Exploring dimensions of social capital in relation to healthy eating behaviours in the US rural south.

OBJECTIVE: This study examined relationships between dimensions of social capital (SC) (social trust, network diversity, social reciprocity and civic engagement) and fruit, vegetable, and sugar-sweetened beverage (SSB) consumption among rural adults. Potential moderators (neighbourhood rurality, food security, gender and race/ethnicity) were explored to develop a more nuanced understanding of the SC-healthy eating relationship. DESIGN: Data were from a 2019 mailed population-based survey evaluating an eleven-county initiative to address health equity. Participants self-reported health behaviours, access to health-promoting resources and demographics. Logistic regression models were used to analyse relationships between predictors, outcomes and moderators. SETTING: Five rural counties, Georgia, USA. PARTICIPANTS: 1120 participants. RESULTS: Among participants who lived in the country (as opposed to in town), greater network diversity was associated with consuming ≥ 3 servings of fruit (OR = 1·08; 95 % CI 1·01, 1·17, P = 0·029), yet among participants who lived in town, greater civic engagement was associated with consuming ≥ three servings of fruit (OR = 1·36; 95 % CI 1·11, 1·65, P = 0·003). Both food-secure and food-insecure participants with greater social reciprocity had lower odds of consuming 0 SSB (OR = 0·92; 95 % CI 0·86, 0·98, P = 0·014, OR = 0·92; 95 % CI 0·86, 0·99, P = 0·037, respectively). Men with greater social trust were more likely to consume 0 SSB (OR = 1·09; 95 % CI 1·01, 1·18, P = 0·038), and Whites with greater network diversity were more likely to meet daily vegetable recommendations (OR = 1·10; 95 % CI 1·01, 1·19, P = 0·028). CONCLUSIONS: Findings provide a basis for future qualitative research on potential mechanisms through which SC and related social factors influence healthy eating in rural communities.

"Maybe it's still good?" A qualitative study of factors influencing food waste and application of the E.P.A. Food recovery hierarchy in U.S. supermarkets.

About 31% of post-harvest food available for human consumption is lost or wasted annually in the United States. Roughly one third (43 billion lbs.) of food loss occurs in grocery and other retail food stores. Supermarkets engage in food waste reduction, rescue, and recycling strategies, but little is known about frontline workers' and department managers' perspectives on food discards and strategies to limit waste. We aimed to increase understanding of factors influencing grocery retail employees' food waste decision-making at the store level, and of the perspectives of those frontline supermarket workers and managers responsible for food waste prevention and mitigation. We conducted 20 qualitative semi-structured interviews and used thematic analysis to explore how grocery workers and managers view food waste decision drivers, and how these impact the feasibility and effectiveness of waste reduction and food rescue and recycling in their stores. Workers and managers report personalized discard decision-making and confusion between quality and safety indicators. Interviewees described in-store policies, resources and trainings as lacking or inconsistently applied, leading to variability in food waste prevention, rescue, and recycling. Overall, interview participants considered waste reduction strategies that rescue profitable goods more feasible than other food rescue and recycling efforts like donation and composting. Workers' and managers' perceptions of in-store food waste drivers and views on extant food waste prevention and mitigation efforts point to areas for future research and intervention.

Nurses' and physicians' opinions on end-of-life: a secondary analysis from an Italian cross-sectional study.

BACKGROUND: In daily clinical practice, healthcare workers face end-of-life issues, such as futility, which is generally defined as the provision of treatments that do not produce any meaningful benefit for patients. STUDY DESIGN: To investigate the end-of-life issues according to Italian nurses' and physicians' opinions and to detect any differences between them, a secondary analysis of existing data from a cross-sectional study was conducted. METHODS: A validated questionnaire was used involving 351 nurses and 128 physicians from four hospitals in Central Italy. RESULTS: Regarding the definition of futility, nurses mainly focused on agony, suffering, and risks, while physicians paid more attention to the hope of healing. Nevertheless, both were distressed by different aspects of the treatments; in particular, nurses by the 'invasiveness of the treatments' and physicians by the 'over-medicalization of death'. Instead, nurses and physicians similarly recognized patients' right to seek to anticipate the end of life when they are terminally-ill and to express freely their desire not to be revived. CONCLUSIONS: The description of experiences and opinions of health professionals could represent a valid basis to develop a 'regulatory system' aimed to guide and support daily clinical and nursing activities.

The clinical efficacy of a sublingual monomeric allergoid at different maintenance doses: a randomized controlled trial.

Sublingual immunotherapy is widely recognized as a viable treatment for allergic rhinitis and asthma, but the optimal dosage is still under debate, especially with modified allergens. We assessed the clinical effects of a monomeric allergoid across 3 different maintenance doses in mite-monosensitized patients with rhinitis and intermittent asthma. Eighty-nine patients allergic to HDM were randomized to 3 maintenance doses of monomeric allergoid (Lais, Lofarma) or medications only. All the patients recorded their symptoms and rescue drug consumption in a diary card from November to February. Additionally, nasal eosinophil count, spirometry and methacholine bronchial challenge were performed at the beginning of the study and after 3 years. The symptom scores showed a clear improvement in all the three active arms versus baseline and versus the controls, irrespective of the dose. Likewise, a similar improvement versus baseline was seen for nasal inflammation and bronchial hyperreactivity. The SLIT with monomeric allergoids produces clinically significant results across a wide range of doses. The absence of significant side effects, even at high doses, is probably due to their low level of allergeni city.

Analysis of factors potentially associated with nursing students' academic outcomes: A thirteen-year retrospective multi-cohort study.

