Definitive and Salvage Radiotherapy Compared to Other Modalities for Laryngeal Carcinoma in Situ

PURPOSE/OBJECTIVE(S)

We sought to analyze survival endpoints for laryngeal carcinoma in situ (CIS) undergoing definitive radiotherapy (RT) compared to other modalities.

MATERIALS/METHODS

Usingour prospectively maintained head and neck cancer database, we identified laryngeal CIS patients treated between 6/2001 and 12/2021. We excluded low-grade dysplasia, CIS with any synchronous invasive squamous cell carcinoma (SCC) within 3 months of the initial CIS biopsy and cases with inadequate follow up. Patients were offered either definitive RT, CO2/KTP laser ablation, photodynamic therapy (PDT) or any sort of therapeutic excision. After first line treatment, follow-up includes visits every 3-6 months with laryngoscopy and biopsies as appropriate. For recurrent CIS beyond 6 months of first line treatment, we reported salvage therapies received and long-term outcomes were reported. Using Kaplan-Meier curves and log-rank test we investigated recurrence free (RFS), progression to invasive SCC free (IFS) and overall (OS) survival across treatment groups. Patients managed with salvage RT were compared to first line RT recipients.

RESULTS

Atotal of 85 CIS cases were included: median age 65 years (IQR: 55-74), 73 males (85%) and 70 white (82.4%). 86% had a history of smoking with median pack year of 38 (IQR: 20-55) and 66% had a history of alcohol use. CIS was glottic in most of the cases (90.6%: 66% unilateral, 21% bilateral & 13% involved commissure); with only 9.4% in the supraglottic region. RT was used in 49.4% (n = 42) after biopsy (55%) or surgery (45%) with median dose of 63 Gy/28 fractions, mainly by 3D conformal RT (76%). The remaining 50.6% (n = 43) got therapeutic excision alone (commonly microflap excision) (46.5%), CO2/KTP laser (32.6%) or PDT (20.9%). Demographics and clinicopathological details were non-different between RT and non-RT patients except for Charlson comorbidity index: median 2 (IQR 1-3) in non-RT vs 1 (IQR 0-2) in 1ry RT; p = 0.007. After a median follow-up of 4.8 years (IQR 3.5), 51.8% had recurrent disease, 21.2% progressed to invasive SCC and 9.4% had laryngectomies mainly for invasive SCC after RT. First line RT had improved 2-(83% vs 39%) and 5-(74% vs 22%) year RFS vs non-RT therapies (p<0.001). Nevertheless, 2- and 5-year IFS (89% vs 98% and 80% vs 79%) and OS (92% vs 93% and 81% vs 77%) were non-significant among both (p>0.05 for all). Among non-RT cases with CIS recurrences, 12/35 (34%) had salvage RT. Following RT, salvage RT patients had similar 2- and 5-year RFS (81% vs 83% and 81% vs 74%) and IFS (81% vs 89% and 81% vs 80%) compared to first line RT (p>0.05 for all). All cases with CIS recurrences were salvaged successfully with 100% living with no CIS at latest follow-up.

CONCLUSION

Laryngeal CIS can be treated with a wide range of modalities including 1ry RT which has better recurrence free survival. Nevertheless, non-RT recurrent CIS can be salvaged successfully with many options including RT with equivalent long-term results.

Cardiometabolic Risk Factors Among Insufficiently Active African American Women With Obesity: Baseline Findings From Smart Walk

BACKGROUND

Low moderate-to-vigorous physical activity (MVPA) levels and obesity are associated with increased cardiometabolic disease risk.

OBJECTIVE

The aim of this study was to describe MVPA and cardiometabolic risk characteristics of insufficiently active African American women with obesity (N = 60) enrolled in a culturally tailored MVPA intervention.

METHODS

We assessed accelerometer-measured and self-reported MVPA, blood pressure, serum lipid profiles, cardiorespiratory fitness (VO 2 peak), and aortic pulse wave velocity.

RESULTS

Participants (mean age, 38.4; mean body mass index, 40.6 kg/m 2 ) averaged 15 min/d of accelerometer-measured MVPA and 30 min/wk of self-reported MVPA. Systolic and diastolic blood pressure levels were elevated (135.4 and 84.0 mm Hg, respectively). With the exception of low-density lipoprotein cholesterol (121.4 mg/dL) and high-density lipoprotein cholesterol (47.6 mg/dL), lipid profiles were within reference ranges. Compared with normative reference values, average VO 2 peak was low (18.7 mL/kg/min), and pulse wave velocity was high (7.4 m/s).

CONCLUSIONS

Our sample of insufficiently active African American women with obesity was at an elevated risk for cardiometabolic disease.

Smart Walk: A Culturally Tailored Smartphone-Delivered Physical Activity Intervention for Cardiometabolic Risk Reduction among African American Women

This article reports the results of Smart Walk: a randomized pilot trial of an 8-month culturally tailored, smartphone-delivered physical activity (PA) intervention for African American women with obesity. Sixty participants (age range = 24−49 years; BMI range = 30−58 kg/m2) were randomized to the Smart Walk intervention (n = 30) or a wellness comparison intervention (n = 30). Results supported the acceptability and feasibility of the intervention, as demonstrated by participant retention (85% at 4 months and 78% at 8 months), Smart Walk app use, and intervention satisfaction (i.e., 100% of PA participants completing the intervention [n = 24] reported they would recommend it to friend). Smart Walk participants also reported greater increases in moderate-to-vigorous PA (4-month between-arm difference in change [b] = 43.3 min/week; p = 0.018; Cohen’s d = 0.69; 8-month b = 56.6 min/week; p = 0.046; d = 0.63) and demonstrated clinically relevant, although not statistically significant (p-values > 0.05), baseline to 4 months improvements in cardiorespiratory fitness (b = 1.67 mL/kg/min; d = 0.40), systolic blood pressure (b = −3.33 mmHg; d = 0.22), diastolic blood pressure (b = −4.28 mmHg; d = 0.37), and pulse wave velocity (b = −0.46 m/s; d = 0.33). Eight-month cardiometabolic outcomes followed similar trends, but had high rates of missing data (45−53%) due to COVID-19 restrictions. Collectively, findings demonstrated favorable outcomes for acceptability and feasibility, while also highlighting key areas for refinement in future research.

Abstract MP13: Lipid Peroxidation And Inflammatory Response Differentiate With Changes In Liver Fat Among Obese Latino Youth Following Lifestyle Intervention

Introduction: Lipid peroxidation and inflammation are pivotal pathological processes involved in the progression of NAFLD, a prelude to cardiovascular disease. Lifestyle intervention is the cornerstone approach for preventing cardiometabolic disease among high-risk populations, yet studies have not examined the mechanisms by which lifestyle intervention may mediate changes in liver fat in youth.

