Promoting physical activity and youth development in schools: the case for near-peer coaches.

Background: Sports-based youth development (SBYD) programs provide an inclusive, supportive environment for promoting physical activity as well as nurturing the development of life skills which, in combination, promote physical, mental, and emotional health in youth. The Up2Us Sports SBYD program was implemented in six schools in New Orleans, Louisiana in 2020-2022, where near-peer coaches from the community were placed in schools and present throughout the school day. The intervention period straddled the COVID-19 pandemic as well as extreme weather events, modifying program delivery. Process/methods: An exploratory case study was conducted to understand participant experience amid program disruptions and modifications, as well as their perceptions of program impact on physical activity and health. Interviews with coaches (n = 7), focus groups with youth (n = 14) and program observation data were triangulated to provide a description of the case. Results: The major theme that emerged from the case study was the centrality of the near-peer mentorship relationships between coaches and youth. Participants believed near-peer relationships facilitated life skill development and increased opportunity for physical activity in schools, but pressures on coaches' time and external challenges in the community were limiting factors to the extent of program impact. Conclusion: This community case study demonstrates the potential role for near-peer mentors in influencing the health and wellbeing of youth from under-resourced communities and highlights the opportunity for school-based SBYD programming to provide youth with a consistent source of both relational and physical activity support.

Participant Perspectives on the Impact of a School-Based, Experiential Food Education Program Across Childhood, Adolescence, and Young Adulthood.

OBJECTIVE: Explore participant perceptions of involvement in an experiential food education program during elementary school and the scope and extent of program influence on food decisions. DESIGN: Focus groups with current participants and program alumni. SETTING: Washington, DC. PARTICIPANTS: Thirty-nine elementary school students and 39 program alumni ranging from middle school through university students. PHENOMENON OF INTEREST: Participant perceptions of program impact from childhood into adolescence and young adulthood. ANALYSIS: Inductive thematic analysis. RESULTS: Nine emergent themes were identified, spread over 3 categories of program impact: immediate, beyond the classroom, and sustained. Immediate program impact themes came from all participants and included enjoyment, hands-on learning, and fostering connection. Beyond the classroom, older elementary students and alumni expressed perceived shifts in individual and family food intake, involvement in household food practices, and desire for fresh food options at school. Themes of sustained program impact among alumni participants were an appreciation for fresh food, openness to trying new foods, and confidence to make informed food decisions. CONCLUSIONS AND IMPLICATIONS: Findings provide a deeper understanding of participant perspectives on the impact of participation in a school-based experiential food education program and a basis for further research on the role of early exposure to food education in influencing food decisions as children grow older.

Food Insecurity and Childhood Obesity: A Systematic Review.

BACKGROUND AND OBJECTIVES: Addressing food insecurity while promoting healthy body weights among children is a major public health challenge. Our objective is to examine longitudinal associations between food insecurity and obesity in US children aged 1 to 19 years. METHODS: Sources for this research include PubMed, CINAHL, and Scopus databases (January 2000 to February 2022). We included English language studies that examined food insecurity as a predictor of obesity or increased weight gain. We excluded studies outside the United States and those that only considered the unadjusted relationship between food security and obesity. Characteristics extracted included study design, demographics, methods of food security assessment, and anthropometric outcomes. RESULTS: Literature searches identified 2272 articles; 13 met our inclusion criteria. Five studies investigated the relationship between food insecurity and obesity directly, whereas 12 examined its relationship with body mass index or body mass index z-score. Three studies assessed multiple outcomes. Overall, evidence of associations between food insecurity and obesity was mixed. There is evidence for possible associations between food insecurity and obesity or greater weight gain in early childhood, for girls, and for children experiencing food insecurity at multiple time points. Heterogeneity in study methods limited comparison across studies. CONCLUSIONS: Evidence is stronger for associations between food insecurity and obesity among specific subgroups than for children overall. Deeper understanding of the nuances of this relationship is critically needed to effectively intervene against childhood obesity.

Urban Youth Perspectives on Food Insecurity during the COVID-19 Pandemic: Evidence from the COACHES Study.

School disruptions during the COVID-19 pandemic were a likely threat to food security and exacerbated risk factors associated with poor nutrition and health outcomes among low-income youth. As part of an ongoing school-based study aimed at improving physical activity and dietary behaviors (the COACHES study), associations between youth-reported food insecurity and dietary intake across the pandemic-affected academic year of 2020-2021 were examined. Middle school students (6th and 7th grade, 94% Black/African-American, 92% free-/reduced-price lunch eligible) answered validated surveys on food insecurity and diet and were measured for height and weight for calculation of weight status during Fall 2020 (n = 88) and Spring 2021 (n = 56). During this time, schools underwent a combination of in-person, hybrid, and remote learning. Nearly half of participants were overweight or obese (47%), and self-reported food insecurity was near 30% at both time points. Less than one-third of youth met fruit and vegetable intake guidelines, and more than half drank two or more sugar-sweetened beverages daily. While controlling for sex, maternal education, and weight status, food insecurity was not significantly associated with fruit and vegetable or sugar-sweetened beverage intake. Independent of weight status, youth were aware of being food insecure, yet it did not have an apparent impact on these food groups of concern. These findings highlight the need for greater understanding of youth perceptions of food insecurity in order to adequately address dietary quality and quantity concerns among children.

