RESUMO
This study explores how adolescents engage with unhealthy food and beverage marketing in online settings, from a gender perspective. Employing an online ethnography approach and using go-along interviews, we explored the experiences of adolescent boys and girls aged 13-17 as they navigated their online experiences with digital food and beverage marketing. Notable themes emerged, including the identification of predatory actions by food companies, the role of protective factors such as family, and the influence of social media influencers in shaping adolescent dietary preferences. Importantly, this research unearthed gender disparities in the participants' responses. Girls, in particular, exhibited a heightened awareness of the protective role played by their families, emphasized the influence of color in marketing strategies, recognized the significance of gender in marketing, and reported exposure to alcohol advertisements-findings that boys less frequently echoed. The study underscores the importance of adolescence as a critical phase in development, during which food companies target these impressionable individuals, driven by their independence and potential for brand loyalty. Moreover, it highlights the potential avenue of gender-specific marketing, offering valuable insights into the gendered dimensions of adolescents' food marketing experiences. By examining the interplay between digital food marketing and gender, this research addresses a critical gap in the literature, shedding light on how gender influences adolescents' perceptions, responses, and behaviors in the context of food marketing strategies. These findings have the potential to inform adolescents of the marketing techniques that target them and guide policymakers in developing and implementing evidence-based regulations aimed at safeguarding adolescents from exposure to unhealthy food marketing.
Assuntos
Alimentos , Marketing , Masculino , Feminino , Adolescente , Humanos , Fatores Sexuais , Marketing/métodos , Bebidas , Dieta , Indústria AlimentíciaRESUMO
BACKGROUND: The COVID-19 pandemic and the associated economic recession has increased parental psychosocial stress and mental health challenges. This has adversely impacted child development and wellbeing, particularly for children from priority populations (culturally and linguistically diverse (CALD) and rural/regional communities) who are at an already increased risk of health inequality. The increased mental health and psychosocial needs were compounded by the closure of in-person preventive and health promotion programs resulting in health organisations embracing technology and online services. Watch Me Grow- Electronic (WMG-E) - developmental surveillance platform- exemplifies one such service. WMG-E was developed to monitor child development and guide parents towards more detailed assessments when risk is identified. This Randomised Controlled Trial (RCT) aims to expand WMG-E as a digital navigation tool by also incorporating parents' mental health and psychosocial needs. Children and families needing additional assessments and supports will be electronically directed to relevant resources in the 'care-as-usual' group. In contrast, the intervention group will receive continuity of care, with additional in-person assessment and 'warm hand over' by a 'service navigator' to ensure their needs are met. METHODS: Using an RCT we will determine: (1) parental engagement with developmental surveillance; (2) access to services for those with mental health and social care needs; and (3) uptake of service recommendations. Three hundred parents/carers of children aged 6 months to 3 years (recruited from a culturally diverse, or rural/regional site) will be randomly allocated to the 'care-as-usual' or 'intervention' group. A mixed methods implementation evaluation will be completed, with semi-structured interviews to ascertain the acceptability, feasibility and impact of the WMG-E platform and service navigator. CONCLUSIONS: Using WMG-E is expected to: normalise and de-stigmatise mental health and psychosocial screening; increase parental engagement and service use; and result in the early identification and management of child developmental needs, parental mental health, and family psychosocial needs. If effective, digital solutions such as WMG-E to engage and empower parents alongside a service navigator for vulnerable families needing additional support, will have significant practice and policy implications in the pandemic/post pandemic period. TRIAL REGISTRATION: The trial (Protocol No. 1.0, Version 3.1) was registered with ANZCTR (registration number: ACTRN12621000766819 ) on July 21st, 2021 and reporting of the trial results will be according to recommendations in the CONSORT Statement.