Hypothesis: Lifestyle intervention will decrease hepatic fat fraction (HFF), tumor necrosis alpha (TNF)-α, and malondialdehyde (MDA)-protein adducts.

Methods: Latino youth with obesity (n=26, age 13.9±1.3, BMI% 98.1±1.1) and prediabetes completed a 6-month lifestyle intervention that included nutrition education (1 d/wk) and physical activity (3 d/wk). HFF was measured by MRI before and after intervention. Fasting serum samples were collected for measurement of lipid peroxidation, measured by MDA-protein adducts, and inflammation, measured by TNF-α. Repeated measures ANOVA models were used to examine the effect of lifestyle intervention on HFF, MDA-protein adducts, and TNF-α. Data are presented as Mean±SE.

Results: The intervention led to significant decreases in HFF (from 7.0±1.1% to 5.4±0.7%, p=0.027) and TNF-α (from 1.7±1.0 to 1.5±0.1 pg/mL, p=0.050), but not MDA-protein adducts (from 266.4±28.4 to 253.8±29.3 pmol/mL, p=0.105). However, there was significant heterogeneity in changes in HFF whereby those with the greatest response (n=14) decreased HFF by -44.0% while non-responders (n=12) increased HFF by 67.5%. HFF responders exhibited significantly greater reductions in MDA-protein adducts (from 256.2±39.4 to 228.1±40.0 pmol/mL, Δ-10.1%) compared to HFF non-responders (from 278.4±42.5 to 283.7±43.2 pmol/mL, Δ2.0%; p=0.023). TNF-α was reduced in HFF responders (from 1.8±0.2 to 1.5±0.1 pg/mL, Δ-17.8%) compared to HFF non-responders (from 1.5±0.2 to 1.5±0.1 pg/mL, Δ-4.4%) but was not significant (p=0.231).

Conclusions: Reductions in HFF through lifestyle changes were associated with greater reductions in markers of lipid peroxidation, but not inflammation. The effect of lifestyle intervention on HFF may be mediated by markers that extend beyond traditional clinical risk factors among high-risk youth.

Results of a Culturally Tailored Smartphone-Delivered Physical Activity Intervention Among Midlife African American Women: Feasibility Trial

BACKGROUND

Regular aerobic physical activity (PA) is an important component of healthy aging. However, only 27%-40% of African American women achieve national PA guidelines. Available data also show a clear decline in PA as African American women transition from young adulthood (ie, 25-44 years) into midlife. This decline in PA during midlife coincides with an increased risk for African American women developing cardiometabolic disease conditions, including obesity, type 2 diabetes, and cardiovascular disease. Thus, effective efforts are needed to promote PA among sedentary African American women during midlife.

OBJECTIVE

This study aims to examine the acceptability and feasibility of a culturally tailored, smartphone-delivered PA intervention, originally developed to increase PA among African American women aged 24-49 years, among a slightly older sample of midlife African American women aged 50-65 years.

METHODS

A single-arm pretest-posttest study design was implemented. In total, 20 insufficiently active African American (ie, ≤60 min per week of PA) women between the ages of 50-65 years participated in the 4-month feasibility trial. The Smart Walk intervention was delivered through the study Smart Walk smartphone app and text messages. Features available on the Smart Walk app include personal profile pages, multimedia PA promotion modules, discussion board forums, and an activity tracking feature that integrates with Fitbit activity monitors. Self-reported PA and social cognitive theory mediators targeted by the intervention (ie, self-regulation, behavioral capability, outcome expectations, self-efficacy, and social support) were assessed at baseline and at 4 months. Feasibility and acceptability were assessed using a postintervention satisfaction survey that included multiple-choice and open-ended questions evaluating participant perceptions of the intervention and suggestions for intervention improvement. Wilcoxon signed-rank tests were used to examine pre- and postintervention changes in the PA and social cognitive theory variables. The effect size estimates were calculated using the Pearson r test statistic.

RESULTS

Participants increased moderate-to-vigorous PA (median 30 minutes per week increase; r=0.503; P=.002) and reported improvements in 2 theoretical mediators (self-regulation: r=0.397; P=.01; behavioral capability: r=0.440; P=.006). Nearly all participants (14/15, 93% completing the satisfaction survey) indicated that they would recommend the intervention to a friend. Participants' suggestions for improving the intervention included enhancing the intervention's provisions of social support for PA.

CONCLUSIONS

The results provide preliminary support for the feasibility of the smartphone-based approach to increase PA among midlife African American women. However, before larger-scale implementation among midlife African American women, enhancements to the social support components of the intervention are warranted.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04073355; https://clinicaltrials.gov/ct2/show/NCT04073355.

Retinal Ependymoma: A Rare Extra-Axial Presentation

Introduction/Objective

Ependymomas are well-demarcated and slow-growing neuroepithelial neoplasms that comprise 3–9% of primary CNS tumors. The vast majority of ependymomas arise either intracranially, mostly in children, or in the spinal cord and are associated with ependymal lining. Histologic hallmarks are perivascular pseudorosettes, ependymal rosettes and alternating zones of nuclear crowding and nuclear free zones composed of coarse cell processes. In high grade ependymomas increased mitoses, necrosis and nuclear pleomorphism may be seen.

Methods

We present the case of a 63-year-old woman in with a past medical history of retinopathy of prematurity, glaucoma and right eye enucleation. She presented with a painful blind left eye refractory to medical treatment and subsequently underwent left eye enucleation.

Results

On histologic examination, an incidental retinal ependymoma was identified. The neoplastic cells were fusiform and had long coarsely fibrillar cell processes. Characteristic periodicity of nuclear crowding and scarcity was observed. In places, neoplastic cell processes extended radially to delicate and sometimes hyalinized blood vessels, forming so-called perivascular pseudorosettes. Definite ependymal rosettes were not recognized in the examined sections. Stigmata of chronicity were found, such as ischemic type necrosis, blood vessels with dystrophic calcifications and foci of ossification replete with fibroadipose tissue in the marrow spaces.

The neoplastic cells labeled with antibodies against glial fibrillary acidic protein (GFAP), thus confirming glial lineage in the neoplastic cell. Additionally, there was scattered intracytoplasmic expression of epithelial membrane antigen (EMA) in a dot-like or circular pattern. The latter is well described in ependymomas and often used to support the diagnosis.

Conclusion

Ependymomas rarely occur at extracranial sites, such as the chest, abdomen and pelvis. We are presenting the fourth case of retinal ependymoma reported in literature. The tumor had classical immunomorphologic findings.

