The effects of acculturation on healthy lifestyle characteristics among Hispanic fourth-grade children in Texas public schools, 2004-2005

BACKGROUND: Childhood obesity is a national epidemic that disproportionately affects Hispanic children. Evidence suggests that increased acculturation among this population adversely affects diet and other healthy lifestyle characteristics, leading to higher rates of overweight and obesity. Healthy lifestyle characteristics must be understood in order to prevent or decrease overweight and obesity among Hispanic children. METHODS: Using the School Physical Activity and Nutrition (SPAN) study, we examined cross‐sectional data on healthy lifestyle characteristics collected in Texas public schools from Hispanic fourth‐grade children in 2004–2005. We calculated adjusted odds ratios and associated confidence intervals using multivariate logistic regression analyses to analyze the association between acculturation and healthy lifestyle characteristics among Spanish‐speaking Hispanic children compared to English‐speaking Hispanic children. RESULTS: Spanish‐speaking Hispanic boys consumed more milk and fruit than English‐speaking Hispanic boys (milk: adjusted odds ratio [AOR]: 1.7, p = .02; fruit: AOR: 2.5, p = .0001). The likelihood that Spanish‐speaking Hispanic boys and girls did not know that there is a relationship between overweight and health problems were 2 times greater (boys: AOR: 1.7, p = .03; girls: AOR: 2.2, p = .006) than their English‐speaking Hispanic counterparts. Likelihood of weight loss attempts was greater among Spanish‐speaking Hispanic boys than English‐speaking Hispanic boys (AOR: 1.9, p = .04). CONCLUSIONS: Results are mixed. Lower levels of acculturation appear to be associated with both positive and negative healthy lifestyle characteristics, depending on sex. These findings have important implications for school health policies and programs and should be distributed to school administrators.     

递增负荷有氧运动14周影响不同衰老程度老年男性的生物学年龄

目的:观察有氧运动对不同衰老程度老年男性生物学年龄的影响。方法:于2002-09/12选择上海市杨浦区退休老年男性13名,年龄59～76岁,平均(64±5)岁,近期无系统健身运动经历。13名老年男性采用功率自行车进行14周递增负荷有氧运动。以最大心率的75%所对应的运动负荷为训练强度;在第4,8周末重新确定运动强度,第5～8周、9～14周以新负荷作为健身运动负荷。每周3次,起始2周每次持续20min,以后每隔2周每次增加5min。采用刘继武等推荐的生物学年龄成套测试方法测定生物学年龄。运动前和运动后测定生物学年龄以及身体形态、心血管、肺功能等生理指标。并根据生物学年龄与实际年龄的差距,分成提前衰老组(生物学年龄大于实际年龄)和延缓衰老组(生物学年龄小于实际年龄)进行对照分析。结果:①老年男性运动前生物学年龄大于实际年龄,差异无显著性意义(P=0.56),有氧运动后生物学年龄小于实际年龄,差异无显著性意义(P=0.066),有氧运动后生物学年龄小于运动前,差异有非常显著性意义[分别为(65.13±6.33),(67.15±7.13)岁,P<0.01]。②根据生物学年龄与实际年龄的差距,将老年男性分成提前衰老组7名和延缓衰老组6名。提前衰老组老年男性有氧运动前生物学年龄大于实际年龄,递增负荷有氧运动后生物学年龄接近实际年龄,低于运动前,差异有非常显著性意义[分别为(69.00±6.73),(71.90±7.55)岁,P<0.01]。延缓衰老组有氧运动前生物学年龄小于实际年龄,有氧运动后生物学年龄进一步减少,低于运动前,差异无显著性意义(P>0.05)。③提前衰老组老年男性有氧运动后腰围低于运动前,腰臀比高于运动前,差异有显著性意义[分别为(94.20±5.14),(99.58±6.48)cm;(0.95±0.03),(0.92±0.04)cm,P<0.05]。延缓衰老组老年男性上臂皮褶厚度低于运动前,差异有显著性意义[分别为(11.00±2.17),(14.42±2.33)mm,P<0.05]。其他身体形态指标变化差异无显著性意义。生理功能指标变化较明显,最大摄氧量、闭眼单脚站立时间均高于运动前,差异有显著性意义[分别为(36.08±5.40),(30.08±2.21)mL/(kg·min);(28.17±20.51),(12.4±14.78)s,P<0.05]。④两组老年男性有氧运动后心血管和肺功能指标中收缩压、舒张压均有下降,肺活量增加。其中延缓衰老组老年男性肺活量高于运动前,差异有显著性意义[分别为(3.98±0.69),(3.61±0.71)L,P<0.05]。结论:有氧运动对不同衰老程度老年男性生物学年龄、身体形态和生理功能均可产生良性影响,达到延缓衰老目的。     