Assuntos
COVID-19 , Desenvolvimento Infantil , Criança , Eletrônica , Humanos , Saúde Mental , Pais , Ensaios Clínicos Controlados Aleatórios como Assunto , SARS-CoV-2RESUMO
This review synthesized evidence from controlled studies pertaining to the impact of targeted policies on anthropometric, dietary and physical activity outcomes amongst socioeconomically disadvantaged children and adults. Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity guidelines were followed. Eligible studies were published from 2004 to August 2015 and examined the impact of targeted policies on anthropometric, dietary and physical activity outcomes amongst socioeconomically disadvantaged populations. Twenty articles (18 studies) were included. Eight studies examined organizational policies within multi-component interventions in schools. Common elements of successful policy-containing interventions included nutritional standards, enhancements to physical education, additional physical activity opportunities, school self-assessments, and nutrition and physical activity education. Of the 10 studies of government policies, policies providing information/education and fruit and vegetable subsidies had positive impacts amongst children, but no impact amongst adults. Policies involving changes to built environments yielded nearly uniformly null findings in children and adults. Overall, the largest quantity of high-quality evidence of effectiveness was for comprehensive interventions that included school policies, and government policies targeting disadvantaged children in schools. None of the government policies targeting disadvantaged adults proved effective. Interventions during childhood may ameliorate negative obesity-related manifestations of socioeconomic disadvantage. Gaps in knowledge remain surrounding effective policies in adults, adolescents and very young children.
Assuntos
Comportamentos Relacionados com a Saúde , Política de Saúde , Obesidade/prevenção & controle , Fatores Socioeconômicos , Populações Vulneráveis , Adolescente , Adulto , Criança , Pré-Escolar , Dieta , Exercício Físico , Preferências Alimentares , Educação em Saúde , Humanos , Política Nutricional , Obesidade/psicologia , Obesidade/terapiaRESUMO
INTRODUCTION: Overweight and obesity are influenced by a complex interplay of individual and environmental factors that affect physical activity and healthy eating. Nevertheless, little has been reported on people's perceptions of those factors. Addressing this critical gap and community partner needs, this study explored how people perceived the influence of micro- and macroenvironmental factors on physical activity and healthy eating. METHODS: Community partners wanted the study results in a format that would be readily and easily used by local decision makers. We used photovoice to engage 35 community members across four municipalities in Alberta, Canada, and to share their narratives about their physical activity and healthy eating. A combination of inductive and deductive analysis categorized data by environmental level (micro vs. macro) and type (physical, political, economic, and sociocultural), guided by the Analysis Grid for Environments Linked to Obesity Framework. RESULTS: Participants conceptualized health-influencing factors more broadly than physical activity and healthy eating to include "community social health." Participants spoke most often about the influence of the microenvironment (n = 792 ANGELO Framework coding tallies) on their physical activity, healthy eating and community social health in comparison to the macroenvironment (n = 93). Photovoice results provided a visual narrative to community partners and decision makers about how people's ability to make healthy choices can be limited by macroenvironmental forces beyond their control. CONCLUSION: Focussing future research on macro- and microenvironmental influences and localized community social health can inform practice by providing strategies on how to implement healthy changes within communities, while ensuring that research and interventions echo diverse people's perceptions.
INTRODUCTION: Le surpoids et l'obésité dépendent de l'interaction complexe entre facteurs liés à l'indivu et facteurs liés à l'environnement ayant une influence sur l'activité physique et une alimentation saine. Il existe pourtant peu d'information sur les perceptions des individus à l'égard de ces facteurs. Afin de combler cette lacune importante et de répondre aux besoins de nos partenaires des collectivités, nous examinons comment les individus perçoivent l'influence des facteurs micro- et macroenvironnementaux sur leur activité physique et leur alimentation. MÉTHODOLOGIE: Nos partenaires des collectivités souhaitaient que les résultats de l'étude soient diffusés dans un format facile à utiliser par les décideurs locaux. Avec la méthode photovoix, nous avons motivé 35 membres issus de quatre collectivités de l'Alberta (Canada) à fournir leurs témoignages à propos de leur activité physique et d'une alimentation saine. Nous avons employé une combinaison d'analyses inductives et déductives pour classer les données par niveau (micro et macro) d'environnement et par type (environnement physique, politique, économique et socioculturel), à l'aide de la Grille d'analyse des environnements liés à l'obésité (ANGELO). RÉSULTATS: Pour les participants, les facteurs liés à la santé étaient plus larges que l'activité physique et une alimentation saine, incluant la « santé sociocommunautaire ¼. Les participants ont parlé plus souvent de l'influence du microenvironnement (score de 792 après codage au moyen du cadre ANGELO) sur l'activité physique, une alimentation saine ou la santé sociocommunautaire que sur l'influence du macroenvironnement (score de 93). Les résultats obtenus avec la méthode photovoix ont fourni aux partenaires des collectivités et aux décideurs un témoignage visuel de la manière dont la capacité des individus à faire des choix sains peut être restreinte par des forces macroenvironnementales qui échappent à leur contrôle. CONCLUSION: Axer les recherches ultérieures sur les influences et macroenvironnementales et microenvironnementales ainsi que sur la santé sociocommunautaire locale sera utile, car cela alimentera les stratégies de changement en vue d'améliorer la santé des collectivités tout en garantissant que la recherche et les interventions font écho aux perceptions diverses de la population.