0255 Comparing Performance, Fatigue and Sleepiness Between Short-Haul And Ultra Long-Haul Commercial Airline Operations

Introduction

Safety performance indicators (SPIs) are used in aviation to determine if a trip that is non-compliant with federal regulations is safe to fly. Exemptions to regulations can be granted if a safety case demonstrates that the SPIs for an alternative means of compliance (AMOC; i.e., a trip outside regulations) are non-inferior to SPIs for a safety standard operation (SSO; i.e. a trip compliant with regulations). Through this process, it has previously been suggested that ultra-long-range flights are non-inferior to long-range flights due to increased sleep opportunity. We determined whether SPIs for non-compliant ultra-long-range (ULR) trips are non-inferior to those for compliant short-haul (SH) trips.

Methods

Performance, fatigue, and sleepiness were assessed at the top of descent (TOD) of flight segments using the Psychomotor Vigilance Task (PVT), Samn-Perelli (SP) fatigue scale, and Karolinska Sleepiness Scale (KSS), respectively. Data were analyzed using non-inferiority testing. Two different ULR trips with different TOD times (ULR trip 1: n=81; ULR trip 2: n=22) were compared to two types of SH trips, including one trip that contained one or more all-night flights (SH trip 1: n=48) and one trip with zero all-night flights (SH trip 2: n=47).

Results

Non-inferiority was found for the SPIs at most comparison points. For example, comparing the SPIs for ULR trip 2 and SH trip 1 at final TOD, non-inferiority was found for all SPIs. In contrast, comparing the SPIs for ULR trip 1 and SH trip 1 at final TOD, non-inferiority was found for SP and KSS, while non-inferiority for PVT was only suggested.

Conclusion

The findings suggest that the AMOC trips are as safe as or safer than the compliant SH trips. This raises questions regarding the structure of SH trips and how differences in the structures play a role in performance, fatigue and sleepiness.

Support

United Airlines

0244 Examining Pilot Safety Performance Indicators at Critical Phases of Flight Across Multiple Flight Legs During Commercial Airline Trips

Introduction

Prior simulation and operational studies have started to address whether the number of consecutive flight segments negatively affects cognitive performance, fatigue, and sleepiness, without reaching a clear consensus. This study expands this literature by determining whether there are significant changes in cognitive performance, fatigue, and sleepiness at critical phases of flight across multiple flight segments, while accounting for the number of segments, flight direction, trip day, and time-of-day.

Methods

Fifty commercial airline pilots were studied. Each pilot flew two separate short-haul trips, each ranging from 1–4 days and 1–10 flight segments. Cognitive performance, fatigue, and sleepiness were assessed at top-of-climb (TOC) and top-of-descent (TOD) of each flight segment and each trip day. Cognitive performance, fatigue, and sleepiness were assessed using Psychomotor Vigilance Task (PVT) speed, Samn-Perelli (SP) ratings, and Karolinska Sleepiness Scale (KSS) ratings, respectively. Data were analyzed using Wilcoxon t-tests and verified using ANOVAs.

Results

Mean PVT speed (Cohen’s d =0.57), SP ratings (Cohen’s d = 0.73), and KSS ratings (Cohen’s d = 0.63) were significantly worse at TOD than TOC (p &lt; 0.001); and, significantly varied across flight segments (p&lt;0.001). Cognitive performance, fatigue, and sleepiness were consistently and significantly degraded around the fifth flight segment, improved around the sixth to eighth flights segments, and were subsequently degraded around the eighth to tenth flight segments.

Conclusion

The results indicate that cognitive performance, fatigue, and sleepiness vary across flight segments, trip day, and phase of flight. Results suggest that these safety performance indices degrade after five segments, and further degrade after eight flight segments. The results presented could be used to inform future airline scheduling and regulation.

Support

This work has been supported by United Airlines.

A Culturally Relevant Smartphone-Delivered Physical Activity Intervention for African American Women: Development and Initial Usability Tests of Smart Walk

Background

Smart Walk is a culturally relevant, social cognitive theory–based, smartphone-delivered intervention designed to increase physical activity (PA) and reduce cardiometabolic disease risk among African American (AA) women.

Objective

This study aimed to describe the development and initial usability testing results of Smart Walk.

Methods

Smart Walk was developed in 5 phases. Phases 1 to 3 focused on initial intervention development, phase 4 involved usability testing, and phase 5 included intervention refinement based on usability testing results. In phase 1, a series of 9 focus groups with 25 AA women (mean age 38.5 years, SD 7.8; mean BMI 39.4 kg/m2, SD 7.3) was used to identify cultural factors associated with PA and ascertain how constructs of social cognitive theory can be leveraged in the design of a PA intervention. Phase 2 included the analysis of phase 1 qualitative data and development of the structured PA intervention. Phase 3 focused on the technical development of the smartphone app used to deliver the intervention. Phase 4 consisted of a 1-month usability trial of Smart Walk (n=12 women; mean age 35.0 years, SD 8.5; mean BMI 40 kg/m2, SD 5.0). Phase 5 included refinement of the intervention based on the usability trial results.

Results

The 5-phase process resulted in the development of the Smart Walk smartphone-delivered PA intervention. This PA intervention was designed to target social cognitive theory constructs of behavioral capability, outcome expectations, social support, self-efficacy, and self-regulation and address deep structure sociocultural characteristics of collectivism, racial pride, and body appearance preferences of AA women. Key features of the smartphone app included (1) personal profile pages, (2) multimedia PA promotion modules (ie, electronic text and videos), (3) discussion boards, and (4) a PA self-monitoring tool. Participants also received 3 PA promotion text messages each week.

Conclusions

The development process of Smart Walk was designed to maximize the usability, cultural relevance, and impact of the smartphone-delivered PA intervention.

Lead, zinc, and copper redistributions in soils along a deposition gradient from emissions of a Pb-Ag smelter decommissioned 100 years ago

Sourcing and understanding the fate of anthropogenic metals in a historical contamination context is challenging. Here we combined elemental and isotopic (Pb, Zn, Cu) analyses with X-ray Absorption Spectroscopy (XAS) measurements (Zn) to trace the fate, in undisturbed soil profiles, of historical metal contamination emitted by a 167-year-old Pb-Ag smelter decommissioned 100 years ago located in the Calanques National Park (Marseilles, France). Lead isotopic measurements show that entire soil profiles were affected by 74 years of Pb emissions up to ~7 km from the smelter under the main NNW wind, and indicate particulate transfer down to 0.8 m at depth. This vertical mobility of anthropogenic Pb contrasts with previous studies where Pb was immobilized in surface horizons. The contribution of anthropogenic Pb to the total Pb concentration in soil was estimated at 95% in surface horizons, and 78% in the deepest horizons. Zinc isotopic signatures of past emissions that are enriched in light isotopes compared to the natural geological background (-0.70 ± 0.04‰ and -0.15 ± 0.02‰, respectively), were detected only in the surface horizons of the studied soils. Using XAS analyses, we showed that anthropogenic Zn was transformed and immobilized in surface horizons as Zn-Layered Double Hydroxide, thus favoring the enrichment in heavy isotopes in these surface horizons. No clear evidence of copper contamination by the smelter was found and Cu isotopes point to a bedrock origin and a natural distribution of Cu concentrations.