BACKGROUND: Low academic success rates lead to fewer than the required number of nurses entering the national health systems, impacting on the supply of nurses and with negative consequences for global health care since low nurse-to-patient ratios are associated with an increase of patients' adverse outcomes. OBJECTIVES: This study was mainly aimed at documenting any of the academic outcomes' potential predictors among Nursing Degree Program (NDP) students' characteristics. DESIGN: A retrospective multi-cohort study was conducted. PARTICIPANTS AND SETTING: Ten cohorts of nursing students enrolled in a central Italy university were involved. METHODS: Qualitative and quantitative data on entry characteristics and academic outcomes were retrieved, observing retrospectively 10 cohorts of Italian nursing students for 13 academic years (2004-2017). Multiple regression analyses were conducted to assess if potential predictors reporting a p-value < 0.05 in univariate analyses were independently related to academic outcomes. RESULTS: A total of 2278 students were enrolled in this study. Multivariate analyses showed that 'female gender', 'having attended classical or scientific upper-secondary school', and 'having higher upper-secondary diploma grade' were associated both with the qualitative outcomes (graduation within the legal duration of NDP) and the quantitative ones (final degree exam grade). The weight of the 'admission-test score' in explaining the variance of academic performances was very low (ß = 0.03, 95% CI = 0.01 to 0.05) compared to the 'upper-secondary diploma grade' (ß = 0.14, 95% CI = 0.12 to 0.16). CONCLUSIONS: This evidence should lead to a reflection on the entry-selection methods for NDP, especially in those countries such as Italy, where these methods are essentially based on the entry-test, which in this study was shown to have a very low predictive power for academic outcomes.

Template for preparation of papers for IEEE sponsored conferences & symposia.

To improve the access to medical information is necessary to design and implement integrated informatics techniques aimed to gather data from different and heterogeneous sources. This paper describes the technologies used to integrate data coming from the electronic medical record of the IRCCS Fondazione Maugeri (FSM) hospital of Pavia, Italy, and combines them with administrative, pharmacy drugs purchase coming from the local healthcare agency (ASL) of the Pavia area and environmental open data of the same region. The integration process is focused on data coming from a cohort of one thousand patients diagnosed with Type 2 Diabetes Mellitus (T2DM). Data analysis and temporal data mining techniques have been integrated to enhance the initial dataset allowing the possibility to stratify patients using further information coming from the mined data like behavioral patterns of prescription-related drug purchases and other frequent clinical temporal patterns, through the use of an intuitive dashboard controlled system.

Actin filament-associated protein 1 is required for cSrc activity and secretory activation in the lactating mammary gland.

Actin filament-associated protein 1 (AFAP1) is an adaptor protein of cSrc that binds to filamentous actin and regulates the activity of this tyrosine kinase to affect changes to the organization of the actin cytoskeleton. In breast and prostate cancer cells, AFAP1 has been shown to regulate cellular responses requiring actin cytoskeletal changes such as adhesion, invadopodia formation and invasion. However, a normal physiologic role for AFAP1 has remained elusive. In this study, we generated an AFAP1 knockout mouse model that establishes a novel physiologic role for AFAP1 in lactation. Specifically, these animals displayed a defect in lactation that resulted in an inability to nurse efficiently. Histologically, the mammary glands of the lactating knockout mice were distinguished by the accumulation of large cytoplasmic lipid droplets in the alveolar epithelial cells. There was a reduction in lipid synthesis and the expression of lipogenic genes without a corresponding reduction in the production of ß-casein, a milk protein. Furthermore, these defects were associated with histologic and biochemical signs of precocious involution. This study also demonstrated that AFAP1 responds to prolactin, a lactogenic hormone, by forming a complex with cSrc and becoming tyrosine phosphorylated. Taken together, these observations pointed to a defect in secretory activation. Certain characteristics of this phenotype mirrored the defect in secretory activation in the cSrc knockout mouse, but most importantly, the activity of cSrc in the mammary gland was reduced during early lactation in the AFAP1-null mouse and the localization of active cSrc at the apical surface of luminal epithelial cells during lactation was selectively lost in the absence of AFAP1. These data define, for the first time, the requirement of AFAP1 for the spatial and temporal regulation of cSrc activity in the normal breast, specifically for milk production.

Mining health care administrative data with temporal association rules on hybrid events.

OBJECTIVE: The analysis of administrative health care data can be helpful to conveniently assess health care activities. In this context temporal data mining techniques can be suitably exploited to get a deeper insight into the processes underlying health care delivery. In this paper we present an algorithm for the extraction of temporal association rules (TARs) on sequences of hybrid events and its application on health care administrative databases. METHODS: We propose a method that extends TAR mining by managing hybrid events, namely events characterized by a heterogeneous temporal nature. Hybrid events include both point-like events (e.g. ambulatory visits) and interval-like events (e.g. drug consumption). The definition of user-defined rule templates can be optionally used to constrain the search only to the extraction of a subset of interesting rules. A TAR post-pruning strategy, based on a case-control approach, is also presented. RESULTS: We analyzed the administrative database of diabetic patients in charge to the regional health care agency (ASL) of Pavia. TAR mining allowed to find patterns specifically related to the diabetic population in comparison with a control group, as well as to check the compliance of the actual clinical careflow with the ASL recommendations. CONCLUSION: The experimental results highlighted the main potentials of the algorithm, such as the opportunity to detect interesting temporal relationships between diagnostic or therapeutic patterns, or to check the adherence of past temporal behaviors to specific expected paths (e.g. guidelines) or to discover new knowledge that could be implicitly hidden in the data.