Assuntos
Meio Ambiente , Obesidade , Condicionamento Físico Humano , Adulto , Alberta/epidemiologia , Integração Comunitária/psicologia , Integração Comunitária/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/epidemiologia , Obesidade/prevenção & controle , Obesidade/psicologia , Condicionamento Físico Humano/psicologia , Condicionamento Físico Humano/estatística & dados numéricos , Percepção SocialRESUMO
Genomic lesions are not investigated during routine diagnostic workup for multiple myeloma (MM). Cytogenetic studies are performed to assess prognosis but with limited impact on therapeutic decisions. Recently, several recurrently mutated genes have been described, but their clinical value remains to be defined. Therefore, clinical-grade strategies to investigate the genomic landscape of myeloma samples are needed to integrate new and old prognostic markers. We developed a target-enrichment strategy followed by next-generation sequencing (NGS) to streamline simultaneous analysis of gene mutations, copy number changes and immunoglobulin heavy chain (IGH) translocations in MM in a high-throughput manner, and validated it in a panel of cell lines. We identified 548 likely oncogenic mutations in 182 genes. By integrating published data sets of NGS in MM, we retrieved a list of genes with significant relevance to myeloma and found that the mutational spectrum of primary samples and MM cell lines is partially overlapping. Gains and losses of chromosomes, chromosomal segments and gene loci were identified with accuracy comparable to conventional arrays, allowing identification of lesions with known prognostic significance. Furthermore, we identified IGH translocations with high positive and negative predictive value. Our approach could allow the identification of novel biomarkers with clinical relevance in myeloma.
Assuntos
Variações do Número de Cópias de DNA , Cadeias Pesadas de Imunoglobulinas/genética , Mieloma Múltiplo/genética , Mutação , Translocação Genética , Alelos , Linhagem Celular Tumoral , Frequência do Gene , Rearranjo Gênico de Cadeia Pesada de Linfócito B , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Perda de Heterozigosidade , Reprodutibilidade dos TestesRESUMO
This systematic review examined the impact of universal policies on socioeconomic inequities in obesity, dietary and physical activity behaviours among adults and children. PRISMA-Equity guidelines were followed. Database searches spanned from 2004 to August 2015. Eligible studies assessed the impact of universal policies on anthropometric, dietary or physical activity-related outcomes in adults or children according to socioeconomic position. Thirty-six studies were included. Policies were classified as agentic, agento-structural or structural, and their impact on inequities was rated as positive, neutral, negative or mixed according to the dominant associations observed. Most policies had neutral impacts on obesity-related inequities regardless of whether they were agentic (60% neutral), agento-structural (68% neutral) or structural (67% neutral). The proportion of positive impacts was similar across policy types (10% agentic, 18% agento-structural and 11% structural), with some differences for negative impacts (30% agentic, 14% agento-structural and 22% structural). The majority of associations remained neutral when stratified by participant population, implementation level and socioeconomic position measures and by anthropometric and behavioural outcomes. Fiscal measures had consistently neutral or positive impacts on inequities. Findings suggest an important role for policy in addressing obesity in an equitable manner and strengthen the case for implementing a broad complement of policies spanning the agency-structure continuum.