Evaluation of historical atmospheric pollution in an industrial area by dendrochemical approaches

We conducted a dendrochemical study in order to evaluate the exposure of territories and populations to different types of pollutants and to characterise the history of pollution in one of the most intensely industrialised areas of Europe: the industrial port zone of Fos, also heavily urbanised. To perform the study, two tree species have been selected, Pinus halepensis and Populus nigra, on a rural plot located roughly 20 km away from the industrial harbour, an urban plot located in the city of Fos-sur-Mer and an industrial plot. Our study indicated that poplar was a more relevant model for the dendrochemical studies, exhibiting a higher bioaccumulation capacity than pine except for Hg, Sb and Mn. Moreover, thanks to this work, we observed significant exposure of the trees in the urban and industrial areas to As, Cd, Co, Cu, Mo, Sb, Zn, Al, Ca, and Mg, highlighting the exposure of the territory and populations living in the vicinity of the industrial harbour. The temporal variability of the concentrations measured in the tree rings corresponds to the increasing industrialisation of the territory as well as to the evolution of the industrial processes. Thus, this project highlighted the exposure of the Gulf of Fos to atmospheric emissions (industrial, road and urban) of the industrial harbour as well as the changes over time. It also pointed out the relevance of using dendrochemistry to measure atmospheric exposure of metals and metalloids and its temporal variability.

Rationale and design of Smart Walk: A randomized controlled pilot trial of a smartphone-delivered physical activity and cardiometabolic risk reduction intervention for African American women

BACKGROUND

African American (AA) women perform low levels of physical activity (PA) and are disproportionally burdened by cardiometabolic disease conditions when compared to White women and the U.S. population as a whole. These disparities emphasize the need for innovative and effective interventions to increase PA and reduce cardiometabolic disease risk among AA women. Recent evidence suggests that mobile health (mHealth) interventions have the potential to increase PA and reduce cardiometabolic disease risk factors. Few studies have examined the efficacy of mHealth PA interventions among racial/ethnic minorities, including AA women. This represents a missed opportunity given the reported success of technology-delivered PA interventions in predominately White populations and the high use of technology among AA women.

OBJECTIVE

To describe the design, theoretical rationale, and cultural relevance of Smart Walk, a culturally sensitive smartphone-delivered PA intervention for AA women.

DESIGN AND METHODS

Smart Walk is an 8-month, randomized controlled pilot trial designed to increase PA and reduce cardiometabolic disease risk among AA women. Sixty physically inactive AA women with obesity will be assigned to receive either a culturally relevant intervention designed to increase PA (by targeting leisure-time, household chore/task-related, and occupational PA) or a culturally relevant wellness attention-matched control condition. Outcomes will be assessed at baseline, 4 months, and 8 months, and include feasibility and acceptability of the PA intervention and evaluation of effects on PA and cardiometabolic risk factors.

SUMMARY

Smart Walk represents a culturally relevant, theory-based approach to promote PA and reduce cardiometabolic disease risk in AA women.

The ProSeal Laryngeal Mask Airway in Prone Patients: A Retrospective Audit of 245 Patients

The use of the classic laryngeal mask airway (classic LMA) in the prone position is controversial, but the ProSeal laryngeal mask airway (ProSeal LMA) maybe more suitable as it forms a better seal and provides access to the stomach. In the following retrospective audit, we describe our experience with the insertion of, and maintenance of anaesthesia with, the ProSeal LMA in 245 healthy adults in the prone position by experienced users. The technique involved (1) the patient adopting the prone position with the head to the side and the table tilted laterally; (2) preoxygenation to end-tidal oxygen >90%; (3) induction of anaesthesia with midazolam/alfentanil/propofol; (4) facemask ventilation (5) a single attempt at digital insertion and if unsuccessful a single attempt at laryngoscope-guided, gum elastic bougie-guided insertion; (6) gastric tube insertion; (7) maintenance of anaesthesia with sevoflurane/O2/N2O; (8) volume controlled ventilation at 8-12 ml/kg; (9) emergence from anaesthesia in the supine position; and (10) removal of the ProSeal LMA when awake. Facemask ventilation was always successful. ProSeal LMA insertion was successful in all patients: 237 with digital insertion and eight with bougie-guided insertion. Ventilation was successful in all patients. Gastric tube insertion was successful in all patients. Correctable partial airway obstruction occurred in three patients, but there was no hypoxia, hypercapnoea, displacement, regurgitation, gastric insufflation or airway reflex activation. Our findings suggest that the insertion of and maintenance of anaesthesia with the ProSeal LMA is feasible in the prone position by experienced users.

Residual Protein Contamination of ProSeal™ Laryngeal Mask Airways after Two Washing Protocols

The risk of prion protein cross-infection has focussed attention on the potential hazards of protein contamination of re-usable medical devices. This study determined the frequency of protein contamination of ProSeal™ laryngeal mask airways (PLMA) after two cleaning procedures and tested the hypothesis that the combination of hand- and machine-washing removes protein contamination more effectively than hand-washing alone. After clinical use fifty-four PLMAs were randomly allocated to be washed by hand or by hand then machine. All PLMAs were then autoclaved at 134°C for 4 minutes. After processing, each PLMA was immersed in a 1.2% solution of erythrosin B and examined for uptake of stain. The site (outer surface, bowl and edges of the cuff, airway and drain tube, finger strap) and severity (nil/mild/moderate/severe) of staining was scored by a blinded observer. There were no differences in the site or severity of staining between the two cleaning procedures. Staining was detected on 89% of PLMAs that were hand-washed and 78% of PLMAs that were hand-, then machine-washed (P=0.27). When staining occurred, it was mild in 98%, moderate in 2% and was never severe. Staining was more frequent on the edge than at any other location (all comparisons: P≤0.01). The strap never had any staining. We conclude that residual contamination of PLMAs with protein deposits is common even when machine-washing is used to augment hand-washing before autoclaving. The infection risk associated with these deposits remains to be determined.

