scholarly journals A multi-level, multi-component obesity intervention (Obesity Prevention and Evaluation of InterVention Effectiveness in NaTive North Americans) decreases soda intake in Native American adults

2021 ◽  
pp. 1-11
Author(s):  
Leslie C Redmond ◽  
Brittany Jock ◽  
Fariba Kolahdooz ◽  
Sangita Sharma ◽  
Marla Pardilla ◽  
...  
Keyword(s):  
Native American ◽  
Primary Source ◽  
Post Intervention ◽  
Food Stores ◽  
Added Sugars ◽  
Sweetened Beverages ◽  
Obesity Intervention ◽  
Intervention Impact ◽  
Multi Level ◽  
The Impact

Abstract Objective: To evaluate the impact of a multi-level, multi-component (MLMC) adult obesity intervention on beverage intake in Native American adults living in five geographically and culturally diverse tribal communities. Design: A 14-month, community-randomised, MLMC design was utilised, with three communities randomised to Intervention and two communities randomised to Comparison. FFQ were administered pre- and post-interventions, and difference-in-differences (DiD) analysis was used to assess intervention impact on beverage intake. Setting: The intervention took place within food stores, worksites, schools and selected media outlets located in the five communities. Key activities included working with store owners to stock healthy beverages, display and dispersal of educational materials, support of policies that discouraged unhealthy beverage consumption at worksites and schools and taste tests. Participants: Data were collected from 422 respondents between the ages of 18 and 75 living in the five communities pre-intervention; of those, 299 completed post-intervention surveys. Only respondents completing both pre- and post-intervention surveys were included in the current analysis. Results: The DiD for daily servings of regular, sugar-sweetened soda from pre- to post-intervention was significant, indicating a significant decrease in Intervention communities (P < 0·05). No other changes to beverage intake were observed. Conclusions: Large, MLMC obesity interventions can successfully reduce the intake of regular, sugar-sweetened soda in Native American adults. This is important within modern food environments where sugar-sweetened beverages are a primary source of added sugars in Native American diets.

scholarly journals Purchasing patterns in low-income neighbourhoods: implications for studying sugar-sweetened beverage taxes

2019 ◽  
Vol 22 (10) ◽  
pp. 1807-1814 ◽  
Author(s):  
Kristine A Madsen ◽  
Jennifer Falbe ◽  
Gabriella Olgin ◽  
Ana Ibarra-Castro ◽  
Nadia Rojas
Keyword(s):  
Low Income ◽  
Primary Source ◽  
Sugar Sweetened Beverage ◽  
Bay Area ◽  
Sweetened Beverages ◽  
Wide Range ◽  
Corner Stores ◽  
Discount Stores ◽  
Purchasing Patterns ◽  
The Impact

AbstractObjectiveThe present study aimed to determine the store types from which people in low-income neighbourhoods purchase most sugar-sweetened beverages (SSB) and to identify associations between purchasing location and demographic characteristics.DesignStreet-intercept surveys of passers-by near high foot-traffic intersections in 2016. Participants completed a beverage frequency questionnaire and identified the type of store (e.g. corner store, chain grocery) from which they purchased most SSB.SettingEight low-income neighbourhoods in four Bay Area cities, California, USA.ParticipantsSample of 1132 individuals who reported consuming SSB, aged 18–88 years, who identified as African-American (41 %), Latino (29 %), White (17 %) and Asian (6 %).ResultsBased on surveys in low-income neighbourhoods, corner stores were the primary source from which most SSB were purchased (28 %), followed by discount stores (18 %) and chain groceries (16 %). In fully adjusted models, those with lower education were more likely to purchase from corner stores or discount groceries than all other store types. Compared with White participants, African-Americans purchased more frequently from corner stores, discount groceries and chain groceries while Latinos purchased more frequently from discount groceries.ConclusionsThe wide range of store types from which SSB were purchased and demographic differences in purchasing patterns suggest that broader methodological approaches are needed to adequately capture the impact of SSB taxes and other interventions aimed at reducing SSB consumption, particularly in low-income neighbourhoods.

