When pictures take away from the message: An examination of young adults' attention to texting and driving advertisements.

This study examined eye-movement patterns of young adults, while they were viewing texting and driving prevention advertisements, to determine which format attracts the most attention. As young adults are the most at risk for this public health issue, understanding which format is most successful at maintaining young adults' attention is especially important. Participants viewed nondriving, general distracted driving, and texting and driving advertisements. Each of these advertisement types were edited to contain text-only, image-only, and text and image content. Participants were told that they had unlimited time to view each advertisement, while their eye-movements were recorded throughout. Participants spent more time viewing the texting and driving advertisements than other types when they comprised text only. When examining differences in attention to the text and image portions of the advertisements, participants spent more time viewing the images than the text for the nondriving and general distracted driving advertisements. However, for texting and driving-specific advertisements the text-only format resulted in the most attention toward the advertisements. These results indicate that in attracting young adults' attention to texting and driving public health advertisements, the most successful format would be text-based. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Indicators to guide health equity work in local public health agencies: a locally driven collaborative project in Ontario. / Indicateurs pour orienter l'action visant l'équité en matière de santé dans les organismes locaux de santé publique : le programme Projets locaux en Ontario.

INTRODUCTION: Funded by a Public Health Ontario 'Locally Driven Collaborative Project' grant, a team led by public health practitioners set out to develop and test a comprehensive set of indicators to guide health equity work in local public health agencies (LPHAs). METHODS: The project began with a scoping review, consultation with content experts, and development of a face-validated set of indicators aligned with the four public health roles to address health inequities (NCCDH, 2014), plus a fifth set of indicators related to an organizational and system development role. We report here on the field testing of the indicators for feasibility, face validity (clarity, relevance), reliability, and comparability in four Ontario LPHAs. Data were collected by two separate individuals or groups at each site, during two consecutive periods. These individuals participated in separate focus groups at the end of each test period, which further examined indicator clarity, data source availability and relevance. A third focus group explored anticipated indicator uses. RESULTS: Field testing showed that indicators addressed important issues in all public health roles. Although the capacity for indicator use varied, all test sites found the indicators useful. Suggestions for improved clarity were used to refine the final set of indicators, and to develop a Health Equity Indicator User Guide with background information and recommended resources. CONCLUSION: The process of evaluating health equity-related activity within LPHAs is still in its early stages. This project provides Ontario LPHAs with a tool to guide health equity work that may be adaptable to other Canadian jurisdictions.

INTRODUCTION: Grâce au programme Projet locaux financé par Santé publique Ontario, une équipe de professionnels de la santé publique a entrepris de concevoir et de tester un ensemble d'indicateurs afin d'orienter l'action visant l'équité en matière de santé au sein des organismes locaux de santé publique (OLSP). MÉTHODOLOGIE: Le projet a démarré avec un examen de la portée de la littérature, la consultation d'experts sur le sujet et l'élaboration d'un ensemble d'indicateurs de validité apparente conforme aux quatre mandats de la santé publique visant à réduire les inégalités en matière de santé (CCNDS, 2014) auxquels on a ajouté un cinquième ensemble d'indicateurs relatifs au mandat de perfectionnement organisationnel et systémique. Nous rendons compte ici des tests de terrain portant sur la faisabilité, sur la validité apparente (clarté et pertinence), sur la fiabilité et sur la comparabilité de ces indicateurs dans quatre OLSP de l'Ontario. Les données ont été recueillies par deux personnes ou groupes différents dans chaque site et en deux périodes. Ces personnes ont participé à des groupes de discussion à la fin de chaque période d'essai, ce qui a permis pour chaque indicateur un examen approfondi de sa clarté, de la disponibilité des sources de données associées et de sa pertinence. Un troisième groupe de discussion a étudié l'utilisation qui pourrait être faite de ces indicateurs. RÉSULTATS: Les essais de terrain ont montré que les indicateurs ont contribué à résoudre des questions importantes en lien avec tous les mandats en santé publique. Bien que les indicateurs ne possèdent pas tous la même utilité, les sites d'essai les ont tous jugés utiles. Diverses recommandations en matière de clarté ont été suivies pour améliorer l'ensemble final d'indicateurs et pour élaborer un guide d'utilisation des indicateurs d'équité en santé offrant des renseignements généraux et des suggestions de ressources. CONCLUSION: Le processus d'évaluation des activités liées à l'équité en matière de santé dans les OLSP n'en est qu'à ses débuts. Ce projet fournit aux OLSP de l'Ontario un outil d'orientation pour leur travail visant l'équité en matière de santé, outil qui pourrait être adapté aux autres provinces et territoires du Canada.