A cost analysis comparing erythropoietin and red cell transfusions in the treatment of anemia of prematurity

BACKGROUND: Anemia of prematurity is invariably observed in very low birth weight infants and may become symptomatic enough to be treated with packed red cell transfusions. Recently, treatment of this condition with recombinant human erythropoietin has been advocated. STUDY DESIGN AND METHODS: To compare the costs of training symptomatic anemia in hospitalized premature infants with transfusions alone or with erythropoietin plus red cell transfusions as needed, cost estimates were derived from local hospital and published cost data. Decision analysis and sensitivity analysis were applied to a "base case." The base case was derived from results of a multicenter erythropoietin trial in the United States in which premature infants received 500 U of erythropoietin per kg of body weight each week. Because erythropoietin treatment began on average at 3 weeks of life, when infants were clinically stable, they had already received 3.5 red cell transfusions. During the 6-week treatment period, erythropoietin- treated infants received significantly fewer additional transfusions: a mean of 1.6 versus 1.1. RESULTS: The base-case cost in 1993 dollars for treating anemia in hospitalized premature infants with erythropoietin and transfusions was $1,326. This was nearly twice the cost of conventional treatment with transfusions alone ($721). If the 6-week treatment period alone is considered, erythropoietin is 3.6 times more costly: $840 versus $235. CONCLUSION: The largest available US study using erythropoietin to treat anemia in premature infants has demonstrated a small, but significant, reduction in transfusion needs. However, this study's cost data alone do not justify the widespread use of erythropoietin in premature infants. When this issue is probed in great depth, sensitivity analyses demonstrate that major reductions in erythropoietin's cost and/or improvements in its effectiveness quite possibly will make its use economically more attractive.     

Chemokines and interleukin-18 are up-regulated in bronchoalveolar lavage fluid but not in serum of septic surgical ICU patients

Our objective was to investigate the levels of chemokines (MIP1-alpha, MCP-1, and Gro-alpha), Interleukin-18 (IL-18), and Interleukin (IL-6) in bronchoalveolar lavage (BAL) fluid and serum at the onset and ongoing states of sepsis as defined by the American College of Chest Physicians/Society of Critical Care Medicine in septic surgical ICU patients. Our summary background data was to understand the significance of compartmentalized inflammatory mediator production in an immunologically active organ (lung) in comparison with levels in the systemic circulation. The study group consisted of 20 septic patients and 10 non-septic patients on surgical ICU. At the onset of sepsis, both BAL fluid and serum samples were taken and levels of MIP-1alpha, MCP-1, GRO-alpha, IL-18, and IL-6 were measured by ELISA. Furthermore, over a subsequent 8-day period, levels of these mediators were determined in serum. In some experiments, IL-18 mRNA levels were determined in peripheral blood lymphocytes (PBL) of septic and non-septic patients. At the onset of sepsis, MIP-1alpha, MCP-1, GRO-alpha, IL-18, and IL-6 levels were significantly up-regulated in BAL fluid as compared with non-septic controls. In marked contrast, with the exception of IL-18 mRNA and IL-6 peptide, there was no increase in serum levels of inflammatory mediators determined both at the onset and during the ongoing states of sepsis. Based on the present data, monitoring levels of serum chemokines and IL-18 protein as markers of sepsis might be misleading since despite their non-detection in serum, they were highly up-regulated in the lung tissue compartment. These data might underscore the role of MIP-1alpha, MCP-1, GRO-alpha, and IL-18 in the mediation of local tissue damage. Furthermore, these findings raise the notion that mediator measurement in immunologically active organs might serve as pivotal indicators of sepsis prior to the actual fulfillment of specific clinical criteria that defines the patient as being septic.     

