Investing in Retail Food Safety: Assessing the NEHA-FDA Retail Flexible Funding Model Grant Program's Distribution Through an SDOH Lens.

Social Determinants of Health (SDOH) have a major impact on community health and quality of life. Healthy People 2030 has an increased focus on SDOH, given their contribution to health disparities and inequalities as a social phenomenon. Despite advances in food hygiene and sanitation, structural disparities related to SDOH leave food systems vulnerable. The Voluntary National Retail Food Regulatory Program Standards (VNRFRPS), otherwise known as the Retail Program Standards initiative is part of the Food and Drug Administration (FDA)'s strategy for prevention-based food safety to reduce foodborne illness. The National Environmental Health Association (NEHA) and the U.S. Food and Drug Administration (FDA) work in partnership to administer the NEHA-FDA Retail Flexible Funding Model (RFFM) Grant Program. The program provides funding to State, Local, Tribal, and Territorial (SLTT) retail food regulatory agencies as they achieve and advance conformance with the VNRFRPS. In its first year (Calendar Year 2022) of the 3-year cycle, the grant program awarded $6.87M in funding to over 200 jurisdictions nationwide. The research note shares preliminary findings of utilizing Geographic Information Systems (GIS) to map the first-year SLTT grant program awardees, with a selection of their jurisdiction's Social Determinants of Health (SDOH) metrics. Integration and analysis of program-specific grant funding and mapping with the relevant health determinants provide an opportunity to understand further the need for comprehensive program investments for greater impact and improvements in public health.

Preliminary Analysis of an Advanced Health Care Practitioner-Led Home-Visit Primary Care Program for High-Risk Patients Reduced Health Care Costs and Utilization.

Background: MemorialCare Medical Group (MCMG) designed and implemented an advanced health care practitioner (AHP)-led home-visit primary care program to address the needs of a frail older adult population, who struggled with arriving for in-office care. We sought to perform a preliminary analysis to determine the program's efficacy. Methods: We conducted a retrospective review of patients enrolled in the program through tabulation of total costs of care, inpatient visits (IPVs), emergency department visits (EDVs), and 30-day readmissions (30DRs) 1-year pre-enrollment and postenrollment. Results: For the prior year and postyear windows, per-member per-month total cost of care decreased 21.4% ($5,883.44-$4,622.31), reflecting a gross savings of $2,693,480.32. Mean IPVs (2.42-1.56), EDVs (1.53-0.93), and 30DRs (0.27-0.13) were reduced. Conclusions: Initial analysis of an AHP-led in-home primary care program for frail seniors shows promise for improved outcomes with a clear decrease in the total cost of care.

Linkage between Neighborhood Social Cohesion and BMI of South Asians in the Masala Study.

Introduction. South Asians in the United States have a high prevalence of obesity and an elevated risk for cardiometabolic diseases. Yet, little is known about how aspects of neighborhood environment influence cardiometabolic risk factors such as body mass index (BMI) in this rapidly growing population. We aimed to investigate the association between perceived neighborhood social cohesion and BMI among South Asians. Methods: We utilized cross-sectional data from the MASALA study, a prospective community-based cohort of 906 South Asian men and women from the San Francisco Bay area and the greater Chicago area. Multivariable linear regression models, stratified by sex, were used to examine the association between perceived level of neighborhood social cohesion and individual BMI after adjusting for sociodemographics. Results: Participants were 54% male, with an average age of 55 years, 88% had at least a bachelor's degree, and the average BMI was 26.0 kg/m2. South Asian women living in neighborhoods with the lowest social cohesion had a significantly higher BMI than women living in neighborhoods with the highest cohesion (ß coefficient = 1.48, 95% CI 0.46-2.51, p=0.02); however, the association was not statistically significant after adjusting for sociodemographic factors (ß coefficient = 1.48, 95% CI 0.46-2.51, p=0.02); however, the association was not statistically significant after adjusting for sociodemographic factors (. Conclusion: Perceived neighborhood social cohesion was not significantly associated with BMI among South Asians in our study sample. Further research is recommended to explore whether other neighborhood characteristics may be associated with BMI and other health outcomes in South Asians and the mechanisms through which neighborhood may influence health.

In vitro evaluation of alternative oral contrast agents for MRI of the gastrointestinal tract.