The Doctor Faustus Dossier

2018 ◽  
Author(s):  
Adrian Daub
Keyword(s):  
Twentieth Century ◽  
Los Angeles ◽  
Primary Source ◽  
Music And Literature ◽  
Twentieth Century Music ◽  
Private And Public ◽  
Doctor Faustus ◽  
Public Lives ◽  
Nazi Era ◽  
The Impact

Arnold Schoenberg and Thomas Mann, two towering figures of twentieth-century music and literature, both found refuge in the German-exile community in Los Angeles during the Nazi era. This complete edition of their correspondence provides a glimpse inside their private and public lives and culminates in the famous dispute over Mann's novel Doctor Faustus. In the thick of the controversy was Theodor Adorno, then a budding philosopher, whose contribution to the Faustus affair would make him an enemy of both families. Gathered here for the first time in English, the letters are complemented by diary entries, related articles, and other primary source materials, as well as an introduction that contextualizes the impact that these two great artists had on twentieth-century thought and culture.

Toxic Political Leadership and the Problems of Professionals in Free State Municipalities

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
David Matheakuena Mohale
Keyword(s):  
Good Governance ◽  
Political Leadership ◽  
Primary Source ◽  
Free State ◽  
Audit Report ◽  
Theoretical Understanding ◽  
Number Of Factors ◽  
Auditor General ◽  
Appointed Officials ◽  
The Impact

The 2016–17 Audit Report by the Auditor General points to the deterioration in audit results of South African municipalities. This deterioration confirms the perennial dysfunctionality of municipalities, at least from the governance perspective. Corporate governance is a function of leadership. Municipal councils are, therefore, responsible for the overall performance of municipalities they lead. Sound regulatory framework, good plans, clear strategies, policies, and systems are inadequate if not supported by highly gifted and ethical leadership. The Auditor General’s Audit Report suggests that local government struggles the most in the area of ethics. The Principal-Agent Theory argues that appointed officials are more likely to subvert the interests of an organisation. However, this article argues that the primary source of problems in municipalities is a combination of ineptitude and unethical political leadership taking root. This conclusion is based on the empirical comparative cases of eight municipalities in the Free State Province.  The conduct of councillors makes it difficult to attract and retain professionals in municipalities, resulting in notable deficiencies in the delivery of services. Essentially, councillors are the root cause for governance failure in municipalities arising from a number of factors. Findings in this study contribute towards the understanding of the impact of leadership in the failure of municipalities to meet good governance and developmental objectives. Further, they deepen the theoretical understanding of the political-administrative interface.

Thermal-aware Output Polarity Selection Based on And-Inverter Graph Manipulation

2019 ◽  
Vol 12 (1) ◽  
pp. 30-39 ◽  
Author(s):  
Apangshu Das ◽  
Sambhu Nath Pradhan
Keyword(s):  
Integrated Circuits ◽  
Power Density ◽  
Logic Synthesis ◽  
Programmable Logic Arrays ◽  
Power Switching ◽  
Nsga Ii ◽  
Multi Level ◽  
Search Approach ◽  
Efficient Power ◽  
The Impact

Background: Output polarity of the sub-function is generally considered to reduce the area and power of a circuit at the two-level realization. Along with area and power, the power-density is also one of the significant parameter which needs to be consider, because power-density directly converges to circuit temperature. More than 50% of the modern day integrated circuits are damaged due to excessive overheating. Methods: This work demonstrates the impact of efficient power density based logic synthesis (in the form of suitable polarity selection of sub-function of Programmable Logic Arrays (PLAs) for its multilevel realization) for the reduction of temperature. Two-level PLA optimization using output polarity selection is considered first and compared with other existing techniques and then And-Invert Graphs (AIG) based multi-level realization has been considered to overcome the redundant solution generated in two-level synthesis. AIG nodes and associated power dissipation can be reduced by rewriting, refactoring and balancing technique. Reduction of nodes leads to the reduction of the area but on the contrary increases power and power density of the circuit. A meta-heuristic search approach i.e., Nondominated Sorting Genetic Algorithm-II (NSGA-II) is proposed to select the suitable output polarity of PLA sub-functions for its optimal realization. Results: Best power density based solution saves up to 8.29% power density compared to ‘espresso – dopo’ based solutions. Around 9.57% saving in area and 9.67% saving in power (switching activity) are obtained with respect to ‘espresso’ based solution using NSGA-II. Conclusion: Suitable output polarity realized circuit is converted into multi-level AIG structure and synthesized to overcome the redundant solution at the two-level circuit. It is observed that with the increase in power density, the temperature of a particular circuit is also increases.

scholarly journals Metagenomic Analysis of the Fecal Archaeome in Suckling Piglets Following Perinatal Tulathromycin Metaphylaxis