Baseline survey of sexually transmitted infections in a cohort of female bar workers in Mbeya Region, Tanzania

OBJECTIVES: To determine baseline prevalence of sexually transmitted infections (STI) and other reproductive tract infections (RTI) and their association with HIV as well as sociodemographic and behavioural characteristics in a newly recruited cohort of female bar workers in Mbeya Region, Tanzania. METHODS: 600 female bar workers were recruited from 17 different communities during September to November 2000 and underwent gynaecological examination, laboratory testing for HIV/STI, and interviews using structured questionnaires. RESULTS: HIV-1 seroprevalence was 68%. Prevalences of STI/RTI were high titre syphilis (TPPA/RPR >/=1/8), 9%; herpes simplex virus 2 antibodies, 87%; chlamydia, 12%; gonorrhoea, 22%; trichomoniasis, 24%; and bacterial vaginosis, 40%. HIV infection was associated with TPPA and HSV-2 seropositivity, bacterial vaginosis and clinically diagnosed genital ulcers, blisters, and warts. Reported high risk sexual behaviour during the past year (having multiple casual partners) was associated with prevalent STI. CONCLUSION: Female bar workers in Mbeya are at high risk of STI and HIV infection. Targeted STI/HIV prevention interventions for these women and their sexual partners need to be reinforced. Methods should be sought to improve healthcare seeking and to provide easily accessible and affordable STI care services.     

Distinct and dynamic activation profiles of circulating dendritic cells and monocytes in mild COVID-19 and after yellow fever vaccination

Dysregulation of the myeloid cell compartment is a feature of severe disease in hospitalized COVID-19 patients. Here, we investigated the response of circulating dendritic cell (DC) and monocyte subpopulations in SARS-CoV-2 infected outpatients with mild disease and compared it to the response of healthy individuals to yellow fever vaccine virus YF17D as a model of a well-coordinated response to viral infection. In SARS-CoV-2-infected outpatients circulating DCs were persistently reduced for several weeks whereas after YF17D vaccination DC numbers were decreased temporarily and rapidly replenished by increased proliferation until 14 days after vaccination. The majority of COVID-19 outpatients showed high expression of CD86 and PD-L1 in monocytes and DCs early on, resembling the dynamic after YF17D vaccination. In a subgroup of patients, low CD86 and high PD-L1 expression were detected in monocytes and DCs coinciding with symptoms, higher age, and lower lymphocyte counts. This phenotype was similar to that observed in severely ill COVID-19 patients, but less pronounced. Thus, prolonged reduction and dysregulated activation of blood DCs and monocytes were seen in a subgroup of symptomatic non-hospitalized COVID-19 patients while a transient coordinated activation was characteristic for the majority of patients with mild COVID-19 and the response to YF17D vaccination.     

Overweight and obesity prevention for and with adolescents: The “Confronting obesity: Co-creating policy with youth” (CO-CREATE) project

The CO-CREATE project focuses on the need for research on obesity prevention in adolescents to move away from studies of single interventions, toward the investigation of systems-based research incorporating youth involvement. This paper provides an overview of the project, presenting the objectives, design, and novel methodologies applied, as well as findings to date and anticipated outcomes. Adolescents (16–18 years old) in five European countries participated. Methods applied in the project include monitoring and benchmarking of policies, systematic literature reviews, epidemiological surveillance, linking observed overweight and obesity trends to observed policy landscapes, group model building to identify perceived drivers of obesity, alliance building with adolescents, dialog with stakeholders, and system dynamics modelling to explore the potential impact of policy options. Outcomes include tools for developing policy ideas and investigation of prevention strategies with adolescents, including policy databases, system maps of drivers of obesity, protocols for organizing youth alliances, an intergenerational policy dialog tool, and system dynamic models exploring the impacts of cocreated policy ideas. These outcomes make an important contribution to building a pan-European infrastructure for designing and evaluating policies and for providing youth with the opportunity to make their voices heard in the development and implementation of obesity prevention measures.