Assuntos
Política de Saúde , Obesidade/epidemiologia , Obesidade/prevenção & controle , Obesidade Infantil/epidemiologia , Obesidade Infantil/prevenção & controle , Fatores Socioeconômicos , Adulto , Criança , Dieta , Exercício Físico , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
AIMS/HYPOTHESIS: Gut microbiota (GM) and diet both appear to be important in the pathogenesis of type 1 diabetes. Fermentable fibres (FFs), of which there is an ample supply in natural, diabetes-promoting diets, are used by GM as a source of energy. Our aim was to determine whether FFs modify GM and diabetes incidence in the NOD mouse. METHODS: Female NOD mice were weaned to a semisynthetic diet and the effects of FF supplementation on diabetes incidence and insulitis were evaluated. Real-time quantitative PCR was employed to determine the effects imposed to gene transcripts in the colon and lymph nodes. Changes to GM were analysed by next-generation sequencing. RESULTS: NOD mice fed semisynthetic diets free from FFs were largely protected from diabetes while semisynthetic diets supplemented with the FFs pectin and xylan (PX) resulted in higher diabetes incidence. Semisynthetic diet free from FFs altered GM composition significantly; addition of PX changed the composition of the GM towards that found in natural-diet-fed mice and increased production of FF-derived short-chain fatty acid metabolites in the colon. The highly diabetogenic natural diet was associated with expression of proinflammatory and stress-related genes in the colon, while the semisynthetic diet free from FFs promoted Il4, Il22, Tgfß and Foxp3 transcripts in the colon and/or pancreatic lymph node. PX in the same diet counteracted these effects and promoted stress-related IL-18 activation in gut epithelial cells. 16S RNA sequencing revealed each diet to give rise to its particular GM composition, with different Firmicutes to Bacteroidetes ratios, and enrichment of mucin-degrading Ruminococcaceae following diabetes-protective FF-free diet. CONCLUSIONS/INTERPRETATION: FFs condition microbiota, affect colon homeostasis and are important components of natural, diabetes-promoting diets in NOD mice.
Assuntos
Colo/microbiologia , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/microbiologia , Microbiota/efeitos dos fármacos , Pectinas/farmacologia , Xilanos/farmacologia , Animais , Diabetes Mellitus Tipo 1/induzido quimicamente , Feminino , Trato Gastrointestinal/microbiologia , Fator 3-gama Nuclear de Hepatócito/metabolismo , Interleucina-18/metabolismo , Interleucina-4/metabolismo , Interleucinas/metabolismo , Linfonodos/microbiologia , Camundongos , Camundongos Endogâmicos NOD , Fator de Crescimento Transformador beta/metabolismo , Interleucina 22RESUMO
BACKGROUND: Somatic mutations in the Janus kinase 2 gene (JAK2) occur in many myeloproliferative neoplasms, but the molecular pathogenesis of myeloproliferative neoplasms with nonmutated JAK2 is obscure, and the diagnosis of these neoplasms remains a challenge. METHODS: We performed exome sequencing of samples obtained from 151 patients with myeloproliferative neoplasms. The mutation status of the gene encoding calreticulin (CALR) was assessed in an additional 1345 hematologic cancers, 1517 other cancers, and 550 controls. We established phylogenetic trees using hematopoietic colonies. We assessed calreticulin subcellular localization using immunofluorescence and flow cytometry. RESULTS: Exome sequencing identified 1498 mutations in 151 patients, with medians of 6.5, 6.5, and 13.0 mutations per patient in samples of polycythemia vera, essential thrombocythemia, and myelofibrosis, respectively. Somatic CALR mutations were found in 70 to 84% of samples of myeloproliferative neoplasms with nonmutated JAK2, in 8% of myelodysplasia samples, in occasional samples of other myeloid cancers, and in none of the other cancers. A total of 148 CALR mutations were identified with 19 distinct variants. Mutations were located in exon 9 and generated a +1 base-pair frameshift, which would result in a mutant protein with a novel C-terminal. Mutant calreticulin was observed in the endoplasmic reticulum without increased cell-surface or Golgi accumulation. Patients with myeloproliferative neoplasms carrying CALR mutations presented with higher platelet counts and lower hemoglobin levels than patients with mutated JAK2. Mutation of CALR was detected in hematopoietic stem and progenitor cells. Clonal analyses showed CALR mutations in the earliest phylogenetic node, a finding consistent with its role as an initiating mutation in some patients. CONCLUSIONS: Somatic mutations in the endoplasmic reticulum chaperone CALR were found in a majority of patients with myeloproliferative neoplasms with nonmutated JAK2. (Funded by the Kay Kendall Leukaemia Fund and others.).
