Building a Healthy Temple diabetes self-management education support program in Hispanic faith community settings: A cluster randomized controlled trial.

Diabetes self-management is key to preventing diabetes complications disproportionately affecting Hispanics. Church appears a promising setting for delivering a diabetes self-management education support (DSMES) program. "Faith-placed" (FP) programing refers to health interventions implemented in the church setting; while "faith-based" (FB) signifies integrating spirituality with health interventions. The Building a Health Temple (BHT) DSMES program integrates spirituality with DSMES to improve diabetic outcomes. This cluster-randomized trial tests the effectiveness of BHT DSMES by adapting an existing DSMES program into faith-based context. A total of 360 participants will be recruited from 18 churches (~20 participants/church). Churches will be randomly assigned to either the FB or FP intervention arm. Intervention activities will be implemented over 14 consecutive weeks. Participants in the FB arm will participate in BHT DSMES including a Health Sermon, the Self-Management Resource Center (SMRC) Diabetes Self-Management Program (DSMP), and a 7-session Healthy Bible Study, delivered by two trained church lay health leaders. Participants in the FP arm will attend the same SMRC DSMP facilitated by outside health professional, followed by a 7-session community health and safety curriculum as a partial attention control intervention. The primary outcome will be a change in Hemoglobin A1c (HbA1c) level. Secondary outcomes include: changes in body mass index, waist circumference, diabetes distress score, diabetes self-care behaviors, eating behavior, and physical activity level. Data will be collected at baseline, 6, 9, and 12 months during the study period. The proposed study will lead to innovative DSMES program delivery through faith settings for Hispanic persons with diabetes.

Association between environmental tobacco smoke exposure and dementia syndromes.

OBJECTIVES: Environmental tobacco smoke (ETS) has a range of adverse health effects, but its association with dementia remains unclear and with dementia syndromes unknown. We examined the dose-response relationship between ETS exposure and dementia syndromes. METHODS: Using a standard method of GMS, we interviewed 5921 people aged ≥60 years in five provinces in China in 2007-2009 and characterised their ETS exposure. Five levels of dementia syndrome were diagnosed using the Automated Geriatric Examination for Computer Assisted Taxonomy instrument. The relative risk (RR) of moderate (levels 1-2) and severe (levels 3-5) dementia syndromes among participants exposed to ETS was calculated in multivariate adjusted regression models. RESULTS: 626 participants (10.6%) had severe dementia syndromes and 869 (14.7%) moderate syndromes. Participants exposed to ETS had a significantly increased risk of severe syndromes (adjusted RR 1.29, 95% CI 1.05 to 1.59). This was dose-dependently related to exposure level and duration. The cumulative exposure dose data showed an adjusted RR of 0.99 (95% CI 0.76 to 1.28) for >0-24 level years of exposure, 1.15 (95% CI 0.93 to 1.42) for 25-49 level years, 1.18 (95% CI 0.87 to 1.59) for 59-74 level years, 1.39 (95% CI 1.03 to 1.84) for 75-99 level years and 1.95 (95% CI 1.34 to 2.83) for ≥100 level years. Significant associations with severe syndromes were found in never smokers and in former/current smokers. There were no positive associations between ETS and moderate dementia syndromes. CONCLUSIONS: ETS should be considered an important risk factor for severe dementia syndromes. Avoidance of ETS may reduce the rates of severe dementia syndromes worldwide.

Míranos! Look at us, we are healthy! An environmental approach to early childhood obesity prevention.

BACKGROUND: Obesity prevention research is sparse in young children at risk for obesity. This study tested the effectiveness of a culturally tailored, multicomponent prevention intervention to promote healthy weight gain and gross motor development in low-income preschool age children. METHODS: Study participants were predominantly Mexican-American children (n = 423; mean age = 4.1; 62% in normal weight range) enrolled in Head Start. The study was conducted using a quasi-experimental pretest/posttest design with two treatment groups and a comparison group. A center-based intervention included an age-appropriate gross motor program with structured outdoor play, supplemental classroom activities, and staff development. A combined center- and home-based intervention added peer-led parent education to create a broad supportive environment in the center and at home. Primary outcomes were weight-based z-scores and raw scores of gross motor skills of the Learning Achievement Profile Version 3. RESULTS: Favorable changes occurred in z-scores for weight (one-tailed p < 0.04) for age and gender among children in the combined center- and home-based intervention compared to comparison children at posttest. Higher gains of gross motor skills were found in children in the combined center- and home-based (p < 0.001) and the center-based intervention (p < 0.01). Children in both intervention groups showed increases in outdoor physical activity and consumption of healthy food. Process evaluation data showed high levels of protocol implementation fidelity and program participation of children, Head Start staff, and parents. CONCLUSION: The study demonstrated great promise in creating a health-conducive environment that positively impacts weight and gross motor skill development in children at risk for obesity. Program efficacy should be tested in a randomized trial.