Gum Elastic Bougie-guided Insertion of the ProSeal™ Laryngeal Mask Airway

We tested the hypothesis that gum elastic-bougie-guided insertion of the ProSeal™ Laryngeal Mask Airway is more frequently successful than introducer tool guided insertion after failed digital insertion. One hundred anaesthetized patients (ASA 1-2, aged 18 to 80 years) were randomized for the second insertion attempt using either the gum elastic bougie-guided or introducer tool techniques. The bougie-guided technique involved priming the drain tube with the bougie, placing the bougie in the oesophagus using laryngoscope guidance, digital insertion along the palato-pharyngeal curve, and bougie removal. The introducer tool technique involved attaching the introducer tool, single-handed rotation along the palatopharyngeal curve, and introducer tool removal. Failed insertion was classified as (i) failed passage into the pharynx, (ii) malposition, or (iii) ineffective ventilation. Any blood staining was documented. Insertion was more frequently successful (50/50 vs 15/50, P=0.0002) and faster (35±17s vs 54±45s, mean±SD, P=0.006) with the bougie-guided technique. All failed insertions with the introducer tool technique were successful with the bougie-guided technique. The aetiology of failed insertion was similar for the digital and introducer tool techniques in 94% (33/35) of patients. There was no blood staining on the bougie, laryngoscope or introducer tool at removal, but blood staining was more common on the Proseal laryngeal mask airway with the introducer tool technique (9/50 vs 2/50, P=0.03). We conclude that the gum elastic bougie-guided insertion has a higher success rate and causes less trauma than the insertion tool insertion technique after failed digital insertion of the Proseal Laryngeal Mask Airway.

Positive Pressure versus Pressure Support Ventilation at Different Levels of PEEP Using the ProSeal™ Laryngeal Mask Airway

We compared positive pressure ventilation with pressure support ventilation at different levels of positive end expiratory pressure (PEEP) using the ProSeal laryngeal mask airway (PLMA). Forty-two anaesthetized adults (ASA 1-2, aged 19 to 63 years) underwent positive pressure ventilation and then pressure support ventilation each with PEEP set at 0, 5 and 10 cmH2O in random order. Pressure support ventilation was with the inspired tidal volume (VTInsp) set at 7 ml/kg and the respiratory rate adjusted to maintain the end-tidal CO2 (ETCO2) at 40 mmHg. Pressure support ventilation was with pressure support set at 5 cmH2O above PEEP and initiated when inspiration produced a 2 cmH2O reduction in airway pressure. Tidal volumes were similar during positive pressure and pressure support ventilation with PEEP, but were higher for the former without PEEP. Respiratory rate and peak inspiratory flow rate were higher during pressure support than positive pressure ventilation (all P<0.001). Peak airway pressure (Ppaw), mean airway pressure (Mpaw), peak expiratory flow rate, and expired airway resistance were lower during pressure support than positive pressure ventilation (all P<0.001). With PEEP set at 10 cmH2O, ETCO2 was lower for pressure support than positive pressure ventilation. During positive pressure ventilation, there was an increase in Ppaw, Mpaw and dynamic compliance (Cdyn) with increasing levels of PEEP (all P<0.01). During pressure support ventilation, there was an increase in inspired and expired tidal volume, Ppaw, peak inspiratory and expiratory flow rates and Cdyn, and a reduction in ETCO2, work of breathing, and expired airway resistance with increasing levels of PEEP (all P<0.01). There were no differences in SpO2, non-invasive mean arterial pressure, heart rate or leak fraction. We conclude that pressure support ventilation provides equally effective gas exchange as positive pressure ventilation during PLMA anaesthesia with or without PEEP at the tested settings. During pressure support, PEEP increases ventilation and reduces work on breathing without increasing leak fraction.

Differential regulation of transcription by the NURR1/NUR77 subfamily of nuclear transcription factors

NURR1 is an orphan member of the nuclear receptor superfamily of transcription factors that shares close sequence homology to the orphan nuclear receptor and immediate early gene product NUR77(NGF1 beta). The physiological role of NURR1 has not been established in mammalian cells. However, the observation that NURR1 and NUR77 interact with at least one common enhancer element (AAAAGGTCA), together with their partly overlapping but differential expression patterns in mammalian tissues, suggests that these proteins may have both shared and independent transcription regulatory functions. To identify potential target genes that may be regulated by NURR1, we analyzed its DNA binding properties to potential cis-acting enhancer elements. Using point mutagenesis of the AAAAGGTCA motif, we have identified three additional sequences that bind specifically to both NURR1 and NUR77, one of which serves as a functional enhancer element. Comparative analysis of the transcription regulatory properties of NURR1 and NUR77 indicates that the proteins can display opposing transregulatory activities that are influenced by the specific cis-acting sequences to which they bind. Our results indicate that the transcriptional responses of specific target genes to the NURR1/NUR77 subfamily may be differentially regulated by the relative cellular levels of NURR1 and NUR77 and influenced by the specific enhancer sequences that mediate their activity. Finally, we have identified several potential target genes of neuronal and neuroendocrine origin whose promoters contain this element.

Piscine mycobacteriosis - Involvement of bacterial species and reflection in pathology

INTRODUCTION

Piscine mycobacteriosis is a lethal disease with zoonotic potential, found worldwide in both fresh and marine fish. More than 20 strains of Mycobacterium spp. are known to persist in fish so far, but the pathogenicity is currently unknown for most of them. However, M. marinum is reported as one of the most pathogenic agents for fish and is involved in zoonotic cases. We examined 47 different cases from two zoological gardens, where fish tuberculosis was identified or previously suspected during the last ten years. We collected PCR and sequencing data, which were then compared to previously collected clinical data and pathology. The clinical signs caused by Mycobacterium spp. were similar in all the cases, except for cases infected by M. marinum, which lacked the presence of skin lesions. Lesions seen in histology caused by M. marinum tended to be more acute and severe compared lesions caused by other Mycobacterium spp. The majority of M. marinum cases have been reported within marine fish. In contrast to previous studies we detected this species to be the predominant bacteria present within freshwater fish. Interestingly, we detected M. holsaticum in one of the seawater systems used in this project, being the first report of this Mycobacterium species shown to be present in a fish.

Interventions for Cardiovascular Disease Risk Reduction in Korean Americans: A Systematic Review

This systematic review was to identify and synthesize literature that described the cultural appropriateness and effectiveness of interventions aimed at cardiovascular risk reduction in Korean Americans. We searched multiple electronic databases for studies published between January 2000 and August 2017 and identified 14 eligible research reports. All reviewed studies targeted first-generation Korean American adults. Most of the reviewed studies incorporated components of surface structure, and leveraged deep structure in those interventions. Significant changes in cardiovascular health outcomes were reported in most of the reviewed studies; however, the role of cultural factors in the outcomes was rarely evaluated, and few reported long-term effects. Future research needs to consider long-term effects. Deploying cultural factors and evaluating their contributions to the target outcomes will enhance the research on cardiovascular health disparities.