Feasibility of collaborating with independent Latino-owned restaurants to increase sales of a healthy combo meal.

Americans spend the majority of their food dollars at restaurants and other prepared food sources, including quick-service and fast-food restaurants (PFS); independent small restaurants make up 66% of all PFS in the US. In this feasibility study, 5 independent and Latino-owned PFS in the Washington DC metro area worked with academic partners to start offering healthy combo meals with bottled water and promote these using on-site, community, and social media advertising. The number of healthy combos sold was collected weekly, showing that the new combos sold, and customers in all 5 sites were surveyed as they exited the PFS (n=50): >85% had noticed the combo meals; 100% thought it was a good idea to offer it, 68% had ordered the combo (of these, >94% of customers responded that they liked it).  Results suggest that it is feasible to work with independent Latino-owned restaurants to promote healthy combos and collect data.

Themes in Train-the-Trainer Nutrition Education Interventions Targeting Middle School Students: A Systematic Review.

Context-appropriate nutrition education interventions targeting middle school students have the potential to promote healthy dietary patters that may help prevent unnecessary weight gain at a point in childhood development when youth experience increasing agency over their food choices. The aim of this review was to identify and synthesize themes in train-the-trainer approaches, intervention content and delivery, and youth receptivity across teacher, mentor, and peer-led nutrition education interventions that targeted middle school-age youth in urban, primarily low-income settings. A systematic, electronic literature search was conducted in seven electronic databases, PubMed/Medline, CINAHL, ERIC, PsycINFO, Scopus, SPORTDiscus, and Cochrane CENTRAL, using fixed inclusion and exclusion criteria. A total of 53 papers representing 39 unique interventions were selected for data extraction and quality assessment. A framework synthesis approach was used to organize the interventions into six categories and identify themes according to whether the intervention was classroom-based or out-of-school-based and whether adults, cross-age peers or same-age peers delivered the intervention. Ten of the interventions contained multiple components such that they were included in two of the categories. The review findings indicated that trainings should be interactive, include opportunities to role-play intervention scenarios and provide follow-up support throughout intervention delivery. Interventions targeting middle school youth should include positive messaging and empower youth to make healthy choices within their specific food environment context.

Adapting to supply-and-demand emerging trends for antigen-negative red blood cell units.

BACKGROUND: A global downtrend in blood usage has been observed by many countries, while the demand for antigen-negative red blood cell (RBC) units used in antigen-matched transfusions keeps increasing. The declining number of units collected exposes blood providers to a rapidly evolving supply challenge. METHODS: This study was conducted retrospectively with use of internal data analysis to weigh Québec's situation regarding global and antigen-negative RBC demand, to measure the effects of community-directed recruitment and blood drives, and to evaluate the benefits of mass-scale RBC genotyping. RESULTS: Our findings confirm a global RBC usage downtrend of over 20% total in the past 10 years with a steady antigen-negative usage and highlight the most requested negative antigen combinations. Our data also show our +39.5% progress regarding the number of Black donors recruited for antigen matching of patients with sickle cell disease in the past 3 years, as well as a constantly growing number of just-in-time blood collection for complex orders. Finally, our data summarize the efficiency of our mass-scale RBC genotyping efforts. CONCLUSION: Altogether, this study confirms the demand trends for regular and antigen-negative RBC units in Québec and the efficient effects of our recruitment and typing strategies.

Alcohol and HER2 polymorphisms as risk factor for cardiotoxicity in breast cancer treated with trastuzumab.

BACKGROUND: Trastuzumab has no major side-effects except the potential for cardiac toxicity. The main objective of this study was to evaluate the association between trastuzumab-associated cardiac toxicity and two potential risk factors: alcohol intake and HER2 polymorphisms. PATIENTS AND METHODS: In a retrospective cohort study of 237 women with non-metastatic HER2-positive breast cancer treated with trastuzumab, traditional risk factors were assessed by review of medical records, alcohol use by an administered questionnaire to women (n=132), and HER2 polymorphisms (Ile655Val and Ala1170Pro) using TaqMan assays (n=73). RESULTS: Association was observed between alcohol intake (10 drinks and more per week) during the trastuzumab treatment and cardiac toxicity (p=0.04). For polymorphisms, compared to Ile/Ile carriers, HER2 Ile/Val was associated with a higher risk of cardiac toxicity (p=0.02). CONCLUSION: Heavy alcohol use during the course of trastuzumab treatment and the HER2 Ile/Val genotype may constitute risk factors for cardiac toxicity.