Organizational level indicators to address health equity work in local public health agencies: A scoping review.

OBJECTIVE: To determine what organizational level indicators exist that could be used by local Ontario public health agencies to monitor and guide their progress in addressing health equity. METHOD: This scoping review employed Arksey and O'Malley's (2005) six-stage framework. Multiple online databases and grey literature sources were searched using a comprehensive strategy. Studies were included if they described or used indicators to assess an organization's health equity activity. Abstracted indicator descriptions were classified using the roles for public health action identified by the Canadian National Collaborating Centre for Determinants of Health (NCCDH). Health equity experts participated in a consultation phase to examine items extracted from the literature. SYNTHESIS: Eighteen peer-reviewed studies and 30 grey literature reports were included. Abstracted indicators were considered for 1) relevance for organizational assessment, 2) ability to highlight equity-seeking populations, and 3) potential feasibility for application. Twenty-eight items formed the basis for consultation with 13 selected health equity experts. Items considered for retention were all noted to require significant clarification, definition and development. Those eliminated were often redundant or not an organizational level indicator. CONCLUSION: Few evidence-based, validated indicators to monitor and guide progress to address health inequities at the level of the local public health organization were identified. There is a need for continued development of identified indicator items, including careful operationalization of concepts and establishing clear definitions for key terms.

Northern Fruit and Vegetable Pilot Program: a process evaluation.

PURPOSE: A process evaluation was conducted of the Northern Fruit and Vegetable Pilot Program (NFVPP), a government-funded health promotion initiative. The objectives were to determine how the program was implemented and to identify program facilitators and challenges. METHODS: Facilitators and challenges in the implementation of the free fruit and vegetable snack program were assessed through qualitative interviews with school-level stakeholders (i.e., food preparers, teachers, and principals) and tracking wasted produce. The implementation of an enhanced nutrition education (ENE) component was assessed through a teacher survey. RESULTS: School-level stakeholders saw the NFVPP as a valuable program. Key facilitators included teacher role-modelling and sufficient funding for supplies and personnel. Key challenges included produce delivery, quality, wastage, and variety. The ENE component was minimally implemented. CONCLUSIONS: The study identified program strengths and areas that could be improved. As a result, changes were made to how the NFVPP was implemented in schools the following year. The use of qualitative methods enabled program planners to understand the program implementation process.

Licensing of natural killer cells by host major histocompatibility complex class I molecules.

Self versus non-self discrimination is a central theme in biology from plants to vertebrates, and is particularly relevant for lymphocytes that express receptors capable of recognizing self-tissues and foreign invaders. Comprising the third largest lymphocyte population, natural killer (NK) cells recognize and kill cellular targets and produce pro-inflammatory cytokines. These potentially self-destructive effector functions can be controlled by inhibitory receptors for the polymorphic major histocompatibility complex (MHC) class I molecules that are ubiquitously expressed on target cells. However, inhibitory receptors are not uniformly expressed on NK cells, and are germline-encoded by a set of polymorphic genes that segregate independently from MHC genes. Therefore, how NK-cell self-tolerance arises in vivo is poorly understood. Here we demonstrate that NK cells acquire functional competence through 'licensing' by self-MHC molecules. Licensing involves a positive role for MHC-specific inhibitory receptors and requires the cytoplasmic inhibitory motif originally identified in effector responses. This process results in two types of self-tolerant NK cells--licensed or unlicensed--and may provide new insights for exploiting NK cells in immunotherapy. This self-tolerance mechanism may be more broadly applicable within the vertebrate immune system because related germline-encoded inhibitory receptors are widely expressed on other immune cells.