Collaborative and partnership research for improvement of health and social services: researcher's experiences from 20 projects

BACKGROUND

Getting research into policy and practice in healthcare is a recognised, world-wide concern. As an attempt to bridge the gap between research and practice, research funders are requesting more interdisciplinary and collaborative research, while actual experiences of such processes have been less studied. Accordingly, the purpose of this study was to gain more knowledge on the interdisciplinary, collaborative and partnership research process by investigating researchers' experiences of and approaches to the process, based on their participation in an inventive national research programme. The programme aimed to boost collaborative and partnership research and build learning structures, while improving ways to lead, manage and develop practices in Swedish health and social services.

METHODS

Interviews conducted with project leaders and/or lead researchers and documentation from 20 projects were analysed using directed and conventional content analysis.

RESULTS

Collaborative approaches were achieved by design, e.g. action research, or by involving practitioners from several levels of the healthcare system in various parts of the research process. The use of dual roles as researcher/clinician or practitioner/PhD student or the use of education designed especially for practitioners or 'student researchers' were other approaches. The collaborative process constituted the area for the main lessons learned as well as the main problems. Difficulties concerned handling complexity and conflicts between different expectations and demands in the practitioner's and researcher's contexts, and dealing with human resource issues and group interactions when forming collaborative and interdisciplinary research teams. The handling of such challenges required time, resources, knowledge, interactive learning and skilled project management.

CONCLUSIONS

Collaborative approaches are important in the study of complex phenomena. Results from this study show that allocated time, arenas for interactions and skills in project management and communication are needed during research collaboration to ensure support and build trust and understanding with involved practitioners at several levels in the healthcare system. For researchers, dealing with this complexity takes time and energy from the scientific process. For practitioners, this puts demands on understanding a research process and how it fits with on-going organisational agendas and activities and allocating time. Some of the identified factors may be overlooked by funders and involved stakeholders when designing, performing and evaluating interdisciplinary, collaborative and partnership research.

Hair As a Barrier to Physical Activity among African American Women: A Qualitative Exploration

Background

African American (AA) women face unique sociocultural barriers to physical activity (PA) engagement. Such barriers may contribute to their low PA levels and high cardiometabolic disease burden. One particular barrier reported among AA women in recent research is that being physically active can have an undesirable effect on the hairstyles and hair maintenance of many AA women. However, the underlying mechanisms contributing to this barrier have not been fully elucidated. The purpose of this study is to explore hairstyle maintenance as a barrier to PA among AA women and to identify effective strategies to overcome this barrier in the design of a culturally relevant PA intervention.

Methods

A qualitative study design was used. Data were collected from the focus groups comprising 23 sedentary and obese AA women (median age = 38.1 years, median body mass index = 39.8 kg/m²). Content analysis was used to analyze these focus group data.

Results

Three key themes emerged from the qualitative narratives of participants: (1) impact of perspiration on hair and hairstyle maintenance, (2) image and social comparisons, and (3) solutions to overcome hair-related barriers to PA. For impact of perspiration and hairstyle maintenance, participants described how perspiring while engaging in PA negatively impacts many of their hairstyles. Participants further discussed how time and monetary burdens associated with PA-related hairstyle maintenance further contributed to this issue. Findings for the theme of image and social comparison focused on how an AA woman’s hairstyle is an important part of the image and the social comparisons made by non-AAs regarding the hairstyles and maintenance practices of AA women. For solutions to hairstyle maintenance barriers, participant described a variety of potential styling techniques that may help alleviate PA-related maintenance concerns, including braids, locks, and natural hairstyles. However, no styling technique was uniformly endorsed by all study participants.

Conclusion

Findings highlight the significance of hair in the AA community and provide further insight on appropriate intervention design strategies to overcome this sociocultural barrier to PA. Future research is needed to corroborate and further expand on our findings.

The Use of Family Rituals in Eating Behaviors in Hispanic Mothers

Food rituals often abruptly change when Hispanic families migrate to the United States. This report describes changes in rituals of food procurement, preparation, and presentation (food-PPP) in Hispanic women following migration to the United States. Focus groups and face-to-face interviews were conducted with 13 low-income, overweight/obese Hispanic women 27 to 40 years of age. Content analysis was used to analyze cultural and contextual sources for food-PPP. Changes in rituals and traditions in food-PPP occurred, including materials and ingredients for traditional meals. Food rituals may play a role in healthful eating and could, therefore, serve as leverage points for interventions designed to promote healthy eating behaviors.

Incorporating religion and spirituality into the design of community-based physical activity programs for African American women: a qualitative inquiry

Objective

Limited research has examined how aspects of religion and spirituality can be incorporated into community-based physical activity programs delivered outside of religious institutions. The purpose of this study was to qualitatively explore how spirituality and religion can be leveraged in the design of community-based physical activity programs for African American women delivered outside of faith-based or faith-placed settings.

Results

Three focus groups were conducted were conducted with 23 African American women (M age = 37.8 years, M BMI = 39.6 kg m²). Results showed that incorporating aspects of spirituality (i.e., words encouraging connectedness to a higher power, meditation, mind–body activities) into a physical activity program was universally accepted among participants, regardless of religious affiliation. In contrast, including concepts of religion (i.e., bible verses and/or quotes from religious leaders) was controversial and not recommended among women who did not identify with a religious faith. Findings indicate that when developing community-based physical activity interventions that will not be delivered through faith-based or faith-placed settings, researchers should avoid references to specific religious beliefs. Instead, interventions should focus on spirituality and emphasize the mind–body relationship between physical activity and an African American women’s inner-being and her connectedness with a higher power.

Trial Registration ClinicalTrials.gov NCT02823379. Registered July 1, 2016

Utility of Social Cognitive Theory in Intervention Design for Promoting Physical Activity among African-American Women: A Qualitative Study

OBJECTIVE

We examined the cultural relevance of Social Cognitive Theory (SCT) in the design of a physical activity intervention for African-American women.

METHODS

A qualitative study design was used. Twenty-five African-American women (Mean age = 38.5 years, Mean BMI = 39.4 kg·m2) were enrolled in a series of focus groups (N = 9) to elucidate how 5 SCT constructs (ie, Behavioral Capability, Outcome Expectations, Self-efficacy, Self-regulation, Social Support) can be culturally tailored in the design of a physical activity program for African-American women.