Animals ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1825
Author(s):  
Mohamed Zeineldin ◽  
Ameer Megahed ◽  
Benjamin Blair ◽  
Brian Aldridge ◽  
James Lowe
Keyword(s):  
Sequencing Analysis ◽  
Metagenomic Sequencing ◽  
Post Intervention ◽  
Gastrointestinal Microbiome ◽  
Health And Wellbeing ◽  
Suckling Piglets ◽  
And Function ◽  
Changes Over Time ◽  
And Control ◽  
The Impact

The gastrointestinal microbiome plays an important role in swine health and wellbeing, but the gut archaeome structure and function in swine remain largely unexplored. To date, no metagenomics-based analysis has been done to assess the impact of an early life antimicrobials intervention on the gut archaeome. The aim of this study was to investigate the effects of perinatal tulathromycin (TUL) administration on the fecal archaeome composition and diversity in suckling piglets using metagenomic sequencing analysis. Sixteen litters were administered one of two treatments (TUL; 2.5 mg/kg IM and control (CONT); saline 1cc IM) soon after birth. Deep fecal swabs were collected from all piglets on days 0 (prior to treatment), 5, and 20 post intervention. Each piglet’s fecal archaeome was composed of rich and diverse communities that showed significant changes over time during the suckling period. At the phylum level, 98.24% of the fecal archaeome across all samples belonged to Euryarchaeota. At the genus level, the predominant archaeal genera across all samples were Methanobrevibacter (43.31%), Methanosarcina (10.84%), Methanococcus (6.51%), and Methanocorpusculum (6.01%). The composition and diversity of the fecal archaeome between the TUL and CONT groups at the same time points were statistically insignificant. Our findings indicate that perinatal TUL metaphylaxis seems to have a minimal effect on the gut archaeome composition and diversity in sucking piglets. This study improves our current understanding of the fecal archaeome structure in sucking piglets and provides a rationale for future studies to decipher its role in and impact on host robustness during this critical phase of production.

Care of children with type 1 diabetes mellitus in school – An interventional study

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Umamaheswari Gurunathan ◽  
Hemchand Krishna Prasad ◽  
Sherline White ◽  
Bala Prasanna ◽  
Thangavelu Sangaralingam
Keyword(s):  
Type 1 Diabetes ◽  
Education Program ◽  
School Teachers ◽  
Post Intervention ◽  
Community Based ◽  
Structured Education ◽  
Type 1 Dm ◽  
The Impact ◽  
Determining Factor

AbstractObjectivesPaucity of data from India on care of children with Type 1 diabetes in schools. Aims: To study assess the knowledge, attitude, practices and fear of Type 1 diabetes in school teachers and to assess the impact of an educational model on the fear of teachers and care of children in Type 1 DM at school hours.MethodsA community based study, involving school teachers and the intervention being educating them about diabetes conducted. Data pertaining to basic demography, attitude of teachers towards diabetic children, Hypoglycemia fear factor survey- parent version with worries domain and preparedness of school was collected. An education program was conducted on diabetes care in children. Immediately and after three months, the proforma details and HFSP-W scores reassessed.ResultsForty two teachers (mean age: 38.7±5.4; M:F ratio 2:40) participated in the study. Post intervention, a higher willingness to have the diabetic child in class (100 vs. 57.1%; p>0.05), better support in daily care (100 vs. 92%; p>0.05), participation in sports activities (100 vs. 7.1%; p<0.05) observed. HFSP-W scores were 38.8±4.5 (pre-intervention), 22.5±4.3 (immediate post intervention) and 29.5±3.2 (at 3months) (p<0.05). To study the determinants of improvement in HFSP-W a regression analysis was performed: presence of glucometer the most likely determining factor (T=1.999, p=0.05).ConclusionThere is a significant element of fear in the minds of teachers towards hypoglycemia which improves with a structured education program.

scholarly journals 87. Utilization of Methicillin-Sensitive/Resistant Staphylococcus aureus Nares Screen to Decrease Vancomycin and Linezolid Use in Hospitalized Patients with Respiratory Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S60-S60
Author(s):  
Noor F Zaidan ◽  
Rachel S Britt ◽  
David Reynoso ◽  
R Scott Ferren
Keyword(s):  
Staphylococcus Aureus ◽  
Respiratory Infections ◽  
Intervention Group ◽  
Kidney Injury ◽  
Post Intervention ◽  
Gram Positive ◽  
Stewardship Program ◽  
Screening Protocol ◽  
The Impact ◽  
Post Intervention Group