PURPOSE: In vitro evaluation of different materials as potential alternative oral contrast agents for small bowel MRI. MATERIALS AND METHODS: The T1 and T2 relaxation times of rose hip syrup, black currant extract, cocoa, iron-deferoxamine solution and a commonly used oral contrast material (1 mM Gd-DTPA) were determined in vitro at different concentrations on a 1.0 T clinical MR scanner. T1 values were obtained with an inversion prepared spoiled gradient echo sequence. T2 values were obtained using multiple echo sequences. Finally the materials were visualized on T1-, T2- and T2*-weighted MR images. RESULTS: The relaxation times of the undiluted rose hip syrup (T1=110+/-5 ms, T2=86+/-3 ms), black currant extract (T1=55+/-3 ms, T2=39+/-2 ms) and 5 mM iron-deferoxamine solution (T1=104+/-4 ms, T2=87+/-2 ms) were much shorter than for a 1mM Gd-DTPA solution (T1=180+/-8 ms, T2=168+/-5 ms). Dilution of black currant extract to 30% or a 3 mM iron-deferoxamine solution conducted to T1 relaxation times which are quite comparable to a 1 mM Gd-DTPA solution. Despite its much lower metal content an aqueous cocoa suspension (100 g/L) produced T2 relaxation times (T1=360+/-21 ms, T2=81+/-3 ms) more or less in the same range like the 5 mM iron-deferoxamine solution. Imaging of our in vitro model using clinical sequences allowed to anticipate the T1-, T2- and T2*-depiction of all used substances. Cocoa differed from all other materials with its low to moderate signal intensity on T1- and T2-weighted sequences. While all substances presented a linear 1/T1 and 1/T2 relationship towards concentration, rose hip syrup broke ranks with a disproportionately high increase of relaxation at higher concentrations. CONCLUSIONS: Rose hip syrup, black currant extract and iron-deferoxamine solution due to their positive T1 enhancement characteristics and drinkability appear to be valuable oral contrast agents for T1-weighted small bowel MRI. Cocoa with its differing relaxation and signal enhancement properties is a promising oral contrast agent but needs further clinical evaluation.

Inflationary oscillometric blood pressure monitoring: validation of the OMRON-MIT.

BACKGROUND: To evaluate the accuracy of the OMRON-MIT, (an automated inflationary oscillometric blood pressure monitoring device) for use in the general population by direct comparison to standard auscultatory mercury sphygmomanometry. DESIGN: Two trained, blinded observers taking simultaneous blood pressure measurements alternating between a mercury sphygmomanometer and the OMRON-MIT. METHODS: The evaluation was carried out according to the revised British Hypertension Society protocol. The validation data was also classified by the American Association for the Advancement of Medical Instrumentation (AAMI). RESULTS: The OMRON-MIT device achieved a BHS grade A for both systolic blood pressure (SBP) and diastolic blood pressure (DBP). It also met the criteria for the AAMI protocol, the mean difference between the MIT and standard was -2.0 +/- 7 mmHg for SBP and -2.0 +/- 6 mmHg for DBP. CONCLUSIONS: Inflationary oscillometry is a valid technique for the measurement of blood pressure. The OMRON-MIT, which uses this technique, is accurate and can be recommended for clinical use in the adult population.

Inflationary oscillometry provides accurate measurement of blood pressure in pre-eclampsia.

OBJECTIVE: To evaluate the accuracy of the OMRON-MIT inflationary oscillometric device for blood pressure measurement in pregnancy and pre-eclampsia. DESIGN: Prospective observational study, using validation methods recommended by the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI). SETTINGS: Antenatal clinics and ward, Guy's Hospital, London. POPULATION: Normotensive pregnant women and those diagnosed with pre-eclampsia according to the definition of the International Society for the Study of Hypertension in Pregnancy. METHODS: Validation according to BHS protocol. MAIN OUTCOME MEASURES: Proportion of readings within 5, 10 and 15 mmHg (absolute differences) between the automated device and two trained, blinded observers, according to the BHS and AAMI criteria. RESULTS: The OMRON-MIT achieved an overall BHS grade B for systolic and grade A for diastolic blood pressure measurement in both pregnancy and pre-eclampsia. The mean (SD) differences between the standard and the test device were -5 (7) mmHg for systolic and 2 (6) mmHg for diastolic blood pressure in pregnancy and -4 (6) mmHg for systolic and 2 (7) mmHg for diastolic blood pressure in pre-eclampsia. This device therefore fulfils the AAMI criteria. CONCLUSION: The OMRON-MIT is the only automated oscillometric device that has proven to be accurate for blood pressure measurement in pre-eclampsia according to the BHS protocol in pregnancy. Inflationary oscillometry may correct the error associated with oscillometric devices in pre-eclampsia.