RESULTS

For the construct of Behavioral Capability, participants were generally unaware of the amount, intensity, and types of physical activity needed for health benefits. Outcome Expectations associated with physical activity included increased energy, improved health, weight loss, and positive role modeling behaviors. Constructs of Self-efficacy and Self-regulation were elicited through the women perceiving themselves as a primary barrier to physical activity. Participants endorsed the need of a strong social support component and identified a variety of acceptable sources to include in a physical activity program (ie, family, friends, other program participants).

CONCLUSIONS

Findings explicate the utility of SCT as a behavioral change theoretical basis for tailoring physical activity programs to African-American women.

Acculturation and Physical Activity Among Latinas Enrolled in a 12-Month Walking Intervention

This report evaluates the relationship between acculturation and assimilation with the physical activity (PA) outcomes of a 12-month walking intervention for postpartum Latinas ( n = 81, M age = 29.2 years, M BMI [body mass index] = 30.0). PA was measured by ActiGraph GT1M accelerometers. Acculturation and assimilation were measured by the Hazuda Acculturation and Assimilation Scales. Data were collected at baseline, 6 months, and 12 months. Results showed a trend for participants classified in the least acculturated groups to engage in more moderate-to-vigorous PA than participants classified in the higher acculturated/assimilated groups for two dimensions of acculturation (Adult Proficiency in English Versus Spanish, p = .002; Adult Pattern of English Versus Spanish Language Usage, p = .001) and two dimensions of assimilation (Childhood Interaction With Members of Mainstream Society, p = .028; Adult Functional Integration With Mainstream Society, p ≤ .001). No other significant effects were observed. Findings highlight the continued need to understand the context in which acculturation and assimilation influence PA.

Recruiting Participants into Pilot Trials

Limited research has focused on recruitment strategies for health promotion researchers conducting smallscale pilot studies. Such research is important because small studies often have limited funding streams and personnel resources. Accordingly, many techniques implemented by large-scale studies are of limited use to smaller research projects. This article provides an overview effective participant recruitment techniques for pilot studies with limited funds and personnel resources. Recruitment techniques were derived from the first author’s experience in recruiting participants during his doctoral and postdoctoral studies, the over 25 years of research experience of each of the co-authors, and an extensive review of the literature. Five key recruitment techniques are discussed: 1) leverage existing social networks and personal contacts, 2) identify and foster collaborations with community gatekeepers, 3) develop a comprehensive list of potential recruitment platforms and venues, 4) create recruitment materials that succinctly describe the purpose of the study, and 5) build respectful and trusting relationships with potential participants. Implementation of the proposed techniques can lead to enhanced recruitment, as well as retention among study participants.

Visual Methods in the Assessment of Diet Intake in Mexican American Women

Assessment of dietary intake is based largely on self-report or use of biomarkers. However, neither self-report nor biomarkers inform nurses of patterns in dietary intake in the context of gender, culture, and ethnicity. This article describes the relevance of visual methods focusing on the context of dietary intake in Mexican American women, illustrated by a formative study. A qualitative, descriptive, methodological design incorporating photo elicitation was used. The sample consisted of 7 Mexican American women, who took photographs of their food intake, food preparation, and context of food consumption, such as family gatherings, which were then described by the women. Data included participant photographs, the descriptions of why each image was obtained, and stories about the photographs. Visual methods were found to be a relevant and important addition to traditional dietary assessment methods, to enhance gender, cultural, and contextually relevant assessment of dietary intake in Mexican American women.

Self-Efficacy Intervention Effect on Physical Activity in Older Adults

This study determined the effectiveness of a self-efficacy intervention designed to improve selfefficacy and physical activity in older adults postcardiac event. An experimental three-group design tested the intervention, with treatment groups receiving 1 of 2 supportive telephone protocols (theory-based self-efficacy coaching or attention control). Outcome variables included selfefficacy expectations for physical activity (PA), self-reported PA, and PA performance (distance walked in 6 minutes). The self-efficacy intervention was effective in demonstrating greater PA performance when compared to the attention control intervention, and PA self-efficacy was significantly correlated with both measures of PA. There were significant main effects of time for PA self-efficacy and distance walked, and a significant interaction effect on the distance walked because of time and treatment condition. Although the self-efficacy intervention did not show a direct effect on level of PA self-efficacy as hypothesized, there was an indirect interaction effect on distance walked and physical activity confidence.

Designing Culturally Relevant Physical Activity Programs for African-American Women: A Framework for Intervention Development

BACKGROUND

African-American women perform low levels of physical activity and are disproportionally burdened by associated cardiometabolic disease conditions (i.e., 57 % are obese, 49 % have cardiovascular disease). The marked health disparities among African-American women indicate the need for innovative strategies to promote physical activity to help attenuate the chronic disease health disparities in this high-risk population. Culturally tailoring physical activity programs to address the sociocultural norms, values, beliefs, and behaviors of African-American women is an advantageous strategy to enhance physical activity promotion efforts. The purpose of this article is to discuss critical aspects for researchers to consider when designing physical activity programs for African-American women and to present a conceptual framework to guide intervention development.

METHODS

Development of the framework was based on our previous physical activity research with African-American women, seminal literature on the topics of cultural adaptation and health promotion, sociological and theoretical perspectives on the role of women in African-American culture, and key determinants of physical activity engagement among African-American women.

RESULTS

Three key concepts are discussed in the conceptual framework: (1) Developmental milestones and life stage transitions of African-American women; (2) Historical, social, and cultural influences associated with physical activity engagement; and (3) Intervention delivery strategies.

DISCUSSION

Using the framework to guide intervention development has the potential to enhance the physical activity and health outcomes of a physical activity program for African-American women.

Validity of two brief physical activity questionnaires with accelerometers among African-American women

AIM

To evaluate the validity of the Stanford Brief Activity Survey (SBAS) and Exercise Vital Sign (EVS) questionnaire against accelerometer-determined time in moderate-to-vigorous physical activity (MVPA) among African-American (AA) women.

BACKGROUND

Limited research has evaluated the validity of brief physical activity (PA) questionnaires among AA women. Since the validity of PA questionnaires may differ among members of varying racial/ethnic groups, research is needed to explore the validity of self-report PA measures among AA women.

METHODS

A total of 30 AA women [M age = 35.5 ± 5.3; M body mass index (BMI) = 31.1 ± 7.8] wore ActiGraph GT3X+ accelerometers (ActiGraph, LLC, Pensacola FL, USA) for seven days and completed both the SBAS and EVS at two different assessment periods (T1 and T2). Criterion validity was calculated using Spearman's rank order correlations between each questionnaire score and accelerometer-measured MVPA. Sensitivity, specificity, and positive and negative predictive values were calculated using accelerometer-measured MVPA as the criterion to determine the ability of each questionnaire to predict whether or not a participant was meeting the 2008 US PA Guidelines.