C21orf91 genotypes correlate with herpes simplex labialis (cold sore) frequency: description of a cold sore susceptibility gene.

BACKGROUND: Herpes simplex virus type 1 (HSV-1) infects >70% of the United States population. We identified a 3-megabase region on human chromosome 21 containing 6 candidate genes associated with herpes simplex labialis (HSL, "cold sores"). METHODS: We conducted single nucleotide polymorphism (SNP) scans of the chromosome 21 region to define which of 6 possible candidate genes were associated with cold sore frequency. We obtained the annual HSL frequency for 355 HSV-1 seropositive individuals and determined the individual genotypes by SNPlex for linkage analysis and parental transmission disequilibrium testing (ParenTDT). RESULTS: Two-point linkage analysis showed positive linkage between cold sore frequency and 2 SNPs within the C21orf91 region, 1 of which is nonsynonymous. ParenTDT analysis revealed a strong association between another C21orf91 SNP, predicted to lie in the 3' untranslated region, and frequent HSL (P = .0047). C21orf 91 is a predicted open reading frame of unknown function that encodes a cytosolic protein. CONCLUSIONS: We evaluated candidate genes in the cold sore susceptibility region using fine mapping with 45 SNP markers. 2 complementary techniques identified C21orf91 as a gene of interest for susceptibility to HSL. We propose that C21orf91 be designated the Cold Sore Susceptibility Gene-1 (CSSG1).

Antibodies to cell surface proteins redirect intracellular trafficking pathways.

Antibody-mediated intracellular delivery of therapeutic agents has been considered for treatment of a variety of diseases. These approaches involve targeting cell-surface receptor proteins expressed by tumors or viral proteins expressed on infected cells. We examined the intracellular trafficking of a viral cell-surface-expressed protein, rabies G, with or without binding a specific antibody, ARG1. We found that antibody binding shifts the native intracellular trafficking pathway of rabies G in an Fc-independent manner. Kinetic studies indicate that the ARG1/rabies G complex progressively co-localized with clathrin, early endosomes, late endosomes, and lysosomes after addition to cells. This pathway was different from that taken by rabies G without addition of antibody, which localized with recycling endosomes. Findings were recapitulated using a cellular receptor with a well-defined endogenous recycling pathway. We conclude that antibody binding to cell-surface proteins induces redirection of intracellular trafficking of unbound or ligand bound receptors to a specific degradation pathway. These findings have broad implications for future developments of antibody-based therapeutics.

Periprosthetic osteolysis: characterizing the innate immune response to titanium wear-particles.

Osteolysis of bone following total hip replacement is a major clinical problem. Examination of the areas surrounding failed implants has indicated an increase in the bone-resorption-inducing cytokine, interleukin 1ß (IL-1ß). NALP3, a NOD-like receptor protein located in the cytosol of macrophages, signals the cleavage of pro-IL-1ß into its mature, secreted form, IL-1ß. Here we showed that titanium particles stimulate the NALP3 inflammasome. We demonstrated that titanium induces IL-1ß secretion from macrophages. This response depended on the expression of components of the NALP3 inflammasome, including NALP3, ASC, and Caspase-1. We also showed that titanium particles trigger the recruitment of neutrophils and that this acute inflammatory response depends on the expression of the IL-1 receptor and IL-1α/ß. Moreover, administration of the IL-1 receptor antagonist (IL-1Ra) diminished neutrophil recruitment in response to titanium particles. Together, these results suggest that titanium particle-induced acute inflammation is due to activation of the NALP3 inflammasome, which leads to increased IL-1ß secretion and IL-1-associated signaling, including neutrophil recruitment. Efficacy of IL-1Ra treatment introduces the potential for antagonist-based therapies for implant osteolysis.

Risk of diarrhea with adult residents of municipalities with significant livestock production activities.

BACKGROUND: The intensification of livestock production has led to situations where the amount of manure that is produced exceeds the amounts needed in some areas. The objective of this study was to evaluate the relationship between the intensity of livestock activities and manure products, particularly in swine farms, and the prevalence of diarrhea in adults. METHODS: A survey was carried out on 8702 adults living in 161 municipalities in Quebec areas with intensive farming activities. Data were collected by a telephonic interview on diarrheal symptoms that occurred during the previous week of the interview, on water consumption and on selected risk factors. Statistical analysis was performed using a 'generalized estimating equations' model. RESULTS: Prevalence of diarrhea was found to be highest in adults aged between 25 and 34 years. No association was found between swine density or liquid manure application and diarrheal prevalence. There was also no association between cattle or total animal density and diarrheal prevalence. In the areas studied, there was no increase in risk associated with the consumption of tap water with suboptimal treatment and susceptible to microbiologic contamination. CONCLUSION: Significant livestock production and excess of manure were not associated with the risk of diarrhea in adults.