Validity of the Food Insecurity Experience Scale and prevalence of food insecurity in The Bahamas.

INTRODUCTION: Despite UN recommendations to monitor food insecurity using the Food Insecurity Experience Scale (FIES), to date there are no published reports of its validity for The Bahamas, nor have prevalence rates of moderate or severe food insecurity been reported for the remote island nation. At the same time, food security is a deep concern, with increasing incidence of natural disasters and health concerns related to diet-related disease and dietary quality plaguing the nation and its food system. This article aims to examine the validity of the FIES for use in The Bahamas, the prevalence of moderate and severe food insecurity, and the sociodemographic factors that contribute to increased food insecurity. METHODS: The FIES survey was administered by randomized and weighted landline telephone survey in Nassau in The Bahamas to 1000 participants in June and July 2017. The Rasch modelling procedure was applied to examine tool validity and prevalence of food insecurity. Equating procedures calibrated this study's results to the global FIES reference scale and computed internationally comparable prevalence rates of both moderate and severe food insecurity. A regression analysis assessed the relationship between household variables and food security. RESULTS: The FIES met benchmarks for fit statistics for all eight items and the overall Rasch reliability is 0.7. As of 2017, Bahamians' prevalence of moderate and severe food insecurity was 21%, and the prevalence of severe food insecurity was 10%. Statistically significant variables that contribute to food insecurity included education, age, gender, and presence of diabetes, high blood pressure, or heart disease. Results also indicated that Bahamians experience food insecurity differently than populations across the globe, likely due in large part to the workings of an isolated food system heavily dependent on foreign imports. Responses showed that by the time a Bahamian worries they will not have enough food to eat, they have already restricted their meals to a few kinds of foods and begun to limit their intake of vegetables and fruits. CONCLUSION: This study, which is among the first to comprehensively measure food security in The Bahamas, provides a baseline for further research and evaluation of practices aimed at mitigating food insecurity in small island developing states. Further, this study provides a benchmark for future research, which may seek to understand the impacts of Hurricane Dorian and COVID-19, disasters further isolating the remote island nation. Post-disaster food security data are needed to further understand the extent to which food security is impacted by natural disasters and identify which sectors and stakeholders are most vital in restructuring the agricultural sector and improving food availability following catastrophic events.

The effects of monocytes on tumor cell extravasation in a 3D vascularized microfluidic model.

Metastasis is the leading cause of cancer-related deaths. Recent developments in cancer immunotherapy have shown exciting therapeutic promise for metastatic patients. While most therapies target T cells, other immune cells, such as monocytes, hold great promise for therapeutic intervention. In our study, we provide primary evidence of direct engagement between human monocytes and tumor cells in a 3D vascularized microfluidic model. We first characterize the novel application of our model to investigate and visualize at high resolution the evolution of monocytes as they migrate from the intravascular to the extravascular micro-environment. We also demonstrate their differentiation into macrophages in our all-human model. Our model replicates physiological differences between different monocyte subsets. In particular, we report that inflammatory, but not patrolling, monocytes rely on actomyosin based motility. Finally, we exploit this platform to study the effect of monocytes, at different stages of their life cycle, on cancer cell extravasation. Our data demonstrates that monocytes can directly reduce cancer cell extravasation in a non-contact dependent manner. In contrast, we see little effect of monocytes on cancer cell extravasation once monocytes transmigrate through the vasculature and are macrophage-like. Taken together, our study brings novel insight into the role of monocytes in cancer cell extravasation, which is an important step in the metastatic cascade. These findings establish our microfluidic platform as a powerful tool to investigate the characteristics and function of monocytes and monocyte-derived macrophages in normal and diseased states. We propose that monocyte-cancer cell interactions could be targeted to potentiate the anti-metastatic effect we observe in vitro, possibly expanding the milieu of immunotherapies available to tame metastasis.

Thymic stromal lymphopoietin (TSLP)-mediated dermal inflammation aggravates experimental asthma.

Individuals with one atopic disease are far more likely to develop a second. Approximately half of all atopic dermatitis (AD) patients subsequently develop asthma, particularly those with severe AD. This association, suggesting a role for AD as an entry point for subsequent allergic disease, is a phenomenon known as the "atopic march." Although the underlying cause of the atopic march remains unknown, recent evidence suggests a role for the cytokine thymic stromal lymphopoietin (TSLP). We have established a mouse model to determine whether TSLP plays a role in this phenomenon, and in this study show that mice exposed to the antigen ovalbumin (OVA) in the skin in the presence of TSLP develop severe airway inflammation when later challenged with the same antigen in the lung. Interestingly, neither TSLP production in the lung nor circulating TSLP is required to aggravate the asthma that was induced upon subsequent antigen challenge. However, CD4 T cells are required in the challenge phase of the response, as was challenge with the sensitizing antigen, demonstrating that the response was antigen specific. This study, which provides a clean mouse model to study human atopic march, indicates that skin-derived TSLP may represent an important factor that triggers progression from AD to asthma.

The post-concussional state: neurophysiological aspects.

BACKGROUND: Twenty-six young men admitted to an Accident and Emergency Department for observation following a minor closed head injury (post-traumatic amnesia (PTA) less than 12 hours) were investigated within 24 hours of admission (day 0) and followed up at 10 days, 6 weeks and 1 year after the trauma. METHOD: Investigations at day 0 included physical examination, completion of post-concussional symptom and stress-arousal checklists, computerised EEG (CEEG) and auditory brainstem evoked potential (BAEP) recordings. These were repeated at ten days and six weeks. At 12 months follow-up, the Present State Examination (PSE) was carried out and a further post-concussional symptom checklist completed. RESULTS: Post-concussional symptomatology declined progressively from day 0 but half had residual symptoms at 1 year. Seventy-two per cent ran an acute course with recovery by 6 weeks, 8% chronic unremitting course and 20% initially improved but had an exacerbation of symptoms between 6 weeks and 12 months. The CEEG alpha-theta ratios decreased significantly between days 0 and 10, reaching a baseline thereafter. Measures of CEEG recovery from all channels correlated with symptom counts at six weeks; the slower the recovery the greater the symptoms. A relative delay in left temporal recovery was associated with residual psychiatric morbidity (PSE ID scores) at 12 months. Prolonged central brainstem conduction times occurred in 27% of patients at day 0. These correlated positively with PTA and degree of psychiatric morbidity (PSE ID scores) at 12 months. CONCLUSIONS: Symptom chronicity was accompanied by continuing brainstem dysfunction, while the degree of transient cortical dysfunction appeared to have a direct influence in the intensity of early organic symptom reaction to the trauma. Levels of perceived stress at the time of the injury, or afterwards, were not related to symptom formation.