These cases represent the first reported clinical examples of posttransfusion thrombocytopenia caused by passively transfused platelet-specific alloantibodies.     

Influence of anesthetic management on quality of magnetoencephalography scan data in pediatric patients: a case series

Background:  Magnetoencephalography (MEG) is increasingly used in the presurgical evaluation of pediatric seizure patients. Many pediatric patients require sedation or anesthesia to tolerate these exams. However, the available literature on anesthetic management in this population is very limited.
Methods:  We retrospectively reviewed the records of all patients who underwent MEG scanning at our institution with regard to the interaction of anesthetic management and quality of scan data.
Results:  High-dose propofol infusions (≥200 μg·kg⁻¹·min⁻¹) were associated with high frequency artifacts that interfered with the identification of epileptiform discharges. Lower-dose propofol infusions (≤100 μg·kg⁻¹·min⁻¹) did not produce artifacts but required co-administration of fentanyl to prevent patient motion. Dexmedetomidine infusions were not associated with signal artifacts and prevented patient motion very well in our initial patients and became our standard technique.
Conclusion:  In our experience, dexmedetomidine infusions are preferable to propofol-based techniques for pediatric MEG scans due to the absence of adverse effect on interictal activity.     

Capacity and Readiness for Implementing Evidence-Based Task-Strengthening Strategies for Hypertension Control in Ghana: A Cross-Sectional Study

BackgroundAssessing the practice capacity for hypertension management and control within community-based health planning and services system is an important step toward implementing evidence-based interventions to reduce uncontrolled hypertension at the community level.ObjectivesTo assess the capacity and readiness of community health workers to implement a task-strengthening strategy for hypertension control (TASSH) at the community level.MethodsThis was a cross-sectional study guided by the Consolidated Framework for Implementation Research conducted among community health workers in 6 contiguous districts within the Brong-Ahafo Region of Ghana. Study variables were described using frequency tables.ResultsA total of 179 community health officers (CHOs) were interviewed. The majority of respondents knew lifestyle-related messages to be provided to their clients such as heart-healthy diets (91.6%, n = 164), physical activity (90.5%, n = 162), and low sodium intake (88.3%, n = 158), but not about other lifestyle-modifying messages such as caffeine reduction (46.4%, n = 83). The majority (79%) of the respondents did not know the names of the first-line hypertension medications. Fifty-one percent of respondents did not know about the blood pressure threshold for initiation of blood pressure management. About 90% of respondents had not been trained on hypertension management. More than 80% are however motivated to implement the TASSH intervention.ConclusionsThe majority of CHOs in this study were aware of lifestyle modifications such as diet modifications and increase in physical activity. However, their knowledge was limited in the blood pressure threshold for initiating treatment and in the knowledge of first-line hypertension medication, irrespective of the number of years practiced. Training on hypertension is also low. However, CHOs are motivated to control hypertension at the community level. Community-level interventions such as TASSH can leverage on their motivation to demonstrate an impact on hypertension control.     

Chronic mercury exposure impairs the sympathovagal control of the rat heart

Mercury is known to cause harmful neural effects affecting the cardiovascular system. Here, we evaluated the chronic effects of low‐dose mercury exposure on the autonomic control of the cardiovascular system. Wistar rats were treated for 30 days with HgCl₂ (1st dose 4.6 μg/kg followed by 0.07 μg/kg per day, intramuscular) or saline. The femoral artery and vein were then cannulated for evaluation of autonomic control of the hemodynamic function, which was evaluated in awake rats. The following tests were performed: baroreflex sensitivity, Von Bezold‐Jarisch reflex, heart rate variability (HRV) and pharmacological blockade with methylatropine and atenolol to test the autonomic tone of the heart. Exposure to HgCl₂ for 30 days slightly increased the mean arterial pressure and heart rate (HR). There was a significant reduction in the baroreflex gain of animals exposed to HgCl₂. Moreover, haemodynamic responses to the activation of the Von Bezold‐Jarisch reflex were also reduced. The changes in the spectral analysis of HRV suggested a shift in the sympathovagal balance toward a sympathetic predominance after mercury exposure, which was confirmed by autonomic pharmacological blockade in the HgCl₂ group. This group also exhibited reduced intrinsic HR after the double block suggesting that the pacemaker activity of the sinus node was also affected. These findings suggested that the autonomic modulation of the heart was significantly altered by chronic mercury exposure, thus reinforcing that even at low concentrations such exposure might be associated with increased cardiovascular risk.