Abstract Background Pharmacist-driven protocols for utilization of methicillin-resistant Staphylococcus aureus (MRSA) nares screenings have shown to decrease duration of empiric gram-positive therapy and rates of acute kidney injury (AKI) in patients with respiratory infections. This study evaluated the impact of a pharmacist-driven MRSA nares screening protocol on duration of vancomycin or linezolid therapy (DT) in respiratory infections. Methods Patients aged 18 years and older with a medication order of vancomycin or linezolid for respiratory indication(s) were included. The MRSA nares screening protocol went into effect in October 2019. The protocol allowed pharmacists to order an MRSA nares polymerase chain reaction (PCR) for included patients, while the Antimicrobial Stewardship Program (ASP) made therapeutic recommendations for de-escalation of empiric gram-positive coverage based on negative MRSA nares screenings, if clinically appropriate. Data for the pre-intervention group was collected retrospectively for the months of October 2018 to March 2019. The post-intervention group data was collected prospectively for the months of October 2019 to March 2020. Results Ninety-seven patients were evaluated within both the pre-intervention group (n = 50) and post-intervention group (n = 57). Outcomes for DT (38.2 hours vs. 30.9 hours, P = 0.601) and AKI (20% vs. 14%, P = 0.4105) were not different before and after protocol implementation. A subgroup analysis revealed a significant reduction in DT within the pre- and post-MRSA PCR groups (38.2 hours vs. 24.8 hours, P = 0.0065) when pharmacist recommendations for de-escalation were accepted. Conclusion A pharmacist-driven MRSA nares screening protocol did not affect the duration of gram-positive therapy for respiratory indications. However, there was a reduction in DT when pharmacist-driven recommendations were accepted. Disclosures All Authors: No reported disclosures

scholarly journals 1346. Implementation of a Multidisciplinary 48 Hour Antibiotic Timeout in a Pediatric Population

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S684-S684
Author(s):  
Victoria Konold ◽  
Palak Bhagat ◽  
Jennifer Pisano ◽  
Natasha N Pettit ◽  
Anish Choksi ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Pediatric Population ◽  
Intervention Group ◽  
Post Intervention ◽  
Days Of Therapy ◽  
New Antibiotics ◽  
Core Elements ◽  
Quasi Experimental ◽  
Empirical Antibiotics ◽  
The Impact

Abstract Background To meet the core elements required for antimicrobial stewardship programs, our institution implemented a pharmacy-led antibiotic timeout (ATO) process in 2017 and a multidisciplinary ATO process in 2019. An antibiotic timeout is a discussion and review of the need for ongoing empirical antibiotics 2-4 days after initiation. This study sought to evaluate both the multidisciplinary ATO and the pharmacy-led ATO in a pediatric population, compare the impact of each intervention on antibiotic days of therapy (DOT) to a pre-intervention group without an ATO, and to then compare the impact of the pharmacy-led ATO versus multidisciplinary ATO on antibiotic days of therapy (DOT). Methods This was a retrospective, pre-post, quasi-experimental study of pediatric patients comparing antibiotic DOT prior to ATO implementation (pre-ATO), during the pharmacy-led ATO (pharm-ATO), and during the multidisciplinary ATO (multi-ATO). The pre-ATO group was a patient sample from February-September 2016, prior to the initiation of a formal ATO. The pharmacy-led ATO was implemented from February-September 2018. This was followed by a multidisciplinary ATO led by pediatric residents and nurses from February-September 2019. Both the pharm-ATO and the multi-ATO were implemented as an active non-interruptive alert added to the electronic health record patient list. This alert triggered when new antibiotics had been administered to the patient for 48 hours, at which time, the responsible clinician would discuss the antibiotic and document their decision via the alert workspace. Pediatric patients receiving IV or PO antibiotics administered for at least 48 hours were included. The primary outcome was DOT. Secondary outcomes included length of stay (LOS) and mortality. Results 1284 unique antibiotic orders (n= 572 patients) were reviewed in the pre-ATO group, 868 (n= 323 patients) in the pharm-ATO and 949 (n= 305 patients) in the multi-ATO groups. Average DOT was not significantly different pre vs post intervention for either methodology (Table 1). Mortality was similar between groups, but LOS was longer for both intervention groups (Table 1). Impact of an ATO on DOT, Mortality and LOS Conclusion An ATO had no impact on average antibiotic DOT in a pediatric population, regardless of the ATO methodology. Disclosures All Authors: No reported disclosures

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