FINDINGS

Spearman correlation coefficients between questionnaire scores and minutes of accelerometer-measured MVPA were low (EVS, r = 0.27 at T1 and r = 0.26 at T2; SBAS, r = 0.10 at T1 and r = 0.28 at T2) and not statistically significant (P's > 0.05). The EVS had sensitivity, specificity, and negative and positive predictive values of 27, 89, 59, and 68% at T1 and 33, 74, 38, and 70% at T2, respectively. The SBAS had sensitivity, specificity, and negative and positive predictive values were 18, 79, 33, and 62% at T1 and 67, 58, 43, and 79% at T2. While both questionnaires may be useful in identifying AA women who do not meet the 2008 PA Guidelines, using the questionnaires to identify AA women meeting the PA Guidelines should be done with caution.

Recruiting Participants into Pilot Trials: Techniques for Researchers with Shoestring Budgets

Limited research has focused on recruitment strategies for health promotion researchers conducting small-scale pilot studies. Such research is important because small studies often have limited funding streams and personnel resources. Accordingly, many techniques implemented by large-scale studies are of limited use to smaller research projects. This article provides an overview effective participant recruitment techniques for pilot studies with limited funds and personnel resources. Recruitment techniques were derived from the first author's experience in recruiting participants during his doctoral and postdoctoral studies, the over 25 years of research experience of each of the co-authors, and an extensive review of the literature. Five key recruitment techniques are discussed: 1) leverage existing social networks and personal contacts, 2) identify and foster collaborations with community gatekeepers, 3) develop a comprehensive list of potential recruitment platforms and venues, 4) create recruitment materials that succinctly describe the purpose of the study, and 5) build respectful and trusting relationships with potential participants. Implementation of the proposed techniques can lead to enhanced recruitment, as well as retention among study participants.

Silicon alleviates Cd stress of wheat seedlings (Triticum turgidum L. cv. Claudio) grown in hydroponics

We investigated the potential role of silicon in improving tolerance and decreasing cadmium (Cd) toxicity in durum wheat (Triticum turgidum L. durum) either through a reduced Cd uptake or exclusion/sequestration in non-metabolic tissues. For this, plants were grown in hydroponic conditions for 10 days either in presence or absence of 1 mM Si and for 11 additional days in various Cd concentrations (0, 0.5, 5.0 and 50 μM). After harvesting, morphological and physiological parameters as well as elemental concentrations were recorded. Cadmium caused reduction in growth parameters, photosynthetic pigments and mineral nutrient concentrations both in shoots and roots. Shoot and root contents of malate, citrate and aconitate increased, while contents of phosphate, nitrate and sulphate decreased with increasing Cd concentrations in plants. Addition of Si to the nutrient solution mitigated these adverse effects: Cd concentration in shoots decreased while concentration of Cd adsorbed at the root cell apoplasmic level increased together with Zn uptake by roots. Overall, total Cd uptake decreased in presence of Si. There was no co-localisation of Cd and Si either at the shoot or at the root levels. No Cd was detected in leaf phytoliths. In roots, Cd was mainly detected in the cortical parenchyma and Si at the endodermis level, while analysis of the outer thin root surface of the plants grown in the 50 μM Cd + 1 mM Si treatment highlighted non-homogeneous Cd and Si enrichments. These data strongly suggest the existence of a root localised protection mechanism consisting in armoring the root surface by Si- and Cd-bearing compounds and in limiting root-shoot translocation.

Egg Intake and Dietary Quality among Overweight and Obese Mexican-American Postpartum Women

Despite their low cost and high nutrient density, the contribution of eggs to nutrient intake and dietary quality among Mexican-American postpartum women has not been evaluated. Nutrient intake and dietary quality, as assessed by the Healthy Eating Index 2010 (HEI-2010), were measured in habitually sedentary overweight/obese (body mass index (BMI) = 29.7 ± 3.5 kg/m²) Mexican-American postpartum women (28 ± 6 years) and compared between egg consumers (n = 82; any egg intake reported in at least one of three 24-h dietary recalls) and non-consumers (n = 57). Egg consumers had greater intake of energy (+808 kJ (193 kcal) or 14%; p = 0.033), protein (+9 g or 17%; p = 0.031), total fat (+9 g or 19%; p = 0.039), monounsaturated fat (+4 g or 24%; p = 0.020), and several micronutrients than non-consumers. Regarding HEI-2010 scores, egg consumers had a greater total protein foods score than non-consumers (4.7 ± 0.7 vs. 4.3 ± 1.0; p = 0.004), and trends for greater total fruit (2.4 ± 1.8 vs. 1.9 ± 1.7; p = 0.070) and the total composite HEI-2010 score (56.4 ± 12.6 vs. 52.3 ± 14.4; p = 0.082). Findings suggest that egg intake could contribute to greater nutrient intake and improved dietary quality among postpartum Mexican-American women. Because of greater energy intake among egg consumers, recommendations for overweight/obese individuals should include avoiding excessive energy intake and incorporating eggs to a nutrient-dense, fiber-rich dietary pattern.

Optimal Health (Spirit, Mind, and Body): A Feasibility Study Promoting Well-Being for Health Behavior Change

Faith-based programs have shown beneficial effects for health and behaviors. Few have specifically intervened on the spiritual, mental (i.e., stress), and physical dimensions of well-being combined for health and healthy behaviors (i.e., exercise and diet). The purpose of this report is to describe the feasibility of executing a spirituality-based health behavior change, program founded upon the Spiritual Framework of Coping. This study was a quasi-experimental one group pretest-posttest design. Feasibility objectives were assessed, and limited efficacy of pretest and posttest measures was analyzed using paired t test (p < .05). Acceptance of the program was positive, and modest demand was shown with initial interest and an average attendance of 78.7%. The program was successfully implemented as shown by meeting session objectives and 88% homework completion. The program was practical for the intended participants and was successfully integrated within the existing environment. Limited efficacy measures showed no pre-post changes. This study provided preliminary support for the design and further testing of the theoretical components of the Spiritual Framework of Coping that informed the program.

Utility of Acculturation in Physical Activity Research in Latina Adults

Latina adults in the United States have a disproportionately higher prevalence of chronic diseases related to low physical activity levels than non-Hispanic women. Literature indicates that acculturation may be a contributing factor to being physically active, but the extent of this association remains unclear. An integrative review of literature was conducted on studies that examined acculturation as it relates to physical activity in Latinas in the United States. Our review of 33 studies revealed inconsistent measurement and conceptualization of acculturation and physical activity across studies. Findings from this review reinforce the importance and continued use of acculturation by behavioral researchers; however, acculturation, as conceptualized in the studies reviewed, may not have had an influence on health as much as traditions, life patterns, and resources of Latinas.