Evaluating Healthy Vending at the American Heart Association National Center: A Pilot Study.

PURPOSE: To determine whether a 100% healthy vending model would affect revenue, employee satisfaction, and nutrition in the workplace. DESIGN: This study compared revenue and nutrition data pre- and post-adoption of nutrition standards from the American Heart Association's (AHA) Healthy Workplace Food and Beverage Toolkit. Employee satisfaction was measured using a survey. SETTING: The AHA National Center which, over time, included 5 vending machines and a micromarket. MEASURES: Comparisons of monthly snack and beverage revenues; survey results assessing employee satisfaction; reduction in mean saturated fat (g) and sodium (mg) per snack sold; reduction in mean sugar (g) per beverage sold; monthly mean number of fruits, vegetable, and dairy sold. ANALYSIS: Paired t tests were used to compare monthly revenue while t tests were used to compare nutrition information pre- and post-adoption of nutrition standards. Survey results and food group purchases were analyzed using descriptive statistics. RESULTS: Mean monthly snack revenue increased (P = .002). Mean monthly beverage revenue did not decrease. Most survey respondents were satisfied with the healthy vending. Mean saturated fat and sodium content per snack sold decreased (P < .001). Mean sugar content per beverage sold decreased. The micromarket sold an average of 210 units of dairy, 85 units of fruit, and 87 units of vegetables per month. LIMITATIONS: This study was conducted at one workplace. CONCLUSION: Healthy vending did not decrease revenue but did decrease saturated fat and sodium per snack, decrease sugar per beverage, and provide fruits, vegetables, and fat-free/low-fat dairy. Employees were generally satisfied with healthy vending.

Diffusion-weighted imaging versus short tau inversion recovery sequence: Usefulness in detection of active sacroiliitis and early diagnosis of axial spondyloarthritis.

OBJECTIVE: To compare the utility of Diffusion weighted imaging (DWI) with short tau inversion recovery (STIR) sequence in the diagnosis of early axial spondyloarthritis (SpA). METHODS: Three hundred and five patients with chronic back pain were recruited consecutively from 3 rheumatology centers. Clinical, radiological and blood parameters were recorded. Patients with back pain duration no more than 3 years were classified as having early disease. STIR sequence and DWI of the sacroiliac joints were obtained and assessed using the Spondyloarthritis Research Consortium of Canada (SPARCC) method. The Assessment in Spondyloarthritis international Society definition was used to define positive STIR and DWI. Results were compared to expert diagnosed axial SpA. RESULTS: When compared to STIR sequence, DWI had similar sensitivity (STIR 0.29, DWI 0.30) and specificity (STIR 0.97, DWI 0.92) in diagnosing sacroiliitis. However, STIR sequence had better reliability (STIR 0.78, DWI 0.61). In early disease group, DWI was not better than STIR sequence in detecting active sacroiliitis (sensitivity DWI vs STIR: 0.34 vs 0.36; specificity DWI vs STIR: 0.93 vs 0.93; positive predictive value DWI vs STIR: 0.92 vs 0.92; negative predictive value DWI vs STIR: 0.36 vs 0.37). Using the Assessment in SpondyloArthritis international Society (ASAS) classification criteria, 67/98 patients with early disease (sensitivity 0.91 specificity 0.90) and 221/305 overall (sensitivity 0.90; specificity 0.92) were classified as axial SpA. Among the expert diagnosed axial SpA patients who did not meet the ASAS criteria, only 2 had positive DWI. CONCLUSION: DWI and STIR have similar sensitivity in diagnosing axSpA in early disease. However, the use of DWI is limited by poorer reliability when compared with STIR.