Pause-2-Play: a pilot schoolbased obesity prevention program / Pause-2-Play: um programa piloto escolar de prevenção de obesidade

OBJECTIVES: Pause-2-Play is an obesity prevention program targeting screen-related sedentary behaviours and increasing physical activity among elementary school students. The program consisted of a Behavioural Modification Curriculum and a Health Promoting Afterschool Program. This pilot study reports program feasibility, practicability, and impact. METHODS: the 12-week pilot program was implemented with 32 grade five and six students. Program feasibility and practicability were assessed using a qualitative approach. Intervention effects were assessed by comparing pre-post changes in BMI, body composition, fitness scores, screen time, and cognitive variables related to screening viewing behaviours. RESULTS: Pause-2-Play was perceived as a useful, fun program with numerous benefits including: children trying new snacks, feeling fitter and better about one's own body shape, and becoming more aware of a healthy lifestyle. The intervention resulted in a statistically significant reduction in percent body fat and an increase in fat-free mass index in overweight children; a decrease in waist circumference and an increase in fat-free mass index were observed in normal weight children. The intervention also statistically improved fitness scores in both normal weight and overweight children. CONCLUSIONS: Pause-2-Play was feasible, practical, and favourably changed body composition and fitness level.

OBJETIVOS: Pause-2-Play é um programa de prevenção da obesidade direcionado aos comportamentos sedentários relacionados ao uso de monitores de computador e televisores, visando promover a atividade física entre estudantes de escolas de educação básica. O programa trata-se de um currículo de modificação comportamental e um programa extracurricular de promoção de saúde. Este estudo-piloto relata sobre a viabilidade, praticidade e impacto do programa. MÉTODOS: o programa de doze semanas foi implementado com 32 alunos escolares do quinto e sexto grau. A viabilidade e a praticidade do programa foram avaliadas a partir de uma abordagem qualitativa. Os efeitos da intervenção foram avaliados por meio de comparação de mudanças de IMC pré e pós, composição corporal, escores de capacidade física, tempo passado diante um monitor ou televisor, e variáveis cognitivos relacionados aos comportamentos que envolvem o uso de monitor ou televisor. RESULTADOS: percebeu-se que Pause-2-Play foi um programa útil e lúdico cujos vários benefícios incluíam: o fato das crianças ter experimentado novos alimentos, uma sensação de melhor forma física e uma auto-imagem da forma do corpo mais positiva, e uma conscientização aumentada em relação a estilos de vida saudáveis. A intervenção resultou numa redução estatisticamente significativa na porcentagem de gordura corporal e um aumento no índice de massa livre de gordura em crianças portadoras de sobrepeso; um decréscimo na circunferência da cintura e um aumento no índice de massa livre de gordura foram observados em crianças eutróficas. Além disso, a intervenção levou a uma melhoria nos escores de capacidade física tanto entre as crianças eutróficas como entre as portadoras de sobrepeso. CONCLUSÕES: Pause-2-Play mostrou se viável e praticável e mudou a composição corporal e os níveis de capacidade física de forma favorável.

Design, biologic evaluation, and SAR of novel pseudo-peptide incorporating benzheterocycles as HIV-1 protease inhibitors.

A series of novel HIV-1 protease inhibitors based on the (hydroxyethylamino)-sulfonamide isostere incorporating substituted phenyls and benzheterocycle derivatives bearing rich hydrogen bonding acceptors as P(2) ligands were synthesized. Prolonged chain linking the benzhereocycle to the carbonyl group resulted in partial loss of binding affinities. Introduction of a small alkyl substituent with appropriate size to the -CH2- of P(1)-P(2) linkage as a side chain resulted in improved inhibitory potency, and in this study, isopropyl was the best side chain. Replacement of the isobutyl substituent at P(1)'group with phenyl substituent decreased the inhibitory potency. One of the most potent inhibitor, compound 23 showing high affinity to HIV-1 protease with an IC(50) value of 5 nM, also exhibited good anti-SIV activity (EC(50) = 0.8 microM) with low toxicity (TC(50) > 100 microM). The flexible docking of inhibitor 23 to HIV-1 protease active site rationalized the interactions with protease.

Synthesis and antiviral activities of novel acylhydrazone derivatives targeting HIV-1 capsid protein.

HIV-1 capsid protein (CA) plays important roles in the viral replication cycle. A number of acylhydrazone derivatives that act as inhibitors of HIV-1 CA assembly, were designed and synthesized. The synthesized compounds were tested for their antiviral activities and cytotoxicities using CEM cells. Some derivatives also were assayed for their ability to inhibit HIV-1 CA assembly in vitro. Among them, compounds 14f and 14i display the most promising potency with EC(50) values of 0.21 and 0.17 microM respectively.