Epistasis between mouse Klra and major histocompatibility complex class I loci is associated with a new mechanism of natural killer cell-mediated innate resistance to cytomegalovirus infection.

Experimental infection with mouse cytomegalovirus (MCMV) has been used to elucidate the intricate host-pathogen mechanisms that determine innate resistance to infection. Linkage analyses in F(2) progeny from MCMV-resistant MA/My (H2 (k)) and MCMV-susceptible BALB/c (H2 (d)) and BALB.K (H2 (k)) mouse strains indicated that only the combination of alleles encoded by a gene in the Klra (also called Ly49) cluster on chromosome 6, and one in the major histocompatibility complex (H2) on chromosome 17, is associated with virus resistance. We found that natural killer cell-activating receptor Ly49P specifically recognized MCMV-infected cells, dependent on the presence of the H2 (k) haplotype. This binding was blocked using antibodies to H-2D(k) but not antibodies to H-2K(k). These results are suggestive of a new natural killer cell mechanism implicated in MCMV resistance, which depends on the functional interaction of the Ly49P receptor and the major histocompatibility complex class I molecule H-2D(k) on MCMV-infected cells.

A subset of natural killer cells achieves self-tolerance without expressing inhibitory receptors specific for self-MHC molecules.

It is widely believed that self-tolerance of natural killer (NK) cells occurs because each NK cell expresses at least one inhibitory receptor specific for a host major histocompatibility complex (MHC) class I molecule. Here we report that some NK cells lack all known self-MHC-specific inhibitory receptors, yet are nevertheless self-tolerant. These NK cells exhibit a normal cell surface phenotype and some functional activity. However, they respond poorly to class I-deficient normal cells, tumor cells, or cross-linking of stimulatory receptors, suggesting that self-tolerance is established by dampening stimulatory signaling. Thus, self-tolerance of NK cells in normal animals can occur independently of MHC-mediated inhibition, and hyporesponsiveness plays a role in self-tolerance of NK cells, as also proposed for B and T cells.

Receptor/ligand avidity determines the capacity of Ly49 inhibitory receptors to interfere with T-cell receptor-mediated activation.

The specificity and the relative affinity of many Ly49 receptors for major histocompatibility complex class I ligands have been studied in detail in various adhesion and binding assays. However, how the level of cell surface expression of a given Ly49 receptor and its ligand affinity influence the strength of the inhibition signal is not well documented. To address this issue, we developed a series of human Jurkat T-cell transfectants expressing the whole range of Ly49A and Ly49C levels found in vivo on natural killer and T cells and evaluated their capacity to alter superantigen-induced NF-AT activation and interleukin-2 production. We show that the strength of the inhibition induced by Ly49A/H-2Dd interaction correlates with Ly49A density up to a certain level after which increasing expression does not further inhibit significantly the T-cell receptor-induced activation. This system also represents a valuable tool for the determination of the relative strength of the inhibitory signals of Ly49 receptors following their interactions with different ligands. Even at high levels of expression there was no evidence that engagement of Ly49A with H-2b class I molecules provided an inhibitory signal. Moreover, we showed that functional inhibitory interactions of Ly49C with H-2b class I molecules were only the result of H-2Kb and that H-2d represent lower affinity ligands for Ly49C than H-2b. Therefore, depending on the relative affinity of Ly49 receptors for their ligands, the modulation of their expression level will be determinant for the functional outcome of activated T cells.