Assuntos
Calreticulina/genética , Mutação , Síndromes Mielodisplásicas/genética , Mielofibrose Primária/genética , Trombocitemia Essencial/genética , Sequência de Aminoácidos , Doenças da Medula Óssea/genética , Calreticulina/análise , Éxons , Humanos , Janus Quinase 2/genética , Leucemia Mieloide/genética , Dados de Sequência Molecular , Neoplasias/genética , Reação em Cadeia da Polimerase , Análise de Sequência de DNARESUMO
BACKGROUND: Myelodysplastic syndromes are a diverse and common group of chronic hematologic cancers. The identification of new genetic lesions could facilitate new diagnostic and therapeutic strategies. METHODS: We used massively parallel sequencing technology to identify somatically acquired point mutations across all protein-coding exons in the genome in 9 patients with low-grade myelodysplasia. Targeted resequencing of the gene encoding RNA splicing factor 3B, subunit 1 (SF3B1), was also performed in a cohort of 2087 patients with myeloid or other cancers. RESULTS: We identified 64 point mutations in the 9 patients. Recurrent somatically acquired mutations were identified in SF3B1. Follow-up revealed SF3B1 mutations in 72 of 354 patients (20%) with myelodysplastic syndromes, with particularly high frequency among patients whose disease was characterized by ring sideroblasts (53 of 82 [65%]). The gene was also mutated in 1 to 5% of patients with a variety of other tumor types. The observed mutations were less deleterious than was expected on the basis of chance, suggesting that the mutated protein retains structural integrity with altered function. SF3B1 mutations were associated with down-regulation of key gene networks, including core mitochondrial pathways. Clinically, patients with SF3B1 mutations had fewer cytopenias and longer event-free survival than patients without SF3B1 mutations. CONCLUSIONS: Mutations in SF3B1 implicate abnormalities of messenger RNA splicing in the pathogenesis of myelodysplastic syndromes. (Funded by the Wellcome Trust and others.).
Assuntos
Síndromes Mielodisplásicas/genética , Fosfoproteínas/genética , Mutação Puntual , Ribonucleoproteína Nuclear Pequena U2/genética , Eritrócitos/patologia , Perfilação da Expressão Gênica , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Fenótipo , Fatores de Processamento de RNARESUMO
UNLABELLED: The undertaking of large-scale DNA sequencing screens for somatic variants in human cancers requires accurate and rapid processing of traces for variants. Due to their often aneuploid nature and admixed normal tissue, heterozygous variants found in primary cancers are often subtle and difficult to detect. To address these issues, we have developed a mutation detection algorithm, AutoCSA, specifically optimized for the high throughput screening of cancer samples. AVAILABILITY: http://www.sanger.ac.uk/genetics/CGP/Software/AutoCSA.
Assuntos
Algoritmos , Mapeamento Cromossômico/métodos , Análise Mutacional de DNA/métodos , DNA de Neoplasias/genética , Testes Genéticos/métodos , Neoplasias/diagnóstico , Neoplasias/genética , Sequência de Bases , Predisposição Genética para Doença/genética , Variação Genética/genética , Humanos , Dados de Sequência Molecular , SoftwareRESUMO
OBJECTIVES: The aim of this pilot study was to compare the nutritional status and food consumption patterns of children under five years. DESIGN: Quantitative, exploratory, cross sectional study. SETTING: Kabarole district, western Uganda. Kabarole district is a rural district with subsistence farming as the main income. SUBJECTS: Two hundred and five children between 12 and 72 months of age living in AIDS affected homes versus children living in non-AIDS affected homes were examined. RESULTS: Fifty-five percent of all children were stunted and 20.5% were underweight. There was no difference in the prevalence of malnutrition between children living in AIDS affected homes versus non-AIDS affected homes. Only children between 12-35 months suffered from a daily deficit in caloric intake. The older children consumed the basic recommended daily intake (RDI) for protein, fat, iron and vitamin A. Due to frequent disease episodes and limitations in the estimations of individual total energy expenditure, the results are likely underestimations of the children's true nutritional requirements. The type of foods given to children in AIDS affected homes and controls were quite similar. CONCLUSION: Young children in Kabarole district suffer from severe chronic malnutrition rates, but rates and feeding patterns are not different in AIDS affected versus non AIDS affected homes.
Assuntos
Síndrome da Imunodeficiência Adquirida , Transtornos da Nutrição Infantil/epidemiologia , Ingestão de Energia , Desnutrição/epidemiologia , Estado Nutricional , Fatores Etários , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Avaliação Nutricional , Projetos Piloto , Prevalência , Fatores de Risco , Uganda/epidemiologiaRESUMO
The issue of gestational diabetes mellitus within disadvantaged communities is being addressed by Healthy Start for Mom & Me, a highly collaborative and multi-faceted prenatal nutrition program targeting at-risk women and teens in Winnipeg, Manitoba. The program s kitchen table approach focuses on the core concepts of education, community participation, and capacity-building to develop effective methods for community-based practice in this population. A qualitative case study of the program was conducted in 1999. This study showed that health education practices in the program are sensitive to marginalized women s needs and enhance service providers understanding of the context of participants lives. Community dietitians roles in this prenatal program are evolving, and are significant for other dietitians charting a new course of community-based practice.
Assuntos
Diabetes Gestacional/prevenção & controle , Educação em Saúde/métodos , Promoção da Saúde/métodos , Ciências da Nutrição/educação , Cuidado Pré-Natal/métodos , Canadá , Diabetes Gestacional/dietoterapia , Feminino , Humanos , Gravidez , Avaliação de Programas e Projetos de Saúde , Fatores de RiscoRESUMO
The province of Alberta is located in western Canada, bordering the eastern slopes of the Rocky Mountains (see O'Loughlin et al., Figure 1). The population of 2.7 million is mostly located in two cities (Calgary and Edmonton) with the balance dispersed in smaller rural centres throughout the province. Principal industries include agriculture, forestry, telecommunications, oil and gas. These industries have helped create a strong provincial economy.
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Promoção da Saúde/organização & administração , Cardiopatias/prevenção & controle , Serviços de Informação/organização & administração , Programas Nacionais de Saúde/organização & administração , Alberta , Tomada de Decisões Gerenciais , Difusão de Inovações , Desenvolvimento de Programas/métodos , Regionalização da Saúde/organização & administraçãoRESUMO
This study traces the evolution of children's feeding programs established in Atlantic Canada from a few months to over 15 years ago. Our qualitative analysis of nine children's feeding programs in Atlantic Canada revealed that they began as an ad hoc, community-based effort to feed hungry children. All subsequently experienced stress related to community mobilization. In order to recover from this stress, programs "routinized," often with fewer volunteers or by adopting measures that ensured efficiency and stability. While one program remained routinized, others gradually assumed more features of institutionalization as a response to externally or internally imposed crises. They did so by adopting professional management strategies and often hiring professional personnel. As the institutionalized programs continued, they became driven by the need to feed themselves, which was often greater than their mission to feed hungry children. The challenge for dietitians assisting children's feeding program operators, policy makers, children's advocates, and citizens is to reflect upon which organizational models of children's feeding programs should be supported.
Assuntos
Serviços de Saúde da Criança/organização & administração , Serviços de Alimentação/organização & administração , Canadá , Criança , Serviços de Saúde da Criança/tendências , Fenômenos Fisiológicos da Nutrição Infantil , Serviços de Alimentação/tendências , Humanos , Fome , PobrezaRESUMO
High-spatial-resolution measurements of axial-stress profiles of UV-irradiated fibers are reported, providing diagnostic information and a technique for the direct observation of UV-written grating structures. Measurements have been made with a spatial resolution of approximately 0.3 microm, which is capable of resolving detail within the pitch of the gratings.